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Regulatory T cells (T(reg) cells) have a critical role in the maintenance of immunological self-tolerance. Here we show that treatment of naive human or mouse T cells with IL-35 induced a regulatory population, which we call 'iT(R)35 cells', that mediated suppression via IL-35 but not via the inhibitory cytokines IL-10 or transforming growth factor-ß (TGF-ß). We found that iT(R)35 cells did not express or require the transcription factor Foxp3, and were strongly suppressive and stable in vivo. T(reg) cells induced the generation of iT(R)35 cells in an IL-35- and IL-10-dependent manner in vitro and induced their generation in vivo under inflammatory conditions in intestines infected with Trichuris muris and within the tumor microenvironment (B16 melanoma and MC38 colorectal adenocarcinoma), where they contributed to the regulatory milieu. Thus, iT(R)35 cells constitute a key mediator of infectious tolerance and contribute to T(reg) cell-mediated tumor progression. Furthermore, iT(R)35 cells generated ex vivo might have therapeutic utility.
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Tolerância Imunológica/imunologia , Interleucinas/imunologia , Ativação Linfocitária/imunologia , Subpopulações de Linfócitos T/imunologia , Linfócitos T Reguladores/imunologia , Animais , Diferenciação Celular/imunologia , Separação Celular , Ensaio de Imunoadsorção Enzimática , Citometria de Fluxo , Humanos , Immunoblotting , Imunoprecipitação , Interleucinas/metabolismo , Camundongos , Microscopia Confocal , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Subpopulações de Linfócitos T/citologia , Linfócitos T Reguladores/citologia , Linfócitos T Reguladores/metabolismoRESUMO
The heterodimeric cytokine interleukin 27 (IL-27) signals through the IL-27Rα subunit of its receptor, combined with gp130, a common receptor chain used by several cytokines, including IL-6. Notably, the IL-27 subunits p28 (IL-27p28) and EBI3 are not always expressed together, which suggests that they may have unique functions. Here we show that IL-27p28, independently of EBI3, antagonized cytokine signaling through gp130 and IL-6-mediated production of IL-17 and IL-10. Similarly, the ability to generate antibody responses was dependent on the activity of gp130-signaling cytokines. Mice transgenic for expression of IL-27p28 showed a substantial defect in the formation of germinal centers and antibody production. Thus, IL-27p28, as a natural antagonist of gp130-mediated signaling, may be useful as a therapeutic for managing inflammation mediated by cytokines that signal through gp130.
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Receptor gp130 de Citocina/metabolismo , Interleucinas/metabolismo , Transdução de Sinais/imunologia , Animais , Formação de Anticorpos/imunologia , Linfócitos B/imunologia , Linfócitos B/metabolismo , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD4-Positivos/metabolismo , Separação Celular , Receptor gp130 de Citocina/imunologia , Citocinas/imunologia , Citocinas/metabolismo , Ensaio de Imunoadsorção Enzimática , Feminino , Citometria de Fluxo , Imuno-Histoquímica , Interleucinas/imunologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Antígenos de Histocompatibilidade Menor , Receptores de Citocinas/imunologia , Receptores de Citocinas/metabolismoRESUMO
Variation among populations in life history and intrinsic population characteristics (i.e., population diversity) helps maintain resilience to environmental change and dampen interannual variability in ecosystem services. As a result, ecological variation, and the processes that generate it, is considered central to strategies for managing risks to ecosystems in an increasingly variable and uncertain world. However, characterizing population diversity is difficult, particularly in large and remote regions, which often prevents its formal consideration in management advice. We combined genetic stock identification of archived scale and tissue samples with state-space run-reconstruction models to estimate migration timing and annual return abundance for eight geographically and genetically distinct Chinook salmon populations within the Canadian portion of the Yukon River. We found that among-population variation in migration timing and return abundances resulted in aggregate return migrations that were 2.1 times longer and 1.4 times more stable than if they had composed a single homogeneous population. We then fit state-space spawner-recruitment models to the annual return abundances to characterize among-population diversity in intrinsic productivity and population size and their consequences for the fisheries they support. Productivity and carrying capacity varied among populations by approximately 2.4-fold (2.9 to 6.9 recruits per spawner) and three-fold (8800 to 27,000 spawners), respectively. This diversity implies an equilibrium trade-off between harvesting of the population aggregate and the conservation of individual populations whereby the harvest rate predicted to maximize aggregate harvests comes at the cost of overfishing ~40% of the populations but with a relatively low risk of extirpating the weakest ones. Our findings illustrate how population diversity in one of the largest salmon-producing river basins in the world contributes to fishery stability and food security in a region where salmon have high cultural and subsistence value. More generally, our work demonstrates the utility of molecular analyses of archived biological material for characterizing diversity in biological systems and its benefits and consequences for trade-offs in decision-making.
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Pesqueiros , Salmão , Animais , Salmão/genética , Ecossistema , Conservação dos Recursos Naturais , CanadáRESUMO
Identifying appropriate strategies for sustainable harvest is a challenge for many terrestrial vertebrate species because of uncertain system dynamics, limited data to inform population models, and potentially conflicting objectives that seek to harvest and maintain populations at desirable levels. The absence of monitoring and assessment infrastructure needed to regularly estimate abundance accentuates this challenge for many species, and limits application of rigorous state-dependent frameworks for decision making that are commonly advocated in natural resource management. Reference points, which define management targets or triggers for changing management, are often used to guide decision-making, but suffer from ambiguity when developed without explicit consideration of uncertainty or trade-offs among competing objectives. We describe an approach for developing unambiguous target reference points for assessment-limited species using structured decision making, and demonstrate the approach to develop target harvest rates for management of fall Wild Turkey (Meleagris gallopavo) harvests in the face of uncertain population and harvest dynamics. We use simulation and decision analyses to identify harvest rates that are optimal for accomplishing explicit management objectives in the face of uncertainty, and harvest rates with robust performance over broad regions of the demographic and harvest model parameter space. We demonstrate that population and harvest parameters commonly uncertain to wildlife managers interact to determine appropriate target harvest rates for Wild Turkeys, and that formally acknowledging a range of plausible values for structurally uncertain parameters results in more conservative target reference points than suggested by previously published studies. The structured decision making framework described here provides a natural conceptual and quantitative framework for extending our approach to develop unambiguous harvest targets for other assessment-limited wildlife populations while formally acknowledging structural uncertainty in system dynamics.
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Conservação dos Recursos Naturais/métodos , Galliformes , Animais , Tomada de Decisões , Michigan , Modelos Biológicos , Dinâmica PopulacionalRESUMO
OBJECTIVE: To investigate the effect of intensive peer mentoring on patient-reported outcomes of self-efficacy and unplanned hospital readmissions for persons with spinal cord injury/disease (SCI/D) within the first 6 months after discharge from inpatient rehabilitation. DESIGN: Randomized controlled trial. SETTING: Nonprofit inpatient rehabilitation hospital specializing in care of persons with SCI/D and brain injury. PARTICIPANTS: Patients (N=158) admitted to the SCI/D rehabilitation program whose discharge location was a community setting. Participants (51% with paraplegia and 49% with tetraplegia) were 73% white and 77% men, with a mean age of 38 years. INTERVENTIONS: Participants in the experimental group received initial consult/introduction with a peer support program liaison and were assigned a peer mentor, who met with the participant weekly throughout the inpatient stay and made weekly contact by phone, e-mail, or in person for 90 days postdischarge. Participants also were encouraged to participate in regularly scheduled peer support activities. Nonexperimental group participants were introduced to peer support and provided services only on request. MAIN OUTCOME MEASURES: General Self-efficacy Scale (adapted to SCI/D), project-developed community integration self-efficacy scale, and patient-reported unplanned rehospitalizations. RESULTS: Growth rate for self-efficacy in the first 6 months postdischarge was significantly higher for experimental group participants than nonexperimental group participants. Experimental group participants also had significantly fewer unplanned hospital days. CONCLUSIONS: This study provides evidence that individuals receiving intensive peer mentoring during and after rehabilitation for SCI/D demonstrate greater gains in self-efficacy over time and have fewer days of unplanned rehospitalization in the first 180 days postdischarge. More research is needed to examine the long-term effects of this intervention on health care utilization and the relation between improved health and patient-reported quality of life outcomes.
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Tutoria/métodos , Readmissão do Paciente/estatística & dados numéricos , Grupo Associado , Autoeficácia , Traumatismos da Medula Espinal/psicologia , Traumatismos da Medula Espinal/reabilitação , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Centros de Reabilitação/organização & administração , Fatores SocioeconômicosRESUMO
Physical removal (e.g., harvest via traps or nets) of mature individuals may be a cost-effective or socially acceptable alternative to chemical control strategies for invasive species, but requires knowledge of the spatial distribution of a population over time. We used acoustic telemetry to determine the current and possible future role of traps to control and assess invasive sea lampreys, Petromyzon marinus, in the St. Marys River, the connecting channel between Lake Superior and Lake Huron. Exploitation rates (i.e., fractions of an adult sea lamprey population removed by traps) at two upstream locations were compared among three years and two points of entry to the system. Telemetry receivers throughout the drainage allowed trap performance (exploitation rate) to be partitioned into two components: proportion of migrating sea lampreys that visited trap sites (availability) and proportion of available sea lampreys that were caught by traps (local trap efficiency). Estimated exploitation rates were well below those needed to provide population control in the absence of lampricides and were limited by availability and local trap efficiency. Local trap efficiency estimates for acoustic-tagged sea lampreys were lower than analogous estimates regularly obtained using traditional mark-recapture methods, suggesting that abundance had been previously underestimated. Results suggested major changes would be required to substantially increase catch, including improvements to existing traps, installation of new traps, or other modifications to attract and retain more sea lampreys. This case study also shows how bias associated with telemetry tags can be estimated and incorporated in models to improve inferences about parameters that are directly relevant to fishery management.
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Espécies Introduzidas , Controle de Pragas , Petromyzon/fisiologia , Telemetria/veterinária , Animais , Great Lakes Region , Humanos , Lagos , Densidade Demográfica , Telemetria/métodosRESUMO
PURPOSE: The purpose of this paper is to describe an extant theoretical model framing Mississippi Healthy Linkages, a successful academic-community partnership undergirding an emergency department (ED) diversion program. DESCRIPTION: The partnership between the University of Mississippi Medical Center, Mississippi State Department of Health, and Federally Qualified Health Centers is grounded in the Structuration Model of Collaboration and utilizes collective action to support an organized system of care linking academic and community care settings to address health disparities, particularly for rural and vulnerable populations. ASSESSMENT: Partners identified three interconnected segments of an integrated patient referral system to improve patient-level care, including galvanization of primary care services for ED patients, connection of primary care patients to specialty care, and linking ED patients with aftercare services. CONCLUSIONS: This academic-community partnership has significant benefits for linking health care and public health systems to address remote and vulnerable population health issues and serves as a model to be replicated in other areas of the United States, particularly in the Southeast and in rural areas.
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Centros Médicos Acadêmicos/organização & administração , Comportamento Cooperativo , Serviços de Saúde Rural/organização & administração , Saúde da População Rural/normas , População Rural , Humanos , MississippiRESUMO
OBJECTIVE: To examine the effects of activity-based therapy (ABT) on neurologic function, walking ability, functional independence, metabolic health, and community participation. DESIGN: Randomized controlled trial with delayed treatment design. SETTING: Outpatient program in a private, nonprofit rehabilitation hospital. PARTICIPANTS: Volunteer sample of adults (N=48; 37 men and 11 women; age, 18-66y) with chronic (≥12mo postinjury), motor-incomplete (ASIA Impairment Scale grade C or D) spinal cord injury (SCI). INTERVENTIONS: A total of 9h/wk of ABT for 24 weeks including developmental sequencing; resistance training; repetitive, patterned motor activity; and task-specific locomotor training. Algorithms were used to guide group allocation, functional electrical stimulation utilization, and locomotor training progression. MAIN OUTCOME MEASURES: Neurologic function (International Standards for Neurological Classification of Spinal Cord Injury); walking speed and endurance (10-meter walk test, 6-minute walk test, and Timed Up and Go test); community participation (Spinal Cord Independence Measure, version III, and Reintegration to Normal Living Index); and metabolic function (weight, body mass index, and Quantitative Insulin Sensitivity Check). RESULTS: Significant improvements in neurologic function were noted for experimental versus control groups (International Standards for Neurological Classification of Spinal Cord Injury total motor score [5.1±6.3 vs 0.9±5.0; P=.024] and lower extremity motor score [4.2±5.2 vs -0.6±4.2; P=.004]). Significant differences between experimental and control groups were observed for 10-meter walk test speed (0.096±0.14m/s vs 0.027±0.10m/s; P=.036) and 6-minute walk test total distance (35.97±48.2m vs 3.0±25.5m; P=.002). CONCLUSIONS: ABT has the potential to promote neurologic recovery and enhance walking ability in individuals with chronic, motor-incomplete SCI. However, further analysis is needed to determine for whom ABT is going to lead to meaningful clinical benefits.
Assuntos
Técnicas de Exercício e de Movimento , Treinamento Resistido , Traumatismos da Medula Espinal/reabilitação , Caminhada/fisiologia , Adolescente , Adulto , Idoso , Algoritmos , Índice de Massa Corporal , Peso Corporal , Doença Crônica , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Recuperação de Função Fisiológica , Participação Social , Traumatismos da Medula Espinal/fisiopatologia , Adulto JovemRESUMO
OBJECTIVE: To gain insight into who is likely to benefit from activity-based therapy (ABT), as assessed by secondary analysis of data obtained from a clinical trial. DESIGN: Secondary analysis of results from a randomized controlled trial with delayed treatment design. SETTING: Outpatient program in a private, nonprofit rehabilitation hospital. PARTICIPANTS: Volunteer sample of adults (N=38; 27 men; 11 women; age, 22-63y) with chronic (≥12mo postinjury), motor-incomplete (American Spinal Injury Association [ASIA] Impairment Scale [AIS] grade C or D) spinal cord injury (SCI). INTERVENTIONS: A total of 9h/wk of ABT for 24 weeks including developmental sequencing; resistance training; repetitive, patterned motor activity; and task-specific locomotor training. Algorithms were used to guide group allocation, functional electrical stimulation utilization, and locomotor training progression. MAIN OUTCOME MEASURES: Walking speed and endurance (10-meter walk test and 6-minute walk test) and functional ambulation (timed Up and Go test). RESULTS: This secondary analysis identified likely responders to ABT on the basis of injury characteristics: AIS classification, time since injury, and initial walking ability. Training effects were the most clinically significant in AIS grade D participants with injuries <3 years in duration. This information, along with information about preliminary responsiveness to therapy (gains after 12wk), can help predict the degree of recovery likely from participation in an ABT program. CONCLUSIONS: ABT has the potential to promote neurologic recovery and enhance walking ability in individuals with chronic, motor-incomplete SCI. However, not everyone with goals of walking recovery will benefit. Individuals with SCI should be advised of the time, effort, and resources required to undertake ABT. Practitioners are encouraged to use the findings from this trial to assist prospective participants in establishing realistic expectations for recovery.
Assuntos
Técnicas de Exercício e de Movimento , Seleção de Pacientes , Treinamento Resistido , Traumatismos da Medula Espinal/reabilitação , Caminhada/fisiologia , Adulto , Doença Crônica , Teste de Esforço , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Teóricos , Recuperação de Função Fisiológica , Traumatismos da Medula Espinal/classificação , Traumatismos da Medula Espinal/fisiopatologia , Fatores de Tempo , Índices de Gravidade do Trauma , Resultado do Tratamento , Adulto JovemRESUMO
Objective: To evaluate the effectiveness of 2 interventions for caregivers of patients with acquired brain injury (ABI) transitioning home after inpatient rehabilitation, to prepare them for the role of caregiving and reduce stress and depression. Design: Controlled trial with participants randomly assigned to (1) usual care (UC), (2) clinician-delivered Problem-Solving Training (PST), or (3) peer-led Building Better Caregivers (BBC) training; both experimental interventions initiated during the inpatient rehabilitation stay, delivered virtually, of similar intensity (six 60-minute sessions), and focused on managing stress and building skills related to caregiving. Setting: Nonprofit rehabilitation hospital specializing in care of persons with acquired brain and spinal cord injuries. Participants: Caregivers (n=169) of patients with ABI (54 stroke; 115 other ABI) admitted for rehabilitation whose discharge location was home with care provided by family members (caregivers: 83% women, 62% White, age [mean ± SD]: 51±11.5 y). Participants were recruited from February 2021 to November 2022, when COVID-19 restrictions were in place. Interventions: Noted above. Main Outcome Measures: Caregiver-reported stress, depressive symptoms, and caregiving self-efficacy; patient unplanned hospital readmissions and emergency department visits 30 days post discharge. Results: Only 61% of participants in the 2 intervention groups completed 3 or more of 6 intervention sessions and only 53% completed all data collection surveys. Statistically significant improvements between UC and PST groups were noted for caregiver stress (p=.039). Positive differences in caregiver self-efficacy found between UC and the BBC intervention groups approached significance at 30 days after discharge (p=.054). Patient unplanned hospital readmissions and days hospitalized were also higher, albeit not statistically significant, for UC participants than both intervention groups. Conclusions: Although positive findings were noted, results were negatively affected by study limitations including low enrollment and limited engagement (intervention completion and follow-up outcomes assessment). These limitations resulted, in part, from restrictions put into place during the COVID-19 pandemic, which limited contact with study participants and required alterations to the BBC intervention likely influencing its effectiveness. Despite limitations noted, the encouraging findings suggest the need for further research.
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Understanding how sublethal impacts of toxicants affect population-relevant outcomes for organisms is challenging. We tested the hypotheses that the well-known sublethal impacts of methylmercury (MeHg) and a polychlorinated biphenyl (PCB126) would have meaningful impacts on cohort growth and survival in yellow perch (Perca flavescens) and Atlantic killifish (Fundulus heteroclitus) populations, that inclusion of model uncertainty is important for understanding the sublethal impacts of toxicants, and that a model organism (zebrafish Danio rerio) is an appropriate substitute for ecologically relevant species (yellow perch, killifish). Our simulations showed that MeHg did not have meaningful impacts on growth or survival in a simulated environment except to increase survival and growth in low mercury exposures in yellow perch and killifish. For PCB126, the high level of exposure resulted in lower survival for killifish only. Uncertainty analyses increased the variability and lowered average survival estimates across all species and toxicants, providing a more conservative estimate of risk. We demonstrate that using a model organism instead of the species of interest does not necessarily give the same results, suggesting that using zebrafish as a surrogate for yellow perch and killifish may not be appropriate for predicting contaminant impacts on larval cohort growth and survival in ecologically relevant species. Our analysis also reinforces the notion that uncertainty analyses are necessary in any modeling assessment of the impacts of toxicants on a population because it provides a more conservative, and arguably realistic, estimate of impact. Environ Toxicol Chem 2024;43:2122-2133. © 2024 SETAC.
Assuntos
Fundulidae , Compostos de Metilmercúrio , Bifenilos Policlorados , Peixe-Zebra , Animais , Peixe-Zebra/crescimento & desenvolvimento , Bifenilos Policlorados/toxicidade , Compostos de Metilmercúrio/toxicidade , Incerteza , Poluentes Químicos da Água/toxicidade , Percas/crescimento & desenvolvimento , Modelos Biológicos , Medição de RiscoRESUMO
This supplement focuses on an important issue in rehabilitation medicine: how to maximize research relevance in order to enhance knowledge translation into clinical practice. Authors provide insights into issues and barriers impacting effective translation of evidence into practice and provide useful guidance for rehabilitation researchers and practitioners on how to structure lines of inquiry to enhance clinical relevance. While this supplement will provide meaningful information to rehabilitation researchers, the content will also be of interest to clinicians, consumers of rehabilitation services, and reviewers for journals featuring rehabilitation research.
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Especialidade de Fisioterapia/organização & administração , Pesquisa Translacional Biomédica/organização & administração , Comunicação , Tomada de Decisões , Pesquisa sobre Serviços de Saúde , HumanosRESUMO
This article offers a framework and practical advice to nurture development of a research culture within a clinical setting. Information is presented on research education, infrastructure, and helping clinicians develop a scientific mindset. Economical ways to facilitate a scientist-practitioner approach to clinical practice are described, as well as metrics to gauge the success of these efforts.
Assuntos
Pesquisa Biomédica/organização & administração , Cultura Organizacional , Especialidade de Fisioterapia/organização & administração , Humanos , Competência ProfissionalRESUMO
Many emergency departments (ED) are experiencing ever increasing volumes as they serve as a safety net for patients without established access to primary care. Impending physician shortages, our aging population, and recent changes in national healthcare policy are expected to further exacerbate this situation and worsen ED overcrowding. These conditions could result in a dilution of ED resources and significantly impact the ability of emergency personnel to provide quality care for patients with serious illnesses. Previous studies have demonstrated that low acuity patients without emergencies can be safely and legally identified in triage and can be sent away from the ED for further outpatient treatment and evaluation. However, without a specific designated clinic follow up, these patients often fail to get the appropriate care required. In this study, we couple the ED medical screening exam process with a timely medical referral system to a local Federally Qualified Healthcare Clinic (FQHC). These referred patients were monitored for subsequent success in satisfaction with their primary care needs and their rate of recidivism to the ED. Most of the non-emergent patients who were judged to be appropriate to refer to the FQHC were satisfied with their medical screening process (89%) and most elected to attend the same day clinic appointment at the FQHC (85%). Only 17% of these patients who were referred out of our ED returned to be seen in our ED within the three-month interval. We concluded that referring low acuity patients out of the emergency department to a primary care clinic setting provided an opportunity for these patients to establish a medical home for future access to non-emergent health care.
Assuntos
Continuidade da Assistência ao Paciente/organização & administração , Serviço Hospitalar de Emergência/organização & administração , Encaminhamento e Consulta/organização & administração , Provedores de Redes de Segurança/organização & administração , Triagem/métodos , Feminino , Humanos , Masculino , Satisfação do PacienteRESUMO
This article summarizes presentations of a symposium examining the potential impact of activity-based therapies (ABT) in promoting neurological and functional recovery after spinal cord injury (SCI). The symposium addressed 3 key questions concerning activity-based therapy in SCI: (1) What clinical approaches are used? (2) Is there empirical evidence supporting efficacy of ABT in promoting neurological recovery and improving overall function, health, and quality of life? (3) What are the issues related to long-term viability of ABT?
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OBJECTIVE: Evaluate effectiveness of peer interventions on self-efficacy, unplanned hospital readmissions, and quality of life for patients with spinal cord injury (SCI) undergoing inpatient rehabilitation. DESIGN: Interrupted time-series analysis (ITSA) examined effects of peer interventions on unplanned readmissions. Intervention variables added to ITSA regression examined relationships with exposure to peer interventions. Heterogeneity of treatment effects (HTE) analysis examined differences in intervention effectiveness for patients with quadriplegia and paraplegia. SETTING: Rehabilitation hospital specializing in SCI and brain injury. PARTICIPANTS: SCI inpatients (n = 1117) admitted for rehabilitation whose discharge location was home (77% male, 71% Caucasian, mean age 38.2 (SD 16.8)). A subsample of 799 patients participated in secondary analyses examining relationship between peer interventions, readmissions, changes in patient-reported outcomes, and HTE. INTERVENTIONS: One-to-one mentoring and participation in peer-led self-management classes. MAIN OUTCOME MEASURES: Unplanned readmissions, general self-efficacy (GSE), and depressive symptoms 30, 90, and 180 days post discharge; satisfaction with life at 180 days. RESULTS: After implementing the peer interventions, we observed a significant decrease in both level and slope of number of patients readmitted, and level only of unplanned hospital days 30-days post-discharge. Reduction in the number of patients and unplanned hospital days was associated with number of peer visits but not peer-led education classes attended. Higher self-efficacy (GSE) was associated with greater exposure to peer mentoring, and a significant relationship between improvement in GSE and reduced hospital readmissions was observed. CONCLUSIONS: One-to-one peer mentoring improves self-efficacy and reduces unplanned hospital readmissions following inpatient rehabilitation for persons with SCI.
Assuntos
Tutoria , Traumatismos da Medula Espinal , Adulto , Assistência ao Convalescente , Feminino , Humanos , Pacientes Internados , Masculino , Alta do Paciente , Readmissão do Paciente , Qualidade de Vida , AutoeficáciaRESUMO
The beverage hydration index (BHI) facilitates a comparison of relative hydration properties of beverages using water as the standard. The additive effects of electrolytes, carbohydrate, and protein on rehydration were assessed using BHI. Nineteen healthy young adults completed four test sessions in randomized order: deionized water (W), electrolytes only (E), carbohydrate-electrolytes (C + E), and 2 g/L dipeptide (alanyl-glutamine)-electrolytes (AG + E). One liter of beverage was consumed, after which urine and body mass were obtained every 60 min through 240 min. Compared to W, BHI was higher (p = 0.007) for C + E (1.15 ± 0.17) after 120 min and for AG + E (p = 0.021) at 240 min (1.15 ± 0.20). BHI did not differ (p > 0.05) among E, C + E, or AG + E; however, E contributed the greatest absolute net effect (>12%) on BHI relative to W. Net fluid balance was lower for W (p = 0.048) compared to C + E and AG + E after 120 min. AG + E and E elicited higher (p < 0.001) overall urine osmolality vs. W. W also elicited greater reports of stomach bloating (p = 0.02) compared to AG + E and C + E. The addition of electrolytes alone (in the range of sports drinks) did not consistently improve BHI versus water; however, the combination with carbohydrate or dipeptides increased fluid retention, although this occurred earlier for the sports drink than the dipeptide beverage. Electrolyte content appears to make the largest contribution in hydration properties of beverages for young adults when consumed at rest.
Assuntos
Bebidas/análise , Desidratação/prevenção & controle , Carboidratos da Dieta/farmacologia , Proteínas Alimentares/farmacologia , Eletrólitos/farmacologia , Equilíbrio Hidroeletrolítico/fisiologia , Adulto , Carboidratos da Dieta/urina , Proteínas Alimentares/urina , Método Duplo-Cego , Eletrólitos/análise , Eletrólitos/urina , Feminino , Humanos , Masculino , Fatores de Tempo , Água/administração & dosagem , Adulto JovemRESUMO
Accessibility of telecommunication technologies by people who are deaf or hard of hearing has been a critical issue since the invention of the telephone. As both telephone and hearing-aid technologies have evolved, finding compatible solutions has been an ongoing challenge. This paper uses the findings of a longitudinal study to examine the impact of Federal hearing-aid compatibility (HAC) regulations in resolving this problem. The study ran concurrently with the phase-in of Federal Communications Commission regulations requiring that mobile handset manufacturers and wireless service providers make available minimum numbers of cell phones with shielding to reduce electromagnetic interference when cell phones are positioned close to a hearing aid user's ear. These regulations also require package labeling and printed information to assist buyers in selecting a hearing-aid compatible phone. The survey presented here focused on changes in satisfaction with sound quality and ease of finding a hearing-aid compatible mobile handset. Data analysis suggests that the regulations have had limited success, and problems persist for consumers in locating a hearing aid compatible phone. The FCC has requested input on more stringent hearing-aid compatibility requirements; study findings suggest that these changes are not likely to remedy the problem.
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Telefone Celular/legislação & jurisprudência , Auxiliares de Comunicação para Pessoas com Deficiência , Auxiliares de Audição , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Telefone Celular/estatística & dados numéricos , Auxiliares de Comunicação para Pessoas com Deficiência/estatística & dados numéricos , Fenômenos Eletromagnéticos , Feminino , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Auxiliares de Audição/estatística & dados numéricos , Perda Auditiva/epidemiologia , Perda Auditiva/reabilitação , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente/estatística & dados numéricos , Rotulagem de Produtos/legislação & jurisprudência , Rotulagem de Produtos/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto JovemRESUMO
Wild turkeys (Meleagris gallopavo; hereafter turkeys) are an important game animal whose popularity among hunters has increased in recent decades. Yet, the number of hunters pursuing turkeys appears to be in flux, patterns of hunter abundance have primarily been described at broad spatial scales, and the ability of management to impact hunter numbers in the post-restoration era of management through opportunity for quality hunting is unclear. We used county-scale estimates of turkey hunter numbers collected over a 14-year period (2001-2014) and time-series analyses to evaluate the spatial scales at which spring and fall turkey hunter populations fluctuate, and also used generalized linear mixed models to evaluate whether attributes related to quality turkey hunting explain recent patterns in hunter abundance. We found heterogeneity in turkey hunter population growth at finer spatial scales than has been previously described (i.e., counties and management units), and provide evidence for spatial structuring of hunter population dynamics among counties that did not always correspond with existing management units. Specifically, the directionality of hunter population change displays spatial structure along an east-west gradient in southern Michigan. We also found little evidence that factors providing opportunity for quality turkey hunting had meaningful impacts on recent spatial-temporal patterns of hunter numbers. Our results imply that providing quality turkey hunting opportunities alone may be insufficient for sustaining populations of turkey hunters in the future, and that modern determinants of hunter participation extend beyond the availability of abundant turkey populations. Moreover, our results demonstrate that interpretation of harvest data as indices of abundance for turkey populations is difficult in the absence of hunter effort data, as changes to turkey harvest are a function of potentially fine-scaled changes in populations of hunters, not simply changes to turkey populations.