Factors affecting adherence to use of hip protectors amongst residents of nursing homes - A correlation study

Background: Hip protectors are protective pads designed to cover the greater trochanter and attenuate or disperse the force of a fall sufficiently to prevent a hip fracture. Promising results from randomised controlled trials in nursing homes have resulted in hip protectors being widely recommended in the health care literature and in national guidelines. Objectives: The objectives of the study were to identify characteristics of individual residents, and the organisational features of the homes in which they live, which may affect adherence to wearing hip protectors. Design: An observational, correlation study designed to identify factors related to adherence. Setting: Forty nursing and residential homes in the UK. Participants: 1346 residents of the homes who were not confined to bed and with no pressure sore on the hip. Methods: The introduction of an evidence-based policy to offer Safehips hip protectors to residents free of charge and with support from a nurse facilitator. Adherence to wearing the hip protectors was observed over 72 weeks. Results: Initial acceptance of the hip protectors was 37.2%. Continued adherence was 23.9% at 24 weeks; 23.2% at 48 weeks; and 19.9% at 72 weeks. Greater adherence was associated with the following individual resident characteristics: a greater degree of dependency (95% CI 1.39 - m3.78) and cognitive impairment (95% CI 1.01 - 2.98); being male rather than female (95% CI 1.06 - 2.48). Greater adherence was also associated with the following organisational characteristics of homes: fewer changes of senior manager during the study period (95% CI 1.01 - 8.51), and being resident in a home with a resident profile showing a greater proportion of residents with a higher degree of dependency (95% CI 1.04 - 1.27). There was wide a variation in the degree of success in implementation between homes (adherence of 0 - 100% at 24 weeks). Conclusions: Those implementing a policy of introducing hip protectors into nursing and residential homes should consider targeting residents with cognitive impairment. Such residents are at greater risk of hip fracture and appear to be more likely to continue wearing hip protectors. Those charged with implementing changes inpractice or policy should consider how the context for implementation can be optimised to increase the likelihood of success.

Perceptions and reality: Economic voting at the 2004 European Parliament elections

One of the most influential explanations of voting behaviour is based on economic factors: when the economy is doing well, voters reward the incumbent government and when the economy is doing badly, voters punish the incumbent. This reward-punishment model is thought to be particularly appropriate at second order contests such as European Parliament elections. Yet operationalising this economic voting model using citizens' perceptions of economic performance may suffer from endogeneity problems if citizens' perceptions are in fact a function of their party preferences rather than being a cause of their party preferences. Thus, this article models a 'strict' version of economic voting in which they purge citizens' economic perceptions of partisan effects and only use as a predictor of voting that portion of citizens' economic perceptions that is caused by the real world economy. Using data on voting at the 2004 European Parliament elections for 23 European Union electorates, the article finds some, but limited, evidence for economic voting that is dependent on both voter sophistication and clarity of responsibility for the economy within any country. First, only politically sophisticated voters' subjective economic assessments are in fact grounded in economic reality. Second, the portion of subjective economic assessments that is a function of the real world economy is a significant predictor of voting only in single party government contexts where there can be a clear attribution of responsibility. For coalition government contexts, the article finds essentially no impact of the real economy via economic perceptions on vote choice, at least at European Parliament elections.

Predator-prey interactions between brown trout Salmo trutta and native and introduced amphipods; their implications for fish diets

An attempt to improve the food base for brown trout Salmo trutta in Northern Ireland was made in 1958.59 by deliberately introducing English Gammarus pulex into several Irish rivers. In addition. another amphipod Crangonyx pseudogracilis, was later accidently introduced into II ish waters. Our study represents the first attempt to examine the trophic interactions between a native fish predator (S. trutta) and an array of these native (Gammarus duebeni celticus) and introduced (G. pulex and C. pseudogracilis) amphipods. Feeding experiments, involving young brown trout predators and ampiphod prey, revealed that the fish actively selected C. pseudogracilis relative to two alternative Gammarus prey species. Although the trout encountered the Gammarus species more than C. pseudogracilis, they were eaten less than Crangonyx. Difficulties in handling and ingestion of Gammarus by trout may be a. key component of the preference fbr the smaller, more easily handled Crangonyx. The microdistribution of the species was altered by the fish, due to predation being greater in particular microhabitats, Our study showed that the introduction of the herbivorous C. pseudogracilis into Irish freshwaters may represent a useful addition to fish diets. particularly for small and/or juvenile fish. The reprecussions of the deliberate introduction of G. pulex are less clear. It may improve feeding for fish. but only if it can coexist with indigenous macroinvertebrates and thus ultimately improve the range and quantity of possible food items in predator diets. Alternatively, being highly predatory towards other macroinvertebrates including G. d. celticus and C. pseudogracilis. G. pulex may be deleterious to the diversity of the resident benthic community and hence reduce the diversity of prey available to fish predators.

Li-6 in the atmosphere of GJ 117 revisited

Detection of Li-6 has been shown for energetic solar events, one chromospherically active binary, and several dwarf halo stars. We had previously found a Li-6/Li-7 = 0.03 +/- 0.01 for active K dwarf GJ 117 using VLT UVES observations. Here we present high signal-to-noise (> 1000) high spectral resolution observations taken with the McDonald Observatory's 2.7 m and echelle spectrometer of GJ 117. We have used the solar spectrum and template stars to eliminate possible blends, such as Ti I, in the Li-6 spectral region. Our new analysis, using an updated PHOENIX model atmosphere, finds Li-6/Li-7 = 0.05 +/- 0.02. In addition, bisector analysis showed no significant red asymmetries that would affect the lithium line profile. No changes above the statistical uncertainties are found between the VLT and McDonald data. The amount of Li-6 derived for GJ 117 is consistent with creation in spallation reactions on the stellar surface, but we caution that uncertainties in the continuum level may cause additional uncertainty in the Li-6 fraction.

Efficacy and mechanism of hypoxic postconditioning in salvage of ex vivo human rectus abdominis muscle from hypoxia/reoxygenation injury

In reconstructive surgery, skeletal muscle may endure protracted ischemia before reperfusion, which can lead to significant ischemia/reperfusion injury. Ischemic postconditioning induced by brief cycles of reperfusion/reocclusion at the end of ischemia has been shown to salvage skeletal muscle from ischemia/reperfusion injury in several animal models. However, ischemic postconditioning has not been confirmed in human skeletal muscle. Using an established in vitro human skeletal muscle hypoxic conditioning model, we tested our hypothesis that hypoxic postconditioning salvages ex vivo human skeletal muscle from hypoxia/reoxygenation injury and the mechanism involves inhibition of opening of the mitochondrial permeability transition pore (mPTP) and preservation of ATP synthesis. Muscle strips (~0.5×0.5×15mm) from human rectus abdominis muscle biopsies were cultured in Krebs-Henseleit-HEPES buffer, bubbled with 95%N(2)/5%CO(2) (hypoxia) or 95%O(2)/5%CO(2) (reoxygenation). Samples were subjected to 3h hypoxia/2h reoxygenation. Hypoxic postconditioning was induced by one or two cycles of 5min reoxygenation/5min hypoxia after 3h hypoxia. Muscle injury, viability and ATP synthesis after 2h of reoxygenation were assessed by measuring lactate dehydrogenase (LDH) release, 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide (MTT) reduction and ATP content, respectively. Hypoxic postconditioning or treatment with the mPTP-opening inhibitors Cyclosporine A (CsA, 5×10(-6)M) or N-Methyl-4-isoleucine Cyclosporine (NIM811, 5×10(-6)M) 10min before reoxygenation decreased LDH release, increased MTT reduction and increased muscle ATP content (n=7 patients; P

Review of: Whitehouse, R. 1993 Underground Religion: cult and culture in prehistoric Italy. Accordia Specialist Studies on Italy 1. London, University of London.

Malone , C., . Antiquity, 1993. 67(256): p. 686-7.