Occurrence of refeeding syndrome in adults started on artificial nutrition support: prospective cohort study

This final article is available for use under the terms of the Creative Commons Attribution Non-Commercial 2.0 Licence; see http://bmjopen.bmj.comRefeeding syndrome is a potentially life-threatening condition characterised by severe intracellular electrolyte shifts, acute circulatory fluid overload and organ failure. The initial symptoms are non-specific but early clinical features are severely low-serum electrolyte concentrations of potassium, phosphate or magnesium. Risk factors for the syndrome include starvation, chronic alcoholism, anorexia nervosa and surgical interventions that require lengthy periods of fasting. The causes of the refeeding syndrome are excess or unbalanced enteral, parenteral or oral nutritional intake. Prevention of the syndrome includes identification of individuals at risk, controlled hypocaloric nutritional intake and supplementary electrolyte replacementPeer reviewedFinal Published versio

Review of international approaches to evaluating rural and community development investment and supports. ESRI Research Series 124 April 2021.

The Department of Rural and Community Development (DRCD) was established in July 2017. Its mission is to ‘promote rural and community development and to support vibrant, inclusive and sustainable communities throughout Ireland’. DRCD’s Statement of Strategy 2021-2023 commits to building capacity to evaluate its work and impact to inform ongoing development of policies and programmes. As such, in September 2019 DRCD and the Economic and Social Research Institute (ESRI) entered into a joint Research Programme to help inform the Department’s rural and community development policy. This report is the first output published under the Research Programme. Its aim is to identify international approaches to the evaluation of rural and community development activities. In turn, this will help to improve public knowledge of measurement and evaluation of projects with a rural and community development emphasis and help inform policymaking decisions of the Department. All DRCD programmes and expenditure are targeted at rural and community development. However, DRCD programmes and expenditure are categorised into different areas of activity in this report to provide focus for the analysis of evaluation approaches internationally. Six main areas of activity were identified to review and examine the associated international approaches to evaluation. The majority of DRCD expenditure is targeted towards programmes with community and/or rural related objectives. For example, four programmes, focusing on either rural or community development, account for approximately 50 per cent of all DRCD expenditure in 2019. Therefore, most emphasis is placed on assessing international approaches in these areas. Many department programmes also involve capital spending. As such, a greater emphasis is also placed on approaches to evaluation in this area compared to other areas examined in this report i.e. enterprise supports, employment supports, and supporting/ developing amenities, which are outlined more briefly. In general, there are specific challenges associated with measuring the causal impact of both community and rural development programmes. For other areas, such as capital expenditure, the framework is more easily defined with Cost Benefit Analysis (CBA) being the main method of assessment. Enterprise supports, employment and provision/development of amenities also generally have a clearer method for analysis. These overall findings and next steps are discussed below for each of the six main areas of department activities

(Lack of) Pension Knowledge

Governments are increasingly concerned about the capacity of pensions systems to meet demands in the coming years. According to the OECD, one part of the policy response in many countries will be greater private provision on the part of individuals through occupational and other pension arrangements. If such a strategy is to work, it requires that individuals are well-informed about pensions. However, there are many reasons to believe that individuals may not be well-informed due to the complexity of pensions systems and degrees of myopia. In this paper, we assess levels of knowledge of pensions using a representative sample of older Irish people. Looking at people who are enrolled in pension schemes, we find that two thirds of these people do not know what amount will be paid out on retirement and/or whether the payments will be in the form of lump-sums, monthly payments or both. Women are more likely not to know, as are people with lower levels of education. While one policy conclusion might be to direct pensions-related information at certain groups, another approach might be to extend the mandatory elements in pension systems such as contribution rates

Stumping and Stunts: Walking in Circles in the “Go-As-You-Please” Race

New York City, 1884: 14 contestants set out to walk round and round a track for six days in the “go-as-you-please” race, taking as little rest as possible. What does this durational act tell us about a type of performance just beginning to be named in New York slang as a “stunt”? Anticipating early-20th-century dance marathons and later durational performance art, the race enacted and troubled circulation, revealing fault lines of valorization: between work and leisure, work and life, and sporting and theatrical performance

Effect of NASA Light-emitting Diode Irradiation on Wound Healing

Objective: The purpose of this study was to assess the effects of hyperbaric oxygen (HBO) and near-infrared light therapy on wound healing. Background Data: Light-emitting diodes (LED), originally developed for NASA plant growth experiments in space show promise for delivering light deep into tissues of the body to promote wound healing and human tissue growth. In this paper, we review and present our new data of LED treatment on cells grown in culture, on ischemic and diabetic wounds in rat models, and on acute and chronic wounds in humans. Materials and Methods: In vitro and in vivo (animal and human) studies utilized a variety of LED wavelength, power intensity, and energy density parameters to begin to identify conditions for each biological tissue that are optimal for biostimulation. Results: LED produced in vitro increases of cell growth of 140–200% in mouse-derived fibroblasts, rat-derived osteoblasts, and rat-derived skeletal muscle cells, and increases in growth of 155–171% of normal human epithelial cells. Wound size decreased up to 36% in conjunction with HBO in ischemic rat models. LED produced improvement of greater than 40% in musculoskeletal training injuries in Navy SEAL team members, and decreased wound healing time in crew members aboard a U.S. Naval submarine. LED produced a 47% reduction in pain of children suffering from oral mucositis. Conclusion: We believe that the use of NASA LED for light therapy alone, and in conjunction with hyperbaric oxygen, will greatly enhance the natural wound healing process, and more quickly return the patient to a preinjury/ illness level of activity. This work is supported and managed through the NASA Marshall Space Flight Center–SBIR Program

Does external walking environment affect gait patterns

The objective of this work is to develop an understanding of the relationship between mobility metrics obtained outside of the clinic or laboratory and the context of the external environment. Ten subjects walked with an inertial sensor on each shank and a wearable camera around their neck. They were taken on a thirty minute walk in which they mobilized over the following conditions; normal path, busy hallway, rough ground, blind folded and on a hill. Stride time, stride time variability, stance time and peak shank rotation rate during swing were calculated using previously published algorithms. Stride time was significantly different between several of the conditions. Technological advances mean that gait variables can now be captured as patients go about their daily lives. The results of this study show that the external environment has a significant impact on the quality of gait metrics. Thus, context of external walking environment is an important consideration when analyzing ambulatory gait metrics from the unsupervised home and community setting

The Streets of Laredo

One of the best-known of the old cowboy folksongs has a Butler County connection. In his memoir of his days as an open-range cowboy throughout the 1870s, Frank Maynard, whose home was Towanda in the western edge of the Flint Hills, told how he came to write the lyrics to the song we know as “The Cowboy’s Lament” or “The Streets of Laredo,” which he set at the doorway of Tom Sherman’s barroom in Dodge City

Paclitaxel-eluting balloon and everolimus-eluting stent for provisional stenting of coronary bifurcations: 12-month results of the multicenter BIOLUX-I study

Background: Several studies investigated the combination of bare metal stents in the main branch and drug-eluting balloons in the side branch in bifurcation lesions, but data on the combination of drug-eluting stents and drug-eluting balloons are scarce. We aim to assess the feasibility of provisional stenting with an everolimus-eluting stent in the main branch and a paclitaxel-eluting balloon in the side branch. Methods: In this prospective, multi-center study conducted in 5 Australian sites, 35 patients with bifurcation lesions were enrolled. Angiographic and intravascular ultrasound assessments were conducted at 9. months; clinical follow-up was conducted until 12. months. Results: The primary endpoint, late lumen loss in the side branch measured by quantitative coronary angiography, was 0.10 ± 0.43. mm. No binary restenosis was observed. One patient died; 3 myocardial infarctions (one suspected and two in non-target vessels) and one target lesion revascularization occurred. No probable or definite stent thrombosis was observed. Conclusion: The combination of an everolimus-eluting stent in the main branch and a paclitaxel-eluting balloon in the side branch appears to be a safe, effective and novel treatment option for bifurcation lesions