The impact of cardiac rehabilitation on lifestyles, psychological correlates and the clinical course of cardiac disease

Objectives: The aim of this research was to evaluate the impact of Cardiac Rehabilitation (CR) on risky lifestyles, quality of life, psychopathology, psychological distress and well-being, considering the potential moderating role of depression, anxiety and psychosomatic syndromes on lifestyles modification. The influence of CR on cardiac morbidity and mortality was also evaluated. Methods: The experimental group (N=108), undergoing CR, was compared to a control group (N=85) of patients affected by cardiovascular diseases, not undergoing CR, at baseline and at 1-month, 6- and 12-months follow-ups. The assessment included: the Structured Clinical Interview for DSM-IV, the structured interview based on Diagnostic Criteria for Psychosomatic Research (DCPR), GOSPEL questionnaire on lifestyles, Pittsburgh Sleep Quality Index, Morisky Medication Adherence Scale, MOS 36-Item Short Form Health Survey, Symptom Questionnaire, Psychological Well-Being Scale and 14-items Type D Scale. Results: Compared to the control group, CR was associated to: maintenance of the level of physical activity, improvement of correct dietary behaviors and stress management, enhancement of quality of life and sleep; reduction of the most frequently observed psychiatric diagnoses and psychosomatic syndromes at baseline. On the contrary, CR was not found to be associated with: healthy dietary habits, weight loss and improvement on medications adherence. In addition, there were no relevant effects on sub-clinical psychological distress and well-being, except for personal growth and purpose in life (PWB). Also, CR did not seem to play a protective role against cardiac recurrences. The presence of psychosomatic syndromes and depressive disorders was a mediating factor on the modification of specific lifestyles. Conclusions: The findings highlight the need of a psychosomatic assessment and an evaluation of psychological sub-clinical symptomatology in cardiac rehabilitation, in order to identify and address specific factors potentially associated with the clinical course of the heart disease.

Effect of different management intensities on natural and human-induced carbon fluxes in a golf course in northern Italy

Turfgrasses are ubiquitous in urban landscape and their role on carbon (C) cycle is increasing important also due to the considerable footprint related to their management practices. It is crucial to understand the mechanisms driving the C assimilation potential of these terrestrial ecosystems Several approaches have been proposed to assess C dynamics: micro-meteorological methods, small-chamber enclosure system (SC), chrono-sequence approach and various models. Natural and human-induced variables influence turfgrasses C fluxes. Species composition, environmental conditions, site characteristics, former land use and agronomic management are the most important factors considered in literature driving C sequestration potential. At the same time different approaches seem to influence C budget estimates. In order to study the effect of different management intensities on turfgrass, we estimated net ecosystem exchange (NEE) through a SC approach in a hole of a golf course in the province of Verona (Italy) for one year. The SC approach presented several advantages but also limits related to the measurement frequency, timing and duration overtime, and to the methodological errors connected to the measuring system. Daily CO2 fluxes changed according to the intensity of maintenance, likely due to different inputs and disturbances affecting biogeochemical cycles, combined also to the different leaf area index (LAI). The annual cumulative NEE decreased with the increase of the intensity of management. NEE was related to the seasonality of turfgrass, following temperatures and physiological activity. Generally on the growing season CO2 fluxes towards atmosphere exceeded C sequestered. The cumulative NEE showed a system near to a steady state for C dynamics. In the final part greenhouse gases (GHGs) emissions due to fossil fuel consumption for turfgrass upkeep were estimated, pinpointing that turfgrass may result a considerable C source. The C potential of trees and shrubs needs to be considered to obtain a complete budget.

Context-sensitive design in transportation infrastructure: relating tire/pavement noise with wearing course characteristics

A design can be defined as context-sensitive when it achieves effective technical and functional transportation solutions, while preserving and enhancing natural environments and minimizing impacts on local communities. Traffic noise is one of the most critical environmental impacts of transportation infrastructure and it affects both humans and ecosystems. Tire/pavement noise is caused by a set of interactions at the contact patch and it is the predominant source of road noise at the regular traffic speeds. Wearing course characteristics affect tire/pavement noise through various mechanisms. Furthermore, acoustic performance of road pavements varies over time and it is influenced by both aging and temperature. Three experimentations have been carried out to evaluate wearing course characteristics effects on tire/pavement noise. The first study involves the evaluation of skid resistance, surface texture and tire/pavement noise of an innovative application of multipurpose cold-laid microsurfacing. The second one involves the evaluation of the surface and acoustic characteristics of the different pavement sections of the test track of the Centre for Pavement and Transportation Technology (CPATT) at the University of Waterloo. In the third study, a set of highway sections have been selected in Southern Ontario with various types of pavements. Noise measurements were carried out by means of the Statistical Pass-by (SPB) method in the first case study, whereas in the second and in the third one, Close-proximity (CPX) and the On-Board Sound Intensity (OBSI) methods have been performed in parallel. Test results have contributed to understand the effects of pavement materials, temperature and aging on tire/pavement noise. Negligible correlation was found between surface texture and roughness with noise. As a general trend, aged and stiffer materials have shown to provide higher noise levels than newer and less stiff ones. Noise levels were also observed to be higher with temperature increase.