Are Albumin Levels a Good Predictor of Mortality in Elderly Patients with Neck of Femur Fractures?

Background Neck of femur (NOF) fractures are associated with significant morbidity and mortality in elderly people with multiple co-morbidities; making management of this patient subgroup challenging. Predictors of an increase in morbidity and mortality would therefore provide a useful framework for the assessment and management of this demographic. Within the current literature, hypoalbuminaemia (<35g/dl) has been highlighted as being a good biochemical predictor of short-term mortality (<12 months). Our aims were to assess whether there was an association between low albumin levels and short-term mortality and whether the severity adversely affects outcomes. Materials and Methods Patients admitted to our large district hospital between January 2011 and December 2012 who had sustained a NOF fracture, were over 65 years old and had a pre-operative albumin level were included. The study concluded in July 2014. Demographic and pre-operative function and albumin data was collated retrospectively. Correlation with mortality was made. Results 471 patients had usable data. Mean pre-operative albumin level was 29.5g/dl (SD 6.22g/dl) in patients who died and 32.8g/dl (SD 6.43g/dl) in patients who survived during the study period. Pre-operative albumin level was significantly associated with survival (hazard ratio0.957: 95% CI (0.937, 0.978); p<0.001) A reduction of 1g/dl in pre-operative albumin is associated with an increased hazard of death of 4.3%. Conclusions Early identification of patients with hypoalbuminaemia on admission with a venous blood sample and timely input from orthogeriatrians could optimise these patients pre- and post-operatively. This may enable rates of morbidity and mortality to fall. Hypoalbuminaemia may be a reasonable predictor of shorter-term mortality in this patient subgroup. However, this may reflect existing co-morbidities rather than an isolated cause. This study supports a correlation between hypoalbuminaemia and poorer outcome for patients with NOF fractures

Space power distribution system technology. Volume 2: Autonomous power management

Electrical power subsystem requirements, power management system functional requirements, algorithms, power management subsystem, hardware development, and trade studies and analyses are discussed

'It's a Form of Freedom': The experiences of people with disabilities within equestrian sport

This paper explores the embodied, gendered experiences of disabled horse‐riders. Drawing on data from five in‐depth interviews with paradressage riders, the ways in which their involvement in elite disability sport impacts upon their sense of identity and confidence are explored, as well as the considerable health and social benefits that this involvement brings. Social models of disability are employed and the shortcomings of such models, when applied to disability sport, are highlighted. The data presented here demonstrates the necessity of seeing disability sport as an embodied experience and acknowledging the importance of impairment to the experiences of disabled athletes. Living within an impaired body is also a gendered experience and the implications of this when applied to elite disability sport are considered

Learning masculinities in a Japanese high school rugby club

This paper draws on research conducted on a Tokyo high school rugby club to explore diversity in the masculinities formed through membership in the club. Based on the premise that particular forms of masculinity are expressed and learnt through ways of playing (game style) and the attendant regimes of training, it examines the expression and learning of masculinities at three analytic levels. It identifies a hegemonic, culture-specific form of masculinity operating in Japanese high school rugby, a class-influenced variation of it at the institutional level of the school and, by further tightening its analytic focus, further variation at an individual level. In doing so this paper highlights the ways in which diversity in the masculinities constructed through contact sports can be obfuscated by a reductionist view of there being only one, universal hegemonic patterns of masculinity

Automatic building information model query generation

Energy efficient building design and construction calls for extensive collaboration between different subfields of the Architecture, Engineering and Construction (AEC) community. Performing building design and construction engineering raises challenges on data integration and software interoperability. Using Building Information Modeling (BIM) data hub to host and integrate building models is a promising solution to address those challenges, which can ease building design information management. However, the partial model query mechanism of current BIM data hub collaboration model has several limitations, which prevents designers and engineers to take advantage of BIM. To address this problem, we propose a general and effective approach to generate query code based on a Model View Definition (MVD). This approach is demonstrated through a software prototype called QueryGenerator. By demonstrating a case study using multi-zone air flow analysis, we show how our approach and tool can help domain experts to use BIM to drive building design with less labour and lower overhead cost.published_or_final_versio

Researching trust in the police and trust in justice: a UK perspective

This paper describes the immediate and more distant origins of a programme of comparative research that is examining cross-national variations in public trust in justice and in the police. The programme is built around a module of the fifth European Social Survey, and evolved from a study funded by the European Commission. The paper describes the conceptual framework within which we are operating – developed in large measure from theories of procedural justice. It reviews some of the methodological issues raised by the use of sample surveys to research issues of public trust in the police, public perceptions of institutional legitimacy and compliance with the law. Finally it gives a flavour of some of the early findings emerging from the programme

"It is what it is": masculinity, homosexuality, and inclusive discourse in mixed martial arts

In this paper we make use of inclusive masculinity theory to explore online media representations of male homosexuality and masculinity within the increasingly popular combat sport of mixed martial arts MMA). Adopting a case-study approach, we discuss narratives constructed around one aspirational male MMA fighter, Dakota Cochrane, whose history of having participated in gay pornography became a major talking point on a number of MMA 'fanzine'/'community' websites during early 2012. While these narratives attempted to discursively 'rescue' Cochrane's supposedly threatened masculinity, highlighting both his 'true' heterosexuality and his prodigious fighting abilities, they also simultaneously celebrated the acceptance of homosexual men within the sport which Cochrane's case implied. Thus, we suggest that these media representations of homosexuality and masculinity within MMA are indicative of declining cultural homophobia and homohysteria, and an inclusive vision of masculinity, as previously described by proponents of inclusive masculinity theory

Together, yet still not equal? Sex integration in equestrian sport

Sex segregation is a core organising principle of most modern sports and is a key element in the marginalisation and subordination of girls and women in sport and beyond. In this article I explore the only Olympic-level sport which is not organised around sex segregation – equestrian sport – in order to consider the implications of sex integration for female participants. I draw on a study conducted on elite riders that found that although sex integration in equestrian sport does not lead to female participants being excluded from high-level competition, men continue to perform disproportionately well. This suggests that although sex integration may be an important step towards breaking down gender hierarchies in sport, without accompanying wider changes in gender norms and expectations, sex integration alone will not be enough to achieve greater gender equality in equestrian sport

Sexual harassment and abuse in sport: The research context

This special issue of the Journal of Sexual Aggression draws on the contributions to a Symposium on ‘Sexual Harassment in Sport – Challenges for Sport Psychology in the New Millennium’, held at the Xth Congress of the International Society for Sport Psychology, Skiathos, Greece from May 28th to June 2nd 2001. The symposium, which was organised by the authors of this editorial, was intended to move forward the international research agenda on sexual harassment and abuse in sport and to examine professional practice issues for sport psychologists. It was clear from the attendance of over 60 delegates at that symposium that international interest in this subject is growing. Further evidence of this came from the attendance of 26 members states – from Azerbaijan to Sweden - at a Council of Europe seminar on The Protection of Children, Young People and Women in Sport, held in Helsinki in September 2001