Parental views from rural Cambodia on disability causation and change

Purpose. This study explored the beliefs of Cambodian parents of children with cerebral palsy regarding disability causation and their perceptions of the effectiveness of interventions in bringing about change in their child. Results. Beliefs around disability causation were mixed, with equal numbers of participants attributing their child's disability to biomedical causes as to traditional causes incorporating elements of Theravada Buddhism, animism and Brahmanism. While many participants had initially sought traditional interventions for their child, few found them to be effective and most had subsequently utilised medical and rehabilitation services. Parents whose children were moderately or severely impaired perceived both traditional interventions and rehabilitation to be less effective than parents of children with mild impairments. Participants generally judged the effectiveness of interventions based on functional changes in their child. Conclusions. The complexity of Khmer belief systems was reflected in the range of participants' perceptions of the cause of their child's disability, yet beliefs around disability causation did not appear to have determined their care-seeking behaviour or their perceptions of effectiveness of interventions

Spectral Analysis Tool 6.2 for Windows

Spectral Analysis Tool 6.2 is the latest version of a computer program that assists in analysis of interference between radio signals of the types most commonly used in Earth/spacecraft radio communications. [An earlier version was reported in Software for Analyzing Earth/Spacecraft Radio Interference (NPO-20422), NASA Tech Briefs, Vol. 25, No. 4 (April 2001), page 52.] SAT 6.2 calculates signal spectra, bandwidths, and interference effects for several families of modulation schemes. Several types of filters can be modeled, and the program calculates and displays signal spectra after filtering by any of the modeled filters. The program accommodates two simultaneous signals: a desired signal and an interferer. The interference-to-signal power ratio can be calculated for the filtered desired and interfering signals. Bandwidth-occupancy and link-budget calculators are included for the user s convenience. SAT 6.2 has a new software structure and provides a new user interface that is both intuitive and convenient. SAT 6.2 incorporates multi-tasking, multi-threaded execution, virtual memory management, and a dynamic link library. SAT 6.2 is designed for use on 32- bit computers employing Microsoft Windows operating systems

Kidney after nonrenal transplantation-the impact of alemtuzumab induction

BACKGROUND.: Calcineurin inhibitor nephrotoxicity in nonrenal allograft recipients can lead to end-stage renal disease and the need for kidney transplantation. We sought to evaluate the role of alemtuzumab induction in this population. PATIENTS AND METHODS.: We evaluated 144 patients undergoing kidney transplantation after nonrenal transplantation between May 18, 1998, and October 8, 2007. Seventy-two patients transplanted between January 15, 2003, and October 8, 2007, received alemtuzumab induction and continued their pretransplant immunosuppression. Seventy-two patients transplanted between May 18, 1998, and July 21, 2007, did not receive alemtuzumab induction, but received additional steroids and maintenance immunosuppression. Donor and recipient demographics were comparable. RESULTS.: Overall, 1-and 3-year patient survival and renal function were comparable between the two groups. One-and 3-year graft survival was 93.0% and 75.3% in the alemtuzumab group and 83.3% and 68.7% in the no alemtuzumab group, respectively (P=0.051). The incidence of acute rejection was lower in the alemtuzumab group, 15.3%, than in the no alemtuzumab group, 41.7% (P=0.0001). The incidence of delayed graft function was lower in the alemtuzumab group, 9.7%, than in the no alemtuzumab group, 25.0% (P=0.003). The incidence of viral complications was comparable. CONCLUSION.: Alemtuzumab induction with simple resumption of baseline immunosuppression in patients undergoing kidney transplantation after nonrenal transplantation represents a reasonable immunosuppressive strategy. Copyright © 2009 by Lippincott Williams & Wilkins

Effects of acute exercise and learning strategy implementation on memory function

© 2019 by the authors. Licensee MDPI, Basel, Switzerland. Background and Objectives: Long-term potentiation (LTP), the functional connectivity among neurons, is considered a mechanism of episodic memory. Both acute exercise and learning are thought to influence memory via an LTP-related mechanism. Limited research has evaluated the individual and combined effects of acute exercise and learning strategy implementation (e.g., 3-R technique, cue-integration) on memory, which was the purpose of this study. Materials and Methods: For Experiment 1, participants (n = 80; Mage = 20.9 years) were randomized into one of four experimental groups, including Exercise + Learning (E + L), Learning Only (L), Exercise Only (E), and Control Group (C; no exercise and no learning strategy implementation). The exercise stimulus involved an acute 15-min bout of lower-intensity (60% of heart rate max) walking exercise and the learning strategy involved the implementation of the 3-R technique. Experiment 2 (n = 77; Mage = 21.1 years) replicated Experiment 1 but addressed limitations (e.g., exposure level of the memory task) from Experiment 1 and employed a higher-intensity bout of exercise (77% of heart rate max). Experiment 3 (n = 80; Mage = 21.0 years) evaluated these same four experimental conditions but employed a cue-integration learning strategy and a moderate-intensity bout of acute exercise (64% of heart rate max). Results: These three experiments demonstrate that both learning techniques were effective in enhancing memory and we also provided evidence of a main effect for acute exercise (Experiment 3). However, we did not observe consistent evidence of a learning by exercise interaction effect. Conclusions: We demonstrate that both acute exercise and different learning techniques are effective in enhancing long-term memory function

SCAMP:standardised, concentrated, additional macronutrients, parenteral nutrition in very preterm infants: a phase IV randomised, controlled exploratory study of macronutrient intake, growth and other aspects of neonatal care

<p>Abstract</p> <p>Background</p> <p>Infants born <29 weeks gestation are at high risk of neurocognitive disability. Early postnatal growth failure, particularly head growth, is an important and potentially reversible risk factor for impaired neurodevelopmental outcome. Inadequate nutrition is a major factor in this postnatal growth failure, optimal protein and calorie (macronutrient) intakes are rarely achieved, especially in the first week. Infants <29 weeks are dependent on parenteral nutrition for the bulk of their nutrient needs for the first 2-3 weeks of life to allow gut adaptation to milk digestion. The prescription, formulation and administration of neonatal parenteral nutrition is critical to achieving optimal protein and calorie intake but has received little scientific evaluation. Current neonatal parenteral nutrition regimens often rely on individualised prescription to manage the labile, unpredictable biochemical and metabolic control characteristic of the early neonatal period. Individualised prescription frequently fails to translate into optimal macronutrient delivery. We have previously shown that a standardised, concentrated neonatal parenteral nutrition regimen can optimise macronutrient intake.</p> <p>Methods</p> <p>We propose a single centre, randomised controlled exploratory trial of two standardised, concentrated neonatal parenteral nutrition regimens comparing a standard macronutrient content (maximum protein 2.8 g/kg/day; lipid 2.8 g/kg/day, dextrose 10%) with a higher macronutrient content (maximum protein 3.8 g/kg/day; lipid 3.8 g/kg/day, dextrose 12%) over the first 28 days of life. 150 infants 24-28 completed weeks gestation and birthweight <1200 g will be recruited. The primary outcome will be head growth velocity in the first 28 days of life. Secondary outcomes will include a) auxological data between birth and 36 weeks corrected gestational age b) actual macronutrient intake in first 28 days c) biomarkers of biochemical and metabolic tolerance d) infection biomarkers and other intravascular line complications e) incidence of major complications of prematurity including mortality f) neurodevelopmental outcome at 2 years corrected gestational age</p> <p>Trial registration</p> <p>Current controlled trials: <a href="http://www.controlled-trials.com/ISRCTN76597892">ISRCTN76597892</a>; EudraCT Number: 2008-008899-14</p

Assessing inequities in heat pump adoption across the U.S

Electrifying space heating is essential to reduce climate impacts in the building sector, and heat pumps have emerged as an energy-efficient and increasingly cost-effective solution. However, other clean energy technologies (e.g., rooftop solar) are less likely to be adopted in underserved communities, and thus policies incentivizing their adoption can be regressive. Unlike previously-studied technologies, the effects of heat pumps on energy bills may be positive or negative, and thus inequities in their adoption are context specific. Here we propose a framework for identifying inequities in heat pump adoption and map these inequities across the U.S. We find that households in communities of color and with high percentages of renters are adopting heat pumps at lower rates across the board, but differences are largest in areas where heat pumps are likely to reduce energy bills. Public policies must address these inequities to advance beneficial electrification and energy justice

Can positive inquiry strengthen obstetric referral systems in Cambodia?

Maternal death remains high in low resource settings. Current literature on obstetric referral that sets out to tackle maternal death tends to focus on problematization. We took an alternative approach and rather asked what works in contemporary obstetric referral in a low income setting to find out if positive inquiry could generate original insights on referral that could be transformative. We documented and analysed instances of successful referral in a rural province of Cambodia that took place within the last year. Thirty women, their families, healthcare staff and community volunteers were purposively sampled for in‐depth interviews, conducted using an appreciative inquiry lens. We found that referral at its best is an active partnership between families, community and clinicians that co‐constructs care for labouring women during referral and delivery. Given the short time frame of the project we cannot conclude if this new understanding was transformative. However, we can show that acknowledging positive resources within contemporary referral systems enables health system stakeholders to widen their understanding of the kinds of resources that are available to them to direct and implement constructive change for maternal health