7,658 research outputs found

    Lifetime Adherence to Physical Activity Recommendations and Fall Occurrence in Community-dwelling Older Adults: a Retrospective Cohort Study

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    Falling is a major health concern for community-dwelling older adults. Regular physical activity has been proposed to prevent falls. The aim of this study was to assess whether the achievement of the 2004 UK Department of Health physical activity recommendations over a lifetime had a protective effect against falling in older people. 313 community-dwelling older adults completed a questionnaire about lifetime physical activity and fall occurrence. There were significantly fewer falls in those who had led an active lifestyle compared to those who had not (χ2Yates=4.568, p=0.033), with a lower relative risk of fall occurrence for the active respondents (RR=0.671) compared to the inactive (RR=1.210). Of those who were sufficiently active in their early adulthood, the decade where there was the biggest decrease in remaining active enough was in the 60s. It is concluded that an active lifestyle may have decreased the likelihood of having a fall in older ag

    The influence of carotid disease on cerebral vascular autoregulation and cerebral vascular reactivity to hypercapnia

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    Cerebral vascular reactivity to hypercapnia, assessed using transcranial Doppler ultrasonography of middle cerebral artery blood flow velocity, is used to assess the extent of cerebral blood flow reserve. It has been assumed that in patients with carotid disease a reduced reactivity to hypercapnia can be interpreted as indicating reduced cerebral perfusion with reduced autoregulatory capacity. This relationship between reactivity to hypercapnia and autoregulation in the cerebral vasculature is tested. A method for the non-invasive measurement of cerebral vascular autoregulation to changes in blood pressure is described and this method is used to assess autoregulation in a group of normal subjects. Hypercapnia is shown to obtund autoregulation whereas hypocapnia is shown to exaggerate cerebral vascular autoregulation to changes in blood pressure. It is shown that volitional respiration significantly increases middle cerebral artery blood flow velocity. Cerebral vascular reactivity to hypercapnia is measured in patients with carotid disease and is shown to be reduced in the presence of internal carotid artery occlusion. It is also shown that whilst some patients with severe carotid artery disease have reduced cerebral vascular reactivity to hypercapnia, the presence of severe carotid artery disease per se does not predict a reduced reactivity index. In the presence of internal carotid artery occlusion an increased degree of contralateral internal carotid artery stenosis reduces ipsilateral cerebral vascular reactivity to hypercapnia. The relationship between cerebral vascular autoregulation and cerebral vascular reactivity to hypercapnia is tested in a group of subjects with severe carotid disease. The methods described for the measurement of cerebral vascular autoregulation and cerebral vascular reactivity to hypercapnia are employed to measure both parameters in each individual in the group and it is shown that there is a strong correlation between the presence of reduced cerebral vascular reactivity to hypercapnia and reduced cerebral vascular autoregulation to pressure change

    Book Review

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    Tax Law and Natural Law

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    Fragmentation of Urban Space in Latin America: a GIS approach to the analysis of segregation in Lima

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    The complex nature of urban space within Latin America’s major cities limits the applicability of many empirical measures of segregation. However, the development of integrated spatial measures allows for the measurement of highly localised patterns of segregation between multiple groups across multiple dimensions. This paper presents a methodology for integrating spatial analysis and GIS tools as an explicit part of investigating the nature and patterns urban segregation. Using Lima, Peru and an example, the related processes of segregation and fragmentation are unpacked across multiple social dimensions and spatial scales. Additionally, this paper empirically tests the theoretical proposition that social groups in Latin America are becoming increasingly fragmented rather than segregated.Peer Reviewe
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