Do Psychosocial Interventions Improve Quality of Life and Wellbeing in Adults with Neuromuscular Disorders? A Systematic Review and Narrative Synthesis

Background: Quality of life and well-being are frequently restricted in adults with neuromuscular disorders. As such, identification of appropriate interventions is imperative. Objective: The objective of this paper was to systematically review and critically appraise quantitative studies (RCTs, controlled trials and cohort studies) of psychosocial interventions designed to improve quality of life and well-being in adults with neuromuscular disorders. Method: A systematic review of the published and unpublished literature was conducted. Studies meeting inclusion criteria were appraised using a validated quality assessment tool and results presented in a narrative synthesis. Results: Out of 3,136 studies identified, ten studies met criteria for inclusion within the review. Included studies comprised a range of interventions including: cognitive behavioural therapy, dignity therapy, hypnosis, expressive disclosure, gratitude lists, group psychoeducation and psychologically informed rehabilitation. Five of the interventions were for patients with Amyotrophic Lateral Sclerosis (ALS). The remainder were for patients with post-polio syndrome, muscular dystrophies and mixed disorders, such as Charcot-Marie-Tooth disease, myasthenia gravis and myotonic dystrophy. Across varied interventions and neuromuscular disorders, seven studies reported a short-term beneficial effect of intervention on quality of life and well-being. Whilst such findings are encouraging, widespread issues with the methodological quality of these studies significantly compromised the results. Conclusion: There is no strong evidence that psychosocial interventions improve quality of life and well-being in adults with neuromuscular disorders, due to a paucity of high quality research in this field. Multi-site, randomised controlled trials with active controls, standardised outcome measurement and longer term follow-ups are urgently required.

Human exposure to particulate and gaseous pollutants in a bar.

There is increasing evidence of a causal link between airborne particles and ill health and this study examined the exposure to both airborne particles and the gas phase contaminants of environmental tobacco smoke (ETS) in a bar. The work reported here utilized concurrent and continuous monitoring using real-time optical scattering personal samplers to record particulate (PM10) concentrations at two internal locations. Very high episodes were observed in seating areas compared with the bar area. A photo-acoustic multi-gas analyser was used to record the gas phases (CO and CO2) at eight different locations throughout the bar and showed little spatial variation. This gave a clear indication of the problems associated with achieving acceptable Indoor Air Quality in a public space and identified a fundamental problem with the simplistic design approach taken to ventilate the space. Both gaseous and particulate concentrations within the bar were below maximum recommended levels although the time-series analysis illustrated the highly episodic nature of this exposure.

The Corporate Manslaughter and Corporate Homicide Act 2007 or the Health and Safety (Offences) Act 2008: corporate killing and the law

This thesis examines the regulatory and legislative approach taken in the United Kingdom to deal with deaths arising from work related activities and, in particular, deaths that can be directly attributed to the behaviour of corporations and other organisations. Workplace health and safety has traditionally been seen in the United Kingdom as a regulatory function which can be traced to the very earliest days of the Industrial Revolution. With an emphasis on preventing workplace accidents and ill-health through guidance, advice and support, the health and safety legislation and enforcement regime which had evolved over the best part of two centuries was considered inadequate to effectively punish corporations considered responsible for deaths caused by their activities following a series of disasters in the late twentieth and early twenty-first centuries. To address this apparent inadequacy, the Corporate Manslaughter and Corporate Homicide Act 2007 was introduced creating the offence of corporate manslaughter and corporate homicide. Based on a gross breach of a relevant duty of care resulting in the death of a person, the Act effectively changed what had previously considered a matter of regulation, an approach that had obvious weaknesses and shortcomings, to one of crime and criminal law. Whether this is the best approach to dealing with deaths caused by an organisation is challenged in this thesis and the apparent distinction between ‘criminal’ and ‘regulatory’ offences is also examined. It was found that an amended Health and Safety at Work etc. Act 1974 to include a specific offence of corporate killing, in conjunction with the Health and Safety (Offences) Act 2008 would almost certainly have resulted in a more effective approach to dealing with organisations responsible for causing deaths as consequence of their activities. It was also found that there was no substantive difference between ‘regulatory’ and ‘criminal’ law other than the stigma associated with the latter, and that distinction would almost certainly disappear, at least in the context of worker safety, as a consequence of the penalties available following the introduction of the Health and Safety (Offences) Act 2008.

The role of context in image annotation and recommendation

With the rise of smart phones, lifelogging devices (e.g. Google Glass) and popularity of image sharing websites (e.g. Flickr), users are capturing and sharing every aspect of their life online producing a wealth of visual content. Of these uploaded images, the majority are poorly annotated or exist in complete semantic isolation making the process of building retrieval systems difficult as one must firstly understand the meaning of an image in order to retrieve it. To alleviate this problem, many image sharing websites offer manual annotation tools which allow the user to “tag” their photos, however, these techniques are laborious and as a result have been poorly adopted; Sigurbjörnsson and van Zwol (2008) showed that 64% of images uploaded to Flickr are annotated with < 4 tags. Due to this, an entire body of research has focused on the automatic annotation of images (Hanbury, 2008; Smeulders et al., 2000; Zhang et al., 2012a) where one attempts to bridge the semantic gap between an image’s appearance and meaning e.g. the objects present. Despite two decades of research the semantic gap still largely exists and as a result automatic annotation models often offer unsatisfactory performance for industrial implementation. Further, these techniques can only annotate what they see, thus ignoring the “bigger picture” surrounding an image (e.g. its location, the event, the people present etc). Much work has therefore focused on building photo tag recommendation (PTR) methods which aid the user in the annotation process by suggesting tags related to those already present. These works have mainly focused on computing relationships between tags based on historical images e.g. that NY and timessquare co-exist in many images and are therefore highly correlated. However, tags are inherently noisy, sparse and ill-defined often resulting in poor PTR accuracy e.g. does NY refer to New York or New Year? This thesis proposes the exploitation of an image’s context which, unlike textual evidences, is always present, in order to alleviate this ambiguity in the tag recommendation process. Specifically we exploit the “what, who, where, when and how” of the image capture process in order to complement textual evidences in various photo tag recommendation and retrieval scenarios. In part II, we combine text, content-based (e.g. # of faces present) and contextual (e.g. day-of-the-week taken) signals for tag recommendation purposes, achieving up to a 75% improvement to precision@5 in comparison to a text-only TF-IDF baseline. We then consider external knowledge sources (i.e. Wikipedia & Twitter) as an alternative to (slower moving) Flickr in order to build recommendation models on, showing that similar accuracy could be achieved on these faster moving, yet entirely textual, datasets. In part II, we also highlight the merits of diversifying tag recommendation lists before discussing at length various problems with existing automatic image annotation and photo tag recommendation evaluation collections. In part III, we propose three new image retrieval scenarios, namely “visual event summarisation”, “image popularity prediction” and “lifelog summarisation”. In the first scenario, we attempt to produce a rank of relevant and diverse images for various news events by (i) removing irrelevant images such memes and visual duplicates (ii) before semantically clustering images based on the tweets in which they were originally posted. Using this approach, we were able to achieve over 50% precision for images in the top 5 ranks. In the second retrieval scenario, we show that by combining contextual and content-based features from images, we are able to predict if it will become “popular” (or not) with 74% accuracy, using an SVM classifier. Finally, in chapter 9 we employ blur detection and perceptual-hash clustering in order to remove noisy images from lifelogs, before combining visual and geo-temporal signals in order to capture a user’s “key moments” within their day. We believe that the results of this thesis show an important step towards building effective image retrieval models when there lacks sufficient textual content (i.e. a cold start).

The use of wild fruits of Fragaria vesca L. in preparations with bioactive properties: chemical characterization, antioxidant, antibacterial and antibiofilm activities

Wild strawberry, Fragaria vesca L., belongs to Rosaceae family and is commonly found in roadsides and slopes [1]. The most consumed parts of this plant are its sweet small fruits, which constitute a source of vitamins and phenolic compounds, being also used in infusions due to their organoleptic properties and for the treatment of some intestinal disorders [2, 3]. In the present work, F. vesca fruits were evaluated for their nutritional value and further used in the preparation of infusions. The chemical composition of the fruits and corresponding infusions was determined in terms of soluble sugars, organic acids, tocopherols, folates (by HPLC coupled to different detectors), phenolic compounds (by HPLC-DAD/ESI-MS) and mineral elements (atomic absorption spectroscopy). Some of these bioactive compounds were correlated with antioxidant and antibacterial properties evaluated either in infusions as also in hydromethanolic extracts. Carbohydrates were the main macronutrients in the fruits, followed by fat and proteins. Regarding the fatty acids, polyunsaturated fatty acids showed higher prevalence, mainly due to the presence of D-linolenic (Cl8:3n3) and y-linolenic (Cl8:3n6) acids. Sucrose and citric acid were, respectively, the main sugar and organic acid found in the fruits and in its infusions. The microelement found in higher amounts in both samples was manganese, while potassium and calcium were the macroelements present in higher levels in the fruits and infusions, respectively. Both samples presented folates and tocopherols, being ytocopherol the main isoform detected in the fruits, while a-tocopherol was the only isoform quantified in the infusion. The hydromethanolic extract prepared from the fruits gave higher antioxidant and antibacterial activities, namely against Escherichia coli and Pseudomonas aeruginosa, than the infusion; it also showed capacity to inhibit the formation of bacterial biofilm. Both bioactivities are highly correlated with the presence of phenolic compounds, in which the major are ellagic acid derivatives (sanguiin hlO) followed by tlavan 3-ols ((+)catechin) and anthocyanin compounds (pelargonidin-3-glucoside). Although fruits of wild F. vesca are mainly consumed in fresh, this study also proves the potentiality of their infusions as a source of bioactive molecules and properties.

Youth-Physical Activity Towards Health: evidence and background to the development of the Y-PATH physical activity intervention for adolescents

Background: Despite known benefits of regular physical activity for health and well-being, many studies suggest that levels of physical activity in young people are low, and decline dramatically during adolescence. The purpose of the current research was to gather data on adolescent youth in order to inform the development of a targeted physical activity intervention. Methods: Cross-sectional data on physical activity levels (using self report and accelerometry), psychological correlates of physical activity, anthropometic characteristics, and the fundamental movement skill proficiency of 256 youth (53% male, 12.40 ± 0.51 years) were collected. A subsample (n = 59) participated in focus group interviews to explore their perceptions of health and identify barriers and motivators to participation in physical activity. Results: Findings indicate that the majority of youth (67%) were not accumulating the minimum 60 minutes of physical activity recommended daily for health, and that 99.5% did not achieve the fundamental movement skill proficiency expected for their age. Body mass index data showed that 25% of youth were classified as overweight or obese. Self-efficacy and physical activity attitude scores were significantly different (p < 0.05) between low, moderate and high active participants. Active and inactive youth reported differences in their perceived understanding of health and their barriers to physical activity participation, with active youth relating nutrition, exercise, energy and sports with the definition of ‘being healthy’, and inactive youth attributing primarily nutritional concepts to ‘being healthy’. Conclusions: Data show a need for targeting low levels of physical activity in youth through addressing poor health related activity knowledge and low fundamental movement skill proficiency. The Y-PATH intervention was developed in accordance with the present study findings; details of the intervention format are presented.

Desórdenes muscoloesqueléticos en el trabajador avícola – intervenciones en salud

Introducción: El trabajador avícola presenta un alto riesgo de sufrir de Desórdenes Musculo esqueléticos, debido a la realización de trabajos manuales repetitivos; posición bípeda prolongada, posturas por fuera de ángulos de confort de miembros superiores Objetivo: Establecer las recomendaciones basadas en la evidencia de las intervenciones en salud para los Desórdenes Musculoesqueléticos (DME) en el trabajador avícola. Metodología: Se realizó una revisión de la literatura de los estudios primarios publicados en las bases de datos Medline, Scient Direct y Scielo desde 1990. Los artículos se clasificaron de acuerdo con: el tipo de estudio, la calidad de éste y el nivel de evidencia que aportaba. Resultados: Dentro de las recomendaciones de la evidencia disponible para el manejo integral de los pacientes de la industria avícola con riesgos o eventos asociados a DME se encuentran las siguientes: 1) incorporar un enfoque sistémico en la atención a dichos trabajadores, 2) incluir aspectos psicosociales en la identificación y explicación de los riesgos y eventos en salud, 3) permitir los descansos, microrupturas y pautas para el ejercicio, 4) facilitar la rotación y ampliación de puestos de trabajo, 5) mejorar las herramientas de trabajo - especialmente el corte de los cuchillos. Conclusiones: Las intervenciones descritas en la presente revisión, apuntan hacia el mejoramiento de la incidencia y la prevalencia de los DMS, la disminución de incapacidad temporal y definitiva por los DMS, el mejoramiento en la producción industrial y la reducción de costos tanto económicos como humanos. Sin embargo, se debe plantear la necesidad de continuar impulsando el desarrollo de investigaciones y estudios que permitan tener mayores elementos de juicio para poder realizar recomendaciones a los tipos de intervenciones propuestas. A pesar de lo anterior, las intervenciones en salud para los trabajadores de la industria avícola deben ser enfocadas desde la prestación integral de los servicios de salud.

Between the centre and the margins: Services location, economic (re)structuring and quality of life in metropolitan periurban areas.

This paper aims to discuss the specificities of the role of services in the economic structuring and in the social liveliness and attractiveness of periurban areas. Drawing upon on the result of an empirical work developed in 5 different parishes of Lisbon Metropolitan area, which represent five categories of periurban spaces previously identified, it is analysed the role of services in these “in-between” territories and the way they are important in the spatial economic structuring of these areas and in the quality of life and well-being of their inhabitants and users. A tentative typology for framing the analysis of the role of services on periurban metropolitan spaces is suggested and some policy implications are pointed out.

WHEN GLOBAL CONSERVATION MEETS LOCAL LIVELIHOODS: PEOPLE AND PARKS IN CENTRAL AMERICA

SummaryNational park and related forest conservation efforts tend to emanate from core areas of the world and are often imposed on rural people living on forest fringes in the least developed regions of lesser developed countries. We address the social and cultural processes that ensue when center-originatingconservation meets local people with their resource-dependent livelihoods, and how these vary under different circumstances. We examine and compare local people’s environmental andforest-related values and behaviors, using cultural models, after the establishment of national parks in two countries with very different social and environmental histories—Costa Rica and Honduras. We find that external cultural models were widely adopted by local people—hegemonic to the extent of structuring even discourse opposing conservation. Local people often expressed environmental values, but used formulaic language that suggested that these values were not well integrated with other aspects of their life and often not motivating. We pay particular attention to relationships between environmental values and livelihood values, and the varying ways that new, local environmental discourses and values emerge that mediate between these often conflicting value spheres.The recent international increase in national parks is a phenomenon of globalization, and often imposes new conservation practices and environmental values onto local people. While these new national parks have some broad public benefits that can be thought of as global, e.g. their role in preventing biodiversity loss and climate change, it is also true that few concrete benefits accrue to local people and that parks often impose great costs on local people in the form of lost land, diminished access to resources, and diminished autonomy as national governments and internationalorganizations extend into local life in new ways.These changes have serious repercussions for local people, often threatening their livelihoods and well-being in significant ways. Yet our results suggest that local people may be willing to work with park managers to co-inhabit landscapes when park managers are able to accommodate local livelihood needs.Keywords: National parks, Central America, Costa Rica, Honduras, forest conservationResumenLos parques nacionales y otros esfuerzos de conservación forestal tienden a surgir en las principales áreas núcleo del mundo, y por lo general son impuestos a los pobladores de espacios rurales que habitan franjas forestales de los países en vías de desarrollo.Este artículo se enfoca en los procesos sociales y culturales que se originan a partir de la imposición de estas áreas de conservación y sobre cómo se ve afectada la subsistencia de los pobladores que dependen de los recursos naturales de dichas áreas. También se evalúan y comparan los valores y comportamientos relacionados con el ambiente, percibidos por los pobladores con el establecimiento de parques nacionales, en dos países con historias sociales y ambientales muy diferentes como lo son Costa Rica y Honduras; para lo cual se utilizaron modelos culturales. Al respecto, se encontró que varios modelos culturales externos, que fueron ampliamente adoptados por los pobladores locales, han llegado a ser hegemónicos, afectando la conservación. Los habitantes del lugar estaban disconformes con respecto a los nuevos valores ambientales, porque estos, por un lado, no estaban adecuadamente integrados con otros aspectos de su vida, y por la escasa motivación en materia de conservación ambiental.De esta forma, se resalta la relación entre los valores ambientales y los valores de sus forma de vida;entre las nuevas formas de ruptura y los valores emergentes que median entre la esfera de valores conflictivos.El reciente aumento internacional de parques naciones es un fenómeno de globalización, y en consecuencia, impone nuevas prácticas de conservación y valores ambientales a los habitantes de estas localidades. Mientras estos nuevos parques nacionales generan algunas ventaja públicas, que pueden ser pensadas como globales (p.ej. su papel en la prevención de la pérdida de diversidad biológica y el cambio de clima), también ocasionan escasos beneficios para las comunidades, al imponer elevados costos para los pobladores locales como lo son: la pérdida de tierras, la disminución en el acceso a los recursos y la reducción de la autonomía, ya sea ante el gobierno nacional u organizaciones internaciones que extienden sus acciones políticas a la vida local en todas sus nuevas formas. Estos cambios repercuten drásticamente en los habitantes del lugar, lo cual a menudo amenaza, en general, el sustento y el bienestar, de modo significativo.Los resultados sugieren que los habitantes del lugar podrían estar dispuestos a trabajar con los gerentes del parque para co-habitar paisajes cuando éstos sean capaces de priorizar las necesidades de sobrevivencia de las formas de vida de los habitantes.Palabras clave: parques nacionales, América Central, Costa Rica, conservación forestal

Leonardo Ricci in the United States (1952-1972). A twenty-year American transfer as a turning experience in teaching and design.

The research solved the historiographic lacuna about Leonardo Ricci’s work in the United States focusing on the span 1952-1972 as a fundamental period for the architect's research, which moved from the project for the community space to macrostructures. The considered period is comprised between Ricci’s first travel to the United States and the date of his resignation from the University of Florida, one year before his resignation from the deanship of the faculty of architecture of Florence (1973). The research retraced philologically the stages of Ricci’s activity in the U.S.A. unveiling the premises and results of his American transfer, and to what extent it marked a turning period for his work as educator and designer and for the wider historiographic contest of the Sixties. The American transfer helped him grounding his belief in avoiding a priori morphological results in favor of what he called the “form-act” design method. Ricci’s research in the U.S.A. is described in his books Anonymous (XX century) and City of the Earth (unpublished). In them and in Ricci’s projects one common thread is traceable: the application of the “form-act” as the best tool to conceive urban design, a discipline established in the United States during Ricci’s first stay at M.I.T., in which he encountered the balance point between architecture and urban planning, between the architect’s sign and his being anonymous, between the collective and the individual dimension. With the notions of “anonymous architecture” and “form-act”, Urban Design and “open work” are the key words to understand Ricci’s work in the United States and in Italy. Urban design’s main goal to design the city as a collective work of art was the solution of that dychothomous research that enlivened Ricci’s work and one possible answer to that tension useful for him to seek the truth of architecture.

CO2 utilization and alternative solvents: effective tools for sustainable applications

The growing concentration of CO2 in the atmosphere and its harmful consequences has led the scientific community to direct its efforts towards sustainable processes. Among the possible approaches, the use of CO2 and alternative solvents are two strategies that are having widespread diffusion. In this work the reuse of CO2 is expressed by using it as a reaction reagent and as trigger to change the physical properties of a catalyst thus facilitating its recovery. As regards the CO2 use as reagent, two catalytic systems have been developed for the conversion of CO2 and epoxides into cyclic carbonates, used in the synthesis of polymers and as aprotic solvents. Homogeneous catalysts made by choline-based eutectic mixtures and heterogeneous catalysts made from biopolymers and waste pyrolysis have been synthesized and tested on this reaction. The carbonate interchange reaction (CIR) of a diol with a linear carbonate (as dimethyl carbonate) is an interesting alternative, for the synthesis of cyclic carbonates; as the second application of CO2 as polarity trigger, it was used for catalyst recovery. In fact DBU, here used as catalyst, is part of the so called “switchable solvents”: they can pass from a less-polar to a more-polar form (and from being soluble to non-soluble in the reaction mixture) when reacting with CO2 in presence of water or alcohols. Also in this case, heterogeneous catalysts made from biopolymers and waste pyrolysis have been synthesized and tested on CIR. As for the use of alternative solvents, this work focuses on the use of Deep Eutectic Solvents (DESs). They are a new generation of solvents composed by a mixture of two or more substances, liquid at room temperature, and non-volatile. New and biobased DESs were here used: i) as reaction media to carry out chemoenzymatic epoxidation; ii) in the extraction of astaxanthin from microalgae culture.

Integrating the age factor in designing industrial environments and workstations in the workforce ageing era

As people spend a third of their lives at work and, in most cases, indoors, the work environment assumes crucial importance. The continuous and dynamic interaction between people and the working environment surrounding them produces physiological and psychological effects on operators. Recognizing the substantial impact of comfort and well-being on employee satisfaction and job performance, the literature underscores the need for industries to implement indoor environment control strategies to ensure long-term success and profitability. However, managing physical risks (i.e., ergonomic and microclimate) in industrial environments is often constrained by production and energy requirements. In the food processing industry, for example, the safety of perishable products dictates storage temperatures that do not allow for operator comfort. Conversely, warehouses dedicated to non-perishable products often lack cooling systems to limit energy expenditure, reaching high temperatures in the summer period. Moreover, exceptional events, like the COVID-19 pandemic, introduce new constraints, with recommendations impacting thermal stress and respiratory health. Furthermore, the thesis highlights how workers' variables, particularly the aging process, reduce tolerance to environmental stresses. Consequently, prolonged exposure to environmental stress conditions at work results in cardiovascular disease and musculoskeletal disorders. In response to the global trend of an aging workforce, the thesis bridges a literature gap by proposing methods and models that integrate the age factor into comfort assessment. It aims to present technical and technological solutions to mitigate microclimate risks in industrial environments, ultimately seeking innovative ways to enhance the aging workforce's comfort, performance, experience, and skills. The research outlines a logical-conceptual scheme with three main areas of focus: analyzing factors influencing the work environment, recognizing constraints to worker comfort, and designing solutions. The results significantly contribute to science by laying the foundation for new research in worker health and safety in an ageing working population's extremely current industrial context.

O papel da propriocepção no desenvolvimento da força muscular e da flexibilidade

Universidade Estadual de Campinas . Faculdade de Educação Física

Homo-motor, ciborgues e... aha! pessoas : da revolução industrial a revolução da informação

Universidade Estadual de Campinas . Faculdade de Educação Física

Estrategias organizacionais para a promoção de saude e qualidade de vida : avaliando a qualidade de vida no trabalho

Universidade Estadual de Campinas . Faculdade de Educação Física