12560 research outputs found
Sort by
Cut-off points for low relative 30-s sit-to-stand power and their associations with adverse health conditions
Get PDFBackground: Despite muscle power derived from the 5-rep sit-to-stand (STS) test having been demonstrated to be a valuable biomarker in older individuals, there is limited information regarding muscle power derived from the 30-s STS test, a widely used test in the clinical setting. This study aimed (i) to compare relative 30-s STS power values between older men and women, (ii) to identify cut-off points for low relative 30-s STS power, (iii) to compare the prevalence of low relative STS power between sexes and (iv) to evaluate the association of low relative 30-s STS power with adverse conditions in older people. Methods: A total of 1475 community-dwelling older adults (65–98 years; 45% men) from the Toledo Study for Healthy Aging were included. Relative STS power was assessed using the 30-s STS test and the Alcazar's equation. Adverse health conditions considered encompassed frailty, depression, disability in basic (BADL) and instrumental activities of daily living (IADL), cognitive impairment and low habitual gait speed (HGS). Results: Relative STS power decreased linearly at an average rate of 1.0% year−1 in men and 1.5% year−1 in women. The cut-off points for low relative STS power were 2.53 and 2.01 W·kg−1 for men and women, respectively. The prevalence of low relative STS power was significantly lower in older men compared with older women (43.5% vs. 50.0%, respectively; p = 0.005). In men, low relative STS power was associated with frailty (OR [95% CI] = 4.4 [2.4–8.0]), cognitive impairment (OR [95% CI] = 1.7 [1.0–2.7]), disability in BADL (OR [95% CI] = 4.5 [1.5–13.8]) and low HGS (OR [95% CI] = 3.4 [1.9–5.9]). In women, low relative STS power was associated with frailty (OR [95% CI] = 5.2 [3.5–7.7]), disability in BADL (OR [95% CI] = 4.3 [1.8–9.9]) and IADL (OR [95% CI] = 3.1 [2.2–4.3]) and low HGS (OR [95% CI] = 6.1 [2.8–13.1]). No associations were found between low relative STS power and disability in IADL or depression in men, nor between low relative STS power and cognitive impairment or depression in women. Conclusion: Relative STS power decreased with increasing age in both men and women. The provided sex-specific cut-off points for low relative STS power using the 30-s STS test adequately identified older people with frailty and were associated with an increased risk of experiencing adverse conditions.</p
Exercise-based prehabilitation for kidney transplant candidates:the FRAILMar Randomized Controlled Trial
No full textRATIONALE & OBJECTIVE: Kidney transplantation (KT) is the preferred treatment for kidney failure but carries significant posttransplant risks, particularly for frail patients. This study evaluated the effects of an exercise-based prehabilitation program on exercise capacity, muscle function, and muscle size among KT candidates.STUDY DESIGN: Analysis of functional outcomes within the FRAILMar study, a randomized controlled trial.SETTING & PARTICIPANTS: 121 KT candidates on the KT waiting list.INTERVENTION: The intervention group participated in a prehabilitation program comprising 24 exercise sessions (1 hour, 3 times per week for 8 weeks); the control group received standard care. Randomization was stratified by frailty status.OUTCOME: The primary outcome was exercise capacity assessed by maximal workload during a cardiopulmonary exercise test. Secondary outcomes included peripheral muscle function, respiratory muscle function, muscle size, and changes in frailty status.RESULTS: The mean age of the 121 individuals who were randomized was 63.4 years, 76% were men, and 40% were frail (Fried phenotype ≥2). Of these patients, 106 completed the prehabilitation program; among them, compared with standard care, prehabilitation significantly improved exercise capacity (+12.8 watts [95% CI, 3.4-22.2], P = 0.008), handgrip strength (+1.8 kg [95% CI, 0.7-2.8], P < 0.001), and rectus femoris thickness (+1.2 mm; [95% CI, 0.3-2.0], P = 0.007). Frail patients showed significant improvements across most measures, demonstrating potential benefits for this subgroup.LIMITATIONS: This analysis was limited by a short follow-up period and the risk of type I error due to multiple comparisons, even though outcomes were prespecified.CONCLUSIONS: An 8-week exercise-based prehabilitation program may improve KT candidates' exercise capacity, muscle function, and muscle size, and these effects also were observed among frail patients. These findings may inform future research in this area and the evaluation of the value of standardized prehabilitation protocols.FUNDING: Grant from government (Instituto de Salud Carlos III).TRIAL REGISTRATION: Registered at Clinicaltrials.gov with study number NCT04701398.PLAIN-LANGUAGE SUMMARY: Kidney transplantation is the preferred treatment for kidney failure, but recovery can be challenging, especially for frail patients with low physical activity and muscle strength. This study examined whether an exercise-based program before surgery can help improve fitness and muscle function in transplant candidates. Patients were randomly assigned to 1 of 2 groups: one followed an exercise program and the other received standard care. The exercise group participated in guided sessions for 8 weeks. The study found that those who exercised had better fitness, stronger grip strength, and larger muscle mass than those who did not. These findings suggest that exercise before transplantation might be clinically beneficial, though further research is needed to confirm these findings.</p
Design of a combined heat store and heat exchanger for CAES Systems
Get PDFA combined heat store and heat exchanger unit (HSX) intended for compressed air energy storage (CAES) is presented. The unit is directly charged by the pressurised air emerging from the compression train, which removes the need for a secondary low-pressure air circuit. Salt is used as the thermal storage medium due to its good heat capacity, thermal conductivity, and its ability to accommodate the thermal expansion of the stainless-steel pipes. This paper uses a CAES system (15 MW, 12-h discharge) driven by an offshore wind turbine as a case study. There are not many commercial CAES systems in operation; however, the levelized cost of the heat storage subsystem of a CAES system (i.e. heat store, set of heat exchangers and ancillary low-pressure circuit) ranges between 45 and 48 £/MWh. Findings show that the most cost-effective design for a HSX has a capital cost of ∼£55k. This translates into a levelized cost of storage of ∼31.5 £/MWh. The roundtrip exergy efficiency of this design is 93.7 %. This accounts for heat-exergy and pressure-exergy losses; losses to ambient are not considered. A HSX unit can considerably reduce the overall cost of a CAES system.</p
Exploring the Associations Between Dysphagia and Health-Related Outcomes in Older Adults:Results from the ilSirente Study
Get PDFObjectives: The present study examined cross-sectional and longitudinal associations between dysphagia and a variety of health-related parameters, including physical performance, cognitive function, malnutrition, sarcopenia, disability, frailty, falls, hospitalization, and mortality in a cohort of octogenarians living in the mountainous Sirente region of Central Italy. Methods: Dysphagia was operationalized as the need to modify the diet to facilitate swallowing and/or the exclusive consumption of specific food consistencies due to swallowing difficulties. Physical performance, cognitive function, malnutrition, disability, falls, and hospitalizations were assessed via the Minimum Data Set for Home Care. Sarcopenia was defined as the coexistence of low muscle mass and dynapenia, while frailty was operationalized according to Fried’s phenotype. History of falls and incident falls, as well as disability, were tracked over two years, while survival status was followed for up to ten years. Results: Data of 362 older adults (men age: 85.9 ± 4.8; body mass index: 25.6 ± 4.53; women: 66.9%; multimorbidity: 21.5%; dysphagia: 6.6%) were analyzed. The results indicated that dysphagia was significantly and cross-sectionally associated with poor physical performance and reduced cognitive function. In contrast, no longitudinal associations were observed. Conclusions: Dysphagia appears to be linked to deficits in physical and cognitive domains, underscoring the value of comprehensive geriatric assessment and the development of multidomain intervention strategies.</p
Sex-dependent effects of aging and insulin resistance on skeletal muscle function and structure in rats
Get PDFSkeletal muscle function is determinant for maintaining functional performance and independence in older adults. Muscle is a primary target of aging and insulin resistance (IR)—two conditions associated with functional decline. Sex-related differences may influence these effects at structural and functional levels. We aimed to evaluate the individual and combined effects of aging and IR on the function and structure of extensor digitorum longus (EDL) and soleus muscles in male and female rats. Animals aged 3 and 20 months were studied, with IR induced by 8 weeks of 20% fructose in drinking water. Muscle contractility was assessed alongside histological and hormonal analyses. In males, aging impaired EDL and soleus contractile force, free testosterone levels, and muscle mass. IR decreased muscle function only in young animals. In females, aging led to muscle loss without affecting contractile strength, but the combination of aging and IR reduced muscle contraction, decreased estradiol and exacerbated muscle loss. Both sexes showed aging-related loss of EDL glycolytic fibers, altered regenerative capacity, and increased fibrosis. IR alone reduced glycolytic fibers in young animals of both sexes but increased fibrosis only in males. These results highlight sex-specific effects of aging and IR on muscle function, relevant for targeted strategies to prevent and treat age- and IR-related muscle function decline.</p
Contributing to multimodal construct definition and operationalization:insights from research into language assessment accommodations
No full textTaylor & Banerjee (2023a) suggested that current approaches to construct definition and operationalization in language assessment are not keeping pace with the realities of communication in a digital age, especially with regard to multimodality. Multimodal communication methods are often used by language users with special needs (e.g., those with visual or hearing loss), in both education and employment. In this paper I reflect on how research into language testing accommodations might help inform current thinking and practice concerning multimodal construct definition and operationalization. Greater engagement with such research could also reflect positive commitment by the field to equity and social justice.</p
EDI in higher education challenge
No full textEDI (Equality, Diversity, and Inclusion) Equality, Diversity, and Inclusion (EDI) presents ongoing challenges in Higher Education. EDI is a framework aimed at ensuring equal opportunities and fair treatment for all, while recognizing and valuing diverse backgrounds and experiences. There is a growing need for inclusive approaches in teaching and presentation strategies. The current EDI movement has significantly influenced various sectors, including Higher Education Institutions (HEIs), particularly in pedagogic research. This paper explores the impact of EDI on higher education and discusses its potential through a focused case study.</p
Empowering P2P energy networks:a blockchain-based multi-parameter reputation management system for grid enhancement
Get PDFA robust and secure reputation management system is required to ensure reliability, trust, and efficiency in energy transactions. This paper proposes a multi-parameter reputation scoring system, which enables combining factors that reflect direct individual performance, and the contribution towards maintaining a stable grid and delivering a high-quality power supply. Further, this study proposes integrating blockchain for the realization of the reputation management of Smart Grid 2.0. This ensures a secure and transparent mechanism, eliminating data poisoning and repudiation of transactions. Smart contracts facilitate the automatic execution of data aggregation, reputation calculation, and selective decision-making processes. The performance of a multi-factor reputation management scheme on Peer-to-Peer energy trading is evaluated through the conducted tests. The superiority has been showcased through benefits to the consumer and the prosumer. Moreover, a comparison against the state-of-the-art reputation scheme is included to further highlight the significance of this study.</p
'This may not reach you …’: letters as a location of narrative in Elizabeth Bowen’s fiction
No full textElizabeth Bowen writes in ‘Notes on Writing a Novel’ that ‘[n]othing can happen nowhere. The locale of the happening always colours the happening, and often, to a degree, shapes it’. Letters in Elizabeth Bowen’s novels, however, often occupy a liminal space – a ‘nowhere’, perhaps – they are often lost, and sometimes found. They play an important role in in the narrative of much of her fiction from delayed letters in The Hotel, hidden letters in The Little Girls, to an undeliverable letter in Eva Trout, or Changing Scenes. Lost, delayed, or found, the letters in Bowen’s fiction serve a narrative function; they impart knowledge, or the emotions of the letter writer secure, perhaps, in the knowledge that the letter won’t reach its intended recipient. They provide information about events and characters, and serve often to provide the impetus of the plot (which, according to Bowen, is the essential element of a novel – in fact, as she writes, ‘[t]he Pre-Essential’ element of good fiction.) These are letters which disrupt, and deliberately confuse; their late arrival may lead to misunderstanding and confusion, or might, by the withholding of the name of the narrattee, as in A World of Love, give rise to the emotions of envy and greed. Through a discussion of a number of letters, this paper will trace Bowen’s use of this narrative device, questioning and discussing their relevance to the furtherance of plot, as Bowen continues to experiment with form and function
Barriers and facilitators of deceased organ donation among Pakistanis living globally:a systematic review
Get PDFOBJECTIVE: To identify the barriers and facilitators towards deceased organ donation among Pakistanis living globally.DESIGN: Systematic review using narrative synthesis.DATA SOURCES: CINAHL, Medline with Full Text, Global Health and PsycINFO via EBSCO; Scopus via Elsevier; Web of Science via Clarivate; and PubMed through the US National Library of Medicine and the National Institutes of Health were searched between 1 January 1995 and 31 July 2024 and limited to English.ELIGIBILITY CRITERIA: We included qualitative and cross-sectional studies involving Pakistani participants aged 18 years and above, conducted both within Pakistan and internationally across settings such as universities, religious venues, hospitals and workplaces.DATA EXTRACTION AND SYNTHESIS: Four independent reviewers were involved in screening, quality assessment and data extraction. A narrative synthesis method was employed to synthesise and integrate the data from qualitative and cross-sectional studies. The Joanna Briggs Institute tool was used to assess the quality of the included studies.RESULTS: Out of 11 944 studies retrieved, 26 studies were included in the current review. Based on the narrative synthesis, the findings are presented under the following five themes: (1) knowledge of deceased organ donation, (2) willingness towards deceased organ donation, (3) collective decision-making overriding individual's preferences, (4) religious uncertainty and its impact on deceased organ donation and (5) trust and the healthcare systems.CONCLUSION: This review shows that decisions about deceased organ donation are shaped by family dynamics, religious beliefs and trust in healthcare. More diverse research is needed to uncover new gaps and improve donor registration and consent rates in Pakistan. A whole-systems approach, considering families, religion and trust, is essential for effective strategies.PROSPERO REGISTRATION NUMBER: CRD42022346343.</p
Data sources:
Access Repository Dashboard
Do you manage University of Bedfordshire Repository? Access insider analytics, issue reports and manage access to outputs from your repository in the CORE Repository Dashboard!