Exploring the Personal Reality of Disability and Recovery: A Tool for Empowering the Rehabilitation Process

People experiencing disability and chronic disease often feel powerless, relinquishing medical control to “more knowledgeable” professionals. This article presents qualitative and quantitative results from three individual patients experiencing an emerging procedure called Recovery Preference Exploration (RPE). To inspire greater patient involvement, self-direction, and individual choice, we instructed participants to create an imagined recovery path, exposing recovery preferences while learning about clinical rehabilitation concepts. Results uncovered important values and feelings about disability, providing a richer context for patient evaluation and treatment goal modification. Applying mixed methods, RPE is presented as an explanatory process for quantifying recovery preferences in a way that stimulates rich narrative of how people see different types of disabilities. RPE shows promise for increasing depth of discussions among patients, family, and clinicians. RPE may promote greater quality of life through patient empowerment by directed learning, increased communication, and enhanced self-knowledge

Enhanced Endurance Performance by Periodization of CHO Intake: "sleep low" strategy

Purpose: We investigated the effect of a chronic dietary periodization strategy on endurance performance in trained athletes. Methods: 21 triathletes (V[Combining Dot Above]O2max: 58.7 +/- 5.7 mL[middle dot]min-1[middle dot]kg-1) were divided into 2 groups: a "sleep-low" (SL, n = 11) and a control group (CON, n = 10) consumed the same daily carbohydrate (CHO) intake (6 g[middle dot]kg-1[middle dot]d-1) but with different timing over the day to manipulate CHO availability before and after training sessions. The "sleep low" strategy consisted of a 3-week training/diet intervention comprising three blocks of diet/exercise manipulations: 1) "train-high" interval training sessions (HIT) in the evening with high-CHO availability; 2) overnight CHO restriction ("sleeping-low"), and 3) "train-low" sessions with low endogenous and exogenous CHO availability. The CON group followed the same training program but with high CHO availability throughout training sessions (no CHO restriction overnight, training sessions with exogenous CHO provision). Results: There was a significant improvement in delta efficiency during submaximal cycling for SL versus CON (CON: +1.4 +/- 9.3 %, SL: +11 +/- 15 %, P<0.05). SL also improved supra-maximal cycling to exhaustion at 150% of peak aerobic power (CON: +1.63 +/- 12.4 %, SL: +12.5 +/- 19.0 %; P = 0.06) and 10 km running performance (CON: -0.10 +/- 2.03 %, SL: -2.9 +/- 2.15 %; P < 0.05). Fat mass was decreased in SL (CON: -2.6 +/- 7.4; SL: -8.5 +/- 7.4 %PRE, P < 0.01), but not lean mass (CON: -0.22 +/- 1.0; SL: -0.16 +/- 1.7 %PRE). Conclusion: Short-term periodization of dietary CHO availability around selected training sessions promoted significant improvements in submaximal cycling economy, as well as supra-maximal cycling capacity and 10 km running time in trained endurance athletes

The antimicrobial efficacy of hypoxia mimicking cobalt oxide doped phosphate-based glasses against clinically relevant Gram positive, Gram negative bacteria and a fungal strain

Bioactive phosphate glasses are of considerable interest for a range of soft and hard tissue engineering applications. The glasses are degradable and can release biologically important ions in a controlled manner. The glasses can also potentially be used as an antimicrobial delivery system. In the given study, novel cobalt-doped phosphate-based glasses, (P 2O 5) 50(Na 2O) 20(CaO) 30-x(CoO) x where 0 ≤ x (mol %) ≤ 10, were manufactured and characterized. As the cobalt oxide concentration increased, the rate of dissolution was observed to decrease. The antimicrobial potential of the glasses was studied using direct and indirect contact methods against both Escherichia coli (NCTC 10538) Staphylococcus aureus (ATCC 6538) and Candida albicans (ATCC 76615). The results showed strong, time dependent, and strain specific antimicrobial activity of the glasses against microorganisms when in direct contact. Antimicrobial activity (R) ≥ 2 was observed within 2 h against Escherichia coli, whereas a similar effect was achieved in 6 h against Staphylococcus aureus and Candida albicans. However, when in indirect contact, the dissolution products from the bioactive glasses failed to show an antimicrobial effect. Following direct exposure to the glasses for 7 days, osteoblast-like SAOS-2 cells showed a 5-fold increase in VEGF mRNA while THP-1 monocytic cells showed a 4-fold increase in VEGF mRNA expression when exposed to 10% CoO-doped glass compared with the cobalt free control glass. Endothelial cells stimulated with conditioned medium taken from cell cultures of THP-1 monocytes exposed to 10% CoO doped glass showed clear tubelike structure (blood vessel) formation after 4 h