Hip protectors to prevent hip fractures - a waste of time and money?

Abstract:
Background: An estimated 30-60% of older
adults fall every year and about 1% of falls result in a hip fracture. Hip fracture is a serious and growing problem, with a 3-10 fold rise in worldwide incidence predicted by 2050 (Gullberg, et al 1997). Hip protectors are underwear with built in protection for the greater trochanter. They are designed to prevent hip fractures by dispersing or absorbing the force of a fall. Trials
published to 2001 were broadly supportive of
the effectiveness of hip protectors, and this
was reflected in a Cochrane review in 2000.
However, earlier trials were methodologically
flawed and subsequent trials have not demonstrated effectiveness. The most recent Cochrane review describes only a marginal benefit (Parker et al, 2005).
Review and Discussion: This presentation
evaluates the current evidence for the use
of hip protectors and discusses the use of
that evidence by manufacturers, suppliers,
professional groups and guideline developers.
Interestingly, despite the limitations of the
evidence base, most advice has been broadly
supportive. Reasons for this are proposed
and discussed in the context of a critique of
evidence-based healthcare. protectors. However, the available evidence can be used in different ways and for different purposes by those with an interest in promoting
the use of hip protectors. A conservative
approach is warranted, where, if we cannot
demonstrate that hip protectors work, we
presume that they do not. This presentation will be of use to practitioners wanting to evaluate the evidence base for hip protectors (and other recommended interventions) on behalf of clients. It will also be of interest to policy makers who must assess the claims made for health care technologies as part of the decisionmaking process.
Recommended reading:
Gullberg B, Johnell O, Kanis JA (1997) Worldwide
projections for hip fracture. Osteoporos
Int. 7(5):407-13 .
Parker MJ, Gillespie WJ, Gillespie LD (2005) Hip
protectors for preventing hip fractures in older
people. The Cochrane Database of Systematic
Reviews Issue 3. Art. No.: CD001255.pub3. DOI:
10.1002/14651858.CD001255.pub3.

A new look at dual-hop relaying: Performance limits with hardware impairments

Physical transceivers have hardware impairments that create distortions which degrade the performance of communication systems. The vast majority of technical contributions in the area of relaying neglect hardware impairments and, thus, assume ideal hardware. Such approximations make sense in low-rate systems, but can lead to very misleading results when analyzing future high-rate systems. This paper quantifies the impact of hardware impairments on dual-hop relaying, for both amplify-and-forward and decode-and-forward protocols. The outage probability (OP) in these practical scenarios is a function of the effective end-to-end signal-to-noise-and-distortion ratio (SNDR). This paper derives new closed-form expressions for the exact and asymptotic OPs, accounting for hardware impairments at the source, relay, and destination. A similar analysis for the ergodic capacity is also pursued, resulting in new upper bounds. We assume that both hops are subject to independent but non-identically distributed Nakagami-m fading. This paper validates that the performance loss is small at low rates, but otherwise can be very substantial. In particular, it is proved that for high signal-to-noise ratio (SNR), the end-to-end SNDR converges to a deterministic constant, coined the SNDR ceiling, which is inversely proportional to the level of impairments. This stands in contrast to the ideal hardware case in which the end-to-end SNDR grows without bound in the high-SNR regime. Finally, we provide fundamental design guidelines for selecting hardware that satisfies the requirements of a practical relaying system.