186 research outputs found

    Collaborative Physical and Music Therapy Interventions for Impairments of Chronic Stroke: A Case Study

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    [Background and Purpose] In the United States, the annual prevalence of stroke is estimated to be 800,000. 1 Following a stroke, physical therapy (PT) interventions aim to help individuals recover from impairments such as muscle weakness and overall functional limitation. Current research supports both physical and music therapy (MT) interventions on an individual basis. The purpose of this case study was to evaluate the effectiveness of combined PT and MT interventions for strength, balance, gait, and functional activity for person following stroke. [Case Description] The patient is a 50- year-old caucasian female post right cerebral vascular accident (CVA) with left hemiparesis that occurred secondary to quadruple bypass surgery, two years prior to the initiation of this research. [Intervention] These therapy sessions were a collaboration of PT and MT techniques. PT interventions included gait training, balance training, functional strengthening, patient and family education, and home exercise instruction. MT interventions included rhythmic auditory stimulation in collaboration with PT interventions and therapeutic instrumental music performance. [Outcomes] The patient increased Berg Balance Scale Score by 12 points (MCD= 5 points). Five Time Sit To Stand test decreased by 7.4 seconds (MCD= 2.5 seconds). [Discussion] Collaborative PT and MT interventions lead to improved strength, balance, gait symmetry, and quality of life in treating a patient with impairments caused by stroke. Further research is needed to generalize these collaborative techniques beyond the findings of this case study

    The invisibility of code enforcement in planning praxis: The case of informal housing in southern California

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    In this article, Jake Wegmann and Jonathan Pacheco Bell argue that more and better engagement with working class neighborhoods and communities of color are urgent imperatives for the planning profession. Drawing on a survey, interviews, and their professional experiences with the informal housing market in Southern California, they show that, although much of this work is managed by code enforcement officers, the planning profession largely holds code enforcement at armsā€™ length. Wegmann and Bell show that ending the estrangement between code enforcement and planning would offer numerous benefits including inculcating cultural competence in planners, addressing vexing issues such as housing unaffordability, and creating better codes and policies

    Washeteria closures, infectious disease and community health in rural Alaska: a review of clinical data in Kivalina, Alaska

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    Background. Kivalina is a northwest Alaska barrier island village of 400 people vulnerable to storm surges exacerbated recently by delayed winter sea and shore ice formation. The village has no in-home piped water or sewage; the “washeteria” is the only structure providing public showers, laundry facilities and flush toilets. In October 2004, a storm damaged the washeteria septic system resulting in prolonged facility closures. We assessed rates of gastrointestinal, respiratory and skin infections potentially impacted by prolonged washeteria closures. Methods. We obtained washeteria closure dates from 2003 to July 2009 and defined >7 day closure as prolonged. We received de-identified data on all Kivalina clinic visits from 2003 to 2009 and selected visits with ICD-9 diagnosis codes for respiratory, skin, or gastrointestinal infection; subsequent same patient/same illness-category visits within 14 days were excluded. We compared annual visit rates, for all ages combined, before (2003–2004) and after (2005–2009) the “2004” storm. Results. The washeteria had prolonged closures for 34 days (4.7%) in the 2 years 2003–2004 and 864 days (51.7%) between January 2005 and July 2009. Closures ranged from 8 to 248 days. Respiratory infection rates declined significantly from 1.32 visits/person/year in the 2003–2004 period to 0.99 visits/person/year in the 2005–2009 period. There was a significant increase in skin infection rates after 2004, peaking at 0.28 visits/person/year in 2007 and then declining significantly to 0.15 visits/person/year in 2009. Gastrointestinal infection rates remained stable and low throughout (average: 0.05 visits/person/year). No temporal association was observed between respiratory, gastrointestinal or skin infection rates and prolonged washeteria closures. Conclusion. The Kivalina washeteria was closed frequently and for extended periods between 2005 and 2009. Initial closures possibly resulted in increased skin infection rates. No increase in respiratory or gastrointestinal infections was noted. Evaluation of community adaptations to closures and other factors (e.g. childhood pneumococcal vaccination) would expand understanding of these findings

    Wafer-scale magnesium diboride thin films and devices with tunable high kinetic inductance

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    Progress in superconducting device and detector technologies over the past decade have realized practical applications in quantum computers, detectors for far-IR telescopes, and optical communications. Superconducting thin film materials, however, have remained largely unchanged, with aluminum still being the material of choice for superconducting qubits, and Nb compounds for higher frequency devices. MgB2\mathrm{MgB}_2, known for its highest Tc\mathrm{T}_c (39 K) among metallic superconductors, is a viable material for higher frequency superconducting devices moving towards THz frequencies. However, difficulty in synthesizing thin films have prevented implementation of MgB2\mathrm{MgB}_2 devices into the application base of superconducting electronics, despite promising preliminary results for a number of applications. We have developed smooth and uniform MgB2\mathrm{MgB}_2 films on 4-inch Si wafers by depositing uniform Mg-B co-sputtered film, capping the film in situ to create a closed environment, followed by an optimized post-annealing step. We further report mature device fabrication processes and demonstrate test structures to measure properties of the films. This includes resonators with internal Q factor over 104\mathrm{10}^4 at 4.5 K and tunable high kinetic inductance (5-50 pH/ā–”\square readily achieved in a 40 nm film), opening up the path for development of high frequency and high temperature MgB2\mathrm{MgB}_2 microdevices

    Heterologous production of the insecticidal pea seed albumin PA1 protein by Pichia pastoris and protein engineering to potentiate aphicidal activity via fusion to snowdrop lectin Galanthus nivalis agglutinin; GNA)

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    BackgroundNew bioinsecticides with novel modes of action are urgently needed to minimise the environmental and safety hazards associated with the use of synthetic chemical pesticides and to combat growing levels of pesticide resistance. The pea seed albumin PA1b knottin peptide is the only known proteinaceous inhibitor of insect vacuolar adenosine triphosphatase (V-ATPase) rotary proton pumps. Oral toxicity towards insect pests and an absence of activity towards mammals makes Pa1b an attractive candidate for development as a bioinsecticide. The purpose of this study was to investigate if Pichia pastoris could be used to express a functional PA1b peptide and if itā€™s insecticidal activity could be enhanced via engineering to produce a fusion protein comprising the pea albumin protein fused to the mannose-specific snowdrop lectin (Galanthus nivalis agglutinin; GNA).ResultsWe report the production of a recombinant full-length pea albumin protein (designated PAF) and a fusion protein (PAF/GNA) comprised of PAF fused to the N-terminus of GNA in the yeast Pichia pastoris. PAF was orally toxic to pea (Acyrthosiphon pisum) and peach potato (Myzus persicae) aphids with respective, Day 5 LC50 values of 54 ĀµM and 105 ĀµM derived from doseā€“response assays. PAF/GNA was significantly more orally toxic as compared to PAF, with LC50 values tenfold (5 ĀµM) and 3.3-fold (32 ĀµM) lower for pea and peach potato aphids, respectively. By contrast, no phenotypic effects were observed for worker bumble bees (Bombus terristrus) fed PAF, GNA or PAF/GNA in acute toxicity assays. Confocal microscopy of pea aphid guts after pulse-chase feeding fluorescently labelled proteins provides evidence that enhanced efficacy of the fusion protein is attributable to localisation and retention of PAF/GNA to the gut epithelium. In contact assays the fusion protein was also found to be significantly more toxic towards A. pisum as compared to PAF, GNA or a combination of the two proteins.ConclusionsOur results suggest that GNA mediated binding to V-type ATPase pumps acts to potentiate the oral and contact aphicidal activity of PAF. This work highlights potential for the future commercial development of plant protein-based bioinsecticides that offer enhanced target specificity as compared to chemical pesticides, and compatibility with integrated pest management strategies

    Exploring the Integration of Environmental Impacts in the Cost Analysis of the Pilot MEL-SELF Trial of Patient-Led Melanoma Surveillance

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    Aims Human health is intrinsically linked with planetary health. But planetary resources are currently being degraded and this poses an existential threat to human health and the sustainability of our healthcare systems. The aims of this study were to (1) describe an approach to integrate environmental impacts in a cost analysis; and (2) demonstrate this approach by estimating select environmental impacts alongside traditional health system and other costs using the example of the pilot MEL-SELF randomised controlled trial of patient-led melanoma surveillance. Methods Economic costs were calculated alongside a randomised trial using standard cost analysis methodology from a societal perspective. Environmental impacts were calculated using a type of carbon footprinting methodology called process-based life cycle analysis. This method considers three scopes of carbon emissions: Scope 1, which occur directly from the intervention; Scope 2, which occur indirectly from the interventionā€™s energy use; and Scope 3, which occur indirectly because of the value chain of the intervention. In this study we only included emissions from patient transport to attend their melanoma clinic over the study period of 6 months. Results The environmental impact per participant across allocated groups for patient transport to their melanoma clinic was estimated to be 10 kg carbon dioxide equivalent. Economic costs across the allocated groups indicated substantial health system costs, out-of-pocket costs, and productivity losses associated with melanoma surveillance. The largest cost contributor was health system costs, and the most expensive category of health system cost was hospital admission

    ā€œYou can't shoot another bullet until you've reloaded the gunā€: Coaches' perceptions, practices and experiences of deloading in strength and physique sports

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    Deloading refers to a purposeful reduction in training demand with the intention of enhancing preparedness for successive training cycles. Whilst deloading is a common training practice in strength and physique sports, little is known about how the necessary reduction in training demand should be accomplished. Therefore, the purpose of this research was to determine current deloading practices in competitive strength and physique sports. Eighteen strength and physique coaches from a range of sports (weightlifting, powerlifting, and bodybuilding) participated in semi-structured interviews to discuss their experiences of deloading. The mean duration of coaching experience at ā‰„ national standard was 10.9 (SD = 3.9) years. Qualitative content analysis identified Three categories: definitions, rationale, and application. Participants conceptualised deloading as a periodic, intentional cycle of reduced training demand designed to facilitate fatigue management, improve recovery, and assist in overall training progression and readiness. There was no single method of deloading; instead, a reduction in training volume (achieved through a reduction in repetitions per set and number of sets per training session) and intensity of effort (increased proximity to failure and/or reduction in relative load) were the most adapted training variables, along with alterations in exercise selection and configuration. Deloading was typically prescribed for a duration of 5 to 7 days and programmed every 4 to 6 weeks, although periodicity was highly variable. Additional findings highlight the underrepresentation of deloading in the published literature, including a lack of a clear operational definition

    Probation practice in the information age

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    This article analyses the implications of the greater use of technology and information in probation practice. Using data generated via an ethnography of probation, the article firstly argues that probation in England and Wales now exists in what scholars would identify as ā€˜the information ageā€™ (i.e. that computers and other technologies work to define and create probation practice as we know it). The article goes on to use actor-network theory to analyse two ā€˜heterogeneous networksā€™ to explore the way in which probation practitioners and the technologies they use interact to create particular forms of practice. The article argues that unless we understand the technology that underpins practice we cannot fully understand practice. Finally, the article considers the implications of this analysis for probation post-Transforming Rehabilitation (TR)

    Boseā€“Einstein condensation in large time-averaged optical ring potentials

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    Interferometric measurements with matter waves are established techniques for sensitive gravimetry, rotation sensing, and measurement of surface interactions, but compact interferometers will require techniques based on trapped geometries. In a step towards the realisation of matter wave interferometers in toroidal geometries, we produce a large, smooth ring trap for Boseā€“Einstein condensates using rapidly scanned time-averaged dipole potentials. The trap potential is smoothed by using the atom distribution as input to an optical intensity correction algorithm. Smooth rings with a diameter up to 300 Ī¼m are demonstrated. We experimentally observe and simulate the dispersion of condensed atoms in the resulting potential, with good agreement serving as an indication of trap smoothness. Under time of flight expansion we observe low energy excitations in the ring, which serves to constrain the lower frequency limit of the scanned potential technique. The resulting ring potential will have applications as a waveguide for atom interferometry and studies of superfluidity
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