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Soybean has been considered a cold intolerant species; based largely upon seed germination and soil emergent evaluations. This study reports a distinct acquisition of cold tolerance, in seedlings, following short acclimation periods. Diversity in cold responses was assessed in eight cultivars of Glycine max and six accessions of G. soja. All varieties of soybean significantly increased in freezing tolerance following acclimation. This study indicates soybean seedlings are indeed capable of sensing cold and acquiring cold tolerance. Germination rates after cold imbibition were negatively correlated with maturity group, but positively correlated with cold acclimation potential in G. soja. Seed fatty acid composition was varied between the species, with Glycine soja accessions containing about 2-times more linolenic acid (18:3) than G. max. Furthermore, high levels of linoleic acid (18:2) in seeds were positively correlated with germination rates following cold imbibition in G. soja only. We suggest that domestication has not impacted the overall ability of soybean to cold acclimate at the seedling stage and that there is little variation within the domesticated species for ability to cold acclimate. Thus, this brief comparative study reduces the enthusiasm for the 'wild' species as an additional source of genetic diversity for cold tolerance. [ABSTRACT FROM AUTHOR]

Background: The literature reports that the eccentric muscular action produces greater force and lower myoelectric activity than the concentric muscular action, while the heart rate (HR) responses are bigger during concentric contraction. Objectives: To investigate the maximum average torque (MAT), surface electromyographic (SEMG) and the heart rate (HR) responses during different types of muscular contraction and angular velocities in older men. Methods: Twelve healthy men (61.7±1.6 years) performed concentric (C) and eccentric (E) isokinetic knee extension-flexion at 60°/s and 120°/s. SEMG activity was recorded from vastus lateralis muscle and normalized by Root Mean Square - RMS (µV) of maximal isometric knee extension at 60°. HR (beats/min) and was recorded at rest and throughout each contraction. The data were analyzed by the Friedman test for repeated measures with post hoc Dunnfs test (p<0.05). Results: The median values of MAT (N.m/kg) was smaller and the RMS (µV) was larger during concentric contraction (C60°/s=2.80 and 0.99; C120°/s=2.46 and 1.0) than eccentric (E60°/s=3.94 and 0.85; E120°/s=4.08 and 0.89), respectively. The HR variation was similar in the four conditions studied. Conclusion: The magnitude of MAT and RMS responses in older men were dependent of the nature of the muscular action and independent of the angular velocity, whereas HR response was not influenced by these factors. [ABSTRACT FROM AUTHOR]

Background: The literature reports that the eccentric muscular action produces greater force and lower myoelectric activity than the concentric muscular action, while the heart rate (HR) responses are bigger during concentric contraction. Objectives: To investigate the maximum average torque (MAT), surface electromyographic (SEMG) and the heart rate (HR) responses during different types of muscular contraction and angular velocities in older men. Methods: Twelve healthy men (61.7±1.6 years) performed concentric (C) and eccentric (E) isokinetic knee extension-flexion at 60°/s and 120°/s. SEMG activity was recorded from vastus lateralis muscle and normalized by Root Mean Square - RMS (µV) of maximal isometric knee extension at 60°. HR (beats/min) and was recorded at rest and throughout each contraction. The data were analyzed by the Friedman test for repeated measures with post hoc Dunnfs test (p<0.05). Results: The median values of MAT (N.m/kg) was smaller and the RMS (µV) was larger during concentric contraction (C60°/s=2.80 and 0.99; C120°/s=2.46 and 1.0) than eccentric (E60°/s=3.94 and 0.85; E120°/s=4.08 and 0.89), respectively. The HR variation was similar in the four conditions studied. Conclusion: The magnitude of MAT and RMS responses in older men were dependent of the nature of the muscular action and independent of the angular velocity, whereas HR response was not influenced by these factors. [ABSTRACT FROM AUTHOR]

Objectives Informal caregivers provide the majority of long-term care. This study examined six health and psychosocial outcomes of caregiving, in the context of multiple characteristics of the caregiving situation, in a representative, statewide sample. METHODS: Data came from 4,041 respondents to the 2007 Connecticut Long-Term Care Needs Assessment. Analyses investigated whether caregiving negatively affects depressive symptoms, health, missing work, and social isolation. Logistic regressions tested the independent effects of caregiver characteristics and conditions of the caregiving situation on these health and psychosocial outcomes. RESULTS: Caregivers rate their health better than noncaregivers and do not report more depressive symptoms or social isolation. Living with the care receiver, inadequate income, and care receivers' unmet need for community-based long-term care services relate to multiple negative outcomes. Care receiver memory problems and caregiver/care receiver relationship do not relate to health or psychosocial outcomes when these other factors are considered. Discussion Caregiving per se does not lead to symptoms of depression, poor health, or social isolation. Many caregivers do need supports in training and education, respite, and physical and mental health care. Such programs should provide outreach to caregivers facing specific stressful conditions, as not all caregivers experience negative consequences. [ABSTRACT FROM AUTHOR]

Purpose. In this article, we aim to develop the understanding of what helps or hinders resumption of valued activities up to 12-months post-stroke. Method. As part of a longitudinal study, semi-structured interviews were conducted with 19 people with stroke and eight informal carers 12-months post-stroke. Interviews covered ongoing effects of stroke, experience of trying to resume activities highlighted as important pre-stroke and factors that influenced progress. Interviews were transcribed, coded and analysed in depth to explore this aspect of the experience of living with stroke. Results. Valued activities discussed related to employment; domestic and social roles including driving; hobbies, sports and socialising. Outcomes for individuals were influenced by: aspects of physical or cognitive disability; environmental factors; the adaptability of the individual; support from others and professional help. Inability to resume activities impacted on people's sense of self and quality of life, but some tolerated change and presented themselves as adaptable. Conclusions. This study indicates a long-term role for rehabilitation services such as: identifying the significance of different types of activities; providing access to support and treatment for debilitating symptoms such as fatigue and dizziness; addressing patients' emotional and behavioural responses to their condition; working with patients' wider social networks and where appropriate, supporting adaptation to a changed way of life. [ABSTRACT FROM AUTHOR]

Purpose. In this paper we aim to develop the understanding of what constitutes a 'good' or 'poor' experience in relation to the transition from hospital to home following a stroke. Method. Semi-structured interviews were carried out with 20 people and 13 carers within one month of being discharged from hospital following a stroke. Interviews covered views of mobility recovery and support from therapy and services. Interviews were transcribed verbatim, coded and analysed in depth in order to explore the discharge process. Results. Participants described models of recovery, which involved a sense of momentum and getting on with their life. Discharge was successful if: (i) This sense of momentum was maintained, (ii) they felt supported, and (iii) they felt informed about what was happening. Discharge was seen as difficult when: (a) Momentum was perceived to be lost, (b) people did not feel supported, or (c) they felt in the dark about the plans or their recovery. Conclusions. The discharge experience could be improved by healthcare professionals understanding and exploring patients' individual models of recovery. This would allow professionals to: (a) Access patients concerns, (b) develop programmes addressing these, (c) correct misinterpretations, (d) keep people fully informed, and (e) share and validate the experience, to reduce their sense of isolation. [ABSTRACT FROM AUTHOR]

This paper reports on findings from a study of teamwork in primary care in one family health services authority in England. It is based on interviews using a semi-structured questionnaire with practice nurses, district nurses, health visitors and midwives in 20 practices. Six topics emerged as important in relation to the views of nurses, midwives and health visitors and their experiences of teamwork: team identity; leadership; access to general practitioners; philosophies of care; understanding of team members' roles and responsibilities; and, disagreement regarding roles and responsibilities. Differences in the various views and experiences of teamwork were identified. Midwives and health visitors emerged as the least integrated members of the primary health care team. Recent changes to the organization of primary health care services, as well as professional changes, are seen as accounting for the different experiences of the nursing groups. The potential for teamwork in the future is discussed. [ABSTRACT FROM AUTHOR]

An abstract of the article "Implementation of ETAT (Emergency Triage Assessment and Treatment) in a Central Hospital in Malawi," by J. Robinson and colleagues is presented.

Background: Brief depression screens have recently been developed, but their use in older or minority populations has not been studied. To date, optimal depression screens and optimal cutpoints have not been identified for middle-aged and older Hispanic primary care patients.Methods: This study compares multiple versions of four depression screening tools--Center for Epidemiologic Studies-Depression Scale (CES-D), Geriatric Depression Scale, Yale 1-question screen, and PRIME-MD 2-question screen--to the Composite International Diagnostic Interview (CIDI), the World Health Organization's diagnostic interview, which has been validated in adult Latino populations, to assess convergent validity. Three hundred and three Puerto Rican primary care patients age 50 and older completed all screens and the CIDI in a face-to-face interview. Sensitivity and specificity for each screen were calculated, and receiver operator characteristic curves were generated.Results: Between 34% and 61% of patients screened positive for depression, depending on the measure, with 12% meeting DSM-IV criteria for major depression (CIDI). The 10-item CES-D worked best to identify major depression in this population, with a sensitivity of 84% and specificity of 64% using a cutpoint of 3.Conclusions: The 10-item CES-D, which takes about 2 minutes to administer, is a useful tool for identifying Puerto Rican patients in need of an in-depth mental health evaluation in a primary care setting. A lower cutpoint of 3 (instead of the conventional cutpoint of 4) is recommended for optimal sensitivity and specificity. [ABSTRACT FROM AUTHOR]

Abstract: Ruminants have the ability to utilize non-protein N compounds as N sources for rumen microbial protein synthesis. The objective of this experiment was to determine if use of a slowly rumen released urea could increase productive performance and/or decrease urinary N components of dairy cows when used as a replacement for urea in diets high in soluble crude protein (CP). Nitroshure, a slowly rumen released encapsulated urea, which is 0.9 urea and 0.1 fat according to the manufacturer, had measured ruminal in sacco N release of 72, 89 and 99% of at 0.5, 4 and 12h of ruminal incubation respectively. Four pens of multiparous lactating cows on a commercial dairy were fed one of two total mixed rations (TMR) formulated to supply 5% of ration CP from urea or encapsulated urea. There were two pens of early lactation cows and two pens of mid-lactation cows. The two experiments (by stage of lactation) consisted of two four week periods, and pen treatments were reversed in each lactation group after the first period. All cows were fed twice daily to appetite with daily intakes recorded by pen. The TMR were sampled at the beginning and middle of the last week of each experimental period and analyzed for nutrients. Cows were milked 3 times daily with milk yield and components measured on one day from each milking at the end of each experimental period. Representative urine samples were collected from 22 to 25 cows per pen that voluntarily urinated (at the morning ‘lock-up’ of cows for reproductive examination) on day 25 of each experimental period, with feces collected from the first 20 of those cows that were identified 24h later at the same time of the day. There were no differences in TMR nutrient analyses between the urea and encapsulated urea supplemented diets. Dry matter (DM) intake did not differ between treatments, but early lactation cows gained from encapsulated urea addition as evidenced by an increase in milk fat (0.068kg/d, P =0.01) and protein (0.041kg/d, P =0.01) output versus the urea group. Milk energy output also increased by 4.2MJ/d (P =0.01) versus urea supplemented cows. No differences in milk production or components occurred in the mid-lactation group of cows, although numerical trends were similar to the differences in early lactation. Neither early nor mid-lactation cows had differences in urinary total, ammonia or urea N concentrations, or estimated urine output, due to treatment. Fecal digestibility of CP and neutral detergent fiber (aNDFom) were similarly unaffected by treatment in either group of cows. Feeding a slowly rumen released urea increased milk fat, protein and energy output in early lactation high producing dairy cows fed a diet high in soluble N, versus feeding an equivalent amount of urea on an N basis, but that it had little impact in mid-lactation cows. In contrast, substituting urea with a slowly rumen released urea had no impact on urinary N components, and calculated urinary output, of N compounds in either group of cows. [Copyright &y& Elsevier]

Abstract: This study describes amaranth’s protein cholesterol-lowering effect and investigates its mechanisms hypercholesterolaemia was induced in male hamsters through diet rich in casein (300g/kg diet) containing regular levels of cholesterol (0.5kg/g) fed during 3 weeks. Animals were divided into three groups and fed ad libitum diets for 4 weeks containing as the sole source of protein: casein (control), amaranth protein isolate or, casein+amaranth protein isolate. Plasma concentrations of cholesterol and triacylglycerols were measured at four different points: at the beginning of the study, after hypercholesterolaemia was induced, in the first week and then at the end of the experimental diet period. The reduction of the total plasma cholesterol concentration at the end of experimental period for animals fed on diets containing amaranth protein isolate pure and with casein were 27% (P <0.05) and 48% (P <0.05), respectively, being the non-HDL fractions the most affected. Digestibility of protein as well as excretion of cholesterol and bile acid, were investigated as the possible mechanisms for this significant hypocholesterolaemic effect. Cholesterol excretion was related to the hypocholesterolaemia but could not explain all the observed reduction. Our findings suggest that amaranth protein has a metabolic effect on endogenous cholesterol metabolism. [Copyright &y& Elsevier]

Purpose. 'Exercise on prescription' (EoP) schemes run by fitness instructors in leisure centres in the UK have potential to promote continued rehabilitation and activity engagement post-discharge from stroke physiotherapy. This study explores the views of physiotherapists, stroke patients and fitness instructors about the appropriateness and acceptability of EoP schemes for stroke patients post-discharge from physiotherapy. Method. This qualitative study collected data from stroke patients referred to EoP, fitness instructors and referring physiotherapists (n = 30). Data were transcribed and analysed thematically. Exploration of key themes within and between groups was made. Results. Referral to EoP appears to alleviate some of the distress that patients and physiotherapists experience at physiotherapy discharge and provide an opportunity for physiotherapists to wean patients from physiotherapy. However, concerns about risks to patients because of fitness instructors' low levels of knowledge about stroke and the limited monitoring of exercisers were identified. Physiotherapists are likely to refer only the most able patients post-stroke to EoP. Conclusions. The study indicates that, in the light of limited health resources, EoP schemes have potential benefit for people post-discharge from physiotherapy. However, safety needs and the concerns of stroke survivors must be considered in EoP scheme development and management if they are to successfully help more people post-stroke maintain healthy levels of activity and fitness. [ABSTRACT FROM AUTHOR]

Presents information pertaining to Medicaid estate planning (MEP) in the United States, highlighting a study which was conducted in selected states to assess the magnitude and nature of MEP. Identification of the selected states; What is Medicaid; Who qualifies for the Medicaid program; Reference to Medicaid eligibility policies and enforcement procedures; In-depth look at MEP strategies.

Agonists for PPARα are used clinically to reduce triglycerides and improve high-density lipoprotein (HDL) cholesterol levels in patients with hyperlipidemia. Whether the mechanism of PPARα activation to lower serum lipids occurs in the liver or other tissues is unknown. To determine the function of hepatic PPARα on lipid profiles in diet-induced obese mice, we placed hepatocyte-specific peroxisome proliferator-activated receptor-α (PPARα) knockout (PparaHepKO) and wild-type (Pparafl/fl) mice on high-fat diet (HFD) or normal fat diet (NFD) for 12 wk. There was no significant difference in weight gain, percent body fat mass, or percent body lean mass between the groups of mice in response to HFD or NFD. Interestingly, the PparaHepKO mice on HFD had worsened hepatic inflammation and a significant shift in the proinflammatory M1 macrophage population. These changes were associated with higher hepatic fat mass and decreased hepatic lean mass in the PparαHepKO on HFD but not in NFD as measured by Oil Red O and noninvasive EchoMRI analysis (31.1 ± 2.8 vs. 20.2 ± 1.5, 66.6 ± 2.5 vs. 76.4 ± 1.5%, P < 0.05). We did find that this was related to significantly reduced peroxisomal gene function and lower plasma β-hydroxybutyrate in the PparaHepKO on HFD, indicative of reduced metabolism of fats in the liver. Together, these provoked higher plasma triglyceride and apolipoprotein B100 levels in the PparaHepKO mice compared with Pparafl/fl on HFD. These data indicate that hepatic PPARα functions to control inflammation and liver triglyceride accumulation that prevent hyperlipidemia. [ABSTRACT FROM AUTHOR]

Objective: To determine the feasibility of a Dance Centre delivering a programme of mixed dances to people with Parkinson's and identify suitable outcomes for a future definitive trial. Design: A two-group randomized controlled feasibility trial. Methods: People with Parkinson's were randomized to a control or experimental group (ratio 15:35), alongside usual care. In addition, participants in the experimental group danced with a partner for one hour, twice-a-week for 10 weeks; professional dance teachers led the classes and field-notes were kept. Control-group participants were given dance class vouchers at the end of the study. Blinded assessments of balance, mobility and function were completed in the home. Qualitative interviews were conducted with a subsample to explore the acceptability of dance. Results: A total of 51 people with Parkinson's (25 male) with Hoehn and Yahr scores of 1-3 and mean age of 71 years (range 49-85 years), were recruited to the study. Dance partners were of similar age (mean 68, range 56-91 years). Feasibility findings focused on recruitment (target achieved); retention (five people dropped out of dancing); outcome measures (three measures were considered feasible, changes were recommended). Proposed sample size for a Phase III trial, based on the 6-minute walk test at six months was 220. Participants described dance as extremely enjoyable and the instructors were skilled in instilling confidence and motivation. The main organizational challenges for a future trial were transport and identifying suitable dance partners. Conclusion: We have demonstrated the feasibility of conducting the study through a Dance Centre and recommend a Phase III trial. [ABSTRACT FROM AUTHOR]

Abstract: The objective of this preliminary investigation was to study the composition of alpaca milk. To define the nutritional requirements of growing alpaca crias, information is needed on the composition of the milk from their dams. Information on milk composition will also contribute to the development of milk formula for alpaca crias. However, there is a paucity of data for the composition of alpaca milk in the literature. The aim of this research was to obtain information on the composition of alpaca milk. Milk samples (n =168) were collected from 11 alpacas on two farms. Average milk concentrations were 3.68% for fat, 4.53% for protein, 6.00% for lactose, and 15.05% for total solids. Milk urea nitrogen averaged 31.4mg/dl of milk. Concentrations of selected minerals (n =22) varied between animals. Concentration of individual milk components, including selected minerals, showed considerable variability. Milk lipids (n =11) had appreciable amounts of fatty acids of 14 carbon chain-length and greater including high amounts of C16:0 (35.04g/100g fatty acids), but there were few fatty acids of 12 carbons and less. [Copyright &y& Elsevier]

The purpose of this study was to describe Operation Iraqi/Enduring Freedom and Operation Desert Storm/Shield deployment experiences from the perspectives of 39 Army Medical Department personnel using a qualitative method in 2004. Thematic content analysis revealed themes from data collected during twelve focus groups. The themes with the most discussion that transcended across wars, branches, echelons of care, and grade were leadership and readiness concerns, followed closely by safety issues. The majority of discussion was about deficiency needs during deployment and the data suggests that problems experienced during deployment are timeless and are not unit-specific; issues were strikingly similar across the two wars, as well as across the varying AMEDD roles and types of medical units. Therefore, the findings of this study may be generically applicable to deployed AMEDD personnel with the potential to alter current policy regarding leadership, readiness, and safety for future AMEDD deployments. [ABSTRACT FROM AUTHOR]

Abstract: Objective:: The purpose of this study was to evaluate the effects of two sex hormones on normal mammary gland of female rats. Methods:: Forty 250-day-old female rats, 20 of them with offspring and 20 not, were ovariectomized and, divided into 4 subgroups in order to receive one of the following subcutaneous treatment: estradiol benzoate (EB), medroxyprogesterone (MPA), EB+MPA or placebo, for 10 weeks. After treatment, mammary glands were studied with optical microscope. Whole gland, lobule, ductule and lumen compartments were evaluated by morphometric methods. Also a qualitative evaluation were performed seeking for secretion, microcalcification and trophic status. Results:: It was found that (a) MPA-only and placebo were similar for all parameters; (b) the same between EB and EB+MPA; (c) EB and EB+MPA increased lobule, ductule and lumen compartments significantly compared to MPA-only or placebo; (d) EB increased epithelium but without significance and EB+MPA increased it significantly compared to placebo or MPA; (e) EB and EB+MPA incremented secretion. Conclusions:: In normal mammary gland of female rats: progestin action depends on estrogen presence. MPA does not revert estrogen-dependent proliferation, but it magnifies estradiol effect. Both EB and EB+MPA stimulate differentiation. Rats without offspring presented a greater epithelial proliferation under treatment with these sex hormones. [Copyright &y& Elsevier]

A prospective, single-blind, randomized controlled trial of antiseptic cream for recurrent epistaxis in childhood Epistaxis is common in children. Trials show antiseptic cream is as effective as cautery, but it is not known whether either is better than no treatment. We wished to know the efficacy of cream in children with recurrent epistaxis. The design was a single-blind, prospective, randomized controlled trial set in the Otolaryngology clinic in a children's hospital. The participants were 103 children referred by their general practitioner for recurrent epistaxis. Excluded were those with suspected tumours, bleeding disorders or allergies to constituents of the cream. Referral letters were randomized to treatment and no treatment groups. Treatment was antiseptic cream to the nose twice daily for 4 weeks, which was prescribed by the general practitioner before clinic attendance. All children were given an appointment for 8 weeks after randomization. The main outcome measures were the proportion of children in each group with no epistaxis in the 4 weeks preceding clinic review. Complete data were available for 88 (85%) of the children. Of the treatment group, 26/47 (55%) had no epistaxis in the 4 weeks before the clinic appointment. Of the controls, 12/41 (29%) had no epistaxis over the 4 weeks. This is a relative risk reduction of 47% for persistent bleeding (95% CI 9–69%) and an absolute risk reduction of 26% (95% CI 12–40%), giving a number needed to treat of 3.8 (95% CI 2.5–8.5). We conclude that antiseptic cream is an effective treatment for recurrent epistaxis in children. [ABSTRACT FROM AUTHOR]