Economic evaluation of a community based exercise programme to prevent falls

OBJECTIVE: To assess the incremental costs and cost effectiveness of implementing a home based muscle strengthening and balance retraining programme that reduced falls and injuries in older women. DESIGN: An economic evaluation carried out within a randomised controlled trial with two years of follow up. Participants were individually prescribed an exercise programme (exercise group, n=116) or received usual care and social visits (control group, n=117). SETTING: 17 general practices in Dunedin, New Zealand. PARTICIPANTS: Women aged 80 years and older living in the community and invited by their general practitioner to take part. MAIN OUTCOME MEASURES: Number of falls and injuries related to falls, costs of implementing the intervention, healthcare service costs resulting from falls and total healthcare service costs during the trial. Cost effectiveness was measured as the incremental cost of implementing the exercise programme per fall event prevented. MAIN RESULTS: 27% of total hospital costs during the trial were related to falls. However, there were no significant differences in health service costs between the two groups. Implementing the exercise programme for one and two years respectively cost $314 and$265 (1995 New Zealand dollars) per fall prevented, and $457 and$426 per fall resulting in a moderate or serious injury prevented. CONCLUSIONS: The costs resulting from falls make up a substantial proportion of the hospital costs for older people. Despite a reduction in falls as a result of this home exercise programme there was no significant reduction in healthcare costs. However, the results reported will provide information on the cost effectiveness of the programme for those making decisions on falls prevention strategies

Reduced flow impacts salmonid smolt emigration in a river with low-head weirs

The impacts of large dams on the hydrology and ecology of river systems are well understood, yet the impacts of low-head structures are poorly known. While impacts of small weirs on upstream-migrating fish have long been mitigated by fish ladders, it is assumed that downstream migration of surface-oriented fishes is unaffected under natural flow regimes. To test this, the effects of low-head weirs and the influence of river flow on the migration of brown trout (Salmo trutta) smolts in the River Tweed, UK, were examined. Movements of acoustic tagged smolts were quantified in 2010 and 2011 using automatic listening stations and manual tracking throughout the migration route. In both years, smolts exhibited major losses, most likely due to predators, with escapement rates of 19% in 2010 and 45% in 2011. Loss rates were greater in 2010 when flows were frequently below Q95 (20% of study period) compared to 2011 when more typical flows predominated (0% of study period below Q95). Smolts experienced significantly longer delays at weirs during 2010 than 2011, associated with the different hydrographs during emigration as well as weir design. Flow comparisons within the study periods and historical records show that low flows experienced in 2010 were not unusual. The swimming behaviour of smolts in relation to flow conditions differed between years, with smolts in 2010 increasing their rate of movement in relation to increasing flow at a faster rate than smolts in 2011. This is the first study to demonstrate river flow impacts on the migration success of wild salmonid smolts at small weirs. Because small weirs are common in rivers and because spring-summer low-flow periods may become more frequent with climate change (based on UKCIP09 models) and altered river hydrology, further research and improved management is needed to reduce the impacts of low river flows in combination with low-head weirs on salmonid smolt migration

Report of the SNOMS Project 2006 to 2012, SNOMS SWIRE NOCS Ocean Monitoring System. Part 1: Narrative description

The ocean plays a major role in controlling the concentration of carbon dioxide (CO2) in the atmosphere. Increasing concentrations of CO2 in the atmosphere are a threat to the stability of the earth’s climate. A better understanding of the controlling role of the ocean will improve predictions of likely future changes in climate and the impact of the uptake of CO2 itself on marine eco-systems caused by the associated acidification of the ocean waters. The SNOMS Project (SWIRE NOCS Ocean Monitoring System) is a ground breaking joint research project supported by the Swire Group Trust, the Swire Educational Trust, the China Navigation Company (CNCo) and the Natural Environment Research Council. It collects high quality data on concentrations of CO2 in the surface layer of the ocean. It contributes to the international effort to better quantify (and understand the driving processes controlling) the exchanges of CO2 between the ocean and the atmosphere. In 2006 and 2007 a system that could be used on a commercial ship to provide data over periods of several months with only limited maintenance by the ships crew was designed and assembled by NOCS. The system was fitted to the CNCo ship the MV Pacific Celebes in May 2007. The onboard system was supported by web pages that monitored the progress of the ship and the functioning of the data collection system. To support the flow of data from the ship to the archiving of the data at the Carbon Dioxide Information Analysis Center (CDIAC in the USA) data processing procedures were developed for the quality control and systematic handling of the data. Data from samples of seawater collected by the ships crew and analysed in NOC (730 samples) have been used to confirm the consistency of the data from the automated measurement system on the ship. To examine the data collected between 2007 and 2012 the movements of the ship are divided into 16 voyages. Initially The Celebes traded on a route circum-navigating the globe via the Panama and Suez Canals. In 2009 the route shifted to one between Australia and New Zealand to USA and Canada. Analysis of the data is an on going process. It has demonstrated that the system produces reliable data. Data are capable of improving existing estimates of seasonal variability. The work has improved knowledge of gas exchange processes. Data from the crew-collected-samples are helping improve our ability to estimate alkalinity in different areas. This helps with the study of ocean acidification. Data from the 9 round trips in the Pacific are currently being examined along with data made available by the NOAA-PMEL laboratory forming time series from 2004 to 2012. The data from the Pacific route are of considerable interest. One reason is that the data monitors variations in the fluxes of CO2 associated with the current that flows westwards along the equator. This is one of the major natural sources of CO2 from the ocean into the atmosphere

Factors contributing to the time taken to consult with symptoms of lung cancer: a cross-sectional study

<b>Objectives</b>: To determine what factors are associated with the time people take to consult with symptoms of lung cancer, with a focus on those from rural and socially deprived areas. <b>Methods</b>: A cross-sectional quantitative interview survey was performed of 360 patients with newly diagnosed primary lung cancer in three Scottish hospitals (two in Glasgow, one in NE Scotland). Supplementary data were obtained from medical case notes. The main outcome measures were the number of days from (1) the date participant defined first symptom until date of presentation to a medical practitioner; and (2) the date of earliest symptom from a symptom checklist (derived from clinical guidelines) until date of presentation to a medical practitioner. <b>Results</b>: 179 participants (50%) had symptoms for more than 14 weeks before presenting to a medical practitioner (median 99 days; interquartile range 31–381). 270 participants (75%) had unrecognised symptoms of lung cancer. There were no significant differences in time taken to consult with symptoms of lung cancer between rural and/or deprived participants compared with urban and/or affluent participants. Factors independently associated with increased time before consulting about symptoms were living alone, a history of chronic obstructive pulmonary disease (COPD) and longer pack years of smoking. Haemoptysis, new onset of shortness of breath, cough and loss of appetite were significantly associated with earlier consulting, as were a history of chest infection and renal failure. <b>Conclusion</b>: For many people with lung cancer, regardless of location and socioeconomic status, the time between symptom onset and consultation was long enough to plausibly affect prognosis. Long-term smokers, those with COPD and/or those living alone are at particular risk of taking longer to consult with symptoms of lung cancer and practitioners should be alert to this

Correlated hopping of electrons: Effect on the Brinkman-Rice transition and the stability of metallic ferromagnetism

We study the Hubbard model with bond-charge interaction (`correlated hopping') in terms of the Gutzwiller wave function. We show how to express the Gutzwiller expectation value of the bond-charge interaction in terms of the correlated momentum-space occupation. This relation is valid in all spatial dimensions. We find that in infinite dimensions, where the Gutzwiller approximation becomes exact, the bond-charge interaction lowers the critical Hubbard interaction for the Brinkman-Rice metal-insulator transition. The bond-charge interaction also favors ferromagnetic transitions, especially if the density of states is not symmetric and has a large spectral weight below the Fermi energy.Comment: 5 pages, 3 figures; minor changes, published versio

Memory usage verification using Hip/Sleek.

Embedded systems often come with constrained memory footprints. It is therefore essential to ensure that software running on such platforms fulfils memory usage specifications at compile-time, to prevent memory-related software failure after deployment. Previous proposals on memory usage verification are not satisfactory as they usually can only handle restricted subsets of programs, especially when shared mutable data structures are involved. In this paper, we propose a simple but novel solution. We instrument programs with explicit memory operations so that memory usage verification can be done along with the verification of other properties, using an automated verification system Hip/Sleek developed recently by Chin et al.[10,19]. The instrumentation can be done automatically and is proven sound with respect to an underlying semantics. One immediate benefit is that we do not need to develop from scratch a specific system for memory usage verification. Another benefit is that we can verify more programs, especially those involving shared mutable data structures, which previous systems failed to handle, as evidenced by our experimental results

Rigorous results on superconducting ground states for attractive extended Hubbard models

We show that the exact ground state for a class of extended Hubbard models including bond-charge, exchange, and pair-hopping terms, is the Yang "eta-paired" state for any non-vanishing value of the pair-hopping amplitude, at least when the on-site Coulomb interaction is attractive enough and the remaining physical parameters satisfy a single constraint. The ground state is thus rigorously superconducting. Our result holds on a bipartite lattice in any dimension, at any band filling, and for arbitrary electron hopping.Comment: 12 page

Symmetry-breaking instability in a prototypical driven granular gas

Symmetry-breaking instability of a laterally uniform granular cluster (strip state) in a prototypical driven granular gas is investigated. The system consists of smooth hard disks in a two-dimensional box, colliding inelastically with each other and driven, at zero gravity, by a "thermal" wall. The limit of nearly elastic particle collisions is considered, and granular hydrodynamics with the Jenkins-Richman constitutive relations is employed. The hydrodynamic problem is completely described by two scaled parameters and the aspect ratio of the box. Marginal stability analysis predicts a spontaneous symmetry breaking instability of the strip state, similar to that predicted recently for a different set of constitutive relations. If the system is big enough, the marginal stability curve becomes independent of the details of the boundary condition at the driving wall. In this regime, the density perturbation is exponentially localized at the elastic wall opposite to the thermal wall. The short- and long-wavelength asymptotics of the marginal stability curves are obtained analytically in the dilute limit. The physics of the symmetry-breaking instability is discussed.Comment: 11 pages, 14 figure

Fluctuations and Intrinsic Pinning in Layered Superconductors

A flux liquid can condense into a smectic crystal in a pure layered superconductors with the magnetic field oriented nearly parallel to the layers. If the smectic order is commensurate with the layering, this crystal is {\sl stable} to point disorder. By tilting and adjusting the magnitude of the applied field, both incommensurate and tilted smectic and crystalline phases are found. We discuss transport near the second order smectic freezing transition, and show that permeation modes lead to a small non--zero resistivity and large but finite tilt modulus in the smectic crystal.Comment: 4 pages + 1 style file + 1 figure (as uufile) appended, REVTEX 3.