An inpatient rehabilitation model of care targeting patients with cognitive impairment

BACKGROUND: The course and outcomes of hip fracture patients are often complicated by the presence of dementia and delirium, referred to as cognitive impairment (CI), which limits access to in-patient rehabilitation. In response to this concern, members of our team developed and piloted an in-patient rehabilitation model of care (Patient-Centred Rehabilitation Model; PCRM) targeting patients with hip fracture and CI (PCRM-CI). We are now conducting a 3-year study comparing an inpatient rehabilitation model of care for community dwelling individuals with hip fracture and CI (PCRM-CI) to usual care to determine whether it results in improved mobility at the time of discharge from inpatient rehabilitation. METHODS/DESIGN: A non-equivalent pre-post design is being used to evaluate the PCRM-CI compared to usual care. All community dwelling (private home or retirement home) patients following a hip fracture are eligible to participate. Recruitment of both cohorts is taking place at two facilities. Target accrual is 70 hip fracture patients in the PCRM-CI cohort and 70 patients in the usual care cohort. We are also recruiting 70 health care providers (HCPs), who are being trained to implement the PCRM-CI, and their unit managers. Patient data are collected at baseline, discharge, and 6 months post-discharge from an inpatient rehabilitation program. Evaluations include mobility, physical function, and living arrangement. Additional outcome variables are being collected from medical records and from the patients via their proxies. Data on the prevalence and severity of dementia and delirium are being collected. Staff data are collected at baseline and one year after implementation of the model to determine change in staff knowledge and attitudes toward patients with hip fracture and CI. Bi-monthly semi-structured interviews with unit managers have been conducted to examine factors and barriers influencing the model implementation. Data collection began in 2009 and is expected to be completed in 2012. The control cohort of 70 patients has been recruited, and 45 patients have been accrued to the intervention group to date. DISCUSSION: Evaluation of this model of care is timely given the increasing proportion of persons with cognitive impairment and hip fractures. TRIAL REGISTRATION: The study is registered at http://clinicaltrials.gov, Identifier NCT01566136

Phylogenies of Microcystin-Producing Cyanobacteria in the Lower Laurentian Great Lakes Suggest Extensive Genetic Connectivity

Lake St. Clair is the smallest lake in the Laurentian Great Lakes system. MODIS satellite imagery suggests that high algal biomass events have occurred annually along the southern shore during late summer. In this study, we evaluated these events and tested the hypothesis that summer bloom material derived from Lake St. Clair may enter Lake Erie via the Detroit River and represent an overlooked source of potentially toxic Microcystis biomass to the western basin of Lake Erie. We conducted a seasonally and spatially resolved study carried out in the summer of 2013. Our goals were to: 1) track the development of the 2013 summer south-east shore bloom 2) conduct a spatial survey to characterize the extent of toxicity, taxonomic diversity of the total phytoplankton population and the phylogenetic diversity of potential MC-producing cyanobacteria (Microcystis, Planktothrix and Anabaena) during a high biomass event, and 3) compare the strains of potential MC-producers in Lake St. Clair with strains from Lake Erie and Lake Ontario. Our results demonstrated a clear predominance of cyanobacteria during a late August bloom event, primarily dominated by Microcystis, which we traced along the Lake St. Clair coastline downstream to the Detroit River's outflow at Lake Erie. Microcystin levels exceeded the Province of Ontario Drinking Water Quality Standard (1.5 µg L(-1)) for safe drinking water at most sites, reaching up to five times this level in some areas. Microcystis was the predominant microcystin producer, and all toxic Microcystis strains found in Lake St. Clair were genetically similar to toxic Microcystis strains found in lakes Erie and Ontario. These findings suggest extensive genetic connectivity among the three systems

Possible Transport of Basal Debris to the Surface of a Mid-Latitude Glacier on Mars

International audience<p><strong>Introduction:</strong> We observe internal flow structures within a viscous flow feature (VFF; 51.24°W, 42.53°S) interpreted as a debris-covered glacier in Nereidum Montes, Mars. The structures are exposed in the wall of a gully that is incised through the VFF, parallel to its flow-direction. They are near to the glacier terminus and appear to connect its deep interior (and possibly its bed) to arcuate flow-transverse foliations on its surface. Such foliations are common on VFF surfaces, but their relation to VFF-internal structures and ice flow is poorly understood. The VFF-internal structures we observe are reminiscent of up-glacier dipping shear structures that transport basal debris to glacier surfaces on Earth.</p><p>Subglacial environments on Mars are of astrobiological interest due to the availability of water ice and shelter from Mars’ surface radiation environment. However, current limitations in drilling technology prevent their direct exploration. If debris on VFF surfaces contains a component of englacial and/or subglacial debris, those materials could be sampled without access to the subsurface. This could reduce the potential cost and complexity of future missions that aim to explore englacial and subglacial environments on Mars.</p><p><strong>Methods: </strong>We use a 1 m/pixel digital elevation model (DEM) derived from 25 cm/pixel High Resolution Imaging Science Experiment (HiRISE) stereo-pair images, and a false-colour (merged IRB) HiRISE image. We measured the dip and strike of the VFF-internal structures using ArcGIS 10.7 and QGIS software. We also input the DEM (and an inferred glacier bed topography derived from it) into ice flow simulations using the Ice Sheet System Model, assuming no basal sliding and present-day mean annual surface temperature (210K).</p><p><strong>Results and Discussion: </strong>The VFF-internal structures dip up-glacier at ~20° from the bed. This is inconsistent with their formation by bed-parallel ice-accumulation layering without modification by ice flow. The VFF-internal structures and surface foliations are spectrally ‘redder’ than adjacent VFF portions, which appear ‘bluer’. This could result from differences in debris concentration and/or surficial dust trapping between the internal structures and the bulk VFF. Modelling experiments suggest that the up-glacier-dipping structures occur at the onset of a compressional regime as ice flow slowed towards the VFF terminus.</p><p>In cold-based glaciers on Earth, up-glacier-dipping folds are common approaching zones of enhanced ice rigidity near the glacier margin. Where multiple folds co-exist, the outermost typically comprises basal ice with a component of subglacial debris entrained in the presence of interfacial films of liquid water at sub-freezing temperatures. In polythermal glaciers, debris-rich up-glacier-dipping thrust faults form where sliding wet-based ice converges with cold-based ice.</p><p><strong>Conclusions: </strong>We propose that the observed up-glacier-dipping VFF-internal structures are englacial shear zones formed by compressional ice flow. They could represent transport pathways for englacial and subglacial material to the VFF surface. The majority of extant mid-latitude VFF on Mars are thought to have been perennially cold-based; thus we favour the hypothesis that the VFF-internal structures are folds formed under a cold-based thermal regime. Under this mechanism, the outermost surface foliation, and its corresponding VFF-internal structure, is the most likely to contain subglacial debris.</p&gt

The Ursinus Weekly, October 26, 1964

Play, varied activities termed success at retreat: Play forms discussion springboard • Senior Prom to feature Raymond band, Camelot • Democrats sweep campus with 57 percent majority: Partisan area shows Johnson strength • Library consultant to discuss career opportunities • Ursinus to honor four alumni in Founders\u27 Day ceremonies: Helfferich\u27s address, college\u27s future • Dooley associate to speak, show film in Y forum • Parents flock to campus in annual festivities: Grid loss dampens day only a little • Election planned to fill WSGA senate vacancies • Editorial: Answering critics • Is the Summer reading program worthless? • New Gym Club forms on campus • Presidential candidates discussed in debate • Library service expanding • Sophomores elect Atkinson, MSGA representative • Letters to the editor • UC gridmen massacred 48-0 by winless Swarthmore foe: Degenhardt, Moser and Videon on injured list • Day students and Demas win titles • Bear booters beat both Delaware and PMC 1-0 • Pfahler film circus: What to do • Advice column • Greek gleaningshttps://digitalcommons.ursinus.edu/weekly/1231/thumbnail.jp

Internal Structure of a Glacier on Mars Revealed by Gully Incision

International audienceDebris transport from / A Mars glacier bed to / Flowlines on surface

The Ursinus Weekly, December 14, 1964

Enthusiastic Pooh audience hears A. A. Milne children\u27s play: Matinee by Curtain Club • Faculty accepts senate approved hours change • Chorus and soloists usher Christmas season with 27th annual Messiah: Students attend full afternoon rehearsal • Christmas activities fill last week of 1964: Robin Roberts at MSGA banquet; Women\u27s banquet; Dorms hold open house; Mrs. Helfferich\u27s party; Candlelight communion; Christmas dance • Greeks hosts to orphans in area parties • Richard P. Richter accepts duties as alumni secretary • Frosh plan cool Ice palace \u2765 • Bridge tourney on UC campus • Spirit of Christmas present • B-ball team splits two close ones, 60-59 and 70-71: Sloppiness and apathy big factors • ZX leads v-ball; Demas second • Wrestling team looks strong • UC girl confesses in dial-a-bride • Letters to the editor • Greek gleanings • Ursinus kitchen food preparation exposedhttps://digitalcommons.ursinus.edu/weekly/1237/thumbnail.jp

The Ursinus Weekly, November 9, 1964

Senior Ball, Friday, offers Camelot, Al Raymond band: Lord and Lady, permanent class officers to be announced • Graduate awards available from science foundation • Miller and Zucker review election returns, meaning • Museum director on American art to be Forum highlight: Dr. Turner to emphasize the 20th century • William Shaffer, vice-president UC Board of Directors, dies • Pancoast in State House to seek greater local power • Faculty action penalizes 4 with fines, demerits • Curtain Club selects cast for Winnie the Pooh production, schedules December showing • English Club to meet tonight • Editorial: Altruism at Ursinus • Life in the cow palace; An eyewitness account • Kaffee Klatsch hosts large crowd to discuss rights • A girl\u27s life at Ursinus: 1906 • Spotlight: UC abroad • Advice column • Bears belt Haverford 19-6 at Haverford homecoming: Tony Motto scores two touchdowns • Soccermen defeat LaSalle 5-2 • Hockey team wins biggest: W.C., best ever, falls 1-0; West Chester places 5 on all-stars, Ursinus team effort proves supreme • Wrestling to start Tuesday • U.C. men\u27s mooning team suffers setback at hands of faculty • 200 dance to Okie Duke at Cafe Montmarte • Greek gleaningshttps://digitalcommons.ursinus.edu/weekly/1233/thumbnail.jp