Home based exercise programme for knee pain and knee osteoarthritis: randomised controlled trial

Objectives To determine whether a home based exercise programme can improve outcomes in patients with knee pain. Design Pragmatic, factorial randomised controlled trial of two years' duration. Setting Two general practices in Nottingham. Participants 786 men and women aged >45 years with self reported knee pain. Interventions Participants were randomised to four groups to receive exercise therapy, monthly telephone contact, exercise therapy plus telephone contact, or no intervention. Patients in the no intervention and combined exercise and telephone groups were randomised to receive or not receive a placebo health food tablet. Main outcome measures Primary outcome was self reported score for knee pain on the Western Ontario and McMaster universities (WOMAC) osteoarthritis index at two years. Secondary outcomes included knee specific physical function and stiffness (scored on WOMAC index), general physical function (scored on SF­36 questionnaire), psychological outlook (scored on hospital anxiety and depression scale), and isometric muscle strength. Results 600 (76.3%) participants completed the study. At 24 months, highly significant reductions in knee pain were apparent for the pooled exercise groups compared with the non­exercise groups (mean difference –0.82, 95% confidence interval –1.3 to –0.3). Similar improvements were observed at 6, 12, and 18 months. Regular telephone contact alone did not reduce pain. The reduction in pain was greater the closer patients adhered to the exercise plan. Conclusions A simple home based exercise programme can significantly reduce knee pain. The lack of improvement in patients who received only telephone contact suggests that improvements are not just due to psychosocial effects because of contact with the therapist.

Report on JERICO Biofouling Monitoring Program (BMP)

The main aim for this document is to report after the Biofouling Monitoring Program (BMP) aiming at identifying major organisms responsible for biofouling in different geographical areas, as an input to the development and application of a more suitable approach to any specific region. This report is strongly linked to the JERICO deliverable D4.3 “Report on Biofouling Prevention Methods”, available at http://www.jerico-fp7.eu/deliverables/d4-3-report-on-biofouling-prevention-methods.

Effects of a rhythmic and choreographic program in obese and overweight participants

Introduction: Currently there is a growing trend in the prevalence of overweight and obesity. This increased prevalence trend leads to an increase in the costs of health care. Objective: The aim of the present study was to analyze the effects on physical fitness and bone mineral density through an intervention program of physical activity based on rhythmic and choreographic activities in an overweight and obese population. Method: An 8-month physical activity based on rhythmic and choreographic activities was conducted in overweight and obese people. Thirty-four participants aged 50.43 ± 10.57 with a body mass index (BMI) 38.37 ± 4.82 took part in the physical activity program. This study assesses the effects of fitness, percentage of body fat and bone mineral density (BMD). Results: After an 8-month physical activity intervention program based on rhythmic and choreographic activities, significant differences were found in: percentage of body fat (p = 0.004), aerobic capacity (p = 0.023), flexibility of the lower limbs (flexibility in the right leg p = 0.029 and left leg p = 0.002), balance (p < 0.001), strength in lower limbs (p = 0..003) and strength in upper limbs (p < 0.001). Besides that, significant differences were found in parameters related with BMD such as T-Score (p = 0.025) and Z-Score (p = 0.012), Bone Quality Index (BQI) (p = 0.026) and an increase in Broadband Ultrasound Attenuation (BUA) although not a statistically significant one (p = 0.939). Conclusions: These findings suggest that a physical activity program based on rhythmic and choreographic activities can act as a preventive method of mobility and fragility, as well as preventing bone loss.

Understanding the cation specific effects on the aqueous solubility of amino acids: from mono to polyvalent cations

The interactions established by mono and polyvalent cations in natural media have important implications on the structure formation, function and physico-chemical behavior of biomolecules, playing therefore a critical role in biochemical processes. In order to further elucidate the molecular phenomena behind the cation specific effects in biological environments, and clarify the influence of the charge of the ions, solubility measurements and molecular dynamics simulations were performed for aqueous solutions of three amino acids (alanine, valine and isoleucine), in the presence of a series of inorganic salts comprising mono-, di- and trivalent cations (LiCl, Li2SO4, K2SO4, CaCl2, AlCl3 and Al-2(SO4)(3)). The evidence gathered indicates that the mechanism by which (salting-in inducing) polyvalent cations affect the solubility of amino acids in aqueous solutions is different from that of monovalent cations. A consistent and refined molecular description of the effect of the cation on the solubility of amino acids based on specific interactions of the cations with the negatively charged moieties of the biomolecules is here proposed.

Results of a round-robin exercise on read-across

A round-robin exercise was conducted within the CALEIDOSLIFE project. The participants were invited to assess the hazard posed by a substance, applying in silico methods and read-across approaches. The exercise was based on three endpoints: mutagenicity, bioconcentration factor and fish acute toxicity. Nine chemicals were assigned for each endpoint and the participants were invited to complete a specific questionnaire communicating their conclusions.The interesting aspect of this exercise is the justification behind the answers more than the final prediction in itself. Which tools were used? How did the approach selected affect the final answer?

The Myosin Heavy Chain specific A4.1025 antibody discriminates different cardiac segments in ancient groups of gnathostomes: Morphological and evolutionary implications

The pan-Myosin Heavy Chain (pan-MyHC) marker MF20 have been reported to show similar, homogeneous signal in the myocardial segments of the heart of teleosts and tetrapods. However, in an ongoing study of the myocardial structure of the dogfish (Scyliorhinus canicula; Chondrichthyes), we observed differential immunostaining of the cardiac segments using another pan-MyHC, the A4.1025 antibody. In order to investigate the relevance of this finding for better understanding of the morphology and evolution of the vertebrate heart, we performed immunohistochemistry, slot blot and western blot in several species of chondrichthyans, actinopterygians and mammals using the above mentioned antibodies. In the dogfish heart, A4.1025 and MF20 specifically recognized MyHC isoforms, although with different degree of affinity. MF20 reactivity was homogeneous and high in all the myocardial segments. However, A4.1025 reactivity was heterogeneous. It was high in the sinus venosus (external layer), atrium and atrioventricular region, low in the ventricle and conus arteriosus, and null in the internal layer of the sinus venosus. A heterogeneous pattern of A4.1025 immunoreactivity was also detected in two other elasmobranchs, a holocephalan, a polypteryform and an acipenseriform. In all of these species, MF20 immunoreactivity was homogeneous. In addition, both markers showed a homogeneous immunoreactivity pattern in teleosts and mammals. Our results indicate that in the hearts of ancient gnathostomes, in all of which a conspicuous conus arteriosus exists, one or more MyHC isoforms with low affinity for A4.1025 show segment-specific distributions. Thus, A4.1025 appears to be an appropriated marker to identify the cardiac segments and their boundaries. We propose that the segmentspecific distribution of MyHC isoforms may generate a particular type of myocardial contractility associated with the presence of a conus arteriosus.

Manual/Instruções de Trabalho para a Integração de Enfermeiros e Alunos no Programa de Saúde Infantil e Juvenil

Atualmente a melhoria da qualidade nos cuidados de saúde implica a passagem de uma prática baseada na experiência para uma baseada na evidência científica; na melhoria tendo por premissa não só o desempenho profissional, mas também os cidadãos como parceiros; de uma qualidade mono-disciplinar, para cuidados partilhados; de uma educação profissional contínua e avaliações de qualidade, para uma gestão da saúde, num contexto de melhoria contínua da qualidade. À Ordem dos Enfermeiros é imputada a defesa da qualidade dos cuidados de enfermagem à população. Cabe a cada enfermeiro, individualmente e em coletivo no contexto do seu exercício, refletir, analisar e prosseguir diariamente na procura da excelência do exercício. A gestão da qualidade parte do empenhamento dos profissionais que funcionando como um todo dentro de um núcleo específico com o objetivo de atingirem o mesmo fim, estabelecem estratégias que visem alcançar esse fim. Neste contexto surge a elaboração do Manual / Instruções de Trabalho para a integração e prestação de cuidados dos enfermeiros e alunos de enfermagem no Programa de Saúde Infantil e Juvenil na Unidade de Cuidados de Saúde Personalizados da Baixa da Banheira. Visando a melhoria da articulação, comunicação, continuidade de cuidados, entre a equipa de Enfermagem, pois só em conjunto se poderá desenvolver ações que visem a aquisição dessa qualidade e que contribuam para o desenvolvimento / harmonioso da criança / jovem e sua família.

Effects of a resistance and stretching training program on forward head and protracted shoulder posture in physical education classes in students aged 15-17 years old

Purpose: This study aimed to characterize the postural alignment of the head and shoulder in the sagittal plane of Portuguese adolescents, 15-17 years old, and to evaluate the effects of a 32-week resistance and stretching training program applied in Physical Education classes on forward head posture and protracted shoulder posture of Portuguese adolescents. After 32-training weeks the detraining effects after a 16-week period were measured. Methods: This randomized and controlled study was conducted in two secondary schools in Portugal for 48 weeks. Prior the study 275 students aged 15-17 years old were evaluated. Sagittal head, cervical and shoulder angle were measured with photogrammetry and Postural Analysis Software. After this assessment 130 adolescents were considered to have forward head and protracted shoulder posture and were randomly assigned to a control group, an experimental group one or experimental group two. The control group (n=46) only did the Physical Education classes whereas the intervention group one (n=42) and two (n=42) performed a 16-week and 32-week stretching and strengthening program in addition to Physical Education classes, respectively. The postural angles were measured before and after the 16-week and 32-week time intervention period for the three groups and after a 16-week detraining period following the 32-week in intervention group two. Results: 68% of the adolescents studied revealed anteriorization of the head whereas 58% of them had protraction of the shoulder. Significant increases were observed in the cervical and shoulder angle in the experimental group (n=84) following the 16-week and in experimental group two (n=42)after the 32 week-intervention period. After the 16-week detraining period no significant differences were observed in the three postural angles in the intervention group two. Conclusions: Forward head and protracted shoulder are common postural disorders in Portuguese adolescents. The exercise intervention was successful ate decreasing forward head and protracted shoulder in adolescents. Detraining period of 16-week didn´t reduce the overall training effects.

Export and import market-specific characteristics. How they drive the decision to trade and how much

Using a rich firm-level dataset on the Italian manufacturing industry, this paper provides a comprehensive analysis of the role that firms and market characteristics play in shaping firms’ trade activities. We enhance the previous analyses by considering firms’ engagement in international transactions, by focusing on either exports or imports. We show that the determinants of a firm’s export participation and value across countries also drive import behavior. Our research is consistent with the presence of country-specific sunk costs and with a qualitatively similar role of gravity forces and other country attributes on both sides of trading activities. Our evidence, however, militates in favor of a framework where variations in market characteristics have a larger impact on imports than exports.

Marker-assisted selection integrated to the embrapa common bean breeding program.

The establishment of a specific Marker-Assisted Selection Facility at the Embrapa Rice and Beans Biotechnology Laboratory, in 2014, has better supported the routine analysis with molecular markers demanded by the Embrapa Common Bean Breeding Program. In addition, it has also supported other Embrapa plant breeding programs, such as rice and cotton.

Comparison of body composition and body fat distribution of patients following a cardiac rehabilitation program and sedentary patients

O objectivo desta investigação foi analisar a composição corporal e a distribuição de gordura corporal de sujeitos com doença das artérias coronárias (DAC) envolvidos num programa estruturado de reabilitação cardíaca (PRC) e sujeitos com DAC que não participam em qualquer PRC. População e métodos: A amostra foi constituída por 62 sujeitos do sexo masculino, caucasianos, com DAC diagnosticada, oriundos de cada um de dois grupos estudados: grupo C/PRC (n=31) foi constituído por sujeitos que participavam na fase IV de um PRC há mais de um ano (idade: 58 + 10 anos); grupo S/PRC (n=31) foi constituído por sujeitos que não participavam em qualquer PRC (idade: 59 + 12 anos). Foi observada a composição corporal e distribuição de gordura corporal dos sujeitos da amostra, através da análise por Densitometria por Raio-X de Dupla Energia (DXA). Foram recolhidas medidas antropometricas. Resultados principais: sujeitos que não participaram em qualquer PRC apresentaram valores superiores, aos sujeitos do grupo C/PRC, nas variáveis massa corporal total (p<0,05), IMC (p<0,05), quantidade (kg) de massa gorda (MG) (p<0,05) e % MG (p<0,05). O grupo S/PRC tambem apresentou valores superiores de MG tronco (p<0,01), % MG tronco (p<0,01), MG abdominal total (p<0,01), % MG abdominal total (p<0,01), MG visceral (p<0,01), % MG visceral total (p<0,01), MG abdominal subcutânea (p=0,05) e na razao MG abdominal total/MG (p<0,05). Tambem foi possivel observar maior prevalencia de obesidade (IMC> 30 kg/m2) no grupo S/PRC (p<0,05), ou seja, neste grupo um em cada tres sujeitos era obeso, enquanto no grupo C/PRC apenas um em cada dez sujeitos foi assim classificado. Nao foram observadas diferencas significativas entre os grupos nas outras variaveis em estudo, incluindo a massa isenta de gordura total e regional. Conclusões: Os resultados encontrados permitem concluir que os sujeitos que não participaram em qualquer PRC apresentaram um perfil de composição corporal e de distribuicao de gordura corporal menos adequado a sua condicao clinica. A maior quantidade de gordura em depositos especificos, assim como os valores superiores encontrados na razao MG abdominal total/MG, confirmam que estes sujeitos apresentaram uma distribuicao de gordura mais adversa. Estes resultados vao ao encontro da tendencia observada em estudos de intervencao em sujeitos com DAC.

Comparison of body composition and body fat distribution of patients following a cardiac rehabilitation program and sedentary patients

O objectivo desta investigação foi analisar a composição corporal e a distribuição de gordura corporal de sujeitos com doença das artérias coronárias (DAC) envolvidos num programa estruturado de reabilitação cardíaca (PRC) e sujeitos com DAC que não participam em qualquer PRC. População e métodos: A amostra foi constituída por 62 sujeitos do sexo masculino, caucasianos, com DAC diagnosticada, oriundos de cada um de dois grupos estudados: grupo C/PRC (n=31) foi constituído por sujeitos que participavam na fase IV de um PRC há mais de um ano (idade: 58 + 10 anos); grupo S/PRC (n=31) foi constituído por sujeitos que não participavam em qualquer PRC (idade: 59 + 12 anos). Foi observada a composição corporal e distribuição de gordura corporal dos sujeitos da amostra, através da análise por Densitometria por Raio-X de Dupla Energia (DXA). Foram recolhidas medidas antropometricas. Resultados principais: sujeitos que não participaram em qualquer PRC apresentaram valores superiores, aos sujeitos do grupo C/PRC, nas variáveis massa corporal total (p<0,05), IMC (p<0,05), quantidade (kg) de massa gorda (MG) (p<0,05) e % MG (p<0,05). O grupo S/PRC tambem apresentou valores superiores de MG tronco (p<0,01), % MG tronco (p<0,01), MG abdominal total (p<0,01), % MG abdominal total (p<0,01), MG visceral (p<0,01), % MG visceral total (p<0,01), MG abdominal subcutânea (p=0,05) e na razao MG abdominal total/MG (p<0,05). Tambem foi possivel observar maior prevalencia de obesidade (IMC> 30 kg/m2) no grupo S/PRC (p<0,05), ou seja, neste grupo um em cada tres sujeitos era obeso, enquanto no grupo C/PRC apenas um em cada dez sujeitos foi assim classificado. Nao foram observadas diferencas significativas entre os grupos nas outras variaveis em estudo, incluindo a massa isenta de gordura total e regional. Conclusões: Os resultados encontrados permitem concluir que os sujeitos que não participaram em qualquer PRC apresentaram um perfil de composição corporal e de distribuicao de gordura corporal menos adequado a sua condicao clinica. A maior quantidade de gordura em depositos especificos, assim como os valores superiores encontrados na razao MG abdominal total/MG, confirmam que estes sujeitos apresentaram uma distribuicao de gordura mais adversa. Estes resultados vao ao encontro da tendencia observada em estudos de intervencao em sujeitos com DAC.

What Are Effective Program Characteristics of Self-Management Interventions in Patients With Heart Failure? : An Individual Patient Data Meta-analysis

Background To identify those characteristics of self-management interventions in patients with heart failure (HF) that are effective in influencing health-related quality of life, mortality, and hospitalizations. Methods and Results Randomized trials on self-management interventions conducted between January 1985 and June 2013 were identified and individual patient data were requested for meta-analysis. Generalized mixed effects models and Cox proportional hazard models including frailty terms were used to assess the relation between characteristics of interventions and health-related outcomes. Twenty randomized trials (5624 patients) were included. Longer intervention duration reduced mortality risk (hazard ratio 0.99, 95% confidence interval [CI] 0.97–0.999 per month increase in duration), risk of HF-related hospitalization (hazard ratio 0.98, 95% CI 0.96–0.99), and HF-related hospitalization at 6 months (risk ratio 0.96, 95% CI 0.92–0.995). Although results were not consistent across outcomes, interventions comprising standardized training of interventionists, peer contact, log keeping, or goal-setting skills appeared less effective than interventions without these characteristics. Conclusion No specific program characteristics were consistently associated with better effects of self-management interventions, but longer duration seemed to improve the effect of self-management interventions on several outcomes. Future research using factorial trial designs and process evaluations is needed to understand the working mechanism of specific program characteristics of self-management interventions in HF patients.

Effect Of Exercise Test On Pulmonary Function Of Obese Adolescents.

to investigate the pulmonary response to exercise of non-morbidly obese adolescents, considering the gender. a prospective cross-sectional study was conducted with 92 adolescents (47 obese and 45 eutrophic), divided in four groups according to obesity and gender. Anthropometric parameters, pulmonary function (spirometry and oxygen saturation [SatO2]), heart rate (HR), blood pressure (BP), respiratory rate (RR), and respiratory muscle strength were measured. Pulmonary function parameters were measured before, during, and after the exercise test. BP and HR were higher in obese individuals during the exercise test (p = 0.0001). SatO2 values decreased during exercise in obese adolescents (p = 0.0001). Obese males had higher levels of maximum inspiratory and expiratory pressures (p = 0.0002) when compared to obese and eutrophic females. Obese males showed lower values of maximum voluntary ventilation, forced vital capacity, and forced expiratory volume in the first second when compared to eutrophic males, before and after exercise (p = 0.0005). Obese females had greater inspiratory capacity compared to eutrophic females (p = 0.0001). Expiratory reserve volume was lower in obese subjects when compared to controls (p ≤ 0,05). obese adolescents presented changes in pulmonary function at rest and these changes remained present during exercise. The spirometric and cardiorespiratory values were different in the four study groups. The present data demonstrated that, in spite of differences in lung growth, the model of fat distribution alters pulmonary function differently in obese female and male adolescents.

Site Specific Spin Dynamics In Bafe2as2: Tuning The Ground State By Orbital Differentiation.

The role of orbital differentiation on the emergence of superconductivity in the Fe-based superconductors remains an open question to the scientific community. In this investigation, we employ a suitable microscopic spin probe technique, namely Electron Spin Resonance (ESR), to investigate this issue on selected chemically substituted BaFe2As2 single crystals. As the spin-density wave (SDW) phase is suppressed, we observe a clear increase of the Fe 3d bands anisotropy along with their localization at the FeAs plane. Such an increase of the planar orbital content is interestingly independent of the chemical substitution responsible for suppressing the SDW phase. As a consequence, the magnetic fluctuations in combination with this particular symmetry of the Fe 3d bands are propitious ingredients for the emergence of superconductivity in this class of materials.