Health-Related Quality of Life and PTSD-Symptoms in Survivors of Extracorporeal Membrane Oxygenation (ECMO) Support

Background: Extracorporeal membrane oxygenation (ECMO) survivors have shown to have poor physical and mental health outcomes post decannulation and hospitalization; thus leading to an overall decreased quality of life. Identifying and managing the psychological components of care in this patient population can improve their physical, emotional, and mental well-being. Purpose: To assess the incidence of impaired health related quality of life (HRQOL) and posttraumatic stress disorder (PTSD) like symptoms in survivors of ECMO; identify which constellation of patients (respiratory vs. cardiac) have poorer HRQOL outcomes post ECMO; and compare the tools used to measure post procedural outcomes in this patient population. Methods: This is a prospective cohort study. 21 patients were invited to participate in this study. Surveys were administered and data collected at discharge, first follow-up appointment (2-4 weeks), and second follow-up appointment (12-16 weeks) post discharge. Demographics were gathered through the patient’s chart and data from the SF12v2 health survey and ICU memory tool (ICUMT). The surveys addressed the incidence of poor HRQOL in relation to PTSD-like symptoms in patients. Results: A total of 8 participants agreed to participate in the surveys, with only 3 participants completing the surveys at all 3 data collection points. At each data collection timepoint, the PCS and MCS scores were not significantly different for the 3 participants, however the MCS scores from the SF12v2 and the ICUMT at data collection points two and three appear to align with similar results. Conclusion: Despite low scores overall, study results did not show any statistical significance in PCS and MCS scores from the SF12v2 survey. The ICUMT and MCS data report similar results and those patients admitted with a cardiac diagnosis had poorer HRQOL outcomes compared to those admitted with a respiratory diagnosis. Further research is recommended

Out of India: Immigrant Hindus and South Asian Hinduism in the United States

The article provides a survey of research on immigrant Hindus and South Asian Hinduism in the United States, focusing in particular on certain trends in the development of American Hinduism (e.g., Americanization, protestantization, ecumenization, congregationalization, homogenization, ritual adaptation) and prominent themes in more recent scholarship on the topic (e.g., race, transnational connections, and Hindu nationalism)

Advances in Fuel Cell Vehicle Design

Factors such as global warming, dwindling fossil fuel reserves, and energy security concerns combine to indicate that a replacement for the internal combustion engine (ICE) vehicle is needed. Fuel cell vehicles have the potential to address the problems surrounding the ICE vehicle without imposing any significant restrictions on vehicle performance, driving range, or refuelling time. Though there are currently some obstacles to overcome before attaining the widespread commercialization of fuel cell vehicles, such as improvements in fuel cell and battery durability, development of a hydrogen infrastructure, and reduction of high costs, the fundamental concept of the fuel cell vehicle is strong: it is efficient, emits zero harmful emissions, and the hydrogen fuel can be produced from various renewable sources. Therefore, research on fuel cell vehicle design is imperative in order to improve vehicle performance and durability, increase efficiency, and reduce costs. This thesis makes a number of key contributions to the advancement of fuel cell vehicle design within two main research areas: powertrain design and DC/DC converters. With regards to powertrain design, this research presents a novel fuel cell-battery-ultracapacitor topology which shows reduced mass and cost, and increased efficiency, over other promising topologies found in the literature. A detailed vehicle simulator created in MATLAB/Simulink is used to perform a comprehensive parametric study on different fuel cell vehicle types, resulting in general conclusions for optimal topologies, as well as component types and sizes, for fuel cell vehicles. Next, a general analytical method to optimize the novel battery-ultracapacitor energy storage system based on maximizing efficiency, and minimizing cost and mass, is developed. With regards to DC/DC converters, it is important to design efficient and light-weight converters for use in fuel cell and other electric vehicles to improve overall vehicle fuel economy. Thus, this research presents a novel soft-switching method, the capacitor-switched regenerative snubber, for the high-power DC/DC boost converters commonly used in fuel cell vehicles. This circuit is shown to increase the efficiency and reduce the overall mass of the DC/DC boost converter

ParticipACTION: A mass media campaign targeting parents of inactive children; knowledge, saliency, and trialing behaviours

<p>Abstract</p> <p>Background</p> <p>In late 2007, Canada's ParticipACTION national physical activity mass media campaign was re-launched, with an initial campaign targeting parents of elementary school-aged children. The campaign informed them about the risks of physical inactivity for children and youth. The purpose of this study was to assess campaign awareness and understanding following the campaign, and to identify whether exposure to this campaign was likely associated with behaviour change.</p> <p>Methods</p> <p>A convenience sample of 1,500 adults was recruited though an existing panel (n = 60,000) of Canadian adults to participate in online surveys. Initial campaign exposure included "prompted" and "unprompted" recall of specific physical activity messages from the 2007 ParticipACTION campaign, knowledge of the benefits of PA, saliency, and initial trial behaviours to help their children become more active.</p> <p>Results</p> <p>One quarter of respondents showed unprompted recall of specific message content from the ParticipACTION campaign, and prompted recall was 57%. Message recall and understanding was associated with knowledge about physical activity, and that in turn was related to high saliency. Saliency was associated with each of the physical activity-related trial behaviours asked.</p> <p>Conclusion</p> <p>Campaign awareness and understanding was high following this ParticipACTION campaign, and was associated with intermediate campaign outcomes, including saliency and trial behaviours. This is relevant to campaign evaluations, as it suggests that an initial focus on influencing awareness and understanding is likely to lead to more substantial change in campaign endpoints.</p

Development of a Rural Childcare Professionals Advisory Board Focused on Mental and Physical Wellbeing

Background. Childcare providers have high rates of stress and obesity, which can have an impact on the care they provide for children. Limited research has described strategies for including childcare providers in the development of wellbeing initiatives, especially in rural areas.Objective. To describe the creation and acceptability of a rural childcare advisory board focused on childcare providers’ wellbeing as well as the acceptability of a wellbeing summit implemented by the board.Methods. A collaborative model guided the actions of the advisory board. Acceptability of the board and the summit were assessed via surveys.Results. Key factors contributing to the success of the advisory board included flexibility around the COVID-19 pandemic, evening meetings, and group text messaging. Both the advisory board and wellbeing summit were deemed acceptable.Conclusions. Future efforts are focused on offering an annual statewide wellbeing summit and other interventions. Work is needed to identify sustainable funding sources

A modified Delphi study to enhance and gain international consensus on the Physical Activity Messaging Framework (PAMF) and Checklist (PAMC)

Abstract Introduction Physical activity messaging is an important step in the pathway towards improving population physical activity levels, but best practice is not yet understood. A gap in the literature exists for a physical activity messaging framework to help guide creation and evaluation of messages. This study aimed to further develop and improve, and gain international expert consensus on, a standardised Physical Activity Messaging Framework and Checklist. Methods A modified Delphi study consisting of three online survey rounds was conducted. Each survey gathered feedback from an international expert panel using quantitative and qualitative methods. The framework and checklist were amended between each round based on survey results until consensus (defined a priori as 80% agreement) was reached. Results The final expert panel (n = 40, 55% female) came from nine countries and comprised academics (55%), healthcare and other professionals (22.5%) and government officials or policymakers (22.5%). Consensus was reached in survey 3 with 85 and 87.5% agreement on the framework and checklist, respectively. Conclusion This study presents an expert- and evidence-informed framework and checklist for physical activity messaging. If used consistently, the Physical Activity Messaging Framework and Checklist may improve practice by encouraging evidence-based and target audience-focused messages, as well as enhance the research base on physical activity messaging by harmonising key terminologies and improving quality of reporting. Key next steps include further refining the Physical Activity Messaging Framework and Checklist based on their use in real-world settings

Habitual physical activity and cardiometabolic risk factors in adults with cerebral palsy

2014 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license(http://creativecommons.org/licenses/by/3.0/).This article has been made available through the Brunel Open Access Publishing Fund.Adults with cerebral palsy (CP) are known to participate in reduced levels of total physical activity. There is no information available however, regarding levels of moderate-to-vigorous physical activity (MVPA) in this population. Reduced participation in MVPA is associated with several cardiometabolic risk factors. The purpose of this study was firstly to compare levels of sedentary, light, MVPA and total activity in adults with CP to adults without CP. Secondly, the objective was to investigate the association between physical activity components, sedentary behavior and cardiometabolic risk factors in adults with CP. Adults with CP (n = 41) age 18–62 yr (mean ± SD = 36.5 ± 12.5 yr), classified in Gross Motor Function Classification System level I (n = 13), II (n = 18) and III (n = 10) participated in this study. Physical activity was measured by accelerometry in adults with CP and in age- and sex-matched adults without CP over 7 days. Anthropometric indicators of obesity, blood pressure and several biomarkers of cardiometabolic disease were also measured in adults with CP. Adults with CP spent less time in light, moderate, vigorous and total activity, and more time in sedentary activity than adults without CP (p < 0.01 for all). Moderate physical activity was associated with waist-height ratio when adjusted for age and sex (β = −0.314, p < 0.05). When further adjustment was made for total activity, moderate activity was associated with waist-height ratio (β = −0.538, p < 0.05), waist circumference (β = −0.518, p < 0.05), systolic blood pressure (β = −0.592, p < 0.05) and diastolic blood pressure (β = −0.636, p < 0.05). Sedentary activity was not associated with any risk factor. The findings provide evidence that relatively young adults with CP participate in reduced levels of MVPA and spend increased time in sedentary behavior, potentially increasing their risk of developing cardiometabolic disease