Understanding carers' fall concern and their management of fall risk among older people at home.

BACKGROUND: Many older people (care recipients) experience long-term psychological distress due to the fear of falling again. Falls can affect carers due to concerns about their care recipients falling. Understanding carers' fall concern is crucial to determine if carers are coping with the provision of care or have adequate knowledge and support in preventing their care recipients from falling at home. METHODS: A descriptive qualitative study was conducted to explore carers' concern about their care recipients being at risk of falling and their management of fall risk at home. Twenty-two carers were recruited from two research registers and a large tertiary hospital in a regional centre of Australia. Carers were interviewed face-to-face, or by telephone using a semi-structured interview guide about their fall concern. The data was analysed using an inductive content analysis method. RESULTS: Eight major themes emerged from the interviews. Four themes described key factors influencing carers' fall concern which include: 1) carers' perception of fall and fall risk, 2) care recipients' behaviour and attitude towards fall risk, 3) care recipients' health and function, and 4) care recipients' living environment. Another four themes described the management of care recipients' fall risk which include: 5) fall prevention strategies used, 6) risk of preventing falls, 7) support from family and friends, and 8) support from healthcare professionals. CONCLUSIONS: The findings from this qualitative study provide an insight into the carers' awareness of fall risk, knowledge, and the availability of support in preventing their care recipients from falling at home. Healthcare professionals are encouraged to include carers and address their fall concern to improve fall prevention programmes for care recipients at risk of falling at home

Carers' concerns about their older persons (Carees) at risk of falling - a mixed-methods study protocol.

BACKGROUND: When dependent older persons (carees) experience a fall at home, their carers worry that they will fall again. This ongoing concern affects the carers' wellbeing, perception of burden and can potentially change care arrangements. Previous research has focused on carers of high fall risk older persons with stroke, dementia or Parkinson's disease. However, little is known about the carers' concerns for carees at risk of falling generally; and there is no validated instrument to measure this concern. This study aims to explore carers' fall concern about carees at risk of falling and the development of an instrument to measure this concern. METHODS: This study utilises an exploratory sequential design in the development of an instrument to measure carers' concerns. Phase One will explore carers' fall concern using a descriptive qualitative approach. Phases Two and Three will involve expert review, pilot testing and field testing of the instrument. Twenty participants will be recruited by purposive sampling in phase one, and convenience sampling of 50 and 250 participants respectively, in Phases Two and Three. The participants will be recruited from research volunteer registers and local hospital outpatient clinics. Participants will be 18 years old and older and the main carer of an older person. Participants will be interviewed about their concerns about falls. Inductive content analysis will be used to analyse interviews and develop items for the instrument. The psychometric properties of the raw instrument will be tested using an online survey. This study has received ethics approval from the Hunter New England Human Health Research Ethics Committee. DISCUSSION: This study aims to provide greater depth of understanding about the psychological concerns and emotional burden related to carees' falls for carers. Quantifying carers' concerns will provide a context for interventions to assist and support carers and in the greater vigilance of monitoring the falling incidence of carees

A coherent middle Pliocene magnetostratigraphy, Wanganui Basin, New Zealand

We document magnetostratigraphies for three river sections (Turakina, Rangitikei, Wanganui) in Wanganui Basin and interpret them as corresponding to the Upper Gilbert, the Gauss and lower Matuyama Chrons of the Geomagnetic Polarity Timescale, in agreement with foraminiferal biostratigraphic datums. The Gauss-Gilbert transition (3.58 Ma) is located in both the Turakina and Wanganui River sections, while the Gauss-Matuyama transition (2.58 Ma) is located in all three sections, as are the lower and upper boundaries of the Mammoth (3.33–3.22 Ma) and Kaena (3.11–3.04 Ma) Subchrons. Our interpretations are based in part on the re-analysis of existing datasets and in part on the acquisition and analysis of new data, particularly for the Wanganui River section. The palaeomagnetic dates of these six horizons provide the only numerical age control for a thick (up to 2000 m) mudstone succession (Tangahoe Mudstone) that accumulated chiefly in upper bathyal and outer neritic palaeoenvironments. In the Wanganui River section the mean sediment accumulation rate is estimated to have been about 1.8 m/k.y., in the Turakina section it was about 1.5 m/k.y., and in the Rangitikei section, the mean rate from the beginning of the Mammoth Subchron to the Hautawa Shellbed was about 1.1 m/k.y. The high rates may be associated with the progradation of slope clinoforms northward through the basin. This new palaeomagnetic timescale allows revised correlations to be made between cyclothems in the Rangitikei River section and the global Oxygen Isotope Stages (OIS) as represented in Ocean Drilling Program (ODP) Site 846. The 16 depositional sequences between the end of the Mammoth Subchron and the Gauss-Matuyama Boundary are correlated with OIS MG2 to 100. The cyclothems average 39 k.y. in duration in our age model, which is close to the 41 k.y. duration of the orbital obliquity cycles. We support the arguments advanced recently in defence of the need for local New Zealand stages as a means of classifying New Zealand sedimentary successions, and strongly oppose the proposal to move stage boundaries to selected geomagnetic polarity transitions. The primary magnetisation of New Zealand mudstone is frequently overprinted with secondary components of diagenetic origin, and hence it is often difficult to obtain reliable magnetostratigraphic records. We suggest specific approaches, analytical methods, and criteria to help ensure robustness and coherency in the palaeomagnetic identification of chron boundaries in typical New Zealand Cenozoic mudstone successions

Optimizing the Performance of Aerosol Photoacoustic Cells using a Finite Element Model. Part 1: Method Validation and Application to Single-Resonator Multipass Cells

This is the final version. Available on open access from Taylor & Francis via the DOI in this recordData access statement: For data related to this paper, please contact Michael I. Cotterell ([email protected]) or Justin M. Langridge ([email protected]).Photoacoustic spectroscopy is the technique-of-choice for non-contact and in situ measurements of light absorption coefficients for aerosols. For most aerosol photoacoustic (PA) detectors, a key process is the amplification of the acoustic pressure wave generated from light absorption through excitation of a pressure eigenmode of a PA cell. To our knowledge, no modelling of the acoustics, sensitivity or signal-to-background ratio (SBR) has been performed for the PA cells applied commonly to aerosol absorption measurements. In this Part 1 manuscript, we develop a finite element method (FEM) framework to simulate the acoustic response and SBR of photoacoustic cells. Furthermore, we validate this modelling framework by comparing FEM predictions of single-resonator PA cells with measurements using a prototype single-resonator cell, the geometry of which can be readily adjusted. Indeed, single-resonator cells are applied commonly to aerosol absorption measurements. We show that our model predicts accurately the trends in acoustic properties with changes to cell geometry. We investigate how common geometric features, used to supress detection of background and noise processes, impact on the SBR of single-resonator PA cells. Such features include using multiple acoustic buffer volumes and tuneable air columns. The FEM model and measurements described in this paper provide the foundation of a companion paper that reports the acoustic properties and optimization of a two-resonator PA cell used commonly in aerosol research.Defence Science and Technology Laboratory (DSTL)Royal Society of ChemistryAnalytical Chemistry Trust FundNatural Environment Research Council (NERC

Optimizing the Performance of Aerosol Photoacoustic Cells using a Finite Element Model. Part 2: Application to a Two-Resonator Cell

This is the author accepted manuscript. The final version is available from Taylor & Francis via the DOI in this recordData availability: For data related to this paper, please contact Michael I. Cotterell ([email protected]).Photoacoustic spectroscopy (PAS) measures aerosol absorption in a non-contact manner, providing accurate absorption measurements that are needed to improve aerosol optical property representations in climate models. Central to PAS is resonant amplification of the acoustic pressure wave generated from laser-heated aerosol transferring heat to surrounding gas by a photoacoustic cell. Although this cell amplifies pressure sources from aerosol absorption (signal), it also amplifies noise and background sources. It is important to maximise the cell signal-to-background ratio (SBR) for sensitive absorption measurements. Many researchers have adopted the two-resonator cell design described by Lack et al. (2006). We show that the uncertainty in PAS measurements of aerosol absorption using this two-resonator cell is significantly degraded by its large sensitivity to background contributions from laser scattering and absorption at the cell windows. In Part 1, we described the use of a finite element method (FEM) to predict cell acoustic properties, validated this framework by comparing model predictions to measurements, and used FEM to test various strategies applied commonly to single-resonator cell optimisation. In this second part, we apply FEM to understand the excitation of resonant modes of the two-resonator cell, with comparison measurements demonstrating accurate predictions of acoustic response. We perform geometry optimisation studies to maximise the SBR and demonstrate that the laser-window interaction background is reduced to undetectable levels for an optimal cell. This optimised two-resonator cell will improve the sensitivity and accuracy of future aerosol absorption measurements.Defence Science and Technology Laboratory (DSTL)Royal Society of ChemistryAnalytical Chemistry Trust FundNatural Environment Research Council (NERC

Air Fraction Correction Optimisation in PET Imaging of Lung Disease

Accurate quantification of radiopharmaceutical uptake from lung PET/CT is challenging due to large variations in fractions of tissue, air, blood and water. Air fraction correction (AFC) uses voxel-wise air fractions, which can be determined from the CT acquired for attenuation correction (AC). However, resolution effects can cause artefacts in either of these corrections. In this work, we hypothesise that the resolution of the CT image used for AC should match that of the intrinsic resolution of the PET scanner but should approximate the reconstructed PET image resolution for AFC. Simulations and reconstructions were performed with the Synergistic Image Reconstruction Framework (SIRF) using phantoms with inhomogeneous attenuation (mu) maps, mimicking the densities observed in lung pathologies. Poisson noise was added to the projection data prior to OSEM reconstruction. AC was performed with a smoothed mu-map, the full-width-half-maximum (FWHM) of the 3D Gaussian kernel was varied (0 - 10 mm). Post-filters were applied to the reconstructed AC images (FWHM: 0 - 8 mm). The simulated mu-map was independently convolved with another set of 3D Gaussian kernels, of varying FWHM (0 - 12 mm), for AFC. The coefficient of variation (CV) in the lung region, designed to be homogeneous post-AFC with optimised kernels, and the mean AFC-standardized uptake value (AFC-SUV) in the regions of simulated pathologies were determined. The spatial resolution of each post-filtered image was determined via a point-source insertion-and-subtraction method on noiseless data. Results showed that the CV was minimised when the kernel applied to the mu-map for AC matched that for the simulated PET scanner and the kernel applied to the mu-map for AFC matched the spatial resolution of the reconstructed PET image. This was observed for all post-reconstruction filters and supports the hypothesis. Initial results from Monte Carlo simulations validate these findings

Spin Calogero Particles and Bispectral Solutions of the Matrix KP Hierarchy

Pairs of $n\times n$ matrices whose commutator differ from the identity by a matrix of rank $r$ are used to construct bispectral differential operators with $r\times r$ matrix coefficients satisfying the Lax equations of the Matrix KP hierarchy. Moreover, the bispectral involution on these operators has dynamical significance for the spin Calogero particles system whose phase space such pairs represent. In the case $r=1$, this reproduces well-known results of Wilson and others from the 1990's relating (spinless) Calogero-Moser systems to the bispectrality of (scalar) differential operators. This new class of pairs $(L, \Lambda)$ of bispectral matrix differential operators is different than those previously studied in that $L$ acts from the left, but $\Lambda$ from the right on a common $r\times r$ eigenmatrix.Comment: 16 page

New Fathers' Perinatal Depression and Anxiety-Treatment Options: An Integrative Review.

More than 10% of fathers experience depression and anxiety during the perinatal period, but paternal perinatal depression (PPND) and anxiety have received less attention than maternal perinatal mental health problems. Few mainstream treatment options are available for men with PPND and anxiety. The aim of this literature review was to summarize the current understanding of PPND and the treatment programs specifically designed for fathers with perinatal depression. Eight electronic databases were searched using a predefined strategy, and reference lists were also hand searched. PPND and anxiety were identified to have a negative impact on family relationships, as well as the health of mothers and children. Evidence suggests a lack of support and tailored treatment options for men having trouble adjusting to the transition to fatherhood. Of the limited options available, cognitive behavioral therapy, group work, and blended delivery programs, including e-support approaches appear to be most effective in helping fathers with perinatal depression and anxiety. The review findings have important implications for the understanding of PPND and anxiety. Future research is needed to address the adoption of father-inclusive and father-specific models of care to encourage fathers' help-seeking behavior. Inclusion of male-specific requirements into support and treatment options can improve the ability of services to engage new fathers. Psychotherapeutic intervention could assist to address the cognitive differences and dissonance for men adjusting to the role of father, including male identity and role expectations

The role of charged residues in the transmembrane helices of monocarboxylate transporter 1 and its ancillary protein basigin in determining plasma membrane expression and catalytic activity

Monocarboxylate transporters MCT1-MCT4 require basigin (CD147) or embigin (gp70), ancillary proteins with a glutamate residue in their single transmembrane (TM) domain, for plasma membrane (PM) expression and activity. Here we use site-directed mutagenesis and expression in COS cells or Xenopus oocytes to investigate whether this glutamate (Glu218 in basigin) may charge-pair with a positively charged TM-residue of MCT1. Such residues were predicted using a new molecular model of MCT1 based upon the published structure of the E. coli glycerol-3-phosphate transporter. No evidence was obtained for Arg306 (TM 8) of MCT1 and Glu218 of basigin forming a charge-pair; indeed E218Q-basigin could replace WT-basigin, although E218R-basigin was inactive. No PM expression of R306E-MCT1 or D302R-MCT1 was observed but D302R/R306D-MCT1 reached the PM, as did R306K-MCT1. However, both were catalytically inactive suggesting that Arg306 and Asp302 form a charge-pair in either orientation, but their precise geometry is essential for catalytic activity. Mutation of Arg86 to Glu or Gln within TM3 of MCT1 had no effect on plasma membrane expression or activity of MCT1. However, unlike WT-MCT1, these mutants enabled expression of E218R-basigin at the plasma membrane of COS cells. We propose that TM3 of MCT1 lies alongside the TM of basigin with Arg86 adjacent to Glu218 of basigin. Only when both these residues are positively charged (E218R-basigin with WT-MCT1) is this interaction prevented; all other residue pairings at these positions may be accommodated by charge-pairing or stabilization of unionized residues through hydrogen bonding or local distortion of the helical structure