Journey patterns of the elderly and disabled in the Cotswolds: a spatial analysis.

The decline of services and transport provision in the North Cotswolds has led to a progressive deterioration in the welfare of the elderly and disabled. This study, based on interviews with 498 individuals in eight typical parishes, relates the travel behaviour of these groups to health status, personal circumstances, the grade and location of services, and mode of transport. The repercussions of the 1985 Transport Act for the car-less and severely disabled are then examined. Given the increased loadings on domiciliary support systems, the case is argued for coordinated initiatives in alternative transport provision which relate, sensitively, to the needs of the different groups among the elderly and disabled.

Communication deviations in alcoholics; a pilot study.

Impairments in speech, language, voice and hearing were observed in 14 of 15 alcoholics in treatment.

Telecommunications and disabled people: a rural perspective.

In the context of the National Health Service and Community Care Act 1990 this paper focuses on the role of home- and community-based telecommunication services in sustaining the life-style and independence of elderly and disabled people in rural Britain. It draws on findings from a recent survey in the North Cotswolds to evaluate four models of telecommunication support: telephone trees; community alarm systems; community teleservice centres (CTCs); and on-line computer systems. The arguments in favour of a "low-cost-voluntary-care-support-model", a variant of the CTC, are discussed with respect to client need and community setting.

Prediction of serum IgG1 concentration in beef calves based on age and serum gamma-glutamyl-transferase activity.

This study examined the relationship between serum gamma-glutamyl-transferase (GGT) activity and passive transfer status in beef calves less than 18 days of age. Immunoglobulin G1 (IgG1) concentrations were measured in 69 commercial beef calves between the ages of 24 and 72 hours. GGT activities were then measured in these same calves at various ages between 3 and 18 days of age. Models were developed predicting serum IgG1 concentration as a function of calf age and serum GGT activity. Minimal association was present between initial serum IgG1 concentration and serum GGT activity when all calves less than 18 days of age were considered (r2 = 0.065). When the study population was restricted to calves less than 8 days of age, the fit of the developed model was greatly improved (r2 = 0.438). Serum GGT activity has no apparent advantage relative to other assay procedures for predicting passive transfer status in beef calves. If serum GGT activity is to be used to assess passive transfer status in beef calves, application of this procedure should be restricted to calves less than 8 days of age.

Use of age and serum gamma-glutamyltransferase activity to assess passive transfer status in lambs.

OBJECTIVE: To develop an algorithm for predicting passive transfer status of lambs of various ages, using the lamb's age and serum gamma-glutamyltransferase (GGT) activity. DESIGN: Prospective study. ANIMALS: 51 Suffolk, Columbia, and crossbred lambs from 1 to 16 days old. PROCEDURE: Serum was obtained from all lambs. Serum GGT activity was measured, using a commercially available kit. Serum IgG concentration was determined by use of radial immunodiffusion. Day-1 serum IgG concentration was estimated from sample IgG concentration, lamb age, and the published 14-day half-life of IgG in lambs. Stepwise multivariate regression models were developed to estimate day-1 serum IgG concentration as a function of the natural logarithm of serum GGT activity (In[GGT]) and natural logarithm of lamb age (In[age]) at the time of sampling. These regression models were then used to calculate serum GGT activities that were equivalent to various day-1 IgG concentrations in lambs of various ages. RESULTS: In(GGT) and In(age) were significantly associated with estimated day-1 IgG concentration. Day-1 serum IgG concentration could be predicted using the formula: IgG = -7,686 + 1,366(In[GGT]) + 1,199(In[age]). The model was moderately accurate in predicting serum IgG concentration (R2 = 0.52). CLINICAL IMPLICATIONS: Serum GGT activity can be used to assess passive transfer status of lambs.

The expanding role of signal-averaged electrocardiography.

Signal-averaged electrocardiography is a valuable diagnostic tool for determining which patients recovering from myocardial infarction are at risk of sudden death due to ventricular arrhythmias. Additionally, the value of this technique in determining which patients with ischemic heart disease and unexplained syncope are likely to have inducible sustained ventricular tachycardia has been established. This noninvasive screening procedure has shown promise in other clinical situations, but more investigation is needed before definitive recommendation can be made. Critical care nurses can help promote the success of signal-averaged electrocardiography by educating patients, promoting acquisition of a quality recording, helping allay patients' concerns, and participating in research activities.

Design of a self-cleaning thermoresponsive nanocomposite hydrogel membrane for implantable biosensors.

Following implantation of a biosensor, adhesion of proteins and cells and eventual fibrous encapsulation will limit analyte diffusion and impair sensor performance. A thermoresponsive nanocomposite hydrogel was developed as a self-cleaning biosensor membrane to minimize the effect of the host response and its utility for an optical glucose sensor, demonstrated here. It was previously reported that thermoresponsive nanocomposite hydrogels prepared from photopolymerization of an aqueous solution of N-isopropylacrylamide (NIPAAm) and polysiloxane colloidal nanoparticles released adhered cells with thermal cycling. However, poly(N-isopropylacrylamide) hydrogels exhibit a volume phase transition temperature (VPTT) of approximately 33-34 degrees C, which is below body temperature. Thus, the hydrogel would be in a collapsed state in vivo, which would ultimately limit diffusion of the target analyte (e.g., glucose) to the encapsulated sensor. In this study, the VPTT of the nanocomposite hydrogel was increased by introducing N-vinylpyrrolidone (NVP) as a comonomer, so that the hydrogel was in the swollen state in vivo. This thermoresponsive nanocomposite hydrogel was prepared by the photopolymerization of an aqueous solution of NIPAAm, NVP, and polysiloxane colloidal nanoparticles. In addition to a VPTT a few degrees above body temperature, the hydrogel also exhibited good mechanical strength, glucose diffusion, and in vitro cell release upon thermal cycling. Thus, this nanocomposite hydrogel may be useful as a biosensor membrane to minimize biofouling and extend the lifetime and efficiency of implantable glucose sensors and other biosensors.

Three-dimensional kinematics of the rearfoot during the stance phase of walking in normal young adult males.

Three-dimensional video analysis was used to quantify three-dimensional motion of the rearfoot in 14 normal young adult males during the stance phase of walking. A stringent calibration procedure enabled standardization of the neutral position of the rearfoot. Surface markers were placed on the calcaneus and lower tibia, and a joint coordinate system was used to determine the relative displacement between the calcaneus and lower leg as representative of rearfoot motion. Confirmation was made of the assumption of a mechanical coupling between the rearfoot displacements of abduction/adduction and eversion/inversion. However, there were several findings which contrasted with commonly held assumptions. For example, the rearfoot was found to evert gradually, rather than rapidly, from heel contact to just prior to heel rise. Also the conventional descriptions of the composite movements of pronation and supination were not applicable to rearfoot movement in this study, and it was therefore concluded that pronation and supination are not valid descriptors of three-dimensional rearfoot motion during the stance phase of walking.

Effect of anionic salts on selenium metabolism in nonlactating, pregnant dairy cows.

The objective of this trial was to determine whether anionic salts in the diets of nonlactating, pregnant cows for 14 to 21 d prepartum affected measures of Se status. One of three dietary treatments (control, anionic salts, and anionic salts plus Se) was administered to 34 nonlactating, pregnant cows using a completely randomized design with repeated measures. The anionic salts were delivered via gelatin capsules that were administered orally in two equal amounts per day, and the Se (3 mg/d) was administered via an intraruminal bolus. The incidence of milk fever among cows was not significantly different across dietary treatments. The severity of hypocalcemia as indicated by concentrations of ionized Ca in serum collected < 2 h postpartum was significantly lessened by dietary anionic salts. Supplementation of anionic salts to the diet did not significantly affect serum Ca concentrations at either 7 d prepartum or 7 d postpartum. Anionic salts did not affect concentrations of Se in blood; however, Se supplementation of the diets of cows significantly increased postpartum concentrations of Se in serum. No treatment effects were detected for concentrations of Se in either serum or whole blood of newborn calves. In conclusion, these data indicate that diets supplemented with anionic salts for 14 to 21 d prepartum and the supplementation of diets with Se had independent effects on concentrations of minerals in blood. Thus, anionic salts administered to prevent milk fever without danger of significantly reducing the transfer of Se from the dam to the calf and without compromising the Se status of the cow when the anionic salts are limited to administration for 14 to 21 d before calving.

C5b-7 and C5b-8 precursors of the membrane attack complex (C5b-9) are effective killers of E. coli J5 during serum incubation.

The finding that C9-deficient sera (C9D) can kill serum sensitive strains of Gram-negative bacteria by us and other investigators, questions the role of C9 in the membrane attack complex as necessary for cell death. In these studies we have demonstrated that C5b-8 complexes generated on E. coli J5 during incubation in C9-depleted and C9-neutralized sera are effective in killing Gram-negative bacteria. In the same study, we extended our investigations to show that the deposition of C5b-7 complexes (from C8-deficient [C8D], C8 depleted and C8-neutralized sera) is also effective in killing Gram-negative bacteria. In all cases, these studies demonstrated that when E. coli J5 was incubated with C8D, C9D and pooled normal human serum [PNHS], deposited C5b-9 complexes from PNHS produced more killing than C5b-7 or C5b-8 complexes alone. These experiments clearly demonstrated that C5b-7 and C5b-8 complexes are bactericidal and that multimeric C9 within C5b-9 is not an absolute requirement for inner membrane damage and cell death of Gram-negative bacteria.