RESUMO
1. During an avian influenza (AI) outbreak in the United Kingdom, the joint aim of the poultry industry and the Government is to eliminate and prevent the spread of infection, through control measures based on the current European Union (EU) Council Directive (2005/94/EC). An essential part of these measures is the cleansing and disinfection (C&D) of infected premises.2. This risk assessment assessed the differences in re-infection in a repopulated flock if the EU Directive is interpreted to permit secondary C&D to be undertaken either with or without dismantling complex equipment. The assessment estimated the probability of virus survival on different types of equipment in a depopulated contaminated poultry house before and after preliminary and secondary C&D procedures. A risk matrix spreadsheet tool was used to carry out the assessment and concluded that, provided secondary C&D is carried out with due diligence (i.e. carried out to a defined code of practice as agreed by both industry and policymakers), the risk of re-infection from equipment is negligible, both with and without dismantling complex equipment in all farm types considered.3. By considering the equipment types individually, the assessment identified those areas of the house which may still contain viable virus post-preliminary C&D and on which attention should be focussed during secondary C&D. The generic risk pathway and matrix spreadsheet tool have the potential to be used for other pathogens and species, given appropriate data.
Assuntos
Surtos de Doenças/veterinária , Abrigo para Animais/normas , Influenza Aviária/epidemiologia , Influenza Aviária/prevenção & controle , Doenças das Aves Domésticas/epidemiologia , Doenças das Aves Domésticas/prevenção & controle , Animais , Surtos de Doenças/prevenção & controle , Desinfecção/normas , Poeira , Equipamentos e Provisões/normas , Equipamentos e Provisões/virologia , Plumas/virologia , Fezes/virologia , Orofaringe/virologia , Aves Domésticas , Doenças das Aves Domésticas/virologia , Medição de Risco , Reino Unido/epidemiologiaRESUMO
Previous research has investigated synergies involved in locomotion and balance reactions; however, there is limited insight into the emergence of skilled balance control with practice of challenging tasks. We explored motor learning of tandem and single leg stance on an unstable surface-a slackline. Balance was tested in 10 naïve healthy adults at four time points: baseline, after one slackline practice session, after 1 week of practice, and 1 week following the final practice session. We recorded kinematics of the upper and lower arms bilaterally, trunk, and thigh and foot unilaterally while participants balanced in tandem and single leg stance on a slackline and narrow rigid beam (transfer task). When participants first attempted to stand on the slackline, they exhibited fast and frequent movements across all joints with actions along the frontal plane (particularly the hip) and fell after a short period (~3 seconds). Performance improved rapidly (fewer falls), and this was accompanied by dampened trunk and foot oscillations and the development of coordinated movement patterns with a progressive emphasis on more distal upper body segments. Continuous relative phase angles between joint pairs began to cluster around either 0° (indicating in-phase movement) or 180° (indicating anti-phase movement). Participants also began to demonstrate coordinated upper body synergies and performance improvements (fewer falls) on the transfer task, while a control group (n = 10) did not exhibit similar synergies or performance improvements. Our findings describe the emergence of coordinated movement synergies involving the upper body as healthy adults learn a challenging balance task.
Assuntos
Aprendizagem , Destreza Motora , Equilíbrio Postural , Braço , Fenômenos Biomecânicos , Feminino , Pé , Humanos , Masculino , Coxa da Perna , Tronco , Adulto JovemRESUMO
Occasional cases of classical bovine spongiform encephalopathy (BSE) still continue to occur within the European Union (EU) for animals born after reinforced feed bans (BARBs), which should in theory have eliminated all risk of infection. The study aimed to determine (i) whether a common rate of decline of BSE infection was evident across EU member states, i.e. to determine whether control measures have been equally effective in all member states, (ii) whether there was any evidence of spontaneous occurrence of BSE in the data and (iii) the expected date for the last BSE case in UK. It was found that there was no significant difference in the rate of decline of BSE prevalence between member states, with a common rate of decline of 33·9% per annum (95% CI 30·9-37%) in successive annual birth cohorts. Trend analysis indicated an ultimate decline to 0 prevalence, suggesting that spontaneous occurrence does not explain the majority of cases. Projecting forward the trends from the back-calculation model indicated that there was approximately a 50% probability of further cases in the UK, and should the current rate of decline continue, there remains the possibility of further occasional cases up until 2026.
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Ração Animal/análise , Encefalopatia Espongiforme Bovina/epidemiologia , Vigilância da População , Animais , Bovinos , Encefalopatia Espongiforme Bovina/etiologia , Europa (Continente)/epidemiologia , União Europeia , Humanos , PrevalênciaRESUMO
AIMS: To determine the risk associated with the use of carcase storage vessels on a scrapie infected farm. METHODS AND RESULTS: A stochastic quantitative risk assessment was developed to determine the rate of accumulation and fate of scrapie in a novel low-input storage system. For an example farm infected with classical scrapie, a mean of 10(3·6) Ovine Oral ID50 s was estimated to accumulate annually. Research indicates that the degradation of any prions present may range from insignificant to a magnitude of one or two logs over several months of storage. CONCLUSIONS: For infected farms, the likely partitioning of remaining prion into the sludge phase would necessitate the safe operation and removal of resulting materials from these systems. If complete mixing could be assumed, on average, the concentrations of infectivity are estimated to be slightly lower than that measured in placenta from infected sheep at lambing. SIGNIFICANCE AND IMPACT OF THE STUDY: This is the first quantitative assessment of the scrapie risk associated with fallen stock on farm and provides guidance to policy makers on the safety of one type of storage system and the relative risk when compared to other materials present on an infected farm.
Assuntos
Criação de Animais Domésticos , Príons/fisiologia , Scrapie/prevenção & controle , Scrapie/transmissão , Carneiro Doméstico , Animais , Medição de RiscoRESUMO
Bovine spongiform encephalopathy (BSE) has presented serious challenges to both the World Organisation for Animal Health and national governments, in defining and implementing appropriate national control measures, and in agreeing trade rules that permit safe trade in cattle and bovine products. Precautionary trade rules were initially necessary, based upon the science of sheep scrapie, but research into BSE later enabled BSE-specific trade rules to be developed. As a result, current rules on trade are underpinned by a sound body of knowledge on BSE. Declining epidemics in most affected countries confirm the appropriateness of current precautions. Nevertheless, risk is primarily dependent on the prevalence of infection with BSE. In the face of low prevalence scenarios, certain precautionary measures in the Terrestrial Animal Health Code may now be considered excessive. A thorough review is therefore deemed appropriate.
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Comércio/legislação & jurisprudência , Encefalopatia Espongiforme Bovina/epidemiologia , Encefalopatia Espongiforme Bovina/prevenção & controle , Internacionalidade/legislação & jurisprudência , Ração Animal/efeitos adversos , Ração Animal/normas , Animais , Bovinos , Europa (Continente)/epidemiologia , Humanos , Fatores de RiscoRESUMO
The European Food Risk Assessment (EU-FORA) Fellowship work programme 'Integration of tools and social science into food safety risk assessments' was proposed and delivered by the Food Standards Agency (FSA), UK. The Food Standards Agency is a non-ministerial government department of the UK, responsible for protecting public health in relation to food in England, Wales and Northern Ireland. The programme was tailored to several different activities to provide an overview of the different tools that can be employed in food safety risk assessment also accounting for the interaction between risk assessment and social science. In order to structure the proposed work, the programme was split into four modules to run over the 12-month period of 'learning-by-doing'. In the first module, the fellow was introduced to Microbiological Risk Assessment (MRA), in the second to Chemical Risk Assessment (CRA), in the third to Social Science, and finally, in the fourth to the Risk Prioritization Tools and Networks in UK - National Dietary Data (NDNS), collection methodology, coding and analysis. The fellow was assigned to the Risk Assessment Unit within the Science, Evidence and Research Department which brings together specialist expertise from Microbiological, Chemical Risk Assessment, and Analytics Units, under one department together with additional staff from the food allergy and radiological risk assessment fields. The aim was to be fully integrated in the organisation's work gaining first-hand experience, increase knowledge of scientific aspects relevant to food safety risk assessment, and more importantly, to enhance network connection activities in the EU food risk assessment environment.
RESUMO
A quantitative risk assessment model was developed to estimate the frequency with which meat waste from ships or aircraft might expose British livestock to infection with foot-and-mouth disease (fmd), and investigate the factors that might contribute to the risk. In the model, the total weight of waste introduced that was contaminated with fmd was estimated to be 26 kg per year, with 90 per cent certainty that it would be between 10 and 53 kg. As a result, it was estimated that there would be a mean of 1429 years between outbreaks of fmd due to ship and aircraft waste, with a 90 per cent certainty that the interval would be between 500 and 10,000 years. These estimates were affected by three principal uncertainties: first, the prevalence of fmd; secondly, the probability of the waste being removed and fed to pigs; and thirdly, the probability that overboard dumping of contaminated waste might expose livestock to fmd. The effect of these uncertainties on the model was investigated in a sensitivity analysis.
Assuntos
Aeronaves , Animais Domésticos , Febre Aftosa/epidemiologia , Eliminação de Resíduos/normas , Navios , África , Animais , Ásia , Charadriiformes , Surtos de Doenças/prevenção & controle , Surtos de Doenças/veterinária , Europa (Continente) , Microbiologia de Alimentos , Febre Aftosa/transmissão , Vírus da Febre Aftosa , Internacionalidade , Carne , Medição de Risco , Reino Unido/epidemiologia , Gerenciamento de ResíduosRESUMO
The EUFORA fellowship programme 'Livestock Health and Food Chain Risk Assessment' was proposed by the Animal and Plant Health Agency (APHA), a British governmental institution responsible for safeguarding animal and plant health in the UK. The working programme, which was organised into four different modules, covered a wide range of aspects related to risk assessment including identification of emerging risks, risk prioritisation methods, scanning surveillance, food production exposure assessment and import risk assessment of animal and human infectious diseases. Over the course of the year, the Fellow had the opportunity to work for international projects with experts in these disciplines. This allowed for significant opportunities to 'learn-by-doing' the methods and the techniques that are employed to assess animal health and food safety risks. Moreover, he consolidated his knowledge by attending several training courses and academic lessons, submitting scientific papers to peer-reviewed journals and conferences, giving presentations and using modelling software.
RESUMO
We present a novel approach of using the multi-criteria pathogen prioritisation methodology as a basis for selecting the most appropriate case studies for a generic risk assessment framework. The approach uses selective criteria to rank exotic animal health pathogens according to the likelihood of introduction and the impact of an outbreak if it occurred in the European Union (EU). Pathogens were evaluated based on their impact on production at the EU level and international trade. A subsequent analysis included criteria of relevance to quantitative risk assessment case study selection, such as the availability of data for parameterisation, the need for further research and the desire for the case studies to cover different routes of transmission. The framework demonstrated is flexible with the ability to adjust both the criteria and their weightings to the user's requirements. A web based tool has been developed using the RStudio shiny apps software, to facilitate this.
Assuntos
Surtos de Doenças/veterinária , Medição de Risco , Animais , Europa (Continente) , União Europeia , ProbabilidadeRESUMO
The adoption of bovine tuberculosis (bTB) risk-based trading (RBT) schemes has the potential to reduce the risk of bTB spread. However, any scheme will have cost implications that need to be balanced against its likely success in reducing bTB. This paper describes the first stochastic quantitative model assessing the impact of the implementation of a cattle risk-based trading scheme to inform policy makers and contribute to cost-benefit analyses. A risk assessment for England and Wales was developed to estimate the number of infected cattle traded using historic movement data recorded between July 2010 and June 2011. Three scenarios were implemented: cattle traded with no RBT scheme in place, voluntary provision of the score and a compulsory, statutory scheme applying a bTB risk score to each farm. For each scenario, changes in trade were estimated due to provision of the risk score to potential purchasers. An estimated mean of 3981 bTB infected animals were sold to purchasers with no RBT scheme in place in one year, with 90% confidence the true value was between 2775 and 5288. This result is dependent on the estimated between herd prevalence used in the risk assessment which is uncertain. With the voluntary provision of the risk score by farmers, on average, 17% of movements was affected (purchaser did not wish to buy once the risk score was available), with a reduction of 23% in infected animals being purchased initially. The compulsory provision of the risk score in a statutory scheme resulted in an estimated mean change to 26% of movements, with a reduction of 37% in infected animals being purchased initially, increasing to a 53% reduction in infected movements from higher risk sellers (score 4 and 5). The estimated mean reduction in infected animals being purchased could be improved to 45% given a 10% reduction in risky purchase behaviour by farmers which may be achieved through education programmes, or to an estimated mean of 49% if a rule was implemented preventing farmers from the purchase of animals of higher risk than their own herd. Given voluntary trials currently taking place of a trading scheme, recommendations for future work include the monitoring of initial uptake and changes in the purchase patterns of farmers. Such data could be used to update the risk assessment to reduce uncertainty associated with model estimates.
Assuntos
Criação de Animais Domésticos/métodos , Comércio , Meios de Transporte , Tuberculose Bovina/epidemiologia , Animais , Bovinos , Análise Custo-Benefício , Inglaterra/epidemiologia , Prevalência , Medição de Risco , Processos Estocásticos , Tuberculose Bovina/microbiologia , País de Gales/epidemiologiaRESUMO
Identifying and ranking cattle herds with a higher risk of being or becoming infected on known risk factors can help target farm biosecurity, surveillance schemes and reduce spread through animal trading. This paper describes a quantitative approach to develop risk scores, based on the probability of infection in a herd with bovine tuberculosis (bTB), to be used in a risk-based trading (RBT) scheme in England and Wales. To produce a practical scoring system the risk factors included need to be simple and quick to understand, sufficiently informative and derived from centralised national databases to enable verification and assess compliance. A logistic regression identified herd history of bTB, local bTB prevalence, herd size and movements of animals onto farms in batches from high risk areas as being significantly associated with the probability of bTB infection on farm. Risk factors were assigned points using the estimated odds ratios to weight them. The farm risk score was defined as the sum of these individual points yielding a range from 1 to 5 and was calculated for each cattle farm that was trading animals in England and Wales at the start of a year. Within 12 months, of those farms tested, 30.3% of score 5 farms had a breakdown (sensitivity). Of farms scoring 1-4 only 5.4% incurred a breakdown (1-specificity). The use of this risk scoring system within RBT has the potential to reduce infected cattle movements; however, there are cost implications in ensuring that the information underpinning any system is accurate and up to date.
Assuntos
Criação de Animais Domésticos/métodos , Tuberculose Bovina/epidemiologia , Animais , Bovinos , Comércio , Análise Custo-Benefício , Inglaterra/epidemiologia , Prevalência , Medição de Risco , Meios de Transporte , Tuberculose Bovina/microbiologia , País de Gales/epidemiologiaRESUMO
To achieve a unified assessment of postural instability in Parkinson's disease (PD) over a range of clinical stance and gait tasks, which may provide an insight into a tendency to fall, we measured trunk sway in the anterior-posterior and medial-lateral directions in freely moving PD patients and age-matched controls. We also measured task duration as time to complete the task or time to loss of balance. Patients had larger amplitudes of trunk sway velocities for stance tasks (e.g. mean pitch velocity when standing on two-legs eyes closed equalled 19.1 +/- 6.4 for PD patients on medication versus 4.8 +/- 0.3 degrees/s for controls, p = 0.0003) and for an expected (following prior warning) retropulsion test (mean roll angle equalled 4.3 +/- 0.5 degrees for PD patients versus 2.2 +/- 0.6 degrees for controls, p = 0.0003) than controls. Patients were more likely to fall earlier for stance tasks, and took longer to complete gait tasks (e.g. walking 3 m eyes closed, mean time 6.8 +/- 0.6 sees versus 4.9 +/- 0.1 sees, p = 0.0001). These differences between patients and controls were, in most cases, independent of medication. Based on these results we defined a simple test battery of stance and gait tasks that could discriminate between PD patients who had recent falls and controls. These results indicate that trunk sway measures recorded during stance and gait tasks provide useful information on balance deficits leading to falls in PD patients.
Assuntos
Marcha , Doença de Parkinson/fisiopatologia , Equilíbrio Postural , Postura , Idoso , Feminino , Humanos , Masculino , Doença de Parkinson/tratamento farmacológico , CaminhadaRESUMO
We propose a two-step clinical evaluation procedure to identify the possible etiology and laterality of a balance deficit. Step 1 employs a minimum clinical test battery, developed in our labs, to screen for the balance deficit by examining changes to trunk sway for standard clinical stance and gait tests. Step 2 characterizes pathophysiological components in balance corrections, as well as deficits brought about by aging, using biomechanical and electromyographic (EMG) responses to multidirectional stance perturbations. This is best accomplished by delivering stance perturbations to patients standing on a support surface that is tipped in four directions: forwards to the left and right, and backwards to the left and right. This review provides an overview of the two procedures and proposes for the screening procedure a minimum clinical test battery with a score, termed the balance control index (BCI).
Assuntos
Equilíbrio Postural , Idoso , Envelhecimento/fisiologia , Eletromiografia , Humanos , Vestíbulo do Labirinto/fisiopatologiaRESUMO
BACKGROUND: The major disadvantage of current clinical tests that screen for balance disorders is a reliance on an examiner's subjective assessment of equilibrium control. To overcome this disadvantage we investigated, using quantified measures of trunk sway, age-related differences of normal subjects for commonly used clinical balance tests. METHODS: Three age groups were tested: young (15-25 years; n = 48), middle-aged (45-55 years; n = 50) and elderly (65-75 years; n = 49). Each subject performed a series of fourteen tasks similar to those included in the Tinetti and Clinical Test of Sensory Interaction in Balance protocols. The test battery comprised stance and gait tasks performed under normal, altered visual (eyes closed), and altered proprioceptive (foam support surface) conditions. Quantification of trunk sway was performed using a system that measured trunk angular velocity and position in the roll (lateral) and pitch (fore-aft) planes at the level of the lower back. Ranges of sway amplitude and velocity were examined for age-differences with ANOVA techniques. RESULTS: A comparison between age groups showed several differences. Elderly subjects were distinguished from both middle-aged and young subjects by the range of trunk angular sway and angular velocity because both were greater in roll and pitch planes for stance and stance-related tasks (tandem walking). The most significant age group differences (F = 30, p <.0001) were found for standing on one leg on a normal floor or on a foam support surface with eyes open. Next in significance was walking eight tandem steps on a normal floor (F = 13, p <.0001). For gait tasks, such as walking five steps while rotating or pitching the head or with eyes closed, pitch and roll velocity ranges were influenced by age with middle-aged subjects showing the smallest ranges followed by elderly subjects and then young subjects (F = 12, p <.0001). Walking over a set of low barriers also yielded significant differences between age groups for duration and angular sway. In contrast, task duration was the only variable significantly influenced when walking up and down a set of stairs. An interesting finding for all tasks was the different spread of values for each population. Population distributions were skewed for all ages and broadened with age. CONCLUSIONS: Accurate measurement of trunk angular sway during stance and gait tasks provides a simple way of reliably measuring changes in balance stability with age and could prove useful when screening for balance disorders of those prone to fall.
Assuntos
Envelhecimento/fisiologia , Equilíbrio Postural , Postura , Caminhada , Adolescente , Adulto , Idoso , Fenômenos Biomecânicos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Propriocepção , Visão OcularRESUMO
Our goal was to document the kinetic strategies for obstacle avoidance in below-knee amputees. Kinematic data were collected as unilateral below-knee traumatic amputees stepped over obstacles of various heights in the walking path. Inverse dynamics were employed to calculate power profiles and work during the limb-elevation and limb-lowering phases. Limb elevation was achieved by employing a different strategy of intra-limb interaction for elevation of the prosthetic limb than for the sound limb, which was similar to that seen in healthy adult non-amputees. As obstacle height increased, prosthetic side knee flexion was increased by modulating the work done at the hip, and not the knee, as seen on the sound side. Although the strength of the muscles about the residual knee was preserved, the range of motion of that knee had previously been found to be somewhat limited. Perhaps more importantly, potential instability of the interface between the stump and the prosthetic socket, and associated discomfort at the stump could explain the altered limb-elevation strategy. Interestingly, the limb-lowering strategy seen in the sound limb and in non-amputees already features modulation of rotational and translational work at the hip, so an alternate strategy was not required. Thus, following a major insult to the sensory and neuromuscular system, the CNS is able to update the internal model of the locomotor apparatus as the individual uses the new limb in a variety of movements, and modify control strategies as appropriate.
Assuntos
Amputados , Membros Artificiais , Marcha/fisiologia , Perna (Membro)/fisiologia , Caminhada/fisiologia , Adaptação Fisiológica , Adulto , Cotos de Amputação/fisiopatologia , Fenômenos Biomecânicos , Feminino , Articulação do Quadril/fisiologia , Humanos , Articulação do Joelho/fisiologia , Masculino , Contração Muscular/fisiologia , Junção Neuromuscular/fisiologia , Dor/fisiopatologia , Desenho de Prótese , Amplitude de Movimento Articular/fisiologia , Rotação , Propriedades de Superfície , Trabalho/fisiologiaRESUMO
Clinicians have sought ways to increase trunk sway so that it is easily observed and a balance deficit more easily identified. One technique often used for this purpose is to reduce the efficacy of ankle proprioceptive inputs on sway. To achieve this reduction either a foam mat is used as an unstable support surface or the subject stands on a surface made unstable with servo-driven ankle-sway-referencing. The purpose of the current study was to investigate differences in trunk pitch and roll sway characteristics using these techniques. Trunk sway while standing quietly on two legs was measured in 25 normal subjects in the age range 20-35 years for three support-surface conditions. Each condition was tested twice for 20 s, once with eyes open and once with eyes closed. The three conditions were standing on a foam support surface, standing on a support surface with pitch (fore-aft) ankle-sway-referencing as used for the standard Sensory Organization Test (SOT) of the Neurocom Equitest System (SOT 4 and 5), and standing with roll (lateral) ankle-sway-referencing. The latter was achieved by having the subjects stand turned 90 degrees to the standard SOT position. Two angular velocity sensors mounted on a belt measured trunk sway in the pitch and roll directions. Trunk roll angle and angular velocity amplitudes for pitch sway-referencing were reduced compared to either the foam or roll sway-referencing conditions, but trunk pitch angle and angular velocities amplitudes were greater. For roll sway-referencing, the trunk roll angle was greater than for the other stimulus conditions. Analyses of the trunk sway velocity in the frequency domain indicated that ankle-sway-referencing in the pitch direction increased trunk pitch sway at 1 Hz and decreased trunk roll sway between 2 and 5 Hz compared to foam support frequency spectra. Roll ankle-sway-referencing decreased trunk roll between 2 and 4 Hz only. These results indicate that using a foam support surface provides multidirectional trunk sway with velocity content across all frequencies in the range 0.8-5.2 Hz. Roll ankle-sway-referencing, but not pitch ankle-sway-referencing, yields trunk sway with similar characteristics to those with foam. Pitch ankle-sway-referencing forces pitch trunk resonance to be around 1 Hz and yields very different trunk sway from that obtained with a foam support surface. Roll sway-referencing is an alternative means to test multidirectional control of sway. Clinically though, foam is simpler to use and provides a more difficult balance task for the patient.
Assuntos
Exame Neurológico/instrumentação , Equilíbrio Postural , Postura , Adulto , Análise de Variância , Tornozelo/fisiologia , Fenômenos Biomecânicos , Desenho de Equipamento , Humanos , PropriocepçãoRESUMO
This study investigated control of posture when standing at different surface heights above ground level. Alterations in surface height were used to modify threat to postural control. Sixty-two healthy adults (mean+/-S.D.=20.3+/-1.3 years) stood quietly on a force plate 40 cm (LOW threat), 100 cm (MEDIUM threat) or 160 cm (HIGH threat) above ground level. Each standing trial was performed with eyes open for 120 s. Postural threat was presented in ascending (n=31) or descending (n=31) order with the first threat condition in each series (LOW threat for ascending group, HIGH threat for descending group) repeated. This manipulation allowed for an examination of set effects (i.e. prior experience of postural threat) on postural control. The results demonstrated scaling of postural control variables to level of postural threat. Amplitude of centre of pressure (COP) displacement decreased and frequency of COP displacement increased linearly as postural threat increased from LOW to HIGH. The central nervous system progressively tightened control of posture as postural threat increased. Initial exposure to the HIGH or LOW threat condition influenced postural control differently. The group who received the HIGH threat condition first (descending) demonstrated increased amplitude of COP displacement in the anterior-posterior direction compared with the group who received the LOW threat condition first (ascending). A 'first trial' effect was observed when standing for two consecutive trials but only at the LOW threat condition. Decreased amplitude and increased frequency of COP displacement were observed on the first trial compared to the second trial. The results of this study demonstrated that control of posture is influenced not only by the threat to posture but also by the order in which the threat to posture is experienced.
Assuntos
Postura/fisiologia , Acidentes por Quedas , Adulto , Medo/psicologia , Humanos , Equilíbrio Postural/fisiologiaRESUMO
This research evaluated whether quantified measures of trunk sway during clinical balance tasks are sensitive enough to identify a balance disorder and possibly specific enough to distinguish between different types of balance disorder. We used a light-weight, easy to attach, body-worn apparatus to measure trunk angular velocities in the roll and pitch planes during a number of stance and gait tasks similar to those of the Tinetti and CTSIB protocols. The tasks included standing on one or two legs both eyes-open and closed on a foam or firm support-surface, walking eight tandem steps, walking five steps while horizontally rotating or pitching the head, walking over low barriers, and up and down stairs. Tasks were sought, which when quantified might provide optimal screening for a balance pathology by comparing the test results of 15 patients with a well defined acute balance deficit (sudden unilateral vestibular loss (UVL)) with those of 26 patients with less severe chronic balance problems caused by a cerebellar-pontine-angle-tumour (CPAT) prior to surgery, and with those of 88 age- and sex-matched healthy subjects. The UVL patients demonstrated significantly greater than normal trunk sway for all two-legged stance tasks especially those performed with eyes closed on a foam support surface. Sway was also greater for walking while rotating or pitching the head, and for walking eight tandem steps on a foam support surface. Interestingly, the patients could perform gait tasks such as walking over barriers almost normally, however took longer. CPAT patients had trunk sway values intermediate between those of UVL patients and normals. A combination of trunk sway amplitude measurements (roll angle and pitch velocity) from the stance tasks of standing on two legs eyes closed on a foam support, standing eyes open on a normal support surface, as well as from the gait tasks of walking five steps while rotating, or pitching the head, and walking eight tandem steps on foam permitted a 97% correct recognition of a normal subject and a 93% correct recognition of an acute vestibular loss patient. Just over 50% of CPAT patients could be classified into a group with intermediate balance deficits, the rest were classified as normal. Our results indicate that measuring trunk sway in the form of roll angle and pitch angular velocity during five simple clinical tests of equilibrium, four of which probe both stance and gait control under more difficult sensory conditions, can reliably and quantitatively distinguish patients with a well defined balance deficit from healthy controls. Further, refinement of these trunk sway measuring techniques may be required if functions such as preliminary diagnosis rather than screening are to be attempted.
Assuntos
Equilíbrio Postural , Postura , Transtornos de Sensação/diagnóstico , Doenças Vestibulares/fisiopatologia , Análise Discriminante , Marcha , Humanos , Transtornos de Sensação/fisiopatologia , Análise e Desempenho de TarefasAssuntos
Doenças dos Animais/epidemiologia , Clima , Doenças Transmissíveis Emergentes/veterinária , Vigilância da População , Medição de Risco , Agricultura , Animais , Animais Domésticos , Animais Selvagens , Controle de Doenças Transmissíveis , Doenças Transmissíveis Emergentes/epidemiologia , Desastres , Surtos de Doenças/veterinária , Reservatórios de Doenças/veterinária , Humanos , Fatores de Risco , Reino Unido/epidemiologia , ZoonosesRESUMO
The goat population in Great Britain (GB), which is mostly oriented to milk production, is small compared to that in other European Union (EU) countries and contributes a very small fraction of the total livestock production. The recent confirmation and cull of scrapie-affected goat herds has raised the concern that the risk of re-introducing scrapie by mass restocking after the cull of a scrapie-affected herd, may not have been fully considered at the time of implementing statutory eradication measures. A conditional probability model has been developed to estimate the probability of introducing at least one animal infected with classical scrapie into a British goat herd under two scenarios: restocking over one year under normal operating conditions (Scenario 1); and restocking post a whole herd cull as part of the compulsory eradication measures (Scenario 2). Several of the parameters were based on expert opinion, as there is a paucity of data regarding goat industry norms for all sectors. Considering all herds, of which 99% have less than 100 animals, the probability of introduction is approximately 2 times higher for Scenario (2) than for Scenario (1). The risk of subsequently re-introducing the disease through the introduction of replacement stock is not insignificant, although it can be considered very low for the vast majority of herds (>99%). In the case of very large herds (>1000 heads), mass restocking would almost certainly reintroduce the disease since it would require purchases from a very large number of herds.