The holistic view of CI rehabilitation : A systematic literature review

Inledning: Helhetssynen på rehabiliteringen efter en CI-operation berörs av många olika aspekter som påverkar livskvaliteten. Vid rehabiliteringen efter att ha opererat in ett cochleaimplantat (CI) är det viktigt att inte bara se till patientens direkta hörselbehov, utan ha en bredare helhetssyn och ta hänsyn till andra behov patienten kan ha. Olika delar i rehabiliteringen efter en CI-operation är teknisk -, medicinsk-, pedagogisk-, psykologisk-, psykosocial-, och samhällelig hörselrehabilitering.   Syfte: Syftet med studien är att undersöka på vilket sätt rehabiliteringsmetoder vid CI-operation sker med utgångspunkt i en helhetssyn på rehabilitering inom audiologisk forskning, samt undersöka hur livskvaliteten påverkas efter CI-operation.   Metod: Examensarbetets syfte och frågeställningar har granskats och besvaras genom en systematisk litteraturstudie.   Resultat: Studier med en helhetssyn på rehabiliteringen som innefattar de sex olika delarna inom hörselrehabilitering saknades. Studiens resultat indikerar att livskvaliteten efter en CI-operation blir avsevärt förbättrad, detta utvärderas med olika självskattningsskalor och rehabiliteringsmetoder.   Slutsatser: Få studier visar prov på ett helhetstänkande enligt den teoretiska beskrivningen av vad en helhetssyn på hörselrehabilitering går ut på. Genom att ha ett helhetstänkande i rehabiliteringen för patienter med CI inkluderas alla olika aspekter som behövs för ett aktivt socialt liv och det emotionella välbefinnandet. Det råder inga tvivel om att livskvaliteten efter en CI-operation ökar

Volunteer tourism impacts in Ghana:A practice approach

Relatively little empirical research has been conducted on impacts of volunteer tourism in local communities. This paper therefore focuses on the local consequences of volunteer tourism for two projects in Tamale, Ghana: Zion Primary School and Tamale Children's Home. A practice approach provides a useful theoretical framework to investigate how volunteers and local actors interact in these projects. In a practice approach, interactions become central to the analysis, highlighting the ways in which volunteers, local people and the local context mutually influence one another. Observations and interviews with volunteers and local actors were used to identify positive and negative consequences of their interactions, which are strongly interlinked and depend on routines, backgrounds and positions of the actors, and contextual conditions. The consequences of volunteer practices are also linked to other current and future practices. A practice approach provides insights into complex situations and may be more suited to analysing the impacts of volunteer tourism than a traditional mono-disciplinary focus

Akt activation is required at a late stage of insulin-induced GLUT4 translocation to the plasma membrane.

International audienceInsulin stimulates the translocation of glucose transporter GLUT4 from intracellular vesicles to the plasma membrane (PM). This involves multiple steps as well as multiple intracellular compartments. The Ser/Thr kinase Akt has been implicated in this process, but its precise role is ill defined. To begin to dissect the role of Akt in these different steps, we employed a low-temperature block. Upon incubation of 3T3-L1 adipocytes at 19 C, GLUT4 accumulated in small peripheral vesicles with a slight increase in PM labeling concomitant with reduced trans-Golgi network labeling. Although insulin-dependent translocation of GLUT4 to the PM was impaired at 19 C, we still observed movement of vesicles toward the surface. Strikingly, insulin-stimulated Akt activity, but not phosphatidylinositol 3 kinase activity, was blocked at 19 C. Consistent with a multistep process in GLUT4 trafficking, insulin-stimulated GLUT4 translocation could be primed by treating cells with insulin at 19 C, whereas this was not the case for Akt activation. These data implicate two insulin-regulated steps in GLUT4 translocation: 1) redistribution of GLUT4 vesicles toward the cell cortex-this process is Akt-independent and is not blocked at 19 C; and 2) docking and/or fusion of GLUT4 vesicles with the PM-this process may be the major Akt-dependent step in the insulin regulation of glucose transport

Akt activation is required at a late stage of insulin-induced GLUT4 translocation to the plasma membrane.

International audienceInsulin stimulates the translocation of glucose transporter GLUT4 from intracellular vesicles to the plasma membrane (PM). This involves multiple steps as well as multiple intracellular compartments. The Ser/Thr kinase Akt has been implicated in this process, but its precise role is ill defined. To begin to dissect the role of Akt in these different steps, we employed a low-temperature block. Upon incubation of 3T3-L1 adipocytes at 19 C, GLUT4 accumulated in small peripheral vesicles with a slight increase in PM labeling concomitant with reduced trans-Golgi network labeling. Although insulin-dependent translocation of GLUT4 to the PM was impaired at 19 C, we still observed movement of vesicles toward the surface. Strikingly, insulin-stimulated Akt activity, but not phosphatidylinositol 3 kinase activity, was blocked at 19 C. Consistent with a multistep process in GLUT4 trafficking, insulin-stimulated GLUT4 translocation could be primed by treating cells with insulin at 19 C, whereas this was not the case for Akt activation. These data implicate two insulin-regulated steps in GLUT4 translocation: 1) redistribution of GLUT4 vesicles toward the cell cortex-this process is Akt-independent and is not blocked at 19 C; and 2) docking and/or fusion of GLUT4 vesicles with the PM-this process may be the major Akt-dependent step in the insulin regulation of glucose transport

Wheat-derived arabinoxylans reduced M2-macrophage functional activity, but enhanced monocyte-recruitment capacity

The immunomodulatory properties of non-digestible polysaccharides (NDPs) have been recognized in in vitro and in vivo studies. The latter mostly demonstrated altered frequencies and inflammatory status of immune cells as clinical parameters. Most of the NDP activity will be exerted in the intestine where they can directly interact with macrophages. The predominant macrophage phenotype in the intestine is M2-like, with M1-like macrophages arising during inflammation. Here, we investigated transcriptional and functional impact on these macrophage phenotypes by NDP-treatment (i.e. yeast-derived soluble β-glucan (yeast-βG), apple-derived RG-I (apple-RGI), shiitake-derived β-glucan (shiitake-βG) or wheat-derived arabinoxylan (wheat-AX)). Wheat-AX, and to a lesser extent shiitake-βG and apple-RGI but not yeast-βG, reduced endocytosis and antigen processing capacity of M1- and M2-like macrophages. Moreover, the NDPs, and most notably wheat-AX, strongly induced transcription and secretion of a unique set of cytokines and chemokines. Conditioned medium from wheat-AX-treated M2-like macrophages subsequently demonstrated strongly increased monocyte recruitment capacity. These findings are in line with clinically observed immunomodulatory aspects of NDPs making it tempting to speculate that clinical activity of some NDPs is mediated through enhanced chemoattraction and modifying activity of intestinal immune cells.</p

A Process Evaluation of a Multi-Component Intervention in Dutch Dietetic Treatment to Improve Portion Control Behavior and Decrease Body Mass Index in Overweight and Obese Patients

The SMARTsize intervention embeds an evidence-based portion control intervention in regular dietetic care. This intervention was evaluated to explore (1) which patients participated, (2) the implementation process, and (3) the outcomes of the intervention. The intervention was evaluated with an observational study design including measures at baseline, and three, six, and nine months after the start of the program. Data concerning the process (participation, dose delivered, dose received, satisfaction) and the outcomes (self-efficacy, intention, portion control strategies, and Body Mass Index (BMI) were collected with forms and questionnaires filled out by dietitians and patients. Descriptive analyses, comparison analyses, and cluster analyses were performed. Patients were mainly obese, moderately to highly educated women of Dutch ethnicity. Use of the intervention components varied from 50% to 100% and satisfaction with the SMARTsize intervention was sufficient to good (grades 7.2&#8315;8.0). Statistically significant (p &lt; 0.001) improvements were observed for self-efficacy (+0.5), portion control strategies (+0.7), and BMI (&#8722;2.2 kg/m2), with no significant differences between patients with or without counselling. Three clusters of patients with different levels of success were identified. To conclude, implementing an evidence-based portion control intervention in real-life dietetic practice is feasible and likely to result in weight loss

A THP-1 Cell Line-Based Exploration of Immune Responses Toward Heat-Treated BLG

Allergen recognition and processing by antigen presenting cells is essential for the sensitization step of food allergy. Macrophages and dendritic cells are both phagocytic antigen presenting cells and play important roles in innate immune responses and signaling between the innate and adaptive immune system. To obtain a model system with a homogeneous genetic background, we derived macrophages and dendritic cells from THP-1 monocytes. The difference between macrophages and dendritic cells was clearly shown by differences in their transcription response (microarray) and protein expression levels. Their resemblance to primary cells was analyzed by comparison to properties as described in literature. The uptake of β-lactoglobulin after wet-heating (60°C in solution) by THP-1 derived macrophages was earlier reported to be significantly increased. To analyse the subsequent immune response, we incubated THP-1 derived macrophages and dendritic cells with native and differently processed β-lactoglobulin and determined the transcription and cytokine expression levels of the cells. A stronger transcriptional response was found in macrophages than in dendritic cells, while severely structurally modified β-lactoglobulin induced a more limited transcriptional response, especially when compared to native and limitedly modified β-lactoglobulin. These results show that processing is relevant for the transcriptional response toward β-lactoglobulin of innate immune cells.</p

Impact of road building on gully erosion risk: A case study from the northern Ethiopian Highlands

Although obvious in the field, the impact of road building on hydrology and gullying in Ethiopia has rarely been analysed. This study investigates how road building in the Ethiopian Highlands affects the gully erosion risk. The road between Makalle and Adwa in the highlands of Tigray (northern Ethiopia), built in 1993-1994, caused gullying at most of the culverts and other road drains. While damage by runoff to the road itself remains limited, off-site effects are very important. Since the building of the road, nine new gullies were created immediately downslope of the studied road segment (6-5 km long) and seven other gullies at a distance between 100 and 500 m more downslope. The road induces a concentration of surface runoff, a diversion of concentrated runoff to other catchments, and an increase in catchment size, which are the main causes for gully development after road building. Topographic thresholds for gully formation are determined in terms of slope gradient of the soil surface at the gully head and catchment area. The influence of road building on both the variation of these thresholds and the modification of the drainage pattern is analysed. The slope gradient of the soil surface at the gully heads which were induced by the road varies between 0.06 and 0.42 m m(-1) (average 0.15 m m(-1)), whereas gully heads without influence of the road have slope gradients between 0.09 and 0.52 m m(-1) (average 0.25 m m(-1)). Road building disturbed the equilibrium in the study area but the lowering of topographic threshold values for gullying is not statistically significant. Increased gully erosion after road building has caused the loss of fertile soil and crop yield, a decrease of land holding size, and the creation of obstacles for tillage operations. Hence roads should be designed in a way that keeps runoff interception, concentration and deviation minimal. Techniques must be used to spread concentrated runoff in space and time and to increase its infiltration instead of directing it straight onto unprotected slopes. Copyright (C) 2002 John Wiley Sons, Ltd.status: publishe