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A knee ankle foot orthosis (KAFO) may be prescribed to the person with severe neuromusculoskeletal impairment of the lower limb to promote walking stability. The locked knee ankle foot orthosis (L-KAFO) is among the KAFO's routinely prescribed; however, long-term use of the L-KAFO is associated with musculoskeletal (arthrogenic and myogenic) and integumentary changes, and gait asymmetry with increased energy expenditure. Consequently, the risk of developing low back pain, osteoarthritis of the lower limbs and spinal joints, skin dermatitis, and ulceration increases, all of which impact quality of life. This article synthesizes the iatrogenic biomechanical and physiological perils of long-term L-KAFO use. It promotes using recent advances in rehabilitation engineering to improve daily activities and independence for proper patient groups.
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Major depressive disorder (MDD) is a neuropsychiatric disorder, which remains challenging to diagnose and manage due to its complex endophenotype. In this aspect, circulatory microRNAs (cimiRNAs) offer great potential as biomarkers and may provide new insights for MDD diagnosis. Therefore, we systemically reviewed the literature to explore various cimiRNAs contributing to MDD diagnosis and underlying molecular pathways. A comprehensive literature survey was conducted, employing four databases from 2012 to January 2021. Out of 1004 records, 157 reports were accessed for eligibility criteria, and 32 reports meeting our inclusion criteria were considered for in-silico analysis. This study identified 99 dysregulated cimiRNAs in MDD patients, out of which 20 cimiRNAs found in multiple reports were selected for in-silico analysis. KEGG pathway analysis indicated activation of ALS, MAPK, p53, and P13K-Akt signaling pathways, while gene ontology analysis demonstrated that most protein targets were associated with transcription. In addition, chromosomal location analysis showed clustering of dysregulated cimiRNAs at proximity 3p22-p21, 9q22.32, and 17q11.2, proposing their coregulation with specific transcription factors primarily involved in MDD physiology. Further analysis of transcription factor sites revealed the existence of HIF-1, REST, and TAL1 in most cimiRNAs. These transcription factors are proposed to target genes linked with MDD, hypothesizing that first-wave cimiRNA dysregulation may trigger the second wave of transcription-wide changes, altering the protein expressions of MDD-affected cells. Overall, this systematic review presented a list of dysregulated cimiRNAs in MDD, notably miR-24-3p, let 7a-5p, miR-26a-5p, miR135a, miR-425-3p, miR-132, miR-124 and miR-16-5p as the most prominent cimiRNAs. However, various constraints did not permit us to make firm conclusions on the clinical significance of these cimiRNAs, suggesting the need for more research on single blood compartment to identify the biomarker potential of consistently dysregulated cimiRNAs in MDD, as well as the therapeutic implications of these in-silico insights.
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MicroARN Circulante/genética , Trastorno Depresivo Mayor/genética , Biomarcadores/sangre , MicroARN Circulante/análisis , Depresión/genética , Trastorno Depresivo Mayor/terapia , Expresión Génica/genética , Perfilación de la Expresión Génica/métodos , Ontología de Genes , Humanos , MicroARNs/genética , MicroARNs/metabolismo , Pronóstico , Transcriptoma/genéticaRESUMEN
Refugees typically experience stronger migration forcedness and higher migration-related perils (harm, adversities and hardship) than do non-refugee migrants. We explored how refugees' and non-refugee migrants' perceptions of their own forcedness of migration and related perils before and during migration are associated with regret about leaving their country of origin and their confidence in integration. In two studies conducted with refugee and non-refugee migrants in Germany (total N = 336), we found correlations between perceived forcedness and premigration perils, and perils during migration, with meaningful differences between groups from different countries. Importantly, regret about migration was predicted by an interaction effect of perceived forcedness and migration perils: Perils encountered during migration increased regret about having migrated when perceived forcedness was low (vs. high). As important potential predictors of confidence in integration and regret, we also assessed discrimination experienced in the receiving society (Study 1) and resilience (Study 2). Importantly, we found that high (vs. low) perceived migration perils buffered negative effects of discrimination experienced in the host country. We discuss implications of our findings for integration in the receiving society, highlighting the role of perceived forcedness in coping with distressing experiences before and after arrival in the host country.
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Refugiados , Migrantes , Emociones , Alemania , HumanosRESUMEN
We review psychological approaches of helping behavior in the context of refugee immigration. Refugee migration, compared with nonrefugee migration, is characterized by greater forcedness and related perils. Taking into account perceptions of forcedness and perils, we examine potential helpers' responses at each of four successive stages toward helping people in perilous, distressing, or emergency situations: (1) noticing and recognizing distressing, help-demanding conditions; (2) taking responsibility; (3) knowing how to help; and (4) transfer of one's knowledge into action. In so doing, we discuss the role of different motives and functions of providing help (e.g. preserving refugees' dependency or facilitating their autonomy) and implications of unequal power relations between help providers and refugees.
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Refugiados , Emigración e Inmigración , Conducta de Ayuda , Humanos , Refugiados/psicologíaRESUMEN
O artigo analisa o impacto negativo de estratégias comumente usadas por organizações de direitos humanos na promoção de suas causas, nomeadamente: relatórios de direitos humanos, advocacy e litígio estratégico. Este artigo questiona se tais estratégias funcionam e para quem funcionam. Questiona ainda a legitimidade de organizações internacionais na representação de vítimas de violações de direitos humanos e a ausência de responsabilidade por parte daquelas organizações em relação às vítimas. A autora argumenta que os meios usados por defensores de direitos humanos podem ser prejudiciais e contra-producentes para as vítimas: seus métodos freqüentemente falsificam a verdadeira experiência vivida pelas vítimas, suprimindo sua independência, competência e solidariedade. Ao invés de eliminar relações de poder e de dominação sobre aqueles que desejam ajudar, o que se faz é sustentar desníveis de poder e utilizar violações como uma mercadoria. O artigo propõe uma cooperação mais ampla entre defensores e vítimas por meio de modelos mais holísticos de ativismo.
The article analyzes the negative impact of popular strategies used by international human rights organizations when promoting human rights causes; namely human rights reporting, advocacy and strategic litigation. It critically assesses these strategies, and questions whether they are working and if so, for whom. At the same time, the author questions the legitimacy of international human rights organizations to represent victims of human rights violations and their lack of accountability towards the victims. The author argues that the means used by human rights advocates in their work might be damaging and counterproductive for the victims as their methods often falsify the true experience of victims of human rights violations and end up suppressing their independence, competence and solidarity. Rather than eliminating power relations and domination over those they aim to help, human rights advocates often sustain power imbalances and use human rights violations as a commodity. The article calls for broader cooperation of human rights advocates with victims, by embracing more holistic models of activism.
El artículo analiza los efectos negativos de estrategias utilizadas por organizaciones internacionales de derechos humanos al momento de promover causas de derechos humanos, a saber, la presentación de informes de derechos humanos, la promoción y defensa y el litigio estratégico. Se evalúan críticamente estas estrategias, y se cuestiona si están funcionando y, en caso afirmativo, a favor de quién. Al mismo tiempo, la autora pone en duda la legitimidad de las organizaciones internacionales de derechos humanos para representar a las víctimas de violaciones de derechos humanos y su falta de rendición de cuentas. La autora sostiene que los medios utilizados por los defensores de derechos humanos en su labor pueden ser perjudiciales y contraproducentes para las víctimas ya que a menudo falsifican la verdadera experiencia de las víctimas y terminan suprimiendo hasta su independencia, competencia y solidaridad. Bukovská afirma que en lugar de eliminar las relaciones de poder y de dominación, los defensores de derechos humanos a menudo perpetúan los desequilibrios de poder y usan las violaciones de derechos humanos como una mercancía. El artículo insta a una cooperación más amplia entre los defensores de los derechos humanos a través de modelos más integrales de activismo.