Effect of Preventive Home Visits by a Nurse on the Outcomes of Frail Elderly People in the Community: a randomized controlled trial

Background: Timely recognition and prevention of health problems among elderly people have been shown to improve their health. In this randomized controlled trial the authors examined the impact of preventive home visits by a nurse compared with usual care on the outcomes of frail elderly people living in the community. Methods: A screening questionnaire identified eligible participants (those aged 70 years or more at risk of sudden deterioration in health). Those randomly assigned to the visiting nurse group were assessed and followed up in their homes for 14 months. The primary outcome measure was the combined rate of deaths and admissions to an institution, and the secondary outcome measure the rate of health services utilization, during the 14 months; these rates were determined through a medical chart audit by a research nurse who was blind to group allocation. Results: The questionnaire was mailed to 415 elderly people, of whom 369 (88.9%) responded. Of these, 198 (53.7%) were eligible, and 142 consented to participate and were randomly assigned to either the visiting nurse group (73) or the usual care group (69). The combined rate of deaths and admissions to an institution was 10.0% in the visiting nurse group and 5.8% in the usual care group (p = 0.52). The rate of health services utilization did not differ significantly between the 2 groups. Influenza and pneumonia vaccination rates were significantly higher in the visiting nurse group (90.1% and 81.9%) than in the usual care group (53.0% and 0%) (p \u3c 0.001). Interpretation: The trial failed to show any effect of a visiting nurse other than vastly improved vaccination coverage

Screening Seniors for Risk of Functional Decline: Results of a Survey in Family Practice

To measure functional status, determine risk of functional decline and assess consistency between responses and standardized instruments. Design: A mailed survey which measured functional impairment, recent hospitalization and bereavement. A positive response on at least one of these factors indicated that the individual was “at risk” for functional decline. A random sample (n=73) of “at risk” subjects (specifically, family practice patients aged 70 and older) were assessed by a nurse. Results: The response rate was 89% (369/415), 59% of seniors were female and the mean age was 77.1 (SD=5.5) years. Self-reported risk, based on activities of daily living (ADLs), was associated with impairment in at least one basic ADL (p\u3c0.0005) using a standardized instrument. The positive predictive value of the survey for ADL impairment was 65%. Conclusion: Response to a mailed survey was high and self-reported ADL risks were consistent with findings from standardized assessment tools

First-passage theory of exciton population loss in single-walled carbon nanotubes reveals micron-scale intrinsic diffusion lengths

One-dimensional crystals have long range translational invariance which manifests as long exciton diffusion lengths, but such intrinsic properties are often obscured by environmental perturbations. We use a first-passage approach to model single-walled carbon nanotube (SWCNT) exciton dynamics (including exciton-exciton annihilation and end effects) and compare it to results from both continuous-wave and multi-pulse ultrafast excitation experiments to extract intrinsic SWCNT properties. Excitons in suspended SWCNTs experience macroscopic diffusion lengths, on the order of the SWCNT length, (1.3-4.7 um) in sharp contrast to encapsulated samples. For these pristine samples, our model reveals intrinsic lifetimes (350-750 ps), diffusion constants (130-350 cm^2/s), and absorption cross-sections (2.1-3.6 X 10^-17 cm^2/atom) among the highest previously reported.and diffusion lengths for SWCNTs.Comment: 6 pages, 3 figure

The size, density, and formation of the Orcus-Vanth system in the Kuiper belt

The Kuiper belt object Orcus and its satellite Vanth form an unusual system in the Kuiper belt. Orcus is amongst the largest objects known in the Kuiper belt, but the relative size of Vanth is much larger than that of the tiny satellites of the other large objects. From Hubble Space Telescope observations we find that Orcus and Vanth have different visible colors and that Vanth does not share the water ice absorption feature seen in the infrared spectrum of Orcus. We also find that Vanth has a nearly face-on circular orbit with a period of 9.5393 +-0.0001 days and semimajor axis of 8980+-20 km, implying a system mass of 6.32+- 0.01 X 10^20 kg or 3.8% the mass of dwarf planet Eris. From Spitzer Space Telescope observations we find that the thermal emission is consistent with a single body with diameter 940+-70 km and a geometric albedo of 0.28+-0.04. Assuming equal densities and albedos, this measurements implies sizes of Orcus and Vanth of 900 and 280 km, respectively, and a mass ratio of 33. Assuming a factor of 2 lower albedo for the non-icy Vanth, however, implies sizes of 820 and 640 km and a mass ratio of 2. The measured density depends on the assumed albedo ratio of the two objects but is approximately 1.5+-0.3 g cm^-3$, midway between typical densities measured for larger and for smaller objects. The orbit and mass ratio is consistent with formation from a giant impact and subsequent outward tidal evolution and even consistent with the system having now achieved a double synchronous state. The system can equally well be explained, however, by initial eccentric capture, Kozai cycling which increases the eccentricity and decreases the pericenter of the orbit of Vanth, and subsequent tidal evolution inward.Comment: Submitted to A

Effect of folic acid supplementation in pregnancy on preeclampsia: The folic acid clinical trial study

Copyright © 2013 Shi Wu Wen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Preeclampsia (PE) is hypertension with proteinuria that develops during pregnancy and affects at least 5% of pregnancies. The Effect of Folic Acid Supplementation in Pregnancy on Preeclampsia: the Folic Acid Clinical Trial (FACT) aims to recruit 3,656 high risk women to evaluate a new prevention strategy for PE: supplementation of folic acid throughout pregnancy. Pregnant women with increased risk of developing PE presenting to a trial participating center between 80/7 and 166/7 weeks of gestation are randomized in a 1: 1 ratio to folic acid 4.0 mg or placebo after written consent is obtained. Intent-to-treat population will be analyzed. The FACT study was funded by the Canadian Institutes of Health Research in 2009, and regulatory approval from Health Canada was obtained in 2010. A web-based randomization system and electronic data collection system provide the platform for participating centers to randomize their eligible participants and enter data in real time. To date we have twenty participating Canadian centers, of which eighteen are actively recruiting, and seven participating Australian centers, of which two are actively recruiting. Recruitment in Argentina, UK, Netherlands, Brazil, West Indies, and United States is expected to begin by the second or third quarter of 2013. This trial is registered with NCT01355159. © 2013 Shi Wu Wen et al.The Canadian Institutes of Healt

Effects of Process Variables and Size Scale on Solidification Microstructure in Laser-Based Solid Freeform Fabrication of Ti-6Al-4V

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