No description available.

Safe and efficient swallowing requires integrity of both motor and sensory systems. Prior studies have established that motor impairment in individuals with PD frequently manifests as abnormalities in swallowing biomechanics. In contrast, very few studies have investigated the contribution of sensory impairment towards pharyngeal biomechanics and airway protection in this patient cohort. This area should be addressed in light of evidence that the severity of limb motor dysfunction in PD does not reliably predict severity of dysphagia. Emerging data suggests that dysphagia in PD cannot be solely attributed to motor impairment, but may also be influenced by deficits in sensory aspects of airway protection. As an example, silent aspiration in up to 100% has been reported in individuals with PD due to laryngopharyngeal sensory deficits have. Even so, current research lacks information on the integration of both motor and sensory components that make up the swallowing process. The aim of this study was to document changes in airway protection with age, in PD and across severity levels of PD. The project was comprised of two parts. In part one, three parallel studies were conducted to assess a series of both motor and sensory airway mechanism (Chapters 4 to 9). In the first study, 16 young (8 males, age range 21.3 - 32.4) and 16 elder adults (8 males, age range 61.5 - 84.7), were assessed to investigate changes in airway protection that accompany ageing. In the second study, data from individuals diagnosed with PD across severity levels (Hoehn-Yahr 1 - 4, age range 64.2 - 84.5) were age and gender-matched to 16 healthy elders in order to examine the effects of PD on airway protection. In the third, the impact of disease severity was studied with data from 16 individuals in the earlier stages (Hoehn-Yahr ≤ 2, 13 males, age range 51.3 - 82.5, ) compared to 16 individuals in the later stages (Hoehn-Yahr ≥ 2.5, 10 males, age range 61.5 - 78.9). In part two of this project, two smaller, pilot studies were completed to probe the influence of pharmacologic and behavioural treatments on airway protection mechanisms. In the first pilot study, the effect of pharmacotherapy on airway protection was investigated in 10 patients 'on' and 'off' levodopa (Chapter 10). In the second study, 5 patients were assessed before and after completing the Lee Silverman Voice Treatment (LSVT) to document effects of speech rehabilitation on airway protection (Chapter 11). Multimodality assessment elicited data from all participants on both motor and sensory components of airway protection (Chapter 3). Specifically, breathing-swallowing coordination (BSC) and swallowing apnoea (SA) were captured using simultaneous directional nasal airflow and surface electromyography (sEMG). Standard, closed-loop spirometry was used to assess pulmonary function. Swallowing biomechanics were screened using a validated timed test of swallowing efficiency and further evaluated using fibreoptic endoscopic evaluation of swallowing (FEES). Finally, chemo-sensation of the laryngopharynx was determined with the administration of the inhalation cough challenge while mechanosensation was examined using FEES. Results suggest that motor control for airway protection is reasonably robust in PD, although sensory response is impaired. The predominant pattern for swallowing respiratory coordination was mid-expiration for all participants regardless of age and disease severity (Chapter 4). Individuals with PD demonstrated a reduction in average time and volume per swallow, leading to an overall decrease in swallowing capacity (Chapter 5). No difference was found for swallowing efficiency between those in early and later stages of PD. Pulmonary function measures were not significantly different as a function of age, PD or PD severity (Chapter 6). In summary, results from motor assessments contributing to airway protection support the robustness of breathing-swallowing coordination (BSC) and pulmonary function across research groups, but identify a reduction in overall swallowing efficiency in PD. Results from sensory assessments contributing to airway protection revealed that chemosensation was not different between age groups but base of tongue mechano-sensation was diminished in individuals with PD. Natural cough thresholds did not differ between young adults and elders but when asked to stifle coughing, elders were less able to do so compared to young adults (Chapter 7). For the first time, a reduction in mechano-reception at the base of tongue was recorded in individuals with PD (Chapter 8). These patients also demonstrated increased post swallow residual (Chapter 5), which offers an explanation for the complaint of globus in this population. These assessments highlight some compromise to sensory aspects of airway protection in PD. Overall, dysphagia had a negative impact on the quality of life of individuals with PD and even more as disease severity progresses (Chapter 9). Results from part two of the study looking at the effects of therapeutic interventions on airway protection revealed some unexpected findings. In chapter 10, results showed a reduction in pulmonary function when 'on' levodopa, but no differences in swallowing efficiency, BSC, or laryngopharyngeal chemo- and mechano-reception were observed. These results suggested a reduction in pulmonary function with levodopa without any increase in risk of airway protection compromise1. Unexpectedly and documented for the first time, the percentage of post swallow inspiration increased after LSVT (Chapter 11) but as with the levodopa study, this was also not accompanied by any apparent increase in aspiration risk. An increase in submental surface electromyography (sEMG) amplitude across all 5 participants may serve as a proxy measure of improvement in hyolaryngeal excursion. Finally, participants reported an overall improvement in social functioning and communication after LSVT. In conclusion, this study provided evidence that mechano-sensory aspect of airway protection is diminished in individuals with PD, possibly compromising airway protection. Patients not only demonstrated increased residue but the lack of sensation may prevent clearing or spontaneous multiple swallows. Overall, airway protection is maintained in ageing but swallowing efficiency declines in the presence of PD. This study contributes significantly to current research efforts in PD by expanding on existing reports regarding motor aspects of airway protection. Specifically, BSC, swallowing efficiency and evaluation of biomechanics using FEES research have never before been investigated exclusively in the PD population. Finally, the chemo- and mechano-sensation evaluated in this study are an important addition to the limited evidence that sensory impairment in individuals with PD potentially compromises airway protection. Results of the present study will serve as a platform upon which future studies may compare and expand.

3 pp. / The publication covers protecting yourself from identity theft. It covers how identity theft happens and ways to protect yourself from identity theft. It also gives you some steps to take if you are a victim of identity theft as well as identity theft contact information.

In 1984 and 1985 visual differences in frost damage were observed among 40 jojoba clones growing in a field in Tucson, Arizona. More detailed data were collected on the clone with the least damage (Clone-1) and the one with the most damage (Clone-2). On 10-ten terminal branch samples, Clone-1 showed an average of 12% leaf damage compared to 35% for Clone-2. Leaf freezing under controlled conditions on a monthly schedule showed that leaves of Clone-1 consistently froze at a lower temperature than Clone-2. Also, a second exotherm occurred in 50% of the samples for Clone-1 whereas a second exotherm occurred in only 15% of the samples of Clone-2. Soil moisture content and plant water potential were measured biweekly. Neither seemed to relate to the differences in freezing tolerance of the two clones. Total nonstructural carbohydrates (TNC), total soluble sugars, sucrose and proline were determined monthly. Accumulation patterns of TNC were similar for the two clones, however, Clone-1 generally accumulated more soluble sugars, sucrose and proline which might have contributed to its freezing tolerance. Growth measurements were recorded monthly to determine whether differences occurred between the two clones. Growth of both clones peaked in the spring, showed minor peaks in summer and ceased in winter. Under greenhouse conditions, pot grown cuttings from Clone-1 and Clone-2 were given zero, six or 12 gm of Osmocote fertilizer and watered at 35 or 70% field capacity to determine the effect of irrigation and fertilization on leaf freezing point. Fertilization significantly increased leaf concentrations of N and P and produced more growth. In the greenhouse study, no differences were found in leaf freezing point due to clones, irrigation or fertilization treatment. Leaves of Clone-1 froze at a higher temperature compared to field grown plants.

Despite considerable efforts to decrease the impact of the Environment on the health of American Indians and Alaska Natives, many health problems attributed to environmental factors continue to pose significant challenges for many tribal communities. The challenges in particular point to the need for environmental protection policies, especially agricultural communities where high and persistent uses of pesticides have bearing on human health conditions. Although there is a need for tribal environmental health policies, research on tribal leaderships' interpretations and the implications the interpretations have for constructing environmental health policies are minimal. For example, understanding how one tribe defines environmental health is central to how they construct and develop environmental protection laws aimed at protecting the environment and human health.This qualitative research study took place in a rural agricultural Indian community on the Colorado River Indian Reservation in Parker, Arizona. The qualitative data assessed Tribal Council leader's interpretations and understanding of how environmental health is defined and understood. The study method employed a semi-structured interview process with selected tribal council members who served a term on tribal council between 1980-2002, especially members who were appointed to specific sub-committees concerned with agricultural activities (i.e. pesticide, agricultural, and farm board). The rationale for conducting qualitative interviews was to determine and ascertain how environmental health has been defined and understood over the past 22 years when these tribal leaders constructing, developing, and implemented various environmental protection laws. Other forms of data acquisition was through relevant public records from Tribal Council and special committee meeting minutes that centered on developing environmental health policy.The central aim of this research was to recognize and comprehend the level of understanding, and consideration employed by tribal leaders as they defined environmental health for their agricultural Indian community. By examining and presenting the core values and interpretations of environmental health policy of the Colorado River Indian Tribes, other tribes may learn from this as they formulate and develop appropriate environmental health policies aimed at protecting their environments, human health, cultural beliefs and practices and become more accountable and responsible to their allegiance to their communities.

Prepared by the Arid Lands Information Center, Office of Arid Lands Studies, University of Arizona ; A. Paige Grant, compiler (with assistance from Doug Stotz).

Prepared by the Arid Lands Information Center, Office of Arid Lands Studies, University of Arizona ; A. Paige Grant, compiler.

Prepared by the Arid Lands Information Center, Office of Arid Lands Studies, University of Arizona ; Robert G. Varady, compiler.

Prepared by the Arid Lands Information Center, Office of Arid Lands Studies, University of Arizona ; M. Justin Wilkinson, compiler.

Revised; Originally Published: 2007 / 3 pp.