Functional Electrical Stimulation following nerve injury in a Large Animal Model.

INTRODUCTION: Controversy exists over the effects of functional electrical stimulation (FES) on reinnervation. We hypothesized that intramuscular FES would not delay reinnervation after recurrent laryngeal nerve (RLn) axonotmesis. METHODS: RLn cryo-injury and electrode implantation in ipsilateral posterior cricoarytenoid muscle (PCA) were performed in horses. PCA was stimulated for 20 weeks in eight animals; seven served as controls. Reinnervation was monitored through muscle response to hypercapnia, electrical stimulation and exercise. Ultimately, muscle fiber type proportions and minimum fiber diameters, and RLn axon number and degree of myelination were determined. RESULTS: Laryngeal function returned to normal in both groups within 22 weeks. FES improved muscle strength and geometry, and induced increased type I:II fiber proportion (p=0.038) in the stimulated PCA. FES showed no deleterious effects on reinnervation. DISCUSSION: Intramuscular electrical stimulation did not delay PCA reinnervation after axonotmesis. FES can represent a supportive treatment to promote laryngeal functional recovery after RLn injury. This article is protected by copyright. All rights reserved

Tandem application of C-C bond-forming reactions with reductive ozonolysis

Several variants of reductive ozonolysis, defined here as the in situ generation of aldehydes or ketones during ozonolytic cleavage of alkenes, are demonstrated to work effectively in tandem with a number of C-C bond-forming reactions. For reactions involving basic nucleophiles (1,2- addition of Grignard reagents, Wittig or Horner-Emmons olefinations, and directed Aldol reactions of lithium enolates) the one-pot process offers a rapid and high-yielding alternative to traditional two-step protocols

The short-term health and psychosocial impacts of domestic energy efficiency investments in low-income areas: a controlled before and after study

Background Research suggests that living in fuel poverty and cold homes contributes to poor physical and mental health, and that interventions targeted at those living in poor quality housing may lead to health improvements. However, little is known about the socio-economic intermediaries and processes that contribute to better health. This study examined the relationship between energy efficiency investments to homes in low-income areas and mental and physical health of residents, as well as a number of psychosocial outcomes likely to be part of the complex relationship between energy efficiency measures and health outcomes. Methods A quasi-experimental field study with a controlled pretest-posttest design was conducted (intervention n = 364; control n = 418) to investigate the short-term health and psychosocial impacts of a domestic energy efficiency programme that took place across Wales between 2013 and 2015. Survey data were collected in the winters before and after installation of energy efficiency measures, including external wall insulation. The study used a multilevel modelling repeated measures approach to analyse the data. Results The energy efficiency programme was not associated with improvements in physical and mental health (using the SF-12v2 physical and mental health composite scales) or reductions in self-reported respiratory and asthma symptoms. However, the programme was associated with improved subjective wellbeing (B = 0.38, 95% CI 0.12 to 0.65), as well as improvements in a number of psychosocial outcomes, including increased thermal satisfaction (OR = 3.83, 95% CI 2.40 to 5.90), reduced reports of putting up with feeling cold to save heating costs (OR = 0.49, CI = 0.25 to 0.94), fewer financial difficulties (B = −0.15, 95% CI -0.25 to -0.05), and reduced social isolation (OR = 0.32, 95% CI 0.13 to 0.77). Conclusion The study showed that investing in energy efficiency in low-income communities does not lead to self-reported health improvements in the short term. However, investments increased subjective wellbeing and were linked to a number of psychosocial intermediaries that are conducive to better health. It is likely that better living conditions contribute to improvements in health outcomes in the longer term. Better understanding of the impacts on recipients of energy efficiency schemes, could improve targeting of future fuel poverty policies

What happened, how, why and what mattered: Three case studies from a low income residential energy efficiency intervention program

In the context of residential retrofit programs as an opportunity for climate change mitigation and health, the mechanisms that lead to unexpected outcomes in indoor temperature and energy consumption are not well understood. Paradoxical and surprising findings have been attributed to householder behaviour. Better knowledge of householder practices is needed for more effective designs of interventions. This paper draws on a mixed methods study of an energy retrofit program for the homes of low-income, elderly or frail householders in Victoria, Australia. A quantitative exploration was combined with a phenomenological enquiry to explain the outcomes in warmth, heating energy consumption and householder satisfaction through householder practices and experiences. This paper details three retrofit case studies that illustrated the diversity of outcomes, the take-back, the prebound and the expected effects. These cases highlighted how the interaction of the material quality of the home, householder capabilities and the meaning of heating shaped the changes in warmth and energy consumption. The householders' evaluations of the intervention program highlighted that 'what mattered' was not necessarily the impact of the retrofit. While the effects discussed here are not new and the results lack generalisability, these case studies demonstrate that the theoretical predictions and the interpretation of the outcomes should be sensitive to contextual determinants. Interventions should include pre-study safety checks and aim for high thermal performance to be effective. Intervention studies should include a control group to assess confounding variables and bias. By identifying some contextual mechanisms that may enhance or hinder benefits in indoor temperatures and energy conservation, this study helps to better understand the effectiveness of residential energy efficiency interventions

Quantitative exploration of winter living room temperatures and their determinants in 108 homes in Melbourne, Victoria

Indoor temperatures are key mediators of housing related health outcomes. In Australia, policy makers have implied improved thermal comfort and better health through more stringent residential energy efficiency, yet empirical evidence is scarce. This study used temperature measurements in the living rooms of 108 detached houses in Melbourne, Victoria, to calculate indoor temperatures indices, assess them against health based guidelines and to explore the association of indoor temperatures with household characteristics and the homes' energy efficiency AccuRate star ratings. The mean home energy rating was 4.7 ± 0.82 AccuRate stars. The mean winter room temperature was a satisfactory 18⁰C, yet occasional over- and underheating may have adversely impacted health. Continuous occupation and heater use as well as higher energy costs were significant predictors of warmer living rooms. Star ratings were a poor predictor of indoor temperatures. Possible reasons are discussed. The findings were limited by the small, non-representative sample and the reliance on self-reported fuel expenditure. The findings highlighted that a residential energy efficiency rating tool may need to be complemented by built quality controls and consider the efficiency of the heating system in order to be predictive of satisfactory indoor temperatures. More research into the heating practices of householders is needed

Sustainable built environments

There seems to be a certainty that our climate is going to change. The predictions for Australia include higher temperatures, rising sea levels, a higher incidence of extreme weather events such as strong wind and hail, increased evaporation, and an increase or decrease in rainfall depending on location (CSIRO) and Australian Bureau of Meteorology 2007). It seems 'very likely' that climate change is induced by a rise in anthropogenic greenhouse gas emissions (Intergovernmental Panel on Climate Change 2007). Major sources of the rapid increase in the concentration of atmospheric carbon dioxide since the beginning of the industrial revolution are believed to be the burning of fossil fuels and deforestation (Treut et al 2007). As Australia is bracing itself for the unknown effects of climate change, building materials can play an important role in determining the country's future

Using the capability approach to evaluate energy vulnerability policies and initiatives in Victoria, Australia

Energy vulnerability is a multi-dimensional, dynamic and context-specific phenomenon that poses a challenge for equity in energy transition policies. The Capability Approach (CA) is a normative framework focused on people’s opportunities and freedoms, used to address dimensions of social justice. Whereas the CA has been used to assess and measure conditions of poverty, exclusion and inequality, its application to evaluate policies is rare. Building on work that establishes being able to heat the home adequately as a secondary capability towards being able to lead a healthy life, this narrative review maps the conditions and processes that shape this secondary capability in Victoria, Australia. It also evaluates local policies and initiatives aimed at addressing energy vulnerability. The map identifies structural, geographical and cultural phenomena and feed-back loops and exposes a hierarchy of capabilities for vulnerable households that need to be satisfied. The policy review finds that current efforts focus on mitigating inequalities in resources with little evidence for outcomes in security or transformative agency. Future initiatives may give more attention to the satisfaction of the tertiary capability of being able to live in an energy efficient dwelling, customise solutions to the multitude and range of conditions and acknowledge the need of warmth throughout the home