Equity of access to adult hospice inpatient care within north-west England.

There is a growing debate about the question of equity of access to hospice and palliative care services. Even countries with relatively well developed palliative care systems are considered to have problems of access and inequity of provision. Despite these concerns, we still lack a relevant evidence base to serve as a guide to action. We present an analysis of access to adult hospice inpatient provision in the north-west region of England that employs Geographical Information Systems (GIS). Measures of the possible demand for, and supply of, hospice inpatient services are used to determine the potential accessibility of cancer patients, assessed at the level of small areas (electoral wards). Further, the use of deprivation scores permits an analysis of the equity of access to adult inpatient hospice care, leading to the identification of areas where additional service provision may be warranted. Our research is subject to a number of caveats�it is limited to inpatient hospice provision and does not include other kinds of inpatient and community-based palliative care services. Likewise, we recognise that not everyone with cancer will require palliative care and also that palliative care needs exist among those with nonmalignant conditions. Nevertheless, our methodology is one that can also be applied more generally

The influence of 6 weeks of maximal eccentric plantarflexor training on muscle-tendon mechanics

Resistance training can influence muscle-tendon properties including strength, flexibility, stretch tolerance and muscle-tendon stiffness; however the specific influence of eccentric-only training is unknown. Therefore, the aims of the present study were to examine the effects of a 6-week maximal eccentric resistance training programme on isometric plantarflexor moment (MVC), dorsiflexion range of motion (ROM), stretch tolerance (peak passive moment), muscle and tendon stiffness and running economy. Thirteen recreationally active men (age = 20.0 ± 0.9 yr, mass = 75.9 ± 8.5 kg, height = 1.8 ± 0.1 m) volunteered for the study after giving written informed consent; ethical approval was granted from the University of Northampton. Training was performed twice weekly for six weeks and consisted of 5 sets of 12 repetitions of 3-s maximal eccentric contractions at 10°•s-1 from 20° plantarflexion to 10° dorsiflexion. Maximal isometric plantarflexor moment, dorsiflexion ROM, stretch tolerance, and muscle, tendon and muscle-tendon unit (MTU) stiffness were measured using isokinetic dynamometry, real-time ultrasound and 3D motion analyses before and after the training. Running economy (VO2) was determined at a running speed equating to 70%VO2max using online gas analysis. Repeated measures t-tests were used to determine significant differences between pre- and post-training data, significance accepted at p0.05). Analysis of ultrasound data revealed a significant decrease in muscle stiffness (20.6%; p0.05). While the training-induced increase in plantarflexor strength was expected, the substantial increases in ROM, stretch tolerance and tendon stiffness, and the reduction in passive muscle stiffness, were important and novel findings. Interestingly, when measured during passive stretch, MTU stiffness remained unchanged while tendon stiffness increased and muscle stiffness decreased. These disparate findings have clear implications for testing methodologies, and indicate that imaging techniques must be utilised in order to examine the effects of interventions on specific tissues. As the training clearly enhanced the capacity of the muscle to tolerate both tissue loading and deformation, which are commonly associated with muscle strain injury, these data have clear implications for both muscular performance and injury risk

The influence of acute variable resistance loading on subsequent free-weight maximal squat performance

Elastic bands attached to a loaded barbell during a squat exercise create a variable resistance (VR), thus changing the mechanical loading and stress placed through the musculoskeletal system. Preconditioning the neuromuscular system using near-maximal or maximal voluntary contractions (MVC) can induce a phenomenon known as post-activation potentiation (PAP) to enhance performance to ‘supramaximal’ levels. However, the potentiating effects of VR on subsequent free-weight resistance (FWR) squat performance have not been examined. Thus, the aim of the present study was to examine the influence of VR exercise using elastic bands on subsequent FWR squat performance. Sixteen recreationally active men (age = 26.0 ± 7.8 yr, height = 1.7 ± 0.2 m, mass 82.6 ± 12.7 kg) experienced in squatting (>3yr) volunteered for the study after giving written informed consent; ethical approval was granted from the University of Northampton. Subjects’ 1-RM were determined then on two subsequent days either a 3-RM FWR (control) or a 3-RM VR (experimental) squat exercise was performed at 85% 1-RM (35% of the load generated from band tension in the VR condition). Five minutes later, motion analysis recorded knee joint kinematics during a subsequent FWR 1-RM squat, with vastus medialis, vastus lateralis, rectus femoris and semitendinosus electromyograms (EMG) simultaneously recorded. Paired t-tests were used to determine significance, accepted at p0.05) or EMG amplitude (5.9%; p>0.05) occurred. No subjects increased 1-RM in the FWR condition, however 13 of 16 (81%) increased 1-RM by ~10% following VR. Preconditioning the neuromuscular system using VR significantly increased 1-RM without changes in knee extensor muscle activity or knee flexion angle, however eccentric and concentric velocities were reduced. Thus, VR can potentiate the neuromuscular system to enhance subsequent maximal lifting performance. The lack of change in EMG suggests that changes in muscle activity were small or non-existent, which may be explained by force-velocity effects (slower movement = larger forces). Alternatively a greater activation of hip musculature (not measured in the present study) may allow a greater total lower limb force to be developed. Regardless, as 1-RM increased greater lower-limb loading occurred, thus VR potentiated the neuromuscular system and could enhance training stimuli

Effect of Pyrolysis on the Removal of Antibiotic Resistance Genes and Class I Integrons from Municipal Wastewater Biosolids

Wastewater biosolids represent a significant reservoir of antibiotic resistance genes (ARGs). While current biosolids treatment technologies can reduce ARG levels in residual wastewater biosolids, observed removal rates vary substantially. Pyrolysis is an anoxic thermal degradation process that can be used to convert biosolids into energy rich products including py-gas and py-oil, and a beneficial soil amendment, biochar. Batch pyrolysis experiments conducted on municipal biosolids revealed that the 16S rRNA gene, the ARGs erm(B), sul1, tet(L), tet(O), and the integrase gene of class 1 integrons (intI1) were significantly reduced at pyrolysis temperatures ranging from 300–700 °C, as determined by quantitative polymerase chain reaction (qPCR). Pyrolysis of biosolids at 500 °C and higher resulted in approximately 6-log removal of the bacterial 16S rRNA gene. ARGs with the highest observed removals were sul1 and tet(O), which had observed reductions of 4.62 and 4.04-log, respectively. Pyrolysis reaction time had a significant impact on 16S rRNA, ARG and intI1 levels. A pyrolysis residence time of 5 minutes at 500 °C reduced all genes to below detection limits. These results demonstrate that pyrolysis could be implemented as a biosolids polishing treatment technology to substantially decrease the abundance of total bacteria (i.e., 16S rRNA), ARGs and intI1 prior to land application of municipal biosolids

Hope Measurement in Mexican American Youth

Hope is a motivational construct that has been associated with many positive outcomes in children, adolescents, and adults. Although research with the Children’s Hope Scale (CHS) has demonstrated support for the reliability and validity of the CHS with various samples of youth, there is little empirical evidence for its use with Latino youth. The current study examined the psychometric properties of the six-item CHS in a sample of 135 Mexican American youth. Confirmatory factor analyses provided support for a hierarchical representation of the CHS with two underlying factors (pathways and agency). CHS scores were found to be positively correlated with measures of positive affect, life satisfaction, support from family and friends, and optimism. Additional analyses provided evidence supporting convergent validity and measurement invariance across gender. Implications and directions for future research are discussed

‘Dominant ethnicity’ and the ‘ethnic-civic’ dichotomy in the work of A. D. Smith

This article considers the way in which the work of Anthony Smith has helped to structure debates surrounding the role of ethnicity in present-day nations. Two major lines of enquiry are evident here. First, the contemporary role of dominant ethnic groups within 'their' nations and second, the interplay between ethnic and civic elements in nationalist argument. The two processes are related, but maintain elements of distinctiveness. Smith's major contribution to the dominant ethnicity debate has been to disembed ethnicity from the ideologically-charged and/or anglo-centric discourse of ethnic relations and to place it in historical context, thereby opening up space for dominant group ethnicity to be considered as a distinct phenomenon. This said, Smith's work does not adequately account for the vicissitudes of dominant ethnicity in the contemporary West. Building on the classical works of Hans Kohn and Friedrich Meinecke, Anthony Smith has also made a seminal contribution to the debate on civic and ethnic forms of national identity and nationalist ideology. As well as freeing this debate from the strong normative overtones which it has often carried, he has continued to insist that the terms civic and ethnic should be treated as an ideal-typical distinction rather than a scheme of classification