Audit of surgical delay in relationship to outcome after proximal femoral fracture.

To ascertain the influence of surgical delay on outcome after proximal femoral fracture in elderly females, a cohort study of patients presenting in 1987 was compared to 1989/90. Organisational changes in the intervening period were introduced to reduce delay to surgical intervention. Two hundred and eighty females aged 65 years and over presenting from the local catchment area of an acute inner-city teaching hospital were enrolled in the study. Seventy-nine patients received surgery in 1987 and 186 in 1989/90. The one year mortality was 34% and 26% respectively. The proportion receiving surgery within 24 hours rose from 34% in 1987 to 57% in 1989/90. The relative hazard of the group receiving surgery on day 2 in comparison to day 1 was 1.7 (95% CI 1.0 to 2.9) when adjusted for co-variance of age and mental score. Medically fit elderly patients presenting with proximal femoral fracture have improved survival with early surgery within 24 hours of admission. Improvements in the organisation of hospital care will result in important benefits for the increasing number of elderly females presenting with proximal femoral fracture

The Formation of the Collisional Family around the Dwarf Planet Haumea

Haumea, a rapidly rotating elongated dwarf planet (~ 1500 km in diameter), has two satellites and is associated with a "family" of several smaller Kuiper Belt objects (KBOs) in similar orbits. All members of the Haumea system share a water ice spectral feature that is distinct from all other KBOs. The relative velocities between the Haumea family members are too small to have formed by catastrophic disruption of a large precursor body, which is the process that formed families around much smaller asteroids in the Main Belt. Here we show that all of the unusual characteristics of the Haumea system are explained by a novel type of giant collision: a graze-and-merge impact between two comparably sized bodies. The grazing encounter imparted the high angular momentum that spun off fragments from the icy crust of the elongated merged body. The fragments became satellites and family members. Giant collision outcomes are extremely sensitive to the impact parameters. Compared to the Main Belt, the largest bodies in the Kuiper Belt are more massive and experience slower velocity collisions; hence, outcomes of giant collisions are dramatically different between the inner and outer solar system. The dwarf planets in the Kuiper Belt record an unexpectedly large number of giant collisions, requiring a special dynamical event at the end of solar system formation.Comment: Accepted for publication in ApJ, 12 pages, 4 figures, 2 tables

The experience of patients with advanced chronic obstructive pulmonary disease and advance care-planning: a South Australian perspective

Advance care-planning conversations with people who have chronic obstructive pulmonary disease (COPD) are important because of the severity of the disease and the unpredictable timing of death. Advance care-planning is a process involving conversations about future wishes, including end-of-life care and the appointment of a substitute decision-maker. This qualitative research explored issues relating to end-of-life decisions with 15 individuals and their carers living in the community who had severe COPD. Findings indicated that, although patients and carers would welcome the opportunity to discuss end-of-life decisions, almost no conversation about care-planning had been initiated by health professionals with any of the participants. It also demonstrated that professional support is required to assist with advance care-planning and the completion of the legal advance directive documents.M. Brown, M.A. Brooksbank, T.A. Burgess, M. Young and G.B. Crawfordhttp://www.ncbi.nlm.nih.gov/pubmed/2343185

Observation of isotonic symmetry for enhanced quadrupole collectivity in neutron-rich 62,64,66Fe isotopes at N=40

The transition rates for the 2_{1}^{+} states in 62,64,66Fe were studied using the Recoil Distance Doppler-Shift technique applied to projectile Coulomb excitation reactions. The deduced E2 strengths illustrate the enhanced collectivity of the neutron-rich Fe isotopes up to N=40. The results are interpreted by the generalized concept of valence proton symmetry which describes the evolution of nuclear structure around N=40 as governed by the number of valence protons with respect to Z~30. The deformation suggested by the experimental data is reproduced by state-of-the-art shell calculations with a new effective interaction developed for the fpgd valence space.Comment: 4 pages, 2 figure

Thermal Hadron Production in High Energy Heavy Ion Collisions

We provide a method to test if hadrons produced in high energy heavy ion collisions were emitted at freeze-out from an equilibrium hadron gas. Our considerations are based on an ideal gas at fixed temperature $T_f$, baryon number density $n_B$, and vanishing total strangeness. The constituents of this gas are all hadron resonances up to a mass of 2 GeV; they are taken to decay according to the experimentally observed branching ratios. The ratios of the various resulting hadron production rates are tabulated as functions of $T_f$ and $n_B$. These tables can be used for the equilibration analysis of any heavy ion data; we illustrate this for some specific cases.Comment: 12 pages (not included :13 figures + tables) report CERN-TH 6523/92 and Bielefeld preprint BI-TP 92/0

Beta-delayed proton emission in the 100Sn region

Beta-delayed proton emission from nuclides in the neighborhood of 100Sn was studied at the National Superconducting Cyclotron Laboratory. The nuclei were produced by fragmentation of a 120 MeV/nucleon 112Sn primary beam on a Be target. Beam purification was provided by the A1900 Fragment Separator and the Radio Frequency Fragment Separator. The fragments of interest were identified and their decay was studied with the NSCL Beta Counting System (BCS) in conjunction with the Segmented Germanium Array (SeGA). The nuclei 96Cd, 98Ing, 98Inm and 99In were identified as beta-delayed proton emitters, with branching ratios bp = 5.5(40)%, 5.5+3 -2%, 19(2)% and 0.9(4)%, respectively. The bp for 89Ru, 91,92Rh, 93Pd and 95Ag were deduced for the first time with bp = 3+1.9 -1.7%, 1.3(5)%, 1.9(1)%, 7.5(5)% and 2.5(3)%, respectively. The bp = 22(1)% for 101Sn was deduced with higher precision than previously reported. The impact of the newly measured bp values on the composition of the type-I X-ray burst ashes was studied.Comment: 15 pages, 14 Figures, 4 Table

Who does not gain weight? Prevalence and predictors of weight maintenance in young women

OBJECTIVE: To investigate the prevalence and predictors of weight maintenance over time in a large sample of young Australian women. DESIGN: This population study examined baseline and 4 y follow-up data from the cohort of young women participating in the Australian Longitudinal Study on Women\u27s Health. SUBJECTS: A total of 8726 young women aged 18-23 y at baseline. MEASURES: Height, weight and body mass index (BMI); physical activity; time spent sitting; selected eating behaviours (eg dieting, disordered eating, takeaway food consumption); cigarette smoking, alcohol consumption; parity; and sociodemographic characteristics. RESULTS: Only 44% of the women reported their BMI at follow-up to be within 5% of their baseline BMI (maintainers); 41% had gained weight and 15% had lost weight. Weight maintainers were more likely to be in managerial or professional occupations; to have never married; to be currently studying; and not to be mothers. Controlling for sociodemographic factors, weight maintainers were more likely to be in a healthy weight range at baseline, and to report that they spent less time sitting, and consumed less takeaway food, than women who gained weight. CONCLUSIONS: Fewer than half the young women in this community sample maintained their weight over this 4 y period in their early twenties. Findings of widespread weight gain, particularly among those already overweight, suggest that early adulthood, which is a time of significant life changes for many women, may be an important time for implementing strategies to promote maintenance of healthy weight. Strategies which encourage decreased sitting time and less takeaway food consumption may be effective for encouraging weight maintenance at this life stage.<br /

Young Stars and Protostellar Cores near NGC 2023

We investigate the young (proto)stellar population in NGC 2023 and the L 1630 molecular cloud bordering the HII region IC 434, using Spitzer IRAC and MIPS archive data, JCMT SCUBA imaging and spectroscopy as well as targeted BIMA observations of one of the Class 0 protostars, NGC 2023 MM1. We have performed photometry of all IRAC and MIPS images, and used color-color diagrams to identify and classify all young stars seen within a 22'x26' field along the boundary between IC 434 and L 1630. For some stars, which have sufficient optical, IR, and/or sub-millimeter data we have also used the online SED fitting tool for a large 2D archive of axisymmetric radiative transfer models to perform more detailed modeling of the observed SEDs. We identify 5 sub-millimeter cores in our 850 and 450 micron SCUBA images, two of which have embedded class 0 or I protostars. Observations with BIMA are used to refine the position and characteristics of the Class 0 source NGC 2023 MM 1. These observations show that it is embedded in a very cold cloud core, which is strongly enhanced in NH2D. We find that HD 37903 is the most massive member of a cluster with 20 -- 30 PMS stars. We also find smaller groups of PMS stars formed from the Horsehead nebula and another elephant trunk structure to the north of the Horsehead. We refine the spectral classification of HD 37903 to B2 Ve. Our study shows that the expansion of the IC 434 HII region has triggered star formation in some of the dense elephant trunk structures and compressed gas inside the L 1630 molecular cloud. This pre-shock region is seen as a sub-millimeter ridge in which stars have already formed. The cluster associated with NGC 2023 is very young, and has a large fraction of Class I sources.Comment: 21 pages, 11 figures. Accepted for publication in A&A Replaced with higher resolution figure