Engaging with clinicians to implement and evaluate the ICF in neurorehabilitation practice

INTRODUCTION: Although deemed a globally accepted framework, there remains scare evidence on the process and outcome of implementing the International Classification of Functioning, Disability and Health (ICF) within neurorehabilitation. OBJECTIVES: This review briefly explores the existing, broader literature and then reports on two action research projects, undertaken in England, specifically within stroke and neurorehabilitation. Working with participants, including clinicians from in-patient and community settings, there are now 35 different ways identified for the use of the ICF. CONCLUSION: The outcome of the first project highlights that using the ICF enhances communication within and beyond the acute stroke service, fosters holistic thinking and clarifies team roles. To adopt it into clinical practice, the ICF must be adapted to meet local service needs. The use of action research has facilitated the knowledge translation process which has enabled the ICF to become a clinical reality in neurorehabilitation, with clinicians identifying a range of potential uses

Metaldehyde removal from drinking water by adsorption onto filtration media: mechanisms and optimisation

Trace micropollutants should be removed during drinking water production without increasing the disinfection-by-product formation potential or energy demand of the treatment process. We demonstrate the efficacy of different filtration media to remove metaldehyde through controlled batch experiments on water augmented with metaldehyde. Equilibrium concentrations of metaldehyde and surrogate organics were successfully described by the Freundlich isotherm. Metaldehyde can be attenuated to varying degrees with activated carbon and sand with an active and inactive biofilm with kf values ranging from 0.006–0.3 (mg g−1)(L mg−1)1/n. The presence of the active biofilm improved metaldehyde adsorption by sand media, due to additional biosorption mechanisms, a greater surface area or biodegradation. Baseline levels of competing natural organic matter surrogates (NOM) reduced overall adsorption efficacy but increasing concentrations of NOM did not impact metaldehyde removal efficacy in a significant way. Biological activated carbon was identified as the most suitable adsorbent of metaldehyde (94% removal) but sand with an acclimated biofilm was capable of acting as a bio-adsorbent of metaldehyde even under environmentally relevant concentrations (41% adsorption from 0.002.5 mg L−1). Moreover, we observed that thermal hydrolysis of metaldehyde occurred at 60 °C, suggesting that thermal regeneration of GAC for this pesticide was possible at relatively low temperatures. Biological adsorption and thermal hydrolysis approaches presented herein offered a way forward to increase efficiency and cost effectiveness of existing treatments for metaldehyde

Technique for predicting high-frequency stability characteristics of gaseous-propellant combustors

A technique for predicting the stability characteristics of a gaseous-propellant rocket combustion system is developed based on a model that assumes coupling between the flow through the injector and the oscillating chamber pressure. The theoretical model uses a lumped parameter approach for the flow elements in the injection system plus wave dynamics in the combustion chamber. The injector flow oscillations are coupled to the chamber pressure oscillations with a delay time. Frequency and decay (or growth) rates are calculated for various combustor design and operating parameters to demonstrate the influence of various parameters on stability. Changes in oxidizer design parameters had a much larger influence on stability than a similar change in fuel parameters. A complete description of the computer program used to make these calculations is given in an appendix

Sleep disturbance and serum ferritin levels associate with high impulsivity and impulse control disorders in male Parkinson\u27s Disease patients

Impulse control disorders (ICDs) occur in a subset of Parkinson’s disease (PD) patients on dopaminergic medications however there are currently no reliable markers to identify patients at risk. Sleep disturbances are more common in patients with an ICD. Serum ferritin levels have been associated with PD disease stage and progression, but have not previously been associated with impulsivity levels. The objective of this study was to determine if serum ferritin levels and sleep disturbance are associated with high traits of impulsivity and ICD in a cohort of PD patients attending a movement disorders clinic. This study assessed impulsiveness in 87 PD patients using the Barratt Impulsiveness Scale. Severity of sleep disturbance was determined using the sleep-related items of the MDS-UPDRS. Serum ferritin, iron and transferrin levels were measured in patients, as well as 36 age-matched healthy controls. Serum ferritin levels were significantly elevated in male PD patients in the high impulsivity group compared to patients in the low (p=.022) and normal range groups (p=.024) and showed a linear increase across the three groups. Sleep disturbance also demonstrated a linear trend, which was most severe in the high impulsivity group (p=.030). A subgroup of 11 male PD patients who fulfilled the DSM-5 criteria for an ICD had significantly higher ferritin levels and more severe sleep disturbance when compared with the remaining male PD cohort. Serum ferritin levels and sleep disturbance severity are highlighted as potential markers for abnormal impulsivity and ICD in PD patients

Alien Registration- Jefferson, Acell R. (Lewiston, Androscoggin County)

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