Functional outcome and health-related quality of life after traumatic brain injury in the framework of the International Classification of Functioning, Disability and Health (ICF)

Traumatic brain injury (TBI) affects people of all ages and is a cause of long-term disability. In recent years, the epidemiological patterns of TBI have been changing. TBI is a heterogeneous disorder with different forms of presentation and highly individual outcome regarding functioning and health-related quality of life (HRQoL). The meaning of disability differs from person to person based on the individual s personality, value system, past experience, and the purpose he or she sees in life. Understanding of all these viewpoints is needed in comprehensive rehabilitation. This study examines the epidemiology of TBI in Finland as well as functioning and HRQoL after TBI, and compares the subjective and objective assessments of outcome. The frame of reference is the International Classification of Functioning, Disability and Health (ICF). The subjects of Study I represent the population of Finnish TBI patients who experienced their first TBI between 1991 and 2005. The 55 Finnish subjects of Studies II and IV participated in the first wave of the international Quality of life after brain injury (QOLIBRI) validation study. The 795 subjects from six language areas of Study III formed the second wave of the QOLIBRI validation study. The average annual incidence of Finnish hospitalised TBI patients during the years 1991-2005 was 101:100 000 in patients who had TBI as the primary diagnosis and did not have a previous TBI in their medical history. Males (59.2%) were at considerably higher risk of getting a TBI than females. The most common external cause of the injury was falls in all age groups. The number of TBI patients ≥ 70 years of age increased by 59.4% while the number of inhabitants older than 70 years increased by 30.3% in the population of Finland during the same time period. The functioning of a sample of 55 persons with TBI was assessed by extracting information from the patients medical documents using the ICF checklist. The most common problems were found in the ICF components of Body Functions (b) and Activities and Participation (d). HRQoL was assessed with the QOLIBRI which showed the highest level of satisfaction on the Emotions, Physical Problems and Daily Life and Autonomy scales. The highest scores were obtained by the youngest participants and participants living independently without the help of other people, and by people who were working. The relationship between the functional outcome and HRQoL was not straightforward. The procedure of linking the QOLIBRI and the GOSE to the ICF showed that these two outcome measures cover the relevant domains of TBI patients functioning. The QOLIBRI provides the patients subjective view, while the GOSE summarises the objective elements of functioning. Our study indicates that there are certain domains of functioning that are not traditionally sufficiently documented but are important for the HRQoL of persons with TBI. This was the finding especially in the domains of interpersonal relationships, social and leisure activities, self, and the environment. Rehabilitation aims to optimize functioning and to minimize the experience of disability among people with health conditions, and it needs to be based on a comprehensive understanding of human functioning. As an integrative model, the ICF may serve as a frame of reference in achieving such an understanding.

Simulation-driven design of helmets for head impact protection using an injury-based criterion

The current paper suggests a new procedure for designing helmets for head impact protection for users such as motorcycle riders. According to the approach followed here, a helmet is mounted on a featureless Hybrid 3 headform that is used in assessing vehicles for compliance to the FMVSS 201 regulation in the USA for upper interior head impact safety. The requirement adopted in the latter standard, i.e. not exceeding a threshold HIC(d) limit of 1000, is applied in the present study as a likely criterion for adjudging the efficacy of helmets. An impact velocity of 6 m/s (13.5 mph) for the helmet-headform system striking a rigid target can probably be acceptable for ascertaining a helmet's effectiveness as a countermeasure for minimizing the risk of severe head injury. The proposed procedure is demonstrated with the help of a validated LS-DYNA model of a featureless Hybrid 3 headform in conjunction with a helmet model comprising an outer polypropylene shell to the inner surface of which is bonded a protective polyurethane foam padding of a given thickness. Based on simulation results of impact on a rigid surface, it appears that a minimum foam padding thickness of 40 mm is necessary for obtaining an acceptable value of HIC(d).

Changes in Behavior, Movement, and Home Ranges of Largemouth Bass Following Large-scale Hydrilla Removal in Lake Seminole, Georgia

About 1,200 ha of hydrilla ( Hydrilla verticillata L.f. Royle) was eliminated in the Spring Creek embayment of Lake Seminole, Georgia, using a drip-delivery application of fluridone (1- methyl-3-phenyl-5-[3-(trifluoromethl) phenyl]-4(1H)-pyridinone) in 2000 and 2001. Two groups of 15 and 20 largemouth bass (Micropterus salmoides Lacepede) were implanted with 400-day radio tags in February 2000 and 2001 to determine changes in movement and behavior before and after hydrilla reduction.(PDF contains 8 pages.)

The Rain Forests of Home: an Atlas of People and Place

pdf contains 31 pages

Home-Automation System

Nuestro proyecto trata de obtener un sistema centralizado para el manejo y monitorización de un conjunto de aparatos eléctricos del hogar, tales como luces, cámaras, sensores, y otros aparatos mediante una aplicación para dispositivos móviles Android. También se facilita una herramienta web para administrar dichos aparatos. Nuestro sistema da soporte al manejo individual y manual de estos aparatos, por ejemplo encender una lámpara, así como la posibilidad de incluir programas que se ejecuten a una determinada hora, y con una determinada recurrencia. Por ejemplo, se puede programar el encendido de una luz todos los días a las 20:00. Además, también se pueden crear reglas que, dado una determinada situación, realicen una serie de acciones. Por ejemplo, si se detecta que la luminosidad baja de cierto valor (detectado mediante un sensor de luz), se encienda una lámpara. Para conseguir esto se ha realizado una aplicación centralizada, a modo de servidor, que se comunica con los aparatos eléctricos mediante diferentes protocolos de comunicación, así como con el dispositivo móvil Android, y una aplicación web administrativa, a través de un portal de servicios web.

Spinal cord injury therapy through active learning

Therapy employing epidural electrostimulation holds great potential for improving therapy for patients with spinal cord injury (SCI) (Harkema et al., 2011). Further promising results from combined therapies using electrostimulation have also been recently obtained (e.g., van den Brand et al., 2012). The devices being developed to deliver the stimulation are highly flexible, capable of delivering any individual stimulus among a combinatorially large set of stimuli (Gad et al., 2013). While this extreme flexibility is very useful for ensuring that the device can deliver an appropriate stimulus, the challenge of choosing good stimuli is quite substantial, even for expert human experimenters. To develop a fully implantable, autonomous device which can provide useful therapy, it is necessary to design an algorithmic method for choosing the stimulus parameters. Such a method can be used in a clinical setting, by caregivers who are not experts in the neurostimulator's use, and to allow the system to adapt autonomously between visits to the clinic. To create such an algorithm, this dissertation pursues the general class of active learning algorithms that includes Gaussian Process Upper Confidence Bound (GP-UCB, Srinivas et al., 2010), developing the Gaussian Process Batch Upper Confidence Bound (GP-BUCB, Desautels et al., 2012) and Gaussian Process Adaptive Upper Confidence Bound (GP-AUCB) algorithms. This dissertation develops new theoretical bounds for the performance of these and similar algorithms, empirically assesses these algorithms against a number of competitors in simulation, and applies a variant of the GP-BUCB algorithm in closed-loop to control SCI therapy via epidural electrostimulation in four live rats. The algorithm was tasked with maximizing the amplitude of evoked potentials in the rats' left tibialis anterior muscle. These experiments show that the algorithm is capable of directing these experiments sensibly, finding effective stimuli in all four animals. Further, in direct competition with an expert human experimenter, the algorithm produced superior performance in terms of average reward and comparable or superior performance in terms of maximum reward. These results indicate that variants of GP-BUCB may be suitable for autonomously directing SCI therapy.

The home range of the signal crayfish in a British lowland river

The signal crayfish Pacifastacus leniusculus (Dana), a native of north-western North America, is now a common resident in some British fresh waters following its introduction to England in 1976 (Lowery & Holdich 1988). In 1984, signal crayfish were introduced into the River Great Ouse, the major lowland river in southern central England, where they have established a large breeding population. This study examines two sites near Thornborough Weir. For the measurement and description of home range a new eletronic microchip system and a modified capture-mark-recapture method were employed. Signal crayfish were marked or tagged to see if they gradually moved away from their burrows. This method proved to be successful for estimating population densities when a section of river is divided into several equidistant linear ”locations”.

Simulation of shock-induced bubble collapse with application to vascular injury in shockwave lithotripsy

Shockwave lithotripsy is a noninvasive medical procedure wherein shockwaves are repeatedly focused at the location of kidney stones in order to pulverize them. Stone comminution is thought to be the product of two mechanisms: the propagation of stress waves within the stone and cavitation erosion. However, the latter mechanism has also been implicated in vascular injury. In the present work, shock-induced bubble collapse is studied in order to understand the role that it might play in inducing vascular injury. A high-order accurate, shock- and interface-capturing numerical scheme is developed to simulate the three-dimensional collapse of the bubble in both the free-field and inside a vessel phantom. The primary contributions of the numerical study are the characterization of the shock-bubble and shock-bubble-vessel interactions across a large parameter space that includes clinical shockwave lithotripsy pressure amplitudes, problem geometry and tissue viscoelasticity, and the subsequent correlation of these interactions to vascular injury. Specifically, measurements of the vessel wall pressures and displacements, as well as the finite strains in the fluid surrounding the bubble, are utilized with available experiments in tissue to evaluate damage potential. Estimates are made of the smallest injurious bubbles in the microvasculature during both the collapse and jetting phases of the bubble's life cycle. The present results suggest that bubbles larger than 1 μm in diameter could rupture blood vessels under clinical SWL conditions.

Home range and habitat use by Kemp's Ridley turtles in West-Central Florida

The Kemp's ridley turtle (Lepidochelys kempii) is an endangered species whose recovery depends in part on the identification and protection of required habitats. We used radio and sonic telemetry on subadult Kemp's ridley turtles to investigate home-range size and habitat use in the coastal waters of west-central Florida from 1994 to 1996. We tracked 9 turtles during May-August up to 70 days after release and fou.ld they occupied 5-30 km2 foraging ranges. Compositional analyses indicated that turtles used rock outcroppings in their foraging ranges at a significantly higher proportion than expected. based on availability within the study area. Additionally. turtles used live bottom (e.g .• sessile invertebrates) and green macroalgae habitats significantly more than seagrass habitat. Similar studies are needed through'mt the Kemp's ridley turtles' range to investigate regional and stage-specific differences in habitat use. which can then be used to conserve important foraging areas.

Perinatal hipoxic ischemic injury in the auditory pathway and the effect of several neuroprotective agents

192 p.