Diastolic function is associated with quality of life and exercise capacity in stable heart failure patients with reduced ejection fraction

Exercise capacity and quality of life (QOL) are important outcome predictors in patients with systolic heart failure (HF), independent of left ventricular (LV) ejection fraction (LVEF). LV diastolic function has been shown to be a better predictor of aerobic exercise capacity in patients with systolic dysfunction and a New York Heart Association (NYHA) classification ≥II. We hypothesized that the currently used index of diastolic function E/e' is associated with exercise capacity and QOL, even in optimally treated HF patients with reduced LVEF. This prospective study included 44 consecutive patients aged 55±11 years (27 men and 17 women), with LVEF<0.50 and NYHA functional class I-III, receiving optimal pharmacological treatment and in a stable clinical condition, as shown by the absence of dyspnea exacerbation for at least 3 months. All patients had conventional transthoracic echocardiography and answered the Minnesota Living with HF Questionnaire, followed by the 6-min walk test (6MWT). In a multivariable model with 6MWT as the dependent variable, age and E/e' explained 27% of the walked distance in 6MWT (P=0.002; multivariate regression analysis). No association was found between walk distance and LVEF or mitral annulus systolic velocity. Only normalized left atrium volume, a sensitive index of diastolic function, was associated with decreased QOL. Despite the small number of patients included, this study offers evidence that diastolic function is associated with physical capacity and QOL and should be considered along with ejection fraction in patients with compensated systolic HF.

Quality of 'Delta Valencia' orange grown in semiarid climate and stored under refrigeration after coating with wax

The effects of carnauba-based wax on the quality of 'Delta Valencia' orange produced in Ceará state, Brazil, were studied. The fruits were coated with carnauba-based wax and refrigerated (7 ± 2 ºC and 85 ± 2% R.H.) for 28 days. The quality attribute parameters assessed were weight loss, peel color (brightness, hue angle, and chromaticity), peel moisture, pH, soluble solids (SS), titratable acidity (TA), SS/TA ratio, ascorbic acid, total soluble sugars, reducing sugars, yellow flavonoids, and polyphenols. The results showed that 'Delta Valencia' oranges grown in the dry climate of Ceará state has excellent quality. The coated fruits lost mass at a lower rate than the the control fruits. No significant loss of soluble solids, titratable acidity, pH, and SS/TA ratio was observed, while ascorbic acid, soluble sugars, reducing sugars, yellow flavonoids, and polyphenols increased during storage in both the coated and control fruits. Carnauba-based wax coated fruits showed no signal of dehydration keeping their shiny green peel up to the end of the storage. The use of coating was crucial for the maintenance of visual quality by reducing mass loss, as well as keeping peel moisture.

Best practices in literacy instruction.

Libro dirigido a profesores en activo o en formación en el área de la alfabetización. Estructurado en cinco partes presenta los últimos estudios sobre el aprendizaje y la enseñanza de la escritura y la lectura, y los aplica de forma práctica desarrollando diferentes estrategias de ayuda para los alumnos, al mismo tiempo que ofrece recomendaciones para orientar la toma de decisiones institucional en la materia. Trata además aspectos como la evaluación, motivación, integración de diferentes tipos de textos y recursos multimedia, la alfabetización de adolescentes y el trabajo con estudiantes de inglés como lengua extranjera.

Quality of learning support for mathematics in transition to University

Resumen basado en el de la publicaci??n

Annual CREMRU-JCI survey of corporate estate management practices in Europe and North America: 1993-1997

This paper summarizes the results of the 1993, 1994, 1995, 1996 and 1997 surveys of chief real estate officers (CREO) from major organizations in Europe and North America. Since 1997 the annual survey is being undertaken jointly by the Corporate Real Estate Management Research Unit (CREMRU) and Johnson Controls Incorporate (JCI). The annual survey has been supported by the International Development Research Council (IDRC) and the International Association of Corporate Real Estate Executives (NACORE International), two leading professional associations concerned with this field of professional activity. The emphasis of this summary is on two aspects of the survey: the incidence of corporate real estate management (CREM) policies, functions and activities; and the assessment of knowledge or skills relevant to the CREM function in the future. Both are of paramount interest to the educational institutions concerned with CREM on both sides of the Atlantic. This includes the educational organs of international organizations concerned with corporate real estate, such as IDRC and NACORE, which play increasingly important roles in the education of their members. The CREMRUJCI annual survey will hopefully offer a useful tool in the international educational effort in this field

Impact of chronic disease on quality of life among the elderly in the state of Sao Paulo, Brazil: a population-based study

Objectives. To assess the impact of chronic disease and the number of diseases on the various aspects of health-related quality of life (HRQOL) among the elderly in Sao Paulo, Brazil. Methods. The SF-36 (R) Health Survey was used to assess the impact of the most prevalent chronic diseases on HRQOL. A cross-sectional and population-based study was carried out with two-stage stratified cluster sampling. Data were obtained from a multicenter health survey administered through household interviews in several municipalities in the state of Sao Paulo. The study evaluated seven diseases-arthritis, back-pain, depression/anxiety, diabetes, hypertension, osteoporosis, and stroke-and their effects on quality of life. Results. Among the 1958 elderly individuals (60 years of age or older), 13.6% reported not having any of the illnesses, whereas 45.7% presented three or more chronic conditions. The presence of any of the seven chronic illnesses studied had a significant effect on the scores Of nearly all the SF-36 (R) scales. HRQOL achieved lower scores when related to depression/anxiety, osteoporosis, and stroke. The higher the number of diseases, the greater the negative effect on the SF-36 (R) dimensions. The presence of three or more diseases significantly affected HRQOL in all areas. The bodily pain, general health, and vitality scales were the most affected by diseases. Conclusions. The study detected a high prevalence of chronic diseases among the elderly population and found that the degree of impact on HRQOL depends on the type of disease. The results highlight the importance of preventing and controlling chronic diseases in order to reduce the number of comorbidities and lessen their impact on HRQOL among the elderly.

Teaching Mathematics in English to Swedish Speaking Students : The Use of Second Language Teaching Practices in the Teaching of Mathematics in English to Swedish Speaking Students in Lower Secondary School

Over 20,000 Swedish lower high school students are currently learning mathematics in English but little research has been conducted in this area. This study looks into the question of how much second language learner training teachers teaching mathematics in English to Swedish speaking students have acquired and how many of those teachers are using effective teaching practices for second language learners. The study confirms earlier findings that report few teachers receive training in second language learning but indicates that some of the teaching practices shown to be effective with second language learners are being used in some Swedish schools

Assessment of Quality of Life and Psychologic Aspects in Patients with Gestational Trophoblastic Disease

OBJECTIVE: To assess quality of life (QoL) and psychological aspects in patients with gestational trophoblastic disease (GTD).METHODS: This cross-sectional self-report study was conducted among 54 women. Validated questionnaires assessed QoL (WHO-QOL-bref), symptoms of depression (Beck Depression Inventory [BDI]) and anxiety (State-Trait Anxiety Inventory [STAI]).RESULTS: Most patients rated overall QoL as good (44.44%) anti were satisfied with their health status (42.59%). Mean QoL domain score was lowest for psychologic health (53.86 +/- 21.46) and highest for social relationships (65.74 +/- 22.41). BDI mean was 15.81 +/- 11.15, indicating dysphoria. STAI means were 46 +/- 6.46 for trait-anxiety and 43.72 +/- 4.23 for state-anxiety, both evidencing medium-high anxiety. Among employed patients, environment domain mean was the highest (p = 0.024). Presence of children resulted in lowest means for physical health (p = 0.041) and environment (p = 0.045). Patients desiring children showed significantly higher means for physical health (p = 0.004), psychological health (p = 0.021) and environment (p = 0.003). Chemotherapy had no significant influence on QoL (p > 0.05).CONCLUSION: This study evidenced psychological impact on GTD patients, suggesting specialized care centers should provide psychological interventions during treatment and follow-up of GTD patients, highlighting the importance of a multidisciplinary approach. (J Reprod Med 2009;54:239-244)