Powered lower limb prosthetics hold promise for improving the mobility of amputees, but errors in the technology may also cause some users to stumble or fall. New research examines exactly what happens when these technologies fail, with the goal of developing a new generation of more robust powered prostheses.

"My work has focused on developing technology that translates electrical signals in human muscle into signals that control powered prosthetic limbs - such as decoding muscle signals to tell a prosthetic leg that it needs to walk forward or step up onto a staircase," says Dr. Helen Huang, senior author of a paper on the work and an associate professor in the joint biomedical engineering program at North Carolina State University and the University of North Carolina at Chapel Hill.

"But sometimes this 'decoding' technology makes mistakes, such as thinking someone wants to climb a step when he doesn't," says Fan Zhang, lead author of the paper and a Ph.D. student in the joint biomedical engineering program. "This is a problem, because we don't want to put users at risk of stumbling or falling."

Huang's team set out to understand exactly what happens to users of powered prosthetic legs when there's an error in the decoding technology.

"We not only want to improve the decoding accuracy, but determine which errors are important and which have little or no impact on users," Huang says. "Understanding the problem is an important step in finding ways to make these prostheses more reliable."

To address the issue, the researchers had study subjects use a customized prosthetic device that was programmed to make errors. This was done in a lab setting that allowed Huang's team to monitor each user's balance and biomechanics. Users were also asked how stable they felt during each trial.

The researchers found that some errors were so insignificant that users didn't even notice them - particularly errors that were short in duration or that occurred when a user's weight was not being applied to the prosthetic leg.

But errors that lasted longer, or that occurred when a user's weight was on the prosthetic limb, were more noticeable. The researchers also determined that critical, or especially noticeable, errors were also characterized by a large "mechanical work change," meaning the prosthetic limb thought it had to do significantly more or less work than the user intended.

"One of the things we'll be doing as we move forward with this work is seek ways to limit that mechanical work change," Huang says.

"Any system that involves a human interface will have occasional errors," Huang notes. "But we think we can find ways to make those errors effectively insignificant."

The paper, "Effects of Locomotion Mode Recognition Errors on Volitional Control of Powered Above-Knee Prostheses," is published in early view online in the journal IEEE Transactions on Neural Systems and Rehabilitation Engineering. The paper was co-authored by Ming Liu, a laboratory manager in the joint biomedical engineering program. The work was supported by the National Science Foundation under grants number 1406750 and 1361549, by the Department of Defense under grant number W81XWH-09-2-0020, and by the National Institute on Disability and Rehabilitation Research under grant number H133G130308.

WASHINGTON, D.C. – Senator Tom Harkin (D-IA) today announced that the University of Iowa and Iowa Central Community College have been awarded a total of $790,350 to apply communication technologies for rural healthcare delivery. The funding comes from the U.S. Department of Agriculture's (USDA) Distance Learning and Telemedicine (DLT) Grant Program.  Harkin is a senior member of the Senate agriculture committee as well as the panel that funds rural development initiatives.

"Residents of all communities - both rural and urban - deserve access to quality medical care.  By using new technology, we are able to provide people in rural areas with the specialty medical care that many urban residents take for granted," said Harkin.  "I congratulate the University of Iowa and Iowa Central Community College for receiving this competitive funding."

The DLT Grant Program works to provide access to education, training and health care resources in rural areas.  Funding is provided to increase educational opportunities and expand health care.

Details of the funding are as follows:

  • Iowa Central Community College: $291,377 to provide career & technical education, special education support services, media & technology services, a variety of instructional services and professional  and leadership development courses to 600 students, 266 teachers and 150 community members via an interactive distance learning videoconferencing system. Iowa counties that will benefit include : Buena Vista, Calhoun, Greene, Hamilton, Humboldt, Pocahontas, Sac, Webster, and Wright.
  • University of Iowa: $498,973 to provide telemedicine videoconferencing services for Family Medicine at 40 rural sites, for Child Health Specialty Clinics at 9 rural sites and for Geriatric Outreach at 15 rural sites. Iowa counties that will benefit include : Allamakee, Appanoose, Benton, Bremer, Buchanan, Buena Vista, Cass, Carroll, Cerro Gordo, Cherokee, Clay, Clayton, Decatur, Delaware, Des Moines, Dickinson, Emmett, Fayette, Fremont, Hardin, Henry, Iowa, Jackson, Jefferson, Johnson, Keokuk, Kossuth, Linn, Louisa, Mahaska, Marion, Montgomery, Page, Plymouth, Polk, Poweshiek, Scott, Shelby, Union, Van Buren, Washington, Wayne, Winneshiek, and Wright.
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Overtraining Can Be as Bad as Not Training at All, He Says

Losing weight was the No. 1 New Year's resolution for 2014, according to a University of Scranton study, which also found that only 8 percent of people succeed in achieving their resolutions.

So it stands to reason, losing weight will again top the resolution charts in 2015.

"You're much more apt to be successful, and keep the weight off, if you don't focus on simply shedding pounds by reducing your caloric intake," says Dr. Brett Osborn, author of "Get Serious, A Neurosurgeon's Guide to Optimal Health and Fitness," www.drbrettosborn.com.

"As a general rule, the best thing you can do for yourself is start doing weight training and keep it simple," Dr. Osborn says.

He shares seven tips for burning up the fat and building muscle through weight training:

•  Make workouts intense. Any exercise or group of exercises must provide sufficient stimulus to trigger the body's adaptive response. A requisite of this is intensity. We are reactive organisms at a base level. Resistance training of sufficient intensity stimulates an increase in testosterone production, and the anabolic, muscle-building process ensues.

•  Always err on the side of training less. So, how do you know just how much is enough? Are you training too often or just the opposite? In both cases, there will be failed gains. That's right - overtraining can stall progress! The answer? Pay meticulous attention to your progress, or lack thereof.

•  Chart your progress. Set training goals, both short-term and long-term, and accomplish them. Buy a log book or download an app (there are many available for free) and make a habit of recording every workout. You don't know where you're going unless you know where you've been.

•  Nutrition is as important as training. You must provide your body with adequate nutrition to rebuild itself. If your fitness goal is muscular hypertrophy and strength, you'll make few if any gains in the context of poor nutrition.

•  You must get adequate sleep. "I have a hard time with this one because of my occupation, so I make it a priority as much as possible," Dr. Osborn says. Without adequate rest, your body won't recover from training. Remember, your muscles are growing while you sleep, provided there is adequate stimulus for growth and sound nutrition.

•  Educate yourself. Learn as much as possible about training and, more specifically, how your body responds to various training modalities. Forget about fitness or fashion magazines - the endorsed regimens there bear little resemblance to those actually utilized by bodybuilders. Don't lose weight for its own sake. Building muscle is the best way to burn fat, so don't pay attention to gimmicky and faddish celebrity fitness articles.

•  Never quit! A well-timed hiatus from training is very different than quitting. In fact, we need intermittent breaks as the majority of us are actually overtraining. Terminating all exercise is akin to quitting health. Push yourself through periods of stalled progress. Don't expect to look like a professional bodybuilder after six to 12 months of training. Unless you're using anabolic agents, you won't look like that. But that's okay! The point is slow and steady progress, which inevitably yields a more muscular physique and, ultimately, better health.

About Dr. Brett Osborn

Brett Osborn is a New York University-trained, board-certified neurological surgeon with a secondary certification in anti-aging and regenerative medicine.  He is a diplomate of the American Bard of Neurological Surgery and of the American Academy of Anti-Aging Medicine. He holds a CSCS honorarium from the National Strength and Conditioning Association. Dr. Osborn specializes in scientifically based nutrition and exercise as a means to achieve optimal health and preventing disease. He is the author "Get Serious, A Neurosurgeon's Guide to Optimal Health and Fitness," www.drbrettosborn.com.

Affordable Care Act provides incentives to encourage doctors to serve in rural America, funds health rural centers, helps rural Americans get access to care

USDA awarding more than $10 million in grants to support telemedicine and rural health research

Washington, D.C., Nov. 20, 2014 - Today, on National Rural Health Day, Agriculture Secretary Tom Vilsack announced more than $10 million in grants through two U.S. Department of Agriculture (USDA) programs to improve access to health care for rural Americans across the nation. The Secretary also highlighted initiatives created by the Affordable Care Act that specifically address critical health needs in rural communities.

"Delivering these programs to rural communities that often do not have access to quality, affordable medical and educational services has tremendous economic and social benefits," Vilsack said. "They also mean that people who live and work in rural areas will not have to travel long distances for specialized health care services. These investments mean that students in rural high schools will have educational opportunities often not available outside urban areas."

Through the Distance Learning and Telemedicine (DLT) program, USDA has helped hundreds of rural communities deliver care in remote areas since it began two decades ago. Today, USDA's Rural Development is awarding $20.4 million in grants that will provide rural Americans access to medical services, improve educational opportunities, and support Native American communities. Fiscal Year 2014 Distance Learning and Telemedicine Grant recipients

Rural residents are more likely to report a fair to poor health status and have higher rates of health complications, morbidity and mortality due to challenges associated with low levels of employment and education, geographic barriers and isolation, lack of quality nutrition and health education, and lack of access to health care.

USDA's National Institute of Food and Agriculture (NIFA) is awarding 12 grants totaling more than $1.4 million to universities aimed at enhancing the quality of life in rural areas through improved health and safety education efforts. NIFA funded the grants through the Rural Health and Safety Education program which addresses these challenges by developing programs that provide the necessary health information to rural residents. The program has three main focus areas: 1) individual and family nutrition and health education; 2) farm safety education; and 3) rural health leadership development education.

Projects funded in fiscal year 2014 focus on a diversity of rural health and safety issues, from diabetes education, obesity prevention, and physical activity and healthy nutrition education, to eco-healthy child care promotion, and rural expansion of 4-H Healthy Living program. Fiscal Year 2014 Rural Health and Safety Education Grant recipients

In addition to today's announcements, Secretary Vilsack encouraged rural Americans to take advantage of the Health Insurance Marketplace created by the Affordable Care Act and discussed the health care reform law's specific benefits for rural communities.

"Rural residents have higher rates of chronic conditions.  This can be exacerbated by a lack of doctors or clinics in rural communities," Secretary Vilsack continued. "The Affordable Care Act is improving the health of rural communities and giving all families the security they deserve. No one should go without healthcare because of where they live, or be forced to leave the communities they love to get the coverage they need."

Rural Americans suffer from higher rates of chronic conditions like diabetes, heart disease and high blood pressure.  The Affordable Care Act has taken steps to address the unique challenges rural communities face when it comes to getting the health care they need.

One in five uninsured Americans lives in a rural area, and yet on average only 10 percent of the nation's physicians practice in these communities. The Affordable Care Act has significantly increased the size of the National Health Service Corps, which offers scholarships and loan repayment to health practitioners in return for practicing in rural communities and other underserved areas. More than 3,500 Corps members now serve in rural areas, and an average of 86 percent of them will remain in their communities even after completing their service.

The Affordable Care Act also invests significantly in expanding services at community health centers, where 7.5 million rural Americans get access to primary and preventive care. That comes on top of the more than $3 billion USDA has invested since 2009 to strengthen health infrastructure in rural areas, building rural hospitals and health clinics and expanding access to health care in remote rural areas through telemedicine.

Not only can a lack of health insurance coverage help lead to high rates of chronic conditions, it threatens rural families economic health as well.  Before the Affordable Care Act passed, the average rural family paid nearly 50% of all health costs out of pocket. One in five farmers is in debt because of medical bills. Uninsured individuals living in rural areas are able to use the Marketplaces to compare qualified health plan insurance options based on price, benefits, quality, and other factors with a clear picture of premiums and cost-sharing amounts to help them choose the qualified health insurance plan that best fits their needs.

Open Enrollment for the Health Insurance Marketplace began Nov. 15, 2014, and runs through Feb. 15, 2015. Those who have plans can continue them without re-enrolling. However, consumers are encouraged to visit HealthCare.gov to review and compare health plan options and find out if they are eligible for financial assistance, which can help pay monthly premiums and reduce out-of-pocket costs when receiving services. In order to have coverage effective on Jan. 1, 2015, consumers must enroll or update their coverage by December 15.

Consumers can find local help at: Localhelp.healthcare.gov or call the Federally-facilitated Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325. Translation services are available. The call is free.

To preview plans in your area, visit: www.healthcare.gov/see-plans/

For more information about Health Insurance Marketplaces, visit: www.healthcare.gov/marketplace

Washington, D.C. - Congressman Dave Loebsack today announced that the University of Iowa has received a $498,973 grant from the USDA's Distance Learning and Telemedicine Grant Program. The funding will be used to provide adult, pediatric and geriatric healthcare for patients at 64 remote rural locations.

"Residents of rural communities deserve to have access to the same medical care as someone living in a larger community," said Loebsack. "I am pleased the University of Iowa is receiving this funding to help them continue to lead the way in providing quality health care to all Iowans, no matter their location."

These funds will be used to provide telemedicine videoconferencing services for Family Medicine at 40 rural sites, for Child Health Specialty Clinics at 9 rural sites and for Geriatric Outreach at 15 rural sites. The rural locations are in the following counties: Allamakee, Appanoose, Benton, Bremer, Buchanan, Buena Vista, Cass, Carroll, Cerro Gordo, Cherokee, Clay, Clayton, Decatur, Delaware, Des Moines, Dickinson, Emmett, Fayette, Fremont, Hardin, Henry, Iowa, Jackson, Jefferson, Johnson, Keokuk, Kossuth, Linn, Louisa, Mahaska, Marion, Montgomery, Page, Plymouth, Polk, Poweshiek, Scott, Shelby, Union, Van Buren, Washington, Wayne, Winneshiek, and Wright.

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'There is Always a Way Through' Emotional Trauma, Says One Who's on the Journey

Neglect. Abuse. Divorce. Addiction. These are just a few of the life experiences that can leave children emotionally bruised or worse, causing some to develop dysfunctional outlooks and behaviors that condemn them to perpetual self-victimization as adults.

"We not only perpetuate, but also protect the obstacles that stand in the way of our healing and happiness," says Marta Maranda. "But there is always a way through, no matter what your situation."

The author of "What It Looks Like," (http://martamaranda.com/), a new memoir detailing her own journey of healing, Maranda says she continued to use the defense mechanisms she developed in response to childhood trauma far into adulthood, which only served to block healthy emotional growth.

"As an adult decades after the initial abuse, I was still surrounding myself with similar trauma, and still reacting in the same ways to the trauma, even though those childhood survival tools no longer served me. Basically, the only one keeping me stuck in a dysfunctional and unfulfilling life was me."

Maranda says she didn't realize she played a part in her own dysfunction until the treatment of a family member for substance abuse caused her to think differently.

"I don't drink, use drugs, or have a sexual dysfunction. I've never even had a cup of coffee in my life," she says. "So it was easy to look at everyone else as the cause of my problems.

"But during family therapy sessions, I finally realized that there are two dysfunctional people in an unhealthy relationship, and there is an entire dysfunctional family in an unhealthy family system."

Maranda became a rarity: sober and voluntarily, she admitted herself into a five-week residential treatment center. That's where her healing began.

"But I'm not done," she says. "Healing involves tearing down all those dysfunctional coping mechanisms?fear, anger, denial, justification?and rebuilding your life piece by piece. I still have to do the work every day."

She offers these tips for others whose past trauma has resulted in self-destructive thought and behavior patterns, such as a willingness to remain in unhealthy relationships or an over-reliance on comforts like food, drugs, or alcohol to soothe painful emotions.

·  Look inward for reasons, not outward for blame.
It's easy to find other people or situations to blame for your problems. Even if the initial trauma was inflicted when you were at your most vulnerable, and by someone you should have been able to trust, at some point you have to take responsibility for your own life. "How are you contributing to the dysfunction in your life?" Maranda asks. "The decision to remain stuck in a dysfunctional life is yours. The responsibility to move forward toward healing and happiness is also yours."

·  If you've done it, admit it.
Look fearlessly at the wrong you've done, at the pain you've inflicted on yourself and others through your own dysfunctional behavior, and admit it. "Only by owning it can you change it," Maranda says. "And only through change can you heal." Likewise, look kindly and with humility at the good you've done. Own all that is valuable about you, and build upon it.

·  Information, not shame.
The lessons of healing always come with a choice: information or shame? If you are doing your healing work properly?meaning completely breaking down every defense mechanism you've built to keep yourself blind to your own dysfunctional behavior?the realizations that you've caused others harm, pain, or even extreme damage will come. But eventually you have to choose between continuing to feel shamed, which leads to feelings of worthlessness and hopelessness, or accepting the realizations as the information necessary to repair your life. "Much like a doctor needs to objectively understand what's broken to diagnose a problem, so do you need to look objectively at your dysfunction and its consequences to heal it," Maranda says. "Then use your healthy guilt feelings, not shame, as a reminder of what you can't do again."

·  Build a support system.
No one's said it better than Einstein: You can't fix a problem with the same broken mind that created it. Left to their own devices, many people who are convinced they need to change will still seek out environments that support their dysfunctions rather than strengthen their healing. "Change is hard, and healing isn't always comfortable," Maranda says. "That's why people often find their way back to what they know, even if what they know is destructive or deadly." Building a support system of people?whether family or friends, or from a therapeutic or spiritual community?whose perspectives get you out of your comfort zone and away from the dysfunction you know is essential for healing.

About Marta Maranda

Marta Maranda is a writer, businesswoman, and author of "What It Looks Like," (http://martamaranda.com/). She holds a bachelor's degree in communications and undertook a year of post-graduate study in psychology. She is currently working on her second book.

Changes in health insurance raise many questions for consumers. Iowa State University Extension and Outreach is offering a FREE online two-hour unbiased, research-based educational workshop for consumers on December 10 from 6 - 8 PM. The Smart Choice Health Insurance Education program will equip consumers with tools they need to make the best possible decision when choosing health insurance plans for themselves and their families. Register for this free online class at http://tinyurl.com/pvmceb7. For more information, contact Phyllis Zalenski, Human Science Family Finance Specialist, at 319-465-3224 or zalenski@iastate.edu

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PEORIA, Ill. (Nov. 19, 2014) - The first nationwide partnership and "Fuel Your Community" campaign between the American Red Cross and energy provider Suburban Propane in October helped collect thousands of lifesaving blood and platelet donations for patients at approximately 2,600 hospitals and transfusions centers served by the Red Cross.

Hundreds of Suburban Propane employees rolled up their sleeves to give blood and volunteer at 64 Red Cross blood drives across the country the October campaign, resulting in more than 1,500 blood donations at those drives, and nearly 600 first-time donors. With each blood donation potentially helping up to three people, as many as 4,500 lives could be impacted.

"Our employees are proud to support the American Red Cross and the hospitals and patients it serves," said Chief Operating Officer Mark Wienberg of Suburban Propane. "This is the sixth time Suburban Propane has partnered with the Red Cross to raise awareness about the constant need for blood and platelet donations, and is our largest and most successful effort to date. We look forward to continuing to support the Red Cross and its humanitarian mission with our national sponsorship."

Through the "Fuel Your Community" campaign, Suburban Propane also sponsored an advertising campaign to raise greater awareness for the constant need for blood and platelet donations, and donated a $5,000 Visa gift card for one lucky presenting blood donor to win.

"Partnering with civic-minded organizations, like Suburban Propane, is at the heart of our humanitarian and volunteer supported organization," said Donna M. Morrissey, director of national partnerships, Red Cross Blood Services. "With Suburban Propane's support, overall the Red Cross collected more than 460,000 blood donations at over 19,000 blood drives in October, helping to meet the need of about 15,000 blood donations every day for patients."

"It's the blood products already on the shelves that help to save lives in an emergency," said Shelly Heiden, community CEO, Red Cross Heart of America Blood Services Region. "Suburban Propane's support helps ensure that blood is available for cancer patients, those fighting blood diseases, trauma victims and others here in the Heart of America Region as well as patients throughout the country."

To learn more about blood donation or find a blood donation opportunity, download the Blood Donor App, visit redcrossblood.org or call 1-800-RED CROSS (1-800-733-2767). Eligible donors with all blood types - especially O negative, A negative and B negative - are needed to maintain an adequate supply for patients.

 

About the American Red Cross

The American Red Cross shelters, feeds and provides emotional support to victims of disasters; supplies about 40 percent of the nation's blood; teaches skills that save lives; provides international humanitarian aid; and supports military members and their families. The Red Cross is a not-for-profit organization that depends on volunteers and the generosity of the American public to perform its mission. For more information, please visit redcross.org or visit us on Twitter at @RedCross.

About Suburban Propane

Suburban Propane Partners, L.P. (NYSE:SPH) is a nationwide distributor of propane, fuel oil and related products and services, as well as a marketer of natural gas and electricity. Headquartered in Whippany, New Jersey, Suburban serves the energy needs of more than 1.2 million residential, commercial, industrial and agricultural customers through approximately 710 locations in 41 states.

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Over time, the presence of too much glucose in your cells can injure the walls of the tiny blood vessels called capillaries that deliver blood to your nerves, especially in the legs. This can cause tingling, numbness, burning, or pain.

Poorly controlled blood glucose can even cause you to lose all sense of feeling in the affected limbs - and a loss of feeling in your feet makes you more vulnerable to injury and infection. Let's say you get a blister or small cut on your foot that you don't feel: Because you don't know it's there, you may miss the symptoms of an infection in the wound. It's imperative for you to check your feet regularly to avoid this and be meticulous in your foot care, because untreated infections can result in gangrene (the death of tissue) and may lead to the amputation of the affected limb or toes.

Diabetes can also make it more difficult for your body to fight infections in general. Various skin conditions are linked to diabetes, and even the most minor cuts or sores can turn serious fast. Any bumps, cuts, or scrapes should be cleaned and treated with an antibiotic cream and monitored carefully.

Nerve Damage: What to Watch For

If you notice any of these symptoms associated with nerve damage or infection, see your doctor:

  • Inflammation and tenderness anywhere on your body
  • Red, itchy rash surrounded by small blisters or scales
  • Cuts, sores, or blisters on your feet that are slow to heal and are not as painful as you would expect (due to a loss of sensation)
  • Numbness, tingling, or burning sensations in your hands or feet, including your fingers and toes
  • Sharp pain that gets worse at night
  • Muscle weakness that makes walking difficult
  • Bladder infections and problems with bladder control
  • Bloating, stomach pain, constipation, nausea, vomiting, or diarrhea
  • Erectile dysfunction in men and vaginal dryness in women

Remember: If you keep your blood-glucose levels on target, you can help prevent or delay nerve damage. If you already have nerve damage, this will help prevent or delay further damage. You should also speak to your doctor about other treatments that can help.

Next step: Protecting Your Kidneys

November 2014 (Muscatine, IA) Gilda's Club, Susan G. Komen Quad Cities, Flickinger Learning Center, and the Diversity Service Center Muscatine are partnering to put on a free of charge breast cancer awareness luncheon in Spanish. A $50 gas card will be raffled off. It will take place Saturday November 22nd at 12:30 p.m. at Flickinger Learning Center 413 Mulberry Avenue, Muscatine, IA. Please call the Diversity Service Center Muscatine at 563-264-8883 to register.

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