Understanding the relationships between the calf muscle pump, ankle range of motion and healing for adults with venous leg ulcers: a review of the literature

Exercise offers the potential to improve circulation, wound healing outcomes, and functional and emotional wellbeing for adults experiencing venous leg ulceration. Individuals with chronic leg ulcers typically have multiple comorbidities such as arthritis, asthma, chronic obstructive airways disease, cardiac disease or neuromuscular disorders, which would also benefit from regular exercise. The aim of this review is to highlight the relationships between the calf muscle pump and venous return and range of ankle motion for adults with venous leg ulcers. The effect of exercise will also be considered in relation to the healing rates for adults experiencing venous leg ulceration. The findings suggest there is evidence that exercises which engage the calf muscle pump improve venous return. Ankle range of motion, which is crucial for complete activation of the calf muscle pump, can also be improved with simple, home-based exercise programs. However, observational studies still report that venous leg ulcer patients are less physically active than age-matched controls. Therefore, the behavioural reasons for not exercising must be considered. Only two studies, both underpowered, have assessed the effect of exercise on the healing rates of venous leg ulcers. In conclusion, exercise is feasible with this patient population. However, future studies with larger sample sizes are needed to provide stronger evidence to support the therapeutic benefit of exercise as an adjunct therapy in wound care.

Less popular but more democratic? Corrie, Clarkson and the dancing Cru

The central cultural experience of modernity has been change, both the ‘creative destruction’ of existing structures, and the growth, often exponential, of new knowledge. During the twentieth century, the central cultural platform for the collective experience of modernising societies changed too, from page and stage to the screen – from publishing, the press and radio to cinema, television and latterly computer screens. Despite the successive dominance of new media, none has lasted long at the top. The pattern for each was to give way to a successor platform in popularity, but to continue as part of an increasingly crowded media menu. Modern media are supplemented not supplanted by their successors.

A quasi stationary approach to drying kinetics of cylindrical food particulates in a heat pump asisted fluid bed dryer

Experiments were undertaken to study drying kinetics of moist cylindrical shaped food particulates during fluidised bed drying. Cylindrical particles were prepared from Green beans with three different length:diameter ratios, 3:1, 2:1 and 1:1. A batch fluidised bed dryer connected to a heat pump system was used for the experimentation. A Heat pump and fluid bed combination was used to increase overall energy efficiency and achieve higher drying rates. Drying kinetics, were evaluated with non-dimensional moisture at three different drying temperatures of 30, 40 and 50o C. Numerous mathematical models can be used to calculate drying kinetics ranging from analytical models with simplified assumptions to empirical models built by regression using experimental data. Empirical models are commonly used for various food materials due to their simpler approach. However problems in accuracy, limits the applications of empirical models. Some limitations of empirical models could be reduced by using semi-empirical models based on heat and mass transfer of the drying operation. One such method is the quasi-stationary approach. In this study, a modified quasi-stationary approach was used to model drying kinetics of the cylindrical food particles at three drying temperatures.

Washout hole for bi-ventricular assist device (BVAD) centrifugal blood pump

The shortage of donor hearts for patients with end stage heart failure has accelerated the development of ventricular assist devices (VAD) that act as a replacement heart. Mechanical devices involving pulsatile, axial and centrifugal devices have been proposed. Recent clinical developments indicate that centrifugal devices are not only beneficial for bridge to transplantation applications, but may also aid myocardial recovery. The results of a recent study have shown that patients who received a VAD have extended lives and improved quality of life compared to recipients of drug therapy. Unfortunately 25% of these patients develop right heart failure syndrome, sepsis and multi-organ failure. It was reported that 17% of patients initially receiving an LVAD later required a right ventricular assist device (RVAD). Hence, current research focus is in the development of a bi-ventricular assist device (BVAD). Current BVAD technology is either too bulky or necessitates having to implant two pumps working independently. The latter requires two different controllers for each pump leading to the potential complication of uneven flow dynamics and the requirements for a large amount of body space. This paper illustrates the combination of the LVAD and RVAD as one complete device to augment the function of both the left and right cardiac chambers with double impellers. The proposed device has two impellers rotating in counter directions, hence eliminating the necessity of the body muscles and tubing/heart connection to restrain the pump. The device will also have two separate chambers with independent rotating impeller for the left and right chambers. A problem with centrifugal impellers is the fluid stagnation underneath the impeller. This leads to thrombosis and blood clots.This paper presents the design, construction and location of washout hole to prevent thrombus for a Bi-VAD centrifugal pump. Results using CFD will be used to illustrate the superiority of our design concept in terms of preventing thrombus formation and hemolysis.

Computational fluid dynamics of a centrifugal heart pump as biventricular assist device(BVAD)

The results of a recent study have shown that there is a severe shortage of donor hearts to meet the demand of patients suffering from acute heart failures, and patients who received a left ventricular assist device (LVAD) have extended lives. However, some of them develop right heart failure syndrome, and these patients required a right ventricular assist device (RVAD). Hence, current research focus is in the development of a bi-ventricular assist device (Bi-VAD). Computational Fluid Dynamics (CFD) is useful for estimating blood damage for design of a Bi-VAD centrifugal heart pump to meet the demand of the left and right ventricles of a normal hearts with a flow rate of 5 lit/min and the supply pressure of 100 mmHg for the left ventricle and 20 mmHg for the right ventricle. Numerical studies have been conducted to predict pressure, flow rate, the velocity profiles, and streamlines in a continuous flow Bi-VAD using. Based on the predictions of numerical simulations, only few flow regions in the Bi-VAD exhibited signs of velocity profiles and stagnation points, thereby signifying potentially low levels of thrombogenesis.

AITPM Email Newsletter Volume 0907, July 2009 : President's Message

President’s Message AITPM President’s Message, July 2009 Hello fellow AITPM members, It’s now very early July so many Australians are going to experience a range of new, or increases in, fees, charges, and perhaps taxes by State and local governments. For example, Queenslanders are to be hit at the petrol pump, no longer living with the luxury of the State’s previous 8c per litre fuel subsidy, bringing general motorists’ fuel costs into line with the other States. A consolation is that they now don’t have to live with the real or perceived “price gouging” that has appeared in the past to make Queensland prices much closer than 8c to those in other States. Environmental lobbyists argue that this Government’s decision brings public transport costs closer to parity with private transport. However, my sense from sloppy petrol price elasticities is that the State’s motorists will get used to the reversal of what was a reverse tax pretty quickly, an amount which can be less than day-of-the week fluctuation. On the other hand, withholding this State revenue may help in some way the funding of the several major public transport infrastructure projects in progress; not to mention some of the cost of running the Transit Authority’s expanding service commitments. Other policy actions, such as a Federal Government review of taxation on employees’ package vehicles, which might discourage rather than encourage excess kilometres travelled, may have a greater environmental benefit. Of course, a downside is that many vehicles used so are Australian built, and discouraging fleet turnover may damage an industry which faces ever increasing uncertainty, and particularly at the present, is in need of some care and attention. I for one hope to this end that the new 4 cylinder (1.8L petrol or 2L diesel) so called “true Holden” Cruze and Toyota’s pending Camry Hybrid are both roaring successes, and will be taken up in droves as fleet and employee use vehicles. I’m not sure what drive-trains Ford and Holden plan to drop into their next full sized models but even if they’re not Australian sourced, let’s hope they coordinate the requisite performance expected by the “Aussie Battler” with suitable green credentials. I am also encouraged to see that already many Government fleet vehicles are smaller in size, but still fit for purpose. For instance, my local police station uses the Camry based Aurion as a district car. I close again in reminding everyone that AITPM’s flagship event, the 2009 AITPM National Conference, Traffic Beyond Tomorrow, is being held in Adelaide from 5 to 7 August. www.aitpm.com has all of the details about how to register, sponsor a booth, session, etc. Best regards all, Jon Bunker