From FiveThirtyEight.com (April 13, 2020):
Category Archives: Health
Health Study: Physical Therapy Superior To Steroid Injection For Knee Osteoarthritis
Patients with osteoarthritis of the knee who underwent physical therapy had less pain and functional disability at 1 year than patients who received an intraarticular glucocorticoid injection.
Osteoarthritis of the knee is a leading cause of disability.1 Current management is typically limited to the treatment of symptoms until late stages of arthritis lead to knee replacement.2 Intraarticular glucocorticoid injections are commonly used as a primary treatment for osteoarthritis of the knee,3 but there are conflicting reports regarding the extent and duration of the relief of symptoms with this therapy.4-6 Complications from these injections occur infrequently but include joint infection,7 accelerated degradation of articular cartilage,8 and subchondral insufficiency fractures.9
PHYSICAL THERAPY
The physical therapy intervention, which is described in the protocol,26 included instructions and images for exercises, joint mobilizations, and the clinical reasoning underlying the priorities, dosing, and progression of treatment. During a typical clinical session, the physical therapist would implement hands-on, manual techniques immediately before the patient performed reinforcing exercises to help the patient perform the movements with little or no pain. For example, if a patient could not fully extend or flex the knee, or those movements were painful, the physical therapist would use a hands-on, passive mobilizing technique to repeatedly move the knee to reduce stiffness while altering the mechanics of the technique to avoid pain. The patient would then perform repeated active knee movements in the same direction.
Medical: Diagnosis And Treatment Of “Parkinson’s Disease” (JAMA Podcast)
More than 6 million people worldwide have Parkinson disease. Even though it is classically associated with tremors, the disease has many manifestations and is very treatable for most patients.
Michael S. Okun, MD, from the Department of Neurology at the University of Florida, Gainesville, discusses the pathophysiology, clinical presentation, diagnosis, and treatment of Parkinson disease.
Coronavirus/Covid-19: “Face Shields” Are Best In Preventing Transmission Says Epidemiologist
From web post by Michael B. Edmond (April 11, 2020):
Our goal should be to have a face shield for every person in the country. It should be worn anytime a person leaves their home, while in any public place, and even at work. From news reports, it appears that face shields are already being more commonly worn in other nations, particularly in some Asian countries.
The advantages of face shields are their durability allowing them to be worn an indefinite number of times, the ability to easily clean them after use, their comfort, and they prevent the wearer from touching their face. Importantly, they cover all the portals of entry for this virus–the eyes, the nose, and the mouth. Moreover, the supply chain is significantly more diversified than that of face masks, so availability is much greater.
Some are critical of any strategy that isn’t perfect. But let’s think about the influenza vaccine. Although the effectiveness varies from year to year, on average it’s 40%. We push this vaccine hard in the hospital and in the community. Could we expect that face shields are at least 40% effective in reducing the transmission of COVID-19? I think so. Universal shielding would bend the curve more quickly and accelerate the ability to reduce social distancing and restrictions on movement.
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Face shields are a simple solution that if implemented universally would have a major impact on public health. Until we have a vaccine, this may be our best intervention for preventing transmission in the community.
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Michael B. Edmond, MD, MPH, MPA, MBA is the Chief Quality Officer and Associate Chief Medical Officer for University of Iowa Health Care and Clinical Professor of Infectious Diseases at the University of Iowa Carver College of Medicine. He previously served as the Richard P. Wenzel Professor of Internal Medicine, Chair of the Division of Infectious Diseases, and Hospital Epidemiologist at Virginia Commonwealth University in Richmond.
Coronavirus Policies: A Look At The Early Missteps By The CDC (Bloomberg)
Historically, the U.S. Centers for Disease control and Prevention has been the agency in charge of predicting, and containing outbreaks of disease. But as Covid 19 ravaged the country, the agency took a backseat to the White House.
Michelle Fay Cortez and John Tozzi discuss how the agency has handled the pandemic response, its early missteps, and how its role is likely to change in the future.
Post-Coronavirus Life: Bathroom Design And Hygiene Will Improve, While Bidet Sales Increase
From a CityLab online article (April 10, 2020):
What might that mean for the bathrooms of the post-coronavirus world? Americans have already demonstrated a keen fixation with this household feature: In the last 50 years, the number of home bathrooms per person has doubled. One could easily see the lavatory-building boom accelerate further as future homeowners keep the needs of the self-quarantined in mind. And many have speculated that sales of bidet attachments will surge as toilet-paper shortages encourage Americans to embrace this more sustainable alternative.
Alter predicted that disease-avoidance would rise to the fore of bathroom design a few years ago, when he observed the traumatizing effects of the 2003 SARS outbreak on Toronto, which killed 44 people. But home design in general — and bathroom design in particular — has long been influenced by infectious disease.
The modern bathroom developed alongside outbreaks of tuberculosis, cholera and influenza; its standard fixtures, wallcoverings, floorings, and finishes were implemented, in part, to promote health and hygiene in the home at a time of widespread public health concerns.
Society: Sleep Industry Helps Consumers “Sleep Less, More Productively” As Their Health Worsens
From a The Architectural Review online article (April 9, 2020):
The sleep industry caters to a working consumer’s wish to sleep less, yet sleep more productively, and accommodates transnational industry which has joined the state as a custodian of biopolitics. Jonathan Crary’s 24/7 spells out in detail how the state and a capitalist economy are encroaching stupendously on the private sphere, in which sleep was one of the last vestiges of unfettered time.
About 15 years ago, someone calculated the financial loss US companies incurred through workers’ illicit practice of sleeping on the job. Indeed, the trope of the lazy sleeper is an old one, resignified at present in our more than callous attitude towards the homeless, whose sleeping bodies punctuate many a journey to and from work.
Even in this most passive stance – someone simply disregarding normative codes and regulations by giving in to a physical need – sleep seems suspiciously subversive. Less an act than a way of being, the sleeper, by sleeping when and where it is not condoned, challenges everyone else, who is doing/working/functioning/functionalised. Contrary to the tree falling in the forest, the sleeper in the workplace or in public space affects and thus ever so slightly transforms those around them.
Coronavirus Infographic: Virus Particles Are Active 24-72 Hours – Wash Your Hands, Disinfect Surfaces
Coronavirus / Covid-19: How Social Gatherings Were “Rocket Fuel” For Spread Of The Pandemic
From a The Guardian article (April 9, 2020):
A hundred days after a Chinese government website announced the discovery of a “pneumonia of unknown cause”, it has become clearer that the dynamics behind the virus’s rapid expansion across the globe has relied heavily on such “cluster effects”.
Each of the countries most heavily hit by the pandemic has reported similar stories of social, cultural or religious gatherings where large numbers spent numerous hours in close company – holding hands, kissing, sharing drinks from the same glass – which then turbo-charged the spread of the pandemic.
“Most infections didn’t take place in supermarkets or restaurants,” Streeck said of his preliminary findings. In Heinsberg, his team of coronavirus detectives could find scant evidence of the virus being transmitted via the surfaces of door handles, smart phones or other objects.
The Elderly & Dementia: “Managing Daily Activities & Fall Prevention” (UCSF)
Presented by Sarah Dulaney, RN, CNS, a nurse at the UCSF Memory and Aging Center, and Helen Medsger, a family caregiver and LBD support group leader, as part of the Lewy Body Dementia Caregiver Webinar Series supported by the UCSF Memory and Aging Center and the Administration for Community Living.
Boomers Daily 