Use of personal call alarms among community-dwelling older people.

Having a fall and then lying on the floor for an hour or more is known as a ‘long lie’, which are associated with serious injury and an elevated risk of admission to hospital, long-term care, and death. Personal call alarms are designed to prevent long lies, although little is known about their use. Using cross-sectional data from the English Longitudinal Study on Ageing, this study investigated the proportion of self-reported users of personal call alarms among 3091 community-dwelling adults aged 65+ who reported difficulties of mobility or activities of daily living. The characteristics of users were then explored through logistic regressions comparing those living alone with those living with others. One hundred and eighty people self-reported using a personal call alarm (6%). Multivariate regression found the following to significantly predict personal call alarm use among both those living alone and with others: greater difficulty with activities / instrumental activities of daily living, older age, and for those living with others only: lower score on the quality of life subscale for control. Personal call alarm use may be markedly lower than the 30 per cent annual incidence of falls among community-dwelling older people. Better understanding is needed of the reasons for low usage, even amongst those at highest falls risk for whom such alarms are most likely to be beneficial

Flight Testing of the Forward Osmosis Bag for Water Recovery on STS-135

The Forward Osmosis Bag (FOB) is a personal water purification device for recovery of potable liquid from almost any non-potable water source. The FOB experiment was flown as a sortie mission on STS-135/ULF7 using flight-certified materials and a design based on the X-Pack(TradeMark) from Hydration Technology Innovations (Albany, OR). The primary objective was to validate the technology for use under microgravity conditions. The FOB utilizes a difference in solute concentration across a selectively permeable membrane to draw water molecules from the non-potable water while rejecting most chemical and all microbial contaminants contained within. Six FOB devices were tested on STS-135 for their ability to produce a potable liquid permeate from a feed solution containing 500 mL potassium chloride (15 g/L) amended with 0.1% methyl blue dye (w:v) tracer against an osmotic gradient created by addition of 60 mL of concentrate containing the osmolytes fructose and glucose, and 0.01% sodium fluorescein (w:v) tracer. Three FOB devices were physically mixed by hand for 2 minutes by a crewmember after loading to augment membrane wetting for comparison with three unmixed FOB devices. Hydraulic flux rate and rejection of salt and dye in microgravity were determined from a 60-mL sample collected by the crew on orbit after 6 hours. Post-flight analysis of samples collected on orbit demonstrated that the Forward Osmosis Bag achieved expected design specifications in microgravity. The hydraulic flux rate of water across the membrane was reduced approximately 50% in microgravity relative to ground controls that generated an average of 50 mL per hour using the same water and osmolyte solutions. The membrane rejected both potassium and chloride at >92% and methyl blue dye at >99.9%. Physical mixing of the FOB during water recovery did not have any significant effect on either flux rate or rejection of solutes from the water solution. The absence of buoyancy-driven convection in microgravity suggests that mass transport was dominated by diffusion, slowing the rate of permeate production across the membrane. It is possible that a predicted reduction in concentration polarization at the membrane surface that may have acted to increase the rate of permeate production in microgravity was negligible under the described test conditions

A Pilot Trial Of Pioglitazone Hcl And Tretinoin In Als: Cerebrospinal Fluid Biomarkers To Monitor Drug Efficacy And Predict Rate Of Disease Progression

Objectives. To determine if therapy with pioglitazone HCl and tretinoin could slow disease progression in patients with ALS. Levels of tau and pNFH in the cerebrospinal fluid were measured to see if they could serve as prognostic indicators. Methods. 27 subjects on stable doses of riluzole were enrolled. Subjects were randomized to receive pioglitazone 30 mg/d and tretinoin 10 mg/BID for six months or two matching placebos. ALSFRS-R scores were followed monthly. At baseline and at the final visit, lumbar punctures (LPs) were performed to measure cerebrospinal fluid (CSF) biomarker levels. Results. Subjects treated with tretinoin, pioglitazone, and riluzole had an average rate of decline on the ALSFRS-R scale of -1.02 points per month; subjects treated with placebo and riluzole had a rate of decline of -. 86 (P =. 18). Over six months of therapy, CSF tau levels decreased in subjects randomized to active treatment and increased in subjects on placebo. Further higher levels of pNF-H at baseline correlated with a faster rate of progression. Conclusion. ALS patients who were treated with tretinoin and pioglitazone demonstrated no slowing on their disease progression. Interestingly, the rate of disease progression was strongly correlated with levels of pNFH in the CSF at baseline. © 2012 Todd D. Levine et al

Extension of corporate services brands: the effect of perceived similarity extension and perceived quality brand

O principal objetivo deste estudo é avaliar o efeito da qualidade percebida da marca-mãe e da similaridade percebida sobre as avaliações de extensões de marcas corporativas de serviços. Adicionalmente, também se deseja verificar se a elaboração das características da extensão contribuem para a sua avaliação. As hipóteses foram testadas por meio de três experimentos que envolveram no total 1.131 respondentes. No Estudo 1 foram utilizadas marcas fictícias como estímulo e verificou-se que a qualidade da marca-mãe teve efeito mais importante que a similaridade percebida sobre as avaliações de uma extensão de marca de serviços. No Estudo 2, utilizando como estímulos marcas reais, os mesmos resultados do Estudo 1 foram obtidos. No Estudo 3 verificou-se que a elaboração das características da extensão contribuiu positivamente apenas para uma das extensões propostas para a marca-mãe de alta qualidade, mas não teve nenhum efeito para as extensões propostas para a marca-mãe de baixa qualidade. Tomados em conjunto, os resultados sugerem que a qualidade percebida da marca-mãe tem papel fundamental na avaliação de extensões de marcas corporativas de serviços. O estudo contribui ainda com diversas hipóteses para estudos futuros e implicações gerenciais para gerentes de marcas corporativas de serviços.The main objective of this study is to assess the effect of parent brand perceived quality and perceived similarity on the evaluation of corporate service brand extensions. It is also the intention of this study to verify whether providing information cues about the characteristics of the extension contributes to the brand extension evaluation. The hypotheses were tested by means of three experiments involving 1,131 subjects. The results of Study 1, conducted with fictitious brands as stimuli, demonstrated that the perceived quality of the parent brand played a more significant role than perceived similarity on the evaluations of brand extensions. In Study 2, where real brands were used as stimuli, the results were the same as in Study 1. Study 3 found that providing information cues about the characteristics of the extensions had a positive effect for one of the extensions of the high quality parent brand but not for the two proposed extensions of the low quality parent brand. Taken as a whole, the results suggest that the perceived quality of the parent-brand plays a fundamental role in the evaluation of corporate service brand extensions. The study also contributes several hypotheses for future studies and managerial implications for managers of corporate service brands

Update to the Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) protocol: statistical analysis plan for a prospective, multicenter, double-blind, adaptive sample size, randomized, placebo-controlled, clinical trial.

BACKGROUND: Observational research suggests that combined therapy with Vitamin C, thiamine and hydrocortisone may reduce mortality in patients with septic shock. METHODS AND DESIGN: The Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) trial is a multicenter, double-blind, adaptive sample size, randomized, placebo-controlled trial designed to test the efficacy of combination therapy with vitamin C (1.5 g), thiamine (100 mg), and hydrocortisone (50 mg) given every 6 h for up to 16 doses in patients with respiratory or circulatory dysfunction (or both) resulting from sepsis. The primary outcome is ventilator- and vasopressor-free days with mortality as the key secondary outcome. Recruitment began in August 2018 and is ongoing; 501 participants have been enrolled to date, with a planned maximum sample size of 2000. The Data and Safety Monitoring Board reviewed interim results at N = 200, 300, 400 and 500, and has recommended continuing recruitment. The next interim analysis will occur when N = 1000. This update presents the statistical analysis plan. Specifically, we provide definitions for key treatment and outcome variables, and for intent-to-treat, per-protocol, and safety analysis datasets. We describe the planned descriptive analyses, the main analysis of the primary end point, our approach to secondary and exploratory analyses, and handling of missing data. Our goal is to provide enough detail that our approach could be replicated by an independent study group, thereby enhancing the transparency of the study. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03509350. Registered on 26 April 2018