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

Classical Teichmuller theory and (2+1) gravity

We consider classical Teichmuller theory and the geodesic flow on the cotangent bundle of the Teichmuller space. We show that the corresponding orbits provide a canonical description of certain (2+1) gravity systems in which a set of point-like particles evolve in universes with topology S_g x R where S_g is a Riemann surface of genus g >1. We construct an explicit York's slicing presentation of the associated spacetimes, we give an interpretation of the asymptotic states in terms of measured foliations and discuss the structure of the phase spaces

Combinatorial Hopf algebra of superclass functions of type DD

We provide a Hopf algebra structure on the space of superclass functions on the unipotent upper triangular group of type D over a finite field based on a supercharacter theory constructed by Andr\'e and Neto. Also, we make further comments with respect to types B and C. Type A was explores by M. Aguiar et. al (2010), thus this paper is a contribution to understand combinatorially the supercharacter theory of the other classical Lie types.Comment: Last section modified. Recent development added and correction with respect to previous version state

Trophic compensation stabilizes marine primary producers exposed to artificial light at night

Artificial light at night (ALAN) is a widespread phenomenon along coastal areas. Despite in - creasing evidence of pervasive effects of ALAN on patterns of species distribution and abundance, the potential of this emerging threat to alter ecological processes in marine ecosystems has remained largely unexplored. Here, we show how exposure to white LED lighting, comparable to that experienced along local urbanized coasts, significantly enhanced the impact of grazing gastropods on epilithic microphytobenthos (MPB). ALAN increased both the photo-synthetic biomass of MPB and the grazing pressure of gastropods, such that consumers compensated for the positive effect of night lighting on primary producers. Our results indicate that trophic interactions can provide a stabilizing compensatory mechanism against ALAN effects in natural food webs

Ecological feedback mechanisms and variable disturbance regimes: the uncertain future of Mediterranean macroalgal forests

Loss of algal canopies can result in a shift towards a turf-dominated state, where variability in species life-history traits can determine new mechanisms of feedback, and influence the degraded system under variable regimes of disturbance. By focusing on rockpools dominated by Cystoseira brachycarpa, we tested the hypothesis that the alga Dictyopteris polypodioides could take advantage of extreme regimes of disturbance related to storms, and outcompete other turfs through a distinctive combination of life traits. Replacement of the canopy was initially driven by a mix of taxon-specific life-traits and resulting assemblages were susceptible to intense events of disturbance. Subsequently, D. polypodioides dominated removal quadrats, favored by density-dependent abilities to intercept more light and reach larger size than the rest of turf. These new positive feedbacks may contribute to maintain the modified state of the system and influence its ability to withstand extreme abiotic conditions

Hybrid Vector and Method Resulting in Protein Overproduction by Eukaryotic Cells

A hybrid vector carrying a first and second DNA segments operationally linked thereto, the first DNA segment encoding a protein capable of cross-linking to the cap structure of mRNA and mediating ribosome-binding, and the second DNA segment encoding a polypeptide or protein, the vector being capable of replication, transcription and translation to express the factor and the polypeptide or protein upon transformation of a eukaryotic host, and the polypeptide or protein being expressed at a level higher than the level of expression thereof in the absence of the first DNA segment. A eukaryotic host is transformed with this hybrid vector. Also disclosed is a method of increasing the synthesis of a polypeptide or protein in a eukaryotic host cell