Physical Deficit Research Articles

IMPAIRED COMFORT AT THE END OF LIFE: AN ASSOCIATION WITH NURSING DIAGNOSIS AND CLINICAL VARIABLES

ABSTRACT Objective: to analyze the associations between the clinical variables and the Nursing diagnoses of NANDA-I Taxonomy II with the presence of Impaired comfort. Method: a quantitative and analytical study conducted with 66 individuals with end-of-life oncological disease, admitted to a specialized institution in the Federal District, Brazil. Primary data were collected between February and November 2018, which covered social, demographic and clinical variables, in addition to three validated scales to identify Nursing diagnoses. To assess the association of impaired comfort (dependent variable) as a function of the independent variables (Nursing diagnosis and clinical variables), the Mann-Whitney non-parametric test and Pearson's chi-square test were used, considering p< 0.05 as significant. Results: a total of 960 diagnoses were identified in 66 patients. There was a positive relationship with Impaired comfort for the following Nursing diagnoses: Chronic pain; Impaired physical mobility; Self-care deficit (for feeding, bathing, intimate hygiene and dressing); Chronic sorrow and Dysfunctional family processes. The following clinical variables showed a statistically significant relationship regarding impaired comfort: time of palliative care, pain, tiredness, appetite, sorrow, anxiety and well-being. Conclusion: an association of the pain, impaired physical mobility, self-care deficit and chronic sorrow nursing diagnoses with impaired comfort was identified. Among the clinical variables, there was a relationship between time of palliative care and symptoms.

Frailty and aging-associated syndromes in lung transplant candidates and recipients.

Many lung transplant candidates and recipients are older and frailer compared to previous eras. Older patients are at increased risk for pre- and posttransplant mortality, but this risk is not explained by numerical age alone. This manuscript represents the product of the American Society of Transplantation (AST) conference on frailty. Experts in the field reviewed the latest published research on assessment of elderly and frail lung transplant candidates. Physical frailty, often defined as slowness, weakness, low physical activity, shrinking, and exhaustion, and frailty evaluation is an important tool for evaluation of age-associated dysfunction. Another approach is assessment by cumulative deficits, and both types of frailty are common in lung transplant candidates. Frailty is associated with death or delisting before transplant, and may be associated with posttransplant mortality. Sarcopenia, cognitive dysfunction, depression, and nutrition are other important components for patient evaluation. Aging-associated inflammation, telomere dysfunction, and adaptive immune system senescence may also contribute to frailty. Developing tools for frailty assessment and interventions holds promise for improving patient outcomes before and after lung transplantation.

An exploration of the breastfeeding behaviors of women after cesarean section: A qualitative study

ObjectivesTo explore the factors affecting breastfeeding behaviors in women after cesarean section. MethodsThis is a qualitative study that used a phenomenological approach. This study used individual face-to-face interviews with 19 women who underwent a cesarean section in a Women and Children’s Hospital in China between July to September 2019. Information saturation was used to determine sample size. Data were analyzed using a thematic content analysis method. Themes were developed based on the theory of planned behavior. ResultsThirteen (68.42%) had a planned cesarean section, and six (31.58%) cesarean sections were unplanned or emergent. Three major themes emerged: ambivalent attitude about breastfeeding, motivation to comply with the traditional cultural norms, and barriers and challenges. The motivating factors for breastfeeding after cesarean sections included perceived benefits of human milk, support from healthcare professionals, and responsibility for breastfeeding. The challenges for breastfeeding after cesarean sections included physical discomfort, knowledge and skills deficit of breastfeeding, lactation deficiency, and lack of knowledge and coping skills in managing their depressive mood after cesarean sections. There were a couple of neutral factors, such as the influences of family and peers. These factors could influence women either positively as facilitators or negatively as barriers. ConclusionsThe findings can offer valuable information for healthcare professionals to help women breastfeed after cesarean sections. To promote women’s breastfeeding behaviors after cesarean sections, it is necessary to change women’s attitudes, belief systems, and the external environments and help them become more confident.

Social, Functional, and Neuropsychological Determinants of the Psychiatric Symptoms of Stroke Patients Receiving Rehabilitation and Living at Home

In view of the strong evidence supporting the hypothesis that high Expressed Emotion of a key relative contributes to relapse in psychiatric patients, methods used in Expressed Emotion research were applied in an investigation of psychiatric disorder in stroke patients receiving hospital based rehabilitation and support. Patient mood in 37 stroke patients was related to the critical attitude of a key relative. Patient depression may also have been associated with severity of dysphasia, but no link was found between patient mood and the other measures of cognitive or physical deficit used in this study. Psychiatric distress in the key relative had a rather different causal basis. Relatives' psychiatric disorders were associated with physical burden, cognitive deficit, and severity of dysphasia. This study suggests that, when the patient is dependent for self-care, rehabilitation-assisted recovery may alleviate relative distress more than patient distress.

The Articulation Handicap Scale with 12 items (AHS-12): a short form of the Articulation Handicap Index (AHI)

Objective The objective is to produce a short instrument for measuring the subjectively experienced articulation handicap, i.e. the extent to which physical, functional, and emotional handicaps caused by a physical deficit are subjectively experienced. Methods The items for the short instrument were selected from the 30 items of the Articulation Handicap Index (AHI) by removing items on the basis of item-total correlations using data from 113 cancer survivors. Reliability and validity of the sum score of the corresponding item selection were used for determining the optimal item selection. This optimal item selection was compared with the AHI in an RCT with patients undergoing phoniatric routine diagnostics. Results With only 12 items left, the measurement instrument was still as reliable and valid as the AHI. With less than 12 items, reliability and validity decreased. In the RCT between the AHI (n = 41) and the 12-item selection (n = 40), reliability and validity of both instruments were the same, but processing times differed (AHI; 3.84 min; 12-item selection: 2.02 min). Conclusion The 12-item selection, further referred to as the Articulation Handicap Scale with 12 items (AHS-12), provides nearly as much information as the original AHI.

Unequal raw material exchange between and within countries: Galicia (NW Spain) as a core-periphery economy

A global multi-regional input-output model with sub-national resolution for Galicia, north-west Spain, was used to study physical and value added trade balances between Galicia, the rest of Spain and the world. Within the framework of Ecologically Unequal Exchange theory, we argue that a region, such as Galicia, can play a twofold role as core and periphery in the global division of extractive activities. We show that Galicia is a sink, i.e. net importer of natural resources from middle- and low-income economies, and that the lower the income of the trade partner, the more raw material intensive the imports (measured as upstream kg per USD imported value added). However, this physical deficit is less accentuated than for the rest of Spain and Galicia's material footprint is significantly lower (~14.2 compared with ~24.5 t/capita). Moreover, Galicia is a source, i.e. net exporter of raw materials compared with more thriving European Union economies and, even for some key trade partners, such as Germany, UK and the rest of Spain, it is a net importer of value added.

Knowledge, Attitude, and Practices Regarding Maxillofacial Defects and their Prosthetic Rehabilitation among Dental Undergraduate Students in Belagavi District- A Cross-sectional Study

Introduction: Maxillofacial defects are facial disfigurements resulting from congenital abnormalities, surgical resection of tumours, trauma, or a combination of these. The resulting deformity often leads to a difficult path of recovery with lifelong consequences, causing both physical disability and mental distress. Prosthetic rehabilitation is not only a solution to cover the physical deficit, but also a way to improve function as well as the quality of life for such patients. However, the knowledge amongst undergraduate dental health professionals about the same has been at sparse. Aim: To evaluate the knowledge, attitude, and practices regarding maxillofacial defects and their prosthetic rehabilitation amongst dental undergraduate students. Materials and Methods: A cross-sectional survey was conducted between January 2020 and June 2020, amidst the third year, fourth year undergraduate students, and interns of Belagavi city, Karnataka, India. The data was collected using a 16-item custom designed proforma, comprising of questions evaluating student’s basic knowledge about the diagnosis, treatment procedures, and treatment planning of maxillofacial defects and their prosthetic rehabilitation. Statistical analysis was done using Chi-square test in each group, using SPSS version 22 p-value <0.05 to be considered significant. Results: A total of 286 participants answered the questionnaire, of which 117 (40.9%) were interns, 116 (40.6%) were third year students, and 53 (18.5%) were fourth year students. 279 (97.6%) participants had an understanding regarding maxillofacial defects. Of those who had witnessed cases, only 18.2% had observed more than three cases (p-value <0.001). Out of respondents with treatment understanding, 184 (64.3%) answered that it required a multidisciplinary approach (p-value <0.001). 197 (68.9%) of the respondents felt that silicone was the most commonly used material (p<0.003). 165 (57.7%) answered that waxes were the most commonly used impression material (p-value <0.001). Out of the respondents awared about treatment modalities, 120 (42%) respondents majority answered that CAD-CAM would contribute the most to maxillofacial rehabilitation. Conclusion: Comprehensive understanding and clinical application of prosthodontic rehabilitation of maxillofacial defects among undergraduate students was found to be lacking. This awareness should be initiated at an early stage of the clinical training for undergraduate training programme, as it will help to understand the basic aspects involved in the prosthodontic rehabilitation of maxillofacial defects.

A cross-sectional study of hand function in inclusion body myositis: Implications for functional rating scale

Inclusion body myositis (IBM) is a slowly progressive and heterogeneous disorder that is a challenge for measuring clinical trial efficacy. The current methods of measuring progression of the disease utilizes the Inclusion Body Myositis Functional Rating Scale, grip strength by dynamometer, and finger flexor strength. One of the hallmarks of the disease is selective deep finger flexor weakness. To date, no adequate data has been available to determine how well the Functional Rating Scale relates to this hallmark physical exam deficit. Our study is the first to investigate the degree of correlation between items pertaining to hand function in the Functional Rating Scale with measured grip and finger flexor strength in IBM patients. We have found a lower than expected correlation with finger flexor strength and even lower with grip strength. The current Functional Rating Scale will benefit from optimization to measure clinical progression more accurately.

Irrigation Regime and Soil Conditioners Impact on Characteristics of Sandy Soil and Washington Navel Orange Trees

Due to limited water resources it has become needed to study the best ways to decrease irrigation water use, increasing the water use efficiency, improve tree growth and sustain citrus crop production under those circumstances. Afield experiment was conducted during 2015/2016 and 2016/2017 seasons at El-Nubaria city, Beheira Governorate to investigate the effect of irrigation regime (80% and 60% from full irrigation) and soil conditioners (hydrogel at rate of 50 and 100g/tree as synthetic water absorbing soil amendments or organic plant residues at rate of 3.5 and 6.5kg/tree as natural absorbing soil amendments) on some properties of sandy soil, growth, yield, quality and productivity of irrigation water (PIW) for Washington navel orange trees under drip irrigation system. The obtained results pointed out that: The application of soil conditioners led to enhancing the properties and microorganisms activities and macronutrients of sandy soil especially with the high rates. Whereas, the low values of soil field capacity (10.47%), wilting point (4.26%) and available water (6.21%) were recorded with full irrigation without conditioners while, the high values (11.31 to 12.28%), (4.35 to 4.68%), (6.78 to 7.62%) respectively under irrigation regime combined conditioners. Soil conditioners application combined with irrigation regime increased the available nitrogen (up to 22.76%, phosphours (up to 9.98%), potassium (up to 15.14%), organic matter (up to 41.79%, CEC (up to 16.53%) and salinity (up to 4.64%) while soil bulk density was decreased (up to 5.66%) compared to full irrigation without conditioners. Moderate irrigation plus organic plant residues at rate of 6.5 kg/tree (T5) or plus hydrogel at 100g/tree (T3) significantly increased the most growth parameters (canopy volume, number of shoots/branch and leaf area), fruit set and decrease the fruit drop. Lowest percentage of fruit splitting (6.58 and 5.87 %) coated with T3 and T5 compared to deficit irrigation treatments plus the lowest rate of hydrogel or organic plant residues (T8 and T9). The highest yield was obtained by T3 (78.6 kg/tree) and T5 (79. 6 kg/tree). Control treatment (T1) followed by T3 and T5 tended to improve the physical fruit quality meanwhile deficit irrigation treatments T8 and T9 increased the most of chemical fruit quality. PIW mean values of Washington navel orange with full irrigation without conditioners were low (2.75 kg m-3) while, irrigation regime at 80 % and 60% recorded high values (3.49 kg m-3 and 3.88 kg m-3, respectively). PIW was increased with the high rates of soil conditioners.

Establishment and evaluation of a simulated high‑altitude hypoxic brain injury model in SD rats.

This study was conducted to establish a stable hypobaric hypoxia brain injury model. SD rats were randomly separated into control and model groups, and placed outside or inside of a hypobaric chamber, respectively. Subsequent to 24 h anoxic exposure, plasma superoxide dismutase (SOD), malondialdehyde (MDA), glutathione (GSH), oxidized glutathione (GSSG) and lactate dehydrogenase (LDH) were measured using commercial biochemical kits. Hematoxylin-eosin (H&E), Nissl's and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining were used to observe the morphology of neurons in the hippocampus. The protein expression levels of apoptotic protease activating factor-1 (Apaf-1), hypoxia inducible factor-1α (HIF-1α), caspase-3, cleaved caspase-3, Bcl-2-associated X protein (Bax) and cytochrome c (cyto-c) were detected using western blot and immunohistochemistry analyses. Hypoxic substantially induced morphological lesions in the hippocampus concomitant with the physical behavioral performance deficit. Furthermore, hypoxia markedly exacerbated the levels of MDA, LDH and GSSG, and restrained GSH (P<0.01) and SOD (P<0.05) levels compared with the control group. In addition, hypoxia significantly induced the protein expression of Apaf-1, HIF-1α, caspase-3, cleaved caspase-3, Bax and Cyto-c (P<0.01) compared with the control group. Finally, a lower number and volume of Nissl bodies were verified in the hypoxic group. TUNEL results demonstrated a greater number of apoptotic cells in the hypoxic group. The present study demonstrates a model of rat hypoxic brain injuries induced by a hypobaric chamber at 9,000 m for 24 h. Furthermore, the redox enzyme, HIF-1α and mitochondrial apoptosis-associated protein, along with H&E and Nissl's staining, may be applied to evaluate the degree of injury.

Leśne przedszkola – odpowiedź edukacji na potrzeby dzieci

Forest kindergartens in Poland are a relatively new, alternative concept of pre-school education functioning in the form of educational projects. The aim of this article is to present the health and educational values of forest kindergartens in the context of life in the technology-grounded reality of the 21st century. In the text I pay special attention to two phenomena: physical activity deficit syndrome and nature deficit syndrome.

Is practising standing-up and moving between sitting and standing early after a severe stroke feasible? A feasibility randomised controlled trial

Purpose: The most common physical deficit caused by stroke is muscle weakness which limits a person's mobility (e.g. out of bed activities, sitting, standing and walking). Moving between sitting and standing is an essential pre-requisite to walking, and one of the most frequently performed functional tasks of daily living. These activities are of paramount importance to people who have had a stroke.

Functional Status Is Associated with Outcomes after Allogeneic Stem Cell Transplantation for Older Patients with Hematologic Malignancies

Introduction:Allogeneic hematopoietic cell transplantation (alloHCT) has historically been reserved for younger, fit patients with hematologic malignancies. With the introduction of non-myeloablative conditioning regimens and improved supportive care, alloHCT has been increasingly offered to older adults.Objectives:To determine the association between functional status as measured by a cancer-specific comprehensive geriatric assessment (CGA) and post-transplant outcomes in an older alloHCT patient population.Methods:We conducted a prospective cohort study of patients aged 50 or older who underwent alloHCT at the University of California San Francisco between October 2011 and September 2017. A cancer-specific CGA (1) was administered prior to alloHCT, which included measures of functional status such as Lawton Instrumental Activities of Daily Living (IADL), Medical Outcomes Study (MOS) Physical Health scale, and patient-reported Karnofsky Performance Status (KPS). Post-transplant outcomes included length of hospital stay (LOS), non-relapse mortality (NRM), progression-free survival (PFS), and overall survival (OS).Results:A total of 148 patients were included in the analysis. The median age at transplant was 62 (range 50-76). Disease types included acute myeloid leukemia (43%), myelodysplastic syndrome (26%), myeloproliferative neoplasm (12%), acute lymphoblastic leukemia (10%), non-Hodgkin lymphoma (5%), multiple myeloma (1%), and other (3%); 68% received non-myeloablative conditioning. Median follow-up was 16.3 months (range 0.9-72.7 months). Median PFS and OS were 22.9 months and 47.6 months, respectively. At baseline, 39% had at least one IADL deficit, and 88% had at least one MOS Physical Health scale deficit. The mean patient-KPS was 82.4 and mean provider-KPS was 91.6; these were weakly correlated (Spearman's r=0.39, p<0.001).In univariate analysis, the presence of any IADL deficit was associated with inferior PFS (HR 1.78, p=0.01) and OS (HR 1.68, p=0.04) (Figure). MOS Physical Health score was associated with increased NRM (HR 1.06 per 1-point change in 20-point scale, p=0.04), inferior OS (HR 1.05, p=0.04), increased LOS (difference 0.63 days, p=0.007), but not with PFS (HR 1.04, p=0.06). Neither patient- nor provider-KPS was associated with NRM, PFS, or OS, but lower patient-KPS was associated with increased LOS (difference 1.94 days, p=0.01). In this study, the Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI), disease risk by American Society for Blood and Marrow Transplantation (ASBMT) classification, and conditioning intensity were not associated with NRM, PFS, or OS.Notably, chronologic age was not associated with NRM, PFS, or OS (Figure). In addition, age was not associated with baseline IADL score (r=-0.02, p=0.26) or MOS Physical Health score (r=-0.13, p=0.06).Conclusion:IADL impairment was associated with inferior PFS and OS, supporting previous studies (2, 3) identifying IADL as an important predictor for alloHCT. In univariate analysis, IADL was a stronger predictor of post-transplant outcomes than traditional prognostication tools such as age, HCT-CI, and provider-KPS. MOS Physical Health score was associated with multiple poor outcomes including NRM and LOS, suggesting a primary impact on alloHCT toxicity. Multivariate analyses, as well as examination of other CGA variables, are ongoing.

A cross-sectional audit of distress in patients undergoing adjuvant therapy or follow-up in central nervous system malignancies.

Unaddressed high distress leads to noncompliance with treatment, negatively affects quality of life, and may also have a negative impact on the prognosis of cancer patients. Patients with brain tumors have higher levels of distress than the general population and hence we hypothesize that even routine visits during adjuvant treatment or follow-up are likely to be stressful. This analysis was performed to identify the incidence of distress and factors affecting it. This was an audit of 84 consecutive patients seen in an adult neuro-medical oncology outpatient department who were either receiving adjuvant chemotherapy or were on follow-up. Distress screening with the National Comprehensive Cancer Network (NCCN) distress thermometer was performed. Patients in whom distress was scored as 4 or above were considered as having high distress. Descriptive statistics and logistic regression analysis were performed to identify factors affecting distress. The median age of the cohort was 40 years (interquartile range, 28.3 to 50 years). Actionable distress defined as a distress score of 4 or more was seen in 52 patients (61.9%, 95% CI 51.2% to 71.5%). Presence of physical deficit (odds ratio [OR] = 3.412, P = .020) and treatment under the private category (OR = 5.273, P = .003) had higher odds of having high distress. A high proportion of brain tumor patients either on adjuvant chemotherapy or on follow-up have high distress levels that need to be addressed even during follow-up.

Standing Practice In Rehabilitation Early after Stroke (SPIRES): a functional standing frame programme (prolonged standing and repeated sit to stand) to improve function and quality of life and reduce neuromuscular impairment in people with severe sub-acute stroke\u2014a protocol for a feasibility randomised controlled trial

BackgroundThe most common physical deficit caused by a stroke is muscle weakness which limits a person’s mobility. Mobility encompasses activities necessary for daily functioning: getting in and out bed, on/off toilet, sitting, standing and walking. These activities are significantly affected in people with severe stroke who typically spend most of their time in bed or a chair and are immobile. Immobility is primarily caused by neurological damage but exacerbated by secondary changes in musculoskeletal and cardiorespiratory systems. These secondary changes can theoretically be prevented or minimised by early mobilisation, in this case standing up early post-stroke.Standing up early post-stroke has been identified as an important priority for people who have suffered a severe stroke. However, trials of prolonged passive standing have not demonstrated any functional improvements. Conversely, task-specific training such as repeated sit-to-stand has demonstrated positive functional benefits. This feasibility trial combines prolonged standing and task-specific strength training with the aim of determining whether this novel combination of physiotherapy interventions is feasible for people with severe stroke as well as the overall feasibility of delivering the trial.Methods/designThis is a pragmatic multi-centre parallel single-blinded two-armed feasibility randomised controlled trial. Fifty people with a diagnosis of severe stroke will be randomly allocated to either the functional standing frame programme or usual physiotherapy. All patient participants will be assessed at baseline and followed up at 3 weeks, then 3, 6 and 12 months post-randomisation. Trial objectives are to determine the feasibility according to the following indicators:: (i) Process: recruitment and retention rate, ability to consent, eligibility criteria, willingness/ability of physiotherapists to recruit, willingness of patients to be randomised, and acceptability of the intervention; (ii) Resource: burden and potential costs; (iii) Management: treatment fidelity, participant adherence, acceptability and completeness of outcome measures, impact and management or orthostatic hypotension; and (iv) Safety: number and nature of adverse and serious adverse events.DiscussionThe functional standing frame programme addresses a key concern for people who have suffered a severe stroke. However, several uncertainties exist which need to be understood prior to progressing to a full-scale trial, including acceptability and tolerance of the functional standing frame programme intervention and practicality of the trial procedures. This feasibility trial will provide important insights to resolve these uncertainties.Trial registrationInternational Standard Randomised Controlled Trial Number ISRCTN15412695. Registration on 19 December 2016.

A Review of Frailty Syndrome and Its Physical, Cognitive and Emotional Domains in the Elderly.

Background: Frailty, a very important complication of increasing age, is a well-recognised concept although it has not been accurately measured in the clinical setting. The aim of this literature review is to summarise commonly used frailty screening tools, and to describe how new measurement methods have been developed recently. Methods: Several frailty measurement tools including the most cited and newly developed scales have been described in this review. We searched the MEDLINE using the search terms; “frailty score, scale, tool, instrument, index, phenotype” and then summarised selected tools for physical, cognitive, emotional and co-morbidity domains. Results: The most cited frailty measurement methods developed from 1999 to 2005 are primarily criteria for physical frailty (e.g., frailty phenotype). More recently developed tools (e.g., triad of impairment and multidimensional frailty score) consider cognitive and emotional domains in addition to physical deficit in measuring frailty. Co-morbidity has also been considered as a domain of frailty in several measurement tools. Conclusion: Although frailty tools have traditionally assessed physical capability, cognitive and emotional impairment often co-exist in older adults and may have shared origins. Therefore, newer tools which provide a composite measure of frailty may be more relevant for future use.

Psychosocial wellbeing and physical health among Tamil schoolchildren in northern Sri Lanka.

BackgroundMental disorders contribute to the global disease burden and have an increased prevalence among children in emergency settings. Good physical health is crucial for mental well-being, although physical health is multifactorial and the nature of this relationship is not fully understood. Using Sri Lanka as a case study, we assessed the baseline levels of, and the association between, mental health and physical health in Tamil school children.MethodsWe conducted a cross sectional study of mental and physical health in 10 schools in Kilinochchi town in northern Sri Lanka. All Grade 8 children attending selected schools were eligible to participate in the study. Mental health was assessed using the Sri Lankan Index for Psychosocial Stress – Child Version. Physical health was assessed using Body Mass Index for age, height for age Z scores and the Multi-stage Fitness Test. Association between physical and mental health variables was assessed using scatterplots and correlation was assessed using Pearson’s R.ResultsThere were 461 participants included in the study. Girls significantly outperformed boys in the MH testing t (459) = 2.201, p < 0.05. Boys had significantly lower average Body Mass Index for age and height for age Z scores than girls (BMI: t (459) = −4.74, p <0.001; Height: t (459) = −3.54, p < 0.001). When compared to global averages, both sexes underperformed in the Multi-Stage Fitness Test, and had a higher prevalence of thinness and stunting. We identified no meaningful association between the selected variables.ConclusionsOur results do not support the supposition that the selected elements of physical health are related to mental health in post-conflict Sri Lanka. However, we identified a considerable physical health deficit in Tamil school children.

Hormonal, Immunological And Neuromuscular Responses During 21 Days Of Military Field Training

Military field training (MFT) exposes warfighters to multiple stressors such as prolonged and strenuous physical activity, sleep deprivation and energy deficit. This has been shown to lead changes in a hormonal profile and decreased physical performance. PURPOSE: To determine the warfighters’ hormonal and neuromuscular responses during a 21-day MFT. METHODS: 49 (age 20±1yrs., height 179±7cm, body mass 73.0±8.7kg) male conscripts participated in the study. Blood samples were drawn and assayed for testosterone (TES), cortisol (COR), insulin-like growth factor 1 (IGF-1), sex hormone binding globulin (SHBG), leptin (LEP), interleukin 1β (IL-1β), interleukin 6 (IL-6) and tumor neurosis factor alpha (TNF-α). Also body composition, maximal isometric force (MVC) from the upper and lower extremities, standing long jump and shooting were measured 4 times during the study. Physical activity (PA) was monitored throughout the 21-day MFT. Daily diaries were collected to follow the workload and mood states of the conscripts. RESULTS: There were significant declines after MFT in TES (11.4%), IGF-1 (21.0%) and LEP (44.4%) and increases in COR (32.0%) and in SHBG (16.3%). In the beginning of MFT, TNF-α increased but decreased in the end and returned to the pre measurement value after the recovery. The same tendency was also found for IL-1β and IL-6. Body mass and fat mass decreased after MFT but recovered during the 4-day recovery period. There was a significant decrease in a standing long jump after MFT and also after the recovery period as compared to the preMFT values. There were no significant changes in MVC during MFT. PA was greater in MFT and the conscripts felt MFT more demanding both physically and mentally than actions in the garrison environment. CONCLUSION: The present study demonstrated slight decrements in warfighter physical performance during the 21-day MFT. Although the conscripts were overloaded during MFT, 4 days of recovery seemed to be enough to obtain the pre measurement values in neuromuscular performance and measured serum hormonal and immunological parameters. The results suggest that it is important to have sufficient recovery time after long MFT to return combat readiness.

Diversificación productiva para mejorar la competitividad en los acuerdos comerciales del sector agroindustrial en el Perú

The study of diversifi cation in order to improve competitiveness in the trade agreements of Peru in the agribusiness sector are key within the challenge of innovation in the productive sector. The physical infrastructure defi cit presented by Peru does not allow the integration of markets nor the introduction of Peruvian companies to the global market. Therefore, management and public investment with private sector participation is required. The development of productive chains and clusters will contribute to the economic and social development of the Peruvian agroindustry.

Rehabilitation of Fine Motor Coordination of Individuals with Chronic Alcohol Dependence

Long term alcohol abuse causes physical, cognitive, psychological and neuropsychological deficit in alcoholic individual. Current study intends assess and rehabilitate fine motor coordination of chronic alcohol dependent cases. Seven chronic cases of alcohol dependence were selected from de-addiction ward of Ranchi Institute of Neuropsychiatry and Allied Sciences, Kanke. All the cases were assessed on LNNB &amp; AIIMS Motor function scale. Each patient was individually given one month rehabilitation training with Talking Pen. All the cases were assessed in pre and post test condition. Result was analyzed using Wilcoxin Sign Rank Test. Result reveals there was significant difference between patient’s pre and post intervention performance which suggests improved fine motor functioning of the alcohol dependent individuals.