Functional performance and quality of life related to training and detraining of community-dwelling elderly

Purpose.?Despite clear evidence of physiological declines during detraining, the effects of detraining on functional performance and quality of life have not often been investigated. The purpose of this study was to investigate functional performance and quality of life measures after a training and detraining programme with community-dwelling elderly.

Method.?Twenty-three subjects took part in a combined programme of muscle strengthening and aerobic conditioning twice a week and were assessed at baseline, after training, and after one, two, and three months of detraining. Functional performance was assessed by gait speed and by the rate of ascending and descending stairs, while quality of life was evaluated by the Nottingham Health Profile.

Results.?Repeated measures ANOVA showed that gains observed in measures of gait speed, ascending, and descending stairs returned to baseline after one, two, and three months of detraining, respectively. However, the gains in quality of life remained unchanged.

Conclusions.?One-month detraining was enough to show functional decline, with gait speed the most sensitive parameter to detect these changes and QL measure most resilient, beneficial factor during the detraining process. Based on these findings, it is recommended that programmes devised for elderly should not be interrupted, to maintain the acquired benefits.     

Evaluation framework for a multi-site practice-based interprofessional education intervention

The interprofessional literature suggests that there is a lack of evidence of the effectiveness of interprofessional education (IPE) on patient outcomes and critiques the methodology used to determine the evidence. This paper describes and critiques a comprehensive evaluation of a practice-based IPE intervention. The evaluation was challenged by the complexity of the project such as having multiple sites with great variability in settings and participants which required a multifaceted evaluation approach. Rather than reporting evaluation findings, this paper discusses the methodological successes and challenges of the evaluation framework used. The evaluation consisted of four components: process, outcomes, context and systems evaluation. A mixed method approach was used to collect information from a variety of data sources. Each evaluation component captured distinctive but complementary aspects of the intervention, providing a more complete understanding of the intervention. However, challenges also emerged, in particular for the outcomes component. Discussion of the challenges and benefits of each evaluation component are intended to inform future evaluation designs of complex practice-based IP education interventions. Specifically, adding systems concepts into evaluation can strengthen the evidence base of the effectiveness of IP education on IP practice and patient outcomes.     

The acceptability of the female condom among US women at high risk from HIV

This study examines the acceptability of the Reality^TM female condom among a population of women in the US exhibiting a high prevalence of risk factors for infection with the human immunodeficiency virus (HIV). The female condom was introduced to incarcerated women via a 20 hour didactic health and HIV education course. The 246 course graduates were interviewed before they started the course (baseline), and at 2, 6, 12 and 16 months post-release. This paper reports on the baseline and two month follow-up data to focus on the women's initial experiences with the female condom. None of the respondents reported ever using a female condom at baseline, but 62% had used one within two months of release from incarceration. Virtually all used it during vaginal sex, with 68% trying it with their husband/boyfriend and 36% trying it with a friend. Overall, 23% report using a female condom and 27% report using a male condom every time they had vaginal sex, so fully half of the respondents reported always using a condom at the 2 month follow-up interview. These data show the women increased their condom use, both male and female, between baseline and the 2 month follow-up. Cette étude examine l'admissibilité du préservatif féminin Reality^TM aux États-Unis, au sein d'un groupe de femmes fortement exposées au risque de contamination par le VIH. Le préservatif féminin a été présenté à des femmes incarcérées dans le cadre d'une formation d'une durée de 20 heures portant sur la santé et le VIH. Les 246 détenues participant à la formation ont été interviewées avant de participerau cours (base de réfeacute;rence) puis 2, 6, 12 et 16 mois après leur libération. Cet article examine les collectées lors de la premiére interview et de l'interview des 2 mois, et se concentre sur les expériences initiales de ces femmes avec le préservatif féminin. Avant de commencer le cours, aucune des participantes n'avait utiliséle préservatif féminin; mais, 2 mois apres leur libération, 62% l'avait fait. La quasi-totalité des participantes l'a utilisélors des rapports vaginaux, 68% d'entre elles l'ayant utilisé avec leur mari/petit ami et 36% l'ayant utilisé avec un partenaire occasionne. Au total, 23% des participantes ont utilisé un préservatif féminin et 27% ont utilisé un préservatif masculin à chaque fois qu'elles ont eu des rapports sexuels vaginaux. Ainsi, plus de la moitié des participantes déclarent, lors de l'interview des 2 mois avoir utilisé un préservatif à chaque fois qu'elles ont eu des rapports sexuels vaginaux. Ces résultats démontrent que ces femmes ont plus utilisé de préservatifs, masculins ou féminins, entre le début de l'enquéte et l'interview des 2 mois. En este estudio se examina en quémedida un grupo de mujeres estadounidenses que muestran un alto grado de factores de riesgos de infección por el virus de inmunodeficiencia humana (VIH) aceptan el condón femenino Reality^TM. En un curso educativo y didáctico sobre salud y VIH, de 20 horas de duración, realizado en una cárcel de mujeres se explicó el uso del condón femenino. Se entrevistaron a las 246 participantes antes de empezar el curso (referencia de base), y otras a las dos, seis, 12 y 16 semanas de salir de la cárcel. En este documento se informa sobre el estudio de base y sobre los resultados a los dos meses para enfocarnos en las experiencias iniciales de las mujeres con el condón femenino. Ninguna de las entrevistadas dijo haber utilizado un condón femenino antes, pero el 62% lo utilizádos meses después de salir de la cárcel. Casi todas lo utilizaron en las relaciones sexuales con penetración vaginal, 68% con sus maridos o novios, y el 36% con un amigo. En general, 23% dijo que utilizaban el condón femenino y el 27% que utilizaban el condón masculino cuando tenía relaciones con penetración vaginal. Resumiendo, la mitad de las entrevistadas dijo que siempre utilizáun condón a los dos meses de realizarse la entrevista. Estos datos demuestran que las mujeres aumentaron el uso del condón, tanto masculino como femenino, durante el periodo entre la referencia de base y los dos meses postcriores.     

Longitudinal analysis of leisure noise exposure among adolescents with special focus on portable listening devices: the OHRKAN cohort study

ABSTRACT

The aim was to investigate leisure noise exposure and sociodemographic determinants of risky leisure noise exposure over five years in 2148 students visiting grade 9 of any school type in a German city from 2009–2011. Within the OHRKAN cohort study, leisure noise exposure was calculated from literature-retrieved sound pressure levels (SPLs) and self-reported duration of 18 leisure activities at baseline and two follow-ups. Risky exposure was defined as exceeding 85?dB(A) averaged over a 40-h-week. Determinants of risky total leisure noise (TLN) exposure and risky exposure to portable listening devices (PLDs) were investigated using generalised estimating equations (GEEs). Up to 73% of students exceeded noise levels of 85?dB(A) at some timepoint. The noise exposure and importance of different leisure activities changed with increasing age. Risky exposure to TLN and PLDs was associated with lower education, single parent households and being male. Risky PLD exposure was additionally associated with a migrant background. Current prevention measures for leisure noise exposure must be extended to at-risk groups. Besides enhancing campaigns in lower education schools, acoustical insulation in sports halls, noise warnings on tools or in videogames could address especially men. Migrants need education about healthy PLD use in their native language if necessary.     

Characterization of uptake of the new PET imaging compound 18F-fluorobenzyl triphenyl phosphonium in dog myocardium.

18F-Labeled p-fluorobenzyl triphenyl phosphonium cation (18F-FBnTP) is a member of a new class of positron-emitting lipophilic cations that may act as myocardial perfusion PET tracers. Here, we characterize the 18F-FBnTP uptake and retention kinetics, in vitro and in vivo, as well as the myocardial and whole-body biodistribution in healthy dogs, using PET. METHODS: Time-dependent accumulation and retention of 18F-FBnTP in myocytes in vitro was studied. Seven anesthetized, mongrel dogs underwent dynamic PET scans of the heart after intravenous administration of 126-240 MBq 18F-FBnTP. In 4 of the 7 dogs, at the completion of a 60-min dynamic scan, whole-body scans (4 bed positions, 5-min emission and 3-min transmission per bed) were acquired. Arterial blood samples were collected at 0, 5, 10, 20, 30, and 60 min after administration, plasma activity was counted, and high-performance liquid chromatographic analyses for metabolites were performed. The extent of defluorination was assessed by measuring 18F-FBnTP bone uptake in mice, compared with 18F-fluoride. RESULTS: The metabolite fraction comprised <5% of total activity in blood at 5 min and gradually increased to 25% at 30 min after injection. In vivo, 18F-FBnTP myocardial concentration reached a plateau level within a few minutes, which was retained throughout the scanning time. In contrast, activity in the blood pool and lungs cleared rapidly (half-life = 19.5 +/- 4.4 and 30.7 +/- 11.6 s, respectively). Liver uptake did not exceed the activity measured in the myocardium. At 60 min, the uptake ratios of left ventricular wall to blood, lung, and liver (mean of 7 dogs) were 16.6, 12.2, and 1.2, respectively. Summation of activity from 5 to 15 min and from 30 to 60 min after injection produced high-quality cardiac images of similar contrast. Circumferential sampling and a polar plot revealed a uniform distribution, near unitary value, throughout the entire myocardium. The mean coefficient of variance, on 30- to 60-min images along the septum-to-anterior wall and the apex-to-base axes was 7.58% +/- 1.04% and 6.11% +/- 0.89% (mean +/- SD; n = 7), respectively, and on 5- to 15-min images was 7.25% +/- 1.43% and 6.12% +/- 1.88%, respectively. 18F-FBnTP whole-body distribution was highly organ specific with the kidney cortex being the major target organ, followed by the heart and the liver. CONCLUSION: 18F-FBnTP is a promising new radionuclide for cardiac imaging using PET with rapid kinetics, uniform myocardial distribution, and favorable organ biodistribution.     

Infliximab treatment and prognostic factors for response in patients with Crohn's disease.

OBJECTIVE: The aim of this study is to report our experience with infliximab and analyse prognostic factors for response in Crohn's disease (CD). MATERIAL AND METHODS: Consecutive patients were prospectively enrolled in the study when referred for infliximab infusion. Data collected included indication for infusion, patient epidemiological characteristics, Vienna classification, previous surgery, previous medications and extra-intestinal manifestations. Adverse events and clinical response were tabulated separately for patients with luminal or fistulous Crohn's disease. RESULTS: 28 patients were treated (7 with inflammatory and 21 with fistulizing disease). Patients received a total of 116 infusions of infliximab: 57.1% (4 of 7) of patients with luminal disease had complete response within a median of 17.5 days (range 15-28 days), and 62% (13 of 21) of patients with fistulizing disease had complete response within a median of 9 days (range 6-51 days). All patients (5) without relapse received concomitant treatment with immune modifiers. The group of patients with previous resection or perianal fistula repair had complete response more frequently p = 0.03 (OR = 30; IC 95% = 1.47-119.8). CONCLUSIONS: Infliximab is safe and beneficial in clinical practice for Crohn's disease. The re-treatment regimen of infliximab is effective in maintaining clinical response. Immunosuppressant therapy may have a role in the duration of maintained clinical remission in patients with fistulizing disease. In patients with perianal fistulizing disease infliximab treatment is more effective when previous resection or fistula repair is present.     

Female sexual enhancers and Neutraceuticals

Throughout the ages, humans have searched for new ways of enhancing sexuality and sexual performance. We review some of the more popular products, such as herbs, botanicals, combination products, and topical formulations that have been heralded as sexual enhancers or have mythological roots suggesting they can be used for the treatment of sexual dysfunction. Lastly, we discuss sexual touch (Tantra), aroma, nutrition, and exercise as modalities that have been used to improve or enhance sexual function.