811 resultados para Pre-test counselling


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Background: Walking speed seems to be related to aerobic capacity, lower limb strength, and functional mobility, however it is not clear whether there is a direct relationship between improvement in muscle strength and gait performance in early postmenopausal women. Objective: To evaluate the effect of muscle strengthening exercises on the performance of the 6-minute walk test in women within 5 years of menopause. Methods: The women were randomized into control group (n=31), which performed no exercise, and exercise group (n=27), which performed muscle strengthening exercises. The exercises were performed twice a week for 3 months. The exercise protocol consisted of warm-up, stretching, and strengthening of the quadriceps, hamstring, calf, tibialis anterior, gluteus maximus, and abdominal muscles, followed by relaxation. Muscular strength training started with 60% of 1MR (2 series of 10-15 repetitions), reaching 85% until the end of the 3-month period (4 series of 6 repetitions each). Results: The between-group comparisons pre- and post-intervention did not show any difference in distance walked, heart rate or blood pressure (p>0.05), but showed differences in muscle strength post-intervention, with the exercise group showing greater strength (p<0.05). In the within-group comparison, there were differences in final heart rate and quadriceps and hamstring strength pre- and post-intervention in the exercise group (p<0.05). Conclusion: The results suggest that muscle strengthening of the lower limbs did not improve performance in the 6-minute walk test in this population of postmenopausal women. Trial registration ACTRN12609001053213.

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Objective: This ex vivo study evaluated the effect of pre-flaring and file size on the accuracy of the Root ZX and Novapex electronic apex locators (EALs). Material and methods: The actual working length (WL) was set 1 mm short of the apical foramen in the palatal root canals of 24 extracted maxillary molars. The teeth were embedded in an alginate mold, and two examiners performed the electronic measurements using #10, #15, and #20 K-files. The files were inserted into the root canals until the "0.0" or "APEX" signals were observed on the LED or display screens for the Novapex and Root ZX, respectively, retracting to the 1.0 mark. The measurements were repeated after the pre-flaring using the S1 and SX Pro-Taper instruments. Two measurements were performed for each condition and the means were used. Intra-class correlation coefficients (ICCs) were calculated to verify the intra-and inter-examiner agreement. The mean differences between the WL and electronic length values were analyzed by the three-way ANOVA test (p<0.05). Results: ICCs were high (>0.8) and the results demonstrated a similar accuracy for both EALs (p>0.05). Statistically significant accurate measurements were verified in the pre-flared canals, except for the Novapex using a #20 K-file. Conclusions: The tested EALs showed acceptable accuracy, whereas the pre-flaring procedure revealed a more significant effect than the used file size.

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Bertuzzi, R, Franchini, E, Tricoli, V, Lima-Silva, AE, Pires, FDO, Okuno, NM, and Kiss, MAPDM. Fit-climbing test: A field test for indoor rock climbing. J Strength Cond Res 26(6): 1558-1563, 2012-The aim of this study was to develop an indoor rock-climbing test on an artificial wall (Fit-climbing test). Thirteen climbers (elite group [EG] = 6; recreational group [RG] = 7) performed the following tests: (a) familiarization in the Fitclimbing test, (b) the Fit-climbing test, and (c) a retest to evaluate the Fit-climbing test's reliability. Gas exchange, blood lactate concentration, handgrip strength, and heart rate were measured during the test. Oxygen uptake during the Fit-climbing test was not different between groups (EG = 8.4 +/- 1.1 L; RG = 7.9 +/- 1.5 L, p > 0.05). The EG performance (120 +/- 7 movements) was statistically higher than the RG climbers' performance (78 +/- 13 movements) during the Fit-climbing test. Consequently, the oxygen cost per movement during the Fit-climbing test of the EG was significantly lower than that of the RG (p < 0.05). Handgrip strength was higher in the EG when compared with that in the RG in both pre-Fit- and post-Fit-climbing test (p < 0.05). There were no significant differences in any other variables analyzed during the Fit-climbing test (p > 0.05). Furthermore, the performance in the Fit-climbing test presented high reliability (intraclass correlation coefficient = 0.97). Therefore, the performance during the Fit-climbing test may be an alternative to evaluate rock climbers because of its specificity and relation to oxygen cost per movement during climbing.

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Masonry spandrels together with shear walls are structural components of a masonry building subjected to lateral loads. Shear walls are the main components of this structural system, even if masonry spandrels are the elements that ensure the connection of shear wall panels and the distribution of stresses through the masonry piers. The use of prefabricated truss type bars in the transversal and longitudinal directions is usually considered a challenge, even if the simplicity of the applications suggested here alleviate some of the possible difficulties. This paper focus on the experimental behavior of masonry spandrels reinforced with prefabricated trusses, considering different possibilities for the arrangement of reinforcement and blocks. Reinforced spandrels with three and two hollow cell concrete blocks and with different reinforcement ratios have been built and tested using a four and three point loading test configuration. Horizontal bed joint reinforcement increased the capacity of deformation as well as the ultimate load, leading to ductile responses. Vertical reinforcement increased the shear strength of the masonry spandrels and its distribution play a central role on the shear behavior. (C) 2011 Elsevier Ltd. All rights reserved.

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The influence of test method factors (notch shape, square or angular, and pre-cracking method, by tapping onto or pressing a razor blade) on the results obtained in plane strain fracture toughness test according to standard ASTM D5045 using SENB specimens made of a commercial PMMA resin were investigated. Results were analyzed quantitatively by comparing the obtained K-IC values and qualitatively by observing their effect on the Moire fringes observed using photoelasticity, showing that, at 95% significance level, the K-IC values are affected by the pre-cracking method, with the most conservative value being obtained when natural pre-cracks were introduced by tapping onto a razor blade (K-IC = 1.15 +/- 0.11 MPa.m(0.5)). This correlates with a perturbation in the stress field close to the pre-crack tip observed in the photoelasticity test sample when it was introduced by pressing the razor blade. Surprisingly, notch geometry only slightly affects the results. (C) 2012 Elsevier Ltd. All rights reserved.

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During the last decade peach and nectarine fruit have lost considerable market share, due to increased consumer dissatisfaction with quality at retail markets. This is mainly due to harvesting of too immature fruit and high ripening heterogeneity. The main problem is that the traditional used maturity indexes are not able to objectively detect fruit maturity stage, neither the variability present in the field, leading to a difficult post-harvest management of the product and to high fruit losses. To assess more precisely the fruit ripening other techniques and devices can be used. Recently, a new non-destructive maturity index, based on the vis-NIR technology, the Index of Absorbance Difference (IAD), that correlates with fruit degreening and ethylene production, was introduced and the IAD was used to study peach and nectarine fruit ripening from the “field to the fork”. In order to choose the best techniques to improve fruit quality, a detailed description of the tree structure, of fruit distribution and ripening evolution on the tree was faced. More in details, an architectural model (PlantToon®) was used to design the tree structure and the IAD was applied to characterize the maturity stage of each fruit. Their combined use provided an objective and precise evaluation of the fruit ripening variability, related to different training systems, crop load, fruit exposure and internal temperature. Based on simple field assessment of fruit maturity (as IAD) and growth, a model for an early prediction of harvest date and yield, was developed and validated. The relationship between the non-destructive maturity IAD, and the fruit shelf-life, was also confirmed. Finally the obtained results were validated by consumer test: the fruit sorted in different maturity classes obtained a different consumer acceptance. The improved knowledge, leaded to an innovative management of peach and nectarine fruit, from “field to market”.

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The dynamics of a passive back-to-back test rig have been characterised, leading to a multi-coordinate approach for the analysis of arbitrary test configurations. Universal joints have been introduced into a typical pre-loaded back-to-back system in order to produce an oscillating torsional moment in a test specimen. Two different arrangements have been investigated using a frequency-based sub-structuring approach: the receptance method. A numerical model has been developed in accordance with this theory, allowing interconnection of systems with two-coordinates and closed multi-loop schemes. The model calculates the receptance functions and modal and deflected shapes of a general system. Closed form expressions of the following individual elements have been developed: a servomotor, damped continuous shaft and a universal joint. Numerical results for specific cases have been compared with published data in literature and experimental measurements undertaken in the present work. Due to the complexity of the universal joint and its oscillating dynamic effects, a more detailed analysis of this component has been developed. Two models have been presented. The first represents the joint as two inertias connected by a massless cross-piece. The second, derived by the dynamic analysis of a spherical four-link mechanism, considers the contribution of the floating element and its gyroscopic effects. An investigation into non-linear behaviour has led to a time domain model that utilises the Runge-Kutta fourth order method for resolution of the dynamic equations. It has been demonstrated that the torsional receptances of a universal joint, derived using the simple model, result in representation of the joint as an equivalent variable inertia. In order to verify the model, a test rig has been built and experimental validation undertaken. The variable inertia of a universal joint has lead to a novel application of the component as a passive device for the balancing of inertia variations in slider-crank mechanisms.

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Il lavoro di questa tesi riguarda principalmente la progettazione, simulazione e test di laboratorio di tre versioni successive di schede VME, chiamate Read Out Driver (ROD), che sono state fabbricate per l'upgrade del 2014 dell'esperimento ATLAS Insertable B-Layer (IBL) al CERN. IBL è un nuovo layer che diverrà parte del Pixel Detector di ATLAS. Questa tesi si compone di una panoramica descrittiva dell'esperimento ATLAS in generale per poi concentrarsi sulla descrizione del layer specifico IBL. Inoltre tratta in dettaglio aspetti fisici e tecnici: specifiche di progetto, percorso realizzativo delle schede e test conseguenti. Le schede sono state dapprima prodotte in due prototipi per testare le prestazioni del sistema. Queste sono state fabbricate al fine di valutare le caratteristiche e prestazioni complessive del sistema di readout. Un secondo lotto di produzione, composto di cinque schede, è stato orientato alla correzione fine delle criticità emerse dai test del primo lotto. Un'indagine fine e approfondita del sistema ha messo a punto le schede per la fabbricazione di un terzo lotto di altre cinque schede. Attualmente la produzione è finita e complessivamente sono state realizzate 20 schede definitive che sono in fase di test. La produzione sarà validata prossimamente e le 20 schede verranno consegnate al CERN per essere inserite nel sistema di acquisizione dati del rivelatore. Al momento, il Dipartimento di Fisica ed Astronomia dell'Università di Bologna è coinvolto in un esperimento a pixel solamente attravers IBL descritto in questa tesi. In conclusione, il lavoro di tesi è stato prevalentemente focalizzato sui test delle schede e sul progetto del firmware necessario per la calibrazione e per la presa dati del rivelatore.

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Nelle matrici ambientali sono spesso presenti xenoestrogeni, molecole sintetiche o di origine naturale ad attività estrogenica in grado di alterare il normale equilibrio ormonale di organismi esposti, incidendo negativamente su alcune funzioni vitali come la riproduzione ed il metabolismo. Diverse sostanze chimiche presenti in ambiente, tra cui alcune molecole ad attività estrogenica, sono anche potenziali composti genotossici, in grado, cioè, di interagire con il DNA ed esercitare effetti anche a lungo termine come l’insorgenza di tumori nei vertebrati, uomo compreso. L’obiettivo del presente lavoro di tesi è stato quello di mettere a punto ed utilizzare due saggi biologici, il saggio E-screen ed il test dei micronuclei, per valutare la presenza di xenoestrogeni e composti genotossici in campioni di acque prelevate prima e dopo i trattamenti di potabilizzazione, utilizzando cellule MCF-7 di adenocarcinoma mammario come modello sperimentale in vitro. Le indagini biologiche sono state condotte sulla base di una convenzione di ricerca con la Società acquedottistica Romagna Acque- Società delle fonti e hanno previsto tre campagne di monitoraggio. I campioni di acqua sperimentale, raccolti prima e dopo i trattamenti presso diversi impianti di potabilizzazione, sono stati preventivamente filtrati, estratti in fase solida, fatti evaporare sotto leggero flusso di azoto, ed infine, saggiati sulle cellule. Il test E-screen, di cui abbiamo dimostrato un elevato livello di sensibilità, ha permesso di escludere la presenza di composti ad attività estrogenica nei campioni esaminati. Allo stesso modo, i risultati del test dei micronuclei hanno dimostrato l’assenza di effetti genotossici, confermando la buona qualità delle acque analizzate. Nell’ambito delle attività di monitoraggio, le indagini biologiche risultano essenziali per la valutazione di una potenziale contaminazione ambientale, in quanto forniscono informazioni anche quando non sono state condotte analisi chimiche. Inoltre, anche quando le analisi chimiche siano state condotte, i test biologici informano della potenzialità tossica di una matrice causata eventualmente da sostanze non oggetto del saggio chimico. Infine, i test biologici permettono di identificare eventuali sinergie tra più contaminanti presenti nelle acque, affermandosi come test da condurre in maniera complementare ai saggi chimici. I test biologici come quelli impiegati nel lavoro di tesi sono molto sensibili ed informativi, ma necessitano della definizione di protocolli standardizzati per garantirne un’uniforme applicazione alle acque ad uso potabile, almeno a livello nazionale.

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Objectives: Previous research conducted in the late 1980s suggested that vehicle impacts following an initial barrier collision increase severe occupant injury risk. Now over 25years old, the data are no longer representative of the currently installed barriers or the present US vehicle fleet. The purpose of this study is to provide a present-day assessment of secondary collisions and to determine if current full-scale barrier crash testing criteria provide an indication of secondary collision risk for real-world barrier crashes. Methods: To characterize secondary collisions, 1,363 (596,331 weighted) real-world barrier midsection impacts selected from 13years (1997-2009) of in-depth crash data available through the National Automotive Sampling System (NASS) / Crashworthiness Data System (CDS) were analyzed. Scene diagram and available scene photographs were used to determine roadside and barrier specific variables unavailable in NASS/CDS. Binary logistic regression models were developed for second event occurrence and resulting driver injury. To investigate current secondary collision crash test criteria, 24 full-scale crash test reports were obtained for common non-proprietary US barriers, and the risk of secondary collisions was determined using recommended evaluation criteria from National Cooperative Highway Research Program (NCHRP) Report 350. Results: Secondary collisions were found to occur in approximately two thirds of crashes where a barrier is the first object struck. Barrier lateral stiffness, post-impact vehicle trajectory, vehicle type, and pre-impact tracking conditions were found to be statistically significant contributors to secondary event occurrence. The presence of a second event was found to increase the likelihood of a serious driver injury by a factor of 7 compared to cases with no second event present. The NCHRP Report 350 exit angle criterion was found to underestimate the risk of secondary collisions in real-world barrier crashes. Conclusions: Consistent with previous research, collisions following a barrier impact are not an infrequent event and substantially increase driver injury risk. The results suggest that using exit-angle based crash test criteria alone to assess secondary collision risk is not sufficient to predict second collision occurrence for real-world barrier crashes.

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Background Replicative phenotypic HIV resistance testing (rPRT) uses recombinant infectious virus to measure viral replication in the presence of antiretroviral drugs. Due to its high sensitivity of detection of viral minorities and its dissecting power for complex viral resistance patterns and mixed virus populations rPRT might help to improve HIV resistance diagnostics, particularly for patients with multiple drug failures. The aim was to investigate whether the addition of rPRT to genotypic resistance testing (GRT) compared to GRT alone is beneficial for obtaining a virological response in heavily pre-treated HIV-infected patients. Methods Patients with resistance tests between 2002 and 2006 were followed within the Swiss HIV Cohort Study (SHCS). We assessed patients' virological success after their antiretroviral therapy was switched following resistance testing. Multilevel logistic regression models with SHCS centre as a random effect were used to investigate the association between the type of resistance test and virological response (HIV-1 RNA <50 copies/mL or ≥1.5log reduction). Results Of 1158 individuals with resistance tests 221 with GRT+rPRT and 937 with GRT were eligible for analysis. Overall virological response rates were 85.1% for GRT+rPRT and 81.4% for GRT. In the subgroup of patients with >2 previous failures, the odds ratio (OR) for virological response of GRT+rPRT compared to GRT was 1.45 (95% CI 1.00-2.09). Multivariate analyses indicate a significant improvement with GRT+rPRT compared to GRT alone (OR 1.68, 95% CI 1.31-2.15). Conclusions In heavily pre-treated patients rPRT-based resistance information adds benefit, contributing to a higher rate of treatment success.

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Previous research conducted in the late 1980’s suggested that vehicle impacts following an initial barrier collision increase severe occupant injury risk. Now over twenty-five years old, the data used in the previous research is no longer representative of the currently installed barriers or US vehicle fleet. The purpose of this study is to provide a present-day assessment of secondary collisions and to determine if full-scale barrier crash testing criteria provide an indication of secondary collision risk for real-world barrier crashes. The analysis included 1,383 (596,331 weighted) real-world barrier midsection impacts selected from thirteen years (1997-2009) of in-depth crash data available through the National Automotive Sampling System (NASS) / Crashworthiness Data System (CDS). For each suitable case, the scene diagram and available scene photographs were used to determine roadside and barrier specific variables not available in NASS/CDS. Binary logistic regression models were developed for second event occurrence and resulting driver injury. Barrier lateral stiffness, post-impact vehicle trajectory, vehicle type, and pre-impact tracking conditions were found to be statistically significant contributors toward secondary event occurrence. The presence of a second event was found to increase the likelihood of a serious driver injury by a factor of seven compared to cases with no second event present. Twenty-four full-scale crash test reports were obtained for common non-proprietary US barriers, and the risk of secondary collisions was determined using recommended evaluation criteria from NCHRP Report 350. It was found that the NCHRP Report 350 exit angle criterion alone was not sufficient to predict second collision occurrence for real-world barrier crashes.

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BACKGROUND AND AIM: We have previously shown in a rat model of focal cerebral ischemia that sleep deprivation after stroke onset aggravates brain damage. Others reported that sleep deprivation prior to stroke is neuroprotective. The main aim of this study was to test the hypothesis that the neuroprotection may be related to an increase in sleep (sleep rebound) during the acute phase of stroke. METHODS: Male Sprague Dawley rats (n=36) were subjected to continuous polygraphic recordings for baseline, total sleep deprivation (TSD), and 24h after ischemia. TSD for 6h was performed by gentle handling and immediately followed by ischemia. Focal cerebral ischemia was induced by permanent occlusion of distal branches of the middle cerebral artery. Control experiments included ischemia without SD (nSD) and sham surgery with TSD (n=6/group). RESULTS: Shortly after stroke, the amount of slow wave sleep (SWS) and paradoxical sleep (PS) increased significantly (p<0.05) in the TSD/ischemia, resulting in an increase in the total sleep time by 30% compared to baseline, or by 20% compared with the nSD/ischemia group. The infarct volume decreased significantly by 50% in the TSD/ischemia compared to nSD group (p<0.02). Removal of sleep rebound by allowing TSD-rats sleep for 24h before ischemia eliminated the reduction in the infarct size. CONCLUSION PRESTROKE: Sleep deprivation results in sleep rebound and reduces brain damage. Sleep rebound may be causally related to the neuroprotection.

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RESEARCH QUESTIONS: To investigate how the daily physical activities of elderly patients can be enhanced by systematic counselling conducted by general practitioners (GPs). METHODS: In this feasibility study with pre-post design, 29 people (14 females, mean age 72.2 years, SD = 6.1) were enrolled during routine visits by two general practitioners. A baseline assessment of current physical activity based on the stages according to the Transtheoretical Model was followed by a counselling session. The target behaviour was defined by performance of 30 minutes of daily moderate-intensity activities that increase the breathing rate, on five days per week. At the 2-month follow-up, subjects were assessed for improvement in stage of physical activity since baseline. After the end of the intervention, participating GPs and patients were asked questions focusing on the feasibility, acceptance and usefulness of counselling. RESULTS: Interview results showed that the two GPs considered the counselling protocol easy to handle and useful for promoting physical activity. Counselling sessions were especially encouraging for the not sufficiently active people. Most of them would like to have additional counselling session. At baseline, 9 of 29 people were sufficiently active. After 2 months, this proportion was 21 of 29. The mean of the number of minutes of physical activity during the previous 4 weeks increased from 247 to 436 minutes (weekly). CONCLUSIONS: The programme was judged positively by the general practitioners and the participating elderly patients. Systematic counselling by general practitioners led to an increase in the physical activity behaviour. Therefore, a more rigorous randomised controlled trial with adequate followup is recommended.

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BACKGROUND In adults it is well documented that there are substantial losses to the programme between HIV testing and start of antiretroviral therapy (ART). The magnitude and reasons for loss to follow-up and death between HIV diagnosis and start of ART in children are not well defined. METHODS We searched the PubMed and EMBASE databases for studies on children followed between HIV diagnosis and start of ART in low-income settings. We examined the proportion of children with a CD4 cell count/percentage after after being diagnosed with HIV infection, the number of treatment-eligible children starting ART and predictors of loss to programme. Data were extracted in duplicate. RESULTS Eight studies from sub-Saharan Africa and two studies from Asia with a total of 10,741 children were included. Median age ranged from 2.2 to 6.5 years. Between 78.0 and 97.0% of HIV-infected children subsequently had a CD4 cell count/percentage measured, 63.2 to 90.7% of children with an eligibility assessment met the eligibility criteria for the particular setting and time and 39.5 to 99.4% of the eligible children started ART. Three studies reported an association between low CD4 count/percentage and ART initiation while no association was reported for gender. Only two studies reported on pre-ART mortality and found rates of 13 and 6 per 100 person-years. CONCLUSION Most children who presented for HIV care met eligibility criteria for ART. There is an urgent need for strategies to improve the access to and retention to care of HIV-infected children in resource-limited settings.