Physiotherapists have accurate expectations of their patients’ future health-related quality of life after first assessment in a subacute rehabilitation setting

BACKGROUND Expectations held by health professionals and their patients are likely to affect treatment choices in subacute inpatient rehabilitation settings for older adults. There is a scarcity of empirical evidence evaluating whether health professionals expectations of the quality of their patients' future health states are accurate. METHODS A prospective longitudinal cohort investigation was implemented to examine agreement (kappa coefficients, exact agreement, limits-of-agreement, and intraclass-correlation coefficients) between physiotherapists' (n = 23) prediction of patients' discharge health-related quality of life (reported on the EQ-5D-3L) and the actual health-related quality of life self-reported by patients (n = 272) at their discharge assessment (using the EQ-5D-3L). The mini-mental state examination was used as an indicator of patients' cognitive ability. RESULTS Overall, 232 (85%) patients had all assessment data completed and were included in analysis. Kappa coefficients (exact agreement) ranged between 0.37-0.57 (58%-83%) across EQ-5D-3L domains in the lower cognition group and 0.53-0.68 (81%-85%) in the better cognition group. CONCLUSIONS Physiotherapists in this subacute rehabilitation setting predicted their patients' discharge health-related quality of life with substantial accuracy. Physiotherapists are likely able to provide their patients with sound information regarding potential recovery and health-related quality of life on discharge. The prediction accuracy was higher among patients with better cognition than patients with poorer cognition.

Avaliação de células germinativas e células de Sertoli em modelo experimental de criptorquidia e orquidopexia

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Evaluating Bucknell's Waste Stream

This thesis examines three questions regarding the content of Bucknell University‟s waste stream and the contributors to campus recycling and solid waste disposal. The first asks, “What does Bucknell‟s waste stream consist of?” To answer this question, I designed a campus-wide waste audit procedure that sampled one dumpster from each of the eleven „activity‟ types on campus in order to better understand Bucknell‟s waste composition. The audit was implemented during the Fall semester of the 2011-2012 school year. The waste from each dumpster was sorted into several recyclable and non-recyclable categories and then weighed individually. Results showed the Bison and Carpenter Shop dumpsters to contain the highest percentage of divertible materials (through recycling and/or composting). When extrapolated, results also showed the Dining Services buildings and Facilities buildings to be the most waste dense in terms of pounds of waste generated per square foot. The Bison also generated the most overall waste by weight. The average composition of all dumpsters revealed that organic waste composed 24% of all waste, 23% was non-recyclable paper, and 20% was non-recyclable plastic. It will be important to move forward using these results to help create effective waste programs that target the appropriate areas of concern. My second question asks, “What influences waste behavior to contribute to this „picture‟ of the waste stream?” To answer this question, I created a survey that was sent out to randomly selected sub-group of the university‟s three constituencies: students, faculty, and staff. The survey sought responses regarding each constituency‟s solid waste disposal and recycling behavior, attitudes toward recycling, and motivating factors for solid waste disposal behaviors across different sectors of the university. Using regression analysis, I found three statistically significant motivating factors that influence solid waste disposal behavior: knowledge and awareness, moral value, and social norms. I further examined how a person‟s characteristics associate to these motivating factors and found that one‟s position on campus proved a significant association. Consistently, faculty and staff were strongly influenced by the aforementioned motivating factors, while students‟ behavior was less influenced by them. This suggests that new waste programs should target students to help increase the influence of these motivators to improve the recycling rate and lower overall solid waste disposal on campus. After making overall conclusions regarding the waste audit and survey, I ask my third question, which inquires, “What actions can Bucknell take to increase recycling rates and decrease solid waste generation?” Bucknell currently features several recycling and waste minimization programs on campus. However, using results from the waste audit and campus survey, we can better understand what are the issues of the waste stream, how do we go about addressing these issues, and who needs to be addressed. I propose several suggestions for projects that future students may take on for summer or thesis research. Suggestions include targeting the appropriate categories of waste that occur most frequently in the waste stream, as well as the building types that have the highest waste density and potential recovery rates. Additionally, certain groups on campus should be targeted more directly than others, namely the student body, which demonstrates the lowest influence by motivators of recycling and waste behavior. Several variables were identified as significant motivators of waste and recycling behavior, and could be used as program tactics to encourage more effective behavior.

Dynamic patterns of ventricular remodeling and apoptosis in hearts unloaded by heterotopic transplantation

BACKGROUND Mechanical unloading of failing hearts can trigger functional recovery but results in progressive atrophy and possibly detrimental adaptation. In an unbiased approach, we examined the dynamic effects of unloading duration on molecular markers indicative of myocardial damage, hypothesizing that potential recovery may be improved by optimized unloading time. METHODS Heterotopically transplanted normal rat hearts were harvested at 3, 8, 15, 30, and 60 days. Forty-seven genes were analyzed using TaqMan-based microarray, Western blot, and immunohistochemistry. RESULTS In parallel with marked atrophy (22% to 64% volume loss at 3 respectively 60 days), expression of myosin heavy-chain isoforms (MHC-α/-β) was characteristically switched in a time-dependent manner. Genes involved in tissue remodeling (FGF-2, CTGF, TGFb, IGF-1) were increasingly upregulated with duration of unloading. A distinct pattern was observed for genes involved in generation of contractile force; an indiscriminate early downregulation was followed by a new steady-state below normal. For pro-apoptotic transcripts bax, bnip-3, and cCasp-6 and -9 mRNA levels demonstrated a slight increase up to 30 days unloading with pronunciation at 60 days. Findings regarding cell death were confirmed on the protein level. Proteasome activity indicated early increase of protein degradation but decreased below baseline in unloaded hearts at 60 days. CONCLUSIONS We identified incrementally increased apoptosis after myocardial unloading of the normal rat heart, which is exacerbated at late time points (60 days) and inversely related to loss of myocardial mass. Our findings suggest an irreversible detrimental effect of long-term unloading on myocardium that may be precluded by partial reloading and amenable to molecular therapeutic intervention.

Rates of egg production, grazing and mortatlity of Calanus finmarchicus measured experimentally in the North Atlantic during the Maria S. Merian cruise MSM26, spring 2013

An incubation experiment at five different temperatures was used to assess the potential for adaptation of Calanus finmarchicus to future warming of the ocean. During a short term (3 h) and long term (6 day) exposure of individual females to a gradient of temperature stress, egg production and fecal pellet production were monitored to indicate secondary production and grazing rates. A longer term (10 day) exposure to elevated temperatures followed by a return to ambient sea temperatures was used to assess the potential recovery of individuals exposed to temperature stress. Females were picked out from WP2 net samples and acclimatised in 2 L bottles of GFF filtered seawater with Thalassiosira weissflogii as prey for >48 h at ambient SST. Experimental bottles were filled with filtered seawater (GFF filtered from non-toxic seawater supply) and acclimated to experimental temperature overnight (0, 5, 10, 15 and 20 °C). Individual females were transferred into bottles using forceps and the bottles were inoculated with T. weissflogii to a final concentration of 5 µg chl L-1. Bottles were then placed into water baths and incubated for 3h or 6 d, and monitored for egg and fecal pellet production rates. A 10 day exposure experiment was used to test the potential for recovery from temperature stress, by returning females incubated at 5, 10, 15 and 20 °C back to 10 °C for 24 h and counting egg and fecal pellet production.

Effects of physical disturbance on infaunal and epifaunal assemblages in subtropical, intertidal seagrass beds

We assessed the impact of large-scale commercial and recreational harvesting of polychaete worms Marphysa spp. on macrobenthic assemblages in a subtropical estuary in Queensland, Australia, by examining: (1) the spatial extent of harvesting activities and the rate of recovery of the seagrass habitat over an 18 to 20 mo period; (2) the recovery of infauna in and around commercial pits of known age; (3) the indirect effects of physical disturbance from trampling and deposition of sediments during harvesting on epibenthos in areas adjacent to commercial and recreational pits; (4) impacts of potential indirect effects through manipulative experimentation. Harvesting caused a loss of seagrass, changes to the topography and compaction of the sediments associated with the creation of walls around commercial pits, and the deposition of rubble dug from within the pit. The walls and rubble were still evident after 1.8 to 20 mo, but comprised only a small proportion of the total area on the intertidal banks. There was a shift from an intertidal area dominated by Zostera capricorni to one with a mixture of Z. capricorni, Halophila spp. and Halodule uninervis, but there was no overall decline in the biomass of seagrass in these areas. There were distinct impacts from harvesting on the abundance of benthic infauna, especially amphipods, polychaetes and gastropods, and these effects were still detectable after 4 mo of potential recovery. After 12 me, there were no detectable differences in the abundances of these infauna between dug areas and reference areas, which suggested that infauna had recovered from impacts of harvesting; however, an extensive bloom of toxic fireweed Lyngbya majsucula may have masked any remaining impacts. There were no detectable impacts of harvesting on epifauna living in the seagrass immediately around commercial or recreational pits.

Atributos do solo sob modelos em estágio inicial de restauração de floresta subtropical

The replacement of native vegetation by other land uses is one of the main degrading ecosystem agents, being the most important component of terrestrial environments, natural or with different levels of human disturbance, besides being the main substrate used by plants to obtain conditions soil for its development. In this context, there is the need to adopt the use and sustainable management of land systems. The study aimed to evaluate what is forest restoration system more efficient degraded areas, based on the potential recovery of physical, chemical, carbon and biological activity in the soil. The work was conducted in a forest restoration area UTFPR- Campus two neighbors, whose experiment was established in October 2010. The experimental design is completely randomized, with four replications and experimental plot of 40 m wide by 54 m long ( 2160 m2) were collected and six sampling points per plot. The soil is classified as a Typic. The models evaluated are: 1 - natural or passive regeneration; 2 - Nucleation; 3 - Planting trees in the total area under lines fill and diversity (total planting); 4 - Reference area (forest). The collection of soil samples in layers of 0.0-0.05, 0.05-0.10, 0.10-0.20 and 0.20-0.40 m was carried out in October 2013 and evaluated physical attributes of texture, bulk density, total porosity, microporosity and soil macroporosity and stability of water in households, chemical properties, and total organic carbon (TOC) and physical particle size fractionation and soil biological activity. To find the best forest restoration model, we designed a Restoration Quality Weighted Index for each variable analyzed. Natural regeneration and total plantation showed generally better soil aggregation over 0.10 m and nucleation volume of similar porosity the forest for these layers. There were no differences between the models below 0.10 m for the variables aggregation and soil porosity. The nucleation template had the lowest bulk density, but being greater than the density in the layer forest 0.05-0.10 m, however, was similar to below 0.10 m above the ground. The models had chemical properties similar to or greater than the forest. The forest had the highest stock of COT and carbon associated with minerals (CAM), but natural regeneration was similar to the particulate organic carbon (POC) in the superficial layers of the soil (0-0.10 m), below 0, 10 m, the forest showed higher stock of COT and COP on the ground. The highest peak of C-CO2 emissions occurred in the 28-35 day range where the total plantation was similar to forest. After four years of experiments, it was found that the effect of restoration methods on physical attributes and soil carbon restricted to 0.10 m deep.

Resource recovery potential from secondary components of segregated municipal solid wastes

Fermentable components of municipal solid wastes (MSW) such as fruit and vegetable wastes (FVW), leaf litter, paddy straw, cane bagasse, cane trash and paper are generated in large quantities at various pockets of the city. These form potential feedstocks for decentralized biogas plants to be operated in the vicinity. We characterized the fermentation potential of six of the above MSW fractions for their suitability to be converted to biogas and anaerobic compost using the solid-state stratified bed (SSB) process in a laboratory study. FVW and leaf litter (papermulberry leaves) decomposed almost completely while paddy straw, sugarcane trash, sugarcane bagasse and photocopying paper decomposed to a lower extent. In the SSB process between 50-60% of the biological methane potential (BMP) could be realized. Observations revealed that the SSB process needs to be adapted differently for each of the feedstocks to obtain a higher gas recovery. Bagasse produced the largest fraction of anaerobic compost (fermentation residue) and has the potential for reuse in many ways.

The potential for thermal energy recovery from wastewater treatment works in Southern England

There is potential to extract energy from wastewater in a number of ways, including: kinetic energy using micro-hydro systems, chemical energy through the incineration of sludge, biomass energy from the biogas produced after anaerobic sludge digestion, and thermal energy as heat. This paper considers the last option and asks how much heat could be recovered under UK climatic conditions and can this heat be used effectively by wastewater treatment plants to reduce their carbon footprint? Four wastewater treatment sites in southern England are investigated and the available heat that can be recovered at those sites is quantified. Issues relating to the environmental, economic and practical constraints on how energy can be realistically recovered and utilised are discussed .The results show there is a definite possibility for thermal energy recovery with potential savings at some sites of up to 35,000 tonnes of total long-cycle carbon equivalent (fossil fuel) emissions per year being achievable. The paper also shows that the financial feasibility of three options for using the heat (either for district heating, sludge drying or thermophilic heating in sludge digestion processes) is highly dependant upon the current shadow price of carbon. Without the inclusion of the cost of carbon, the financial feasibility is significantly limited. An environmental constraint for the allowable discharge temperature of effluent after heat-extraction was found to be the major limitation to the amount of energy available for recovery. The paper establishes the true potential of thermal energy recovery from wastewater in English conditions and the economic feasibility of reducing the carbon footprint of wastewater treatment operations using this approach.

Service user involvement in drug treatment programs: Barriers to implementation and potential benefits for client recovery

Service user forums have the potential for improving awareness of services, empowering service users and strengthening community partnerships within an inclusive treatment and rehabilitation framework. The research aimed to investigate perspectives about service user involvement in order to inform the development of effective service user forum(s) in west Ireland. A total of 30 interviews with key service providers and 12 interviews with service users were conducted, with interview questions focusing on: (1) awareness of the Service User Support Team and (2) barriers to service user involvement and the development of service user forums in the region. An integrated data collection and thematic analysis was undertaken. Current levels of service user involvement were low, restricted by one-way communication and appeared grounded in user-provider power differentials and stigma relating to drug dependency. Service providers queried the actual terms of reference, capacity and training that would be needed for service user forums to advocate and lobby for service users. The use of existing support groups, creation of internet user forums and rotation of rural meetings were recommended to promote engagement among service users. The research underscores the need for transparency, resources and a framework for good practice that reflects a participatory approach


Read More: http://informahealthcare.com/doi/abs/10.3109/09687637.2012.671860

Early reperfusion hemodynamics predict recovery in rat hearts: a potential approach towards evaluating cardiac grafts from non-heart-beating donors

Aims Cardiac grafts from non-heartbeating donors (NHBDs) could significantly increase organ availability and reduce waiting-list mortality. Reluctance to exploit hearts from NHBDs arises from obligatory delays in procurement leading to periods of warm ischemia and possible subsequent contractile dysfunction. Means for early prediction of graft suitability prior to transplantation are thus required for development of heart transplantation programs with NHBDs. Methods and Results Hearts (n = 31) isolated from male Wistar rats were perfused with modified Krebs-Henseleit buffer aerobically for 20 min, followed by global, no-flow ischemia (32°C) for 30, 50, 55 or 60 min. Reperfusion was unloaded for 20 min, and then loaded, in working-mode, for 40 min. Left ventricular (LV) pressure was monitored using a micro-tip pressure catheter introduced via the mitral valve. Several hemodynamic parameters measured during early, unloaded reperfusion correlated significantly with LV work after 60 min reperfusion (p<0.001). Coronary flow and the production of lactate and lactate dehydrogenase (LDH) also correlated significantly with outcomes after 60 min reperfusion (p<0.05). Based on early reperfusion hemodynamic measures, a composite, weighted predictive parameter, incorporating heart rate (HR), developed pressure (DP) and end-diastolic pressure, was generated and evaluated against the HR-DP product after 60 min of reperfusion. Effective discriminating ability for this novel parameter was observed for four HR*DP cut-off values, particularly for ≥20 *103 mmHg*beats*min−1 (p<0.01). Conclusion Upon reperfusion of a NHBD heart, early evaluation, at the time of organ procurement, of cardiac hemodynamic parameters, as well as easily accessible markers of metabolism and necrosis seem to accurately predict subsequent contractile recovery and could thus potentially be of use in guiding the decision of accepting the ischemic heart for transplantation.

The potential of solid phase microextraction (SPME) for the recovery of explosives followed by gas and liquid chromatographic analysis

The potential of solid phase microextraction (SPME) in the analysis of explosives is demonstrated. A sensitive, rapid, solventless and inexpensive method for the analysis of explosives and explosive odors from solid and liquid samples has been optimized using SPME followed by HPLC and GC/ECD. SPME involves the extraction of the organic components in debris samples into sorbent-coated silica fibers, which can be transferred directly to the injector of a gas chromatograph. SPME/HPLC requires a special desorption apparatus to elute the extracted analyte onto the column at high pressure. Results for use of GC/ECD is presented and compared to the results gathered by using HPLC analysis. The relative effects of controllable variables including fiber chemistry, adsorption and desorption temperature, extraction time, and desorption time have been optimized for various high explosives. ^

The potential of solid phase microextraction (spme) for the recovery of explosives followed by gas and liquid chromatographic analysis

The potential of solid phase microextraction (SPME) in the analysis of explosives is demonstrated. A sensitive, rapid, solventless and inexpensive method for the analysis of explosives and explosive odors from solid and liquid samples has been optimized using SPME followed by HPLC and GC/ECD. SPME involves the extraction of the organic components in debris samples into sorbent-coated silica fibers, which can be transferred directly to the injector of a gas chromatograph. SPME/HPLC requires a special desorption apparatus to elute the extracted analyte onto the column at high pressure. Re suits for use of GC[ECD is presented and compared to the results gathered by using HPLC analysis. The relative effects of controllable variables including fiber chemistry, adsorption and desorption temperature, extraction time, and desorption time have been optimized for various high explosives.