Combined hormonal contraceptive use is not protective against musculoskeletal conditions or injuries: a systematic review with data from 5 million females.

OBJECTIVE: Assess the association between combined hormonal contraceptives (CHC) use and musculoskeletal tissue pathophysiology, injuries or conditions. DESIGN: Systematic review with semiquantitative analyses and certainty of evidence assessment, guided by the Grading of Recommendations Assessment, Development and Evaluation approach. DATA SOURCES: MEDLINE, EMBASE, CENTRAL, SPORTDiscus, CINAHL searched from inception to April 2022. ELIGIBILITY: Intervention and cohort studies that assessed the association between new or ongoing use of CHC and an outcome of musculoskeletal tissue pathophysiology, injury or condition in postpubertal premenopausal females. RESULTS: Across 50 included studies, we assessed the effect of CHC use on 30 unique musculoskeletal outcomes (75% bone related). Serious risk of bias was judged present in 82% of studies, with 52% adequately adjusting for confounding. Meta-analyses were not possible due to poor outcome reporting, and heterogeneity in estimate statistics and comparison conditions. Based on semiquantitative synthesis, there is low certainty evidence that CHC use was associated with elevated future fracture risk (risk ratio 1.02-1.20) and total knee arthroplasty (risk ratio 1.00-1.36). There is very low certainty evidence of unclear relationships between CHC use and a wide range of bone turnover and bone health outcomes. Evidence about the effect of CHC use on musculoskeletal tissues beyond bone, and the influence of CHC use in adolescence versus adulthood, is limited. CONCLUSION: Given a paucity of high certainty evidence that CHC use is protective against musculoskeletal pathophysiology, injury or conditions, it is premature and inappropriate to advocate, or prescribe CHC for these purposes. PROSPERO REGISTRATION NUMBER: This review was registered on PROSPERO CRD42021224582 on 8 January 2021.

Dose assessment for polonium-210 (Po-210) in New Zealand shellfish.

Worldwide, Po-210 is an important contributor to human ionising radiation exposure through food. To characterise the ionising radiation dose for New Zealanders from Po-210 in shellfish, a dose assessment was undertaken. Deterministic and probabilistic dietary models were constructed by assigning shellfish consumption rates to Po-210 activity concentrations measured in shellfish. Modelling was undertaken for different shellfish consumer populations and geographical areas. Dietary modelling estimated an annual dose range from 4 µSv to 6070 µSv. The lowest dose was calculated for the overall shellfish consumer population residing in areas where baseline Po-210 activity concentrations were measured in shellfish. The highest dose was calculated for the high shellfish consumer population residing in areas where elevated activity concentrations were measured in shellfish. For the majority of the New Zealand population, the total estimated dose did not exceed the selected reference level of 1000 µSv, and Po-210 is therefore not a cause of concern. About 50% of high shellfish consumers residing in areas where shellfish had elevated Po-210 activity concentrations were exposed to ionising radiation resulting in an annual dose higher than 1000 µSv. Exposure assessment for different demographic groups identified that higher shellfish consumption rates in the population identifying as Maori lead to higher doses of ionising radiation for this group.

Spatial variability in Polonium-210 and Lead-210 activity concentration in New Zealand shellfish and dose assessment.

The activity concentrations of Polonium-210 (210Po) and Lead-210 (210Pb) were determined in shellfish (Perna canaliculus and Paphies subtriangulata) sampled bimonthly from March 2018 to February 2019 from 14 sites around New Zealand. Activity concentrations of 210Po ranged from 4.7 ±â€¯1.1 to 324 ±â€¯17 Bq. kg-1 with a mean value of 57 ±â€¯72 Bq. kg-1 (wet weight). The activity concentrations of 210Pb were lower than those for 210Po (0.1 ±â€¯0.4 and 1.9 ±â€¯0.4 Bq. kg-1, with a mean value of 0.7 ±â€¯0.4 Bq. kg-1, wet weight). The calculated 210Po/210Pb activity concentration ratios were higher than unity in all samples indicating that radionuclides are not in equilibrium in shellfish and most of the 210Po was unsupported by its grandparent 210Pb. No significant difference was noted in 210Po activity concentration between different seasons, species or shellfish condition index. Significant spatial variability in 210Po activity concentration was observed with elevated 210Po activity concentration in two sampling sites: Ninety Mile Beach (mean 257 ±â€¯47 Bq. kg-1) and Maunganui Bluff (mean 127 ±â€¯22 Bq. kg-1). Elevated 210Po is hypothesised to be related to an increase of 210Po accumulation through diet. Individuals who consume large quantities of shellfish (10 g per day or more) from areas affected by elevated 210Po activity concentration may be exposed to an annual committed effective dose from 210Po in shellfish in excess of 1 mSv.

Sensitive plant (Mimosa pudica) hiding time depends on individual and state.

The decisions animals make to adjust their antipredator behavior to rapidly changing conditions have been well studied. Inducible defenses in plants are an antipredator behavior that acts on a longer time scale, but sensitive plants, Mimosa pudica, have a much more rapid antipredator response; they temporarily close their leaves when touched. The time they remain closed is defined as hiding time. We studied hiding time in sensitive plants and found that individual plants differed significantly in their hiding times. We then showed that the effect of individual explained substantial variation in hiding time on a short time scale. Finally, on a longer time scale, individuality persisted but the amount of variation attributed to individual decreased. We hypothesized that variation in plant condition might explain this change. We therefore manipulated sunlight availability and quantified hiding time. When deprived of light for 6 h, sensitive plants significantly shortened their hiding times. But when only half a plant was deprived of light, hiding times on the deprived half and light exposed half were not significantly different. This suggests that overall condition best explains variation in sensitive plant antipredator behavior. Just like in animals, sensitive plant antipredator behavior is condition dependent, and, just like in animals, a substantial amount of the remaining variation is explained by individual differences between plants. Thus, models designed to predict plasticity in animal behavior may be successfully applied to understand behavior in other organisms, including plants.

Validity of a sensor-based table-top platform to measure upper limb function.

Objective measurement is an essential part of the assessment process in neurological dysfunction such as stroke. However, current clinical scores are insensitive and based on subjective observation from experts. Technology provides an opportunity for enhanced accuracy and specificity of objective measurement. This study describes the use of an interactive force-sensitive table-top platform for the assessment of reach in post-stroke patients, admitted as part of a three week intensive upper limb training programme. Objective measures from the reachable workspace were extracted and included normalised reach distance, normalised reached speed and reach dragging. The data was compared to standardised Fugl-Meyer (FM) clinical scores, recorded at admission (FMPRE) and discharge (FMPOST). Results indicate strong relationships between the three objective measures and subjective FM scores, with significant Spearman correlations found in all cases (|ρ| > 0.5, p < 0.05). The results highlight the validity for a sensor-based table-top system to provide a simple, flexible, and objective platform for assessment of impaired upper limb motor function.

e-Health and new moms: Contextual factors associated with sources of health information.

OBJECTIVE: Guided by the Uses and Gratifications approach, to examine mothers' use and preference of e-Health media, and associated contextual factors. DESIGN AND SAMPLE: Cross-sectional survey of 165 mothers (White, African-American, and Hispanic) from a stratified random sample. MEASURES: Use of online media about mother-baby care; favorite websites about motherhood and best-liked features of Web sites; channel preferences (Web site, postal mail, text) for receiving three types of health information; and contextual factors, e.g., education. RESULTS: Media use ranged from 96% for health information searches about babies to 46% for YouTube viewing about mother-baby topics. Contextual factors, such as education, were associated with media use. Babycenter was the most frequently reported favorite Web site and rich, relevant information was the best-liked feature. Across three health topics (weight, stress/depression, parenting) mothers preferred receiving information by Web site, followed by postal mail and least by text messaging (χ2 statistics, p < .001). Stress and race/ethnicity were among factors associated with preferences. CONCLUSIONS: Mothers widely used e-Health related media, but use was associated with contextual factors. In public health efforts to reach new mothers, partnering with mother-favored Web sites, focusing on audience-relevant media, and adopting attributes of successful sites are recommended strategies.

SITAR: a system for independent task-oriented assessment and rehabilitation.

INTRODUCTION: Over recent years, task-oriented training has emerged as a dominant approach in neurorehabilitation. This article presents a novel, sensor-based system for independent task-oriented assessment and rehabilitation (SITAR) of the upper limb. METHODS: The SITAR is an ecosystem of interactive devices including a touch and force-sensitive tabletop and a set of intelligent objects enabling functional interaction. In contrast to most existing sensor-based systems, SITAR provides natural training of visuomotor coordination through collocated visual and haptic workspaces alongside multimodal feedback, facilitating learning and its transfer to real tasks. We illustrate the possibilities offered by the SITAR for sensorimotor assessment and therapy through pilot assessment and usability studies. RESULTS: The pilot data from the assessment study demonstrates how the system can be used to assess different aspects of upper limb reaching, pick-and-place and sensory tactile resolution tasks. The pilot usability study indicates that patients are able to train arm-reaching movements independently using the SITAR with minimal involvement of the therapist and that they were motivated to pursue the SITAR-based therapy. CONCLUSION: SITAR is a versatile, non-robotic tool that can be used to implement a range of therapeutic exercises and assessments for different types of patients, which is particularly well-suited for task-oriented training.

Investigation of isometric strength and control of the upper extremities in multiple sclerosis.

Isometric force assessment can provide insights into strength and motor control in patients with neurological disabilities. This study investigated the connection between isometric strength and control in nine multiple sclerosis (MS) patients and four healthy subjects using a compact isometric setup. The participants carried out isometric assessment tasks in both upper extremities in six directions. Strength was measured through maximum voluntary force/torque (MVF/T), while control ability was measured by applying a constant force/torque of 25% of MVF/T. Isometric control was quantified using coefficient of variation, force directing ability, sample-entropy and spectral bandwidth. The MS patients were also assessed using two impairment measures (Motricity Index and hand-grip strength), and two activity measures (Action Research Arm Test and Nine Hole Peg Test). The results indicate that isometric strength and control (measured by spectral bandwidth) were correlated in most directions. Among the four control measures, spectral bandwidth - a measure introduced in this study - was found to be strongly related to the force/torque regularity as measured by sample-entropy. Isometric strength and spectral bandwidth for all directions were well correlated with the impairment measures, but their correlation with the activity scales was moderate and direction-dependent. Overall the results show potential for using the isometric setup and protocol for assessment in MS population.

Mental health literacy and postpartum depression: a qualitative description of views of lower income women.

The purpose of this study is to understand mental health literacy (MHL) (Jorm, 2000) in lower income women postpartum and share participant experiences of recognizing and seeking help for depressive symptoms. Focus group textual data were received from 25 participants who completed a weight and psychosocial health longitudinal study. Iterative content data analysis using Jorm's framework provided thematic understandings descriptive of MHL. Women recognized behavioral changes indicating mental distress, but fears prevented them from seeking help, and some resorted to risky behaviors. This framework could guide providers to identify women who may benefit from early intervention for postpartum depressive symptoms.

Cumulative poor psychosocial and behavioral health among low-income women at 6 weeks postpartum.

BACKGROUND: During the postpartum period, women may experience unfavorable psychosocial and behavioral health in multiple domains with adverse effects on parenting and maternal and infant health. Yet, little is known about the accumulation of poor health across the domains of depressive symptoms; body image; diet and physical activity; substance use including smoking and alcohol; and general self-care at 6 weeks postpartum, the usual end of maternity care. OBJECTIVES: The aims of this study were to evaluate relationships among the domains comprising psychosocial and behavioral health and to examine the distribution and risk factors associated with cumulative poor psychosocial and behavioral health at 6 weeks postpartum. METHODS: This study was a secondary analysis of cumulative poor health assessed by self-report scales for depressive symptoms, body image dissatisfaction, diet and exercise, substance use, and general self-care among 419 low-income White, African American, and Hispanic women at 6 weeks postpartum. Multivariable Poisson and logistic regression were used in key analyses. RESULTS: The correlation among psychosocial and behavioral domains had a range of r = .50-.00. In this sample of women, 45% had two or more domains in which they had poor health. The model testing risk factors for cumulative poor health was significant (likelihood ratio chi-square = 39.26, df = 11, p < 0.05), with two significant factors: not exclusively breastfeeding (odds ratio [OR] = 1.459, 95% confidence interval [CI] [1.119, 1.901]) and Hispanic ethnicity (OR = 0.707, 95% CI [0.582, 0.858], psuedo-R = .029). Within individual domains, significant risk factors (body mass index, not exclusively breastfeeding, ethnicity, education level, and parity) varied by domain. DISCUSSION: Many low-income women postpartum have poor psychosocial and behavioral health in multiple domains, which constitute areas for health promotion and early disease prevention.

A study of the health literacy needs of people with visual impairments.

The purpose of this mixed methods study was to understand preferences surrounding health literacy for 18 men and women with permanent and severe visual impairment (VI). Participants completed demographic questions--the National Eye Institute Visual Function Questionnaire (NEI-VFQ)--and 1 semi-structured interview to ascertain views on obtaining, processing, and understanding health information. Overall, the sample had low total eye health scores on the NEI-VFQ--indicating that the sample represented a group with severe visual impairments. The sample mentioned multiple health promotion topics of interest and types of devices used to gain information. They also described multiple barriers to health information, which could be eliminated. Implications for intervention development and technology use are provided.

The locus and modulation of the location negative priming effect.

Responding to the location of a target is slower when it appears at a recent distractor location [ignored-repetition (IR) trial] than when it arises at a new position [control (CO) trial], defining the location negative priming (NP) effect. On IR trials, both the distractor location and response are from the prior trial, and the locus question asks whether the delayed responding that arises is caused by the reused distractor position (i.e., a location locus) or the need to execute a distractor output (i.e., a response locus). A location NP procedure was used, incorporating a many:1 location-to-response mapping design, along with a response cue on some trials. A response locus for the location NP effect was indicated. Distractor-turned-target responses took longer to initiate than new outputs (many:1 paradigm), and valid response cues reduced distractor response interference and the location NP effect. Importantly, a possible S-R compatibility problem within the many:1 S-R paradigm was not supported.

Can the location negative priming process operate in a proactive manner?

The location negative priming (NP) effect refers to the fact that the processing of a current target stimulus (probe trial) is delayed when it appears at a location that has recently contained a distractor event (prime trial), relative to when it occurs at a previously unoccupied position. One view is that the process causing the NP effect involves the inhibition of the internal representation of the prime-distractor event, and that the future processing of target stimuli that involve this event are prolonged because this distractor inhibition is persistent. In this study, we examined the possibility that the NP process (inhibition) could act proactively; specifically asking whether inhibition could be allocated to a location merely predicted to hold a future distractor event. To do this, we cued the probe distractor's location using an otherwise traditional location NP paradigm. No evidence of a proactive NP process was obtained. Probe-trial target latency was the same whether it appeared at the cued distractor location or at a new location, but was delayed when it occupied the prime-distractor location (NP effect). The location NP process is seemingly a reactive one, applying inhibition only when an actual distractor is present, much as past theories have implied.

The locus of location repetition latency effects.

We examined the processing locus (location vs. response) of location repetition effects in terms of the event [target (t) or distractor (d)] that initially occupied and then re-occupied the repeated location (i.e., t-to-t, t-to-d, d-to-t, d-to-d). Trials were presented in pairs (prime, then probe) and 2:1 location-to-response mappings were used. Generally, for all repetition conditions, perceptual processing at the repeated location itself was facilitated (location locus), while re-activated responses delayed output production (response locus). More specifically, perceptual facilitation observed for a repeated location was independent of the kind of processing (i.e., t or d) that occurred earlier, suggesting that it is not the labeling of locations as relevant or irrelevant that determines location repetition effects. Response production was significantly slowed only when a just-inhibited response had then to be executed, which supported the view that the spatial negative priming effect has a response locus.

The influence of distractor-only prime trials on the location negative priming mechanism.

Two experiments were conducted that examined the influence of distractor-only prime trials on the "location" negative priming (NP) effect. In all experiments, the probe trial always lacked a distractor. We showed that the predictable absence of a probe distractor caused the elimination of the location NP effect when the prime trial contained both a target and a distractor event (T + D-->T), but not when the prime contained only a to-be-ignored distractor event (D-->T) (Milliken, Tipper, Houghton, & Lupianez, 2000). The preservation of the NP effect seen with the distractor-only prime trials (D-->T) was not the result of its lacking a prime-trial selection, nor was it the consequence of its representing a higher level of episodic similarity than the T + D-->T condition. Finally, the location NP effect observed for the D-->T condition is seemingly consistent with the view that location NP and the inhibition-of-return effects share a common underlying process (Milliken et al., 2000).