Alison W. Fletcher

Abstract Objective: To estimate the clinical and cost effectiveness of compression systems for treating venous leg ulcers. Methods: Systematic review of research. Search of 19 electronic databases including Medline, CINAHL, and Embase. Relevant journals and conference proceedings were hand searched and experts were consulted. Main outcome measures: Rate of healing and proportion of ulcers healed within a time period. Study selection: Randomised controlled trials, published or unpublished, with no restriction on date or language, that evaluated compression as a treatment for venous leg ulcers. Results: 24 randomised controlled trials were included in the review. The research evidence was quite weak: many trials had inadequate sample size and generally poor methodology. Compression seems to increase healing rates. Various high compression regimens are more effective than low compression. Few trials have compared the effectiveness of different high compression systems. Conclusions: Compression systems improve the healing of venous leg ulcers and should be used routinely in uncomplicated venous ulcers. Insufficient reliable evidence exists to indicate which system is the most effective. More good quality randomised controlled trials in association with economic evaluations are needed, to ascertain the most cost effective system for treating venous leg ulcers. Key messages Compression treatment increases the healing of ulcers compared with no compression High compression is more effective than low compression but should only be used in the absence of significant arterial disease No clear differences in the effectiveness of different types of compression systems (multilayer and short stretch bandages and Unna's boot) have been shown Intermittent pneumatic compression appears to be a useful adjunct to bandaging Rather than advocate one particular system, the increased use of any correctly applied high compression treatment should be promoted

Studies of animal personality improve our understanding of individual variation in measures of life history and fitness, such as health and reproductive success. Using a 54 trait personality questionnaire developed for studying great apes and other nonhuman primates, we obtained ratings on 116 wild mountain gorillas (Gorilla beringei beringei) monitored by the Dian Fossey Gorilla Fund's Karisoke Research Center in Rwanda. There were 8 raters who each had more than 1.5 years of working experience with the subjects. Principal component analyses identified 4 personality dimensions with high interrater reliabilities-Dominance, Openness, Sociability, and Proto-Agreeableness-that reflected personality features unique to gorillas and personality features shared with other hominoids. We next examined the associations of these dimensions with independently collected behavioral measures derived from long-term records. Predicted correlations were found between the personality dimensions and corresponding behaviors. For example, Dominance, Openness, Sociability, and Proto-Agreeableness were related to gorilla dominance strength, time spent playing, rates of approaches, and rates of interventions in intragroup conflicts, respectively. These findings enrich the comparative-evolutionary study of personality and provide insights into how species differences in personality are related to ecology, social systems, and life history.

Before being weaned, young primates must learn which plant species are suitable to eat, and how to process and combine them to meet their nutritional needs. This study provides a detailed investigation of the development of feeding behaviour in a wild population of western lowland gorillas observed in a bai habitat. The behaviour of 56 known immature individuals aged between 0 and 8 years was recorded at Mbeli Bai, Republic of Congo, using focal, scan and all-occurrence sampling over a period of 16 months. Results indicated that independent feeding skills were acquired by the end of infancy and did not undergo significant change beyond this point. However, suckling continued into the juvenile period, suggesting that some continued investment by the mother was necessary until the strength and skills of immatures developed, perhaps to enable self-sufficiency through periods of succulent fruit (assumed to be the most suitable weaning food) scarcity. This was supported by observations of an increase in feeding-related behaviour with age, particularly during infancy. Additionally, age-related differences in the species and plant parts selected by different age classes, as well as in levels of food processing, were apparent. Play feeding, suggested to be a precursor to independent feeding, was most prevalent in infancy, decreasing as feeding skills developed. Thus, it would appear, given that food transfer also occurs (Nowell & Fletcher, 2006), that feeding skills in western lowland gorillas are learned by a combination of exposure to and manipulation of food items, and probably also through the observation of conspecifics. Observations in a forest habitat are needed to improve our understanding of feeding development in this subspecies.