The influence of inspiratory muscle training upon exertional breathlessness in healthy elderly men and women

Breathlessness is a common complaint amongst seemingly, healthy, elderly people, mild exertion being sufficient to illicit extremely debilitating sensations. This places an unacceptable physical limitation on the individual and reduces their quality of life. Previous investigators have suggested that the strength and condition of the respiratory muscles are contributing factors in the sensation of breathlessness on exertion (Aldrich, 1990; Killian, 1990). Therefore, the aim of the research contained within the thesis, was firstly; to characterise the respiratory muscle function of a group of healthy elderly subjects, and secondly; to assess the influence of inspiratory muscle training upon the genesis of exertional breathlessness in healthy, elderly men and women. The respiratory muscle strength of a group of healthy, elderly people was determined by measuring the maximum static and dynamic respiratory pressures on two occasions separated by approximately one week. The results suggested the maximum (or minimum) mouth pressure averaged over a one second period, measured using a hand-held mouth pressure meter (Precision Medical Ltd, U.K.), represents a reliable and reproducible index of respiratory muscle function in healthy, elderly subjects. In addition, the data was used to establish a contemporary set of prediction equations, and normal values were derived to facilitate the estimation of respiratory muscle strength in healthy, elderly subjects. Finally, the data suggested that the respiratory muscle function of healthy, elderly people declines with advancing age. However, the strength of the respiratory muscles does not correlate significantly with indices of body size, but is strongly influenced by customary levels of physical activity. Breathlessness during both cycle ergometry and treadmill walking was measured using both the visual analogue scale and the modified Borg scale. For healthy, elderly subjects, poor correlations existed between exertional breathlessness and the prevailing level of ventilation. Mean breathlessness scores were therefore used as an alternative index of breathlessness. The use of this parameter was validated by examining its reproducibility during both cycle and treadmill exercise. During cycle ergometry, the modified Borg scale provided more reproducible ratings of breathlessness than the visual analogue scale. However, a treadmill walking protocol was developed, which induces breathlessnesss afely, and during which, elderly people rated their breathlessnessr eproducibly using both the VAS and modified Borg scale. In general, elderly subjects preferred using the modified Borg scale. Finally, the role of the respiratory muscles in the genesis of exertional breathlessness was examined by determining the influence of inspiratory muscle training upon the sensation of breathlessness during treadmill exercise. Respiratory muscle training, using an inspiratory muscle training device, increased the inspiratory muscle strength of healthy, elderly men and women by approximately 20% and ameliorated the sensation of exertional breathlessness by 21.4%. Inspiratory muscle training was also associated with improvements in elderly people's subjective perception of their breathing, their ability to perform daily routine activities and their "well-being". Together, these results suggest that inspiratory muscle training may improve the quality of life of healthy, elderly people

Credible impact evaluation in complex contexts:Confirmatory and exploratory approaches

Debate continues over how best international development agencies can evaluate the impact of actions intended to reduce poverty, insecurity and vulnerability in diverse and complex contexts. There are strong ethical grounds for simply asking those intended to benefit what happened to them, but it is not obvious how to do so in a way that is sufficiently free from bias in favour of confirming what is expected. This article considers scope for addressing this problem by minimizing the prior knowledge participants have of what is being evaluated. The tensions between more confirmatory and exploratory methodological approaches are reviewed in the light of experience of designing and piloting a qualitative impact assessment protocol for evaluating NGO interventions in complex rural livelihood transformations. The article concludes that resolving these tensions entails using mixed methodologies, and that the importance attached to exploratory (nested within confirmatory) approaches depends on contextual complexity, the type of evidence sought and the level of trust between stakeholders. </jats:p

Discontinuous Galerkin spatial discretisation of the neutron transport equation with pyramid finite elements and a discrete ordinate (SN) angular approximation

In finite element analysis it is well known that hexahedral elements are the preferred type of three dimensional element because of their accuracy and convergence properties. However, in general it is not possible to mesh complex geometry problems using purely hexahedral meshes. Indeed for highly complex geometries a mixture of hexahedra and tetrahedra is often required. However, in order to geometrically link hexahedra and tetrahedra, in a conforming finite element mesh, pyramid elements will be required. Until recently the basis functions of pyramid elements were not fully understood from a mathematical or computational perspective. Indeed only first-order pyramid basis functions were rigorously derived and used within the field of finite elements. This paper makes use of a method developed by Bergot that enables the generation of second and higher-order basis functions, applying them to finite element discretisations of the neutron transport equation in order to solve nuclear reactor physics, radiation shielding and nuclear criticality problems. The results demonstrate that the pyramid elements perform well in almost all cases in terms of both solution accuracy and convergence properties

Detecting modification of biomedical events using a deep parsing approach

<p>Abstract</p> <p>Background</p> <p>This work describes a system for identifying event mentions in bio-molecular research abstracts that are either speculative (e.g. <it>analysis of IkappaBalpha phosphorylation</it>, where it is not specified whether phosphorylation did or did not occur) or negated (e.g. <it>inhibition of IkappaBalpha phosphorylation</it>, where phosphorylation did <it>not </it>occur). The data comes from a standard dataset created for the BioNLP 2009 Shared Task. The system uses a machine-learning approach, where the features used for classification are a combination of shallow features derived from the words of the sentences and more complex features based on the semantic outputs produced by a deep parser.</p> <p>Method</p> <p>To detect event modification, we use a Maximum Entropy learner with features extracted from the data relative to the trigger words of the events. The shallow features are bag-of-words features based on a small sliding context window of 3-4 tokens on either side of the trigger word. The deep parser features are derived from parses produced by the English Resource Grammar and the <it>RASP </it>parser. The outputs of these parsers are converted into the Minimal Recursion Semantics formalism, and from this, we extract features motivated by linguistics and the data itself. All of these features are combined to create training or test data for the machine learning algorithm.</p> <p>Results</p> <p>Over the test data, our methods produce approximately a 4% absolute increase in F-score for detection of event modification compared to a baseline based only on the shallow bag-of-words features.</p> <p>Conclusions</p> <p>Our results indicate that grammar-based techniques can enhance the accuracy of methods for detecting event modification.</p

Uppermost Triassic to Lower Jurassic sediments of the island of Ireland and its surrounding basins

The uppermost Triassic to Lower Jurassic interval has not been extensively studied across the island of Ireland. This paper seeks to redress that situation and presents a synthesis of records of the uppermost Triassic and Lower Jurassic from both onshore and offshore basins as well as describing the sedimentological characteristics of the main lithostratigraphical units encountered. Existing data have been supplemented with a re-examination and logging of some outcrops and the integration of data from recent hydrocarbon exploration wells and boreholes. The Late Triassic Penarth Group and Early Jurassic Lias Group can be recognised across the Republic of Ireland and Northern Ireland. In some onshore basins, almost 600 m of strata are recorded, however in offshore basins thicknesses in excess of two kilometres for the Lower Jurassic have now been recognised, although little detailed information is currently available. The transition from the Triassic to the Jurassic was a period of marked global sea-level rise and climatic change (warming) and this is reflected in the lithostratigraphical record of these sediments in the basins of Northern Ireland and offshore basins of the Republic of Ireland. In general, the sediments of this interval are thicker than those in Great Britain and have potential for detailed study of climatic and sea-level fluctuation