Complications following spinal cord injury: occurrence and risk factors in a longitudinal study during and after inpatient rehabilitation

Objective: To assess the occurrence and risk factors for complications following spinal cord injury during and after inpatient rehabilitation. Design: Multicentre longitudinal study. Subjects: A total of 212 persons with a spinal cord injury admitted to specialized rehabilitation centres. Methods: Assessments at the start of active rehabilitation (n = 212), 3 months later (n = 143), at discharge (n = 191) and 1 year after discharge (n = 143). Results: Multi-level random coefficient analyses revealed that complications were common following spinal cord injury. Most subjects reported neurogenic and musculoskeletal pain, or had spasticity at each assessment. During the year after discharge, complications remained common: urinary tract infections and pressure sores affected 49% and 36% of the population, respectively. The degree of pain decreased, whereas the degree of spasticity increased significantly during inpatient rehabilitation. Overall, increased age, increased body mass index, traumatic lesion, tetraplegia, and complete lesion all increased the risk of complications. Conclusion: Complications are common following spinal cord injury. They need specific attention after discharge from inpatient rehabilitation and within subpopulations. © 2007 Foundation of Rehabilitation Information

Naar Buijten! : hoogwaardige akkernatuur en recreatie in het Buijtenland van Rhoon

De overheid wil meer natuur en recreatiemogelijkheden in het akkerbouwgebied Het Buijtenland van Rhoon (IJsselmonde). Op verzoek van een aantal agrariërs heeft de Vereniging Nederlands Cultuurlandschap een voorstel gemaakt voor inrichting en beheer van het gebied. Provincie Zuid- Holland heeft Alterra en LEI gevraagd hierop te reageren

A prospective study on physical activity levels after spinal cord injury during inpatient rehabilitation and the year after discharge

van den Berg-Emons RJ, Bussmann JB, Haisma JA, Sluis TA, van der Woude LH, Bergen MP, Stam HJ. A prospective study on physical activity levels after spinal cord injury during inpatient rehabilitation and the year after discharge. Objectives: To assess the change over time in the physical activity level after a spinal cord injury (SCI), to explore its determinants, and to compare the physical activity level 1 year after discharge from the rehabilitation center with the level in able-bodied persons. Design: Prospective cohort study. Measurements were obtained at the start of active rehabilitation, 3 months later, at discharge, 2 months after discharge, and 1 year after discharge. Setting: Rehabilitation center in The Netherlands and the participant's home. Participants: Persons (n=40) with SCI. Interventions: Not applicable. Main Outcome Measures: The physical activity level, as indicated by the duration of dynamic activities (ie, wheelchair driving, walking, cycling, noncyclic movement) per day, and the intensity of everyday activity; both were measured with an accelerometry-based activity monitor during 2 consecutive weekdays. Results: Random coefficient analyses showed that the duration of dynamic activities and the intensity of everyday activity increased during inpatient rehabilitation at rates of 41% and 19%, respectively (P<.01). Shortly after discharge, there was a strong decline (33%; P<.001) in the duration of dynamic activities. One year after discharge, this decline was restored to the discharge level but was low in comparison with levels in able-bodied persons. The level of lesion and completeness of lesion were determinants of the change in the physical activity level after discharge. Conclusions: The physical activity level increased during inpatient rehabilitation, but this increase did not continue after discharge, and the level 1 year after discharge was distinctly lower than the level in able-bodied persons. Subpopulations had a different change over time in the physical activity level after discharge. © 2008 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Changes in physical capacity during and after inpatient rehabilitation in subjects with a spinal cord injury

Haisma JA, Bussmann JB, Stam HJ, Sluis TA, Bergen MP, Dallmeijer AJ, de Groot S, van der Woude LH. Changes in physical capacity during and after inpatient rehabilitation in subjects with a spinal cord injury. Objective: To assess changes in physical capacity and its determinants in persons with a spinal cord injury. Design: Prospective cohort study. Measurements at the start of active rehabilitation (t1), 3 months later (t2), at discharge (t3), and 1 year after discharge (t4). Setting: Eight rehabilitation centers in The Netherlands. Participants: A total of 186 subjects at t1 and 123 subjects at t4. Interventions: Not applicable. Main Outcome Measures: Peak aerobic power output (POpeak), peak oxygen uptake (V

How much Biodiversity is in Natura 2000? : the “Umbrella Effect” of the European Natura 2000 protected area network : technical report

In order to assess the significance of the presumed “umbrella effect” of Natura 2000 areas the European Commission initiated a study, in 2013, to address the following questions: 1) Which are, amongst the species regularly occurring within the European territory of the EU-28 Member States, those that significantly benefit from the site conservation under the EU Birds and Habitats Directive? 2) What is the percentage of all species occurring in the wild in the EU that benefit significantly from Natura 2000? 3) How significant is the contribution of Natura 2000 in relation to the objective of halting and reversing biodiversity loss? The approach used existing data, and covered the terrestrial mammals, birds, reptiles, amphibian, butterfly and plant species. The analysis is mostly based on statistical distribution models and GIS processing of species distribution data in relation to their presence within protected areas of the Natura 2000 network. The main findings for all species groups were: Animal species for which Natura 2000 areas were not specifically designated occur more frequently inside Natura 2000 than outside (in particular breeding birds and butterflies). These species do, therefore, gain benefit from the protected areas network. The species for which Natura 2000 areas were designated generally occur more frequently within the Natura 2000 site boundaries than the nonannex species; this is in particular the case for birds and butterflies, for amphibians and reptiles the difference is negligible. More specific conclusions and findings, as well as discussion of these results and implications for further studies are included in the report

Effects of respiratory alkalosis on human skeletal muscle metabolism at the onset of submaximal exercise

The purpose of this study was to examine the effects of respiratory alkalosis on human skeletal muscle metabolism at rest and during submaximal exercise. Subjects exercised on two occasions for 15 min at 55 % of their maximal oxygen uptake while either hyperventilating (R-Alk) or breathing normally (Con). Muscle biopsies were taken at rest and after 1 and 15 min of exercise. At rest, no effects on muscle metabolism were observed in response to R-Alk. In the first minute of exercise, there was a delayed activation of pyruvate dehydrogenase (PDH) in R-Alk compared with Con, resulting in a reduced rate of pyruvate oxidation. Also, glycogenolysis was higher in R-Alk compared with Con, which was attributed to a higher availability of the monoprotonated form of inorganic phosphate (Pi), resulting in an elevated rate of pyruvate production. The mismatch between pyruvate production and its oxidation resulted in net lactate accumulation. These effects were not seen after 15 min of exercise, with no further differences in muscle metabolism between conditions. The results from the present study suggest that respiratory alkalosis may play an important role in lactate accumulation during the transition from rest to exercise in acute hypoxic conditions, but that other factors mediate lactate accumulation during steady-state exercise