The short-term impact of curative colorectal cancer treatment on physical activity, functional status and quality of life: A systematic review protocol

REVIEW QUESTION/OBJECTIVE The quantitative objectives are to identify the impact of curative colorectal cancer treatment (surgery or adjuvant therapy) on physical activity, functional status and quality of life within one year of treatment or diagnosis. INCLUSION CRITERIA Types of participants: This review will consider studies that include individuals aged 18 years and over who have been diagnosed with colorectal cancer. Types of intervention(s)/phenomena of interest: This review will consider studies that evaluate the impact of curative colorectal cancer treatment: surgery and/or adjuvant therapy. Types of outcomes: This review will consider studies that include the following outcome measures assessed within one year of diagnosis or treatment: Physical activity - any bodily movement produced by skeletal muscles resulting in energy expenditure. Physical activity is not exclusive to exercise; activities can also be walking, housework, occupational or leisure. Physical activity can be measured objectively using pedometers or accelerometers, or subjectively using self-reported measures. Functional status – measured as the capacity to perform all activities of daily living such as walking, showering, and eating; and instrumental activities of daily living such as (but not limited to) grocery shopping, housekeeping and laundry. Quality of life – defined as the individual meaning of mental, physical and psychosocial wellbeing, as measured by validated tools such as SF-36, EORTC-QLQ-C30, or FACT-C.

Effect of shoes' heel height on the energy cost during jogging

The purpose of this study is to examine the changes of energy cost during a high-heeled continuous jogging.Thirteen healthy female volunteers jointed in this study with heel height of the shoes varied from 1, 4.5 and 7 cm, respectively. Each subjects jogged on the treadmill with K4b2 portable gas analysis system. The results of this study showed that ventilnation, relative oxygen consumption and energy expenditure increased with the increase of heel height and these values shows significantly larger when the heel height reached to 7 cm. Present study suggest that wearing high heel shoes jogging could directly increase energy consumption, causing neuromuscular fatigue.

Numerical modelling of particle deposition in idealized porous channels

This project provides a steppingstone to comprehend the mechanisms that govern particulate fouling in metal foam heat exchangers. The method is based on development of an advanced Computational Fluid Dynamics model in addition to performing analytical validation. This novel method allows an engineer to better optimize heat exchanger designs, thereby mitigating fouling, reducing energy consumption caused by fouling, economize capital expenditure on heat exchanger maintenance, and reduce operation downtime. The robust model leads to the establishment of an alternative heat exchanger configuration that has lower pressure drop and particulate deposition propensity.

Nuori konservatiivi : Tuure Junnila ja hänen poliittinen toimintansa vuoteen 1956

Tuure Junnila, PhD (1910-1999) was one of Finland's most renowned conservative politicians of the post-war period. Junnila is remembered primarily as a persistent opponent of Urho Kekkonen, a long-term Member of Parliament, a conspicuous opposition member and a prolific political writer. Junnila's ideologies and political views were conservative, and he is one of the most outstanding figures in the history of the National Coalition Party. Junnila also made an extensive career outside of politics, first as an economist and then as an executive of Finland's leading commercial bank Kansallis-Osake-Pankki. The Young Conservative is a partial biography written using traditional historical research methods, which examines Junnila's personal history and his activity in public life up to 1956. The study begins by investigating Junnila's background through his childhood, school years, university studies and early professional career. It also looks at Junnila's work as an economist and practical banker. Particular attention is paid to Junnila's political work, constantly focusing on the following five often overlapping areas: (1) economic policy, (2) domestic policy, (3) foreign and security policy, (4) Junnila and Urho Kekkonen, (5) Junnila, the Coalition Party and Finnish conservatism. In his economic policy, Junnila emphasised the importance of economic stability, opposed socialisation and the growth of public expenditure, defended the free market system and private entrepreneurship, and demanded tax cuts. This policy was very popular within the Coalition Party during the early 1950s, making Junnila the leading conservative economic politician of the time. In terms of domestic policy, Junnila demanded as early as the 1940s that a "third force" should be established in Finland to counterbalance the agrarian and labour parties by uniting conservative and liberal ideologies under the same roof. Foreign and security policy is the area of Junnila's political activity which is most clearly situated after the mid-1950s. However, Junnila's early speeches and writings already show a striving towards the unconditional neutrality modelled by Switzerland and Sweden and a strong emphasis on Finland's right to internal self-determination. Junnila, as did the Coalition Party as a whole, adopted a consistently critical approach towards Urho Kekkonen between 1951 and 1956, but this attitude was not as bluntly negative and all-round antagonistic as many previous studies have implied. Junnila was one of the leading Finnish conservatives of the early 1950s and in all essence his views were analogous to the general alignment of the Coalition Party at the time: conservative in ideology and general policy, and liberal in economic policy.

Kuluttaminen ja ylhäisaatelin elämäntapa 1700-luvun Ruotsissa

Consumption and the lifestyle of the high nobility in eighteenth-century Sweden This monograph is an analysis of the lifestyle, consumption and private finances of the Swedish high nobility during the eighteenth century (ca 1730 1795). It describes the lifestyle of one noble house, the House of Fersen. The Fersen family represents the leading political, economic and cultural elite in eighteenth-century Sweden. The analysis concentrates on Count Carl von Fersen (1716 1786) and his brother Count Axel von Fersen (1719 1794), their spouses and children. Carl von Fersen was a courtier whilst Axel von Fersen was an officer and one of the leaders of the Francophile Hat party. His son, Axel von Fersen the younger, was in his time an officer and a favourite of Gustavus III, King of Sweden, as well as a favourite and trusted confidant of Marie-Antoinette, Queen of France. The research is based upon the Fersen family s private archives, the Counts personal account books, probate inventories, letters and diaries. The study discusses the Fersens landed property and investments in ironworks and manufacturing, the indebtedness of the high nobility, high offices in civil administration, the militia and at court, as well as marriages as the foundations of noble wealth and power. It analyses the Count von Fersens revenue and expenditure, their career options and personal expenses, their involvement in the building and decorating of palaces, and the servants in service of the Fersen family as well as the ideal nobleman and his consumption. Central themes are inheritance, children s education, marriages and ladies preparing their trousseaux, the nobility ordering luxury goods from France, the consumption of Counts and Countesses before and after marrying and having children, the pleasures of a noble life as well as the criticism of luxury and sumptuousness. The study contributes to the large body of research on consumption and nobility in the eighteenth century by connecting the lifestyle, consumption and private finances of the Swedish high nobility to their European context. Key words: nobility, Fersen, lifestyle, consumption, private finances, Sweden, eighteenth century

Effects of electrical muscle stimulation on oxygen consumption

Electrical muscle stimulation (EMS) devices are being marketed as weight/ fat loss devices throughout the world. Commercially available stimulators have the ability to evoke muscle contractions that may affect caloric expenditure while the device is being used. The aim of this study was to test the effects of two different EMS devices (Abtronic and Feminique) on oxygen consumption at rest. Subjects arrived for testing after an overnight fast, had the devices fitted, and then positioned supine with expired air measured to determine oxygen consumption. After a 10-minute acclimation period, oxygen consumption was measured for 20 minutes with the device switched off (resting) then 20 minutes with the device switched on (stimulated). There were no significant differences (p > 0.05) in oxygen consumption between the resting and stimulated periods with either the Abtronic (mean +/- SD; resting, 3.40 +/- 0.44; stimulated, 3.45 +/- 0.53 ml of O2[middle dot]kg-1[middle dot]min-1) or the Feminique (resting, 3.73 +/- 0.45; stimulated, 3.75 +/- 0.46 ml of O2[middle dot]kg-1[middle dot]min-1). In summary, the EMS devices tested had no effect on oxygen consumption during muscle stimulation.

Heavy haul sleeper design: A rational cost-saving method

Heavy haul railway lines are important and expensive items of infrastructure operating in an environment which is increasingly focussed on risk-based management and constrained profit margins. It is vital that costs are minimised but also that infrastructure satisfies failure criteria and standards of reliability which account for the random nature of wheel-rail forces and of the properties of the materials in the track. In Australia and the USA, concrete railway sleepers/ties are still designed using methods which the rest of the civil engineering world discarded decades ago in favour of the more rational, more economical and probabilistically based, limit states design (LSD) concept. This paper describes a LSD method for concrete sleepers which is based on (a) billions of measurements over many years of the real, random wheel-rail forces on heavy haul lines, and (b) the true capacity of sleepers. The essential principles on which the new method is based are similar to current, widely used LSD-based standards for concrete structures. The paper proposes and describes four limit states which a sleeper must satisfy, namely: strength; operations; serviceability; and fatigue. The method has been applied commercially to two new major heavy haul lines in Australia, where it has saved clients millions of dollars in capital expenditure.

Using a supply chain approach to guide R&D

Consumers today are presented with an increasing array of products. The growing competition for consumer expenditure requires a whole of supply chain approach to maintain market share for existing cultivars and to successfully commercialise new cultivars. The supply chain needs to deliver value and satisfaction to the end customer and profitability to their members. Critical to getting the product right is developing inherent robustness into the cultivar, and developing processes and systems through the whole supply chain that maintain product quality and add value. This paper describes the approach we have used in working with supply chains in Australia and Indonesia to identify priority areas for improvement. Our experience demonstrates the need for a champion in the supply chain with significant influence and a desire to improve. The paper also describes our approach towards improving a specific supply chain to achieve successful commercialisation of a new cultivar. The cultivar was primarily selected for good production characteristics and attractive visual appeal. The performance of the fruit is being monitored from farm to retail shelf to identify points where quality is lost and practices can be improved. A targeted R&D program is investigating ways of improving production efficiency (nutrition, flowering and canopy management), maturity standards to optimise flavour, harvesting and packing practices to reduce skin damage, and ripening and handling practices to optimise shelf life. This integrated approach is based on similar approaches used to improve the performance of existing mango and avocado cultivars.

The Eligibility Definition Used in the Social Security Administration’s Disability Programs Needs to be Changed

In its October 2003 report on the definition of disability used by the Social Security Administration’s (SSA’s) disability programs [i.e., Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) for people with disabilities], the Social Security Advisory Board raises the issue of whether this definition is at odds with the concept of disability embodied in the Americans with Disabilities Act (ADA) and, more importantly, with the aspirations of people with disabilities to be full participants in mainstream social activities and lead fulfilling, productive lives. The Board declares that “the Nation must face up to the contradictions created by the existing definition of disability.” I wholeheartedly agree. Further, I have concluded that we have to make fundamental, conceptual changes to both how we define eligibility for economic security benefits, and how we provide those benefits, if we are ever to fulfill the promise of the ADA. To convince you of that proposition, I will begin by relating a number of facts that paint a very bleak picture – a picture of deterioration in the economic security of the population that the disability programs are intended to serve; a picture of programs that purport to provide economic security, but are themselves financially insecure and subject to cycles of expansion and cuts that undermine their purpose; a picture of programs that are facing their biggest expenditure crisis ever; and a picture of an eligibility determination process that is inefficient and inequitable -- one that rations benefits by imposing high application costs on applicants in an arbitrary fashion. I will then argue that the fundamental reason for this bleak picture is the conceptual definition of eligibility that these programs use – one rooted in a disability paradigm that social scientists, people with disabilities, and, to a substantial extent, the public have rejected as being flawed, most emphatically through the passage of the ADA. Current law requires eligibility rules to be based on the premise that disability is medically determinable. That’s wrong because, as the ADA recognizes, a person’s environment matters. I will further argue that programs relying on this eligibility definition must inevitably: reward people if they do not try to help themselves, but not if they do; push the people they serve out of society’s mainstream, fostering a culture of isolation and dependency; relegate many to a lifetime of poverty; and undermine their promise of economic security because of the periodic “reforms” that are necessary to maintain taxpayer support. I conclude by pointing out that to change the conceptual definition for program eligibility, we also must change our whole approach to providing for the economic security of people with disabilities. We need to replace our current “caretaker” approach with one that emphasizes helping people with disabilities help themselves. I will briefly describe features that such a program might require, and point out the most significant challenges we would face in making the transition.

The Municipal Budgetary Response to Changing Labor Costs: The Case of San Francisco

"This paper analyzes how expenditures of the city of San Francisco were altered in response to changes in municipal labor costs over the period 1945 through 1976. A hybrid of the "demands" and the "organizational" models of budgeting is used to measure the budgetary response to changes in the relative prices of labor inputs. Descriptive and econometric evidence reveals significant adjustments both among and within departments in reaction to changes in relative labor costs. The empirical evidence demonstrates that the city's budgetary process is guided by simple allocative rules modified by price-responsive adjustments."

100 Years of U.S. Consumer Spending: Data for the Nation, New York City, and Boston

[From Preface] The Consumer Expenditure Survey is among the oldest publications of the Bureau of Labor Statistics. With information on the expenditures, incomes, and demographic characteristics of households, the survey documents the spending patterns and economic status of American families. This report offers a new approach to the use of Consumer Expenditure Survey data. Normally, the survey presents an indepth look at American households at a specific point in time, the reference period being a calendar year. Here, the authors use consumer expenditure data longitudinally and draw on information from decennial census reports to present a 100-year history of significant changes in consumer spending, economic status, and family demographics in the country as a whole, as well as in New York City and Boston.

Physical activity, fitness, abdominal obesity, and cardiovascular risk factors in Finnish men and women : The National FINRISK 2002 Study

Physical inactivity, low cardiorespiratory fitness, and abdominal obesity are direct and mediating risk factors for cardiovascular disease (CVD). The results of recent studies suggest that individuals with higher levels of physical activity or cardiorespiratory fitness have lower CVD and all-cause mortality than those with lower activity or fitness levels regardless of their level of obesity. The interrelationships of physical activity, fitness, and abdominal obesity with cardiovascular risk factors have not been studied in detail. The aim of this study was to investigate the associations of different types of leisure time physical activity and aerobic fitness with cardiovascular risk factors in a large population of Finnish adults. In addition, a novel aerobic fitness test was implemented and the distribution of aerobic fitness was explored in men and women across age groups. The interrelationships of physical activity, aerobic fitness and abdominal obesity were examined in relation to cardiovascular risk factors. This study was part of the National FINRISK Study 2002, which monitors cardiovascular risk factors in a Finnish adult population. The sample comprised 13 437 men and women aged 25 to 74 years and was drawn from the Population Register as a stratified random sample according to 10-year age groups, gender and area. A separate physical activity study included 9179 subjects, of whom 5 980 participated (65%) in the study. At the study site, weight, height, waist and hip circumferences, and blood pressure were measured, a blood sample was drawn, and an aerobic fitness test was performed. The fitness test estimated maximal oxygen uptake (VO2max) and was based on a non-exercise method by using a heart rate monitor at rest. Waist-to-hip ratio (WHR) was calculated by dividing waist circumference with hip circumference and was used as a measure of abdominal obesity. Participants filled in a questionnaire on health behavior, a history of diseases, and current health status, and a detailed 12-month leisure time physical activity recall. Based on the recall data, relative energy expenditure was calculated using metabolic equivalents, and physical activity was divided into conditioning, non-conditioning, and commuting physical activity. Participants aged 45 to 74 years were later invited to take part in a 2-hour oral glucose tolerance test with fasting insulin and glucose measurements. Based on the oral glucose tolerance test, undiagnosed impaired glucose tolerance and type 2 diabetes were defined. The estimated aerobic fitness was lower among women and decreased with age. A higher estimated aerobic fitness and a lower WHR were independently associated with lower systolic and diastolic blood pressure, lower total cholesterol and triglyceride levels, and with higher high-density lipoprotein (HDL) cholesterol and HDL to total cholesterol ratio. The associations of the estimated aerobic fitness with diastolic blood pressure, triglycerides, and HDL to total cholesterol ratio were stronger in men with a higher WHR. High levels of conditioning and non-conditioning physical activity were associated with lower high-sensitivity C-reactive protein (CRP) levels. High levels of conditioning and overall physical activities were associated with lower insulin and glucose levels. The associations were stronger among women than men. A better self-rated physical fitness was associated with a higher estimated aerobic fitness, lower CRP levels, and lower insulin and glucose levels in men and women. In each WHR third, the risk of impaired glucose tolerance and type 2 diabetes was higher among physically inactive individuals who did not undertake at least 30 minutes of moderate-intensity physical activity on five days per week. These cross-sectional data show that higher levels of estimated aerobic fitness and regular leisure time physical activity are associated with a favorable cardiovascular risk factor profile and that these associations are present at all levels of abdominal obesity. Most of the associations followed a dose-response manner, suggesting that already low levels of physical activity or fitness are beneficial to health and that larger improvements in risk factor levels may be gained from higher activity and fitness levels. The present findings support the recommendation to engage regularly in leisure time physical activity, to pursue a high level of aerobic fitness, and to prevent abdominal obesity.

Bat habitat requirements : implications for land use planning

Knowledge of the habitat requirements of bat species is needed in decision making in land use planning. Bats' hibernation requirements were studied both in Estonia and in southern Finland. In both countries, the northern bat and the brown long-eared bat hibernated in colder and drier locations, whereas Daubenton's bat and Brandt's/whiskered bats hibernated in warmer and more humid locations. In Estonia, the pond bat hibernated in the warmest and most humid conditions, whereas Natterer's bat hibernated in the coldest and driest conditions. Hibernacula were at their coldest in mid-season and became warmer towards the end of the season. The results suggest that bats made an active choice of colder hibernation temperatures at the seasons end. They minimised the negative effects of hibernation early in the hibernation season by hibernating in warmer locations and energy expenditure late in the hibernation season by hibernating in colder locations. The use of foraging habitats was studied in northern and southern Finland. The northern bat used foraging sites opportunistically. Daubenton's bat foraged mainly in water habitats, whereas Brandt's/whiskered bats and the brown long-eared bat foraged mainly in forest habitats. In northern Finland, Daubenton's bats foraged almost exclusively on rivers and typically together with the northern bat. Daubenton's bats and Brandt's/whiskered bats were found only where there were lower ambient light levels. One of the most important things in the management of foraging areas for them is to keep them shady. Hibernacula in Finland typically housed few bats, suggesting that hibernation sites used by even a small number of bats are important. Bats typically used natural stone for hibernation suggesting that natural underground sites in rocks or cliffs or man-made underground sites built using natural stone are important for them. The results suggest that appropriate timing of surveys may vary according to the species and latitude.

Balancing entertainment and behaviour value: M-games as a social marketing agent of change

In a marketplace where millions of dollars are spent on the design of mobile games (m-games), social marketers are now using this technology as a tool for behaviour change. Despite high expenditure by governments and non-profits on social marketing m-games, little is known about their effectiveness in terms of creating value. Value creation has been demonstrated to have an important impact on satisfaction and behaviour. This paper reports the results of a qualitative study involving four focus groups with 23 participants to reveal two categories of experiential value, entertainment and behaviour. Additionally, it was discovered that entertainment could be characterised by amusement and social value dimensions. Whereas, behaviour could be made up of information, simulation and distraction value dimensions. The categories of value, as well as the dimensions of information, simulation and distraction are entirely new to the social marketing literature and thus represents a unique contribution to social marketing.

The need for cost-effectiveness analyses of antimicrobial stewardship programmes: A structured review

The cost effectiveness of antimicrobial stewardship (AMS) programmes was reviewed in hospital settings of Organisation for Economic Co-operation and Development (OECD) countries, and limited to adult patient populations. In each of the 36 studies, the type of AMS strategy and the clinical and cost outcomes were evaluated. The main AMS strategy implemented was prospective audit with intervention and feedback (PAIF), followed by the use of rapid technology, including rapid polymerase chain reaction (PCR)-based methods and matrix-assisted laser desorption/ionisation time-of-flight (MALDI-TOF) technology, for the treatment of bloodstream infections. All but one of the 36 studies reported that AMS resulted in a reduction in pharmacy expenditure. Among 27 studies measuring changes to health outcomes, either no change was reported post-AMS, or the additional benefits achieved from these outcomes were not quantified. Only two studies performed a full economic evaluation: one on a PAIF-based AMS intervention; and the other on use of rapid technology for the selection of appropriate treatment for serious Staphylococcus aureus infections. Both studies found the interventions to be cost effective. AMS programmes achieved a reduction in pharmacy expenditure, but there was a lack of consistency in the reported cost outcomes making it difficult to compare between interventions. A failure to capture complete costs in terms of resource use makes it difficult to determine the true cost of these interventions. There is an urgent need for full economic evaluations that compare relative changes both in clinical and cost outcomes to enable identification of the most cost-effective AMS strategies in hospitals.