Traumatic spinal cord injury in South Africa and Sweden : epidemiologic features and functioning

Background: Trauma to the human spinal cord typically strikes out of the blue, leaving those surviving the initial ordeal with permanent or temporary deficits in health and functioning. Because of this, traumatic spinal cord injuries (TSCI) impose a significant burden on society. While these facts are well known for certain countries, the International Perspectives on Spinal Cord Injury Report highlights the need for the remaining countries to establish a foundation upon which injuries could be prevented and functioning problems addressed. In South Africa, the foundation for primary prevention and knowledge of the unmet needs of persons with TSCI are not yet established. Aim: To develop an evidence-based foundation for TSCI in South Africa that addresses prevention both in terms of injury occurrence and problems with functioning. Methods: This thesis utilised a mixed-method approach to answer epidemiologic and functioning questions. A prospective, population-based design was used in Study I and II to determine the incidence, aetiology and injury profiles of newly-injured adults with TSCI in Cape Town, South Africa and Stockholm, Sweden. In the Functioning section of the thesis (Study III), a comparative content validity design was used to define the nature of functioning categories in a generic outcome measure currently used in the South African SCI rehabilitation field, and a standardised measure not yet adopted in the local context, against the International Classification of Functioning, Disability and Health and the brief ICF core sets for SCI in the post-acute context. In Study IV, qualitative description was used to explore the experiences of reclaiming participation in 17 chronic survivors of TSCI by emphasising their met and unmet needs as well as the conditions influencing them. Findings: One-hundred and forty-seven and 49 incident cases, resulting in an annual crude incidence rate of 75.6 and 19.0 per million population, were registered for the region of South Africa (study I) and Sweden (study II), respectively. The leading cause of injury in South Africa was assault, accounting for approximately 60% of all incident cases, compared with the leading cause in Sweden, where falls was responsible for 58% of all cases. The two cohorts differed significantly with respect to demographic and aetiologic characteristics. Concerning functioning, Study III found that the generic rehabilitation outcome measure was not fully conceptualised within the ICF and did not cover all the essential functioning aspects as contained in the brief core set. In contrast, the standardised outcome measure was fully conceptualised within the ICF and covered, in its entirety, the activity and participation categories contained in the brief core set. In Study IV, clients’ perspectives confirmed 'participation' as a desirable and possible goal by effectively dealing with the new self, negotiating obstacles, identifying facilitators of participation, and becoming an agent. These critical aspects − also categories − were essential for reconstructing meaning and prioritising important life situations. Conclusions: The incidence of TSCI in South Africa is among the highest in the world and is mainly caused by assault, while the incidence in Sweden appeared consistent to what is proposed for Western Europe. Furthermore, there is a need to raise awareness and facilitate the use of standardised outcome measures in TSCI rehabilitation, since the current operational measure in the South African SCI rehabilitation field presented some shortcomings. It is remarkable to conclude that while participation is indeed a reality after injury, the dimensionality of challenges remains an issue for further discourse. The insights gained from these studies provide an evidence-based foundation for impacting primary prevention action plans and the alignment of rehabilitation practices towards addressing the unmet needs of survivors

Calibration Curve Raw Data.xlsx

In this research PTR-ToF-MS was used to measure the concentration of five haloamines (monochloramine, dichloramine, monobromamine, dibromamine, and bromochloramine) in aqueous standards and during kinetic experiments that simulate drinking water disinfection. Gas phase sampling was performed and correlated to aqueous concentrations.</p

Falls and fear of falling predict future falls and related injuries in ambulatory individuals with spinal cord injury: a longitudinal observational study

Questions: What is the 1-year incidence of falls and injurious falls in a representative cohort of community-dwelling ambulatory individuals with chronic spinal cord injury? What are the predictors of recurrent falls (more than two/year) and injurious falls in this population? Design: One-year longitudinal observational multi-centre study. Participants: A representative sample of 68 (of 73 included) community-dwelling ambulatory individuals with traumatic SCI attending regular follow-up programs at rehabilitation centres. Outcome measures: Primary outcome measures were incidence and predictors of recurrent falls (more than two/year) and injurious falls reported every 2 weeks for 1 year. Results: A total of 48% of participants reported recurrent falls. Of the 272 reported falls, 41% were injurious. Serious injuries were experienced by 4% of participants, all of whom were women. Multivariate logistic regression analysis showed that recurrent falls in the previous year (OR = 111, 95% CI = 8.6 to 1425), fear of falling (OR = 6.1, 95% CI = 1.43 to 26) and longer time taken to walk 10 m (OR = 1.3, 95% CI = 1.0 to 1.7) were predictors of recurrent falls. Fear of falling (OR = 4.3, 95% CI = 1.3 to 14) and recurrent falls in the previous year (OR = 4.2, 95% CI = 1.2 to 14) were predictors of injurious falls. Conclusion: Ambulatory individuals have a high risk of falling and of fall-related injuries. Fall history, fear of falling and walking speed could predict recurrent falls and injurious falls. Further studies with larger samples are needed to validate these findings. [Jørgensen V, Butler Forslund E, Opheim A, Franzén E, Wahman K, Hultling C, Seiger Å, Ståhle A, Stanghelle JK, Roaldsen KS (2017) Falls and fear of falling predict future falls and related injuries in ambulatory individuals with spinal cord injury: a longitudinal observational study. Journal of Physiotherapy 63: 108–113

Role of grinding method on granular activated carbon characteristics

A coconut shell (AC1230CX) and a bituminous coal based (F400) granular activated carbon (GAC) were ground with mortar and pestle (MP), a blender, and a bench-scale ball milling unit (BMU). Blender was the most time-efficient for particle size reduction. Four size fractions ranging from 20 × 40 to 200 × 325 were characterized along with the bulk GACs. Compared to bulk GACs, F400 blender and BMU 20 × 40 fractions decreased in specific surface area (SSA, –23% and –31%, respectively) while smaller variations (–14% to 5%) occurred randomly for AC1230CX ground fractions. For F400, the blender and BMU size fraction dependencies were attributed to the combination of (i) radial trends in the F400 particle properties and (ii) importance of shear (outer layer removal) versus shock (particle fracturing) size reduction mechanisms. Compared to bulk GACs, surface oxygen content (At%-O1s) increased up to 34% for the F400 blender and BMU 20 × 40 fractions, whereas all AC1230CX ground fractions, except for the blender 100 × 200 and BMU 60 × 100 and 100 × 200 fractions, showed 25–29% consistent increases. The At%-O1s gain was attributed to (i) radial trends in F400 properties and (ii) oxidization during grinding, both of which supported the shear mechanism of mechanical grinding. Relatively small to insignificant changes in point of zero charge (pHPZC) and crystalline structure showed similar trends with the changes in SSA and At%-O1s. The study findings provide guidance for informed selection of grinding methods based on GAC type and target particle sizes to improve the representativeness of adsorption studies conducted with ground GAC, such as rapid small-scale column tests. When GACs have radial trends in their properties and when the target size fraction only includes larger particle sizes, manual grinding is recommended

Monochloramine-sensitive amperometric microelectrode: optimization of gold, platinum, and carbon fiber sensing materials for removal of dissolved oxygen interference

Monochloramine electrochemical determination in an aqueous system using newly fabricated gold and platinum microelectrodes was investigated to optimize sensor operation and to eliminate dissolved oxygen (DO) interference during monochloramine measurements. Carbon fiber microelectrodes were also compared for reference purposes. Gold and platinum microelectrodes exhibited no oxygen interference during monochloramine measurement and provided a linear relationship when operated at +150 and +300 mV vs. Ag/AgCl over a wide concentration range (0–4.2 mg Cl2/L), respectively. The carbon fiber microelectrode with 7-μm tip diameter was not sufficiently sensitive to monochloramine concentrations for detailed study. The baseline signal of both gold and platinum microelectrodes (i.e., signal without monochloramine) was near zero. With the same geometric tip diameter (20-μm tip diameter), gold microelectrodes resulted in better amperometric electrode response to monochloramine than platinum microelectrodes; gold microelectrodes had a higher sensitivity (52 ± 0.7 vs. 18 ± 0.07 pA/[mg Cl2/L]) and lower detection limit (0.12 ± 0.013 vs. 0.33 ± 0.10 mg Cl2/L), resulting in gold as the preferred microelectrode material. The developed gold microelectrode will allow accurate in situ monochloramine determination in biofilm while eliminating the confounding effects of oxygen interference