Evaluation of improvement in quality of life and physical activity after total knee arthroplasty in greek elderly women.

BACKGROUND: The aim of this study was to evaluate the changes in quality of life of patients after total knee arthroplasty and to assess the changes in physical activity by using a self-reported questionnaire and by counting the number of steps 3-6 months after post-operatively. METHODS: Included were fifty two elderly women (age 72.6±65.9 years, mean±SD) with knee osteoarthritis undergoing primary knee arthroplasty. Health-related quality of life, physical activity, pain and function and the number of steps were assessed before, 3 and 6 months post-operatively. We used the Medical Outcomes Study Short Form (SF-36), the Physical Activity Scale for the Elderly (PASE) and the pedometer SW200 Digiwalker of Yamax. RESULTS: Patients showed a significant improvement (p< 0.01, η2 =0.22) in health-related quality of life, particularly in physical function, (p<0 .001) body pain (p< 0.001) and vitality scale (p< 0.001) of SF-36 at 3 and 6 months after the procedure. Physical activity (PASE score) increased at 3 and 6 months after arthroplasty (p< 0.001, η2 =0.74), and the number of steps increased 6 months after, compared to the assessment that took place 3 months after operation (p< 0.001). CONCLUSIONS: Our results suggest that total knee arthroplasty leads to a gradual improvement in quality of life of elderly patients over the first 6 post-operative months.

Identifying governance strategies that effectively support ecosystem services, resource sustainability, and biodiversity.

Conservation scientists, national governments, and international conservation groups seek to devise, and implement, governance strategies that mitigate human impact on the environment. However, few studies to date have systematically investigated the performance of different systems of governance in achieving successful conservation outcomes. Here, we use a newly-developed analytic framework to conduct analyses of a suite of case studies, linking different governance strategies to standardized scores for delivering ecosystem services, achieving sustainable use of natural resources, and conserving biodiversity, at both local and international levels. Our results: (i) confirm the benefits of adaptive management; and (ii) reveal strong associations for the role of leadership. Our work provides a critical step toward implementing empirically justified governance strategies that are capable of improving the management of human-altered environments, with benefits for both biodiversity and people.

A multicriteria model for planning agricultural regions within a context of groundwater rational management.

Current international research focuses on topics like sustainable development, regional planning, environmental decision making and implementation, biodiversity conservation plus a number of other relevant issues, especially at times of economic crisis as today. Economic growth and environmental protection can go hand in hand, provided that decision makers develop and use tools and insights targeting in the implementation of successful and robust long term policies. This paper was developed in the framework of a European research project and implements a Multicriteria Mathematical Programming model that optimises the sustainable management of agricultural regions taking in account the available resources (land, labour, capital) and environmental parameters (agrochemicals, water consumption). The model achieves the optimum farm plan in the area combining different criteria to a utility function under a set of constraints and the spatial integration of the vulnerability maps of the regions into the model enables the regional authorities to design policies for the optimal agricultural development and the groundwater protection from the agricultural land uses. Furthermore, the model is used to simulate different scenarios and policies by the local stakeholders, due to changes on different social, economic and environmental parameters. In this way the decision makers can achieve alternative farm plans and agricultural land uses as well as to estimate economic, social and environmental impacts of different policies. The model has been applied to an agricultural region in Northern Greece and proved to be a valuable tool in the implementation of environmental policies and actions, especially in agricultural regions in a delicate balance as the study area.

Hypovolemic shock due to giant uterus leiomyoma detachment.

Uterine leiomyoma (UL) is the most common benign gynecologic tumor of the reproductive age females. It is symptomatic only in 25% of the patients causing dysmenorrhea, menorrhagia or anemia. In some patients it occurs just as a palpable abdominal mass. In this study, we report a 50-year-old woman with a giant mass, attached to the uterus, which was detached and therefore led to shock due to major hemorrhage. Surgical removal of both the mass and the uterus confirmed the diagnosis of a pedunculated uterine leiomyoma.

A Decision Support System approach for rivers monitoring and sustainable management.

This paper presents a Decision Support System (DSS) approach developed in the context of the Copernicus project entitled System for Water Monitoring and Sustainable Management based on Ground Stations and Satellite Images (WATERMAN). The main objective of WATERMAN is the monitoring and management of the Strymon River in the Southern Balkans. The specific DSS integrates the main components of WATERMAN and helps the decision maker to monitor the Strymon region; to control and forecast the quantity and quality of the river water; as well as to make objective decisions about the state of the water based on data provided by radio computers, earth stations and satellite images processed by mathematical and statistical models and Geographical Information Systems (GIS).

Identification of rib cage's lower margin in cardiopulmonary resuscitation.

The Guidelines of the American Heart Association (J Am Med Assoc 1992;268(16):2184-2198) and the European Resuscitation Council (Resuscitation 1992;24:103-110; Resuscitation 1998;37:67-80) for adult basic cardiopulmonary resuscitation (CPR), suggest that the hands of the rescuer should be positioned on the sternum of the victim after identification of the lower margin of the rib cage, but how this identification is made is not described. Lay persons have problems with the identification of anatomical structures that they cannot actually see (Bahr et al., Resuscitation 1997;35:23-6). Although this does not present a problem for those familiar with human anatomy, we have noticed that lay persons have problems with the identification of the lower margin of the rib cage. In this report, we suggest a method for correct and rapid recognition of the costal margin.