Rhodium and silicon system: I. Glassy metallic alloy formation

Detailed characterizations of rhodium/silicon films prepared by co-deposition using magnetron sputtering have been carried out on silicon substrates at room temperature. Effects of the silicon content incorporated in the film on the chemical bonding state and crystallinity were investigated using XPS/UPS, XRD and SEM. It should be emphasized that XPS/UPS measurements are carried out without breaking the vacuum to avoid any contamination of the film. All x-ray diffraction patterns revealed a high degree of amorphization. There is only a weak Rh pattern and a weak Rh(2)Si pattern for 20 and 37 at.% of Si, respectively, i.e. showing a formation of glassy metallic alloy. A negative shift in the Rh core level binding energy for rhodium-rich alloys is mainly referred to relaxation effects due to a high density of d-states near the Fermi level. The filling of the d-states is completed between 25 and 40 atomic concentration of Si. Valence orbital transformation due to the Si-Rh interactions is causing the progressive positive shift in the binding energy for higher silicon content.

Rhodium and silicon system: II. Rhodium silicide formation

Detailed characterizations of rhodium/silicon films prepared by co-deposition using magnetron sputtering have been carried out on silicon substrates at room temperature up to 900 degrees C. The properties of the films were investigated using XPS/UPS, XRD, SIMS, SEM and AFM techniques. It should be emphasized that XPS/UPS measurements are carried out without breaking the vacuum to avoid any contamination of the film. Up to 500 degrees C an interdiffusion between the oxidized silicon wafer and the deposited Rh/Si film occurred leading to hole formation in the entire film at 900 degrees C. Diffraction patterns for the compounds Rh(2)Si, Rh(5)Si(3), RhSi and Rh(3)Si(4) were measured. Upon annealing the covalent character is increased and for the samples forming the compound RhSi the valence band structure is markedly changed. Depth profiling (XPS and SIMS) reveals a stable composition in the bulk of the film. For these measurements the silicon-rich alloy in the interfacial layer is probably an effect of sputtering, by implanting the Rh atoms into the silicon substrate. A previously reported negative shift for the compound Rh(5)Si(3) could be connected to the sample preparation, as sputtering of the surface is reducing the silicon content and inducing a glassy state. For the first phase Rh(2)Si formed on the rhodium-rich side the shift in binding energy is unclear, for all the other compounds encountered in this work a positive shift relative to pure rhodium was found.

Patient radiation doses in the most common interventional cardiology procedures in Croatia: first results

Apart from its benefits, the interventional cardiology (IC) is known to generate high radiation doses to patients and medical staff involved. The European Union Medical Exposures Directive 97/43/Euroatom strongly recommend patient dosimetry in interventional radiology, including IC. IC patient radiation doses in four representative IC rooms in Croatia were investigated. Setting reference levels for these procedures have difficulties due to the large difference in procedure complexity. Nevertheless, it is important that some guideline values are available as a benchmark to guide the operators during these potentially high-dose procedures. Local and national diagnostic reference levels (DRLs) were proposed as a guidance. A total of 138 diagnostic (coronary angiography, CA) and 151 therapeutic (PTCA, stenting) procedures were included. Patient irradiation was measured in terms of kerma-area product (KAP), fluoroscopy time (FT) and number of cine-frames (F). KAP was recorded using calibrated KAP-meters. DRLs of KAP, FT and F were calculated as third quartile values rounded up to the integer. Skin doses were assessed on a selected sample of high skin dose procedures, using radiochromic films, and peak skin doses (PSD) were presented. A relative large range of doses in IC was detected. National DRLs were proposed as follows: 32 Gy cm(2), 6.6 min and 610 frames for CA and 72 Gy cm(2), 19 min and 1270 frames for PTCA. PSD <1 Gy were measured in 72 % and PSD >2 Gy in 8 % of selected patients. Measuring the patient doses in radiological procedures is required by law, but rarely implemented in Croatia. The doses recorded in the study are acceptable when compared with the literature, but optimisation is possible. The preliminary DRL values proposed may be used as a guideline for local departments, and should be a basis for radiation reduction measures and quality assurance programmes in IC in Croatia.

High-resolution 3T MR angiography of the carotid arteries: comparison of manual and semiautomated quantification of stenosis

BACKGROUND AND PURPOSE

High-resolution contrast-enhanced MR angiography (CE-MRA) acquired at 3T exquisitely depict carotid artery (CA) stenosis. In this study, we examined the agreement of different vessel-analysis tools with manual quantitative measurement by 2 readers using CE-MRA data.

MATERIALS AND METHODS

Three vessel tools determining the trajectory of the vessel of interest and, subsequently, the vessel dimensions were tested against manual measurements. Diameter and area stenoses were calculated. CE-MRA data of 32 patients with CA stenosis were evaluated. The agreement between different measurements was assessed with kappa statistics after categorizing stenosis (<25%, 25%-49%, 50%-69%, 70%-99%, and 100%).

RESULTS

The mean grades of stenosis based on diameter measurements were 59% (readers) and 60%/56%/59% based on the analysis with tools A/B/C (P = 0.2-0.7). kappa values for agreement between readers and the vessel tools were 0.73/0.77/0.77 (tools A/B/C for all CAs) and 0.66/0.74/0.75 (for the symptomatic side). The mean grades of stenoses based on area measurements for tools A/B/C were 68%/63%/69% versus 58% for readers. Values from readers differed significantly from those for tools A and C (P < 0.01). kappa values for agreement between readers and the vessel tools were 0.66/0.55/0.64 (for all CAs) and 0.53/0.44/0.57 (for the symptomatic side).

CONCLUSIONS

The automated approach allows accurate assessment of vessel dimensions in MRA images at least for diameter measurements according to the North American Symptomatic Carotid Endarterectomy Trial criteria.

Recombinant inbred line differential identifies race-specific resistance to phytophthora root rot in Capsicum annuum

A differential series is the normal method for identification of races within a plant pathogen and a host interaction. A host differential is extremely useful for phytopathological as well as breeding purposes. A set of recombinant inbred lines (RILs) were developed and characterized for race differentiation of Phytophthora root rot caused by Phytophthora capsici. The highly resistant Capsicum annuum accession Criollo de Morelos-334 was hybridized to a susceptible cultivar, Early Jalapeno, to generate the RIL population. The host differential characterized 17 isolates of P. capsici into 13 races. The establishment of a stable host differential for the P. capsici and C. annuum interaction will assist researchers in understanding the complex inheritance of resistance to Phytophthora root rot and to develop resistant cultivars.

[Seven years of botulinum toxin type A in the treatment of neurogenic detrusor hyperactivity]

BACKGROUND

A decompensated storage function with high pressures is the greatest risk factor regarding life expectancy and quality of life in patients with neurogenic detrusor hyperactivity. Previously, this problem could only be managed with administration of anticholinergic medications or--if this approach was either not effective enough or the patients exhibited drug intolerance--by invasive surgical interventions. The use of botulinum toxin type A to treat these patients rapidly proved to be a beneficial alternative to those two therapeutic options ever since its introduction in Germany in 1998 as a minimally invasive procedure and has become established worldwide.

MATERIAL AND METHODS

The medical records of first-time users at the clinic were retrospectively analyzed for a 7-year period. The total of 492 injections in 277 patients--of which 365 injections in 216 patients were performed following a standardized protocol--represents the largest number of cases worldwide. The treatment was indicated in patients experiencing insufficient efficacy of anticholinergic agents or drug intolerance who were capable of self-catheterization.

RESULTS

The standard injection contained either 300 MU Botox or 750 MU Dysport. Urodynamic parameters before and up to 8 months post-intervention showed significantly lowered detrusor pressure and improved cystometric capacity. This corresponded to the clinical assessment and subjective impression of the patients that detrusor activity had been reduced to a large extent with improved continence. Evacuation was carried out in all cases without any difficulty by aseptic intermittent catheterization. The average duration of the effect was subjectively determined to be 8.7 months. In the vast majority of cases, anticholinergic medications could be discontinued or considerably reduced. Side effects not requiring treatment developed in only four instances. Antibody formation no longer occurred with those products available on the market since 2001. Even after repeated injections (up to ten times) there was no evidence for decreased efficacy.

CONCLUSION

Due to its reliable effect and low rate of side effects, botulinum toxin type A quickly became accepted worldwide for the treatment of neurogenic detrusor hyperactivity and has contributed to a substantial enrichment of the more conservative therapy options. Prospective studies focusing especially on injection site and optimizing the duration of efficacy are desirable.

In vivo results for interstitial laser application in thyroid gland

OBJECTIVE

Aim of this study was to evaluate the potential of denaturation of hormone active tissue in the thyroid gland by laser induced interstitial thermotherapy (LITT) as a treatment of autonomous hyperthyroidism.

MATERIALS AND METHODS

An interstitial thyroid laser application (Nd:YAG 1064 nm, 5W, 2 min) was performed in 5 pigs. During laser application, the laryngeal recurrent nerve was controlled electro-physiologically. Postoperatively, TSH, total T(3) (TT(3)) and free T(4) (FT(4)) were measured regularly. After a follow-up period of up to 6 weeks, pigs were sacrificed and the thyroid glands were evaluated histological.

RESULTS

A malfunction of the nerve due to laser treatment was not detected. During the first postoperative week there was a decrease of both FT(4) and TSH whereas TT(3) showed an extreme decline of its plasma levels reaching nearly the detection limit. All values showed a recovery to their initial levels during an interval of 10 days and than increased to levels sometimes higher than baseline. The coagulation zones were demarcated clearly towards normal tissue with increasing fibrosis of the treated areas.

CONCLUSION

Interstitial thyroid ablation using a Nd:YAG laser is a minimal invasive, safe and effective procedure. Further evaluation including long term follow-up in humans is needed to confirm these results.

Comparison of a Healing Touch, Coaching, and a Combined Intervention on Comfort and Stress in Younger College Students

Three nursing interventions to increase total comfort and reduce stress-related events in young college students experiencing stress were compared. Healing Touch, coaching, and a combination of both, were compared to a waitlist. On comfort and stress, Healing Touch had better immediate results, while coaching had better carryover effects.

Evaluation of carotid artery stenosis with multisection CT and MR imaging: influence of imaging modality and postprocessing

BACKGROUND AND PURPOSE

We prospectively evaluated the influence of different imaging techniques (time-of-flight MR angiography [TOF-MRA], contrast-enhanced MR angiography [CE-MRA], multisection CT angiography [CTA]) and postprocessing methods (maximum intensity projection [MIP], multiplanar reformation [MPR]) on carotid artery stenosis grading.

MATERIALS AND METHODS

Fifty patients (34 men, 16 women) with symptomatic stenosis of the internal carotid artery were examined with a 16-section spiral CT and a 1.5T MR unit. Two MRA techniques were applied: 3D-TOF and CE-MRA. MPR was used for postprocessing with all modalities; MIP was used only with MRA. Four readers measured and calculated the percentage diameter stenosis independently according to NASCET criteria. The Wilcoxon test was used to measure interobserver variability, and the Friedman test was used to test the null-hypothesis of equality of the modalities.

RESULTS

The hypothesis for global equality was rejected (P < .001). TOF-MRA and CTA assessed with MPR showed the highest concordance (difference, 0.6%; confidence interval [CI], -3.0, 4.3%), and CE-MRA with MIP and CTA showed the lowest concordance in stenosis grading (difference, 7.0%; CI, 3.4, 10.6%). MPR resulted in lower degrees of stenosis than MIP for both MRA sequences, although not statistically significant (CE, -3.0%; CI, -6.6, 0.6%; TOF, -2.2%; CI, -5.8, 1.4%). When only studies with good or excellent image quality were considered, the differences decreased, but the trends remained.

CONCLUSION

Stenosis grading is dependent on the examination method and postprocessing technique. CTA and TOF-MRA evaluated with MPR revealed highest concordance.

SLIM: A new method for molecular imaging

We used spectrally resolved fluorescence lifetime imaging (SLIM) to investigate the mitochondria staining dye rhodamine 123 and binding of DAPI to RNA and DNA in cells. Moreover, different components of the photosensitizer Photofrin were resolved in cell cultures by SLIM. To record lifetime images (tau-mapping) with spectral resolution we used a laser scanning microscope equipped with a spectrograph, a 16 channel multianode PMT, and multidimensional time-correlated single photon counting. A Ti:Saphir laser was used for excitation or alternatively a ps diode laser. With this system the time- and spectral-resolved fluorescence characteristics of different fluorophores were investigated in cell cultures. As an example, the mitochondria staining dye rhodamine I23 could be easily distinguished from DAPI, which binds to nucleic acids. Also different binding sites of DAPI could be discriminated. This was proved by the appearance of different lifetime components within different spectral channels. Moreover, we were able to detect monomeric and aggregated forms of Photofrin in cells. Different lifetimes could be attributed to the various compounds. In addition, a detailed analysis of the autofluorescence by SLIM could explain changes of mitochondrial metabolism during Photofrin-PDT.

Development of the Healing Touch Comfort Questionnaire

This study provided preliminary evidence for internal consistency reliability (Cronbach alpha = .94) of the newly developed Healing Touch Comfort Questionnaire. Fifty-six Healing Touch (HT) recipients (51 women and 5 men with a mean age of 51) completed the questionnaire. Participants with more than 4 HT treatments had higher comfort levels than those with fewer than 4.

Effects of Hand Massage on Comfort of Nursing Home Residents

Patient comfort is a goal of therapeutic nursing practice and a primary nursing function. Residents in nursing homes have many comfort needs including physical, psychospiritual, sociocultural, and environmental. These comfort needs are addressed by various caregivers including nurses, nursing assistants, and family members. Hand massage is a simple comfort intervention that can be incorporated readily into routine nursing care activities and conveys caring through touch, individual attention, and presence. As an intervention, hand massage promotes comfort and facilitates communication between care recipients and caregivers. The purpose of this study was to test the effectiveness of hand massage as an intervention that affects nursing home residents' comfort and satisfaction. Results are presented for 35 participants who received hand massage and 25 participants in a comparison group. Findings showed no significant differences in comfort levels or satisfaction with care over time. Significant group differences, however, were found for comfort and satisfaction when measured at specific time periods. The discussion highlights these mixed findings and presents implications for further development of hand massage as part of nursing home residents' care.

Gene expression in skeletal muscle of coronary artery disease patients after concentric and eccentric endurance training

Low-intensity concentric (CET) and eccentric (EET) endurance-type training induce specific structural adaptations in skeletal muscle. We evaluated to which extent steady-state adaptations in transcript levels are involved in the compensatory alterations of muscle mitochondria and myofibrils with CET versus EET at a matched metabolic exercise intensity of medicated, stable coronary patients (CAD). Biopsies were obtained from vastus lateralis muscle before and after 8 weeks of CET (n=6) or EET (n=6). Transcript levels for factors involved in mitochondrial biogenesis (PGC-1alpha, Tfam), mitochondrial function (COX-1, COX-4), control of contractile phenotype (MyHC I, IIa, IIx) as well as mechanical stress marker (IGF-I) were quantified using an reverse-transcriptase polymerase chain reaction approach. After 8 weeks of EET, a reduction of the COX-4 mRNA level by 41% and a tendency for a drop in Tfam transcript concentration (-33%, P=0.06) was noted. This down-regulation corresponded to a drop in total mitochondrial volume density. MyHC-IIa transcript levels were specifically decreased after EET, and MyHC-I mRNA showed a trend towards a reduction (P=0.08). Total fiber cross-sectional area was not altered. After CET and EET, the IGF-I mRNA level was significantly increased. The PGC-1alpha significantly correlated with Tfam, and both PGC-1alpha and Tfam significantly correlated with COX-1 and COX-4 mRNAs. Post-hoc analysis identified significant interactions between the concurrent medication and muscular transcript levels as well as fiber size. Our findings support the concept that specific transcriptional adaptations mediate the divergent mitochondrial response of muscle cells to endurance training under different load condition and indicate a mismatch of processes related to muscle hypertrophy in medicated CAD patients.

[Practice guidelines: conservative treatment of fibroids]

The conservative treatment of uterine fibroids is essentially based on symptomatology and patient's choice of treatment. The gynaecologist must develop a clear therapeutic protocol based on clinical examination, available test results and consideration of patient preference. The therapeutic options include close surveillance, hormonal treatments, conservative operative endoscopy and arterial embolization.

Details of the 1998 Watt Balance Experiment Determining the Planck Constant

The National Institute of Standards and Technology (NIST) watt balance experiment completed a determination of Planck constant in 1998 with a relative standard uncertainty of 87 × 10(-9) (k = 1), concurrently with an upper limit on the drift rate of the SI kilogram mass standard. A number of other fundamental physical constants with uncertainties dominated by this result are also calculated. This paper focuses on the details of the balance apparatus, the measurement and control procedures, and the reference calibrations. The alignment procedures are also described, as is a novel mutual inductance measurement procedure. The analysis summary discusses the data noise sources and estimates for the Type B uncertainty contributions to the uncertainty budget. Much of this detail, some historical progression, and a few recent findings have not been included in previous papers reporting the results of this experiment.

Eccentric endurance training in subjects with coronary artery disease: a novel exercise paradigm in cardiac rehabilitation?

This study evaluated the effects of 8 weeks of eccentric endurance training (EET) in male subjects (age range 42-66 years) with coronary artery disease (CAD). EET was compared to concentric endurance training (CET) carried out at the same metabolic exercise intensity, three times per week for half an hour. CET ( n=6) was done on a conventional cycle ergometer and EET ( n=6) on a custom-built motor-driven ergometer. During the first 5 weeks of the training program the metabolic load was progressively increased to 60% of peak oxygen uptake in both groups. At this metabolic load, mechanical work rate achieved was 97 (8) W [mean (SE)] for CET and 338 (34) W for EET, respectively. Leg muscle mass was determined by dual-energy X-ray absorptiometry, quadriceps strength with an isokinetic dynamometer and muscle fibre composition of the vastus lateralis muscle with morphometry. The leg muscle mass increased significantly in both groups by some 3%. Strength parameters of knee extensors improved in EET only. Significant changes of +11 (4.9)%, +15 (3.2)% and +9 (2.5)% were reached for peak isometric torque and peak concentric torques at 60 degrees s(-1) and 120 degrees s(-1), respectively. Fibre size increased significantly by 19% in CET only. In conclusion, the present investigation showed that EET is feasible in middle-aged CAD patients and has functional advantages over CET by increasing muscle strength. Muscle mass increased similarly in both groups whereas muscle structural composition was differently affected by the respective training protocols. Potential limitations of this study are the cautiously chosen conditioning protocol and the restricted number of subjects.

Real-time augmentation of USDA yield grade application to beef carcasses using video image analysis

In two phases, this study assessed the ability of two video image analysis (VIA) instruments, VIASCAN and Computer Vision System (CVS), to augment assignment of yield grades (YG) to beef carcasses to 0.1 of a YG at commercial packing plant speeds and to test cutout prediction accuracy of a YG augmentation system that used a prototype augmentation touchpanel grading display (designed to operate commercially in real-time). In Phase I, beef carcasses (n = 505) were circulated twice at commercial chain speeds (340 carcasses per hour) by 12 on-line USDA graders. During the first pass, on-line graders assigned a whole-number YG and a quality grade (QG) to carcasses as they would normally. During the second pass, on-line graders assigned only adjusted preliminary yield grades (APYG) and QG to carcasses, whereas the two VIA instruments measured the longissimus muscle area (LMA) of each carcass. Kidney, pelvic, and heart fat (KPH) was removed and weighed to allow computation of actual KPH percentage. Those traits were compared to the expert YG and expert YG factors. On-line USDA graders' APYG were closely related (r = 0.83) to expert APYG. Instrument-measured LMA were closely related (r = 0.88 and 0.94; mean absolute error = 0.3 and 0.2 YG units, for VIASCAN and CVS, respectively) to expert LMA. When YG were augmented using instrument-measured LMA and computed either including or neglecting actual KPH percentage, YG were closely related (r = 0.93 and 0.92, mean absolute error = 0.32 and 0.40 YG units, respectively, using VIASCAN-measured LMA; r = 0.95 and 0.94, mean absolute error = 0.24 and 0.34 YG units, respectively, using CVS-measured LMA) to expert YG. In Phase II, augmented YG were assigned (0.1 of a YG) to beef carcasses (n = 290) at commercial chain speeds using VIASCAN and CVS to determine LMA, whereas APYG and QG were determined by online graders via a touch-panel display. On-line grader YG (whole-number), expert grader YG (to the nearest 0.1 of a YG), and VIASCAN- and CVS-augmented YG (to the nearest 0.1 of a YG) accounted for 55, 71, 60, and 63% of the variation in fabricated yields of closely trimmed subprimals, respectively, suggesting that VIA systems can operate at current plant speeds and effectively augment official USDA application of YG to beef carcasses.

Accuracy and repeatability of beef carcass longissimus muscle area measurements

This study was conducted to determine the accuracy and repeatability of beef carcass longissimus muscle area (LMA) measurements obtained by three different methods. Longissimus muscle area for beef carcass sides (n = 100) randomly selected in a commercial packing plant was determined: 1) independently by three USDA grading supervisor "experts" using the grid method to obtain triplicate measurements of the same longissimus muscle (LM); 2) by three different Colorado State University personnel tracing the LMA on acetate paper and subsequently measuring the area via a polar planimeter three different times (total of 3 x 3 = 9 observations/LM); and 3) by use of two identical video image analysis (VIA) instruments making triplicate measurements for each LM using three different procedures. Video image analysis Procedure 1 required that LMA be measured by placing the camera head unit over the LM and collecting three sequential images without moving the camera head unit while carcasses were in a stationary position; Procedure 2 required measurement of LMA by placing the camera head unit over the LM and collecting three images, but removing and repositioning the camera head unit between collection of each image while carcasses were in a stationary position; and Procedure 3 required that LMA be measured by placing the camera head unit over the LM and obtaining an image while carcasses were in continuous motion (chain speed of 360 carcasses/ h) during three different circulations past the grading stand. Overall, VIA-derived LMA measurements were highly accurate for all three procedures compared with expert-gridded (R2 = 0.92, 0.90, and 0.84 for Procedures 1, 2, and 3, respectively) and acetate/planimeter-traced (R2 = 0.94, 0.93, and 0.86 for Procedures 1, 2, and 3, respectively) LMA measurements. Instrument LMA repeatability also was comparable to expert-gridded and acetate/planimeter-traced LMA repeatability, as the means of the absolute differences between individual measurements and the average of those same measurements per LM were 1.29, 1.35, 0.52, 0.84, and 1.87 cm2 for expert-gridded, acetate/planimeter-traced, and VIA Procedures 1, 2, and 3, respectively. Therefore, VIA instrumentation can be used to assess beef carcass LMA in both a stationary and operational scenario with high levels of accuracy and repeatability.

[The cannulated osteo-support rod, a new device for the minimally invasive reduction of fractures]

We report a newly developed device for fracture reduction and the positioning of K-wires, especially the guide wires of cannulated screws. It is designed as a cannulated ball spike pusher whose tip and inlay consists of a K-wire fixed in the lumina of the device by a screw. Thus, in displaced fractures, the (guide) wire can be inserted into the bone from the point of reduction, simplifying the intra-operative technique especially in minimally invasive procedures. Additionally, severely displaced fracture fragments can be handled quite comfortably percutaneously by using this device with a "joy stick" technique. The first practical experience in cannulated screw and K-wire osteosyntheses using this device are reported here.

Variable-angle total internal reflection fluorescence microscopy (VA-TIRFM): realization and application of a compact illumination device

A novel compact illumination device in variable-angle total internal reflection fluorescence microscopy (VA-TIRFM) is described. This device replaces the standard condensor of an upright microscope. Light from different laser sources is delivered via a monomode fibre and focused onto identical parts of a sample under variable angles of total internal reflection. Thus, fluorophores in close proximity to a cell-substrate interface are excited by an evanescent wave with variable penetration depth, and localized with high (nanometre) axial resolution. In addition to quantitative measurements in solution, fluorescence markers of the cytoplasm and the plasma membrane, i.e. calcein and laurdan, were examined using cultivated endothelial cells. Distances between the glass substrate and the plasma membrane were determined using the mathematical algorithm of a four-layer model, as well as a Gaussian-shaped intensity profile of the illumination spot on the samples. Distances between 0 and 30 nm in focal contacts and between 100 and 300 nm in other parts of the cell were thus determined. In addition to measurements of cell-substrate topology, the illumination device appears appropriate for numerous applications in which high axial resolution is required, e.g. experiments on endocytosis or exocytosis, as well as measurements of ion concentrations proximal to the plasma membrane. The compact illumination device is also suitable for combining TIRFM with further innovative techniques, e.g. time-resolved fluorescence spectroscopy, fluorescence lifetime imaging (FLIM) or fluorescence resonance energy transfer (FRET).

[Eccentric muscle work--the unknown side of our movements]

Eccentric muscle work is an important part of our everyday activity, i.e. in breaking and preventing falls. Eccentric phases of movements improve the efficiency of cyclic repetitive activities. The molecular function in eccentric work is not understood, however its characteristics are a low metabolic demand and a high power output. Compared to concentric work there are only small differences in the hemodynamics of eccentric work. The muscle capacity for mechanical load is the limiting factor in eccentric work. Unaccustomed eccentric activity leads to damage of the cytoskeleton, which is the reason for delayed onset of muscle soreness. In sports and rehabilitation eccentric training can result in significant strength gain. Its use is today established to improve structures, which are exposed to eccentric loads in everyday activity. The high mechanical power may be promising in the musculoskeletal rehabilitation of patients with cardiopulmonary limitations.

The addition of coaching to cognitive strategies: interventions for persons with compromised urinary bladder syndrome

Compromised urinary bladder syndrome (CUBS) is defined as urinary frequency (UF) and/or urinary incontinence (UI) sufficient to be a problem. This term is an expansion of separate mainstream concepts referring to UF and UI, because the new term entails both phenomena considered at one time. Cognitive strategies (CS) offer one way to enhance the effectiveness and implementation of behavioral interventions directed to assist persons with CUBS. Two hypotheses predicted that persons receiving bladder health information would show less improvement on the outcomes than those receiving CS only or those receiving CS plus coaching after adjusting for type of UI. Secondly, persons receiving CS only would show less improvement on the outcomes than those receiving CS plus coaching. Data were collected at 3 time points, and the outcomes measured were comfort, bladder function, incidents of UF/UI (as recorded by participants in a diary), and perception of health. Neither hypothesis was fully supported. However, persons receiving information and information with CS plus coaching improved on comfort and UI/UF; all groups increased on bladder function; and perception of health did not change in any of the groups. Explanations for the mixed findings are proposed. In general, these findings support the application of conservative, noninvasive cognitive interventions innovatively applied through the use of pamphlets and audiotapes to help persons with CUBS experience increased comfort and improved bladder function. Implications for clinical practice are to provide a two-tiered intervention: education followed by CS with coaching if needed to enhance bladder function. A nursing role (as coaching) to augment specific interventions for CUBS is supported and should be differentiated for persons with symptoms of urgency.