Cardiometabolic multimorbidity (CM) is defined as having a diagnosis of at least two of stroke, heart disease, or diabetes, and is an emerging health concern, but the prevalence of CM at a population ...level in Canada is unknown. The objectives of this study were to quantify the: 1) prevalence of CM in Canada; and 2) association between CM and lifestyle behaviours (e.g., physical activity, consumption of fruits and vegetables, and stress).
Using data from the 2016 Canadian Community Health Survey, we estimated the overall and group prevalence of CM in individuals aged ≥50 years (n = 13,226,748). Multiple logistic regression was used to quantify the association between CM and lifestyle behaviours compared to a group without cardiometabolic conditions.
The overall prevalence of CM was 3.5% (467,749 individuals). Twenty-two percent (398,755) of people with diabetes reported having another cardiometabolic condition and thus CM, while the same was true for 32.2% (415,686) of people with heart disease and 48.4% (174,754) of stroke survivors. 71.2% of the sample reported eating fewer than five servings of fruits and vegetables per day. The odds of individuals with CM reporting zero minutes of physical activity was 2.35 95% CI = 1.87 to 2.95 and having high stress was 1.89 95% CI = 1.49 to 2.41 times the odds of the no cardiometabolic condition reference group. The odds of individuals with all three cardiometabolic conditions reporting zero minutes of physical activity was 4.31 95% CI = 2.21 to 8.38 and having high stress was 3.93 95% CI = 2.03 to 7.61.
The number of Canadians with CM or at risk of CM is high and these individuals have lifestyle behaviours that are associated with adverse health outcomes. Lifestyle behaviours tend to diminish with increasing onset of cardiometabolic conditions. Lifestyle modification interventions focusing on physical activity and stress management for the prevention and management CM are warranted.
This systematic review examines the incidence and prevalence of traumatic spinal cord injury (SCI) in different countries worldwide and their trends over time. The literature search of the studies ...published between 1950 and 2012 captured 1,871 articles of which 64 articles on incidence and 13 articles on prevalence fulfilled the inclusion and exclusion criteria. The global incidence of SCI varied from 8.0 to 246.0 cases per million inhabitants per year. The global prevalence varied from 236.0 to 1,298.0 per million inhabitants. In addition to regional differences regarding the prevalence rates of SCI across the globe, there has been a trend towards increasing prevalence rates over the last decades. Our results suggest a relatively broad variation of incidence and prevalence rates of SCI among distinctive geographic regions. These results emphasize the need for further studies on incidence and prevalence of SCI, and for international standards and guidelines for reporting on SCI.
Purpose
The aims of this review were to describe the self-management interventions used to improve risk factor control in stroke patients and quantitatively assess their effects on the following: 1) ...overall risk factor control from lifestyle behaviour (i.e. physical activity, diet and nutrition, stress management, smoking, alcohol, and medication adherence), and medical risk factors (i.e. blood pressure, cholesterol, blood glucose) and (2) individual risk factors.
Method
We systematically searched the PubMed, PsycINFO, CINAHL and Cochrane Database of Systematic Reviews databases to September 2015 to identify relevant randomized controlled trials investigating self-management to improve stroke risk factors. The self-management interventions were qualitatively described, and the data included in meta-analyses.
Results
Fourteen studies were included for review. The model estimating an effect averaged across all stroke risk factors was not significant, but became significant when four low-quality studies were removed (SMD = 0.10 95 % CI = 0.02 to 0.17,
I
2
= 0 %,
p
= 0.01). Subgroup analyses revealed a significant effect of self-management interventions on lifestyle behaviour risk factors (SMD = 0.15 95 % CI = 0.04 to 0.25,
I
2
= 0 %,
p
= 0.007) but not medical risk factors. Medication adherence was the only individual risk factor that self-management interventions significantly improved (SMD = 0.31 95 % CI = 0.07 to 0.56,
I
2
= 0 %,
p
= 0.01).
Conclusion
Self-management interventions appear to be effective at improving overall risk factor control; however, more high-quality research is needed to corroborate this observation. Self-management has a greater effect on lifestyle behaviour risk factors than medical risk factors, with the largest effect at improving medication adherence.
We empirically examine the determinants of the price of patent licensing. We find factors affecting the profitability of patents and bargaining power of licensors and licensees are good predictors of ...the royalty rate of patent licensing, while proxies for the reservation price of licensors are less informative. Our findings suggest large licensors’ adverse selection to license only small and unprofitable inventions. Large, technology-intensive licensees appear to have greater bargaining power, whereas research organizations exercise weak bargaining power. More appropriable patents command higher prices.
This is a study protocol to co-create with knowledge users a core outcome set focused on middle-aged and older adults (40 years+) for use in social prescribing research.
We will follow the Core ...Outcome Measures in Effectiveness Trials (COMET) guide and use modified Delphi methods, including collating outcomes reported in social prescribing publications, online surveys, and discussion with our team to finalize the core outcome set. We intentionally center this work on people who deliver and receive social prescribing and include methods to evaluate collaboration. Our three-part process includes: (1) identifying published systematic reviews on social prescribing for adults to extract reported outcomes; and (2) up to three rounds of online surveys to rate the importance of outcomes for social prescribing. For this part, we will invite people (n = 240) who represent the population experienced in social prescribing, including researchers, members of social prescribing organizations, and people who receive social prescribing and their caregivers. Finally, we will (3) convene a virtual team meeting to discuss and rank the findings and finalize the core outcome set and our knowledge mobilization plan.
To our knowledge, this is the first study designed to use a modified Delphi method to co-create core outcomes for social prescribing. Development of a core outcome set contributes to improved knowledge synthesis via consistency in measures and terminology. We aim to develop guidance for future research, and specifically on the use of core outcomes for social prescribing at the person/patient, provider, program, and societal-level.
Randomized-controlled trials (RCTs), prospective cohort, case-control, pre-post studies, and case reports that assessed pharmacological and non-pharmacological intervention for the management of the ...neurogenic bowel after spinal cord injury (SCI) were included.
To systematically review the evidence for the management of neurogenic bowel in individuals with SCI.
Literature searches were conducted for relevant articles, as well as practice guidelines, using numerous electronic databases. Manual searches of retrieved articles from 1950 to July 2009 were also conducted to identify literature.
Two independent reviewers evaluated each study's quality, using Physiotherapy Evidence Database scale for RCTs and Downs and Black scale for all other studies. The results were tabulated and levels of evidence assigned.
A total of 2956 studies were found as a result of the literature search. On review of the titles and abstracts, 57 studies met the inclusion criteria. Multifaceted programs are the first approach to neurogenic bowel and are supported by lower levels of evidence. Of the non-pharmacological (conservative and non-surgical) interventions, transanal irrigation is a promising treatment to reduce constipation and fecal incontinence. When conservative management is not effective, pharmacological interventions (for example prokinetic agents) are supported by strong evidence for the treatment of chronic constipation. When conservative and pharmacological treatments are not effective, surgical interventions may be considered and are supported by lower levels of evidence in reducing complications.
Often, more than one procedure is necessary to develop an effective bowel routine. Evidence is low for non-pharmacological approaches and high for pharmacological interventions.
As physical activity in people poststroke is low, devices that monitor and provide feedback of walking activity provide motivation to engage in exercise and may assist rehabilitation professionals in ...auditing walking activity. However, most feedback devices are not accurate at slow walking speeds.
This study assessed the accuracy of one accelerometer to measure walking steps of community-dwelling individuals poststroke.
This was a cross-sectional study.
Two accelerometers were positioned on the nonparetic waist and ankle of participants (N=43), and walking steps from these devices were recorded at 7 speeds (0.3-0.9 m/s) and compared with video recordings (gold standard).
When positioned at the waist, the accelerometer had more than 10% error at all speeds, except 0.8 and 0.9 m/s, and numerous participants recorded zero steps at 0.3 to 0.5 m/s. The device had 10% or less error when positioned at the ankle for all speeds between 0.4 and 0.9 m/s.
Some participants were unable to complete the faster walking speeds due to their walking impairments and inability to maintain the requested walking speed.
Although not recommended by the manufacturer, positioning the accelerometer at the ankle (compared with the waist) may fill a long-standing need for a readily available device that provides accurate feedback for the altered and slow walking patterns that occur with stroke.
A systematic review.
To critically review quality of life (QOL) instruments used with spinal cord injury (SCI) populations.
Vancouver, Canada.
A systematic literature review was conducted for ...publications assessing the measurement properties of QOL outcome measures. Pre-established criteria were used to evaluate the measurement properties.
Fourteen articles reporting on 13 QOL instruments met the inclusion criteria, including the Patient Reported Impact of Spasticity Measure (PRISM), Quality of Well-being Scale, Qualiveen, Sickness Impact Profile (SIP68), Short Form (SF)-36, SF-36V, SF-12, SF-6D, Quality of Life Index, Quality of Life Profile for Adults with Physical Disabilities (QOLP-PD), Satisfaction with Life Scale, Sense of Well-being Index (SWBI), and the World Health Organization Quality of Life-BREF scale (WHOQOL-BREF). The SF-36 and WHOQOL-BREF have been widely used and validated. The SIP68, QOLP-PD, SF-36V, and SWBI are promising with limited investigation. The Qualiveen and PRISM performed well and are specific to SCI complications.
The WHOQOL-BREF is presently the most acceptable and established instrument to assess QOL after SCI. The SIP68, QOLP-PD, SF-36V, and SWBI are promising; however, require further evaluation of their measurement properties.
IntroductionApproximately 30% of individuals with stroke report unmet lower extremity recovery needs after formal hospital-based rehabilitation programmes have ended. Telerehabilitation can mitigate ...issues surrounding accessibility of rehabilitation services by providing ongoing support to promote recovery, however, no review exists that is specific to telerehabilitation for lower extremity recovery. This paper describes the protocol of a systematic review and meta-analysis that aims to describe and evaluate the effectiveness of lower extremity-focused telerehabilitation interventions on clinical outcomes poststroke.Methods and analysisA systematic review of relevant electronic databases (MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, Google Scholar, PEDro, PubMed and Cochrane Library) between inception and February 2022 will be undertaken to identify eligible interventional studies published in English that compared telerehabilitation focusing on lower extremity recovery to another intervention or usual care for individuals living in the community with stroke. Clinical outcomes examined will include those related to physical function and impairment, activities and participation that are typically assessed in clinical practice and research. Two reviewers will independently screen results, identify studies to be included for review, extract data and assess risk of bias. Meta-analyses will be performed if sufficient data exist. Sensitivity analyses will be performed by removing studies with low methodological quality, and subgroup analyses will be performed if data allow by stratifying papers based on salient demographic or stroke factors and comparing results. The reporting of the review will follow the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The quality of evidence regarding various outcomes for telerehabilitation for lower extremity recovery poststroke will be assessed according to the Grading of Recommendation, Assessment, Development and Evaluation approach.Ethics and disseminationNo ethical approval or informed consent is needed for this systematic review. The findings of this review will be disseminated via peer-reviewed publications and conference presentations.PROSPERO registration numberCRD42021246886.
Abstract
Turbocharger compressors operate under pulsating flow due to continuous opening and closing of engine valves placed downstream of the compressor but exhibit a hysteresis loop deviating from ...steady characteristics. As the flow in a compressor is throttled, both pressure and flow discharge unstably oscillate. The instability is known as surge and it affects not only the compressor itself but also its whole engine-turbocharger system. For estimating the stable operation range, partial flow tests of a turbocharger compressor under pulsating flow were conducted. Using a compressor test apparatus with a pulsating flow generator and a tank whose capacity can be changed, the flow rate was controlled by a valve. Under steady flow, surge hysteresis loops caused by oscillating pressure and flow rate were obtained in each rotational speed. By Fast Fourier Transform (FFT) of pressure signals, the occurrence of surge with different frequencies was confirmed depending on the tank capacity. Next in pulsating flow tests, a compressor rotational speed is fixed, and pulsating frequencies given by the pulsating flow generator are changed. The obtained surge frequencies were different from those in steady flow tests. Especially, it is likely to be drawn to the frequency that is equal, two times and a half rate of the pulsating frequency. Numerical computation with one-dimensional calculation is conducted to investigate such a phenomenon.
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