RESUMEN
To date the influence that specific sitting posture has on the head/neck posture and cervico-thoracic muscle activity has been insufficiently investigated. Therefore the aim of this study was to investigate whether three different thoraco-lumbar sitting postures affect head/neck posture and cervico-thoracic muscle activity. Twenty (10 men, 10 women) asymptomatic subjects were placed in 3 standardized thoraco-lumbar sitting postures (lumbo-pelvic, thoracic upright and slump) to investigate their influence on cervico-thoracic muscle activity and head/neck posture. There were significant differences in lumbar and thoracic curvatures in the 3 different sitting postures (P<0.002). Slump sitting was associated with greater head/neck flexion, anterior translation of the head (P<0.001) and increased muscle activity of cervical erector spinae (CES) compared to thoracic and lumbo-pelvic sitting (P=0.001). Thoracic upright sitting showed increased muscle activity of thoracic erector spinae (TES) compared to slump and lumbo-pelvic postures (P=0.015). Upper trapezius (UT) demonstrated no significant difference in muscle activation in the 3 sitting postures (P<0.991). This study demonstrates that different sitting postures affect head/neck posture and cervico-thoracic muscle activity. It highlights the potential importance of thoraco-lumbar spine postural adjustment when training head/neck posture.
Asunto(s)
Cabeza/fisiología , Región Lumbosacra/fisiología , Músculo Esquelético/fisiología , Cuello/fisiología , Postura/fisiología , Tórax/fisiología , Adulto , Análisis de Varianza , Fenómenos Biomecánicos , Enfermedad Crónica , Electromiografía , Femenino , Movimientos de la Cabeza/fisiología , Humanos , Masculino , Músculos del Cuello/fisiología , Dolor de Cuello/etiología , Dolor de Cuello/fisiopatología , Enfermedades Profesionales/etiología , Enfermedades Profesionales/fisiopatología , Rango del Movimiento Articular , RotaciónRESUMEN
INTRODUCTION: Accessibility and quality of primary health care services in rural areas are challenging issues, particularly for the elderly and those with chronic or complex medical conditions. The objective of the Nurse-Physician Collaborative Partnership was to implement and evaluate a collaborative partnership between homecare nurses and family physicians in the rural Trochu-Delburne-Elnora area of Alberta. METHODS: Overall, 37 patients were enrolled in a shared care plan, which included comprehensive biopsychosocial assessment, early intervention, health education and self-management. Patient and provider outcomes were assessed using quantitative and qualitative data collected at baseline, 6 months and 12 months. RESULTS: Results showed that patients made improvements in activities of daily living and robust cognitive status. In interviews, patients reported improvements in psychological well-being, knowledge of disease processes and confidence to manage health issues. Patients' use of acute health care services decreased, showing a 51% reduction in the number of days in hospital, a 32% reduction in emergency department visits and a 25% reduction in hospital admissions. Total acute service costs, excluding program costs, decreased by 40% from an average of $15,485 to $9,313 per person (p < or = 0.05). CONCLUSION: Based on these results, policy initiatives that incorporate the shared care model developed in this project may be considered. To our knowledge, this type of evaluation has not previously been conducted in a rural Canadian setting.
Asunto(s)
Enfermedad Crónica/terapia , Continuidad de la Atención al Paciente , Anciano Frágil , Relaciones Médico-Enfermero , Servicios de Salud Rural/organización & administración , Anciano de 80 o más Años , Alberta , Medicina Familiar y Comunitaria/organización & administración , Femenino , Servicios de Atención de Salud a Domicilio/organización & administración , Humanos , Masculino , Persona de Mediana Edad , Modelos Organizacionales , Evaluación de Resultado en la Atención de Salud , Estudios ProspectivosRESUMEN
Indigenous bacteria found in the sediment of the Emerald Basin (depth of 215 m, Atlantic Ocean) located offshore of Halifax Harbour (Nova Scotia, Canada) were previously found to be able to degrade the explosive compound hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX). In the present study, a novel obligately respiratory, denitrifying and RDX-mineralizing bacterium, designated strain HAW-EB4(T), was isolated from the marine sediment. This bacterium utilized peptone, yeast extract, Casamino acids, esters (Tweens 20, 40 and 80), sugars (N-acetyl-D-glucosamine, ribose), several C2 and C3 acids (acetate, pyruvate, lactate, propionate) and amino acids (serine, proline) as sole carbon and energy sources. Aerobically grown cells (in marine broth 2216 at 10 degrees C) contained C(14 : 0) (6 %), iso-C(15 : 0) (12 %), C(16 : 0) (20 %), C(16 : 1)omega7 (37 %), C(18 : 1)omega7 (7 %) and C(20 : 5)omega3 (7 %) as major membrane fatty acids, and Q7 (28.1 %) and MK-7 (60.9 %) as dominant respiratory quinones, consistent with deep-sea species of Shewanella. The novel bacterium had a DNA G+C content of 45 mol% and showed similarity to Shewanella species in terms of 16S rRNA and gyrB gene sequences (93-99 and 67.3-88.4 % similarity, respectively), with Shewanella pealeana being the most closely related species. Genomic DNA-DNA hybridization between strain HAW-EB4T and S. pealeana revealed a level of relatedness of 17.9 %, lower than the 70 % species cut-off value, indicating that strain HAW-EB4T (= NCIMB 14093T = DSM 17350T) is the type strain of a novel species of Shewanella, for which the name Shewanella halifaxensis sp. nov. is proposed.