Self-management programs in stage 1-4 chronic kidney disease : a literature review.

Background Chronic kidney disease (CKD) is a complex health problem, which requires individuals to invest considerable time and energy in managing their health and adhering to multifaceted treatment regimens. Objectives To review studies delivering self-management interventions to people with CKD (Stages 1–4) and assess whether these interventions improve patient outcomes. Design: Systematic review. Methods Nine electronic databases (MedLine, CINAHL, EMBASE, ProQuest Health & Medical Complete, ProQuest Nursing & Allied Health, The Cochrane Library, The Joanna Briggs Institute EBP Database, Web of Science and PsycINFO) were searched using relevant terms for papers published between January 2003 and February 2013. Results The search strategy identified 2,051 papers, of which 34 were retrieved in full with only 5 studies involving 274 patients meeting the inclusion criteria. Three studies were randomised controlled trials, a variety of methods were used to measure outcomes, and four studies included a nurse on the self-management intervention team. There was little consistency in the delivery, intensity, duration and format of the self-management programmes. There is some evidence that knowledge- and health-related quality of life improved. Generally, small effects were observed for levels of adherence and progression of CKD according to physiologic measures. Conclusion The effectiveness of self-management programmes in CKD (Stages 1–4) cannot be conclusively ascertained, and further research is required. It is desirable that individuals with CKD are supported to effectively self-manage day-to-day aspects of their health.

Gain's in knowledge, attitude and skills of counselors across three trainings programs

The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) sponsored by the G20 nations has helped fund the development of training programs for HIV/AIDS counselors in India. To date no study has examined the effectiveness of these training programs. This study, therefore, aimed to examine the impact of a 12 training program in improving the knowledge of new HIV/AIDS counselors in West Bengal and compare benefits of three training programs. Pre and post measures were taken from 87 counsellors attending three training programs organized by the GFATM-7 team of the Department of Applied Psychology, University of Calcutta. Overall pre and post training scores of three training programs together show significant improvements in knowledge. The findings from this study provide confidence that the 12 day training program can be effectively implemented among West Bengal HIV/AIDS counsellors.

Valuation of hospital bed-days released by infection control programs: A comparison of methods

We performed a contingent valuation survey to elicit the opportunity cost of bed-days consumed by healthcare-associated infections in 11 European hospitals. The opportunity cost of a bed-day was significantly lower than the accounting cost; median values were i72 and i929, respectively (P ! .001). Accounting methods overestimate the opportunity cost of bed-days...

Day-ahead Resource Scheduling Including Demand Response for Electric Vehicles

The energy resource scheduling is becoming increasingly important, as the use of distributed resources is intensified and massive gridable vehicle (V2G) use is envisaged. This paper presents a methodology for day-ahead energy resource scheduling for smart grids considering the intensive use of distributed generation and V2G. The main focus is the comparison of different EV management approaches in the day-ahead energy resources management, namely uncontrolled charging, smart charging, V2G and Demand Response (DR) programs i n the V2G approach. Three different DR programs are designed and tested (trip reduce, shifting reduce and reduce+shifting). Othe r important contribution of the paper is the comparison between deterministic and computational intelligence techniques to reduce the execution time. The proposed scheduling is solved with a modified particle swarm optimization. Mixed integer non-linear programming is also used for comparison purposes. Full ac power flow calculation is included to allow taking into account the network constraints. A case study with a 33-bus distribution network and 2000 V2G resources is used to illustrate the performance of the proposed method.

The use of ICT by adults with learning disabilities in day and residential services

The use of Information and Communication Technology (ICT) by adults with learning disabilities has been positively promoted over the past decade. More recently, policy statements and guidance from the UK government have underlined the importance of ICT for adults with learning disabilities specifically, as well as for the population in general, through the potential it offers for social inclusion. The aim of the present study was to provide a picture of how ICT is currently being used within one organisation providing specialist services for adults with learning disabilities and more specifically to provide a picture of its use in promoting community participation. Nine day and 14 residential services were visited as part of a qualitative study to answer three main questions: What kinds of computer programs are being used? What are they being used for? Does this differ between day and residential services? Computers and digital cameras were used for a wide range of activities and ‘mainstream’ programs were used more widely than those developed for specific user groups. In day services, ICT was often embedded in wider projects and activities, whilst use in houses was based around leisure interests. In both contexts, ICT was being used to facilitate communication, although this was more linked to within-service activities, rather than those external to service provision.

Humoral and cellular immune response generated by different vaccine programs before and after Salmonella Enteritidis challenge in chickens

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Genotype by environment interaction for 450-day weight of Nelore cattle analyzed by reaction norm models

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Production performance and egg quality of quails (Coturnix japonica) during several periods of the day

Three experiments were carried out to analyze the performance and egg quality of Japanese quails throughout the day when submitted to different lighting programs. In each experiment, birds were submitted to a period of 28 days for adaptation to the lighting program. During the following three days, each day - from 7 am to 7 pm or 9 pm - was divided into six or seven periods of two hours each, and the remaining hours corresponded to another single period. All birds were submitted to the same management practices, and received water and feed ad libitum. The experimental diet was formulated according to NRC (1994) standards. It was observed lower feed intake in the period of 9 pm to 7 am, and a higher incidence of lay from 3 pm to 7 pm, as opposite to hens, which peak of egg laying occurs during the morning. Some controversial results were found among experiments as to eggshell quality during the different periods of the day. Variation on the lighting program had little influence on the other performance and egg quality parameters.

Feeding programs to induce molting in Japanese quails (Coturnix japonica)

The experiment was carried out in the experimental poultry house of the Research and Development Unit of Brotas of Agência Paulista de Tecnologia dos Agronegócios do Centro-Oeste, SP, Brazil. The objective of the study was to evaluate forced-molting methods and their effects on body weight, egg production, feed intake, and mortality, as well as bird performance during the second laying cycle. A total number of 400 65-week-old Japanese quails was distributed in a completely randomized experimental design into five treatments, with four replicates of 20 birds each. The following treatments were applied: T1= not submitted to forced molting, T2= 01 day of fasting + 13 days receiving 15g feed/bird/day (1F+R), T3= 02 days of fasting + 12 days receiving 15g feed/bird/day (2F+R), T4= 03 days of fasting + 11 days receiving 15g feed/bird/day (3F+R), and T5= 3 days of fasting and fed ad libitum thereafter (3F+AL). Significant differences were detected among treatments. When submitted to 3 days of fasting followed by ad libitum feeding, birds presented complete body weight recovery. No egg production percentage differences were detected in birds submitted to forced molting.

L-carnitine as an ergogenic aid for patients with chronic obstructive pulmonary disease submitted to whole-body and respiratory muscle training programs

The effects of adding L-carnitine to a whole-body and respiratory training program were determined in moderate-to-severe chronic obstructive pulmonary disease (COPD) patients. Sixteen COPD patients (66 ± 7 years) were randomly assigned to L-carnitine (CG) or placebo group (PG) that received either L-carnitine or saline solution (2 g/day, orally) for 6 weeks (forced expiratory volume on first second was 38 ± 16 and 36 ± 12%, respectively). Both groups participated in three weekly 30-min treadmill and threshold inspiratory muscle training sessions, with 3 sets of 10 loaded inspirations (40%) at maximal inspiratory pressure. Nutritional status, exercise tolerance on a treadmill and six-minute walking test, blood lactate, heart rate, blood pressure, and respiratory muscle strength were determined as baseline and on day 42. Maximal capacity in the incremental exercise test was significantly improved in both groups (P < 0.05). Blood lactate, blood pressure, oxygen saturation, and heart rate at identical exercise levels were lower in CG after training (P < 0.05). Inspiratory muscle strength and walking test tolerance were significantly improved in both groups, but the gains of CG were significantly higher than those of PG (40 ± 14 vs 14 ± 5 cmH2O, and 87 ± 30 vs 34 ± 29 m, respectively; P < 0.05). Blood lactate concentration was significantly lower in CG than in PG (1.6 ± 0.7 vs 2.3 ± 0.7 mM, P < 0.05). The present data suggest that carnitine can improve exercise tolerance and inspiratory muscle strength in COPD patients, as well as reduce lactate production.

Use of cooled bull semen as a strategy to increase the pregnancy rate in fixed-time artificial insemination programs-case report

Semen cryopreservation is still considered suboptimal due to lower fertility when compared to fresh semen. The reasons for the loss of fertility are various and related to irreversible damage caused to the cells during the freeze-thaw process. An alternative to conventional cryopreservation represents the use of chilled bull semen, preventing the damage associated with freezing, thereby guaranteeing greater sperm viability. The aim of this study was to describe the use of cooled bull semen as a strategy to increase the pregnancy for Fixed-Time Artificial Insemination (FTAI) of Nellore (Bos indicus) cows. One ejaculate of a select Nellore bull obtained by electroejaculation was used; the semen sample was fractioned into two aliquots: one diluted in Botu-Bov® extender containing 6.4% glycerol for cryopreservation (BB-F, frozen group) and one diluted in the same extender, free from cryoprotectants and used for cooling (BB-C, cooled semen group). The samples in the BB-C group were chilled to 5°C using an isothermic box and maintained for 24 h prior to use. A total of 349 lactating Nellore cows (70-90 days after birth) were synchronized by the insertion of a progesterone releasing device (1.0 g) and estradiol benzoate (2.0 mg i.m.) on a random day of the estrous cycle (Day 0); FTAI was performed 44-48 h after the removal of the device. The pregnancy rates were 45.71 and 61.49% (P<0.05), respectively, for the cryopreserved or chilled bovine semen groups. In conclusion, the use of bull semen cooled for 24 h represents an alternative to conventionally cryopreserved semen, as determined by the increase the pregnancy per artificial insemination in bovine herds. © 2012 Science Publication.

PHOTOGRAPHIC RECORDS — THEIR IMPORTANCE IN TODAY'S ENVIRONMENTALLY SENSITIVE BIRD MANAGEMENT PROGRAMS

We are living in a day of change. Environmental awareness is a part of our everyday life in a way unprecedented in history. The courts, in their infinite wisdom, have initiated the joint and several liability (deep pocket) rules that make everyone at risk in almost all situations. Bird management programs, by their very nature, are extremely sensitive. Any project, if not evaluated, planned, carried out, and documented properly can result in adverse regulatory agency action, bad publicity, and even fines or lawsuits. Proper photographic documentation can play a vital part in helping to provide the necessary records to help prevent problems and/or defend yourself in case of lawsuit or regulatory action. In the preparation of this paper, we surveyed state pesticide lead agencies, state Department of Conservation (Fish and Wildlife) agencies, some U.S. Fish and Wildlife Law Enforcement personnel, and several individuals to get their reaction to and their comments about this concept of supplemental recordkeeping. Of those responding, a majority thought the concept of supplemental photographic recordkeeping would be an asset to individuals and organi¬zations conducting bird management projects.

Availability of a rich source of sodium during the perinatal period programs the fluid balance restoration pattern in adult offspring

Osmoregulatory mechanisms can be vulnerable to electrolyte and/or endocrine environmental changes during the perinatal period, differentially programming the developing offspring and affecting them even in adulthood. The aim of this study was to evaluate whether availability of hypertonic sodium solution during the perinatal period may induce a differential programming in adult offspring osmoregulatory mechanisms. With this aim, we studied water and sodium intake after Furosemide-sodium depletion in adult offspring exposed to hypertonic sodium solution from 1 week before mating until postnatal day 28 of the offspring, used as a perinatal manipulation model [PM-Na group]. In these animals, we also identified the cell population groups in brain nuclei activated by Furosemide-sodium depletion treatment, analyzing the spatial patterns of Fos and Fos-vasopressin immunoreactivity. In sodium depleted rats, sodium and water intake were significantly lower in the PM-Na group vs. animals without access to hypertonic sodium solution [PM-Ctrol group]. Interestingly, when comparing the volumes consumed of both solutions in each PM group, our data show the expected significant differences between both solutions ingested in the PM-Ctrol group, which makes an isotonic cocktail: however, in the PM-Na group there were no significant differences in the volumes of both solutions consumed after Furosemide-sodium depletion, and therefore the sodium concentration of total fluid ingested by this group was significantly higher than that in the PM-Ctrol group. With regard to brain Fos immunoreactivity, we observed that Furosemide-sodium depletion in the PM-Na group induced a higher number of activated cells in the subfornical organ, ventral subdivision of the paraventricular nucleus and vasopressinergic neurons of the supraoptic nucleus than in the PM-Ctrol animals. Moreover, along the brainstem, we found a decreased number of sodium depletion-activated cells within the nucleus of the solitary tract of the PM-Na group. Our data indicate that early sodium availability induces a long-term effect on fluid drinking and on the cell activity of brain nuclei involved in the control of hydromineral balance. These results also suggest that availability of a rich source of sodium during the perinatal period may provoke a larger anticipatory response in the offspring, activating the vasopressinergic system and reducing thirst after water and sodium depletion, as a result of central osmosensitive mechanism alterations. (C) 2011 Elsevier Inc. All rights reserved.

Integration of Pasturing Systems for Cattle Finishing Programs

A 3-year study, using 84 fall-born and 28 spring-born calves of similar genotypes, was conducted to integrate pasturing systems with drylot feeding systems. Calves were started on test following weaning in May and October. Seven treatments were imposed: 1) fall-born calves directly into feedlot; 2 and 3) fall-born calves put on pasture with or without ionophore and moved to the feedlot at the end of July; 4 and 5) fall-born calves put on pasture with or without ionophore and moved to the feedlot at the end of October; 6 and 7) spring-born calves put on pasture with or without ionophore and moved to the feedlot at the end of October. A bromegrass pasture consisting of 16 paddocks, each 1.7 acre in size, was available. Each treatment group had access to 1 paddock at a time and was rotated at approximately 3-day intervals. In the feedlot, steers were provided an 82% concentrate diet containing whole-shelled corn, ground alfalfa hay, and a protein, vitamin and mineral supplement containing ionophore and molasses. As pens of cattle reached about 1150 lb. average live weight, they were processed and carcass traits were evaluated. Pasture daily gains were highest for cattle on pasture for the longest duration (P < .03), and overall daily gains were highest for drylot cattle (P < .01) and decreased with increased time spent on pasture. Although differences among treatments existed in numerical scores for yield and quality grades (P < .05 and P < .03, respectively), all treatments provided average yield grade scores of 2 and quality grades of low Choice or higher. Use of four production costs and pricing scenarios revealed that fall-born calves placed on pasture for varying lengths of time were the most profitable (P < .04) among the treatments. Furthermore, employing a 5% price sensitivity analysis, indicated that fed-cattle selling price had great impact on profit potential and was followed in importance by feeder purchase price and corn grain price. Overall, these findings should provide significant production alternatives for some segments of the cattle feeding industry and also lend substantial credence to the concept of sustainable agriculture.

Integrating Web-based Curricula into Allied Health Programs

This workshop will include \"Best Practices\" related to the integration of web-based instruction into allied health programs or courses. [See PDF for complete abstract]