RESPOND – A patient-centred programme to prevent secondary falls in older people presenting to the emergency department with a fall: Protocol for a mixed methods programme evaluation.

Background Programme evaluations conducted alongside randomised controlled trials (RCTs) have potential to enhance understanding of trial outcomes. This paper describes a multi-level programme evaluation to be conducted alongside an RCT of a falls prevention programme (RESPOND). Objectives 1) To conduct a process evaluation in order to identify the degree of implementation fidelity and associated barriers and facilitators. 2) To evaluate the primary intended impact of the programme: participation in fall prevention strategies, and the factors influencing participation. 3) To identify the factors influencing RESPOND RCT outcomes: falls, fall injuries and ED re-presentations. Methods/ Design Five hundred and twenty eight community-dwelling adults aged 60–90 years presenting to two EDs with a fall will be recruited and randomly assigned to the intervention or standard care group. All RESPOND participants and RESPOND clinicians will be included in the evaluation. A mixed methods design will be used and a programme logic model will frame the evaluation. Data will be sourced from interviews, focus groups, questionnaires, clinician case notes, recruitment records, participant-completed calendars, hospital administrative datasets, and audio-recordings of intervention contacts. Quantitative data will be analysed via descriptive and inferential statistics and qualitative data will be interpreted using thematic analysis. Discussion The RESPOND programme evaluation will provide information about contextual and influencing factors related to the RCT outcomes. The results will assist researchers, clinicians, and policy makers to make decisions about future falls prevention interventions. Insights gained are likely to be transferable to preventive health programmes for a range of chronic conditions

‘Choicest unguents’: molecular evidence for the use of resinous plant exudates in late Roman mortuary rites in Britain

YesResinous substances were highly prized in the ancient world for use in ritual contexts. Details gleaned from classical literature indicate that they played a significant role in Roman mortuary rites, in treatment of the body and as offerings at the tomb. Outside of Egypt, however, where research has shown that a range of plant exudates were applied as part of the mummification process, resins have rarely been identified in the burial record. This is despite considerable speculation regarding their use across the Roman Empire. Focusing on one region, we investigated organic residues from forty-nine late Roman inhumations from Britain. Using gas chromatographyemass spectrometry and the well-attested biomarker approach, terpenic compounds were characterized in fourteen of the burials analysed. These results provided direct chemical evidence for the presence of exudates from three different plant families: coniferous Pinaceae resins, Mediterranean Pistacia spp. resins (mastic/terebinth) and exotic Boswellia spp. gum-resins (frankincense/olibanum) from southern Arabia or beyond. The individuals accorded this rite had all been interred with a package of procedures more elaborate than the norm. These findings illuminate the multiplicity of roles played by resinous substances in Roman mortuary practices in acting to disguise the odour of decomposition, aiding temporary soft-tissue preservation and signifying the social status of the deceased. Nevertheless, it was their ritual function in facilitating the transition to the next world that necessitated transportation to the most remote outpost of the late Roman Empire, Britain.R.C.B is supported by a PhD studentship from the Art and Humanities Research Council (43019R00209)

The reflective fostering programme: evaluating the intervention co-delivered by social work professionals and foster carers

PURPOSE: There is little evidence regarding how to best support the emotional well-being of children in foster care. This paper aims to present the evaluation of an adaptation of the reflective fostering programme, a group-based programme to support foster carers. This study aimed to explore whether a version of the programme, co-delivered by a social work professional and an experienced foster carer, was acceptable and relevant to foster carers and to gather data on programme effectiveness. DESIGN/METHODOLOGY/APPROACH: In total, 38 foster carers attended the programme and took part in this study. Data was collected regarding carer- and child-focused outcomes at pre-intervention, post-intervention and four-month follow-up. Focus interviews were also conducted to further assess acceptability and relevance for foster carers. FINDINGS: Analysis of quantitative outcome showed statistically significant improvements in all outcomes considered including foster carers stress and carer-defined problems, as well as carer-reported measures of child difficulties. Focus group interviews with foster carers suggested that the programme as co-delivered by a foster carer and a social worker was felt to be relevant and helpful to foster carers. ORIGINALITY/VALUE: These results provide a unique contribution to limited understandings of what works for supporting foster carers and the children in their care. Promising evidence is provided for the acceptability and relevance of the revised version of this novel support programme and its effectiveness in terms of carer- and child-related outcome measures. This work paves the way for further necessary impact evaluation

RESPOND – A patient-centred program to prevent secondary falls in older people presenting to the emergency department with a fall: Protocol for a multi-centre randomised controlled trial

Introduction: Participation in falls prevention activities by older people following presentation to the Emergency Department (ED) with a fall is suboptimal. This randomised controlled trial (RCT) will test the RESPOND program which is designed to improve older persons’ participation in falls prevention activities through delivery of patient-centred education and behaviour change strategies. Design and setting: An RCT at two tertiary referral EDs in Melbourne and Perth, Australia. Participants: Five-hundred and twenty eight community-dwelling people aged 60-90 years presenting to the ED with a fall and discharged home will be recruited. People who: require an interpreter or hands-on assistance to walk; live in residential aged care or >50 kilometres from the trial hospital; have terminal illness, cognitive impairment, documented aggressive behaviour or history of psychosis; are receiving palliative care; or are unable to use a telephone will be excluded. Methods: Participants will be randomly allocated to the RESPOND intervention or standard care control group. RESPOND incorporates: (1) home-based risk factor assessment; (2) education, coaching, goal setting, and follow-up telephone support for management of one or more of four risk factors with evidence of effective intervention; and (3) healthcare provider communication and community linkage delivered over six months. Primary outcomes are falls and fall injuries per-person-year. Discussion: RESPOND builds on prior falls prevention learnings and aims to help individuals make guided decisions about how they will manage their falls risk. Patient-centred models have been successfully trialled in chronic and cardiovascular disease however evidence to support this approach in falls prevention is limited. Trial registration. The protocol for this study is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12614000336684)

Adopting basic principles of the United Nations Academic Impact initiative (UNAI): Can cultural differences be predicted from value orientations and globalization?

© 2017 Nechtelberger, Renner, Nechtelberger, Supeková, Hadjimarkou, Offurum, Ramalingam, Senft and Redfern. The United Nations Academic Impact (UNAI) Initiative has set forth 10 Basic Principles for higher education. In the present study, a 10 item self-report questionnaire measuring personal endorsement of these principles has been tested by self-report questionnaires with university and post-graduate students from Austria, China, Cyprus, India, Nigeria, and Slovakia (total N = 976, N = 627 female, mean age 24.7 years, s = 5.7). Starting from the assumptions of Moral Foundations Theory (MFT), we expected that personal attitudes toward the UNAI Basic Principles would be predicted by endorsement of various moral foundations as suggested by MFT and by the individual's degree of globalization. Whereas for the Austrian, Cypriot, and Nigerian sub- samples this assumption was largely confirmed, for the Chinese, Indian, and Slovak sub- samples only small amounts of the variance could be explained by regression models. All six sub-samples differed substantially with regard to their overall questionnaire responses: by five discriminant functions 83.6% of participants were classified correctly. We conclude that implementation of UNAI principles should adhere closely to the cultural requirements of the respective society and, where necessary should be accompanied by thorough informational campaigns about UN educational goals

Variation of theanine, phenolic, and methylxanthine compounds in 21 cultivars of Camellia sinensis harvested in different seasons

This is the first study to use chemometric methods to differentiate among 21 cultivars of Camellia sinensis from China and between leaves harvested at different times of the year using 30 compounds implicated in the taste and quality of tea. Unique patterns of catechin derivatives were observed among cultivars and across harvest seasons. C. sinensis var. pubilimba (You 510) differed from the cultivars of C. sinensis var. sinensis, with higher levels of theobromine, (+)-catechin, gallocatechin, gallocatechin gallate and theasinensin B, and lower levels of (−)-epicatechin, (−)-epigallocatechin (EGC) and (-)-epigallocatechin gallate (EGCG), respectively. Three cultivars of C. sinensis var. sinensis, Fuyun 7, Qiancha 7 and Zijuan contained significantly more caffeoylquinic acids than others cultivars. A Linear Discriminant Analysis model based on the abundance of 12 compounds was able to discriminate amongst all 21 tea cultivars. Harvest time impacted the abundance of EGC, theanine and afzelechin gallate

A recent change in the optical and γ-ray polarization of the Crab nebula and pulsar

We report on observations of the polarization of optical and γ-ray photons from the Crab nebula and pulsar system using the Galway Astronomical Stokes Polarimeter (GASP), the Hubble Space Telescope, Advanced Camera for Surveys and the International Gamma-Ray Astrophysics Laboratory satellite (INTEGRAL). These, when combined with other optical polarization observations, suggest that the polarized optical emission and γ-ray polarization changes in a similar manner. A change in the optical polarization angle has been observed by this work, from 109.5 ± 0∘.7 in 2005 to 85.3 ± 1∘.4 in 2012. On the other hand, the γ-ray polarization angle changed from 115 ± 11° in 2003–2007 to 80 ± 12° in 2012–2014. Strong flaring activities have been detected in the Crab nebula over the past few years by the high-energy γ-ray missions Agile and Fermi, and magnetic reconnection processes have been suggested to explain these observations. The change in the polarized optical and γ-ray emission of the Crab nebula/pulsar as observed, for the first time, by GASP and INTEGRAL may indicate that reconnection is possibly at work in the Crab nebula. We also report, for the first time, a non-zero measure of the optical circular polarization from the Crab pulsar+knot system