Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: systematic review and meta-analyses

OBJECTIVES: To evaluate the evidence for strategies to prevent falls or fractures in residents in care homes and hospital inpatients and to investigate the effect of dementia and cognitive impairment. DESIGN: Systematic review and meta-analyses of studies grouped by intervention and setting (hospital or care home). Meta-regression to investigate the effects of dementia and of study quality and design. DATA SOURCES: Medline, CINAHL, Embase, PsychInfo, Cochrane Database, Clinical Trials Register, and hand searching of references from reviews and guidelines to January 2005. RESULTS: 1207 references were identified, including 115 systematic reviews, expert reviews, or guidelines. Of the 92 full papers inspected, 43 were included. Meta-analysis for multifaceted interventions in hospital (13 studies) showed a rate ratio of 0.82 (95% confidence interval 0.68 to 0.997) for falls but no significant effect on the number of fallers or fractures. For hip protectors in care homes (11 studies) the rate ratio for hip fractures was 0.67 (0.46 to 0.98), but there was no significant effect on falls and not enough studies on fallers. For all other interventions (multifaceted interventions in care homes; removal of physical restraints in either setting; fall alarm devices in either setting; exercise in care homes; calcium/vitamin D in care homes; changes in the physical environment in either setting; medication review in hospital) meta-analysis was either unsuitable because of insufficient studies or showed no significant effect on falls, fallers, or fractures, despite strongly positive results in some individual studies. Meta-regression showed no significant association between effect size and prevalence of dementia or cognitive impairment. CONCLUSION: There is some evidence that multifaceted interventions in hospital reduce the number of falls and that use of hip protectors in care homes prevents hip fractures. There is insufficient evidence, however, for the effectiveness of other single interventions in hospitals or care homes or multifaceted interventions in care homes.

The role of voltage gated T-type Ca2+ channel isoforms in mediating "capacitative" Ca2+ entry in cancer cells

The mechanism by which Ca2+ enters electrically non-excitable cells is unclear. The sensitivity of the Ca2+ entry pathway in electrically non-excitable cells to inhibition by extracellular Ni2+ was used to direct the synthesis of a library of simple, novel compounds. These novel compounds inhibit Ca2+ entry into and, consequently, proliferation of several cancer cell lines. They showed stereoselective inhibition of proliferation and Ca2+ influx with identical stereoselective inhibition of heterologously expressed Cav3.2 isoform of T-type Ca2+ channels. Proliferation of human embryonic kidney (HEK)293 cells transfected with the Cav3.2 Ca2+ channel was also blocked. Cancer cell lines sensitive to our compounds express message for the Cav3.2 T-type Ca2+ channel isoform, its delta25B splice variant, or both, while a cell line resistant to our compounds does not. These observations raise the possibility that clinically useful drugs can be designed based upon the ability to block these Ca2+ channels.

The effects of the informal sector on construction

Most construction sectors around the world have a high percentage of output being produced informally. In developing countries informal construction activities can account for as much as 80% of employment (Farrell 2004). In general, the informal sector equates to a significant percentage of country’s GDP — 40% in developing countries and 18% in the OECD high-income countries. The informal sector in construction is not well understood and difficult to measure and is thriving both in the developed and developing world. Construction industries are made up of a large number of small firms and a small number of large firms. Many small firms are less likely to be able (or to want to) afford the bureaucratic demands of a nation’s fiscal and legal system. This evasion means a reduction in tax income for the government, and also leads to inaccurate estimates of the true value of construction output. Some national statistical agencies factor in an estimate of the size of the informal sector, but without effective measurement, there is no guarantee that the estimate is a fair one. The message from the paper is that the informal sector in construction is likely to grow. We need to understand the sector and recognise its impact on construction.

Evaluating a realistic agent in an advice-giving task

The aim of this study was to empirically evaluate an embodied conversational agent called GRETA in an effort to answer two main questions: (1) What are the benefits (and costs) of presenting information via an animated agent, with certain characteristics, in a 'persuasion' task, compared to other forms of display? (2) How important is it that emotional expressions are added in a way that is consistent with the content of the message, in animated agents? To address these questions, a positively framed healthy eating message was created which was variously presented via GRETA, a matched human actor, GRETA's voice only (no face) or as text only. Furthermore, versions of GRETA were created which displayed additional emotional facial expressions in a way that was either consistent or inconsistent with the content of the message. Overall, it was found that although GRETA received significantly higher ratings for helpfulness and likability, presenting the message via GRETA led to the poorest memory performance among users. Importantly, however, when GRETA's additional emotional expressions were consistent with the content of the verbal message, the negative effect on memory performance disappeared. Overall, the findings point to the importance of achieving consistency in animated agents. (c) 2005 Elsevier Ltd. All rights reserved.

Parallel performance and scalability experiments with the Danish Eulerian Model on the EPCC supercomputers

The Danish Eulerian Model (DEM) is a powerful air pollution model, designed to calculate the concentrations of various dangerous species over a large geographical region (e.g. Europe). It takes into account the main physical and chemical processes between these species, the actual meteorological conditions, emissions, etc.. This is a huge computational task and requires significant resources of storage and CPU time. Parallel computing is essential for the efficient practical use of the model. Some efficient parallel versions of the model were created over the past several years. A suitable parallel version of DEM by using the Message Passing Interface library (AIPI) was implemented on two powerful supercomputers of the EPCC - Edinburgh, available via the HPC-Europa programme for transnational access to research infrastructures in EC: a Sun Fire E15K and an IBM HPCx cluster. Although the implementation is in principal, the same for both supercomputers, few modifications had to be done for successful porting of the code on the IBM HPCx cluster. Performance analysis and parallel optimization was done next. Results from bench marking experiments will be presented in this paper. Another set of experiments was carried out in order to investigate the sensitivity of the model to variation of some chemical rate constants in the chemical submodel. Certain modifications of the code were necessary to be done in accordance with this task. The obtained results will be used for further sensitivity analysis Studies by using Monte Carlo simulation.