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To explore the experiences of older adults participating in strength and balance exercise programmes and understand participants’ rationale for programme uptake and completion.
Regular physical activity, specifically strength and balance exercises, has been shown to improve health and well-being and reduce the risk of falling in older adults. With the number of people living into older age increasing, understanding older people’s experiences of strength and balance programmes and what encourages their take-up and completion is extremely important. This paper reports on the qualitative experiences of older adults that previously participated in ProAct65+, a randomised controlled trial of Falls Management Exercise (FaME) programme and Otago Exercise Programme (OEP) versus usual care.
Ten general practices in Nottinghamshire and Derbyshire, England, who participated in the ProAct65+ trial were approached to take part. Using maximum variation sampling (age, gender, falls history, fear of falling and trial arm) we recruited, via the practices, 30 people that had participated in the FaME (n = 15) or OEP (n = 15) trial arms. Participants were interviewed in their own homes. Interviews were audio-recorded, transcribed verbatim and thematically analysed.
We identified five themes: choice of exercise programme; commitment, discipline and motivation; benchmarking, feedback and monitoring; benefits of the exercise programmes and reactions to the end of the programmes. There were four sub-themes within the benefits theme: pleasure and boredom, social interaction and isolation, physical benefits, and knowledge and understanding.
This study has outlined the experiences and identified specific barriers and facilitators to uptake and completion of falls-prevention exercises by older adults. The perspective and experiences of these participants is important if programmes are to be designed to meet the needs of the target population. Insights from this study will enable commissioners to develop and provide appropriate falls-prevention exercise programmes that encourage high uptake and programme completion.
Despite the lack of another Flagship-class mission such as Cassini–Huygens, prospects for the future exploration of Saturn are nevertheless encouraging. Both NASA and the European Space Agency (ESA) are exploring the possibilities of focused interplanetary missions (1) to drop one or more in situ atmospheric entry probes into Saturn and (2) to explore the satellites Titan and Enceladus, which would provide opportunities for both in situ investigations of Saturn’s magnetosphere and detailed remote-sensing observations of Saturn’s atmosphere. Additionally, a new generation of powerful Earth-based and near-Earth telescopes with advanced instrumentation spanning the ultraviolet to the far-infrared promise to provide systematic observations of Saturn’s seasonally changing composition and thermal structure, cloud structures and wind fields. Finally, new advances in amateur telescopic observations brought on largely by the availability of low-cost, powerful computers, low-noise, large-format cameras, and attendant sophisticated software promise to provide regular, longterm observations of Saturn in remarkable detail.
Non-motor features of Parkinson's disease (PD) and dementia with Lewy bodies (DLB), such as auditory hallucinations (AH), contribute to disease burden but are not well understood.
Systematic review and random-effects meta-analyses of studies reporting AH associated with PD or DLB. Prevalence of visual hallucinations (VH) in identified studies meeting eligibility criteria were included in meta-analyses, facilitating comparison with AH. Synthesis of qualitative descriptions of AH was performed. PubMed, Web of Science and Scopus databases were searched for primary journal articles, written in English, published from 1970 to 2017. Studies reporting AH prevalence in PD or DLB were screened using PRISMA methods.
Searches identified 4542 unique studies for consideration, of which, 26 met inclusion criteria. AH pooled prevalence in PD was estimated to be 8.9% [95% confidence interval (CI) 5.3–14.5], while in DLB was estimated to be 30.8% (±23.4 to 39.3). Verbal hallucinations, perceived as originating outside the head, were the most common form of AH. Non-verbal AH were also common while musical AH were rare. VH were more prevalent, with an estimated pooled prevalence in PD of 28.2% (±19.1 to 39.5), while in DLB they were estimated to be 61.8% (±49.1 to 73.0). Meta-regression determined that the use of validated methodologies to identify hallucinations produced higher prevalence estimates.
AH and VH present in a substantial proportion of PD and DLB cases, with VH reported more frequently in both conditions. Both AH and VH are more prevalent in DLB than PD. There is a need for standardised use of validated methods to detect and monitor hallucinations.
Active labour market policy (ALMP) is a well-established strategy but one aspect is greatly neglected – employer participation – about which there is a lack of systematic evidence. The question of why and how employers participate in ALMP, and whether there may be some shift from employers solely being passive recipients of job-ready candidates to having a more proactive and strategic role, is addressed by drawing on new research into Talent Match, a contemporary UK employability programme which places particular emphasis on employer involvement. The research findings point to a conceptual distinction between employers’ roles as being reactive gatekeepers to jobs and/or being proactive strategic partners, with both evident. It is argued that the Talent Match programme demonstrates potential to benefit employers, jobseekers and programme providers, with devolution of policy to the local level a possible way forward. The conclusion, however, is that the barrier to wider replication is not necessarily a problem of practice but of centralised control of policy and, in particular, commitment to a supply-side approach. Empirical, conceptual and policy contributions are made to this under-researched topic.
Çatalhöyük is one of the most well-known and important Neolithic/Chalcolithic sites in the Middle East. Settlement at the site encompasses two separate tell mounds known as Çatalhöyük East and West, with the focus of attention having traditionally been upon what is often regarded as the main site, the earlier East Mound. Limitations of dating evidence have, however, rendered the nature of the relationship between the settlements on these mounds unclear. Traditional models favoured a hiatus between their occupation, or, alternatively, a rapid shift from one site to the other, often invoking changes in natural conditions by way of an explanation. New dates challenge these theories, and indicate a potentially significant overlap between the occupation of the mounds, starting in the late seventh millennium BC.
Bats (Order: Chiroptera) have been widely studied as reservoir hosts for viruses of concern for human and animal health. However, whether bats are equally competent hosts of non-viral pathogens such as bacteria remains an important open question. Here, we surveyed blood and saliva samples of vampire bats from Peru and Belize for hemotropic Mycoplasma spp. (hemoplasmas), bacteria that can cause inapparent infection or anemia in hosts. 16S rRNA gene amplification of blood showed 67% (150/223) of common vampire bats (Desmodus rotundus) were infected by hemoplasmas. Sequencing of the 16S rRNA gene amplicons revealed three novel genotypes that were phylogenetically related but not identical to hemoplasmas described from other (non-vampire) bat species, rodents, humans, and non-human primates. Hemoplasma prevalence in vampire bats was highest in non-reproductive and young individuals, did not differ by country, and was relatively stable over time (i.e., endemic). Metagenomics from pooled D. rotundus saliva from Peru detected non-hemotropic Mycoplasma species and hemoplasma genotypes phylogenetically similar to those identified in blood, providing indirect evidence for potential direct transmission of hemoplasmas through biting or social contacts. This study demonstrates vampire bats host several novel hemoplasmas and sheds light on risk factors for infection and basic transmission routes. Given the high frequency of direct contacts that arise when vampire bats feed on humans, domestic animals, and wildlife, the potential of these bacteria to be transmitted between species should be investigated in future work.
The Neolithic in the central Balkans saw dramatic changes in settlement forms, architecture, and material culture, with substantial, often long-lived settlements that can reasonably be called villages emerging in the later part of the period. This paper examines the role of herding practices in the development of these large, more-or-less settled communities. Radiocarbon results (including twenty-seven new AMS dates from Gomolava, Opovo, and Petnica) are used to place the available zooarchaeological data into a chronological framework, allowing comparison of inter- and intra-site changes across the region. The data point to the development of large-scale cattle herding in the later Neolithic, the implications of which for mobility and community cohesion are discussed. This trend is seen clearly over time at certain sites but, like the settlement evidence, is neither universal nor synchronous across the region, emphasizing that change occurred, and should be understood, on the level of individual communities.
The first infrared photometry of an L-type brown dwarf, DENIS J0255-4700, includes N-band and narrow-band 8.8-μm detections, with upper limits in narrow-band 10.3 and 11.7 μm. Model-independent blackbody fits of existing data yield Teff = 1250 – 1750 K, with models favoring the lower end of that range. Dusty atmospheric models by Allard, Burrows and Marley which match the near-infrared photometry are not completely consistent with our mid-infrared photometry.
The Exeter Book Riddles are anonymous, and the generally formulaic character of all Old English verse discourages attempts to establish unity or diversity of authorship for them; but correlations between the sequence of Riddles in the manuscript and the recurrence from poem to poem of aspects of form, content (including solutions), presentation and style sometimes suggest common authorship for particular runs of texts, or reveal shaping episodes in the collection's transmission. Investigation along these lines throws up clear differences between the two main blocks of Riddles (1–59 and 61–95), and evidence emerges that the composition of many (at least) of Riddles 61–95 was influenced by a reading of Riddles 1–59.
Determination of atmospheric temperature structure is of paramount importance to the understanding of planetary atmospheric structure. The most powerful methods for determining atmospheric structure exploit the opacities provided by the collision induced H2 dipole and the ν4 fundamental of CH4. In addition to earth-based observations, useful measurements of thermal emission from Jupiter and Saturn have been or soon will be made by several spacecraft, with results cross-checked with independent radio occultation results. For Uranus and Neptune, only a limited set of whole-disk earth-based data exists. All the outer planets show evidence for stratospheric temperature inversions; temperature minima range from about 105 K for Jupiter and 87 K for Saturn, to roughly 55 K for Uranus and Neptune. In addition to better data, remaining problems may be resolved by better quantitative understanding of gas and aerosol absorption and scattering properties, chemical composition, and non-LTE source functions. Ultimately, temperature structure results must be supplemented by quantitative energy equilibrium models which will allow some meaning to be given to the relationships between such characteristics as temperature, clouds, incident solar and planetary radiation, and chemical composition.
Background: Recanalization rates and patient outcomes in acute occlusion of the carotid terminus have previously been poor. The use of stent-retrievers has resulted in better recanalization and patient outcomes. We sought to compare outcomes in patients treated with stent-retrievers to outcomes in older techniques. Methods: We retrospectively compared a stent-retriever cohort to a historical cohort. We evaluated recanalization rates and good outcomes (defined as mRS < 2 at 30 days or 10 point drop in NIHSS). Results: There were twenty patients treated with stent-retrievers versus nine without. The recanalization rate in patients treated with stent retrievers was significantly higher than that of other modalities (90% vs 33%, p=0.004). Good outcomes were significantly higher in the stent retriever cohort (70% vs 22%, p=0.041). Conclusion: The use of stent-retrievers in patients with carotid “T” occlusions shows promise in comparison to older techniques. A randomized trial comparing stent-retriever therapy to IV thrombolysis is warranted to determine the efficacy of this new generation of devices.
Model scale tests of modern ‘open rotor’ propulsor concepts that have potential for significant fuel burn reduction for aircraft applications were completed at NASA Glenn Research Center. The recent test campaign was a collaboration between NASA, FAA, and General Electric (GE). GE was the primary industrial partner, but other organisations were involved such as Boeing and Airbus who provided additional hardware for fuselage simulations. The open rotor is a modern version of the UnDucted Fan (UDF®) that was flight tested in the late 1980s through a partnership between NASA and GE. The UDF® was memorable for its scimitar shaped propeller blades and its unique noise signature. Design methods of the time were not able to optimise for both high aerodynamic efficiency and low noise simultaneously. Contemporary CFD/CAA based design methods can produce open rotor blade designs that maintain efficiency with acceptable acoustic signatures. Tests of two generations of new open rotor designs were conducted in the 9’ × 15’ Low Speed Wind Tunnel and the 8’ × 6’ Supersonic Wind Tunnel starting in late 2009 and completed in early 2012. Aerodynamic performance and acoustic data were obtained for take-off, approach and cruise conditions in isolated and semi-installed configurations. Additional detailed flow diagnostic measurements and acoustic measurements, including canonical shielding configurations, were obtained by NASA. NASA and GE conducted joint systems analysis to evaluate the performance of the new blade designs on a Boeing 737 class aircraft. The program demonstrated a 2-3% improvement in overall net efficiency relative to the best efficiency designs of the 1980s while nominally achieving 15-17 EPNdB noise margin to Chapter 4 (at a Technology Readiness Level of 5) for a notional aircraft system defined by NASA.