Age, physical inactivity, obesity, health conditions, and health-related quality of life among patients receiving conservative management for musculoskeletal disorders

Background Musculoskeletal conditions and insufficient physical activity have substantial personal and economic costs among contemporary aging societies. This study examined the age distribution, comorbid health conditions, body mass index (BMI), self-reported physical activity levels, and health-related quality of life of patients accessing ambulatory hospital clinics for musculoskeletal disorders. The study also investigated whether comorbidity, BMI, and self-reported physical activity were associated with patients’ health-related quality of life after adjusting for age as a potential confounder. Methods A cross-sectional survey was undertaken in three ambulatory hospital clinics for musculoskeletal disorders. Participants (n=224) reported their reason for referral, age, comorbid health conditions, BMI, physical activity levels (Active Australia Survey), and health-related quality of life (EQ-5D). Descriptive statistics and linear modeling were used to examine the associations between age, comorbidity, BMI, intensity and duration of physical activity, and health-related quality of life. Results The majority of patients (n=115, 51.3%) reported two or more comorbidities. In addition to other musculoskeletal conditions, common comorbidities included depression (n=41, 18.3%), hypertension (n=40, 17.9%), and diabetes (n=39, 17.4%). Approximately one-half of participants (n=110, 49.1%) self-reported insufficient physical activity to meet minimum recommended guidelines and 150 (67.0%) were overweight (n=56, 23.2%), obese (n=64, 28.6%), severely obese (n=16, 7.1%), or very severely obese (n=14, 6.3%), with a higher proportion of older patients affected. A generalized linear model indicated that, after adjusting for age, self-reported physical activity was positively associated (z=4.22, P<0.001), and comorbidities were negatively associated (z=-2.67, P<0.01) with patients’ health-related quality of life. Conclusion Older patients were more frequently affected by undesirable clinical attributes of comorbidity, obesity, and physical inactivity. However, findings from this investigation are compelling for the care of patients of all ages. Potential integration of physical activity behavior change or other effective lifestyle interventions into models of care for patients with musculoskeletal disorders is worthy of further investigation.

A Boundary-Oriented Chinese Segmentation Method Using NGram Mutual Information

This paper describes our participation in the Chinese word segmentation task of CIPS-SIGHAN 2010. We implemented an n-gram mutual information (NGMI) based segmentation algorithm with the mixed-up features from unsupervised, supervised and dictionarybased segmentation methods. This algorithm is also combined with a simple strategy for out-of-vocabulary (OOV) word recognition. The evaluation for both open and closed training shows encouraging results of our system. The results for OOV word recognition in closed training evaluation were however found unsatisfactory.

Nutritional risk of cancer patients receiving chemotherapy in the ambulatory care setting : a prospective study

Background Cancer itself can alter the metabolic and physiologic of the body's nutritional needs. As a result, some patients experience some degree of weight loss before the start of the treatment. Aim The aim of the study was to determine at which chemotherapy treatment cycle patients with cancer begin to exhibit signs and symptoms of malnutrition. Methods A prospective descriptive correlational design was used to assess the nutritional risk of 111 patients with cancer receiving chemotherapy in the ambulatory setting. The data were collected by using a nutritional screening tool. Findings The prevalence of malnutrition risk was 45% in patients undergoing the first cycle of chemotherapy. Patients who received the first three cycles of chemotherapy were 2.62 times more likely to develop malnutrition than those who received seven or more cycles. The risk of developing malnutrition varies depending on the type of cancer, the types of chemotherapy regime, the number of chemotherapy cycles, body mass index and the stage of cancer. Conclusion The study found about half of the patients had developed signs and symptoms of nutritional risk at cycle one. Hence, nutritional support may be required even before the start of chemotherapy.

On the Security of Two RFID Mutual Authentication Protocols

In this paper, the security of two recent RFID mutual authentication protocols are investigated. The first protocol is a scheme proposed by Huang et al. [7] and the second one by Huang, Lin and Li [6]. We show that these two protocols have several weaknesses. In Huang et al.’s scheme, an adversary can determine the 32-bit secret password with a probability of 2−2 , and in Huang-Lin-Li scheme, a passive adversary can recognize a target tag with a success probability of 1−2−4 and an active adversary can determine all 32 bits of Access password with success probability of 2−4 . The computational complexity of these attacks is negligible.

Analysis of impedance matched circuit for wireless power transfer

Typical wireless power transfer systems utilize series compensation circuit which is based on magnetic coupling and resonance principles that was first developed by Tesla. However, changes in coupling caused by gap distance, alignment and orientation variations can lead to reduce power transfer efficiencies and the transferred power levels. This paper proposes impedance matched circuit to reduce frequency bifurcation effect and improve on the transferred power level, efficiency and total harmonic distortion (THD) performance of the series compensation circuit. A comprehensive mathematical analysis is performed for both series and impedance matched circuits to show the frequency bifurcation effects in terms of input impedance, variations in transferred power levels and efficiencies. Matlab/Simulink results validate the theoretical analysis and shows the circuits’ THD performance when circuits are fed with power electronic converters.

The effectiveness of education or behavioral interventions on adherence to phosphate control in adults receiving hemodialysis: A systematic review protocol

The objective of this review is to identify the effectiveness of education or behavioral interventions on adherence to phosphate control in adults with end stage kidney disease (ESKD) receiving hemodialysis (HD).

A survey of patients' experience of pain and other symptoms while receiving care from palliative care services

Context In Australia, patients at the end of life with complex symptoms and needs are often referred to palliative care services (PCSs), but little is known about the symptoms of patients receiving palliative care in different settings. Objective To explore patients’ levels of pain and other symptoms while receiving care from PCSs. Method PCSs registered through Australia's national Palliative Care Outcomes Collaboration (PCOC) were invited to participate in a survey between 2008 and 2011. Patients (or if unable, a proxy) were invited to complete the Palliative Care Outcome Scale. Results Questionnaires were completed for 1800 patients. One-quarter of participants reported severe pain, 20% reported severe ‘other symptoms’, 20% reported severe patient anxiety, 45% reported severe family anxiety, 66% experienced depressed feelings and 19% reported severe problems with self-worth. Participants receiving care in major cities reported higher levels of depressed feelings than participants in inner regional areas. Participants receiving care in community and combined service settings reported higher levels of need for information, more concerns about wasted time, and lower levels of family anxiety and depressed feelings when compared to inpatients. Participants in community settings had lower levels of concern about practical matters than inpatients. Conclusions Patients receiving care from Australian PCSs have physical and psychosocial concerns that are often complex and rated as ‘severe’. Our findings highlight the importance of routine, comprehensive assessment of patients’ concerns and the need for Specialist Palliative Care clinicians to be vigilant in addressing pain and other symptoms in a timely, systematic and holistic manner, whatever the care setting.

Integrated decoupling and matching network incorporated in the ground plane of a compact monopole array

Compact arrays enable various applications such as antenna beam-forming and multi-input, multi-output (MIMO) schemes on limited-size platforms. The reduced element spacing in compact arrays introduces high levels of mutual coupling which can affect the performance of the adaptive array. This coupling causes a mismatch at the input ports, which disturbs the performance of the individual elements in the array and affects the implementation of beam steering. In this article, a reactive decoupling network for a 3-element monopole array is used to establish port isolation while simultaneously matching input impedance at each port to the system impendence. The integrated decoupling and matching network is incorporated in the ground plane of the monopole array, providing further development scope for beamforming using phase shifters and power splitters in double-layered circuits.

How does symptom burden differ in people with advanced CKD who are non-dialysis or currently receiving dialysis?

Background Chronic kidney disease (CKD) leads to a range of symptoms which are often under-recognised. Little is known about the full range of symptoms, particularly in who are pre-dialysis. Understanding symptom prevalence, distress, severity and frequency will help prioritise symptom management. Aims To examine symptom burden in advanced CKD (stages 4 and 5) and compare the symptom experience between those receiving dialysis or those who are pre-dialysis. Methods Using a cross-sectional design, a convenience sample of 436 people from three hospitals completed the Modified Dialysis Symptom Index (MDSI). Demographic and renal history data was also collected. Based on the 32 symptoms, we compared the prevalence, severity, distress and frequency of each symptom by treatment modality. Results Mean age was 48 years (range 18-87 years) and 53% were male. 75.5% (haemodialysis = 287; peritoneal dialysis = 42) were receiving dialysis and 24.5% (n = 107) were pre-dialysis. Overall, the mean symptom prevalence was 12.6 ± 7.9 and the most prevalent symptoms were fatigue (77%), bone or joint pain (60.3%) and itching (59.6%) across all CKD groups. The distress, severity and frequency of the symptoms were higher in the dialysis group. However, a higher frequency of psychological symptoms (worrying, feeling nervous and depression) were reported in the pre-dialysis group. Implication for clinical practice Patients with advanced CKD have a high symptom burden with those who are pre-dialysis needing greater psychological support. The MDSI could be used in nursing practice to screen patients for symptoms which could lead to timely and appropriate interventions.

The time taken for the regional distribution of ventilation to stabilise: An investigation using electrical impedance tomography

Electrical impedance tomography is a novel technology capable of quantifying ventilation distribution in the lung in real time during various therapeutic manoeuvres. The technique requires changes to the patient’s position to place the electrical impedance tomography electrodes circumferentially around the thorax. The impact of these position changes on the time taken to stabilise the regional distribution of ventilation determined by electrical impedance tomography is unknown. This study aimed to determine the time taken for the regional distribution of ventilation determined by electrical impedance tomography to stabilise after changing position. Eight healthy, male volunteers were connected to electrical impedance tomography and a pneumotachometer. After 30 minutes stabilisation supine, participants were moved into 60 degrees Fowler’s position and then returned to supine. Thirty minutes was spent in each position. Concurrent readings of ventilation distribution and tidal volumes were taken every five minutes. A mixed regression model with a random intercept was used to compare the positions and changes over time. The anterior-posterior distribution stabilised after ten minutes in Fowler’s position and ten minutes after returning to supine. Left-right stabilisation was achieved after 15 minutes in Fowler’s position and supine. A minimum of 15 minutes of stabilisation should be allowed for spontaneously breathing individuals when assessing ventilation distribution. This time allows stabilisation to occur in the anterior-posterior direction as well as the left-right direction.

Hampson type heat-exchanger technology and economic evaluation for LNG re- gasification and power generation At LNG receiving terminals

The system for high utilization of LNG cold energy is proposed by use of process simulator. The proposed design is a closed loop system, and composed by a Hampson type heat exchanger, turbines, pumps and advanced humid air turbine (AHAT) or Gas turbine combined cycle (GTCC). Its heat sources are Boil-off gas and cooling water for AHAT or GTCC. The higher cold exergy recovery to power can be about 38 to 56% as compared to the existing cold power generation of about 20% with a Rankine cycle of a single component. The advantage of the proposed system is to reduce the number of heat exchangers. Furthermore, the environmental impact is minimized because the proposed design is a closed loop system. A life cycle comparative cost is calculated to demonstrate feasibility of the proposed design. The development of the Hampson type exchangers is expected to meet the key functional requirements and will result in much higher LNG cold exergy recovery and the overall system performance i.e. re-gasification. Additionally, the proposed design is expected to provide flexibility to meet different gas pressure suited for the deregulation of energy system in Japan and higher reliability for an integrated boil-off gas system.

Segmental bioelectrical impedance in the assessment of body composition of Sri Lankan children

Abstract: Over the years bioelectrical impedance assay (BIA) has gained popularity in the assessment of body composition. However, equations for the prediction of whole body composition use whole body BIA. This study attempts to evaluate the usefulness of segmental BIA in the assessment of whole body composition. A cross sectional descriptive study was conducted at the Professorial Paediatric Unit of Lady Ridgeway Hospital, Colombo, involving 259 (M/F:144/115) 5 to 15 year old healthy children. The height, weight, total and segmental BIA were measured and impedance indices and specific resistivity for the whole body and segments were calculated. Segmental BIA indices showed a significant association with whole body composition measures assessed by total body water (TBW) using the isotope dilution method (D2O). Impedance index was better related to TBW and fat free mass (FFM), while specific resistivity was better related to the fat mass of the body. Regression equations with different combinations of variables showed high predictability of whole body composition. Results of this study showed that segmental BIA can be used as an alternative approach to predict the whole body composition in Sri Lankan children.

Transportation disadvantage impedance indexing: A methodological approach to reduce policy shortcomings

Access to transport systems and the connection to such systems provided to essential economic and social activities are critical to determine households' transportation disadvantage levels. In spite of the developments in better identifying transportation disadvantaged groups, the lack of effective policies resulted in the continuum of the issue as a significant problem. This paper undertakes a pilot case investigation as test bed for a new approach developed to reduce transportation policy shortcomings. The approach, ‘disadvantage-impedance index’, aims to ease transportation disadvantages by employing representative parameters to measure the differences between policy alternatives run in a simulation environment. Implemented in the Japanese town of Arao, the index uses trip-making behaviour and resident stated preference data. The results of the index reveal that even a slight improvement in accessibility and travel quality indicators makes a significant difference in easing disadvantages. The index, integrated into a four-step model, proves to be highly robust and useful in terms of quick diagnosis in capturing effective actions, and developing potentially efficient policies.