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Development and validation of the Patient-Reported Outcome Measure–Older adult care Transitions from the Emergency Department (PROM-OTED) tool
No full textBackground
Care transitions from the emergency department (ED) to the community represent a critical period that can significantly impact clinical outcomes of older adults, yet there is a lack of standardized tools to measure patient-reported experiences and outcomes during this transition. Our objective was to develop and validate the Patient-Reported Outcome Measure–Older adult care Transitions in the ED (PROM-OTED) tool to measure care transition outcomes within 4–10 days after ED discharge.
Methods
Older adults (65+ years) discharged from four EDs were enrolled between November 2021 and April 2024 in a multiphase process: qualitative interviews, item generation, member checking, cognitive debriefing, technical expert panel review, and psychometric evaluation and validation. We employed descriptive statistics, item analysis, interitem correlation, and factor analyses to assess the tool‘s validity and reliability.
Results
Across all phases, we enrolled 290 older adults. The final 18-item PROM-OTED tool included items that addressed understanding of discharge instructions, medication management, follow-up care, and quality of life. The tool demonstrated feasibility with a mean (±SD) completion time of 4.97 (±3.04) min and was able to be administered electronically or via telephone. The tool additionally demonstrated excellent internal consistency (Cronbach‘s alpha 0.9376, McDonald‘s omega 0.9988) and good test–retest reliability (r = 0.8437). Exploratory factor analysis supported a robust factor structure and significant correlations between the PROM-OTED tool with the Care Transitions Measure-3, a general measure of hospital discharge quality of care, support its concurrent validity.
Conclusions
The PROM-OTED tool is a reliable and preliminarily valid instrument for use during the immediate post-ED period, with potential clinical applications in enhancing discharge practices and assessing care transition outcomes of older adults during observational or interventional studies
Exploring accounting academics’ views on sustainability: a Freirean dialogical pedagogic perspective
No full textThe emancipatory power of accounting is crucial for enabling sustainable living, placing a responsibility on accounting educators to unlock this potential. As sustainability remains an evolving global discussion, teaching it requires a shift from traditional, didactic approaches to accounting education. Paulo Freire's dialogical approach offers a valuable framework, assuming educators have the critical consciousness and pedagogical skills to co-create knowledge with learners. However, there is limited insight into educators' views on sustainability in accounting—an essential perspective for fostering critical consciousness—and their readiness for a dialogical teaching approach. These gaps present challenges to promoting sustainability through accounting education. This exploratory study adopts a phenomenographic approach to gain insights through semi-structured interviews with UK accounting academics, applying Freire's theoretical lens to deepen the analysis. The results reveal qualitatively different ways in which educators perceive sustainability in accounting, offering novel insights into accounting education and making an initial step toward fostering critical consciousness. Findings indicate that educators may lack the pedagogical skills necessary for a dialogical approach, often assuming roles as knowledge distributors rather than co-creators. This highlights the need to strengthen pedagogical capacity in order to move beyond traditional didactic teaching methods
Selling Education in England, 1650–1715
No full textIn the period 1650–1715, a growing consensus emerged that educational culture in England did not meet the needs of the population, and that change was required—change in what was taught, how, and to whom. This article argues for a conception of an English ‘educational economy’ in which fragmenting institutions and a patchy licensing regime made space for substantial private educational provision. This educational economy gave rise to debates about the appropriate education for learners of different backgrounds and social status, and prompted teachers to new defences of their own value, authority and competence. It was shaped in public, making education the business not only of schoolrooms or private homes, but also of coffeehouses, taverns and the press. This article argues that printed advertisements are the best archive for this educational economy, providing crucial information about its shape—from the subjects on offer to the students it served. Advertisements help to illuminate the venues of early modern education, and show how educational activity was woven through the public and semi-public spaces of the period’s cities and towns. They offer new ways of thinking about educational labour: who was doing it, what it consisted of, how it fitted into the urban knowledge economy, and how authority and prestige were debated and discussed in this transformative phase in England’s educational history
Exploring Melanoma Awareness in the Australian Adult Population: A Cross-Sectional Survey
No full textBackground
Given Australia's high UV exposure and sun-seeking habits, public awareness is critical for early melanoma diagnosis. This study aims to assess melanoma awareness in Australian adults.
Methods
An adapted Melanoma Cancer Awareness Measure (M-CAM) survey with both prompted and unprompted questions was used to assess knowledge of melanoma signs and symptoms, targeting adults over 18 years, excluding healthcare professionals.
Results
Among 390 participants, the mean number of correctly identified melanoma signs and symptoms was 3.5 out of 17 (unprompted) and 11 out of 14 (prompted). For melanoma risk factors, participants recalled an average of 3.1 items out of 21 (unprompted), and 14 out of 20 items when prompted. The most commonly identified symptoms (unprompted) were changes in the colour (72%), size (41%) and shape (34%) of an existing mole. Sun exposure was the most recognised melanoma risk factor (89%) in unprompted recall, followed by family history of melanoma (64%) and fair skin colour (47%).
Conclusion
In this Australian sample, unprompted awareness was low, even among those with a melanoma history. Targeted efforts to identify sub-groups with low awareness, alongside education highlighting less common signs, may enhance early detection and improve melanoma outcomes
At the Top of the Mind: Peak Prices and the Disposition Effect
Get PDFThe disposition effect is the reluctance to sell assets at a loss relative to a salient point of reference, typically assumed to be the purchase price. Using data on stocks and housing sales, we show that the peak price achieved by an asset during the investor’s period of holding constitutes an additional salient reference point for asset owners that overlaps—and interacts—with the purchase price reference point. Peaks occurring before the investor purchased the asset do not affect future sales, indicating that ownership affects how investors form reference points
73 GHz pHEMT pumped transconductance RX Mixer with low local oscillator drive power
No full textFuture mmWave mobile architectures will benefit from low power RF circuits and systems. In this work we propose two pumped transconductance balanced mixers requiring low LO drive power and DC power. The mixers operate at circa 73 GHz RF and 70 GHz LO. A 90-degree hybrid is used on the input to simplify input matching. Off-chip IF matching is implemented on a test PCB. We observe a conversion gain of -17 dB for an LO power of -10 dBm, with a DC current of 1.3 mA and an IP1dB of - 3.3 dBm for one of the prototypes. LO powers down to -20 dBm are also potentially viable, if greater loss can be accepted
Introduction: Responding to the Climate Crisis in Eastern Africa
Get PDFThe introduction reflects on the current state and leadership towards climate justice in Eastern Africa, while introducing the key contributions of the book’s contributors. It argues for putting climate finance at the heart of climate justice, unsettling climate justice to foreground intersectionality, fairness, justice and rights, centres the lived experiences of a youth climate activist (JulietGrace Luwedde), and highlights the importance of putting Eastern Africa at the centre of the climate-justice debate
Fast females, slow males: accelerated ageing and reproductive senescence in Drosophila melanogaster females across diverse social environments
Get PDFFemales and males typically differ in lifespan, patterns of ageing, and reproduction. General explanations for variation in the magnitude of this sex-specificity remain elusive, and the role of the social environment in this context is under-explored. Sexual selection theory predicts that males should adopt a “live fast, die young” strategy, as their fitness is likely to be contingent on intense investment to achieve success in competing for potentially few matings. However, there is a growing realization that sexual selection can act on a much broader suite of “general performance” traits than only those directly related to mating competition. This, combined with frequently observed high costs of reproduction in females, makes an alternative prediction—that ageing and reproductive senescence can be high for females, and could potentially exceed what is seen in males. We tested these contrasting predictions in the fruit fly Drosophila melanogaster, using assays in which both sexes competed for reproductive opportunities over their lifetimes within varying socio-sexual environments. Females consistently exhibited “live fast, die young” life histories, whereas males had significantly longer lifespans and showed only limited declines in age-specific fitness and mating performance. We also identified new same-sex exposure effects—females housed with females exhibited faster reproductive ageing at a marginal lifespan cost, whereas corresponding males maintained higher courtship and activity with age, with no detectable effect on lifespan. The results highlight the crucial importance of social environments to the study of ageing and fitness. The possibility that rapid reproductive senescence is widespread in females is key to broadening our holistic understanding of the biology of sex differences in ageing and reproduction
Emissions Measurement to Improve Sanitation in Indonesia (EMISI): Policy Brief - From Evidence to Action: The Climate Mitigation Role of Indonesia’s Sanitation Sector
No full textChickpea Aquafaba as a Natural Stabiliser for Chilli Oleoresin Encapsulation: Stabilisation, Rheological and Microstructural Characterisation
No full textThe underpinnings and applications of aquafaba (AF) as a stabiliser of chilli oleoresin-in-water emulsions have only started to be studied. Pickering stabilisation by British Kabuli chickpea AF incidental nanoparticles (formed during cooking) and denatured proteins was examined in the present study. This entailed optimisation of the composition of the most stable chilli oleoresin-in-water emulsions, and the characterisation of the rheological behaviour and morphological features of the optimised systems. To this end, optimised formulations of chilli oleoresin-in-water emulsions stabilised by freeze-dried and resuspended AF, in regard to AF (%), oil (%, oleoresin: MCT, 1:1 (w/w)) and water (%), were investigated using I-optimal mixture design. The instability index of emulsions, as probed by a centrifugation/laser scanning device (LUMiSizer), was used as the response variable. Based on the best-fit linear mixture model, the three most stable formulations, comprising 13.85 to 15.00% AF, 1.00 to 6.64% oil, and 78.36 to 85.15% water, with an overall desirability value ≥ 0.96, were selected for further rheological and microstructural analysis via CLSM and Cryo-SEM imaging. These emulsions gelled upon standing at 25 °C, as demonstrated by small-deformation oscillatory rheology showing a sharp increase in G′ over G″ and gel-like frequency dependence. Complex viscosity (η*) also increased with rising AF content. After shear-induced breakdown, the gels reformed upon resting, suggesting reversible, physically driven network formation. Cryo-SEM images revealed the presence of raspberry-like surface topology at the surface of the oil droplets, consistent with the hypothesis of Pickering emulsion stabilisation by AF nanoparticles. Overall, emulsions formulated with 15% AF, 6.64% oil, and 78.36% water (Run 13) yielded superior stability, rheological, and morphological properties for further applications. In conclusion, the results provided compelling evidence that AF can function as a wall material for capsaicin oleoresins encapsulation, leading to gelled emulsions
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