Acute geriatrics at the front door.

Older people with frailty and urgent care needs are major uses of health and social care services. Comprehensive geriatric assessment (CGA) is an evidence-based approach to improving their outcomes, as well as improving service outcomes. Geriatricians form a small proportion of the overall workforce and cannot address the population need alone, so all clinicians (doctors, nurses, therapists and so on) need to engage in delivering CGA as a process of care, underpinned by specific competencies - which can be developed. Delivery of this care pathway needs to be measured and improved as rigorously as campaigns like those for improving sepsis or eradicating methicillin-resistantStaphylococcus aureus

Promoting healthy gender relationships in secondary schools through a mixed netball competition

Context: Gender-based violence is a widespread problem with significant impacts. Young people are identified as a priority group: as targets for change, and agents of change in violence prevention strategies. By increasing knowledge; providing opportunities to discuss issues in a supportive environment; challenging attitudes about roles and expectations; and providing skills to challenge sexism, harassment, and gender-based discrimination; we hope to prevent gender-based violence. Objectives: • Increase adolescent awareness to recognise the early warning signs of relationship and gender-based violence and the multiple factors that enable it; • Provide students the opportunity to practice and implement skills to take bystander action to prevent or intercede in situations of relationship and gender-based violence Process: Students participated in workshops exploring consent, gender equity, the role of the bystander and the impact of attitudes and behaviours on enabling or preventing the incidence of gender-based violence. These workshops were followed by a mixed round robin netball competition. Analysis: Interviews and surveys were conducted to measure baseline of students’ knowledge and confidence to intervene and impact of the workshops and netball competition. Outcomes: 75 surveys were completed. 66.2% reported learning about early signs of unhealthy relationships. 55.6% would only act if it was safe to. Some participants were unable to transfer class-based learning to the netball competition. Evidence showed students were surprised and strongly impacted by the data provided. Presumptions cannot be made that information is available and known to most. Efforts to raise awareness of the statistics on violence against women needs to continue

The challenges of using the Hospital Frailty Risk Score - Author's reply

We thank John Soong and colleagues, Sandra M Shi and Dae H Kim, and Rónán O'Caoimh and colleagues for their careful consideration of our Article. We note some concerns about the clinical utility of our scoring method; our approach is to position the Hospital Frailty Risk Score (HFRS) as a tool that can be implemented without the need for additional assessment or data collection, and direct high-risk individuals towards frailty-attuned interventions, such as the Comprehensive Geriatric Assessment (CGA).1 We acknowledge that the HFRS can only be generated after an initial admission, so risk stratification information would not be possible at first presentation. Two-thirds of people aged 75 years or older access acute-care hospitals more than once over a 2-year period, and those patients who have not previously accessed hospital care are typically at low risk of hospital-related adverse outcomes; thus, we view the HFRS as being especially useful to identify individuals at the highest risk of hospital-related harm and resource use. We accept that manual scales, such as the Clinical Frailty Scale,2 could be used, but the HFRS has the advantage of being automated and capturing all patients, not just a selected sample

Activist dispositions for social justice in advantaged and disadvantaged contexts of schooling

This article advances current conceptions of teacher activism through an exploration of the social justice dispositions of teachers in advantaged and disadvantaged contexts of schooling. We interrogate the practices of teachers in a government school, with a high proportion of refugee students and students from low socio-economic backgrounds, in a high-fees, multi-campus independent school, and in a disadvantaged Systemic Catholic school to illustrate how Bourdieu’s notion of dispositions (which are constitutive of the habitus) and Fraser’s distinction between affirmative and transformative justice are together productive of four types of teacher activism. Specifically, we show that activist dispositions can be characterised as either affirmative or transformative in stance and as either internally or externally focused in relation to the education field. We argue that the social, cultural and material conditions of schools are linked to teachers’ activist dispositions and conclude with the challenge for redressing educational inequalities by fostering a transformative activism in teachers’ practices

Mepolizumab does not alter the blood basophil count in severe asthma.

[First paragraph] To the Editor: Mepolizumab (anti‐IL‐5) depletes blood and airway eosinophils, and, clinically, allows down‐titration of oral corticosteroid and a reduction in the frequency of eosinophil‐dependent exacerbations.1 Basophils also express IL‐5Rα, participate in T2‐mediated inflammatory pathways2 and have been associated with exacerbation frequency.3 Whilst basophil progenitors are unlikely to depend on IL‐5 for development,4 blood basophil counts measured in routine clinical laboratories suggest they decrease following mepolizumab treatment.5-