Cognition and type 2 diabetes : the interplay of risk factors

Type 2 diabetes is a risk factor for dementia. Over a period of twelve years, a more rapid decline in cognitive function was found in people suffering from diabetes compared to people who did not suffer from this disease. It was shown, among other things, that cognitive impairment in people suffering from diabetes was associated with high blood pressure as well as low blood pressure. In elderly women, larger amounts of fat and muscle tissue were found to be associated with a lower risk of developing dementia. In men, only larger amounts of muscle tissue were found to be associated with a lower risk of developing dementia. These findings could lead to new ways to delay or prevent dementia. Furthermore, it was shown that an impaired understanding of words was associated with the presence of cardiovascular disease, neuralgia and lower levels of physical fitness. Therefore, doctors should be aware of the level of education reached by their diabetes patients

The treatment of soft-tissue defects of the lower leg after a traumatic open tibial fracture

The treatment of large soft-tissue defects of the lower leg remains a challenge. The timing of the operation, the most suitable type of tissue, and the decision between local or free flap coverage still remains under discussion. Fifty-two patients were treated with local or free flap coverage after a traumatic soft-tissue defect of the lower leg. We compared the results after treatment with local versus free flaps and fasciocutaneous flaps versus musculocutaneous flaps. In the case of primary reconstruction, we also compared the results regarding the timing of the operation: patients treated within 72 h after the trauma versus patients treated after 72 h. Thirty-five patients (67%) have been treated because of posttraumatic soft-tissue defects and, therefore, insufficient fracture coverage. Seventeen patients (33%) were treated because of a chronic osteomyelitis that arose after the trauma. In our study, we did not find a statistically significant difference between the postoperative complications of local and free flaps. A significant increase could be demonstrated in the number of revisions after treatment with a free flap. Treatment with a fasciocutaneous flap in the entire study group was associated with significantly more postoperative complications than treatment with a musculocutaneous flap. There was no significant difference in results after early or late flap coverage. Patients treated with local or free flaps achieved equal outcomes, except for the number of postoperative revisions in which local flaps required lesser revisions. Treatment with a musculocutaneous flap is preferable to treatment with a fasciocutaneous flap regarding postoperative complications. The timing of operation proved not to be a discriminating factor

Monkey see, monkey do: truth-telling in matching algorithms and the manipulation of others

We test the effect of the amount of information on the strategies played by others in the theoretically strategy-proof Top Trading Cycles (TTC) mechanism. We find that providing limited information on the strategies played by others has a negative and significant effect in truth-telling rates. Subjects report truthfully more often when either full information or no information on the strategies played by others is available. Our results have potentially important implications for the design of markets based on strategy-proof matching algorithms

Dealing with patients with behavioural problems after acquired brain injury: nurses’ experiences with the antecedent behaviour consequence method

Context: Behavioural problems are common after brain injury and can cause feelings of distress in the nursing staff, which can in turn have a negative influence on the behaviour of the patient. Nurses often do not feel they have the necessary skills to apply behavioural interventions in daily practise. They may benefit from the ABC (Antecedent-Behaviour-Consequence) method. Objective(s): This study examined nurses’ impressions of the effects after implementation of the ABC method on a brain-injury ward. Method(s): This study is part of the long-term follow-up (LT-FU) of our longitudinal group intervention study. Nurses were asked to complete a questionnaire once at the time of the LT-FU. Outcome measures were based on the theory of planned behaviour (Ajzen, 1991). Descriptive statistics were used. Findings: After implementation of the ABC method, most nurses reported they perceived behavioural control, received social support, had few feelings of fear, and had confidence in the way they deal with behavioural problems. Moreover, nurses reported positive changes in all these topics since working with the method. Limitations: Although first findings are interesting, we must also underline that the absence of a baseline measurement is a shortcoming of the study. Implications: Training nursing staff in managing behavioural problems with the ABC method might give them more perceived control and decrease feelings of distress and fear. Further longitudinal research is needed to investigate these experiences of the nursing staff to examine whether this has a positive effect on their well-being, job-satisfaction, and the behavioural problems of patients