Effectiveness of continence promotion for older women via community organisations: A cluster randomised trial

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/Objectives: The primary objective of this cluster randomised controlled trial was to compare the effectiveness of the three experimental continence promotion interventions against a control intervention on urinary symptom improvement in older women with untreated incontinence recruited from community organisations. A second objective was to determine whether changes in incontinence-related knowledge and new uptake of risk-modifying behaviours explain these improvements. Setting: 71 community organisations across the UK. Participants: 259 women aged 60 years and older with untreated incontinence entered the trial; 88% completed the 3-month follow-up. Interventions: The three active interventions consisted of a single 60 min group workshop on (1) continence education (20 clusters, 64 women); (2) evidence-based self-management (17 clusters, 70 women); or (3) combined continence education and self-management (17 clusters, 61 women). The control intervention was a single 60 min educational group workshop on memory loss, polypharmacy and osteoporosis (17 clusters, 64 women). Primary and secondary outcome measures: The primary outcome was self-reported improvement in incontinence 3 months postintervention at the level of the individual. The secondary outcome was change in the International Consultation on Incontinence Questionnaire (ICIQ) from baseline to 3-month follow-up. Changes in incontinence-related knowledge and behaviours were also assessed. Results: The highest rate of urinary symptom improvement occurred in the combined intervention group (66% vs 11% of the control group, prevalence difference 55%, 95% CI 43% to 67%, intracluster correlation 0). 30% versus 6% of participants reported significant improvement respectively (prevalence difference 23%, 95% CI 10% to 36%, intracluster correlation 0). The number-needed-to-treat was 2 to achieve any improvement in incontinence symptoms, and 5 to attain significant improvement. Compared to controls, participants in the combined intervention reported an adjusted mean 2.05 point (95% CI 0.87 to 3.24) greater improvement on the ICIQ from baseline to 3-month follow-up. Changes in knowledge and self-reported risk-reduction behaviours paralleled rates of improvement in all intervention arms. Conclusions: Continence education combined with evidence-based self-management improves symptoms of incontinence among untreated older women. Community organisations represent an untapped vector for delivering effective continence promotion interventions.Canadian Institutes of Health Research – Institute on Aging and the Economic and Social Research Council (UK

Simultaneous entanglement swapping of multiple orbital angular momentum states of light

Entanglement swapping generates remote quantum correlations between particles that have not interacted and is the cornerstone of long-distance quantum communication, quantum networks, and fundamental tests of quantum science. In the context of spatial modes of light, high-dimensional entanglement provides an avenue to increase the bandwidth of quantum communications and provides more stringent limits for tests of quantum foundations. Here we simultaneously swap the entanglement of multiple orbital angular momentum states of light. The system is based on a degenerate filter that cannot distinguish between different anti-symmetric states, and thus entanglement swapping occurs for several thousand pairs of spatial light modes simultaneously

The ownership of inshore fisheries in Scotland: An opportunity for community ownership?

The Scottish Government has pledged to reform inshore fisheries by 2020, while the UK Government is in the process of reforming fisheries legislation with the Fisheries Bill, brought forward in anticipation of the departure of the UK from the EU. . As the necessary starting point for any regulatory reform is an understanding of the existing rights subject to regulation, this article investigates the nature of the existing rights to fish in inshore Scottish waters and assesses whether reform of the ownership of Scotland’s fishery needs to be assessed at the same time as its regulation. The article considers the theory behind Scotland’s fishing rights, the extent of the right to fish, the Crown’s right to alienation and the statutory impacts on the right to fish, before finally placing these findings in the context of contemporary developments of Scottish property and land reform la

Assessing proposed designs for a non-invasive DNA collection device suitable for use in possum (Trichosurus vulpecula) population monitoring

The Australian bushtail possum (Trichosurus vulpecula) is an introduced mammalian pest species within New Zealand ecosystems, responsible for causing extensive damage to native flora and fauna at the same time as transmitting bovine tuberculosis between cattle herds. Due to their impact on environments and economies, they are intensively controlled using a variety of methods including aerial toxin delivery and trapping, led by the Department of Conservation and TBfree NZ. Along with control, wildlife managers monitor population trends across the country using an array of monitoring tools developed for various scenarios. One major need for those monitoring T. vulpecula populations is the ability to identify individual animals, to harness an idea of total population abundance and disease prevalence. Non-invasive genetic monitoring from saliva DNA samples taken from WaxTags® has proved promising in the past, however environmental exposure degrades DNA quality making individual identification difficult. This report describes laboratory, pen and field trials aimed at designing a device capable of collecting and preserving DNA samples from possum saliva. A DNA trial investigated the effect of environmental exposure on non-invasively collected saliva samples. After 14 days of weathering, individual possum identifications were at 80% and 20% for covered and uncovered DNA samples respectively. It was found protection following collection significantly increased the ability to genotype saliva based DNA (p = 0.033). Pen trials on captive animals developed prototypes of prospective devices, testing for initial encounter behaviours, trigger rates, ability of animals to re-access triggered baiters and durability throughout possum interactions. Multilocation field trials allowed for comments to be made on the DNA devices ability to calculate population abundances and densities when compared with BMI and RTCI estimates. Other field trial results allow for comments to be made on the devices performance in a realistic environment pertaining to ease of use, non-target interactions and device sensitivity. Finally, a Landcare Research field trial collected 122 saliva samples using the devices described throughout this report, leading to the identifcation of 17 individual possums in a regenerating mixed podocarp forest plot, with a 68% genotyping success rate. Ear notch analysis of 22 subsequently detained individuals revealed 7 matches to the DNA device collections, meaning 10 animals were not caught using leghold traps and 15 animals were not surveyed using DNA devices. This leaves the recommendation that future monitoring operators wishing to accurately calculate population abundance should implement a combination of both live trapping and DNA analysis to complement one another. Finally, future research options are discussed including improved collection media and increasing device sensitivity

Controlled production of the elusive metastable form II of acetaminophen (paracetamol) : a fully scalable templating approach in a cooling environment

A scalable, transferable, cooling crystallisation route to the elusive, metastable, form II of the API acetaminophen (paracetamol) has been developed using a multicomponent "templating" approach, delivering 100% polymorphic phase pure form II at scales up to 120 g. Favourable solubility and stability properties are found for the form II samples

Factors associated with work ability in patients with chronic whiplash-associated disorder grade II-III: a cross-sectional analysis

Objective: To investigate the factors related to self-perceived work ability in patients with chronic whiplash-associated disorder grades II-III. Design: Cross-sectional analysis. Patients: A total of 166 working age patients with chronic whiplash-associated disorder. Methods: A comprehensive survey collected data on work ability (using the Work Ability Index); demographic, psychosocial, personal, work- and condition-related factors. Forward, stepwise regression modelling was used to assess the factors related to work ability. Results: The proportion of patients in each work ability category were as follows: poor (12.7%); moderate (39.8%); good (38.5%); excellent (9%). Seven factors explained 65% (adjusted R2= 0.65, p < 0.01) of the variance in work ability. In descending order of strength of association, these factors are: greater neck disability due to pain; reduced self-rated health status and health-related quality of life; increased frequency of concentration problems; poor workplace satisfaction; lower self-efficacy for performing daily tasks; and greater work-related stress. Conclusion: Condition-specific and psychosocial factors are associated with self-perceived work ability of individuals with chronic whiplash-associated disorder

Giblin Letters Index: Royal Society Collection

Letter from Joseph Milligan, from London, to Thomas Giblin, dated 19 Jan. 1861, refering to jewellery, Fingal gold, exhibitions, etc. Letter from M.A. Giblin to Sir James Agnew enclosing the above letter, 25 April 1901. Royal Society RS.9

A Pretargeted Approach for the Multimodal PET/NIRF Imaging of Colorectal Cancer

The complementary nature of positron emission tomography (PET) and near-infrared fluorescence (NIRF) imaging makes the development of strategies for the multimodal PET/NIRF imaging of cancer a very enticing prospect. Indeed, in the context of colorectal cancer, a single multimodal PET/NIRF imaging agent could be used to stage the disease, identify candidates for surgical intervention, and facilitate the image-guided resection of the disease. While antibodies have proven to be highly effective vectors for the delivery of radioisotopes and fluorophores to malignant tissues, the use of radioimmunoconjugates labeled with long-lived nuclides such as 89Zr poses two important clinical complications: high radiation doses to the patient and the need for significant lag time between imaging and surgery. In vivo pretargeting strategies that decouple the targeting vector from the radioactivity at the time of injection have the potential to circumvent these issues by facilitating the use of positron-emitting radioisotopes with far shorter half-lives. Here, we report the synthesis, characterization, and in vivo validation of a pretargeted strategy for the multimodal PET and NIRF imaging of colorectal carcinoma. This approach is based on the rapid and bioorthogonal ligation between a trans-cyclooctene- and fluorophore-bearing immunoconjugate of the huA33 antibody (huA33-Dye800-TCO) and a 64Cu-labeled tetrazine radioligand (64Cu-Tz-SarAr). In vivo imaging experiments in mice bearing A33 antigen-expressing SW1222 colorectal cancer xenografts clearly demonstrate that this approach enables the non-invasive visualization of tumors and the image-guided resection of malignant tissue, all at only a fraction of the radiation dose created by a directly labeled radioimmunoconjugate. Additional in vivo experiments in peritoneal and patient-derived xenograft models of colorectal carcinoma reinforce the efficacy of this methodology and underscore its potential as an innovative and useful clinical tool

G_2 Perfect-Fluid Cosmologies with a proper conformal Killing vector

We study the Einstein field equations for spacetimes admitting a maximal two-dimensional abelian group of isometries acting orthogonally transitively on spacelike surfaces and, in addition, with at least one conformal Killing vector. The three-dimensional conformal group is restricted to the case when the two-dimensional abelian isometry subalgebra is an ideal and it is also assumed to act on non-null hypersurfaces (both, spacelike and timelike cases are studied). We consider both, diagonal and non-diagonal metrics and find all the perfect-fluid solutions under these assumptions (except those already known). We find four families of solutions, each one containing arbitrary parameters for which no differential equations remain to be integrated. We write the line-elements in a simplified form and perform a detailed study for each of these solutions, giving the kinematical quantities of the fluid velocity vector, the energy-density and pressure, values of the parameters for which the energy conditions are fulfilled everywhere, the Petrov type, the singularities in the spacetimes and the Friedmann-Lemaitre-Robertson-Walker metrics contained in each family.Comment: Latex, no figure

Prevalence-Dependent Costs of Parasite Virulence

Costs of parasitism are commonly measured by comparing the performance of infected groups of individuals to that of uninfected control groups. This measure potentially underestimates the cost of parasitism because it ignores indirect costs, which may result from the modification of the competitiveness of the hosts by the parasite. In this context, we used the host-parasite system consisting of the yellow fever mosquito Aedes aegypti and the microsporidian parasite Vavraia culicis to address this question: Do infected individuals exert a more or less intense intraspecific competition than uninfected individuals? Our experimental results show that, indeed, infected hosts incur a direct cost of parasitism: It takes them longer to become adults than uninfected individuals. They also incur an indirect cost, however, which is actually larger than the direct cost: When grown in competition with uninfected individuals they develop even slower. The consequence of this modification of competitiveness is that, in our system, the cost of parasitism is underestimated by the traditional measure. Moreover, because the indirect cost depends on the frequency of interactions between infected and uninfected individuals, our results suggest that the real cost of parasitism, i.e., virulence, is negatively correlated with the prevalence of the parasite. This link between prevalence and virulence may have dynamical consequences, such as reducing the invasion threshold of the parasite, and evolutionary consequences, such as creating a selection pressure maintaining the host's constitutive resistance to the parasite