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Living labs are spaces where public and private stakeholders work together to develop and prototype new products, technologies and services in real environments embedded in the community or market place. This paper outlines the approach chosen by AUSILIA (Assisted Unit for Simulating Independent Living Activities), a living lab established in Provincia Autonoma di Trento in 2016 to develop an innovation model for taking care of the elderly or disabled patient by fusion of technology innovation and patient centered integrated care approach. AUSILIA goal is triple: i. to provide an innovative framework based on augmented virtual reality for occupational therapy in ageing and fragile individuals; ii. to help people who are losing autonomy and independence living at home reducing care burden; iii. warrant continuous innovation through the mixed contribution of the academy and private enterprise. The paper describes the specific solutions adopted for the three objectives, reporting an implementation example for each of them.

Taking blood samples is a common method in biomedical and biological research using guinea pigs. However, most blood sampling techniques are complicated and highly invasive and may therefore not be appropriate for certain research topics concerning stress and reproduction. Thus, a non-invasive method to measure steroid hormones is critically needed. The aim of this study was the biological validation of corresponding enzyme immunoassays for the measurement of fecal cortisol, progesterone, estrogen, and testosterone metabolites in guinea pigs. We examined the effect of subcutaneous injections of ACTH or saline on fecal cortisol metabolites to investigate the suitability of fecal samples to monitor adrenocortical activity. Furthermore, we investigated whether fecal sex steroid metabolites accurately reflected endocrine changes observed in plasma samples during female estrous cycles and male puberty, respectively. In addition, we compared fecal testosterone metabolites of intact males, castrated males, and females to investigate the reliability of fecal samples in discriminating gonadal status of males. Concentrations of fecal cortisol metabolites were significantly increased following ACTH challenge, indicating that adrenocortical activity can be monitored via fecal samples. Secondly, in females, plasma and fecal gonadal steroids were significantly correlated in most subjects. The assay for testosterone metabolites, on the other hand, could not clearly discriminate between test groups. From these findings we conclude that fecal samples can be used for the non-invasive assessment of adrenocortical and female reproductive status in guinea pigs. Testosterone metabolism seems to be more complex and further investigations are needed to establish a more suitable assay.

Polygynous mating systems can inflict considerable costs on males, often causing the emergence of alternative mating strategies to ensure reproductive success. These strategies can lead to different morphs of color, size, or behavior. The present work was done on guinea pigs, a polygynous rodent species. Some males can show a reduced readiness for conflict, perhaps employing an alternative mating strategy. To test this hypothesis, a two-stage experiment was set up, with males (N = 16) and females (N = 16) initially living in isosexual groups. Visual and olfactory contact was possible through a wire mesh. Male agonistic behavior was observed for 15 days, confirming the existence of less-conflict-involved (LCI, N = 7) and more-conflict-involved males (MCI, N = 9). Significant differences were found for a conditional parameter, body mass, and a morphometric one, testis width: LCI consistently surpassed MCI. Hormonally, cortisol was comparable, while testosterone was distinctly higher in MCI. Next, males and females were joined and observed for further 24 days. Males initially lost weight but reached original mass towards the end of the experiment. Testis width patterns were similar. Again, LCI had higher body mass. Cortisol was comparable, but testosterone release 3 days after merging was significantly higher in LCI. Behaviorally, LCI exhibited significantly less male–male aggression and more socio-sexual behavior than MCI. The former were more successful, with 57% capable of accessing females, in contrast to 11% of MCI. The existence of two distinct behavioral phenotypes in guinea pig males suggests that different reproductive strategies may exist in this species.

Background. The aim of the present study was to investigate the relationships between personality and quality of life during the course of geriatric rehabilitation, against the background of Cloninger's biosocial theory of personality.Methods. All consecutive patients of a geriatric rehabilitation clinic during one year were evaluated at admission and discharge () by means of the ‘‘Vienna List’’ (a newly developed questionnaire for the assessment of quality of life in patients with severe dementia), and two variants of the Temperament and Character Inventory.Results. Self-directedness showed the most general and highest impact on quality of life and successful rehabilitation.Conclusions. It is probable in old and very old individuals who are on their highest level of maturity that the character represents the most important regulatory system in the encounter with challenges of daily life, which necessitates rehabilitation.

The reason for the study was to investigate the discriminative, content- and criterion-related validity of the 'Vienna List', a newly developed proxy-rating measurement for quality of life in very old and severely demented persons. The total population of patients of a geriatric rehabilitation clinic of one year (from November 2001 to October 2002; n = 687) was evaluated at admission and discharge by means of this proxy rating method together with the mini mental state examination, the timed up and go test, the Tinetti measure, the Barthel Index, and the Katz activities of daily living list. Differences, mainly on factors communication, mobility, aggression, and negative affect, appeared between seven diagnostic groups as well between several care-related categories and destination after discharge. The five factors of the measurement explained a significant amount of variance with a high specificity and more than 50% of the Barthel Index scores. The 'Vienna List', originally developed for the assessment of quality of life in severely demented patients, proved to be a useful, differentiating, less time-consuming and practical tool for the documentation of the outcome of geriatric inpatient rehabilitation, as well.

Quality of life (QoL) appears as an adequate outcome measure of geriatric rehabilitation since it reflects its major goals in terms of improvement in self-service, mobility, interpersonal behavior and communication. The objective of the present study was the application of a newly developed instrument, the 'Vienna List', in this context. Its sensitivity to detect changes during geriatric rehabilitation and the ability to differentiate between various diseases and disturbances of functional abilities has been investigated. The total population of patients of one geriatric rehabilitation clinic of 1 year (from November 2001 to October 2002; N=683) was evaluated at admission and discharge by means of this proxy rating. Several reasonable differences appeared between seven diagnostic groups as well as between admission and discharge concerning crucial areas, which are the focus of geriatric rehabilitation such as communication and mobility and which reflect an improved QoL. On the other hand, some factors remained mostly unaffected, e.g. negative affect and bodily contact. The 'Vienna List' which was originally developed for the assessment of QoL in severely demented patients, proved to be a useful, differentiating, less time-consuming and practical tool for the documentation of the outcome of geriatric inpatient rehabilitation.

Behandlungsentscheidungen bei inkompetenten, schwerkranken Patienten stellen den Arzt vor viele schwierige medizinische, ethische und rechtliche Probleme. Krankenschwestern stellen die Gruppe des medizinischen Personals dar, die den engsten Kontakt zu den Patienten hat und die Entscheidungen und Anweisungen in wesentlichen Teilen realisieren mussen. Behandlungsentscheidungen und deren Determinanten werden mittels eines Fragebogens mit einer Fallbeschreibung mit drei verschiedenen Niveaus der Verfugbarkeit von Informationen uber den Patientenwillen (keine, DNR-Anweisung, Patientendirektive) erfast. Daten von 191 Arzten und 182 Krankenschwestern derselben Kliniken wurden ausgewertet. Ethische Faktoren und die Wunsche des Patienten werden von beiden Gruppen am bedeutsamsten fur ihre Entscheidungen bewertet. Mit zunehmendem Informationsgrad uber den Patientenwillen nimmt in beiden Gruppen die Compliance zu, bei den Schwestern ausgepragter als bei den Arzten. Je wichtiger der Willen des Patienten eingeschatzt wird, desto weniger Schwierigkeiten bereiten Entscheidungen, desto weniger intensive Behandlungsniveaus werden gewahlt, desto seltener erfolgt Wiederbelebung gegen den Willen des Patienten und desto hilfreicher werden Informationen uber den Willen des Patienten fur die eigene Behandlungsentscheidung erlebt. Diese bedeutsamen Zusammenhange lassen sich vor allem fur die Gruppe der Krankenschwestern nachweisen. Auch das Alter und der Demenzgrad der Patienten steht im Zusammenhang mit diesen Entscheidungen, wenn auch die Wichtigkeit dieser Faktoren geringer eingeschatzt wird. Je wichtiger juristische Aspekte bewertet werden, desto aggressiver ist das gewahlte Behandlungsniveau. Kostenfaktoren werden eher als unwichtig eingestuft und beeinflussen die Entscheidungen nicht. Die Ergebnisse weisen deutlich darauf hin, das die verstarkte Nutzung von Patientendirektiven (Patiententestamente) die Patientenautonomie fordern und gleichzeitig das medizinische Personal entlasten konnte. Umfassende und tiefgrundige Schulung sowohl des medizinischen Personals als auch der Bevolkerung wird gefordert.

Hibernating myocardium has been defined as a persistent impairment of contractile function resulting from reduced coronary blood flow that can be partially or completely resolved once coronary perfusion is restored. In fact, recent clinical reports have documented a dramatic improvement in contractile function after relief of chronic sublethal ischemia. To investigate the phenomenon of sublethal ischemia followed by reperfusion, we assessed myocyte morphology, high-energy phosphate content, and regional contractile function in dogs undergoing (1) 3 hours of subtotal coronary artery occlusion (CO) and 3 hours of reflow or (2) 3 hours of total CO followed by reflow, in which myocyte viability was maintained by extensive collateral perfusion during ischemia (total CO/negligible necrosis). Data were compared with findings in a third group of dogs with total CO and low collateral blood flow during ischemia, in which large confluent infarcts developed. Endocardial blood flow averaged 30 +/- 6% (p less than 0.01) and 27 +/- 4% (p less than 0.01) of baseline preocclusion values during ischemia in the groups with subtotal CO and total CO/negligible necrosis, versus 3 +/- 1% of baseline values in dogs with total CO/confluent necrosis. Both the subtotal CO and total CO/negligible necrosis groups exhibited only mild-to-moderate reversible myocyte injury (assessed by electron microscopy) and had essentially no necrosis: infarct size was 1 +/- 1% (p less than 0.01) and 4 +/- 2% (p less than 0.01) of the risk region in the subtotal CO and total CO/negligible necrosis groups, versus 55 +/- 9% of the risk region in the total CO/confluent necrosis group. Furthermore, myocardial high-energy phosphate stores were in part preserved in all dogs that underwent sublethal ischemia: endocardial adenosine triphosphate (ATP) content was 55 +/- 11% (p less than 0.01) and 56 +/- 8% (p less than 0.01) versus 11 +/- 2% of baseline values in the subtotal CO, total CO/negligible necrosis, and total CO/confluent necrosis groups, respectively. At 3 hours post occlusion, segment shortening averaged +21 +/- 10% of baseline values in dogs with subtotal CO, (p less than 0.01 versus both total CO groups), -29 +/- 9% in dogs with total CO/negligible necrosis, and -36 +/- 13% in dogs with total CO/confluent necrosis. Reperfusion after sublethal ischemia produced an acute improvement in contractile function in both the subtotal CO and total CO/negligible necrosis groups.(ABSTRACT TRUNCATED AT 400 WORDS)

In many species, somatic and reproductive maturation are sensitive to seasonally-fluctuating environmental conditions such as food quality. The protein content of the diet during early development has been considered to be particularly important, a low-protein diet during gestation and lactation typically delaying growth and reproductive onset. To investigate the effects of maternal and early postnatal diet quality on body weight and puberty of male and female domestic guinea pigs, we fed F0-mothers either a low-protein (14%, LQ-group) or a high-protein diet (23%, HQ-group) during gestation and lactation. Their male and female offspring received the same respective diets until six weeks of age; afterward they were switched to an intermediate control diet. Body weight of F1-subjects was significantly affected by the dietary treatment. Reproductive parameters were only affected in F1-females but not in F1-males. We conclude that in guinea pigs, growth is sensitive to the quality of the maternal and early postnatal diet, and that reproductive maturation is more sensitive in females.

Little is known about the effects of the early environment on the development of non-seasonally reproducing species like the domestic guinea pig (Cavia aperea f. porcellus). Although guinea pigs reproduce throughout the year, there is evidence for environmental sensitivity of their reproductive physiology. To investigate the sensitivity of juvenile body weight and puberty to differences in the prenatal and early postnatal environment, subjects were exposed to either of two experimental conditions mimicking seasonal variation: a long photoperiod with 25 degrees C ambient temperature ("LD/25 degrees C"), or a short photoperiod with 15 degrees C ("SD/15 degrees C"). Mean body weight of F1-males from LD/25 degrees C-conditions was higher than that of SD/15 degrees C-males during the whole pubertal period, although the difference was significant only during the early growth phase. Testosterone concentrations also differed significantly between the two treatment groups, pointing to an earlier pubertal onset in LD/25 degrees C- than SD/15 degrees C-males. In F1-females, treatment effects on body weight or age at first estrus were absent. This indicates that the somatic and reproductive development is more sensitive to early photoperiod and temperature conditions in male than female guinea pigs, and that other environmental factors may also play a crucial role for reproductive maturation in this species.

Brief episodes of ischemia protect or “precondition” the heart and reduce infarct size caused by a subsequent sustained ischemic insult. Despite a decade of intensive investigation, the cellular mechanism(s) responsible for this paradoxical protection remain poorly understood. In this review, we focus on the emerging concept that alterations in intracellular calcium homeostasis may participate in either triggering and/or mediating infarct size reduction with preconditioning.

Mechanisms responsible for the well-documented "protection" against myocardial ischemia and infarction in young women and subsequent loss of protection after menopause remain speculative. One possibility is that gender-related variables (such as endogenous hormone levels or regular loss of stored iron) alter the susceptibility of the heart to ischemia: if so, then premenopausal women when compared with men may manifest endogenous protection against acute myocardial ischemic injury. Using the canine model we therefore sought to determine whether gender influences acute myocardial ischemia and infarction. Retrospective analysis was performed on data compiled from 60 mature adult dogs subjected to 1 hour of coronary artery occlusion and ≥4 hours of reperfusion. We first compared the incidence of lethal ventricular fibrillation in the male and female cohorts and then for survivors compared collateral blood flow during coronary occlusion (by injection of radioactive microspheres), infarct size (assessed by tetrazolium staining and expressed as a percentage of the myocardium at risk), and regional wall motion (by somomicrometry) in the infarct-related area. The incidence of lethal ventricular fibrillation was 23% in the male dogs and 19% in the female dogs ( p = 0.70, difference not significant). For survivors, the area at risk of infarction was comparable in males and females (23 ± 2% and 22% ± 1% of the total left ventricular weight), and the groups were equally ischemic during coronary occlusion, with collateral blood flow to the ischemic subendocardium averaging 0.05 ± 0.02 and 0.07 ± 0.01 ml/min/g tissue. There was no difference in infarct size between the two cohorts: area of necrosis was 17% ± 6% and 18% ± 3% of the myocardium at risk in the males and females, respectively. In addition, the groups were equally dyskinetic during occlusion and equally hypokinetic after reperfusion. We conclude that gender does not influence acute myocardial ischemia and infarction in the canine model.

The present study was designed to determine the feasibility of using single-photon emission tomography (SPET) imaging with rubidium-81 (T1/2 = 4.54 h) to detect ischaemic heart disease, using a stress-reinjection protocol and a specially constructed 511-keV hexagonal hole collimator for a standard gamma camera. The diagnostic performance of 81Rb SPET in detecting coronary artery disease (CAD) was investigated in 52 patients with a high prevalence of CAD. Coronary arteriography was performed in 34 patients, 25 of whom were classified as having significant stenosis (or = 50%). At peak exercise (Cornell protocol), 111-222 MBq 81Rb was injected i.v. for stress imaging, and after 3 h of rest, 74-111 MBq was reinjected for rest imaging. The displayed short- and long-axis slices and the polar map images were interpreted qualitatively. In comparison to coronary arteriography, which served as the gold standard, the performance of 81Rb SPET revealed a sensitivity of 95% for the detection of CAD. Images of diagnostic quality were obtained in all patients, these being comparable to thallium-201 SPET images. In conclusion, these results indicate that the described method can be routinely used for the positron emitter 81Rb with a conventional gamma camera and special shielding. 81Rb has the well-known advantages of a potassium analogue and 81Rb SPET permits better visualization, particularly of the posterior wall of the myocardium, due to the higher photon energy. Considering the typical dose of 201Tl used for SPET (74-148 MBq), a 81Rb SPET scan imposes a significantly lower radiation burden on the patient.

Numerous studies have described a progressive deterioration in resting myocardial blood flow following relief of sustained ischemia in both necrotic and salvaged myocardium (termed "no reflow" and "low reflow", respectively). We sought to determine whether release of the potent vasoconstrictor peptide endothelin-1 may play a role in these phenomena. As part of a previous study in our laboratory, 14 anesthetized open-chest dogs underwent 1 h of coronary artery occlusion and 4 h of reperfusion, while 2 dogs served as time-matched sham-operated controls (artery isolated but not occluded). Regional myocardial blood flow was measured by injection of radiolabeled microspheres at 30 min and 4 h post reflow; endothelin-1 concentrations in the coronary sinus were determined by radioimmunoassay at baseline, during coronary occlusion and at 30 min and 4 h after reperfusion; and the extent of myocardial necrosis was delineated by post-mortem tetrazolium staining. As expected, in dogs subjected to ischemia/reperfusion, regional myocardial blood flow deteriorated between 30 min and 4 h post reflow in both the subendocardium (1.40 +/- 0.30 versus 0.48 +/- 0.06 ml/min/g; p = 0.003; reflecting a mixture of no reflow and low reflow) and subepicardium (0.84 +/- 0.08 versus 0.64 +/- 0.07 ml/min/g; p = 0.03; due to low reflow). However, endothelin levels showed only a modest and nonsignificant increase during the protocol (4.1 +/- 0.5, 4.7 +/- 0.2 and 4.9 +/- 0.6 pg/ml plasma at baseline, 30 min and 4 h post reflow; p = NS), and regression analysis revealed no correlation between release of endothelin and deterioration in blood flow in either myocardial layer. Moreover, the sham-operated controls showed a similar modest increase in endothelin levels, with no change in myocardial perfusion during the course of the protocol. We therefore conclude that deterioration in myocardial blood flow following relief of sustained ischemia in the anesthetized open-chest dog is not associated with release of endothelin-1 into the coronary sinus.

In 1986, Murry et al. showed that repeated short episodes of coronary occlusion protect the myocytes against subsequent sustained ischemia: This phenomenon was termed ischemic preconditioning [1]. While there is no doubt that preconditioning limits infarct size, myocardial necrosis is not the only consequence of sustained/ischemia reperfusion: One or more hours of occlusion followed by reflow also results in ventricular arrhythmias, postischemic contractile dysfunction or “stunning,” and abnormalities in myocardial perfusion. The obvious question therefore arises: Do the benefits of ischemic preconditioning extend beyond the concept of myocyte viability and attenuate other deleterious sequelae associated with sustained ischemia/reperfusion?

The personal characteristics of 80 clients with elevated 2-4 (D-PD) scales on their MMPIs were compared with those of 109 clients without these elevations. Clients with the 2-4 elevated were significantly more depressed, had lower self-esteem, and were more likely to come from disturbed families. They also had poor relationships with the opposite sex, became more dependent on the therapist, and often made little improvement in therapy. In comparison to previous descriptions of hospitalized patients with similar profiles, the counseling center clients continue to function in the community and show less pathological behavior. Implications for therapy are discussed.

The ability to withhold a response on the basis of a punishing electrical shock after 0, 20, 40 training trials was investigated in rats following radical bilateral hippocampal destruction, damage to the posterolateral neocortex, or sham operations. Hippocampectomized animals continued to make the response despite the previous shock under all training conditions (impaired passive avoidance behavior) but their response latencies were shorter when 20 or 40 training trials had been given.