The Influence of Socioeconomic Factors on Fear of Falling and Mobility Outcomes after Lower Limb Loss: a Preliminary Study

Background and Purpose: Current research has revealed that as much as 52.4% of individuals with lower limb loss report falling at least once in the past year. Previous research has also indicated that rehabilitation, including physical therapy (PT), generally improves patient outcomes after definitive amputation. Socioeconomic status has been shown to be an important factor in accessing healthcare but has yet to be investigated in this population. The purpose of this study was to investigate the effects of socioeconomic status and access to PT, and how limb loss affects mobility and fear of falling perception. We hypothesized: [1] individuals with socioeconomic difficulty would have reduced access to PT after amputation, and [2] individuals with limb loss will have increased fear of falling and decreased mobility performance when compared to non-amputee, age-matched controls. Subjects: 23 participants (7 females,16 males) mean age 51.30 years old (+ 13.17 SD, range 22-70) with lower limb loss ambulating with a definitive prosthesis. Materials/Methods: Participants completed a survey that included the Fear of Falling Avoidance Behavior Questionnaire (FFABQ), questions to determine their socioeconomic status, and whether they received PT after amputation. Mobility outcomes were measured using the standardized Timed Up and Go test (TUG) and the Six Minute Walk Test (6MWT). Results: There was no statistically significant difference in access to PT after amputation between those with and without financial difficulty (p=.354). However, 75% of participants who had no socioeconomic difficulty reported receiving PT, in comparison to only 25% in those who had socioeconomic difficulty. Additionally, 34.8% of our participants reported socioeconomic difficulties. When comparing the participants with amputation to the non-amputee, age-matched controls, there was a significant difference in the TUG (p\u3c.001), 6MWT (p\u3c.001), and FFABQ (p=.008). On average, participants with limb loss were 4.4 seconds slower on the TUG, walked 136.4m less on the 6MWT, and had an increased FFABQ score of 6.6 points out of 56 points. Discussion: Access to physical therapy and socioeconomic status have been overlooked in current literature for individuals after amputation. While the effect of socioeconomic status on PT access did not reach statistical significance in this preliminary study, only 25% of those who reported socioeconomic difficulty received physical therapy after amputation, compared to 75% in those who reported no difficulty. Further research is needed to determine whether low socioeconomic status is predictive of receiving rehabilitation services post-amputation and long-term outcomes. Our findings also showed that when compared to age-matched non-amputees, amputees tend to have impaired mobility and higher degree of fear of falling. These findings agree with current literature. Conclusion: Although not statistically significant, our preliminary findings showed that socioeconomic difficulty may affect access to physical therapy after amputation. Furthermore, our data demonstrated that individuals with lower limb loss exhibit reduced mobility performance and increased fear of falling when compared to the age-matched controls

Recycling wind turbine blade composite material as aggregate in concrete

This study investigates the beneficial reuse of composite material from wind turbine blades as aggregate in concrete pavement. The thesis is divided into three parts including an experiment, economic analysis, environmental impact study. An economic analysis revealed that the cost to process composite aggregate from wind turbine blades would need to be less than a value of $62.72 per ton of composite aggregate to be financially feasible. The environmental impact study conducted a life cycle analysis (LCA) which favored the practice of recycling the composite aggregate based on a CO2 emission avoidance on 2.3 lb (1.0 kg) per ton of composite aggregate produced. The experiment included pretests to determine the appropriate size and volume fraction of composite aggregate necessary to maintain a minimum of 4000 psi compressive strength. Following pretest, the full experiment consisted of an ASTM C39 compression test and ASTM C496 split tensile test using a Test Mark CM-4000 SD machine, ASTM C157 shrinkage prism test using CDI LogicTM ALG gage, and a final corrosion test. Samples were cured in two environments of 100% humidity fog room and a calcium hydroxide bath at 160F (70C). These samples were tested at 7, 28, and 90 days. A maximum compression and tensile strength of 6,318 psi (43.6 MPa) and 578 psi (3.1 MPa) was observed in the humidity cured samples which was significantly higher than those stored in the hot bath. For the ASTM C157 test, hot bath samples yielded between 0.27 and 0.33% expansion which was approximately ten times higher than those in the fog experiment. Finally, a weight gain due to water absorption of 1.66% and 0.49% in the composite aggregate and limestone aggregate respectively was seen. In general, this study supports the use of composite material from wind turbine blades as aggregate in concrete

Making as Pedagogical Practice in HCI: From Artefacts to Theory Building

This paper introduces the notion of making as a pedagog-ical practice in HCI education. Our focus is on generative design teaching in HCI that prioritizes collaborative en-gagements across a wide range of material encounters. We take the view that HCI education without a critical view of the relationship between people and objects results in abstract reasoning that runs the risk of an impoverished ba-sis in praxis. To support this position, we provide a series of examples from our own teaching. Through these exam-ples we locate our work in the field of new materiality and post-human design asking the question: How can HCI edu-cation account for the material turn? We observe that there is important theory-building work to be done in this area and propose some methods and a direction this work could take. HCI education remains dominated by an instrumen-talist, problem-solving, evaluative approach. We suggest meaning making through material exploration can invigorate the discipline with a new design praxis

Hydrologic and Environmental Thresholds in Stream Fish Assemblage Structure Across Flow Regimes

The characteristic pattern of variation in flow magnitude, frequency, duration, timing, and rate of change defines the flow regime of rivers and streams and is a key driver of ecosystem processes in fluvial ecosystems. Under-standing how freshwater biotic assemblages change across gradients of hydrology and anthropogenic-source disturbance in different streamflow regimes is crucial to managing for sustainable environmental flows and watershed conservation. We compiled long-term (1916-2016) occurrence records for fishes collected in the Ouachita-Ozark Interior Highlands and West Gulf Coastal Plain streams, together with hydrologic metrics calculated from daily streamflow data measured at USGS stream gauging stations (n = 111), to examine important drivers and thresholds for fish assemblage turnover in groundwater (GW), runoff (RO), and inter-mittent (INT) flow regimes. We also examined the importance of spatial gradients (latitude, longitude, elevation, drainage area) and anthropogenic-source stressors (Hydrologic Disturbance Index; HDI) for fish assemblage turnover using a gradient forest modeling approach. Watershed fragmentation was of high importance for fish assemblage turnover in RO and INT streams, while changes in dam storage were more important for fishes in GW streams. Hydrologic metrics describing seasonal and stochastic properties of daily streamflow (Mag6) were most important for fish assemblage turnover in INT streams. Timing of high flow events had significantly higher importance compared to flow magnitude, duration, and frequency metrics, especially for fish assemblages in GW and INT streams. The frequency and timing of low flow events had high importance for fish assemblage turnover across all stream flow classes, while the magnitude of low flows and the magnitude and rate of change of average flows was most important for INT stream fish assemblages. In addition to benefiting multi-species conservation and management actions through identification of local and regional flow-ecology relationships generalized across different flow regimes, the results of this study provide a better understanding of complex nonlinear threshold effects, which is critical to anticipating changes in aquatic ecosystems and communities

There are Not Enough: The Banning of Traditional Birth Attendants in Zambia

There are currently health policies being passed in countries around the world aiming to ban traditional birth attendants from delivering. The World Health Organization associated TBAs with increasing global maternal mortality ratios – specifically in the global south – due to their lack of knowledge and education surrounding birth complications (Kruske and Barclay 2004:307).One country which banned traditional birth attendants as a response to high maternal mortality ratios was Zambia. According to the World Health Organization, the current maternal mortality ratio (MMR) in Zambia is 224 deaths per 100,000 live births (World Health Organization 2015). The ratio has declined significantly since 1990, where the MMR was 577 deaths per 100,000 live births (World Health Organization 2011). These reductions can be contributed, at least in part, to the use of midwives and traditional birth attendants. However, the Zambian Ministry of Health decided to cut all funding for traditional birth attendant training programs and bar the maternal health attendants from delivering mothers at home in 2010. I am interested to see the role TBAs and midwives have played in combatting the maternal mortality ratio in Zambia and how this role has changed since the health policy passed in 2010. I am specifically interested in understanding the traditional birth attendants and midwives’ perspective on their changing roles in society as a result of a reproductive policy change in the country.Bachelor of Art

Effect of permissive dehydration on induction and decay of heat acclimation, and temperate exercise performance

Purpose: It has been suggested that dehydration is an independent stimulus for heat 32 acclimation (HA), possibly through influencing fluid-regulation mechanisms and increasing 33 plasma volume (PV) expansion. There is also some evidence that HA may be ergogenic in 34 temperate conditions and that this may be linked to PV expansion. We investigated: i) the 35 influence of dehydration on the time-course of acquisition and decay of HA; ii) whether 36 dehydration augmented any ergogenic benefits in temperate conditions, particularly those related to PV expansion. Methods: Eight males (VO2max: 56.9(7.2) mL·kg-1 ·min-1 37 ) undertook 38 two HA programmes (balanced cross-over design), once drinking to maintain euhydration 39 (HAEu) and once with restricted fluid-intake (HADe). Days 1, 6, 11 and 18 were 60 min exercise- 40 heat stress tests (HST [40°C; 50%RH]), days 2-5 and 7-10 were 90 min, isothermal-strain 41 (Tre~38.5°C), exercise-heat sessions. Performance parameters (VO2max, lactate threshold, 42 efficiency, peak power output [PPO]) were determined pre and post HA by graded exercise test 43 (22°C; 55 %RH). Results: During isothermal-strain sessions hypohydration was achieved in 44 HADe and euhydration maintained in HAEu (average body mass loss -2.71(0.82)% vs. - 45 0.56(0.73)%, P<0.001), but aldosterone concentration, power output and cardiovascular strain 46 were unaffected by dehydration. HA was evident on day 6 (reduced end-exercise Tre [- 0.30°C(0.27)] and exercise heart rate [-12(15) beats.min-1 47 ], increased PV [+7.2(6.4)%] and sweat-loss [+0.25(0.22) L.hr-1 48 ], P<0.05) with some further adaptations on day 11 (further reduced end-exercise Tre [-0.25(0.19)°C] and exercise heart rate [-3(9) beats.min-1 49 ], P<0.05). 50 These adaptations were not notably affected by dehydration and were generally maintained 7- 51 days post HA. Performance parameters were unchanged, apart from increased PPO (+16(20) 52 W, irrespective of condition). Conclusions: When thermal-strain is matched, permissive 53 dehydration which induces a mild, transient, hypohydration does not affect the acquisition and 54 decay of HA, or endurance performance parameters. Irrespective of hydration, trained 55 individuals require >5 days to optimise HA