Building resilience and reversing frailty: a randomised controlled trial of a primary care intervention for older adults.

Background: There is a need for effective primary care interventions that help older people combat frailty and build resilience.

Objective: To study the effectiveness of an optimised exercise and dietary protein intervention.

Design: Multicentre, randomised-controlled, parallel-arm trial.

Protocol for a randomised controlled trial of a primary care intervention to Reverse Frailty and Enhance Resilience through Exercise and dietary protein Education (REFEREE) in community-dwelling adults aged 65 and over.

Resistance exercises and dietary protein have been shown to reverse frailty, yet they are not commonly offered in clinical practice. We aim to measure changes in health outcomes, including physical frailty status (SHARE-FI), clinical frailty status (CFS) and muscle mass, as a result of an optimised exercise and dietary intervention versus usual care in a primary care (PC) setting. The intervention has been derived from our systematic review and meta-analysis findings and optimised through patient and public involvement and multidisciplinary team input.

Femoral offset found not to affect metal ion levels in metal-on-metal total hip arthroplasty.

Background: Failure to restore femoral offset in metal on polyethylene total hip arthroplasty (THA) causes polyethylene wear and aseptic loosening. To our knowledge, no study to date has investigated the relationship between femoral offset and wear in metal-on-metal (MOM) THA.

Aims: In this study, we investigated the relationship between femoral offset and wear by measuring circulating metal ion levels in MOM THA.

Perforated closed-loop obstruction secondary to gallstone ileus of the transverse colon: a rare entity.

Introduction. Gallstone ileus (GSI) of the colon is an extremely rare entity with potentially serious complications including perforation. Case Presentation.

An analysis of medical students' attitude to surgical careers and pursuing intercalated research degrees.

Introduction: Major changes are occurring in surgical training in the UK and Ireland. Training time is reduced due to the introduction of run-through training and the EWTD. Streamlined training also may affect the number of trainees engaging in full-time higher degrees by research, in spite of the fact that those who do engage are more academically productive.

Factors regulating tapeworm populations: estimations of the infection pressure and index of clustering from Taenia hydatigena before and after the removal of infected dogs.

A pasture was prepared so that an equilibrium of fresh and ageing eggs of Taenia hydatigena was present. This was done by placing dogs with patent infections on it for six months. Five months after their introduction, groups of lambs were grazed there for two, four, eight, 16 or 32 days.

Mosquito-borne infections in Fiji. V. The 1971-73 dengue epidemic.

A dengue epidemic due to type 2 virus involving some 3,400 cases began in Fiji early in 1971, had a peak during May, June and July, and cases have continued to occur with a low incidence during 1972 and 1973. Many of the notified cases showed classical dengue fever symptoms and there were no confirmed cases of haemorrhagic fever. A serological survey indicated that there had been at least 20,000 subclinical infections.

A study of immunity to rubella in villages in the Fiji islands using the haemagglutination inhibition test.

In the villages of Fiji, apart from Viti Levu, rubella is a disease occurring solely in widely spaced epidemics. Some villages may not be infected for over 20 years and will then contain substantial numbers of susceptible women of child-bearing age.Evidence is produced that haemagglutination-inhibiting (H.

Mosquito-borne infections in Fiji. 3. Filariasis in northern Fiji: epidemiological evidence regarding the mechanisms of pathogenesis.

During a filariasis survey conducted in northern Fiji in 1968-9 examinations were made for microfilaraemia, enlarged lymph nodes and elephantiasis. Analysis of the microfilarial densities at different ages and the number of anatomical sites showing lymph gland enlargement or elephantiasis have been used to provide evidence on the clustering of infections and pathogenesis.Although there is no evidence of clustering of risk of infection, there is evidence favouring the clustering of adult filariae in individuals.

Mosquito-borne infections in Fiji. II. Arthropod-borne virus infections.

Surveys of arbovirus activity in Fiji were conducted over a 10-year period from December 1959 to December 1969. No arboviruses were isolated from over 200,000 mosquitoes, 9000 ticks, or 575 serum samples. Eight thousand human and 1117 bird, bat and animal sera were tested for haemagglutination-inhibiting arbovirus antibody using a variety of group A, group B and Bunyamwera group antigens.

Mosquito-borne infections in Fiji. I. Filariasis in northern Fiji: epidemiological evidence regarding factors influencing the prevalence of microfilaraemia of Wuchereria bancrofti infections.

A survey of microfilaraemia among the population of Vanua Levu, Taveuni and Koro islands in northern Fiji was conducted in 1968 and 1969 as a prelude to a campaign of mass treatment with diethylcarbamazine.The prevalences of microfilaraemia were found in the more moist conditions of Taveuni and Koro and on the windward southern side of Vanua Levu to be higher than on the drier northern side of Vanua Levu. On both sides of Vanua Levu prevalences were lower inland than near the coast.

International collaborative assay of the international reference preparation of anti-yellow-fever serum.

A yellow fever immune serum was established in 1962 by the WHO Expert Committee on Biological Standardization as the International Reference Preparation of Anti-Yellow-Fever Serum, intended to serve as an immune reference serum in the mouse protection test used in the control of yellow fever vaccines.Before its establishment as the International Reference Preparation, the proposed material was assayed in eleven laboratories in ten countries against a number of other immune and non-immune sera, and was found stable. Neutralization test results were consistent and the relative potency was sufficiently high.