Effects of lead accumulation on the Azolla caroliniana-Anabaena association.

The effect of lead accumulation on photopigment production, mineral nutrition, and Anabaena vegetative cell size and heterocyst formation in Azolla caroliniana was investigated. Plants were exposed to 0, 1, 5, 10, and 20 mg L(-1) lead acetate for ten days. Lead accumulation increased when plants were treated with higher lead concentrations. Results revealed a statistically significant decline in total chlorophyll, chlorophyll a, chlorophyll b, and carotenoids in 5, 10, and 20 mg Pb L(-1) treatment groups as compared to plants with 0 or 1 mg Pb L(-1) treatments. No statistically significant change in anthocyanin production was observed. Calcium, magnesium, and zinc concentrations in plants decreased in increasing treatment groups, whereas sodium and potassium concentrations increased. Nitrogen and carbon were also found to decrease in plant tissue. Anabaena vegetative cells decreased in size and heterocyst frequency declined rapidly in a Pb dose-dependent manner. These results indicate that, while A. caroliniana removes lead from aqueous solution, the heavy metal causes physiological and biochemical changes by impairing photosynthesis, changing mineral nutrition, and impeding the growth and formation of heterocysts of the symbiotic cyanobacteria that live within leaf cavities of the fronds.

Evaluation of simplified tests for the diagnosis of nerve function impairment in leprosy: the Sensory Motor Screening (SMS) study.

OBJECTIVE: Rapid and simple tests for diagnosing nerve function impairment (NFI) in leprosy are required in integrated settings. We examined whether simplified tests performed by newly trained general health workers (GHWs) have comparable diagnostic accuracy to the reference test conducted by experienced physiotherapists. DESIGN: This multi-centre study from India and Bangladesh evaluated three simplified tests named: ILEP Learning Guide Two (M2), Indian dance (M3), and a questionnaire (M4) in 408 people affected by leprosy. Sensitivity (Se) and specificity (Sp) of the three tests were calculated using the full assessment (M1) as reference. Se and Sp were calculated at both whole body and individual nerve levels: whether any NFI and if single NFI (voluntary muscle testing of lid gap, eye closure, little finger out, thumb up and foot up, sensory testing of hands and of feet) was present. RESULTS: M2 had 83% Se and 69% Sp, M3 had 76% Se and 84% Sp and M4 had 85% Se and 46% Sp in diagnosing any NFI. At the level of single NFI, M2 was most or similarly accurate in diagnosing single NFIs with highest prevalence (ST feet, ST hands, little finger out, thumb up), compared to M3 and M4. CONCLUSIONS: ILEP Learning Guide Two (M2) and Indian dance (M3) were found to be the most accurate simplified tests for diagnosing the presence of NFI compared to the reference. M2 was the most useful test, because of greatest accuracy for most of the common types of NFI and inclusion of sensory testing of the hands. M2 is considered to be a useful tool in the hands of GHWs with time constraints in integrated settings.

Dimensions of personal meaning from engagement in occupations: A metasynthesis.

BACKGROUND.: Occupational scientists have offered various theoretical propositions regarding the dimensions of meaning derived from engagement in occupations, and empirical studies have explored the personal meaning of engaging in a wide range of occupations. PURPOSE.: The study aimed to distil the dimensions of personal meaning from existing research, with a view to informing theory in this area. METHOD.: A qualitative metasynthesis of research studies was conducted, focusing on research reporting individuals' accounts of the personal meaning of an occupation to them. Twenty papers met the search criteria and were reviewed, rated for quality, analyzed, and synthesized following a process of meta-aggregation. FINDINGS.: There were four common dimensions of personal meaning: a sense of fulfilment; a sense of restoration; social, cultural, and intergenerational connection; and identity shaping. IMPLICATIONS.: This review provides occupational therapists with sound evidence of the link between engagement in a meaningful occupation and a sense of personal and social well-being.

Ensuring inter-tester reliability of voluntary muscle and monofilament sensory testing in the INFIR Cohort Study.

OBJECTIVE: To assess the reliability of monofilament (MF) and voluntary muscle strength (VMT) testing carried out by nine physiotherapy staff recruited for the ILEP Nerve Function Impairment & Reaction (INFIR) Cohort Study in India. DESIGN: A multiple pair inter-tester reliability study was carried out in Uttar Pradesh, India. Newly trained testers were paired up with an experienced physiotherapist, whose assessment served as the gold standard. Each pair completed a series of assessments. All testers had undertaken a week of specific VMT and MF training, followed by a month of practice in the hospital setting. Reliability was assessed by calculating weighted Kappa (Kw) statistics, which may be interpreted as the chance-corrected proportion of agreement between testers. RESULTS: Eight newly-trained physiotherapists and one physiotechnician took part in the study. In the early stages of the study some areas of weak agreement were identified and correct assessment technique was reviewed, particularly for the eye. Good to very good reliability (Kw 0.62 to 0.99) was found for all sensory tests and most muscle strength tests. The only lower Kw scores (0-48 to 0-59, suggesting only moderate reliability) were for the VMT of muscles supplied by the median nerve in one of the study's two field centres. Even in this case, testers never varied by more than one grade, but calculation of Kw was negatively influenced by a lack of variation among the subjects. In addition, testers never varied by more than one grade from the gold standard. CONCLUSION: Even though all testers were professionally trained and received additional specific training and practice in MF and VMT testing, discrepancies in technique required an early review and correction. This fact highlights the need for careful training and formal reliability testing. This should extend to referral centres where staff are involved in assessing the symptoms of reaction and monitoring response to treatment. Reliability testing provides the opportunity to address important discrepancies in technique that may persist even in the presence of protocols and qualified and trained staff. It is therefore a valuable tool as part of a training procedure for situations, where patients may be assessed by different testers. Overall, our results were deemed good enough to proceed with the INFIR study, using VMT and MF testing as a baseline against which to compare more sophisticated methods of nerve function testing.

Evaluation of treatment in the Smart Home IRIS in terms of functional independence and occupational performance and satisfaction.

The development of assistive technologies, home modifications, and smart homes has rapidly advanced in the last two decades. Health professionals have recognised the benefits of these technologies in improving individual's quality of life. The Smart Home IRIS was established in 2008 within the University Rehabilitation Institute in Ljubljana with the aim to enable persons with disabilities and elderly people to test various assistive technologies and technical solutions for their independent living. We investigated the effect of treatments in the Smart Home IRIS. A convenience sample of 59 persons with disabilities and elderly people (aged 24-81 years) who were treated in the Smart Home IRIS from April to December 2011 participated. Standardised instruments--the Canadian Occupational Performance Measure (COPM) and the Functional Independence Measure (FIM)--were administered at the first assessment in the Smart Home IRIS and at a second assessment at the participant's home after 6-12 months. All the outcomes statistically significantly improved from the first to the second assessment. The treatments in the Smart Home IRIS appeared to contribute to higher occupational performance and satisfaction with performance and higher functional independence of persons with disabilities and elderly people.