The causes of falls: views of older people with sight impairment

Background Sight impairment increases with age and, compared with the general older population, older people with sight impairment are more likely to fall. There is a growing body of evidence on the views and perceptions of older people about falls, but little is published on the views of older people with sight impairment. Objective To explore what older people with sight impairment believe to be the causes of falls. Design A qualitative design was used, incorporating focus groups and interviews in which participants discussed falls and falls prevention. Framework analysis was employed to identify themes arising from participants' discussions of the causes of falls. Setting and participants Fifty-four community dwelling men and women with sight impairment, aged 65 and over, were recruited from across Greater Manchester, UK. Results Five types of factors were identified that were believed to cause falls: (i) health issues and changes in balance caused by ageing; (ii) cognitive and behavioural factors; (iii) the impact of sight impairment on getting around the home; (iv) the impact of sight impairment on negotiating the environment away from home; and (v) unexplained falls. Discussion and conclusions Older people with sight impairment reported many researched risk factors previously identified by older people without sight impairment but also described many perceived risks unique to people with sight impairment. There are few interventions to prevent falls aimed at older people with sight impairment, and the results of this study allow further tailoring of such interventions based on views of older people with sight impairment

Probing dark energy using baryonic oscillations in the galaxy power spectrum as a cosmological ruler

We show that the baryonic oscillations expected in the galaxy power spectrum may be used as a "standard cosmological ruler'' to facilitate accurate measurement of the cosmological equation of state. Our approach involves a straight-forward measurement of the oscillation "wavelength'' in Fourier space, which is fixed by fundamental linear physics in the early Universe and hence is highly model-independent. We quantify the ability of future large-scale galaxy redshift surveys with mean redshifts z~1 and z~3 to delineate the baryonic peaks in the power spectrum, and derive corresponding constraints on the parameter w describing the equation of state of the dark energy. For example, a survey of three times the Sloan volume at z ~ 1 can produce a measurement with accuracy dw ~ 0.1. We suggest that this method of measuring the dark energy powerfully complements other probes such as Type Ia supernovae, and suffers from a different (and arguably less serious) set of systematic uncertainties.Comment: Submitted to Astrophysical Journal, 11 pages, 8 figure

A feasibility study to prevent falls in older people who are sight impaired: the VIP2UK randomised controlled trial.

BACKGROUND: Published evaluations of successful interventions to prevent falls in people with sight impairment (SI) are limited. The aim of this feasibility study is to optimise the design and investigation of home safety (HS) and home exercise (HE) programmes to prevent falls in older people with SI. METHODS: A community-based feasibility study in north-west England comprising a three-arm randomised controlled trial (RCT) allocated participants to (1) a control group receiving usual care and social visits, (2) an experimental group receiving the HS programme and (3) an experimental group receiving the HS + HE programme. Participants were community-dwelling, aged 65 years and older and sight impaired. Primary outcome data on falls were collected continuously over 6 months. Secondary outcomes on physical activity (self-report and instrumented) and adherence were collected at baseline and 3 and 6 months for HE and at 6 months for the HS programme. Costs for the HS and HS + HE groups were calculated from logs of time spent on home visits, telephone calls and travel. The research assistant and statistician were blinded to group allocation. RESULTS: Altogether, 49 people were recruited over a 9-month period (randomised: 16 to control, 16 to HS, 17 to HS + HE). The interventions were implemented over 6 months by an occupational therapist at a cost per person (pounds sterling, 2011) of £249 (HS) and £674 (HS + HE). Eighty-eight percent (43/49) completed the trial and 6-month follow-up. At 6-month follow-up, 100 % reported partially or completely adhering to HS recommendations but evidence for adherence to HE was equivocal. Although self-reported physical activity increased, instrumented monitoring showed a decrease in walking activity. There were no statistically significant differences in falls between the groups; however, the study was not powered to detect a difference. CONCLUSION: It is feasible and acceptable for an occupational therapist to deliver HS and HE falls prevention programmes to people with SI living independently in the community. Future studies could access Local Authority Registers of people with SI to improve recruitment rates. Further research is required to identify how to improve adherence to HE and to measure changes in physical activity before conducting a definitive RCT. TRIAL REGISTRATION: ISRCTN53433311 , registered on 8 May 2014

Advanced cancer patient preferences for receiving molecular profiling results

Objective: This study aimed to discern preferences for receiving somatic molecular profiling (MP) results in cancer patients who have given consent to undergo testing. Methods: We conducted a mixed‐methods study to explore patients’ views on which MP results they would like to receive and why. Advanced cancer patients (n=1299) completed questionnaires after giving consent to participate in a parent genomics study and undergoing MP. A subset of patients (n=20) participated in qualitative interviews. Results: Almost all (96%) participants were interested in receiving results which would direct cancer treatment (i.e. were actionable). A smaller majority wanted to access results which were not actionable (64%) or were variants of unknown significance (60%). Most (86%) were interested in finding out about germline findings, though not as a priority. Themes identified in interview data were: 1) Cancer is the focus; 2) Trust in clinicians; and 3) Respect for a right not to know. Conclusions: The majority of advanced cancer patients undergoing MP prioritised results which would lead to treatment options. They trusted their oncologists to help them navigate the results return process. While there was interest in knowing about other results, this was a lesser priority. Nevertheless, given high levels of interest in receiving all results, ethical aspects of not providing uninformative results requires further research, including a consideration of patient rationales for desiring this information and what health professionals can and should do to support patients in the absence of meaningful information being available. This article is protected by copyright. All rights reserved

A combined measurement of cosmic growth and expansion from clusters of galaxies, the CMB and galaxy clustering

Combining galaxy cluster data from the ROSAT All-Sky Survey and the Chandra X-ray Observatory, cosmic microwave background data from the Wilkinson Microwave Anisotropy Probe, and galaxy clustering data from the WiggleZ Dark Energy Survey, the 6-degree Field Galaxy Survey and the Sloan Digital Sky Survey III, we test for consistency the cosmic growth of structure predicted by General Relativity (GR) and the cosmic expansion history predicted by the cosmological constant plus cold dark matter paradigm (LCDM). The combination of these three independent, well studied measurements of the evolution of the mean energy density and its fluctuations is able to break strong degeneracies between model parameters. We model the key properties of cosmic growth with the normalization of the matter power spectrum, sigma_8, and the cosmic growth index, gamma, and those of cosmic expansion with the mean matter density, Omega_m, the Hubble constant, H_0, and a kinematical parameter equivalent to that for the dark energy equation of state, w. For a spatially flat geometry, w=-1, and allowing for systematic uncertainties, we obtain sigma_8=0.785+-0.019 and gamma=0.570+0.064-0.063 (at the 68.3 per cent confidence level). Allowing both w and gamma to vary we find w=-0.950+0.069-0.070 and gamma=0.533+-0.080. To further tighten the constraints on the expansion parameters, we also include supernova, Cepheid variable and baryon acoustic oscillation data. For w=-1, we have gamma=0.616+-0.061. For our most general model with a free w, we measure Omega_m=0.278+0.012-0.011, H_0=70.0+-1.3 km s^-1 Mpc^-1 and w=-0.987+0.054-0.053 for the expansion parameters, and sigma_8=0.789+-0.019 and gamma=0.604+-0.078 for the growth parameters. These results are in excellent agreement with GR+LCDM (gamma~0.55; w=-1) and represent the tightest and most robust simultaneous constraint on cosmic growth and expansion to date.Comment: 14 pages, 5 figures, 1 table. Matches the accepted version for MNRAS. New sections 3 and 6 added, containing 2 new figures. Table extended. The results including BAO data have been slightly modified due to an updated BAO analysis. Conclusions unchange

The WiggleZ Dark Energy Survey: measuring the cosmic expansion history using the Alcock-Paczynski test and distant supernovae

Astronomical observations suggest that today's Universe is dominated by a dark energy of unknown physical origin. One of the most notable consequences in many models is that dark energy should cause the expansion of the Universe to accelerate: but the expansion rate as a function of time has proven very difficult to measure directly. We present a new determination of the cosmic expansion history by combining distant supernovae observations with a geometrical analysis of large-scale galaxy clustering within the WiggleZ Dark Energy Survey, using the Alcock-Paczynski test to measure the distortion of standard spheres. Our result constitutes a robust and non-parametric measurement of the Hubble expansion rate as a function of time, which we measure with 10-15% precision in four bins within the redshift range 0.1 < z < 0.9. We demonstrate that the cosmic expansion is accelerating, in a manner independent of the parameterization of the cosmological model (although assuming cosmic homogeneity in our data analysis). Furthermore, we find that this expansion history is consistent with a cosmological-constant dark energy.Comment: 13 pages, 7 figures, accepted for publication by MNRA

The WiggleZ Dark Energy Survey: Joint measurements of the expansion and growth history at z < 1

We perform a joint determination of the distance-redshift relation and cosmic expansion rate at redshifts z = 0.44, 0.6 and 0.73 by combining measurements of the baryon acoustic peak and Alcock-Paczynski distortion from galaxy clustering in the WiggleZ Dark Energy Survey, using a large ensemble of mock catalogues to calculate the covariance between the measurements. We find that D_A(z) = (1205 +/- 114, 1380 +/- 95, 1534 +/- 107) Mpc and H(z) = (82.6 +/- 7.8, 87.9 +/- 6.1, 97.3 +/- 7.0) km/s/Mpc at these three redshifts. Further combining our results with other baryon acoustic oscillation and distant supernovae datasets, we use a Monte Carlo Markov Chain technique to determine the evolution of the Hubble parameter H(z) as a stepwise function in 9 redshift bins of width dz = 0.1, also marginalizing over the spatial curvature. Our measurements of H(z), which have precision better than 7% in most redshift bins, are consistent with the expansion history predicted by a cosmological-constant dark-energy model, in which the expansion rate accelerates at redshift z < 0.7.Comment: 11 pages, 11 figures, accepted for publication in MNRA

The 6dF Galaxy Survey: z \approx 0 measurement of the growth rate and sigma_8

We present a detailed analysis of redshift-space distortions in the two-point correlation function of the 6dF Galaxy Survey (6dFGS). The K-band selected sub-sample which we employ in this study contains 81971 galaxies distributed over 17000deg^2 with an effective redshift z = 0.067. By modelling the 2D galaxy correlation function, xi(r_p,pi), we measure the parameter combination f(z)sigma_8(z) = 0.423 +/- 0.055. Alternatively, by assuming standard gravity we can break the degeneracy between sigma_8 and the galaxy bias parameter, b. Combining our data with the Hubble constant prior from Riess et al (2011), we measure sigma_8 = 0.76 +/- 0.11 and Omega_m = 0.250 +/- 0.022, consistent with constraints from other galaxy surveys and the Cosmic Microwave Background data from WMAP7. Combining our measurement of fsigma_8 with WMAP7 allows us to test the relationship between matter and gravity on cosmic scales by constraining the growth index of density fluctuations, gamma. Using only 6dFGS and WMAP7 data we find gamma = 0.547 +/- 0.088, consistent with the prediction of General Relativity. We note that because of the low effective redshift of 6dFGS our measurement of the growth rate is independent of the fiducial cosmological model (Alcock-Paczynski effect). We also show that our conclusions are not sensitive to the model adopted for non-linear redshift-space distortions. Using a Fisher matrix analysis we report predictions for constraints on fsigma_8 for the WALLABY survey and the proposed TAIPAN survey. The WALLABY survey will be able to measure fsigma_8 with a precision of 4-10%, depending on the modelling of non-linear structure formation. This is comparable to the predicted precision for the best redshift bins of the Baryon Oscillation Spectroscopic Survey (BOSS), demonstrating that low-redshift surveys have a significant role to play in future tests of dark energy and modified gravity.Comment: 17 pages, 13 figures, 1 tabl

Sketching women in court: The visual construction of co-accused women in court drawings

This paper explores the visual construction and representation of co-accused women offenders in court drawings. It utilises three case studies of female co-defendants who appeared in the England and Wales court system between 2003 and 2013. In doing so this paper falls into three parts. The first part considers the emergence of the sub-discipline, visual criminology and examines what is known about the visual representation of female offenders. The second part presents the findings of an empirical investigation, which involved engaging in a critical, reflexive visual analysis of a selection of court drawings of three female co-offenders. The third part discusses the ways in which the court artists' interpretation, the conventions of court sketching, and motifs of female offenders as secondary actors, drew on existing myths and prejudices by representing the women as listening, remorseless ‘others’