Falls prevention and support:: translating research, integrating services and promoting the contribution of service users for quality and innovative programmes of care

Falls are a significant threat to the safety, health and independence of older citizens. Despite the substantial evidence that is available around effective falls prevention programmes and interventions, their translation into falls reduction programmes and policies has yet to be fully realised. While hip fracture rates are decreasing, the number and incidence of fall-related hospital admissions among older people continue to rise. Given the demographic trends that highlight increasing numbers of older people in the UK, which is broadly reflected internationally, there is a financial and social imperative to minimise the rate of falls and associated injuries. Falling is closely aligned to growing older (Slips, Trips and Falls Update: From Acute and Community Hospitals and Mental Health Units in England and Wales, Department of Health, HMSO, London, 2010). According to the World Health Organization, around 30% of older people aged over 65 and 50% of those over 80 will fall each year (Falls Fact Sheet Number 344, WHO, Geneva, 2010). Falls happen as a result of many reasons and can have harmful consequences, including loss of mobility and independence, confidence and in many cases even death (Cochrane Database Syst Rev 15, 2009, 146; Slips, Trips and Falls Update: From Acute and Community Hospitals and Mental Health Units in England and Wales, Department of Health, HMSO, London, 2010; Falling Standards, Broken Promises: Report of the National
Audit of Falls and Bone Health in Older People 2010, Health Care Quality
Improvement Partnership, London, 2011). What is neither fair nor correct is the
common belief by old and young alike that falls are just another inconvenience to put up with. The available evidence justifiably supports the view that well-organised services, based upon national standards and expert guidance, can prevent future falls among older people and reduce death and disability from fractures. This paper will draw from the UK, as an exemplar for policy and practice, to discuss the strategic direction of falls prevention programmes for older people and the partnerships that need to exist between researchers, service providers and users of services to translate evidence to the clinical setting. Second, it will propose some mechanisms for disseminating evidence to healthcare professionals and other stakeholders, to improve the quality and capacity of the clinical workforce.

Female narratives of ‘new’ citizens’ belonging(s) and identities in Europe: case studies from the Netherlands and Britain

Public discourses on citizenship, identity and nationality, which link geographical borders and the political boundaries of a community, are infused with tensions and contradictions. This paper illustrates how these tensions are interwoven with multilayered notions of home, belonging, migration, citizenship and individual’s ‘longing just to be’, focusing on the Dutch and the British context. The narratives of a number of Dutch and British women, who either immigrated to the respective countries or were born to immigrants, illustrate how the growing rigid integration and assimilative discourses in Europe contradict an individual anchoring in national and local communities. The narratives of women participating in these studies show multilayered angles of belonging presenting an alternative to the increasing strong argument for a fixed notion of positioning and national belonging. The female ‘new’ citizens in our study tell stories of individual choices, social mobility and a sense of multiple belonging in and across different communities.

The microtubule targeting agent PBOX-15 inhibits integrin-mediated cell adhesion and induces apoptosis in acute lymphoblastic leukaemia cells

Although recent decades have seen an improved cure rate for newly diagnosed paediatric acute lymphoplastic leukaemia (ALL), the treatment options for adult ALL, T-cell ALL (T-ALL) and relapsed disease remain poor. We have developed a novel series of pyrrolo-1,5-benzoxazepine (PBOX) compounds and established their anticancer efficacy in a variety of human tumour cell types. Here, we demonstrate that PBOX-15 inhibits cell growth, and induces G2/M cell cycle arrest and apoptosis in both T-ALL and B-cell ALL (B-ALL) cells. In addition, prior to PBOX-15-induced apoptosis, PBOX-15 decreases ALL cell adhesion, spreading and migration. Concurrently, PBOX-15 differentially down-regulates β1-, β2- and α4-integrin expression in ALL cells and significantly decreases integrin-mediated cell attachment. PBOX-15 interferes with the lateral mobility and clustering of integrins in both B-ALL and T-ALL cells. These data suggest that PBOX-15 is not only effective in inducing apoptosis in ALL cells, but also has the potential to disrupt integrin-mediated adhesion of malignant lymphocytes, which represents a novel avenue for regulating leukaemic cell homing and migration.

Occupy Differently: Space, Community and Urban Counter-Conduct

This article demonstrates how the concept of counter-conducts helps us understand Occupy by directing attention to the correlation between the way advanced liberalism works to control urban spaces and the way that control is countered through Occupy’s tactics. The first section outlines the term counter-conducts by looking to Foucault’s short and undeveloped theorisation. The second examines how advanced liberalism conducts conduct through the use of urban space, concentrating on London which comes to form a space of and for the mobility and circulation of goods, people and ideas. Occupy’s tactics directly confront and counter such movement while engaging in its own forms of counter-circulation and (im)mobility. The third section examines how advanced liberal techniques have increasingly come to use a particular, heavily instrumentalised understanding of community in order to divide and control urban populations. Occupy’s tactics embody versions of community which confront and oppose such instrumentalisation, ultimately both engaging with that control and partially reproducing it. Through these counter-conducts we can come to a view of Occupy as inevitably succeeding in its failure as a movement and failing in its success, while opening to an (im)possible
futurity of occupying urban space differently.

On the low-frequency electrical polarization of bacterial cells in sands

We performed electrical measurements on sands flushed with bacterial suspensions of varying concentration. The first experiment was conducted with Shewanella putrefaciens (biomass 0â??0.5 mg/L) and the second with Escherichia coli (biomass 0â??42 mg/L). We measured a biomass-dependent low-frequency (10 Hz) polarization. At cell density 12 mg/L polarization increased (up to 15%). We attribute the decrease in polarization at low cell density to alteration of the mineral-fluid interface due to mineral-cell interactions. The polarization enhancement at higher cell density is possibly a pore throat mechanism resulting from decreased ionic mobility and/or electron transfer due to cell accumulation in pores.

Correlates of constipation in people with Parkinson's

Purpose: To investigate clinical, demographic and dietary factors associated with constipation in a sample of community dwelling people with Parkinson's disease, recruited through a specialist outpatient clinic. Partners/carers provided a convenience control group. Scope: Participants completed a baseline questionnaire (background information, diet and exercise, activities of daily living: mobility and manual dexterity, health-related quality of life (SF-12), stool frequency and characteristics, extent of concern due to constipation, laxative taking), and a four-week stool diary. The Rome criterion was used to determine constipation status. Multiple regression methods were used to explore the correlates of constipation. Baseline data were provided by 121 people with Parkinson's, (54 controls), of whom 73% (25%) met the Rome criterion. Prospective diary data from 106 people with Parkinson's (43 controls) showed lower proportions: 35% (7%) meeting the Rome criterion. Among all study subjects, i.e. Parkinson's patients and controls taken together, the presence of constipation is predicted by having Parkinson's disease (p=.003; odds ratio 4.80, 95% CI 1.64-14.04) and mobility score (p=.04; odds ratio 1.15, 95% CI 1.01-1.31), but not by dietary factors. Amongst people with Parkinson's constipation is predicted by number of medications (p=.027). Laxative taking masks constipation, and is significantly associated with wearing protection against bowel incontinence (p=.009; odds ratio 4.80, 95% CI: 1.48-15.52). Conclusions: Constipation is disease-related, not a lifestyle factor. More research is needed on optimal management and laxative use. © 2010 Elsevier Ltd.

Physicochemical characterisation of injectable polymeric gels for use in the treatment of periodontal disease

The physicochemical characteristics of the injectable polymeric gels for use in the treatment of periodontal disease were investigated. The hardness, compressibility, and mucoadhesive properties of the gel were determined using a TA-XT2 Texture analyzer. The effect of of polymer concentration on the various viscoelastic, textural, bioadhesive properties and drug release were also analyzed using multifactorial analysis of variance. It was found that increased polymer concentration significantly increased gel structure, reduced polymer chain mobility and subsequently decreased the swelling/erosion and diffusion properties of the gel networks.

End-to-End QoS Enhancement ofHSDPA End-User Multi-flow Traffic Using RAN Buffer Management

High speed downlink packet access (HSDPA) was introduced to UMTS radio access segment to provide higher capacity for new packet switched services. As a result, packet switched sessions with multiple diverse traffic flows such as concurrent voice and data, or video and data being transmitted to the same user are a likely commonplace cellular packet data scenario. In HSDPA, radio access network (RAN) buffer management schemes are essential to support the end-to-end QoS of such sessions. Hence in this paper we present the end-to-end performance study of a proposed RAN buffer management scheme for multi-flow sessions via dynamic system-level HSDPA simulations. The scheme is an enhancement of a time-space priority (TSP) queuing strategy applied to the node B MAC-hs buffer allocated to an end user with concurrent real-time (RT) and non-real-time (NRT) flows during a multi-flow session. The experimental multi- flow scenario is a packet voice call with concurrent TCP-based file download to the same user. Results show that with the proposed enhancements to the TSP-based RAN buffer management, end-to-end QoS performance gains accrue to the NRT flow without compromising RT flow QoS of the same end user session

Photography

This chapter explains the relationship between photography, mobility and materiality

Asking the Critical Questions: An Evaluation of Social Work Students' Experiences in an International Placement

Preparing social work students for the demands of changing social environments and to promote student mobility and interest in overseas employment opportunities have resulted in an increasing demand for international social work placements. The literature describes numerous examples of social work programmes that offer a wide variety of international placements. However, research about the actual benefit of undertaking an overseas placement is scant with limited empirical evidence on the profile of students participating, their experience of the tasks offered, the supervisory practice and the outcomes for students' professional learning and career. This study contributes to the existing body of literature by exploring the relevance of international field placements for students and is unique in that it draws its sample from students who have graduated so provides a distinctive perspective in which to compare their international placement with their other placement/s as well as evaluating what were the benefits and drawbacks for them in terms of their careers, employment opportunities and current professional practice.

Mundane Mobilities in ‘Post-Socialist’ Sofia: Making Urban Borders Visible

This article reflects on an on-going research project which aims to expand the understanding of the production and transformation of urban borders in the Eastern European cities of the ex ‘communist bloc’, starting from the case of Sofia. It explores the proposition that there has been a prolific process of wall making in this city associated with ‘vanishing public spaces’, ‘rescaling of enclosure’, and ‘corrosion of the collective urban realm’ (Hirt, 2012). The paper seeks to understand the social and political effects of this process by delving into the sensorial, emotional and embodied experiences associated with the mundane mobilities of urban residents. Using participants’ self-directed photography and videos from ‘walk-along’ interviews it explores the ways in which borders are made visible and are produced, challenged or resisted through mobility, and delves into the associated senses of deepening social and spatial differentiation in the city.