The effects of enhanced discharge education on knowledge retention in first time stroke/TIA patients

The purpose of this study is to determine whether patients aged 40-65 years, who are admitted for stroke or a transient ischemic attack (TIA) for the first time and who receive enhanced stroke discharge education have higher levels of education retention than patients aged 40-65 years who are admitted for stroke/TIA for the first time who receive standard stroke discharge education without the enhancement. Forty male and female participants were randomly placed into either a standard discharge education N=20 or enhanced discharge education group: N=20. The standard discharge education group received the usual stroke/TIA discharge education administered by the staff nurses on the stroke unit while the enhanced discharge education group received a one on one education session, with the principal investigator, in addition to the standard hospital discharge education provided by the staff. Participants were administered the Stroke Patient Education Retention (SPER) Questionnaire prior to the education, after the education (prior to discharge) and at 30 days after discharge. Utilizing an independent samples t-test it was determined that there was not a statistically significant difference between the two groups in relation to the pretest scores (p=.497). However, a statistically significant difference did exist between the two groups on the post test and 30-day follow-up with (

Lung volumes identify an at-risk group in persons with prolonged secondhand tobacco smoke exposure but without overt airflow obstruction.

IntroductionExposure to secondhand smoke (SHS) is associated with occult obstructive lung disease as evident by abnormal airflow indices representing small airway disease despite having preserved spirometry (normal forced expiratory volume in 1 s-to-forced vital capacity ratio, FEV1/FVC). The significance of lung volumes that reflect air trapping in the presence of preserved spirometry is unclear.MethodsTo investigate whether lung volumes representing air trapping could determine susceptibility to respiratory morbidity in people with SHS exposure but without spirometric chronic obstructive pulmonary disease, we examined a cohort of 256 subjects with prolonged occupational SHS exposure and preserved spirometry. We elicited symptom prevalence by structured questionnaires, examined functional capacity (maximum oxygen uptake, VO2max) by exercise testing, and estimated associations of those outcomes with air trapping (plethysmography-measured residual volume-to-total lung capacity ratio, RV/TLC), and progressive air trapping with exertion (increase in fraction of tidal breathing that is flow limited on expiration during exercise (per cent of expiratory flow limitation, %EFL)).ResultsRV/TLC was within the predicted normal limits, but was highly variable spanning 22%±13% and 16%±8% across the increments of FEV1/FVC and FEV1, respectively. Respiratory complaints were prevalent (50.4%) with the most common symptom being ≥2 episodes of cough per year (44.5%). Higher RV/TLC was associated with higher OR of reporting respiratory symptoms (n=256; r2=0.03; p=0.011) and lower VO2max (n=179; r2=0.47; p=0.013), and %EFL was negatively associated with VO2max (n=32; r2=0.40; p=0.017).ConclusionsIn those at risk for obstruction due to SHS exposure but with preserved spirometry, higher RV/TLC identifies a subgroup with increased respiratory symptoms and lower exercise capacity

A blade for all seasons? Making and using Amudian blades at Qesem Cave, Israel

The Qesem Cave prehistoric sequence consists of one dominant lithic industry - the Amudian, a part of the Acheulo-Yabrudian (late Lower Paleolithic) cultural complex. The Acheulo-Yabrudian complex comprises three major lithic industries - Acheulo-Yabrudian, Yabrudian and Pre-Aurignacian/Amudian. While the first two industries are dominated by typical Lower Paleolithic lithic traditions, namely flake production technologies, hand-axes and scrapers, the Amudian presents an innovative blade industry. This relatively poorly known industry is of importance being stratigraphically situated between the Lower Paleolithic Acheulian and the Middle Paleolithic Mousterian. The available radiometric dates for this entity indicate a range from ca. 400 to about 200 kyr. The Amudian in the Levant is characterized by systematic blade production and a major component of shaped blades. At Qesem Cave the majority of the lithic artefacts belong to the Amudian industry with distinctive blade-dominated assemblages throughout a stratigraphic sequence of 7.5 meters. During the 2006 excavation season a scraper-dominated Yabrudian assemblage was discovered, indicating variability and more complex human behaviour at the cave rather than specialized blade-related activities only. The Amudian at Qesem Cave is a very early blade production industry and it reflects technological choices of the artisans as well as specific modes of resource exploitation and subsistence activities. This paper will summarize the current state of research on the Qesem cave lithic assemblages, focusing on the composition of the rich Amudian assemblages, the reconstruction of Amudian blade production and the functional interpretation of Amudian blades. A short survey of the new Yabrudian assemblage will be provided as well. We finally discuss interpretations of Acheulo-Yabrudian lithic variability and the meaning of late Lower Paleolithic blade production as a technological, functional and cultural phenomenon.The Qesem Cave prehistoric sequence consists of one dominant lithic industry - the Amudian, a part of the Acheulo-Yabrudian (late Lower Paleolithic) cultural complex. The Acheulo-Yabrudian complex comprises three major lithic industries - Acheulo-Yabrudian, Yabrudian and Pre-Aurignacian/Amudian. While the first two industries are dominated by typical Lower Paleolithic lithic traditions, namely flake production technologies, hand-axes and scrapers, the Amudian presents an innovative blade industry. This relatively poorly known industry is of importance being stratigraphically situated between the Lower Paleolithic Acheulian and the Middle Paleolithic Mousterian. The available radiometric dates for this entity indicate a range from ca. 400 to about 200 kyr. The Amudian in the Levant is characterized by systematic blade production and a major component of shaped blades. At Qesem Cave the majority of the lithic artefacts belong to the Amudian industry with distinctive blade-dominated assemblages throughout a stratigraphic sequence of 7.5 meters. During the 2006 excavation season a scraper-dominated Yabrudian assemblage was discovered, indicating variability and more complex human behaviour at the cave rather than specialized blade-related activities only. The Amudian at Qesem Cave is a very early blade production industry and it reflects technological choices of the artisans as well as specific modes of resource exploitation and subsistence activities

Focused and Deep Brain Magnetic Stimulation Using New Coil Design in Mice

Deep brain transcranial magnetic stimulation (TMS) offers promising treatment for neurological disorders that originate from deeper regions of the brain, such as Parkinson\u27s disease. Coils designed for the human head need significant redesigning to stimulate selective regions of the mouse brain for advanced TMS therapy analysis. We report a focused and deep brain TMS coil for mice that is based on a two coil configuration similar to the \u27Halo coil\u27. A heterogeneous MRI derived head model of mouse was used to obtain an electric field of about 150 V/m in selective deeper regions of the brain. Focality of stimulation was quantified using the ratio of half value volume to half value of depth of electric field. A prototype of the final coil design was fabricated and characterized to compare simulated and physical magnetic field profiles