The impact of elder abuse training on subacute health providers and older adults: study protocol for a randomized control trial.

BACKGROUND: Elder abuse often goes unreported and undetected. Older people may be ashamed, fearful, or otherwise reticent to disclose abuse, and many health providers are not confident in asking about it. In the No More Shame study, we will evaluate a co-designed, multi-component intervention that aims to improve health providers' recognition, response, and referral of elder abuse. METHODS: This is a single-blinded, pragmatic, cluster randomised controlled trial. Ten subacute hospital sites (i.e. clusters) across Australia will be allocated 1:1, stratified by state to a multi-component intervention comprising a training programme for health providers, implementation of a screening tool and use of site champions, or no additional training or support. Outcomes will be collected at baseline, 4 and 9 months. Our co-primary outcomes are change in health providers' knowledge of responding to elder abuse and older people's sense of safety and quality of life. We will include all inpatients at participating sites, aged 65 + (or aged 50 + if Aboriginal or Torres Strait Islander), who are able to provide informed consent and all unit staff who provide direct care to older people; a sample size of at least 92 health providers and 612 older people will provide sufficient power for primary analyses. DISCUSSION: This will be one of the first trials in the world to evaluate a multi-component elder abuse intervention. If successful, it will provide the most robust evidence base to date for health providers to draw on to create a safe environment for reporting, response, and referral. TRIAL REGISTRATION: ANZCTR, ACTRN12623000676617p . Registered 22 June 2023

Global Effect of Modifiable Risk Factors on Cardiovascular Disease and Mortality.

BACKGROUND: Five modifiable risk factors are associated with cardiovascular disease and death from any cause. Studies using individual-level data to evaluate the regional and sex-specific prevalence of the risk factors and their effect on these outcomes are lacking. METHODS: We pooled and harmonized individual-level data from 112 cohort studies conducted in 34 countries and 8 geographic regions participating in the Global Cardiovascular Risk Consortium. We examined associations between the risk factors (body-mass index, systolic blood pressure, non-high-density lipoprotein cholesterol, current smoking, and diabetes) and incident cardiovascular disease and death from any cause using Cox regression analyses, stratified according to geographic region, age, and sex. Population-attributable fractions were estimated for the 10-year incidence of cardiovascular disease and 10-year all-cause mortality. RESULTS: Among 1,518,028 participants (54.1% of whom were women) with a median age of 54.4 years, regional variations in the prevalence of the five modifiable risk factors were noted. Incident cardiovascular disease occurred in 80,596 participants during a median follow-up of 7.3 years (maximum, 47.3), and 177,369 participants died during a median follow-up of 8.7 years (maximum, 47.6). For all five risk factors combined, the aggregate global population-attributable fraction of the 10-year incidence of cardiovascular disease was 57.2% (95% confidence interval [CI], 52.4 to 62.1) among women and 52.6% (95% CI, 49.0 to 56.1) among men, and the corresponding values for 10-year all-cause mortality were 22.2% (95% CI, 16.8 to 27.5) and 19.1% (95% CI, 14.6 to 23.6). Harmonized individual-level data from a global cohort showed that 57.2% and 52.6% of cases of incident cardiovascular disease among women and men, respectively, and 22.2% and 19.1% of deaths from any cause among women and men, respectively, may be attributable to five modifiable risk factors. (Funded by the German Center for Cardiovascular Research (DZHK); ClinicalTrials.gov number, NCT05466825.)

Nucinellidae Vokes 1956

Family Nucinellidae Vokes, 1956 Genus Nucinella Wood, 1851 Type species. Pleurodon ovalis Wood, 1840 Remarks. Nucinella has sometimes been placed in the family Manzanellidae Chronic, 1952 (e.g. Amano et al. 2007; Kiel et al. 2008a). However, the Permian genus Manzanella Girty, 1909, is longer than high, with roughly equidistantly positioned beaks. Furthermore, it is dimyarian, with anterior and posterior adductor muscle scars roughly equal in size (Chronic 1952). This contrasts with the genus Nucinella Wood, 1851, which is monomyarian and has a very short posterior shell margin (e.g. Allen & Sanders 1969). A dimyarian condition was previously postulated for the supposed sister genus Huxleyia Adams, 1860 (e.g. Habe 1958; pl. 9, fig. 16; La Perna 2004, p. 571). However, investigation of Huxleyia habooba Oliver & Taylor, 2012, and Huxleyia sulcata Adams, 1860, revealed no sign of a posterior adductor muscle, which supports separation of Nucinella and Huxleyia into a separate family Nucinellidae (Oliver & Taylor 2012), with Manzanellidae restricted to the genus Manzanella.Published as part of Hryniewicz, Krzysztof, Little, Crispin T. S. & Nakrem, Hans Arne, 2014, Bivalves from the latest Jurassic-earliest Cretaceous hydrocarbon seep carbonates from central Spitsbergen, Svalbard, pp. 1-66 in Zootaxa 3859 (1) on page 12, DOI: 10.11646/zootaxa.3859.1.1, http://zenodo.org/record/493011

Solemyidae Gray 1840

Family Solemyidae Gray, 1840 Genus Solemya Lamarck, 1818 Type species. Solemya mediterranea (Lamarck, 1818) = Tellina togata Poli, 1795 (by subsequent designation, Children, 1823). Remarks. Our species is included in Solemya Lamarck, 1818, because of its internal ligament (Taylor et al. 2008; Kamenev 2009; Oliver et al. 2011). It is not a member of the genus Acharax Dall, 1908, because this taxon has an external ligament positioned above the thickened shell margin, developed probably as a support for the ligament nymphs (Amano & Ando 2011; Oliver et al. 2011; Taviani et al. 2011). Solemya has an internal ligament with a distinct resilium supported on a chondrophore. Fossil solemyids are morphologically very conservative, having a cylindrical shape with inequilaterally positioned beaks and an elongated shell anterior (e.g. Logan 1967; Duff 1978; Liljedahl 1984; Cope 1996; Kiel et al. 2008a; Bailey 2011). This conservatism (e.g. Taylor & Glover 2010) is maintained not only at the genus, but also at the species level, as testified by the presence of cryptic modern species of Acharax (Neulinger et al. 2006). Thus, the taxonomy of solemyids is difficult, and there are few characters useful for species discrimination. Subgenus Petrasma Dall, 1908 Type species. Solemya borealis Totten, 1834 Remarks. We have included our species in the subgenus Petrasma Dall, 1908, because of the presence of a chondrophore supporting an oblique buttress adjoining the anterior side of the posterior adductor muscle scar, and small ligament demipads elongated along the dorsal margin and developed in front of the chondrophore. A buttress in front of the posterior adductor muscle scar is also present in the subgenera Solemyarina Iredale, 1931, Zesolemya Iredale, 1939, and Austrosolemya Taylor, Glover & Williams 2008, all of which have large ligament demipads perpendicular to the dorsal margin in front of the chondrophore (e.g. Kamenev 2009, fig. 4–6). For more detailed discussion of subgeneric differences in the genus Solemya see Taylor et al. (2008), Kamenev (2009) and Oliver et al. (2011).Published as part of Hryniewicz, Krzysztof, Little, Crispin T. S. & Nakrem, Hans Arne, 2014, Bivalves from the latest Jurassic-earliest Cretaceous hydrocarbon seep carbonates from central Spitsbergen, Svalbard, pp. 1-66 in Zootaxa 3859 (1) on pages 7-8, DOI: 10.11646/zootaxa.3859.1.1, http://zenodo.org/record/493011