Cardiac rehabilitation (CR) is a multi-disciplinary intervention designed to stabilise, slow, or reverse CVD, restore health following a cardiac event and facilitate the prevention of further events. The Model of Therapeutic Engagement (MTE) is a comprehensive conceptual model for explaining the process of engagement in rehabilitation. Of concern is that the role of socio-environmental factors is absent from explaining individual engagement in the MTE. There is also a lack of prospective studies investigating the impact of socio-environmental barriers on engagement in CR programs over time. This study aimed to expand the MTE, by illuminating the role of socio-environmental barriers in a three-stage process of engagement in CR programs. A prospective study was conducted, with 217 individuals recruited from the Cardiology Ward in the Gold Coast University Hospital (GCUH) and the Robina Cardiac Rehabilitation Centre. The collected data were examined using a structural equation model that added socio-environmental factors into the MTE, using multi-group analyses. In this study, we found that socio-environmental factors were not associated with intention to engage in the CR program, but were related to actual attendance and maintenance of participation in CR programs. Knowing how these socio-environmental barriers affect the process of engagement at different stages may help to tailor more accessible CR programs for the population.

The primary aim of this study was to test the causal structure of the model of therapeutic engagement (MTE) for the first time, to examine whether the model assists in understanding the process of patient engagement in cardiac rehabilitation (CR) programs. This study used a prospective design, following up patients from the Gold Coast University Hospital Cardiology ward who attended Robina Cardiac Rehabilitation Clinic. A structural equation model of the interactions among the proposed variables within the three stages of the MTE (intention to engage in CR programs, CR initiation, and sustained engagement) revealed significant relationships among these variables in a dataset of 101 patients who attended a CR program. However, no relationship was discerned between outcome expectancies and patient intention to engage in CR. Patients’ willingness to consider the treatment also mediated the relationship between perceived self-efficacy and patient intention to engage in CR. These findings help clarify the process proposed by Lequerica and Kortte (2010) in the context of patient engagement in CR programs. The findings also reveal information on how patients engage in CR programs. Importantly, this provides new information for healthcare providers, enabling them to more effectively engage patients according to their stage of engagement.

This study aimed to compile existing evidence about the proposed relationships among variables at three stages of the model of therapeutic engagement (MTE): patient intention to engage in cardiac rehabilitation (CR), CR initiation, and sustained engagement. This model has not been tested in any rehabilitation setting. Therefore, this systematic literature review is key to future research and application of MTE to predict and enhance patient engagement in CR. Model-centric systematic literature reviews have been conducted for each stage of the MTE. A coherent approach to understanding and monitoring the process of patient engagement in CR is absent. Few relevant studies included in the model-centric reviews met the criteria: eight in stage 1, four in stage 2, and six in stage 3 of the MTE. In total, the tenets of the MTE were supported in patient intention to engage in CR. However, there was less evidence quantifying the proposed relationships among variables that impact on CR initiation and sustained engagement. There is a scarcity of research examining rehabilitation engagement in depth to better understand the complicated process contributing to behavioural outcomes. No decision-support models currently exist to alert patients and healthcare provider to the factors that influence non-engagement.

Postel Nunatak in the Patuxent Range has been previously mapped as Nelson Limestone but there was no biostratigraphic support for that interpretation until now. We confirm that limestone exposures at Postel Nunatak are at least partly correlated with the Nelson Limestone of the Neptune Range, 160 km north-east, and are not correlative with the lower Cambrian Schneider Hills Limestone of the Argentina Range. Upper beds have yielded the trilobites Suludella? davnii Palmer & Gatehouse, 1972 and Solenopleura pruina Palmer & Gatehouse, 1972, which provide a basis for assignment to Cambrian Series 3 (late middle Cambrian), within the Drumian or lower Guzhangian stages. Limestone beds were deposited in a shallow marine setting, ranging from supratidal to lagoonal facies with rare subtidal intervals. These settings contrast with deeper water facies of the Neptune Range. Despite limitations in sampling density, isotopic analysis indicates that a greater than +2.5‰ shift in δ13C is consistent with δ13C trends documented for the Drumian Stage. Because the upper and lower contacts at Postel Nunatak are covered by snow and ice, the relationship with rocks mapped as the Patuxent Formation in the Patuxent Range remains uncertain, but part of it may belong to the Precambrian Hannah Ridge Formation.

Alternative methods are needed to control weeds in no-till corn and soybean which minimize herbicide contamination of surface or ground water. The objective of this research was to determine whether between-row (BR) mowing + band-applied herbicide could help reduce herbicide use, without sacrificing summer annual weed control or yield, in no-till soybean and field corn. Glyphosate was applied shortly before or at planting to control emerged winter annual weeds in all treatments. In the BR mowing weed management system, the band-applied soil residual herbicides imazaquin + alachlor in soybean or atrazine + alachlor in corn were applied shortly before or after planting followed by two or more between-row mowings to control summer annual weeds. Annual weeds were first mowed when they were about 8 cm tall and again just before crop canopy closure. Between-row mowing weeds very close to the soil surface two or three times killed or suppressed summer annual grass and broadleaf weeds, chiefly giant foxtail, common cocklebur, and horseweed, when timed properly. The BR mowing weed management system increased yield above a weedy check in these no-till crops. It also controlled weeds and yielded as well as or better than broadcast-applied herbicide at the same rates. Use of soil residual herbicides to control summer annual weeds was reduced 50% by banding because only 50% of the field area was sprayed.

Silurian (Llandovery–Ludlow) Encrinurinae from Wisconsin, Indiana, and Illinois include species of Balizoma Holloway, 1980, Curriella Lamont, 1978, Distyrax Lane, 1988, Encrinurus Emmrich, 1844, Mackenziurus Edgecombe and Chatterton, 1990a, and Nucleurus Ramsköld, 1986. Mackenziurus lauriae n. sp. is described from Wenlock strata of the Racine and Sugar Run Dolomites; nine segments in the holaspid thorax are the fewest known for any encrinurid. A square rostral plate is diagnostic of Mackenziurus. New morphological data are provided by Illinois specimens of Balizoma indianensis (Kindle and Breger, 1904) from the Wenlock–Ludlow Racine Dolomite, and of Curriella tuberculifrons (Weller, 1907) from the Llandovery Elwood–Wilhelmi Formations. Nucleurus n. sp. is possibly from Llandovery strata in Wisconsin. Distyrax n. sp. occurs in the Brandon Bridge Member (late Llandovery–early Wenlock) of the Joliet Dolomite in Illinois. The type pygidia and possible topotype material of Encrinurus nereus Hall, 1867, confirm assignment to that genus as currently viewed; this reefal species is distinct from the closely related inter-reef species E. egani Miller, 1880, and appears to be distinct from reefal E. reflexus Raymond, 1916. Lectotypes are selected for these Encrinurus species.

Morphologic discrimination of species of scleractinian reef corals has long been plagued by a shortage of independent characters and by high ecophenotypic plasticity. Because of these two factors, many species appear to intergrade morphologically. We outline a newly developed protocol for the morphometric recognition of species, which uses size and shape coordinates derived from landmark data. The landmarks consist of spatially homologous points digitized in three dimensions on upper calical surfaces. The approach is more powerful than linear measurements at detecting subtle distinctions among species; and the distinctions are easy to visualize and interpret biologically, which increases the accuracy and resolution of subsequent phylogenetic and large-scale faunal analyses.

As an example, we distinguish morphospecies in collections of Porites made at three Caribbean locations. Size and shape coordinates are analyzed using principal component analysis, average linkage cluster analysis, and a series of iterative discriminant analyses. Positions of different corallites from the same colonies are examined on cluster dendrograms to determine cutoffs for group recognition, and discriminant classifications for different corallites from the same colonies are compared to maximize group assignments. The results yield seven morphospecies, which are generally in 90% agreement with classification of the same animals using allozyme electrophoresis. Measures of corallite size and the relative heights and locations of the pali and septal denticles all reveal unique patterns of variation among morphospecies.

A new dromomerycine palaeomerycid artiodactyl, Surameryx acrensis new genus new species, from upper Miocene deposits of the Amazon Basin documents the first and only known occurrence of this Northern Hemisphere group in South America. Osteological characters place the new taxon among the earliest known dromomerycine artiodactyls, most similar to Barbouromeryx trigonocorneus, which lived in North America during the early to middle Miocene, 20–16 Ma. Although it has long been assumed that the Great American Biotic Interchange (GABI) began with the closure of the Isthmus of Panama in the late Pliocene, or ca. 3.0–2.5 Ma, the presence of this North American immigrant in Amazonia is further evidence that terrestrial connections between North America and South America through Panama existed as early as the early late Miocene, or ca. 9.5 Ma. This early interchange date was previously indicated by approximately coeval specimens of proboscideans, peccaries, and tapirs in South America and ground sloths in North America. Although palaeomerycids apparently never flourished in South America, proboscideans thrived there until the end of the Pleistocene, and peccaries and tapirs diversified and still live there today.

Multimodal evoked potentials were analyzed from 58 possible, 62 probable and 100 definite (total 220) multiple sclerosis (MS) patients. Visual evoked potentials (VEP) were most frequently abnormal yielding 39%, 69%, 84% in the three diagnostic groups respectively. Median nerve sensory evoked potentials (SEP) yielded abnormalities in 26%, 65%, 79% respectively. Brainstem auditory evoked responses (BAER) were abnormal in 17%, 39%, 66% respectively. We measured the combined amplitude (CA) of waves III, IV, V in the BAER of these patients as an objective measure of amplitude asymmetry. The CA was considered abnormal if it was 1SD below the lowest CA value in the control group. The CA was abnormal in 9.2% of BAER with normal central conduction time. The BAER diagnostic yield in MS patients increased 11% by using CA analysis.

Lymphocytic adenohypophysitis (LAH) is an uncommon disorder in the spectrum of pituitary disease. Twenty-three cases proven by biopsy or at autopsy have been reported since 1962. We report 2 further cases and review the etiology, immunology and pathology of the disease. The diagnosis should be considered in afemale patient who presents during the post-partum period with the clinical picture of a non-functional or prolactin cell pituitary adenoma and evidence of hypopituitarism.

Background: This study examined mortality due to multiple sclerosis (MS) in Canada, 1975-2009 to determine whether there has been a change in age at death relative to the general population and decrease in MS mortality rates. Methods: Mortality rates/100,000 population for MS and all causes were calculated using data derived from Statistics Canada, age-standardized to the 2006 population. Results: The average annual Canadian MS mortality rate, 1975-2009 was 1.23/100,000. Five-year rates for 1975-79, 1980-84, 1985-89, 1990-94, 1995-99, 2000-04, 2005-09 were: 1.16, 0.94, 1.01, 1.16, 1.30, 1.43, 1.33. Trend analysis showed mortality rates over the entire 35 years were stable (average annual percent change of less than one percent). The average annual 1975-2009 rates for females and males were 1.45 and 0.99. Five-year female rates were always higher than males. Regardless of gender, there was a decrease in MS mortality rates in the 0-39 age group and increases in the 60-69, 70-79, and 80+ groups over time. In contrast, there were decreases in all-cause mortality rates across each age group. The highest MS mortality rates for 1975-2009 were consistently in the 50-59 and 60-69 groups for both genders, while the highest all-cause mortality rates were in the 80+ group. Conclusions: Changes in the age distribution of MS mortality rates indicate a shift to later age at death, possibly due to improved health care. However MS patients remain disadvantaged relative to the general population and changes in age at death are not reflected in decreased mortality rates.

The economic development of any area is tied to its natural resource base. Water, one of the most important of these natural resources, is used for a multitude of purposes including crop irrigation, human consumption, food processing, generation of electricity, transportation, recreation and waste disposal.

Municipal water use is essential in the development of any state. Florida is no exception. One of the first considerations in development of an area's water resources is that of furnishing municipal water for commercial, industrial, residential and public uses.

Two questions commonly raised by cow-calf producers are, “What type of beef animal is most profitable?” and “Can profits be increased by maintaining ownership of calves through the stocker and feeding stages?”

These two questions are highly interrelated as performance in cow-calf stage carries over into the Dostweanine staees.