Master of Science

thesisExtensive research has been published on the benefits of yoga for older adults; however, little is known about older adults’ beliefs and perceived barriers to participating in yoga. The purpose of this research was to conduct an exploratory study that examined older adults’ beliefs about yoga with regard to experiences, knowledge about location, affordability, accessibility, and perceived barriers to engaging in yoga. A convenience sample of faint-and-fall clinic patients aged 55 years and older was surveyed about home environment and physical activity levels. The Beliefs About Yoga Scale (BAYS) was used to measure beliefs about and perceived barriers to yoga. Participants were asked to describe intentions to practice yoga, as well as social and environmental barriers. Survey data were linked to demographic and health-status medical record data. The theoretical framework, Theory of Planned Behavior, guided this research. Participants (N = 37) had a mean age of 72.81 years; 59.5% were female. Participants were prefrail (66.7%) or frail (33.3%), and most (78.4%) had fallen in the past year. The majority (>72%) did not engage in more than light physical activity. The BAYS mean score was 59.17 (SD = 12.5), with a possible range of 11 to 77. This score was not significantly different than a previously reported BAYS score (M = 55.62; SD = 8.58) (p = 0.138; t (28) = 1.53; independent sample t-test). The study sample had fairly positive beliefs about yoga, as measured by the BAYS, and mean scores did not differ significantly from previously reported scores from a middle-aged sample. More than 90% of participants had no past or current yoga experience, 97.1% had no intentions to practice yoga, 61.8% did not know locations of classes, 82.4% did not know the average class cost, and only 56.3% reported having available transportation to yoga classes. The top three barriers to practicing yoga were level of difficulty, lack of motivation, and fear of injury. Interestingly, 23.7% of participants did not answer questions about yoga, even though they answered questions about physical activity. Overall, participants held positive beliefs about yoga, yet showed limited experience and little intention to participate in a yoga program. More research to devise yoga classes tailored to the needs of older adults is warranted

Historic sediment accretion rates in a Louisiana coastal marsh and implications for sustainability

Deltaic marshes of the Mississippi River in Louisiana disappeared at a rate of 88 km2 annually from 1956 to 2000 (Barras et al. 2003) as marshes become inundated by sea water. Marsh surface elevation varies spatially and temporally due to fluvial sediment deposition, resuspension, erosion, compaction, sea level rise, and organic matter accumulation and decomposition. If net accretion from sediment deposition and/or peat production is insufficient, marshes respond to sea level rise by migrating landward. Since human development prevents landward migration of marsh in Breton Sound Basin, Louisiana, marsh sustainability can only be achieved if vertical accretion keeps pace with a relative sea level rise of 10 mm/yr so that marsh surface elevation is maintained within the tidal range. Measurement time scale and changing influences on marsh sediment were considered in an assessment of the long-term sustainability of Breton Sound marsh based on comparison of the rate of relative sea level rise to measured accretion rates. Six cores (~4 m long each) were collected in Breton Sound and a combination of three radioisotopes, as well as stratigraphic analysis were used to measure accretion rates and identify evidence of historical river effects and storms. Net accretion rates over recent short-term (decadal) and long-term (centennial/millennial) time scales were measured using 210Pb, 137Cs, and 14C dating. Long-term mean accretion based on 14C dating was highly variable (3.5 mm/yr, σ=4.5). Three 210Pb rates were recovered, averaging 4.3 mm/yr (σ=1.9). Accretion rates measured using 137Cs averaged 7.7 mm/yr (σ=2.3). Rates of sediment accretion are ultimately insufficient to offset relative sea level rise, especially after allowing for sediment volume reduction encountered over the long term. The combined effects of reduced fluvial input, rising sea level, and prevention of landward marsh migration create an environment that is inherently unstable

Wetland Plants of Great Salt Lake, A Guide to Identification, Communities, & Bird Habitat

Wetland Plants of Great Salt Lake: a guide to identification, communities, & bird habitat is a wetland plant identification guide, resulting from collaborative research efforts about Great Salt Lake (GSL) wetland conditions and bird habitat. Dr. Rebekah Downard collected dissertation field data from GSL wetlands during 2012–2015, the majority of which informed this work. Dr. Maureen Frank contributed her guide to GSL wetland vegetation and how to manage native plants as high-quality habitat for birds. The intended purpose in producing this guide was to create an informative source that could assist researchers, land managers, birders, and wetland enthusiasts in identifying, studying, managing, and understanding Great Salt Lake wetland plants, communities, and birds

Development and Evaluation of Effective Turbidity Monitoring Methods for Construction Projects

Various agencies have discussed the possibility of using turbidity as an effluent standard for construction site. Turbidity monitoring can be difficult for dynamic construction sites. This project investigated turbidity relationships for conditions of Minnesota and developed protocols for the design and installation of cost-effective monitoring systems. Turbidity characteristics of fourteen different soils in Minnesota were investigated using the laboratory protocols. Trends in turbidity with sediment concentrations were well represented by power functions. The exponent of these power functions was relatively constant between soils and the log-intercept, or scaling parameter varied substantially among the different soils. A regression analysis for the scaling parameter was a function of percent silt, interrill erodibility, and maximum abstraction. A power value of 7/5 was chosen to represent all soils. The field studies were also used to develop turbidity monitoring systems that would be adaptable to construction sites and to collect turbidity data on construction site runoff. Construction site turbidities often exceeded 1000 NTUs and sometimes surpassed 3000 NTUs.Department of Civil Engineering, Department of Bioproducts and Biosystems Engineering, Department of Civil Engineering

Enhancing the Teaching and Learning of Biometeorology in Higher Education

Information about the annual meeting organized by the organizations the International Society of Biometeorology (ISB) and the Students and New Professionals (SNP) held in Norfolk, Virginia from July 28 to August 1, 2016 is presented. The event was organized to improve the teaching methods of teachers and learning of students on high education biometeorology and the presentations, practical sessions and group discussions participated by attendees

Resuscitation with pre-hospital blood products in adults with trauma-related haemorrhagic shock:the RePHILL RCT

Background: The treatment of traumatic haemorrhagic shock has been transformed through better haemorrhage control, use of tranexamic acid and use of blood products. The improved survival seen from these strategies has stimulated an interest in pre-hospital transfusion.Objectives: To determine if the clinical effectiveness of resuscitation with red blood cells and lyophilised plasma was superior to 0.9% saline for improving tissue perfusion and reducing mortality in adults with haemorrhagic shock following major trauma.Design: A multi-centre, allocation concealed, open-label, parallel group, randomised controlled trial (with internal pilot).Setting: The trial was conducted in four civilian pre-hospital critical care services who operated within the National Health Service (NHS) England Major Trauma Networks.Participants: Adults (aged ≥16 years) who had sustained traumatic injuries, were attended by a pre-hospital emergency medical team and were hypotensive (systolic blood pressure &lt;90 mmHg or absence of radial pulse) as a consequence of traumatic haemorrhage were eligible for inclusion. The exclusion criteria were known or apparently &lt;16 years, blood administered on scene prior to the arrival of the RePHILL team, traumatic cardiac arrest where (1) the arrest occurred prior to arrival of the team and/or (2) the primary cause is not hypovolaemia, refusal of blood product administration, known Jehovah’s Witness, pregnancy, isolated head injury without evidence of external haemorrhage, prisoners in the custody of HM Prison and Probation Service.Interventions: Participants were randomised to receive up to either two units each of red blood cells and lyophilised plasma or up to 1 L 0.9% saline. Treatment was administered through the intravenous or intraosseous route.Main outcome measures: The primary outcome was a composite of episode mortality and/or impaired lactate clearance. The secondary outcomes included the individual components of the primary outcome.Results: From 6 December 2016 to 2 January 2021, pre-hospital medical teams randomised 432 participants to red blood cell/lyophilised plasma (n = 209) or 0.9% saline (n = 223) out of a target sample size of 490. Most participants were white (62%), males (82%), median age 38 (interquartile range 26 to 58), involved in a road traffic collision (62%) with severe injuries (median injury severity score 36, interquartile range 25 to 50). Prior to randomisation participants had received on average 430 ml crystalloid fluids and tranexamic acid (90%). The primary outcome occurred in 128/199 (64.3%) of participants randomised to red blood cell/lyophilised plasma and 136/210 (64.8%) randomised to 0.9% saline [adjusted risk difference –0.025% (95% confidence interval –9.0% to 9.0%), p = 0.996]. The event rates for the individual components of the primary outcome, episode mortality and lactate clearance were not statistically different between groups [adjusted average differences −3% (−12% to 7%); p = 0.57 and −5% (−14% to 5%), p = 0.33, respectively].Limitations: Recruitment stopped prematurely due to disruption caused by the COVID-19 pandemic.Future work: Identify the characteristics of patients who may benefit from pre-hospital blood products and whether alternative transfusion regimens are superior to standard care.Conclusions: The trial did not demonstrate that pre-hospital red blood cell/lyophilised plasma resuscitation was superior to 0.9% saline for trauma-related haemorrhagic shock.Trial registration: This trial is registered as ISRCTN62326938.Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Efficacy and Mechanism Evaluation Programme (NIHR award ref: 14/152/14) and is published in full in Efficacy and Mechanism Evaluation; Vol. 11, No. 2. See the NIHR Funding and Awards website for further award information.<br/

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention