Nutritional issues in older adults with wounds in a clinical setting

Albay, Auckland, New Zealan

Assessment of wound healing: validity, reliability and sensitivity of available instruments

Objectives: If wound assessment instruments are to be used in the periodic assessment of wound healing, they must prove to be valid, reliable and sensitive measures of wound healing. Thus, this systematic literature review aims to examine available wound healing instruments in terms of these parameters. Method: Only instruments able to measure changes in wound healing were included in this review and not those used to predict healing, classify wounds, or measure wound characteristics per se. All wound types were suitable for inclusion. Results: A total of 20 articles were found, evaluating the validity of 10 instruments used to monitor wound healing. No instrument satisfied all criteria required for instrument validation. Instruments used to assess pressure ulcers, notably the Pressure Ulcer Scale for Healing (PUSH) and Pressure Sore Status Tool (PSST), had been validated to the greatest extent, whilst those describing healing in leg ulcers and general or surgical wounds tended to lack comprehensive and quality evaluation. Conclusion: This review identified substantial gaps in the literature with regard to validation of existing wound healing instruments. Future studies are needed to comprehensively validate these instruments

A 3-year follow-up study of inpatients with lower limb ulcers: evidence of an obesity paradox?

Objectives: To determine whether body composition is related to long-term outcomes amongst vascular inpatients with lower limb ulcers. Design: Prospective study with 3 years follow-up. Materials and methods: Body mass index (BMI), fat, and fat-free mass were measured and associations with readmission to hospital (number, cause, length of stay) and all-cause mortality were explored. Results: Thirty patients (22 men, 8 women) participated in the study. Ten patients (33%) had a BMI ≥ 30 kg/m2. 18/20 (90%) patients with a BMI < 30 kg/m2 and 9/10 (90%) patients with a BMI ≥ 30 kg/m2 were admitted to hospital in the 3 years of follow-up. Patients with a BMI < 30 kg/m2 were admitted more frequently, earlier and for longer compared to those with BMI ≥ 30 kg/m2 but these did not reach statistical significance. The 3 year mortality rate for patients with BMI ≥ 30 kg/m2 was 20% (n = 2/10) compared to 70% (n = 14/20) with a BMI <30 kg/m2, P = 0.019. Conclusion: This preliminary study suggests that higher BMI may have a protective effect against mortality in vascular patients with lower limb ulcers. These findings contradict the universal acceptance that obesity leads to poor health outcomes. Further work is required to confirm these findings and explore some of the potential mechanisms for this effect

"Cult of equity": actuaries and the transformation of pension fund investing, 1948–1960

This article examines the mid-twentieth-century transformation of U.K. pension fund investment policy known as the “cult of equity.” It focuses on the influence exercised by the Association of Superannuation and Pension Funds over actuarial and corporate governance standards, through actuaries who were members of its council. This intervention led to increasingly permissive actuarial valuations that reduced contributions for sponsors of pension funds investing in equities. Increased demand for equities required pension funds to adopt a more permissive approach to corporate governance than insurance companies and investment trusts, and contributed to declining standards of corporate governance

Publicising lattice field theory through visualisation

The gluon field configurations that form the foundation of every lattice QCD calculation contain a rich diversity of emergent nonperturbative structure. Visualisations of these phenomena not only serve to explain the concept of a nontrivial vacuum but also entertain a diverse audience from research funding panels to the next generation of science enthusiasts. In this brief review, a collection of QCD-vacuum visualisations is presented including the structure of chromo-electromagnetic fields, centre-cluster evolution at finite temperature, the structure of projected centre vortices, and novel correlations between the electromagnetic fields of QED and the chromo-electromagnetic fields of QCD in QED+QCD dynamical-fermion simulations from the QCDSF collaboration.James Biddle, Josh Charvetto, Waseem Kamleh, Derek Leinweber, Helen Piercy, Ethan Puckridge, Finn Stokes, Ross D. Young, James Zanott

Mississippi River and Sea Surface Height Effects on Oil Slick Migration

Millions of barrels of oil escaped into the Gulf of Mexico (GoM) after the 20 April, 2010 explosion of Deepwater Horizon (DH). Ocean circulation models were used to forecast oil slick migration in the GoM, however such models do not explicitly treat the effects of secondary eddy-slopes or Mississippi River (MR) hydrodynamics. Here we report oil front migration that appears to be driven by sea surface level (SSL) slopes, and identify a previously unreported effect of the MR plume: under conditions of relatively high river discharge and weak winds, a freshwater mound can form around the MR Delta. We performed temporal oil slick position and altimeter analysis, employing both interpolated altimetry data and along-track measurements for coastal applications. The observed freshwater mound appears to have pushed the DH oil slick seaward from the Delta coastline. We provide a physical mechanism for this novel effect of the MR, using a two-layer pressure-driven flow model. Results show how SSL variations can drive a cross-slope migration of surface oil slicks that may reach velocities of order km/day, and confirm a lag time of order 5–10 days between mound formation and slick migration, as observed form the satellite analysis. Incorporating these effects into more complex ocean models will improve forecasts of slick migration for future spills. More generally, large SSL variations at the MR mouth may also affect the dispersal of freshwater, nutrients and sediment associated with the MR plume