virtual reality gaming provides clinicians with a useful tool for improving dynamic balance and balance confidence in older adults.

Background: Evidence suggesting that a diet high in fruits and vegetables may be beneficial to bone health has sparked interest in the potential benefit of a vegetarian diet. However, other studies have raised a question regarding the adequacy of protein in such a diet. Objective: The aim of the present study was to take a whole foods approach in examining the effects of foods high in protein on the risk of wrist fracture (WF) in a cohort with a significant proportion consuming a meat-free diet. Design: A cohort study of women who completed two lifestyle surveys 25 years apart. Subjects: One thousand eight hundred and sixty-five peri-and postmenopausal women at the time of the first survey.Results: There was a significant interaction between meat consumption and foods high in vegetable protein. Among vegetarians, those who consumed the least vegetable protein intake were at highest risk for fracture. However, increasing levels of plant-based high-protein foods decreased WF risk, with a 68% reduction in risk (hazard ratio (HR) 5 0.32, 95% confidence interval (CI) 0.13-0.79) in the highest intake group. Among those with lowest vegetable protein consumption, increasing meat intake decreased the risk of WF, with the highest consumption decreasing risk by 80% (HR 5 0.20,. Conclusions: The finding that higher consumption frequencies of foods rich in protein were associated with reduced WF supports the importance of adequate protein for bone health. The similarity in risk reduction by vegetable protein foods compared with meat intake suggests that adequate protein intake is attainable in a vegetarian diet.

Study Design: Randomized controlled 2-group, pretest-posttest, multivariate study of patients with shoulder musculoskeletal disorders. Objectives: The purpose of this study was to evaluate the immediate effect of soft tissue mobilization (STM) with proprioceptive neuromuscular facilitation (PNF) to increase glenohumeral external rotation at 45°of shoulder abduction and overhead reach. Background: It is postulated that limitation in glenohumeral external rotation, when measured at 45°of shoulder abduction, represents subscapularis muscle flexibility deficits and is associated with the inability to fully reach overhead. No research, however, is available to demonstrate whether intervention strategies intended to improve subscapularis flexibility and glenohumeral external rotation range of motion at 45°of shoulder abduction will improve a patient's ability to reach overhead. Methods and Measures: Twenty patients (10 males, 10 females; age range, 21-83 years) with limited glenohumeral external rotation and overhead reach of 1 year duration or less served as subjects. The subjects were randomly assigned to a treatment group, which consisted of soft tissue mobilization to the subscapularis and proprioceptive neuromuscular facilitation to the shoulder rotators, or a control group. Goniometric measurements of glenohumeral external rotation at 45°a bduction and overhead reach were taken preintervention and immediately postintervention for the treatment group or at prerest and postrest periods for the control group. Results: The treatment group improved by a mean of 16.4°(95% confidence interval [CI], 12.5°-20.3°) of glenohumeral external rotation, as compared to less than a 1°gain (95% CI, Ϫ0.2°-2.0°) in the control group (PϽ.0005). Overhead reach in the treatment group improved by a mean of 9.6 cm (95% CI, 5.2-14.0 cm) in comparison to a mean gain of 2.4 cm (95% CI, Ϫ0.8-5.6 cm) for the control group (P = .009). Conclusion: These findings suggest that a single intervention session of STM and PNF was effective for producing immediate improvements in glenohumeral external rotation and overhead reach in patients with shoulder disorders. J Orthop Sports Phys Ther 2003;33:713-718.

It has been 10 years since the Federative Committee on Anatomical Terminology (FCAT) published Terminologia Anatomica (TA), the current authority on anatomical nomenclature. There exists a perceived lack of unity among anatomists to adopt many FCAT recommended anatomical terms in TA. An e-mail survey was sent to members of the American Association of Anatomists (AAA) to determine the frequency of FCAT term usage by North American anatomists. The survey consisted of 29 questions, including 25 different sets of synonymic names for selected gross anatomical structures or related terms. Overall results indicate that the FCAT preferred term had the highest frequency of usage in only 44.0% of the survey questions. As frequency of use of FCAT terms decreased, the corresponding frequency of use of non-FCAT terms increased. Some questions showed almost complete compliance with the FCAT preferred terms (highest = 98.4% usage) to almost complete disregard for the FCAT terms (lowest = 0.8% usage). A slight association (P = 0.06) may exist between FCAT familiarity and concern for usage of synonymic terms. The more familiar anatomists were with the FCAT, the more concerned they were with anatomic synonyms.

Respiratory insufficiency after birth and pulmonary hypertension are independent predictors of mortality in infants with omphalocele.

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Objective In contrast to non-vegetarians, vegetarians consume more legumes and meat analogues as sources of protein to substitute for meat intake. The present study aimed to assess the association between foods with high protein content (legumes, meat, meat analogues) by dietary pattern (vegetarians, non-vegetarians) and hip fracture incidence, adjusted for selected lifestyle factors. Design A prospective cohort of Adventist Health Study-2 (AHS-2) enrollees who completed a comprehensive lifestyle and dietary questionnaire between 2002 and 2007. Setting Every two years after enrolment, a short questionnaire on hospitalizations and selected disease outcomes including hip fractures was sent to these members. Subjects Respondents (n 33 208) to a baseline and a follow-up questionnaire. Results In a multivariable model, legumes intake of once daily or more reduced the risk of hip fracture by 64% (hazard ratio=0·36, 95% CI 0·21, 0·61) compared with those with legumes intake of less than once weekly. Similarly, meat intake of four or more times weekly was associated with a 40% reduced risk of hip fracture (hazard ratio=0·60, 95% CI 0·41, 0·87) compared with those whose meat intake was less than once weekly. Furthermore, consumption of meat analogues once daily or more was associated with a 49% reduced risk of hip fracture (hazard ratio=0·51, 95% CI 0·27, 0·98) compared with an intake of less than once weekly. Conclusions Hip fracture incidence was inversely associated with legumes intake and, to a lesser extent, meat intake, after accounting for other food groups and important covariates. Similarly, a high intake of meat analogues was associated with a significantly reduced risk of hip fracture.

Infants with non-giant omphalocele can achieve full enteral feeds within the first week of life, but giant omphalocele infants require significantly more time. Breast milk independently promotes feeding success while GERD and respiratory insufficiency at birth independently delay feeding in infants with omphalocele.