Do central banks react to house prices?

The substantial fluctuations in house prices recently experienced by many industrialized economies have stimulated a vivid debate on the possible implications for monetary policy. In this paper, we ask whether the U.S. Fed, the Bank of Japan and the Bank of England have reacted to house prices. We study the responses of these central banks by estimating a structural model for each country where credit constrained agents borrow against real estate. The main result is that house price movements did play a separate role in the U.S., U.K.. and Japanese central bank reaction functions

Physical Activity Interventions in Children with Juvenile Idiopathic Arthritis: A Systematic Review of Randomized Controlled Trials

Introduction: Children with juvenile arthritis (JA) experience pain, stiffness, fatigue, and decreased motion leading to difficulties with daily activities and low physical activity (PA). PA is critical to improve health and function and mitigate JA-associated symptoms. This study evaluated the evidence for PA interventions in children with JA. Materials and methods: A systematic review of randomized controlled trials (RCTs) of PA interventions in children with JA was conducted. Ovid (Medline), Cochrane Library, EMBASE, and CINAHL databases were searched for papers published in English between 1/1/1946 and 9/1/2021. Studies which concurrently assessed medical interventions were excluded. Participant and intervention characteristics and outcomes were extracted. Study internal validity and intervention attributes were assessed. Results: A total of 555 studies were identified, with 13 studies from 10 countries included. Data from 672 children diagnosed with juvenile idiopathic arthritis (JIA) (range of mean ages, 8.7 to 16.1 years) were analyzed. Fifty-two percent of intervention arms incorporated strengthening exercise alone or combined with other exercise, with 61.9% performed 3x/week. About 43.5% of sessions lasted \u3e45 to ≤60 minutes and 65.2% of programs were ≥12 tointensity, reasons for dropouts, and adherence. Only two studies incorporated strategies to promote adherence. Discussion: RCTs of PA interventions in JA only include JIA. Available RCTs used mixed modes of interventions. Reporting of PA interventions lacks sufficient detail to discern the dose-response relationship. Strategies to motivate engagement in PA and to support families to promote PA are lacking, as are studies of long-term outcomes. Conclusion: There are limited RCTs of PA interventions in JIA. Adherence was better with low intensity programs. PA interventions for JIA yield positive health benefits but better reporting of PA intervention details is needed to generate more high-quality evidence and inform clinical practice

Femur shaft fractures in children : an epidemiological and biomechanical study

Aims: The purpose of this thesis is to describe trends in the epidemiology and treatment of femur shaft fractures in children, to identify risk factors for femur shaft fractures and to compare the stability of various configurations of intramedullary nails to manage these fractures. Background: There are no prior national epidemiologic studies of femur shaft fractures in children. Research indicates that sociodemographic factors are associated with increased incidence of childhood injuries. A child who suffers a fracture or a softtissue injury at a young age faces an increased risk of subsequent injuries during childhood. Intramedullary elastic nails are typically used to treat length-unstable femur shaft fractures among school age children. Another possible treatment is a semi-rigid pediatric locking nail. Methods: In Study I-III, children with a diagnostic ICD-code for femur shaft fracture were selected from the Swedish national inpatient register and compared with age and sex matched controls. Demographic, socioeconomic and injury data were based on record linkage between six Swedish registers. The following cohorts were studied: Study I: Children (n = 4,984), 0-14 years of age, diagnosed in 1987 to 2005. Study II: Children (n = 1,874), 0-14 years of age, diagnosed in 1997 to 2005 compared with matched controls (n = 18,740). Study III:Children (n = 1,404), 1-3 years of age, diagnosed in 1990 to 2005 compared with matched children (n = 13,814). In Study IV twenty-four femur models with a length-unstable oblique midshaft fracture were used. Three groups with different combinations of titanium elastic nails (TEN) with end caps and one group with a pediatric locking nail (PLN) were biomechanically tested. Results: Study I-III:The incidence of femur shaft fractures declined by 42% between 1987 and 2005. Treatment modalities shifted toward an increased use of operative treatment. Hospital stay decreased by 81%, from 26 days in 1987 to 5 days in 2005. Children whose parents had a university education had a reduced risk of femur shaft fractures during childhood. Fracture risk increased for older boys with younger parents and for older girls from low-income households. Neither family composition, number of siblings, birth order nor receiving social welfare influenced fracture risk. Boys with a femur shaft fracture at one to three years of age appeared to be at greater risk for a lower leg fracture that required inpatient care during childhood, but there was no significantly increased risk for upper-limb fractures or soft-tissue injuries. Study IV: PLN provided the greatest stability in all planes compared to TEN models with end caps, even though the difference from the two 4.0 mm or four 3.0 mm TEN models was small. Conclusions: During the study period of 1987-2005, the incidence of femur shaft fractures decreased, there was a shift in treatment modalities and the length of hospital stay became shorter. Data indicate that sociodemographic variables influenced the rate of femur shaft fractures; in older children the influence differs between boys and girls. The risk for subsequent fractures in the lower leg that required inpatient care during childhood increased for boys but not for girls with a femur shaft fracture between the ages of one and three. PLN gives a biomechanically more stable construct than TEN in a model of a length-unstable oblique midshaft femur fracture

Large variations in walking, standing up from a chair, and balance in women and men over 85 years: an observational study

QuestionsWhat is the physical ability of very old people? Is physical ability affected by age or sex? Is it affected by type of housing, level of independence in activities of daily living, cognition, or nutrition?DesignA population-based cross-sectional observational study.ParticipantsHalf the 85-year-old population, and the total population aged 90 and ≥ 95 (range 95–103) in Umeå, Sweden who were measured in the Umeå 85+ Study (n = 238).Outcome measuresUsual and fastest gait speed (m/s) over 2.4 metres, three consecutive chair stands (s), the Berg Balance Scale, and ability to perform the measures (yes/no).ResultsThe median (10th to 90th percentile) usual gait speed was 0.49 m/s (0.23–0.75), time to perform the chair stands test was 12.6 seconds (8.5–20.2), and the Berg Balance Scale score was 45 (0–54). Men had greater physical ability than women. An age-related decline in physical ability was seen in women, but not in men. The Berg Balance Scale showed no floor or ceiling effects, but gait speed and chair stands resulted in a floor effect, especially for women.ConclusionThere were large variations in physical ability in these very old people. These data provide valuable reference values of physical ability in the oldest age groups for commonly-used clinical measures

Femur shaft fracture at a young age and the risk of subsequent severe injuries during childhood: a cohort study

Background: A child who suffers a fracture or a soft-tissue injury at a young age faces an increased risk of subsequent injuries during childhood. This risk could be related to personal and family characteristics or to lower-than-average bone-mineral density. The purpose of this nationwide cohort study was to estimate the association between a femur shaft fracture at a young age and the subsequent risk of hospitalization for injuries during childhood. Methods: We compared the subsequent risk of hospitalization for injuries during childhood among 1,404 children (exposed) who were one to three years of age when they suffered a femur shaft fracture with the risk among 13,814 randomly selected, gender- and age-matched femur fracture–free children (unexposed). Hazard ratios (HRs) and 95% confidence intervals (CIs) for severe injuries defined as fractures or soft-tissue injuries requiring hospital admission were estimated in a Cox proportional hazards model. Results: Exposed children exhibited no significantly increased risk of upper-extremity fractures or soft-tissue injuries during childhood, regardless of sex and follow-up time. Boys exhibited a 162% increased risk of suffering a lower leg fracture requiring hospital admission (HR?=?2.62, 95% CI: 1.45–4.71), but the refracture risk was not significant for girls 2.02 (0.58–6.97). Conclusions: We found an increased risk for subsequent fractures in the lower leg that requires inpatient care during childhood for boys, but not for girls, who were one to three years of age when they first suffered a femur shaft fracture. This increased fracture risk is probably not simply the result of greater risk-taking among boys. The explanation might relate to factors affecting the bone quality of the lower leg

Caring through barriers—Newly graduated registered nurses' lived experiences in emergency departments during the COVID-19 pandemic

Aim - To illuminate the meaning of newly graduated registered nurses' experiences of caring for patients in emergency departments during the COVID-19 pandemic. Design - A phenomenological hermeneutical study guided by Lindseth and Norberg. Methods - In-depth one-on-one interviews with 14 nurses from five hospitals were conducted from March to November 2020 and analysed using thematic analysis. The consolidated criteria for reporting qualitative research (COREQ) were used as the reporting guideline. Results - The findings comprise one main theme Caring through barriers and three themes with sub-themes. In the first theme, having intention to care, participants revealed their dedication to care for patients during the pandemic despite extensive stress, little experience and skills. The second theme, with tied hands in human suffering, illuminates experiences of being disconnected from the patient, overwhelmed by responsibility and unable to relieve suffering. The third theme, feeling inadequate, reveals experiences of lack of support and doubts meaning less space to develop into the nurse one wants to be. Conclusion - Findings reveal a new understanding of new nurses' experiences during times of crisis. The essence of caring in the emergency department during the pandemic can be explained as mediated through spatial, temporal and emotional barriers preventing new nurses from providing holistic care. Impact - The results may be used as anticipatory guidance for new nurses and inform targeted support interventions to support new nurses entering the profession in crisis conditions. Public Contribution - This study involved new nurses in semi-structured interviews

Reporting of Harm in Randomized Controlled Trials of Therapeutic Exercise for Knee Osteoarthritis: A Systematic Review

Objective: The Consolidated Standards of Reporting Trials (CONSORT) recommends reporting adverse events (AEs) and dropouts (DOs) with their definitions. The purpose of this study was to identify how AEs and DOs were reported in randomized controlled trials (RCTs) of therapeutic exercise for knee osteoarthritis (OA). Methods: Data sources were the Cochrane Library, EMBASE, PUBMED, and CINAHL. Databases were searched to identify RCTs of therapeutic exercise for Knee OA published from January 1, 1980, through July 23, 2020. Researchers independently extracted participant and intervention characteristics and determined whether a clear statement of and reasons for AEs and DOs existed. The primary outcome was exercise-related harm. Physiotherapy Evidence Database (PEDro) scoring described study quality and risk of bias. Descriptive and inferential statistics characterized results. Meta-analysis was not performed due to data heterogeneity. Results: One hundred 13 studies (152 arms) from 25 countries were included with 5909 participants exercising. PEDro scores ranged from 4 to 9. Exercise intensity was not specified in 57.9% of exercise arms. Fifty studies (44.2%) included an AE statement and 24 (21.2%) reported AEs, yielding 297 patients. One hundred three studies (91.2%) had a DO statement. Sixteen studies (15.5%) provided reasons for DOs that could be classified as AEs among 39 patients, yielding a 13.1% increase in AEs. Thus, 336 patients (6.0%) experienced exercise-related harm among studies with a clear statement of AEs and DOs. A significant difference existed in misclassification of DOs pre- and post-CONSORT 2010 (12.2% vs 3.1%; X21 = 21.2). Conclusions: In some studies, the reason for DOs could be considered AEs, leading to potential underreporting of harm. Improvements in reporting of harm were found pre-and post-CONSORT 2010. Greater clarity regarding AE and DO definitions and TherEx intensity are needed to determine safe dosing and mode of therapeutic exercise for knee OA. Impact: More adherence to the CONSORT statement is needed regarding reporting of and defining AEs, DOs, and therapeutic exercise intensity; however, despite this, therapeutic exercise seems to be associated with minimal risk of harm

Falls in very old people: the population-based Umeå 85+ Study in Sweden

Artikkelen omhandler en studie hvor hensikten var å beskrive forekomst av fall og fallrelaterte skader, og å identifisere predisponerende faktorer for fall hos eldre 85 år og eldre.The aim of this study was to describe incidences of falls and fall-related injuries, and to identify predisposing factors for falls in very old people in a prospective population-based follow-up study for falls. The study is part of the Umeå 85+ Study which includes half of the population aged 85, and the total population aged 90 and ≥95 (−103), in Umeå, Sweden. Of the 253 people interviewed, 220 (87%) were followed up for falls for 6 months, of whom 109 lived in ordinary and 111 in institutional housing. A comprehensive geriatric baseline assessment was made through interviews and testing during home visits. Forty percent of the participants did fall a total 304 times, corresponding to 2.17 falls per Person Year (PY). It occurred 0.83 injuries per PY, including 0.14 fractures per PY. In a Cox regression analysis, the independent explanatory risk factors for time to first fall were dependency in activities of daily living (ADL), thyroid disorders, treatment with selective serotonin reuptake inhibitors (SSRIs) and occurrence of falls in the preceding year. It could be predicted that every seventh participant and every third of the people who did fall would suffer a fracture within 1 year. ADL, thyroid disorders and treatment with SSRIs should be considered in fall prevention programmes

Exchange Rate Pass-through in South America: An Overview

The effectiveness of exchange rate adjustments depends critically on the extent to which depreciations "pass through" to inflation, an effect that is known as exchange rate pass-through (ERPT). In particular, if an exchange rate depreciation does not result in a lasting change in relative prices, namely a real depreciation, it will not provide the desirable competitiveness gains. This paper looks at the question of pass-through and its determinants for the group of countries whose central banks are members of the Financial Stability and Development (FSD) network. All of these countries experienced large terms of trade shocks and large depreciations in the past couple of years. The findings are that ERPT in the FSD countries is moderate and has become lower over time, in line with the international experience. The pass-through moderation has benefitted from the adoption of floating exchange rates and especially an increase in monetary policy credibility. Despite the relatively lower ERPT in the past two decades, the exchange rate continues to be a large determinant of inflation in several countries

The quality of intervention reporting in trials of therapeutic exercise for hip osteoarthritis: a secondary analysis of a systematic review

Background: Therapeutic exercise is recommended as a core treatment for hip osteoarthritis (HOA). Whilst it is widely accepted that exercise can improve pain and disability, optimal type and dose of exercise are yet to be agreed upon. This may, in part, be attributed to the wide variation and inadequate reporting of interventions within the literature. This study evaluates the quality of intervention reporting among trials of therapeutic exercise in HOA. Methods: Randomised controlled trials (RCTs) were sourced in a systematic review, completed in August 2020. Two raters independently used the Template for Intervention Description and Replication (TIDieR) and Consensus on Exercise Reporting Template (CERT) to evaluate intervention reporting. Correlations between quality assessment scores and CERT and TIDieR scores evaluated the relationship between internal validity and external applicability. The year of publication was compared to the quality of reporting scores. Results: Fourteen RCTs were included in the analysis. On average, studies were awarded 9.43 ± 1.95 out of 12 points for the TIDieR checklist (range 4–12) and 13.57 ± 4.01 out of 19 points for the CERT (range 5–19). Pearson’s correlation coefficient suggested that the quality of reporting had improved over time and that there was a fair, positive relationship between internal validity and external applicability. Discussion: Whilst the quality of intervention reporting is improving, many RCTs of therapeutic exercise in HOA lack the detail necessary to allow accurate evaluation and replication. Researchers are encouraged to utilise the standardised reporting guidelines to increase the translation of effective interventions into clinical practice