Illinois Forest Game Investigations W-87-R-9, Quarterly Federal Aid Performance Report 1 July - 30 September 1987

Quarterly Federal Aid Performance Report W-87-R-9, 1 July - 30 September 1987; Study No. VII-D Harvest Strategies for Illinois Deer Herds, Urban Deer StudyReport issued on: September 30, 1987INHS Technical Report prepared for unspecified recipien

Alien Registration- Witham, Evelyn M. (Portland, Cumberland County)

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Do ACE inhibitors improve the response to exercise training in functionally impaired older adults? A randomized controlled trial

<br>Background: Loss of muscle mass and strength with ageing is a major cause for falls, disability, and morbidity in older people. Previous studies have found that angiotensin-converting enzyme inhibitors (ACEi) may improve physical function in older people. It is unclear whether ACEi provide additional benefit when added to a standard exercise training program. We examined the effects of ACEi therapy on physical function in older people undergoing exercise training.</br> <b>Methods:</b> Community-dwelling people aged ≥65 years with functional impairment were recruited through general (family) practices. All participants received progressive exercise training. Participants were randomized to receive either 4 mg perindopril or matching placebo daily for 20 weeks. The primary outcome was between-group change in 6-minute walk distance from baseline to 20 weeks. Secondary outcomes included changes in Short Physical Performance Battery, handgrip and quadriceps strength, self-reported quality of life using the EQ-5D, and functional impairment measured using the Functional Limitations Profile.<p></p> <b>Results:</b> A total of 170 participants (n = 86 perindopril, n = 84 placebo) were randomized. Mean age was 75.7 (standard deviation [SD] 6.8) years. Baseline 6-minute walk distance was 306 m (SD 99). Both groups increased their walk distance (by 29.6 m perindopril, 36.4 m placebo group) at 20 weeks, but there was no statistically significant treatment effect between groups (−8.6m [95% confidence interval: −30.1, 12.9], p = .43). No statistically significant treatment effects were observed between groups for the secondary outcomes. Adverse events leading to withdrawal were few (n = 0 perindopril, n = 4 placebo).<p></p> <b>Interpretation:</b> ACE inhibitors did not enhance the effect of exercise training on physical function in functionally impaired older people.<p></p&gt

Research note – barriers and solutions to linking and using health and social care data in Scotland

Integration of health and social care will require integrated data to drive service evaluation, design, joint working and research. We describe the results of a Scottish meeting of key stakeholders in this area. Potential uses for linked data included understanding client populations, mapping trajectories of dependency, identifying at risk groups, predicting required capacity for future service provision, and research to better understand the reciprocal interactions between health, social circumstances and care. Barriers to progress included lack of analytical capacity, incomplete understanding of data provenance and quality, intersystem incompatibility and issues of consent for data sharing. Potential solutions included better understanding the content, quality and provenance of social care data; investment in analytical capacity; improving communication between data providers and users in health and social care; clear guidance to systems developers and procurers; and enhanced engagement with the public. We plan a website for communication across Scotland on health and social care data linkage, educational resources for front line staff and researchers, plus further events for training and information dissemination. We believe that these processes hold lessons for other countries with an interest in linking health and social care data, as well as for cross-sector data linkage initiatives in general.</p

Effect of two different participant information sheets on recruitment to a falls trial:an embedded randomised recruitment trial

Background/Aims: Recruitment to trials of intervention for older people who fall is challenging. Evidence suggests that the word falls has negative connotations for older people, and this may present a barrier to engaging with trials in this area. We therefore tested whether a participant information sheet that minimised reference to falls could improve recruitment rates. Methods: We conducted a study within a trial, embedded within a randomised controlled trial of vitamin K versus placebo to improve postural sway in patients aged 65 and over with a history of falls. Potential participants were identified from primary care lists in 14 practices and were randomised to receive either a standard participant information sheet or an information sheet minimising use of the word falls, instead focussing on maintenance of health, fitness and balance. The primary outcome for this embedded trial was the proportion of responses expressing interest in participating received in each arm. Secondary outcomes were the proportion of those contacted attending a screening visit, consenting at screening, and the proportion contacted who were randomised into the main trial. Results: In all, 4145 invitations were sent, with an overall response rate of 444 (10.7%). In all, 2148 individuals received the new information sheet (minimising reference to falls); 1997 received the standard information sheet. There was no statistically significant difference in response rate between those individuals sent the new information sheet and those sent the standard information sheet (10.1% vs 11.4%; difference 1.3% (95% confidence interval -0.6% to 3.2%); p = 0.19). Similarly, we found no statistically significant difference between the percentage of those who attended and consented at screening in the two groups (2.1% vs 2.7%; difference 0.6% (95% confidence interval: -0.4% to 1.6%); p = 0.20), and no statistically significant difference between the percentage randomised in the two groups (2.0% vs 2.6%; difference 0.6% (95% confidence interval -0.4% to 1.6%); p = 0.20). Conclusions: Use of a participant information sheet minimising reference to falls did not lead to a greater response rate in this trial targeting older people with a history of falls.</p