What happens post-pilot testing? A model for revising a disability awareness and competency training program.

Disability awareness and competency trainings are an important component of addressing ableism and health equity in the health promotion context. This commentary describes our process of developing, implementing, and refining a disability competency training, the Inclusive Community Exercise Training, for community-based group exercise instructors. The training originated from a partnership between academic researchers, community organizations, and individuals with disabilities. After initial pilot testing, we used feedback from participants to enhance the training. To optimize successful dissemination of this training, we utilized the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, which is widely used in public health. The revision process focused on generalizing content to suit a wider audience, utilizing an eLearning platform for dissemination, and optimizing interactivity to improve learning effectiveness. The commentary emphasizes the lessons learned and the significance of systematic program revision, considering diverse expertise, content tailoring, and the benefits of accessible eLearning platforms.

Detection of Aliphatically Bridged Multi-Core Polycyclic Aromatic Hydrocarbons in Sooting Flames with Atmospheric-Sampling High-Resolution Tandem Mass Spectrometry.

This paper provides experimental evidence for the chemical structures of aliphatically substituted and bridged polycyclic aromatic hydrocarbon (PAH) species in gas-physe combustion environments. The identification of these single- and multicore aromatic species, which have been hypothesized to be important in PAH growth and soot nucleation, was made possible through a combination of sampling gaseous constituents from an atmospheric pressure inverse coflow diffusion flame of ethylene and high-resolution tandem mass spectrometry (MS-MS). In these experiments, the flame-sampled components were ionized using a continuous VUV lamp at 10.0 eV and the ions were subsequently fragmented through collisions with Ar atoms in a collision-induced dissociation (CID) process. The resulting fragment ions, which were separated using a reflectron time-of-flight mass spectrometer, were used to extract structural information about the sampled aromatic compounds. The high-resolution mass spectra revealed the presence of alkylated single-core aromatic compounds and the fragment ions that were observed correspond to the loss of saturated and unsaturated units containing up to a total of 6 carbon atoms. Furthermore, the aromatic structures that form the foundational building blocks of the larger PAHs were identified to be smaller single-ring and pericondensed aromatic species with repetitive structural features. For demonstrative purposes, details are provided for the CID of molecular ions at masses 202 and 434. Insights into the role of the aliphatically substituted and bridged aromatics in the reaction network of PAH growth chemistry were obtained from spatially resolved measurements of the flame. The experimental results are consistent with a growth mechanism in which alkylated aromatics are oxidized to form pericondensed ring structures or react and recombine with other aromatics to form larger, potentially three-dimensional, aliphatically bridged multicore aromatic hydrocarbons.

People with MS are less physically active than healthy controls but as active as those with other chronic diseases: An updated meta-analysis.

BACKGROUND: There has been remarkable growth in research examining physical activity behavior (any bodily movement produced by skeletal muscle contraction that results in energy expenditure) among people living with multiple sclerosis (MS) over the past decade. The current meta-analysis quantified physical activity participation levels in persons with MS compared with non-diseased and other clinical populations. METHODS: We searched PUBMED, PsycINFO and Web of Science using the keywords physical activity, exercise, and physical fitness in conjunction with MS. We conducted a quantitative synthesis of the difference in physical activity participation levels among persons with MS compared with non-diseased populations and other clinical populations and then examined moderators that might explain variation in the overall effect size (ES). RESULTS: 21 studies were included involving 5303 persons with MS and yielded a mean ES of -0.57 (95% CI=-0.76, 60.37). The weighted mean ES was heterogeneous (Q=443.811, df=31, p<0.001). The magnitude of the mean ES increased when comparing the MS population with non-diseased populations, but decreased when comparing MS with clinical populations. CONCLUSION: The cumulative evidence reinforces that persons with MS are less physically active than non-diseased, but not clinical populations, and this observation supports the need for new efforts on promoting physical activity across the MS community.

Retinal shows its true colours: photoisomerization action spectra of mobility-selected isomers of the retinal protonated Schiff base.

Retinal is one of Nature's most important and widespread chromophores, exhibiting remarkable versatility in its function and spectral response, depending on its protein environment. Reliable spectroscopic and photochemical data for the isolated retinal molecule are essential for calibrating theoretical approaches that seek to model retinal's behaviour in complex protein environments. However, due to low densities and possible co-existence of multiple isomers, retinal is a challenging target for gas-phase investigations. Here, the photoisomerization behaviour of the trans isomer of the retinal protonated Schiff base (RPSB) is investigated in the gas phase by irradiating mobility-selected RPSB ions with tunable light in a tandem ion mobility spectrometer. trans RPSB ions are converted to single cis isomers and also more compact isomers through irradiation with visible light. The S1← S0 photoisomerization action spectrum of trans RPSB, obtained by monitoring production of cis isomers as a function of wavelength, exhibits a single well-defined peak with a maximum at 618 ± 5 nm. Corresponding action spectra of cis RPSB isomers exhibit broader peaks, conclusively demonstrating an isomeric dependence for the RPSB spectrum in the gas phase.

Photoisomerization action spectrum of retinal protonated Schiff base in the gas phase.

The photophysical behaviour of the isolated retinal protonated n-butylamine Schiff base (RPSB) is investigated in the gas phase using a combination of ion mobility spectrometry and laser spectroscopy. The RPSB cations are introduced by electrospray ionisation into an ion mobility mass spectrometer where they are exposed to tunable laser radiation in the region of the S1 ← S0 transition (420-680 nm range). Four peaks are observed in the arrival time distribution of the RPSB ions. On the basis of predicted collision cross sections with nitrogen gas, the dominant peak is assigned to the all-trans isomer, whereas the subsidiary peaks are assigned to various single, double and triple cis geometric isomers. RPSB ions that absorb laser radiation undergo photoisomerization, leading to a detectable change in their drift speed. By monitoring the photoisomer signal as a function of laser wavelength an action spectrum, extending from 480 to 660 nm with a clear peak at 615 ± 5 nm, is obtained. The photoisomerization action spectrum is related to the absorption spectrum of isolated retinal RPSB molecules and should help benchmark future electronic structure calculations.

Ion Mobility Unlocks the Photofragmentation Mechanism of Retinal Protonated Schiff Base.

Retinal protonated Schiff base (RPSB) is a key molecular component of biological photoreceptors and bacterial photosynthetic structures, where its action involves photoisomerization around bonds in the polyene chain. In a vacuum environment, collisional activation or exposure to visible light causes the RPSB molecule to disintegrate, producing charged molecular fragments with m/z = 248 Da that cannot be formed by simple cleavage of the polyene chain. Photofragments resulting from laser excitation of RPSB at a wavelength of 532 nm are analyzed in an ion mobility mass spectrometer (IMMS) and found to be the protonated Schiff base of ß-ionone. Density functional theory calculations at the M06-2X/cc-pVDZ level support a fragmentation mechanism in which RPSB undergoes an electrocyclization/fragmentation cascade with the production of protonated Schiff base of ß-ionone and toluene.

An ion mobility mass spectrometer for investigating photoisomerization and photodissociation of molecular ions.

An ion mobility mass spectrometry apparatus for investigating the photoisomerization and photodissociation of electrosprayed molecular ions in the gas phase is described. The device consists of a drift tube mobility spectrometer, with access for a laser beam that intercepts the drifting ion packet either coaxially or transversely, followed by a quadrupole mass filter. An ion gate halfway along the drift region allows the instrument to be used as a tandem ion mobility spectrometer, enabling mobility selection of ions prior to irradiation, with the photoisomer ions being separated over the second half of the drift tube. The utility of the device is illustrated with photoisomerization and photodissociation action spectra of carbocyanine molecular cations. The mobility resolution of the device for singly charged ions is typically 80 and it has a mass range of 100-440 Da, with the lower limit determined by the drive frequency for the ion funnels, and the upper limit by the quadrupole mass filter.

Changing the shape of molecular ions: photoisomerization action spectroscopy in the gas phase.

A new approach for studying the photoisomerization of molecular ions in the gas phase is described. Packets of molecular ions are injected into a drift tube filled with helium buffer gas, where they are irradiated with tunable laser light. Photoisomerization changes the ions' cross section for collisions with helium atoms so that they arrive at the ion detector slightly earlier or later than the parent ions. By monitoring the photo-isomer peak as a function of laser wavelength one can record an action spectrum that is related to the ions' absorption spectrum modulated by the photoisomerization probability. The approach is demonstrated using the polymethine dye HITC (1,3,3,1',3',3'-hexamethylindotricarbocyanine). The data show that both trans and cis forms of HITC(+) exist in the gas phase with trans→cis photoisomerization predominating over the 550-710 nm range and cis→trans photoisomerization occurring over the 735-770 nm range. The gas-phase photoisomerization action spectrum is comparable to the absorption spectra of trans HITC and cis HTIC in the condensed phase, but with the absorption peaks shifted to shorter wavelength. The gas-phase photoisomerization action spectrum of the (HITC)2(2+) dication dimer is also reported. (HITC)2(2+) cations photoisomerize over the 550-770 nm range to form more compact structures.

Ethanol photo-oxidation on a rutile TiO2(110) single crystal surface.

The reaction of ethanol has been studied on the surface of rutile TiO(2)(110) by Temperature Programmed Desorption (TPD), online mass spectrometry under UV excitation and photoelectron spectroscopy while the adsorption energies of the molecular and dissociative modes of ethanol were computed using the DFT/GGA method. The most stable configuration is the dissociative adsorption in line with experimental results at room temperature. At 0.5 ML coverage the adsorption energy was found equal to 80 kJ mol(-1) for the dissociative mode (ethoxide, CH(3)CH(2)O(a) + H(a)) followed by the molecular mode (67 kJ mol(-1)). The orientation of the ethoxides along the [001] or [110] direction had minor effect on the adsorption energy although affected differently the Ti and O surface atomic positions. TPD after ethanol adsorption at 300 K indicated two main reactions: dehydration to ethylene and dehydrogenation to acetaldehyde. Pre-dosing the surface with ethanol at 300 K followed by exposure to UV resulted in the formation of acetaldehyde and hydrogen. The amount of acetaldehyde could be directly linked to the presence of gas phase O(2) in the vacuum chamber. The order of this photo-catalytic reaction with respect to O(2) was found to be 0.5. Part of acetaldehyde further reacted with O(2) under UV excitation to give surface acetate species. Because the rate of photo-oxidation of acetates (acetic acid) was slower than that of ethoxides (ethanol), the surface ended up by being covered with large amounts of acetates. A reaction mechanism for acetaldehyde, hydrogen and acetate formation under UV excitation is proposed.

A biopsychosocial model of pain and depression in rheumatoid arthritis: a 12-month longitudinal study.

OBJECTIVE: To cross-validate a biopsychosocial model using physical disability, helplessness and passive coping to predict depression and pain in rheumatoid arthritis (RA). METHODS: Clinical and psychological measures were collected from 157 RA patients at three time points over a period of 12 months. Path analysis was used for cross-sectional and longitudinal prediction of depression and pain. RESULTS: Helplessness and passive coping were found to be significant mediators of the relationship between the physical disability and future depression and pain. Cross-sectionally, the predictive model could account for 52-94% of the variance of pain and 37-71% of the variance of depression. Longitudinally, the predictive model could explain 29-43% of the variance of pain and 21-33% of the variance of depression. CONCLUSIONS: These results suggest that physical disability, helplessness and passive coping have a significant impact on the levels of pain and depression experienced by RA patients.

Use of a cell-based interactive wound dressing to enhance healing of excisional wounds in nude mice.

The need to have viable, metabolically active cells to heal wounds is well recognized, because there is clear evidence that cellular dysfunction delays healing. This suggests that addition of metabolically active cells to a delayed healing tissue could enhance the healing of the tissue. Therefore, we examined the ability of an interactive wound dressing composed of human keratinocytes or fibroblasts grown on microporous bio-reactor beads and placed into a polyethylene bag to facilitate the delayed healing of wounds in nude mice. A 1 x 1 cm wound was made on the backs of nude mice, and the dressing with or without viable cells was placed on the wound for 8 to 24 days, with dressing changes every other day. Wound area and time to heal measurements were compared after various interventions including freeze-thawing. The data shows that the interactive wound dressing was more effective than the control dressings (p<0.05) and that keratinocytes were more effective than fibroblasts in wound healing (p<0.05). Freezing-thawing of the interactive wound dressings destroyed the activity of the dressing. Studies examining cells using a live/dead viability assay showed that both keratinocytes and fibroblasts were alive after 2 days on the mice. Surprisingly, human fibroblasts appeared to exhibit bridging behavior that is indicative of fibroblast proliferation. We conclude that a simple interactive wound dressing using either keratinocytes or fibroblasts can enhance the healing of wounds in nude mice.

Coping with stress in the workplace: implications for new health professionals.

Because health care professionals must provide high-quality care while simultaneously adjusting to the new demands of a rapidly changing health care system, work stress and possibly even burnout are prevalent issues for both senior professionals and recent health science graduates upon entry into the workforce. This article examines the experience of stress and the importance of coping abilities, particularly focusing on students enrolled in health professional courses and those who have recently entered the workforce. It also presents research pertaining to whether newly graduated health professionals are coping effectively with the demands of work. Suggestions for improving stress-coping abilities are given.

The impact of passive coping on rheumatoid arthritis pain.

OBJECTIVE: To determine the ability of coping to predict pain. METHODS: Data on 111 rheumatoid arthritis (RA) patients (86 women and 25 men) were gathered from a mail survey. Statistical analyses were conducted on a range of clinical and psychological variables: physical disability, disease duration, pain, depression, helplessness, and passive and active coping. Pain was measured with both the pain subscale of the Arthritis Impact Measurement Scales and a visual analogue scale, and coping was measured with the Vanderbilt Pain Management Inventory. RESULTS: A series of multiple regression analyses revealed that the optimal predictors of pain in RA were physical disability and passive coping, which accounted for 40% of the variance associated with pain. Path analysis revealed that passive coping mediates between the physical disability and pain, and between physical disability and depression. CONCLUSION: The results of this study have implications for the overall management of RA. In addition to the medical treatment, the experience of pain and depression in RA should be addressed through an intervention programme designed to enhance coping strategies.

Onycholysis as a complication of systemic chemotherapy: report of five cases associated with prolonged weekly paclitaxel therapy and review of the literature.

BACKGROUND: Onycholysis has been reported in association with the use of several noncytotoxic drugs and with chemotherapy in 135 patients. Onycholysis may be precipitated by exposure to ultraviolet radiation. METHODS: The authors studied 91 patients who received paclitaxel and 187 patients who received doxorubicin. RESULTS: Onycholysis occurred in 5 of 21 patients who received > 6 courses of weekly paclitaxel, developing in the summer months in all 5 patients. It did not occur in patients who received fewer weekly paclitaxel courses or those who were treated every 3 weeks. Onycholysis did not occur in 187 patients who received doxorubicin. Review of the literature revealed that onycholysis is nearly exclusively associated with anthracycline and taxane therapy. CONCLUSIONS: Prolonged weekly paclitaxel, other taxanes, and anthracyclines cause onycholysis in some patients, which may be precipitated by exposure to sunlight. Patients receiving these drugs should protect their nails from sunlight.

An analysis of managerial skills for the current and future health care environment.

A survey questioned 503 experienced practitioners about managerial tasks and responsibilities of senior professionals in four allied health fields: physiotherapy, speech-language pathology, occupational therapy, and medical radiation science. Participants worked in a range of settings, including the private and public sectors, small and large departments/units, and community and hospital-based work sites. Factor analysis identified eight managerial areas of functioning: department running, staff relations management, legislative knowledge, career path management, implementation and change, quality assurance, management of future planning, and prioritizing work. The professional field of the practitioner influenced the importances attached to these areas, while work setting and gender of practitioner had minimal impact. Level of involvement in managerial tasks had no bearing on the importance attached to competency areas. Open-ended comments added depth to the results of the factor analysis. The findings are discussed with respect to the changing requirements being placed upon health service personnel.

The creation of strategic alliances: the experience of the London Health Sciences Centre and southwestern Ontario.

This article describes the framework and strategies that the London Health Sciences Centre has developed to foster trusting and collaborative relationships with its regional partners in Southwestern Ontario. A four-phase approach was used to identify, implement and evaluate system-wide opportunities to improve the integration of clinical care in Southwestern Ontario. Specific case studies are illustrated that used this framework to improve both access to patient services and length of stay, while positively affecting operating resources.

Australian speech pathologists' views of what professional practices lead to successful outcomes of therapy.

The relative importance attributed to factors perceived by speech pathologists as contributing to successful levels of therapeutic outcomes were addressed in a survey of 372 practicing therapists in Australia. The survey consisted of 42 items derived from interviews with a sample of ten speech pathologists in Sydney. Therapists were asked to rate the importance of each item on a seven-point scale ranging from "not at all important" to "critically important." The findings indicate that the most important ingredients of successful therapy incorporate a mix of support and therapeutic activity outside the clinic; the clinicians' organizational skills and involvement in conducting therapy and their use of techniques; the positive therapeutic relationship between clinician and client; and, finally, the client's attitude to therapy. These findings suggest that speech pathologists, like other allied health professionals, endorse a humanistic or holistic approach to health care. The results provide insights into the practices that should be addressed and fostered in undergraduate speech pathology programs.