Negotiating the challenges of ageing as a British migrant in Spain

There has been a proliferation of research on lifestyle migration, including studies of older people who move from Northern to Southern European countries in retirement. This body of research has generally focused on ‘third age’ retirees who exercise mobility to improve their quality of life and to achieve optimal ageing, and these healthy and active migrants are yet to face the challenges associated with the fourth age. In this paper we focus on how retirees in both the third and fourth ages of life experience and exercise mobility and how some experience the transition from ‘young old’ to ‘old old’ age in Spain. Whilst the third age is characterised by new opportunities and activities, the fourth age is a time of decreasing mobility, dependence and bodily decline. We bring together narrative interview data from two separate studies undertaken with older British people in Spain to examine three main issues: first we uniquely unravel how the experiences and identities of retired migrants change in response to the ageing body; second, we explore the strategies deployed by retired migrants to manage the fourth age; and third, we explicate how lifestyle migration as a theoretical category captures the experiences of migrants in their fourth age. This paper therefore presents an original contribution to knowledge by exploring how lifestyle migrants transition from the third to the fourth age, in particular how they negotiate bodily decline and decreasing mobility. We indicate that ageing represents an important structural context that both enables and restricts opportunities and experiences of mobility

Adaptable night camouflage by cuttlefish

Author Posting. © University of Chicago Press, 2007. This article is posted here by permission of University of Chicago Press for personal use, not for redistribution. The definitive version was published in American Naturalist 169 (2007): 543–551, doi:10.1086/512106.Cephalopods are well known for their diverse, quick‐changing camouflage in a wide range of shallow habitats worldwide. However, there is no documentation that cephalopods use their diverse camouflage repertoire at night. We used a remotely operated vehicle equipped with a video camera and a red light to conduct 16 transects on the communal spawning grounds of the giant Australian cuttlefish Sepia apama situated on a temperate rock reef in southern Australia. Cuttlefish ceased sexual signaling and reproductive behavior at dusk and then settled to the bottom and quickly adapted their body patterns to produce camouflage that was tailored to different backgrounds. During the day, only 3% of cuttlefish were camouflaged on the spawning ground, but at night 86% (71 of 83 cuttlefish) were camouflaged in variations of three body pattern types: uniform (n=5), mottled (n=33), or disruptive (n=34) coloration. The implication is that nocturnal visual predators provide the selective pressure for rapid, changeable camouflage patterning tuned to different visual backgrounds at night.This work was made possible by grant 7456-03 from the National Geographic Society Committee on Research and Exploration and support from the Sholley Foundation

The Effect of Preoperative Opioid Education on Patient’s Postoperative Opioid Usage Following Hip Arthroscopy: A Randomized, Prospective Trial

Introduction: Over the past twenty years, opioid usage has continued to rise significantly, resulting in what many have termed an “opioid epidemic”. Several studies have noted that patients are routinely over-prescribed opioids following common surgical procedures, resulting in a large number of unused and therefore readily available opioid pills. Additionally, the highest reported age population for illicit drug usage is in individuals ages 20-39 years old, which is the same group that commonly undergoes hip arthroscopy. A previous study in patients undergoing arthroscopic rotator cuff repair demonstrated that patients who received pre-operative opioid education consumed significantly less opioids 3 months after surgery than those patients who did not receive the pre-operative education. As a result, further investigation is necessary in patients undergoing hip arthroscopy to determine the potential effects opioid education materials have on this patient population. The primary objective of this study was to investigate the effect that a pre-operative opioid educational video has on patient’s opioid consumption following hip arthroscopy procedures. Methods: This is a prospective, randomized trial enrolling patients undergoing arthroscopic hip surgery for either isolated or concomitant labrum repair, acetabuloplasty, or femoral osteoplasty. Exclusion criteria included a history of drug use, workman’s compensation, open surgery, patients \u3c18 years of age, and non-English speaking patients. Patients were randomly assigned a 1:1 ratio to either be shown an educational video detailing the risks of opioid utilization and dependence versus standard protocol. All patients received the current standard protocol for managing post-operative discomfort (local anesthetic injection at the time of surgery [20cc of ropivacaine intra-articularly], with 40 tablets of oxycodone 5mg/acetaminophen 325mg given for post-operative pain. All prescriptions were monitored through the state prescription monitors database and correlated with patient reporting. Physicians who performed the surgical procedure were blinded to which patients received patient education. Patients pain levels and opioid usage were determined through a custom narcotics use survey. Patients recorded their pain levels and opioid usage levels pre-operatively and then 2 weeks, 6 week, and 3 months after surgery. Included in each survey was the custom narcotic use survey, along with the Modified Harris Hip Score and Single Assessment Numeric Evaluation (SANE) rating. Number of opioid pills consumed was converted to morphine milligram equivalents for statistical analysis. Results: Ninety-eight patients were included in the analysis (48 controls, 49 who received the opioid education). There were no significant differences between the two groups in mean age at surgery (31.5 in control and 32.0 in education group P=0.445), MI (24.6 and 24.7, P=0.790), or sex ratio (26M/23F in control and 22M/27F in education group (P=0.544). There were also no significant preoperative differences between the two groups in patient reported function, as measured by SANE (48.0 in control and 47.9 in education group, P=0.976) or patient reported pain and function as measured by Modified Harris Hip score (67.5 in control and 70.2 in education group, P=0.409). Patients in the education group had a significantly higher median morphine milligram equivalents (MME) consumed at 2 weeks (65.0 education vs. 30.0 control, P=0.013). However, there was no significant difference in the median MME consumed at 6 weeks (75.0 education vs 35.0 control, P=0.077), or 12 weeks (75.0 education vs 41.2 control, P=0.504). When the two groups were compared, there were no significant differences in duration of opioid consumption, as measured by the question” are you still taking narcotic medication to control your hip pain”, or patient reported pain and function as reported by the SANE scale an MHHS at 2 weeks, 6 weeks, and 12 weeks postoperatively. Power analysis revealed an effect size of 0.416 and power of 0.53 for mean MME consumed at 2 weeks. Discussion and Conclusion: While those who received the preoperative education module on opioid medications actually demonstrated a higher mean amount of opioid pills consumed in the short term post-operative period at 2 weeks compared to the control group, they did not significantly differ from the control group at 6 and 12 weeks. Overall, the preoperative education module has no parent effect on patient-reported pain or function in the post-operative period

Does Prehabilitation Prior to Ulnar Collateral Ligament Surgery Affect Return to Sport Rate or Time in Baseball Players with Partial UCL Tears?

Those who suffer a partial thickness ulnar collateral ligament (UCL) tear often undergo a period of nonoperative management including physical therapy rehabilitation. This treatment is aimed at optimizing range of motion (ROM) and strengthening the supporting structures around the elbow to help offload the UCL. Unfortunately, some of these patients fail nonoperative management and require surgical intervention. This creates a unique set of patients who essentially underwent “prehabilitation” prior to their UCL surgery. Prehabilitation is considered a period of structured physical therapy rehabilitation aimed at strengthening structures surrounding an injured tendon or ligament, to allow for dissipation of stress away from the repaired structure after surgery. Prehabilitation has been studied extensively and implemented into the clinical practice of anterior cruciate ligament (ACL) rehabilitation, and is being studied for other injuries as well. However, the efficacy of prehabilitation for UCL surgical patients with partial thickness UCL tears has not been evaluated. This chart review: - determines if baseball players with partial UCL tears who completed at least 4 weeks of prehabilitation prior to surgery (Prehab) had better return to play (RTP) rates and quicker return to sport (RTS) time than players who attempted 0-3 weeks of physical therapy prior to UCL surgery (No Prehab) - compares revision, reoperation, and patient reported outcomes between Prehab and No Prehab player

Does Prehabilitation Before Surgery Affect Return to Sport in Baseball Pitchers With Partial Ulnar Collateral Ligament Tears?

BACKGROUND: Purposeful rehabilitation before surgery (prehabilitation) has been researched and implemented in the treatment of anterior cruciate ligament tears. However, it is unclear whether prehabilitation would affect outcomes for baseball pitchers with partial ulnar collateral ligament (UCL) tears. PURPOSE/HYPOTHESIS: The purpose of this study was to determine whether baseball pitchers with partial UCL tears who completed ≥4 weeks of prehabilitation (prehab group) have different return to play (RTP) outcomes than pitchers with 0 to 3 weeks of preoperative physical therapy (no prehab group). We hypothesized that pitchers in the prehab group would have similar RTP rates compared with pitchers in the no prehab group. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Baseball pitchers of all competitive levels who underwent primary UCL reconstruction (UCLR) or UCL repair between 2010 and 2019 were included. Physician chart notes, magnetic resonance images, and operative notes were screened to confirm primary UCLR or UCL repair of a partial UCL tear and to identify whether the nonoperative treatment had been attempted. Patients were contacted via RedCap for postoperative complications, reoperations, RTP, and patient-reported outcomes (Kerlan-Jobe Orthopaedic Clinic score, Andrews-Timmerman score, Conway-Jobe score, and satisfaction). RESULTS: Overall, 105 baseball pitchers (n = 55 prehab group; n = 50 no prehab group) were included and evaluated at 3.4 ± 2.5 years postoperatively. Six pitchers underwent UCL repair, and 99 pitchers underwent UCLR. All demographic characteristics were similar between groups except the prehab group received a gracilis graft more frequently (76.5% vs 51.2%; CONCLUSION: Postoperative and patient-reported outcomes did not differ significantly between pitchers with partial UCL tears who performed rehabilitation before UCL surgery and pitchers who did not attempt a significant period of rehabilitation before UCL surgery. Clinicians should feel comfortable recommending rehabilitation for patients with partial UCL tears who wish to attempt a period of nonoperative treatment, as postoperative outcomes are not affected if UCL surgery is later needed

Sustainable computational science: the ReScience initiative

Computer science o ers a large set of tools for prototyping, writing, running, testing, validating, sharing and reproducing results, however computational science lags behind. In the best case, authors may provide their source code as a compressed archive and they may feel con dent their research is reproducible. But this is not exactly true. Jonathan Buckheit and David Donoho proposed more than two decades ago that an article about computational results is advertising, not scholarship. e actual scholarship is the full so ware environment, code, and data that produced the result. is implies new work ows, in particular in peer-reviews. Existing journals have been slow to adapt: source codes are rarely requested, hardly ever actually executed to check that they produce the results advertised in the article. ReScience is a peer-reviewed journal that targets computational research and encourages the explicit replication of already published research, promoting new and open-source implementations in order to ensure that the original research can be replicated from its description. To achieve this goal, the whole publishing chain is radically di erent from other traditional scienti c journals. ReScience resides on GitHub where each new implementation of a computational study is made available together with comments, explanations, and so ware tests

Geochemical response of the mid-depth Northeast Atlantic Ocean to freshwater input during Heinrich events 1 to 4

PublishedArticleHeinrich events are intervals of rapid iceberg-sourced freshwater release to the high latitude North Atlantic Ocean that punctuate late Pleistocene glacials. Delivery of fresh water to the main North Atlantic sites of deep water formation during Heinrich events may result in major disruption to the Atlantic Meridional Overturning Circulation (AMOC), however, the simple concept of an AMOC shutdown in response to each freshwater input has recently been shown to be overly simplistic. Here we present a new multi-proxy dataset spanning the last 41,000 years that resolves four Heinrich events at a classic mid-depth North Atlantic drill site, employing four independent geochemical tracers of water mass properties: boron/calcium, carbon and oxygen isotopes in foraminiferal calcite and neodymium isotopes in multiple substrates. We also report rare earth element distributions to investigate the fidelity by which neodymium isotopes record changes in water mass distribution in the northeast North Atlantic. Our data reveal distinct geochemical signatures for each Heinrich event, suggesting that the sites of fresh water delivery and/or rates of input played at least as important a role as the stage of the glacial cycle in which the fresh water was released. At no time during the last 41 kyr was the mid-depth northeast North Atlantic dominantly ventilated by southern-sourced water. Instead, we document persistent ventilation by Glacial North Atlantic Intermediate Water (GNAIW), albeit with variable properties signifying changes in supply from multiple contributing northern sources.This research used samples provided by the Integrated Ocean Drilling (Discovery) Program IODP, which is sponsored by the US National Science Foundation and participating countries under management of Joint Oceanographic Institutions, Inc. We thank Walter Hale and Alex Wülbers for help with sampling, Kirsty Crocket for providing additional samples and Matt Cooper, Andy Milton, Mike Bolshaw and Dave Spanner for analytical support. Heiko Pälike, David Thornalley and Rachel Mills are thanked for productive discussions and comments on earlier versions of this work. We also thank three anonymous reviewers for their constructive feedback, which greatly improved the manuscript. Funding for this project was provided by NERC studentships to A.J.C. (grant NE/D005728/2) and T.B.C. (NE/I528626/1), with additional funding support from a Royal Society Wolfson Research Merit Award and NERC grants NE/F00141X/1 and NE/I006168/1 to P.A.W. and NE/D00876X/2 to G.L.F

Nature meets nurture: molecular genetics of gastric cancer

The immensity of genes and molecules implicated in gastric carcinogenesis is overwhelming and the relevant importance of some of these molecules is too often unclear. This review serves to bring us up-to-date with the latest findings as well as to look at the larger picture in terms of how to tackle the problem of solving this multi-piece puzzle. In this review, the environmental nurturing of intestinal cancer is discussed, beginning with epidemiology (known causative factors for inducing molecular change), an update of H. pylori research, including the role of inflammation and stem cells in premalignant lesions. The role of E-cadherin in the nature (genotype) of diffuse gastric cancer is highlighted, and finally the ever growing discipline of SNP analysis (including IL1B) is discussed