Economic evaluation of a community based exercise programme to prevent falls

OBJECTIVE: To assess the incremental costs and cost effectiveness of implementing a home based muscle strengthening and balance retraining programme that reduced falls and injuries in older women. DESIGN: An economic evaluation carried out within a randomised controlled trial with two years of follow up. Participants were individually prescribed an exercise programme (exercise group, n=116) or received usual care and social visits (control group, n=117). SETTING: 17 general practices in Dunedin, New Zealand. PARTICIPANTS: Women aged 80 years and older living in the community and invited by their general practitioner to take part. MAIN OUTCOME MEASURES: Number of falls and injuries related to falls, costs of implementing the intervention, healthcare service costs resulting from falls and total healthcare service costs during the trial. Cost effectiveness was measured as the incremental cost of implementing the exercise programme per fall event prevented. MAIN RESULTS: 27% of total hospital costs during the trial were related to falls. However, there were no significant differences in health service costs between the two groups. Implementing the exercise programme for one and two years respectively cost $314 and$265 (1995 New Zealand dollars) per fall prevented, and $457 and$426 per fall resulting in a moderate or serious injury prevented. CONCLUSIONS: The costs resulting from falls make up a substantial proportion of the hospital costs for older people. Despite a reduction in falls as a result of this home exercise programme there was no significant reduction in healthcare costs. However, the results reported will provide information on the cost effectiveness of the programme for those making decisions on falls prevention strategies

Complementarity and the uncertainty relations

We formulate a general complementarity relation starting from any Hermitian operator with discrete non-degenerate eigenvalues. We then elucidate the relationship between quantum complementarity and the Heisenberg-Robertson's uncertainty relation. We show that they are intimately connected. Finally we exemplify the general theory with some specific suggested experiments.Comment: 9 pages, 4 figures, REVTeX, uses epsf.sty and multicol.st

Distributed normal faulting in the tip zone of the South Alkyonides Fault System, Gulf of Corinth, constrained using 36Cl exposure dating of late-Quaternary wave-cut platforms

The geometry, rates and kinematics of active faulting in the region close to the tip of a major crustal-scale normal fault in the Gulf of Corinth, Greece, are investigated using detailed fault mapping and new absolute dating. Fault offsets have been dated using a combination of 234U/230Th coral dates and in situ 36Cl cosmogenic exposure ages for sediments and wave-cut platforms deformed by the faults. Our results show that deformation in the tip zone is distributed across as many as eight faults arranged within ~700 m across strike, each of which deforms deposits and landforms associated with the 125 ka marine terrace of Marine Isotope Stage 5e. Summed throw-rates across strike achieve values as high as 0.3–1.6 mm/yr, values that are comparable to those at the centre of the crustal-scale fault (2–3 mm/yr from Holocene palaeoseismology and 3–4 mm/yr from GPS geodesy). The relatively high deformation rate and distributed deformation in the tip zone are discussed in terms of stress enhancement from rupture of neighbouring crustal-scale faults and in terms of how this should be considered during fault-based seismic hazard assessment

The Local Bubble and Interstellar Material Near the Sun

The properties of interstellar matter (ISM) at the Sun are regulated by our location with respect to the Local Bubble (LB) void in the ISM. The LB is bounded by associations of massive stars and fossil supernovae that have disrupted natal ISM and driven intermediate velocity ISM into the LB interior void. The Sun is located in such a driven ISM parcel. The Local Fluff has a bulk velocity of 19 km/s in the LSR, and an upwind direction towards the center of the gas and dust ring formed by the Loop I supernova remnant interaction with the LB. When the ram pressure of the LIC is included in the total LIC pressure, and if magnetic thermal and cosmic ray pressures are similar, the LIC appears to be in pressure equilibrium with the local hot bubble plasma.Comment: Proceedings of Symposium on the Composition of Matter, honoring Johannes Geiss on the occasion of his 80th birthday. Space Science Reviews (in press

Targeting Toll-like receptor-4 to tackle preterm birth and fetal inflammatory injury

Every year, 15 million pregnancies end prematurely, resulting in more than 1 million infant deaths and long-term health consequences for many children. The physiological processes of labour and birth involve essential roles for immune cells and pro-inflammatory cytokines in gestational tissues. There is compelling evidence that the mechanisms underlying spontaneous preterm birth are initiated when a premature and excessive inflammatory response is triggered by infection or other causes. Exposure to pro-inflammatory mediators is emerging as a major factor in the 'fetal inflammatory response syndrome' that often accompanies preterm birth, where unscheduled effects in fetal tissues interfere with normal development and predispose to neonatal morbidity. Toll-like receptors (TLRs) are critical upstream gatekeepers of inflammatory activation. TLR4 is prominently involved through its ability to sense and integrate signals from a range of microbial and endogenous triggers to provoke and perpetuate inflammation. Preclinical studies have identified TLR4 as an attractive pharmacological target to promote uterine quiescence and protect the fetus from inflammatory injury. Novel small-molecule inhibitors of TLR4 signalling, specifically the non-opioid receptor antagonists (+)-naloxone and (+)-naltrexone, are proving highly effective in animal models for preventing preterm birth induced by bacterial mimetic LPS, heat-killed Escherichia coli, or the TLR4-dependent pro-inflammatory lipid, platelet-activating factor (PAF). Here, we summarise the rationale for targeting TLR4 as a master regulator of inflammation in fetal and gestational tissues, and the potential utility of TLR4 antagonists as candidates for preventative and therapeutic application in preterm delivery and fetal inflammatory injury.Sarah A Robertson, Mark R Hutchinson, Kenner C Rice, Peck-Yin Chin, Lachlan M Moldenhauer, Michael J Stark, David M Olson, Jeffrey A Keela

Alpha scattering and capture reactions in the A = 7 system at low energies

Differential cross sections for $^3$He-$\alpha$ scattering were measured in the energy range up to 3 MeV. These data together with other available experimental results for $^3$He $+ \alpha$ and $^3$H $+ \alpha$ scattering were analyzed in the framework of the optical model using double-folded potentials. The optical potentials obtained were used to calculate the astrophysical S-factors of the capture reactions $^3$He$(\alpha,\gamma)^7$Be and $^3$H$(\alpha,\gamma)^7$Li, and the branching ratios for the transitions into the two final $^7$Be and $^7$Li bound states, respectively. For $^3$He$(\alpha,\gamma)^7$Be excellent agreement between calculated and experimental data is obtained. For $^3$H$(\alpha,\gamma)^7$Li a $S(0)$ value has been found which is a factor of about 1.5 larger than the adopted value. For both capture reactions a similar branching ratio of $R = \sigma(\gamma_1)/\sigma(\gamma_0) \approx 0.43$ has been obtained.Comment: submitted to Phys.Rev.C, 34 pages, figures available from one of the authors, LaTeX with RevTeX, IK-TUW-Preprint 930540

Introduced and invasive cactus species – a global review

Understanding which species are introduced and become invasive and why are central questions in invasion science. Comparative studies on model taxa have provided important insights, but much more needs to be done to unravel the context-dependencies of these findings. The cactus family (Cactaceae), one of the most popular horticultural plant groups, is an interesting case study. Hundreds of cactus species have been introduced outside their native ranges; a few of them are among the most damaging invasive plant species in the world. We reviewed the drivers of introductions and invasions in the family and seek insights that can be used to minimise future risks. We compiled a list of species in the family and determined which have been recorded as invasive. We also mapped current global distributions and modelled the potential global distributions based on bioclimatic data of known invasive taxa. Finally, we identified whether invasiveness is phylogenetically clustered for cacti and whether particular traits are correlated with invasiveness. Only 57 of the 1922 cactus species recognised in this treatment have been recorded as invasive. There are three invasion hotspots: South Africa (35 invasive species recorded), Australia (26 species), and Spain (24 species). However, there are large areas of the world with climates suitable for cacti that are at risk of future invasion - in particular parts of China, eastern Asia and central Africa. The invasive taxa represent an interesting subset of the total species pool. There is a significant phylogenetic signal: invasive species occur in two of the three major phylogenetic clades, and in 13 of the 130 genera. This phylogenetic signal is not driven by human preference, i.e. horticultural trade. Moreover, all invasive species are from five of the 12 cactus growth forms. Finally, invasive species tend to have significantly larger native ranges than noninvasive species, and none of the invasive species are of conservation concern in their native range. These results suggest fairly robust correlates of invasiveness that can be used for proactive management and risk assessments.The Working for Water (WfW) Programme of the South African Department of Environmental Affairs and the DST-NRF Centre of Excellence for Invasion Biology (C•I•B) as part of the C•I•B/WfW collaborative research programme on ―Research for Integrated Management of Invasive Alien Species‖. DMR acknowledges additional support from the National Research Foundation (grant 85417) and the Oppenheimer Memorial Trust.http://aobpla.oxfordjournals.orgam201

Tensor-scalar gravity and binary-pulsar experiments

Some recently discovered nonperturbative strong-field effects in tensor-scalar theories of gravitation are interpreted as a scalar analog of ferromagnetism: "spontaneous scalarization". This phenomenon leads to very significant deviations from general relativity in conditions involving strong gravitational fields, notably binary-pulsar experiments. Contrary to solar-system experiments, these deviations do not necessarily vanish when the weak-field scalar coupling tends to zero. We compute the scalar "form factors" measuring these deviations, and notably a parameter entering the pulsar timing observable gamma through scalar-field-induced variations of the inertia moment of the pulsar. An exploratory investigation of the confrontation between tensor-scalar theories and binary-pulsar experiments shows that nonperturbative scalar field effects are already very tightly constrained by published data on three binary-pulsar systems. We contrast the probing power of pulsar experiments with that of solar-system ones by plotting the regions they exclude in a generic two-dimensional plane of tensor-scalar theories.Comment: 35 pages, REVTeX 3.0, uses epsf.tex to include 9 Postscript figure

An Effective-Medium Tight-Binding Model for Silicon

A new method for calculating the total energy of Si systems is presented. The method is based on the effective-medium theory concept of a reference system. Instead of calculating the energy of an atom in the system of interest a reference system is introduced where the local surroundings are similar. The energy of the reference system can be calculated selfconsistently once and for all while the energy difference to the reference system can be obtained approximately. We propose to calculate it using the tight-binding LMTO scheme with the Atomic-Sphere Approximation(ASA) for the potential, and by using the ASA with charge-conserving spheres we are able to treat open system without introducing empty spheres. All steps in the calculational method is {\em ab initio} in the sense that all quantities entering are calculated from first principles without any fitting to experiment. A complete and detailed description of the method is given together with test calculations of the energies of phonons, elastic constants, different structures, surfaces and surface reconstructions. We compare the results to calculations using an empirical tight-binding scheme.Comment: 26 pages (11 uuencoded Postscript figures appended), LaTeX, CAMP-090594-

Testing gravity to second post-Newtonian order: a field-theory approach

A new, field-theory-based framework for discussing and interpreting tests of gravity, notably at the second post-Newtonian (2PN) level, is introduced. Contrary to previous frameworks which attempted at parametrizing any conceivable deviation from general relativity, we focus on the best motivated class of models, in which gravity is mediated by a tensor field together with one or several scalar fields. The 2PN approximation of these "tensor-multi-scalar" theories is obtained thanks to a diagrammatic expansion which allows us to compute the Lagrangian describing the motion of N bodies. In contrast with previous studies which had to introduce many phenomenological parameters, we find that the 2PN deviations from general relativity can be fully described by only two new 2PN parameters, epsilon and zeta, beyond the usual (Eddington) 1PN parameters beta and gamma. It follows from the basic tenets of field theory, notably the absence of negative-energy excitations, that (beta-1), epsilon and zeta (as well as any new parameter entering higher post-Newtonian orders) must tend to zero with (gamma-1). It is also found that epsilon and zeta do not enter the 2PN equations of motion of light. Therefore, light-deflection or time-delay experiments cannot probe any theoretically motivated 2PN deviation from general relativity, but they can give a clean access to (gamma-1), which is of greatest significance as it measures the basic coupling strength of matter to the scalar fields. Because of the importance of self-gravity effects in neutron stars, binary-pulsar experiments are found to constitute a unique testing ground for the 2PN structure of gravity. A simplified analysis of four binary pulsars already leads to significant constraints: |epsilon| < 7x10^-2, |zeta| < 6x10^-3.Comment: 63 pages, 11 figures.ps.tar.gz.uu, REVTeX 3.