958 resultados para INDEPENDENCE
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The Iowa Power Fund and the Office of Energy Independence are charged with the responsibility of creating an economically viable and sound energy future for Iowa through energy independence. This vision can only be achieved if a majority, if not all Iowans, are united in this cause and actively participate in it
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New evidence shows that older adults need more dietary protein than do younger adults to support good health, promote recovery from illness, and maintain functionality. Older people need to make up for age-related changes in protein metabolism, such as high splanchnic extraction and declining anabolic responses to ingested protein. They also need more protein to offset inflammatory and catabolic conditions associated with chronic and acute diseases that occur commonly with aging. With the goal of developing updated, evidence-based recommendations for optimal protein intake by older people, the European Union Geriatric Medicine Society (EUGMS), in cooperation with other scientific organizations, appointed an international study group to review dietary protein needs with aging (PROT-AGE Study Group). To help older people (>65 years) maintain and regain lean body mass and function, the PROT-AGE study group recommends average daily intake at least in the range of 1.0 to 1.2 g protein per kilogram of body weight per day. Both endurance- and resistance-type exercises are recommended at individualized levels that are safe and tolerated, and higher protein intake (ie, ≥1.2 g/kg body weight/d) is advised for those who are exercising and otherwise active. Most older adults who have acute or chronic diseases need even more dietary protein (ie, 1.2-1.5 g/kg body weight/d). Older people with severe kidney disease (ie, estimated GFR <30 mL/min/1.73m(2)), but who are not on dialysis, are an exception to this rule; these individuals may need to limit protein intake. Protein quality, timing of ingestion, and intake of other nutritional supplements may be relevant, but evidence is not yet sufficient to support specific recommendations. Older people are vulnerable to losses in physical function capacity, and such losses predict loss of independence, falls, and even mortality. Thus, future studies aimed at pinpointing optimal protein intake in specific populations of older people need to include measures of physical function.
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Power Fund Awarded Projects from the Office of Energy Independence.
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Power Fund Awarded Projects from the Office of Energy Independence.
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Record flooding occurred May 17-20, 1999, in the Volga and Wapsipinicon River Basins following thunderstorm activity over northeast Iowa. On Sunday, May 16, between 6 and 8 inches of rain fell during a 24- hour period over portions of Bremer, Butler, and Fayette Counties. Highest rainfall during this 24-hour period was 8.3 inches recorded north of Oelwein in southwest Fayette County. A peak discharge of 29,800 cubic feet per second in the Volga River at Mederville, 53,900 cubic feet per second in the Turkey River at Garber, and 31, 100 cubic feet per second in the Wapsipinicon River at Independence set new peak discharge records. The peak discharge at Garber was greater than a theoretical 500-year flood, and the peak discharge at Independence was the equivalent of a 90- year flood. Information about the basins, rain storms, flooding, and a profile of high water marks are presented for selected intervals along the Volga River, Wapsipinicon River, Crane Creek, Little Wapsipinicon River, and Otter Creek.
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OBJECTIVES: We assessed the clinical characteristics of patients with acute ischemic stroke (AIS) with left ventricular ejection fraction (EF) ≤ 35% and investigated the association of low EF with early and long-term outcome. METHODS: A total of 2439 patients of the Acute Stroke Registry and Analysis of Lausanne (ASTRAL) were selected. Demographics, risk factors, pre-stroke treatment, and clinical, radiological and metabolic variables in patients with and without low EF were compared. Functional independence (modified Rankin Score ≤ 2) and mortality were recorded 1 week up to 12 months from admission. RESULTS: Low EF patients (n=119) were more commonly men, older, had higher rates of coronary artery disease and atrial fibrillation (AF), and more frequent pretreatment with anticoagulants, antiplatelets and antihypertensive agents. On admission, they presented with higher stroke severity and had lower values of systolic blood pressure, higher heart rate, and worse estimated glomerular filtration rate. Stroke-related disability and death rates were higher in low EF patients during follow-up (19.5% vs. 7.8% at 1 week, and 36.1% vs. 16.5% at 12 months). Increasing age, stroke severity, and AF were independent predictors of one-year mortality in these patients while prior use of statins had a favorable effect on early mortality. CONCLUSIONS: AIS in patients with low EF is associated with older age, cardiac comorbidities, and more severe clinical presentation. Low EF can identify a subset of AIS patients at high risk of early and long-term functional disability and mortality.
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BACKGROUND: Upper limb paresis remains a relevant challenge in stroke rehabilitation. AIM: To evaluate if adding mirror therapy (MT) to conventional therapy (CT) can improve motor recovery of the upper limb in subacute stroke patients. DESIGN: Prospective, single-center, single-blind, randomised, controlled trial. SETTING: Subacute stroke patients referred to a Physical and Rehabilitation Medicine Unit between October 2009 and August 2011. POPULATION: Twenty-six subacute stroke patients (time from stroke <4 weeks) with upper limb paresis (Motricity Index â0/00¤ 77). METHODS: Patients were randomly allocated to the MT (N.=13) or to the CT group (N.=13). Both followed a comprehensive rehabilitative treatment. In addition, MT Group had 30 minutes of MT while the CT group had 30 minutes of sham therapy. Action Research Arm Test (ARAT) was the primary outcome measures. Motricity Index (MI) and the Functional Independence Measure (FIM) were the secondary outcome measures. RESULTS: After one month of treatment patients of both groups showed statistically significant improvements in all the variables measured (P<0.05). Moreover patients of the MT group had greater improvements in the ARAT, MI and FIM values compared to CT group (P<0.01, Glass's Î" Effect Size: 1.18). No relevant adverse event was recorded during the study. CONCLUSION: MT is a promising and easy method to improve motor recovery of the upper limb in subacute stroke patients. CLINICAL REHABILITATION IMPACT: While MT use has been advocated for acute patients with no or negligible motor function, it can be usefully extended to patients who show partial motor recovery. The easiness of implementation, the low cost and the acceptability makes this therapy an useful tool in stroke rehabilitation.
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In advanced Parkinson's disease (PD), the emergence of symptoms refractory to conventional therapy poses therapeutic challenges. The success of deep brain stimulation (DBS) and advances in the understanding of the pathophysiology of PD have raised interest in noninvasive brain stimulation as an alternative therapeutic tool. The rationale for its use draws from the concept that reversing abnormalities in brain activity and physiology thought to cause the clinical deficits may restore normal functioning. Currently the best evidence in support of this concept comes from DBS, which improves motor deficits, and modulates brain activity and motor cortex physiology, although whether a causal interaction exists remains largely undetermined. Most trials of noninvasive brain stimulation in PD have applied repetitive transcranial magnetic stimulation (rTMS), targeting the motor cortex. Current studies suggest a possible therapeutic potential for rTMS and transcranial direct current stimulation (tDCS), but clinical effects so far have been small and negligible with regard to functional independence and quality of life. Approaches to potentiate the efficacy of rTMS include increasing stimulation intensity and novel stimulation parameters that derive their rationale from studies on brain physiology. These novel parameters are intended to simulate normal firing patterns or to act on the hypothesized role of oscillatory activity in the motor cortex and basal ganglia with regard to motor control and its contribution to the pathogenesis of motor disorders. Noninvasive brain stimulation studies will enhance our understanding of PD pathophysiology and might provide further evidence for potential therapeutic applications.
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Independence, respect, and equality are values important to all people. These values help define the concepts of autonomy (independence and freedom) and self-determination (the right to make decisions for one’s self). Because these rights are so valued in our society and are something that most of us would value for ourselves, the “least restrictive alternative” should always be considered before taking away a person’s civil and legal rights to make decisions for him or herself. The least restrictive alternative is an option, which allows a person to keep as much autonomy, and self-determination as possible while providing only the level of protection and supervision that is necessary. Some examples may include: representative payee for certain government benefit checks, joint bank accounts or advance directives for health care.
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Exchange of immature loggerhead sea turtles (Caretta caretta) between the northern and southern regions of the western Mediterranean was investigated using data obtained from several Spanish tagging programmes. Tagged turtles ranged in straight carapace length from 23.0 to 74.0 cm. Thirty-six turtles were recaptured after an average interval of 390.5±462.6 days (SD). As the mean dispersal distance (MDD) of a turtle population that spreads over the western Mediterranean would stabilize after 117 days (CI 95%: 98 to 149), two analyses were conducted that included data from turtles recaptured after 98 and 149 days respectively. In both analyses, turtles were recaptured more often than expected in the same region where they had been tagged. No difference was found in either of the two regions between the average distance between the capture and recapture locations and the expected MDD if the turtles were to remain in the region where they were first captured. Turtles recaptured after 15 and 25 days respectively were excluded from the analysis to ensure data independence. The overall evidence indicates that immature turtles exhibit strong site fidelity to certain areas and that there is a strong barrier to dispersal between the northern and southern parts of the western Mediterranean. Therefore, loggerhead turtles in the western Mediterranean should be split into at least two management units.
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The best indirect evidence that increased bone turnover contributes to fracture risk is the fact that most of the proven therapies for osteoporosis are inhibitors of bone turnover. The evidence base that we can use biochemical markers of bone turnover in the assessment of fracture risk is somewhat less convincing. This relates to natural variability in the markers, problems with the assays, disparity in the statistical analyses of relevant studies and the independence of their contribution to fracture risk. More research is clearly required to address these deficiencies before biochemical markers might contribute a useful independent risk factor for inclusion in FRAX(®).
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El debat sobiranista català està a l‟ordre del dia i actualment no passa desapercebut en cap mitjà de comunicació ni tampoc en el món polític, econòmic i empresarial. El fet d‟estar tan viva una temàtica així de delicada està ocasionant controvèrsies dins l‟empresariat català o que té la seva empresa ubicada a Catalunya perquè tot plegat provoca moltes incerteses, que són el pitjor enemic dels empresaris i dels negocis. Tanmateix, però, les informacions publicades o emeses venen marcades per les opinions polítiques i periodístiques, que es troben censurades en certa mesura perquè segueixen una determinada línia política i/o editorial. Per això s‟ha elaborat un reportatge digital focalitzat en l‟empresariat català i l‟encaix Catalunya-Espanya que pretén aportar noves valoracions entorn a aquest debat donant veu a empresaris i professionals, entre altres. La part teòrica de la memòria defineix els conceptes bàsics que són de forçat coneixement per realitzar una part pràctica que ha de ser entesa per qualsevol persona i que s‟ha de tractar amb la major objectivitat possible. Per això, el web http://laquestiocatalana.cat aporta un llenguatge planer i les eines bàsiques per donar a conèixer una matèria molt criticada per alguns sectors. A través d‟entrevistes a personatges rellevants, el web introdueix nous punts de vista sobre una qüestió marcada, a simple vista, per la preocupació d‟un possible boicot per part d‟Espanya. Però aquesta no sembla ser la principal inquietud dels entesos, i és que hi ha altres aspectes encara més alarmants que poden influir en l‟empresariat i que no són tractats per cap mitjà de comunicació convencional.
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Aquest article presenta les dificultats que van haver d’afrontar entre 1768 i 1863 els hereus de la casa Baldrich de Valls per liquidar els dots i les deixes testamentàries. Anton Baldrich Janer va nomenar hereu el fill gran del primer matrimoni amb l’obligació de pagar als seus germans i especialment als seus germanastres unes quantitats molt elevades de diners atorgats en un moment de grans expectatives econòmiques, gràcies al comerç amb Amèrica i el nord d’Europa. Durant la primera meitat del segle XIX, alguns anys de males collites, les contínues guerres i la independència de les colònies americanes feren minvar els recursos i van afeblir la hisenda familiar. Els successius hereus maldaven per pagar les contínues reclamacions dels cabalers i les cabaleres de les diferents generacions, fet que els impedia invertir en noves empreses per tal d’ampliar i modernitzar els seus negocis. L’any 1863, el darrer hereu Baldrich va morir sense descendència, havent pagat els darrers deutes familiars però sense haver creat nous horitzons per als seus successors.
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It is well known the relationship between source separation and blind deconvolution: If a filtered version of an unknown i.i.d. signal is observed, temporal independence between samples can be used to retrieve the original signal, in the same manner as spatial independence is used for source separation. In this paper we propose the use of a Genetic Algorithm (GA) to blindly invert linear channels. The use of GA is justified in the case of small number of samples, where other gradient-like methods fails because of poor estimation of statistics.
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Although sources in general nonlinear mixturm arc not separable iising only statistical independence, a special and realistic case of nonlinear mixtnres, the post nonlinear (PNL) mixture is separable choosing a suited separating system. Then, a natural approach is based on the estimation of tho separating Bystem parameters by minimizing an indcpendence criterion, like estimated mwce mutual information. This class of methods requires higher (than 2) order statistics, and cannot separate Gaarsian sources. However, use of [weak) prior, like source temporal correlation or nonstationarity, leads to other source separation Jgw rithms, which are able to separate Gaussian sourra, and can even, for a few of them, works with second-order statistics. Recently, modeling time correlated s011rces by Markov models, we propose vcry efficient algorithms hmed on minimization of the conditional mutual information. Currently, using the prior of temporally correlated sources, we investigate the fesihility of inverting PNL mixtures with non-bijectiw non-liacarities, like quadratic functions. In this paper, we review the main ICA and BSS results for riunlinear mixtures, present PNL models and algorithms, and finish with advanced resutts using temporally correlated snu~sm