A cluster randomised controlled trial to evaluate a policy of making hip protectors available to residents of nursing homes

Objectives: to evaluate the effectiveness of a policy of making hip protectors available to residents of nursing homes. Design: a cluster randomised controlled trial of the policy in nursing and residential homes, with the home as the unit of randomisation. Setting: 127 nursing and residential homes in the greater Belfast area of Northern Ireland. Participants: 40 homes in the intervention group (representing 1,366 occupied beds) and 87 homes in the control group (representing 2,751 occupied beds). Interventions: a policy of making hip protectors available free of charge to residents of nursing homes and supporting the implementation process by employing a nurse facilitator to encourage staff in the homes to promote their use, over a 72-week period. Main outcome measures: the rate of hip fractures in intervention and control homes, and the level of adherence to use of hip protectors. Results: there were 85 hip fractures in the intervention homes and 163 in the control homes. The mean fracture rate per 100 residents was 6.22 in the intervention homes and 5.92 in the control homes, giving an adjusted rate ratio for the intervention group compared to the control group of 1.05 (95% CI 0.77, 1.43, P = 0.76). Initial acceptance of the hip protectors was 37.2% (508/1,366) with adherence falling to 19.9% (272/1,366) at 72 weeks. Conclusions: making hip protectors available to residents of nursing and residential homes did not reduce the rate of hip fracture.

Rates of childhood trauma in a sample of patients with schizophrenia as compared with a sample of patients with non-psychotic psychiatric diagnoses

Despite strong evidence of high rates of childhood and adult trauma in schizophrenia, the area remains under-researched. Our objectives in the study were first, to examine the rates of exposure to childhood, adult and lifetime (child plus adult) trauma in a population with schizophrenia and a population with non-psychotic psychiatric diagnoses and second, to examine the effect of trauma on the symptoms of schizophrenia. Two groups, those with schizophrenia (n = 40), and those with a non-psychotic diagnosis (n = 30), were recruited. Data were collected for demographic, psychiatric and trauma histories for all participants and on psychosocial functioning and psychiatric symptomatology for the patients with schizophrenia. Childhood exposure to trauma was significantly more common in the schizophrenia group (t = 5.196, df = 68, p <0.001, Eta squared = 0.28), with the strongest relationship being childhood physical assault. In the schizophrenia group a history of trauma was significantly related to poor communication skills (r = -0.529, p <0.001) and depressive symptoms (r = 0.443, p = 0.004). Evidence that childhood exposure to trauma is more common in a population with schizophrenia is consistent with other studies and raises the possibility that such trauma is of etiological importance. Further research is required to replicate those findings, to elucidate possible pathways by which the experience of trauma may contribute to the development of schizophrenia, and to explore the relationship between a history of childhood trauma and the experience of depressive symptoms in schizophrenia.

Single-shot characterisation of independent femtosecond extreme ultraviolet free electron andf infrared laser pulses

Two-color above threshold ionization of helium and xenon has been used to analyze the synchronization between individual pulses of the femtosecond extreme ultraviolet (XUV) free electron laser in Hamburg and an independent intense 120 fs mode-locked Ti:sapphire laser. Characteristic sidebands appear in the photoelectron spectra when the two pulses overlap spatially and temporally. The cross-correlation curve points to a 250 fs rms jitter between the two sources at the experiment. A more precise determination of the temporal fluctuation between the XUV and infrared pulses is obtained through the analysis of the single-shot sideband intensities. ©2007 American Institute of Physics

Operation of a free-electron laser from the extreme ultraviolet to the water window

We report results on the performance of a free-electron laser operating at a wavelength of 13.7 nm where unprecedented peak and average powers for a coherent extreme-ultraviolet radiation source have been measured. In the saturation regime, the peak energy approached 170 J for individual pulses, and the average energy per pulse reached 70 J. The pulse duration was in the region of 10 fs, and peak powers of 10 GW were achieved. At a pulse repetition frequency of 700 pulses per second, the average extreme-ultraviolet power reached 20 mW. The output beam also contained a significant contribution from odd harmonics of approximately 0.6% and 0.03% for the 3rd (4.6 nm) and the 5th (2.75 nm) harmonics, respectively. At 2.75 nm the 5th harmonic of the radiation reaches deep into the water window, a wavelength range that is crucially important for the investigation of biological samples.