Recovery after stroke : a qualitative perspective

The purpose of this study was to determine the impact of stroke on survivors of the condition and to identify their physical and psychosocial needs in rural and regional settings. Data were collected via focus group interviews with stroke survivors, carers and key informants. Data were managed using NUD*IST and analysed using a content analysis method identifying major themes related to the impact of living in the community after having a stroke. It was found that stroke survivors suffered severe physical and emotional effects. The findings also identified the vulnerability of this group and a lack of organised, on-going psychosocial and rehabilitative support. Recommendations are made to enhance the current management of stroke after the acute and subacute phases.

A new genus of Rhynchonellid Brachiopod from the Lower Triassic of South China and Implications for timing the recovery of Brachiopoda after the end-Permian mass extinction

A new genus, Meishanorhynchia, is proposed based on new material from the Lower Triassic of the Meishan section, South China. It is of a late Griesbachian age based on both associated biozones (ammonoids and
bivalves) and radiometric dates of the intercalated volcanic ash beds. Comparison with both Palaeozoic and Mesozoic-Cenozoic-related genera suggests that it may represent the first radiation of progenitor brachiopods in the aftermath of the end-Permian extinction. The lowest brachiopod horizon that contains the genus is estimated to be about 250.1±0.3 Ma. This implies that the initial stage of recovery of Brachiopoda in the Early Triassic was probably about 1.3±0.3 myr after the major pulse of the end-Permian mass extinction (dated as 251.4±0.3 Ma). This is in agreement with Hallam's expectancy that biotic recovery typically begins within one million years or so of major mass extinctions, in contrast to current views on the end-Permian extinction event which propose that the recovery of most if not all biotic groups in the Early Triassic was severely delayed and only began about five million years after the end-Permian extinction.

Narratives of recovery from traumatic injury: issues in the nursing care of patients in rehabilitation

Patients who sustain multiple orthopaedic injuries through trauma frequently undergo lengthy rehabilitation. There is little information available about how patients experience hospital rehabilitation programs. In particular, not much is known about factors that inhibit or facilitate the rehabilitation process. This paper describes a qualitative study that explored the rehabilitation  experiences of thirteen patients who had serious orthopaedic injuries.  In-depth interviews revealed issues about good and bad care, the importance of mateship, getting through the day and living with pain. In addition, participants spoke of the impact that the accident and resulting injuries had on their relationships, their experience of loss, how difficult it was to manage everyday issues and the ways in which the accident changed them. The findings of the study have been set into a framework of therapeutic emplotment, a novel way to view the role of the rehabilitation nurse.

The impact of grazing by eastern grey kangaroos (macropus giganteus) on vegetation recovery after fire at Reef Hills regional park, Victoria

In southeastern Australia ecological burning is frequently used to maintain a number of plant and animal populations. However, many of these prescribed fires are small, and may focus intense grazing activity on new regrowth. At Reef Hills Regional Park, Victoria shrub species have senesced, presumably due to the absence of fire. Ecological burning may be necessary to promote regeneration, however, the population density of the Eastern Grey Kangaroo (Macropus giganteus) is high (approx 38 per km2), and grazing pressure presents a significant risk to postfire vegetation recovery. An assessment of grazing patterns and their effects on postfire recovery was carried out at Reef Hills Regional Park through grazing exclusion plots. Preferential grazing by Eastern Grey Kangaroos occurred on small burnt plots compared to adjacent unburnt areas as determined by faecal pellet counts. On burnt areas, there was a significant reduction in shrub diversity on grazed plots compared to ungrazed plots. Most observations of kangaroos were of animals grazing on farmland surrounding the Park, and it is likely that any burning might shift grazing from farmland to burnt areas when new growth occurs. This needs to be considered before any ecological burn plan is applied to manage vegetation communities, particularly if the plan requires small areas to be burnt. We recommended that a large area up to 200 ha area be burnt and monitored to determine whether burning larger areas disperses grazing pressure from macropods to a level where impacts on vegetation are reduced and localized plant extinctions do not occur.

Recovery from gynaecological day surgery : are we underestimating the process

This paper reports a study investigating the post operative experiences of 80 women following gynaecological day surgery. Women kept a diary for the first 4 days following surgery. The diary included a recovery rating scale and a symptom management index focusing particularly on symptoms. A telephone interview conducted on post-operative day 10 further explored experiences. Results at day 4 indicated women experienced significant problems with pain, moving around and tiredness. By day 10, women were still experiencing tiredness, pain and other lingering problems. The study indicates that patients experience more problems than discharge education assumes.

Carbohydrates and fat for training and recovery

An important goal of the athlete's everyday diet is to provide the muscle with substrates to fuel the training programme that will achieve optimal adaptation for performance enhancements. In reviewing the scientific literature on post-exercise glycogen storage since 1991, the following guidelines for the training diet are proposed. Athletes should aim to achieve carbohydrate intakes to meet the fuel requirements of their training programme and to optimize restoration of muscle glycogen stores between workouts. General recommendations can be provided, preferably in terms of grams of carbohydrate per kilogram of the athlete's body mass, but should be fine-tuned with individual consideration of total energy needs, specific training needs and feedback from training performance. It is valuable to choose nutrient-rich carbohydrate foods and to add other foods to recovery meals and snacks to provide a good source of protein and other nutrients. These nutrients may assist in other recovery processes and, in the case of protein, may promote additional glycogen recovery when carbohydrate intake is suboptimal or when frequent snacking is not possible. When the period between exercise sessions is  <8 h, the athlete should begin carbohydrate intake as soon as practical after the first workout to maximize the effective recovery time between sessions. There may be some advantages in meeting carbohydrate intake targets as a series of snacks during the early recovery phase, but during longer recovery periods (24 h) the athlete should organize the pattern and timing of carbohydrate-rich meals and snacks according to what is practical and comfortable for their individual situation. Carbohydrate-rich foods with a moderate to high glycaemic index provide a readily available source of carbohydrate for muscle glycogen synthesis, and should be the major carbohydrate choices in recovery meals. Although there is new interest in the recovery of intramuscular triglyceride stores between training sessions, there is no evidence that diets which are high in fat and restricted in carbohydrate enhance training.

A comparative study at the logical level of centralised and distributed recovery in clusters

Cluster systems are becoming more prevalent in today’s computer society and users are beginning to request that these systems be reliable. Currently, most clusters have been designed to provide high performance at the cost of providing little to no reliability. To combat this, this report looks at how a recovery facility, based on either a centralised or distributed approach could be implemented into a cluster that is supported by a check pointing facility. This recovery facility can then recover failed user processes by using checkpoints of the processes that have been taken during failure free execution.

The haemodynamic status of cardiac surgical patients in the initial 2-h recovery period

Background
Critical care nurses caring for cardiac patients in the immediate postoperative period continually make decisions about the implications and treatment of their patients' haemodynamic status.

Aim
The aim of this study was to describe the haemodynamic status of patients on admission to critical care and over the 2-h period following cardiac surgery.

Methods
A quantitative, descriptive design was used. Data were collected using non-participant observation and an observation tool. The sample consisted of 38 patients.

Results
Analysis of data revealed the dynamic nature of the haemodynamic status of postoperative cardiac patients. On admission, 60% of patients (n = 23) were haemodynamically unstable. The instability in these patients (n = 23) was due to hypotension (34%), bleeding (21%) and hypoxaemia (18%). During the 2-h recovery period, 55% of patients were hypotensive, 16% of patients had low cardiac output syndrome and 16% of patients had low systemic vascular resistance (SVR) syndrome. Twenty-one percent of patients experienced bleeding complications. Shivering was a clinically significant problem in terms of occurrence (23%) and duration (X = 45, S.D. = 30 min). Twenty-nine percent of patients (n = 11) had a profound deterioration in haemodynamic status, necessitating urgent interventions.

Conclusion
Haemodynamic parameters indicate that 95% of patients in this study were haemodynamically unstable at some time during the initial 2-h recovery period. These findings inform resourcing decisions by organisations and have implications for nurses' assessment and interventional haemodynamic decision making.

Life-cycle energy analysis of building integrated photovoltaic systems (BiPVs) with heat recovery unit

Building integrated photovoltaic (BiPV) systems generate electricity, but also heat, which is typically wasted and also reduces the efficiency of generation. A heat recovery unit can be combined with a BiPV system to take advantage of this waste heat, thus providing cogeneration. Two different photovoltaic (PV) cell types were combined with a heat recovery unit and analysed in terms of their life-cycle energy consumption to determine the energy payback period. A net energy analysis of these PV systems has previously been performed, but recent improvements in the data used for this study allow for a more comprehensive assessment of the combined energy used throughout the entire life-cycle of these systems to be performed. Energy payback periods between 4 and 16.5 years were found, depending on the BiPV system. The energy embodied in PV systems is significant, emphasised here due to the innovative use of national average input–output (I–O) data to fill gaps in traditional life-cycle inventories, i.e. hybrid analysis. These findings provide an insight into the net energy savings that are possible with a well-designed and managed BiPV system.

Relationship marketing and pay TV: satisfaction, complaining behavior, service recovery, and repurchase

The aims of this research included demonstrating the detenninants of Pay TV subscriber satisfaction, and displaying the relationships between key aspects of relationship marketing, such as perceptions of value, satisfaction, customer complaint behavior and service recovery, and the intention to repurchase. A survey of 171 Australian respondents suggested that the perceived quality of the variety of the programs available and the perceived quality of the monthly program guide were major contributors to value, and that value was the main driver of overall satisfaction, which in tum was the main driver of the likelihood of disconnection from the Pay TV service. Those respondents who reported having a problem but not complaining directly about it were significantly more likely to have the intention to disconnect in the future, but they were not significantly different in tenns of their value perceptions or overall satisfaction.

The cost of recovery protocols in web-based database systems

The cost of recovery protocols is important with respect to system performance during normal operation and failure in terms of overhead, and time taken to recover failed transactions. The cost of recovery protocols for web database systems has not been addressed much. In this paper, we present a quantitative study of cost of recovery protocols. For this purpose, we use an experiment setup to evaluate the performance of two recovery algorithms, namely the, two-phase commit algorithm and log-based algorithm. Our work is a step towards building reliable protocols for web database systems.

Service failure and recovery in the presence of service guarantees

This paper presents a conceptual model and propositions outlining how, in a service recovery encounter, service guarantees (unconditional and specific) operate in conjunction with other organisational recovery variables (guarantee facilitation and service provider concern), to influence customers’ justice perceptions and subsequent satisfaction evaluations.

Polypyrrole-coated electrospun nanofibre membranes for recovery of Au(III) from aqueous solution

In this paper, for the first time, polypyrrole-coated electrospun nanofibre mats have been used as separation membranes to electrolessly recover Au from aqueous [Au(III)Cl₄]− solutions, based on a continuous-flow membrane separation process. With a [Au(III)Cl₄]− solution passing through the nanofibre membrane, the Au(III) ions were converted into elemental Au. The gold recovered was deposited on the nanofibre membranes in the form of Au particles, as confirmed by EDX and XPS measurements. It has been found that the polypyrrole-coated electrospun nanofibres are good candidate membrane material for the recovery of Au, and the recovery efficiency is affected by the membrane thickness, the permeate flux rate and the initial [Au(III)Cl₄]− concentration.

Effect of a weight-loss program on mental stress-induced cardiovascular responses and recovery

Objective: We assessed the effect of weight loss on blood pressure (BP) and pulse rate during rest, psychological stress, and recovery after stress.

Methods: Two groups of men completed two mental stress tests 12 wk apart. The control group continued their usual diet, whereas the weight-loss group underwent a dietary weight-loss program in which they were randomized to a high-fruit/vegetable and low-fat dairy diet or a low-fat diet.

Results: Fifty-five men with a baseline BP of 125.9 ± 6.9/83.6 ± 7.1 mmHg (mean ± SD) completed the study (weight-loss group, n = 28; control group, n = 27). The weight-loss group lost weight (mean ± SEM, −4.3 ± 0.3 versus +0.4 ± 0.4 kg, P = 0.001) compared with controls and had a significant decrease in resting systolic BP (SBP; −2.0 ± 1.1% versus +2.0 ± 1.1%, P < 0.05). There was a greater decrease in SBP (P < 0.05) and pulse rate (P < 0.05) at all time points during the stress test in the weight loss compared with the control group. At week 12, SBP in 23 (82%) subjects in the weight-loss group and 24 (89%) in the control group returned to resting levels, with recovering levels in the weight-loss group returning to resting levels 6.1 ± 2.6 min earlier than in the control group (P < 0.05). There was an overall greater decrease in diastolic BP (DBP; P < 0.05) and DBP during recovery up to 27 min after stress (P < 0.05) in the high-fruit/vegetable and low-fat dairy diet group (n = 14) compared with the low-fat diet group (n = 14).

Conclusion: A 5% loss of weight decreased BP during rest and returned SBP to resting levels faster, thus decreasing the period of increased BP as a result of mental stress, which is likely to lower the risk of cardiovascular disease in the long term.