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This document provides a summary of a hackathon event organized by the Ministry of Justice (MoJ) and Aon, a reinsurance company, to explore the social impacts of climate change. The hackathon focused on developing consistent scenarios for future climate risk, understanding uncertainties in European windstorm modeling, and providing real-time context for extreme weather events. The teams developed tools and methodologies to assess the severity and potential impact of extreme events on insured losses. The collaboration between the MoJ, Aon, and participants from various institutions aims to further research and develop papers and grant proposals in these areas. [Extracted from the article]

Simple Summary: The cartilage-to-bone transition is an essential process in healthy bone development and repair. Our previous work has shown that when the cells found within the human periosteum (the membrane surrounding the bone) are cultured in human serum (HS) as opposed to the standard animal serum (FBS), these cells have greater bone-forming capacity as assessed in an ectopic assay in nude mice. What is not understood is the molecular interactions that permitted this enhanced biological potency. Herein, virtual networks are created to identify the key proteins driving increased bone formation from these cells. Key signalling factors were identified through a network analysis, where FGFR3 was pinpointed as a major differential regulator between cells grown in HS and cells grown in FBS. This analysis was validated through an analysis of human-derived periosteal progenitor cells (PDCs) containing a constitutively active (ca) FGFR3. Following removal and analysis, we found that the FGFR3-ca cells that were implanted on bone void filler scaffolds in mice had an abundance of bone and cartilage that were present compared to the scaffold containing normal/healthy cells. This suggests that these cells were undergoing enhanced cartilage-to-bone transitions and that this protein may be a potentially novel therapeutic target for diseases where the cartilage-to-bone transition is affected such as during poor fracture healing. Human periosteum-derived progenitor cells (hPDCs) have the ability to differentiate towards both the chondrogenic and osteogenic lineages. This coordinated and complex osteochondrogenic differentiation process permits endochondral ossification and is essential in bone development and repair. We have previously shown that humanised cultures of hPDCs enhance their osteochondrogenic potentials in vitro and in vivo; however, the underlying mechanisms are largely unknown. This study aimed to identify novel regulators of hPDC osteochondrogenic differentiation through the construction of miRNA-mRNA regulatory networks derived from hPDCs cultured in human serum or foetal bovine serum as an alternative in silico strategy to serum characterisation. Sixteen differentially expressed miRNAs (DEMis) were identified in the humanised culture. In silico analysis of the DEMis with TargetScan allowed for the identification of 1503 potential miRNA target genes. Upon comparison with a paired RNAseq dataset, a 4.5% overlap was observed (122 genes). A protein–protein interaction network created with STRING interestingly identified FGFR3 as a key network node, which was further predicted using multiple pathway analyses. Functional analysis revealed that hPDCs with the activating mutation FGFR3N540K displayed increased expressions of chondrogenic gene markers when cultured under chondrogenic conditions in vitro and displayed enhanced endochondral bone formation in vivo. A further histological analysis uncovered known downstream mediators involved in FGFR3 signalling and endochondral ossification to be upregulated in hPDC FGFR3N540K-seeded implants. This combinational approach of miRNA-mRNA-protein network analysis with in vitro and in vivo characterisation has permitted the identification of FGFR3 as a novel mediator of hPDC biology. Furthermore, this miRNA-based workflow may also allow for the identification of drug targets, which may be of relevance in instances of delayed fracture repair. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to understand how people living with Parkinson's and healthcare professionals perceived their care management and interactions with health services were affected during the COVID‐19 pandemic. Background: During the COVID‐19 pandemic, many governments introduced restrictions and services that support Parkinson's care management had to cease or be delivered remotely. These changes may have had an impact on the well‐being of people living with Parkinson's. Methods: A qualitative exploratory UK study was carried out. Semi‐structured individual interviews with people living with Parkinson's and health professionals were recorded, transcribed verbatim and analysed using Braun´s and Clarke´s thematic analysis. Eleven patients and 10 health professionals were recruited between April and September 2020. The study was reported using the COREQ. Results: Two main themes were identified. In the first theme, many patients and professionals reported that the COVID‐19 pandemic made some people living with Parkinson's feel isolated and vulnerable due to disruptions to their social networks and usual activities related to Parkinson's disease care. However, other patients remained connected with their networks. In the second theme, patients and most professionals mentioned that some clinical practices were cancelled, delayed or transformed to remote consultation. Conclusion: The COVID‐19 restrictions had an impact on how people living with Parkinson's managed their care and in their interactions with healthcare services. Health professionals should assess the risk of vulnerability, social isolation, physical inactivity and confidence with remote consultations in people living with Parkinson's. This might inform a rethinking of existing clinical interactions with people living with Parkinson's towards a flexible, sustainable, person‐centred care model. Relevance to clinical practice: This study has shown that Parkinson's care management and interactions with healthcare services should provide personalised and flexible support. To meet this challenge, the design of the organisation of health services should include greater involvement of patients and person‐centred care models. [ABSTRACT FROM AUTHOR]

Background: People with long-term conditions must complete many healthcare tasks such as take medications, attend appointments, and change their lifestyle. This treatment burden and ability to manage it (capacity) is not well-researched in Parkinson's disease. Objective: To explore and identify potentially modifiable factors contributing to treatment burden and capacity in people with Parkinson's disease and caregivers. Methods: Semi-structured interviews with nine people with Parkinson's disease and eight caregivers recruited from Parkinson's disease clinics in England (ages 59–84 years, duration of Parkinson's disease diagnosis 1–17 years, Hoehn and Yahr (severity of Parkinson's disease) stages 1–4) were conducted. Interviews were recorded and analyzed thematically. Results: Four themes of treatment burden with modifiable factors were identified: 1) Challenges with appointments and healthcare access: organizing appointments, seeking help and advice, interactions with healthcare professionals, and caregiver role during appointments; 2) Issues obtaining satisfactory information: sourcing and understanding information, and satisfaction with information provision; 3) Managing medications: getting prescriptions right, organizing polypharmacy, and autonomy to adjust treatments; and 4) Lifestyle changes: exercise, dietary changes, and financial expenses. Aspects of capacity included access to car and technology, health literacy, financial capacity, physical and mental ability, personal attributes and life circumstances, and support from social networks. Conclusions: There are potentially modifiable factors of treatment burden including addressing the frequency of appointments, improving healthcare interactions and continuity of care, improving health literacy and information provision, and reducing polypharmacy. Some changes could be implemented at individual and system levels to reduce treatment burden for people with Parkinson's and their caregivers. Recognition of these by healthcare professionals and adopting a patient-centered approach may improve health outcomes in Parkinson's disease. [ABSTRACT FROM AUTHOR]

Despite the long-acknowledged and widespread association of wind instrumentalists with English cathedrals in the late 16th and 17th centuries, and the continued performance tradition enjoyed by sacred vocal music of the period, the performance practices of English cathedral wind bands during this time have been strangely neglected in the existing literature. Drawing on a combination of traditional musicological and archival research and bespoke practice-led research methodologies, this article discusses some possible solutions to the question of how wind instrumentalists may have been employed in the day-to-day enactment of Prayer Book services during a turbulent period of English history. New archival evidence surrounding the life of William Mather, cornettist at Canterbury Cathedral in the years before the suspension of sung worship in 1642, sheds new light on the interplay between civic and ecclesiastical music-making in the city, contributing to our knowledge of the historical and social contexts of the people and practices involved, and offering a tantalizing glimpse into life in the 17th-century gig economy. [ABSTRACT FROM AUTHOR]

The purpose of this technical report is to present the methodology that will be implemented to address the terms of reference of a mandate received from the European Commission (EC). This mandate requests EFSA to assess the effectiveness of some of the control measures related to Category 'A' diseases. More specifically, in this report EFSA illustrates the methodology to assess the following features: i) the sampling of animals and establishments for the detection of category 'A' diseases in terrestrial animals; ii) the monitoring period; and iii) the minimum radius of restricted zones and duration of the disease control measures in restricted zones. The first step was to understand in detail the request of the EC and the outcome of this exercise is reported in the sections dedicated to the interpretation of the terms of reference. For the identification of the most suitable methodology, specific scenarios were identified, for each measure, to ensure that the approach was able to cover as many situations as possible in the field. Once the approach was identified, it was possible to define the data needs and the potential sources of information. Extensive literature search appeared to be essential to retrieve some of the necessary inputs for some diseases and for some important parameters; for this reason, and in the interest of time, EFSA procured this work by means of a public call. In case the scientific literature will not offer the required information, expert knowledge elicitation will serve the purpose. A section was dedicated to the assessment of the uncertainty. In conclusion, this work represents the general methodological framework underpinning the scientific opinions that will be issued for each category 'A' disease. Any unavoidable deviation from the approach as described here will be duly documented in the scientific opinions [ABSTRACT FROM AUTHOR]

Academic geriatric medicine activity lags behind the scale of clinical activity in the specialty. A meeting of UK academic geriatricians was convened in March 2018 to consider causes and solutions to this problem. The meeting highlighted a lack of research-active clinicians, a perception that research is not central to the practice of geriatric medicine and a failure to translate discovery science to clinical studies. Solutions proposed included better support for early-career clinical researchers, schemes to encourage non-University clinicians to be research-active, wider collaboration with organ specialists to broaden the funding envelope, and the need to co-produce research programmes with end-users. Solutions to grow academic geriatric medicine are essential if we are to provide the best care for the growing older population. [ABSTRACT FROM AUTHOR]

Interactions between humans and nature are understood to be beneficial for human well-being. In cities, urban green spaces are believed to provide many benefits to urban populations in terms of mental and emotional well-being. Through a case study of 60 urban green spaces in Birmingham, United Kingdom, this article investigates the spatial and temporal variation of the emotions experienced by individuals whilst using urban green spaces. Using a dataset obtained from Twitter as the basis for emotional explorations, sentiment analysis was performed on over 10,000 tweets to ascertain the positivity/negativity of individuals. Positive responses were more common than negative responses across all seasons, with happiness and appreciation of beauty being the common positive emotions identified. For the negative responses, fear and anger were present in similar amounts, with fewer tweets indicating sadness and disgust. Our findings show that Twitter data is a viable source of information to researchers investigating human interaction and emotional response to space in cities. Such information has implications for urban planners and park managers, enabling the creation of evidence-based spaces which enhance positive outdoor experience. Limitations in using Twitter data are discussed and these should be considered in future research. [ABSTRACT FROM AUTHOR]

The article discusses the facilitating peer-based formative assessment through online quizzes, using technology to support the learning and retention of vocabulary in modern foreign languages, and discusses how feedback is most beneficial to students when it focuses on strengths and weaknesses.

Purpose: To explore the fear of cataract surgery experienced by the residents of the Kwale district of southern Kenya. Methods: The Kwale Eye Centre (KEC) is the only stationary specialist hospital in the Kwale County of southern Kenya. Patients attending the Centre as a walk-in clients during the data collection period were screened and recruited to the study. Fully informed consent was obtained. Qualitative semi-structured interviews (SSI's) were used for data collection. Each interview followed a question guide and was recorded in a digital-audio format. The interviews were transcribed verbatim and thematic analysis performed on the consequent transcripts. Results: A total of 20 SSI's were performed. Most preoperative fears are directly linked to or provoked by "rumours" that surround cataract surgery; 65% of participants identified fear originating from narratives passed on to them by friends and family. These rumours ranged from inaccurate reporting of the process of cataract surgery to completely unfounded information. The most common intraoperative fear of cataract surgery was concern over the injection. A frequently noted postoperative fear was that of suffering further eye damage. Conclusion: The long-standing service the KEC has provided might have decreased the fear surrounding cataract surgery as a consequence of increased awareness. Yet, even when accurate information is provided, rumours continue to spread. Knowledge of the cataract surgery plays an incredibly important role in decreasing fear across all the operative stages. This study shows a great deal of fear is not rational and may perhaps be significantly lessened if addressed. [ABSTRACT FROM AUTHOR]

Abstract The lakes of the eastern Africa Rift often contain great thicknesses of sediment that may provide continuous records of environmental change over decadal to million-year timescales. However interpretation of these changes is greatly compromised without a reliable chronology. Luminescence dating has not been used extensively in lacustrine settings; instead previous studies have often relied upon radiocarbon dating, using extrapolation beyond the upper limit of that technique, and employing opportunistic sampling of tephra and palaeomagnetic signatures where possible. This study from Lake Tana, Ethiopia, demonstrates that recent advances in luminescence methodology can provide long chronologies for lake sediments that are not dependent on the intermittent presence of dateable material, as is the case for radiocarbon and tephra-based methods. Specifically, this study generates luminescence ages that agree with independent chronology based on radiocarbon dating in the upper part of the core, and extends significantly beyond the range of radiocarbon dating to provide one of the longest independently dated lacustrine sediment records in eastern Africa, thus demonstrating the tremendous potential of luminescence for constructing lacustrine sediment chronologies over 100,000 year timescales. Highlights • Recent advances make it timely to apply luminescence methods to date lake sediments. • Luminescence dating can provide long chronologies throughout lake sediment cores. • The application of luminescence dating to sediments from Lake Tana is discussed. • One of the longest independently dated lake records in eastern Africa. • Demonstrates the contribution luminescence dating can make to lacustrine studies. [ABSTRACT FROM AUTHOR]

Rock luminescence dating has grown in popularity in recent years, and potentially offers several advantages over traditional sediment luminescence dating. One key advantage when determining burial ages is the potential for an individual rock surface or clast to preserve clear evidence for bleaching prior to the burial event of interest and the subsequent accumulation of dose, and in some circumstances these materials may even preserve a history of multiple exposure and burial events. This previous exposure and burial history is inferred from the study of variation in age with increasing depth away from the rock surface. But such patterns in age-depth profiles in rock may also potentially be influenced by inhomogeneous radionuclide distributions causing spatial variations in the dose rate [1, 2]. In unconsolidated sediment dating it is recognised that various factors such as accuracy and reproducibility of heating [3] and grain size [4] can also influence the assessment of equivalent dose, and the same is anticipated to be true of rock slices. Minimising sources of variability within and between rock slices is important if rock age-depth profiles are to be interpreted appropriately. This study investigates the influence of various parameters on the reproducibility of assessments of equivalent dose from rock slices. The factors explored include the thickness of the materials being measured, beta source calibration, the reproducibility and efficacy of heating rock slices, and variations in optical attenuation. The ability to cut reproducibly thin and flat rock slices minimises the likelihood of variability within and between rock slices for many parameters, and gives greater confidence in the equivalent dose values determined and in their interpretation as part of a rock age-depth profile describing the bleaching and burial history. A method to achieve this routine preparation of uniformly thin and flat rock slices is described. Working with thin rock slices also means that the number of slices that can be prepared over a given depth into rock is obviously greater than can be achieved using thicker slices, which can be particularly advantageous for rock types which permit limited penetration of light, improving their potential to provide information on prior bleaching and burial events. [ABSTRACT FROM AUTHOR]

Devices for imaging luminescence emissions have been used for a number of years [e.g. 1], but where analysis of a sequence of measurements of the luminescence signal following different treatments is required a significant challenge has been to accurately register the images so that a signal measured from a region of interest defined in one image is compared with the corresponding part of the other images. This is particularly an issue with automated instruments where sample repositioning varies from one measurement step to the next, resulting in samples moving laterally and/or rotationally with respect to the EMCCD field of view. The calcitic opercula of Bithynia tentaculata are of interest for their TL emission which grows to doses in excess of 8,000 Gy, meaning it is potentially able to date the entire Quaternary period. The opercula are teardrop shaped and typically 2-4 mm on their longest axis. Imaging using an EMCCD permits spatially resolved equivalent dose determination, but registering the images has been a major impediment to analysis of sequences of measurements. Previous work [2] manually determined the translation and rotation of the opercula using distinctive features on the periphery of the opercula as markers. However, this approach is time consuming, especially where between 30 and 50 images of each opercula may need to be aligned for a sequence of measurements; it is also prone to human error. An automated process of image registration has been developed using ImageJ [3] capable of tracking each opercula. This procedure identifies the outline of the opercula in each image and then registers them. Using the translation and rotation of each image, any region of interest defined on one image looks at the same part of the opercula on all other images. Additionally, since the process identifies the outline of the opercula it allows a series of morphometric measurements to be made automatically, and for a series of regions of interest to be defined within the confines of the outline shape. The new approach is described and illustrated. A number of techniques are used to assess the accuracy of the registration process, and the impact upon the determination of De or other measurements such as pulse annealing are shown. This approach could also have applications for other types of object, such as rock slices, although they would need to be non-circular to be able to assess rotation of the object. It could also be adapted to enable the comparison of images captured by different devices mounted on the same instrument. [ABSTRACT FROM AUTHOR]

Rift lakes are perfect places for sediment accumulation and hence potentially contain continous paleoclimate records. Located in the eastern African rift valley, in southern Ethiopia, Lake Chew Bahir preserves a record of environmental change which is pertinent to the story of hominin evolution and dispersal. Independent chronology from various dating techniques is available throughout this 293 m composite core record, from which a coherent Bayesian age-depth model was generated spanning the last 620 ka and providing one of the longest directly-dated lacustrine sediment sequences in eastern Africa [1]. However, there are regions of the core where the age depth model could be improved if further datable materials were available. For instance, beyond ~50 m depth, the quartz OSL signal appears to be saturated and there is a large gap to the first 40Ar/39Ar age. The luminescence signal from feldspars saturates at a greater De value than that from quartz and therefore offers the potential to extend the maximum age range of the luminescence-derived chronology in the core, and to fill in gaps within the quartz-derived chronology where quartz is not available. The luminescence chronology for the Lake Chew Bahir core was refined and extended using the fading corrected post-IR IRSL225 signal from polymineral fine grains. However, there are challenges and complications regarding both assessment of fading and the subsequent application of the fading rates. The duration of the delay times used to assess fading, and the given laboratory dose (two critical factors in measurement of fading rates), were the same for all samples, but because of variability in lithology in the core, it is not clear whether sample specific fading rates should be used or if the mean fading rate of all samples is appropriate. Moreover, selection of the most appropriate fading correction model is critical. To circumvent the complications of fading rate measurement and its application, the recently developed post-Isothermal (pIt) IRSL protocol [2] was therefore also explored. Application of a modified pIt-IRSL225 protocol to polymineral fine grains from this core, demonstrates that this signal is successful in providing accurate ages for this material without any fading correction. Additionally, uncertainty on the derived ages were reduced in comparison with the fading corrected post-IR IRSL225 ages. However, since the calculated De from this protocol relies on the IR50/pIRIR225 De ratio, it seems to be limited to the saturation limit of the IR50 signal. This may be the reason that the pIt-IRSL225 age for one of the older samples in the core (~300 ka) does not agree with its fading corrected post-IR IRSL225 age. Possible modifications to the pIt-IRSL225 protocol to overcome this limitation will be discussed. Furthermore, the suitability of the isothermal annealing step in this protocol to account for the athermal process of signal loss (i.e. fading) was investigated. The data suggest there is a correlation between the isothermal annealing time (for which the De in the pIt- IRSL225 protocol is reached) and the g-values determined using IR50 and pIRIR225 signals. [ABSTRACT FROM AUTHOR]

Accessible summary: When young people with learning disabilities leave the care system, they can experience many problems. Here we describe some of these problems and what they do (or would like us to do) to improve things. Young people do not always want the same things that professionals or family carers want. We do not spend enough time listening to what young people can tell us. Abstract: Background: Young people with learning disabilities are frequently underrepresented in research accounts. This study describes the experiences of young people moving from the care system. Methods: We scoped the English and Swedish literature for first‐hand accounts and interviewed four young people with learning disabilities leaving the English care system. We combined findings from both sources. Findings: “Grey” and campaigning literature are more likely than academic studies to include the voices of service users, but even then, the voices tend to be those of professional or family carers. Both the literature and interviews demonstrate young peoples’ awareness and understanding of the social as well as financial benefits of work. Good foster care could be precarious, and young people in unhappy placements lacked direction. Exploitation around a young person's housing and finances could be problems. There was evidence of “threshold” difficulties in accessing services. Conclusions: Despite an NHS commitment to listening to users in the UK, and similar aspirations in Sweden, our search of the literature identified few studies reporting care leavers' with learning disabilities own words. Our data add to the voices of a group frequently silent or silenced. We found evidence of resilience and hope as well as difficulties and frustrations. The accounts in the literature and our interviews provide data on what it can be like to try to operate “the system.” The people we spoke with and those whose accounts we found in the literature were thoughtful and engaging. They provide an important source of knowledge for policy and practice. [ABSTRACT FROM AUTHOR]

The behavior of the post-blue violet stimulated luminescence (VSL) signal from quartz with respect to thermal treatments is explored. The results suggest that more than one source trap may be responsible for the VSL signal and therefore, the separation of this signal from the preceding blue stimulated luminescence (BSL) signal is challenging. Furthermore, the behavior of the VSL dose response curve (DRC) in a single aliquot regenerative (SAR) protocol is demonstrated to be influenced significantly by the test dose size and the efficacy of signal depletion prior to measurement of the test dose signal, and hence a modified VSL SAR measurement protocol is considered for further investigations in this study. The ability of this protocol to recover a given dose is tested and it is shown that by selecting different integration limits, two signals with distinct dose response characteristics can be separated from the same original VSL decay curve. Dose response curves derived from early signal integration (Signal A) saturate at ∼150 Gy and cannot recover given doses beyond this limit, whereas later signal integration (Signal B) results in a DRC that continues to grow exponentially to doses >> 500 Gy, and can recover given doses up to at least ∼3200 Gy. However, Signal B underestimates by ∼90% the equivalent dose (D e) for a sample with expected D e value of ∼500 Gy. This may suggest thermal instability of Signal B over geological time and needs further investigation. • Test dose size and prior VSL signal depletion influence dose response curves. • Two signals with different dose response characteristics can be isolated. • Dose response curves from early signal integration (Signal A) saturate at low doses (∼150 Gy). • Dose response curves from late signal integration (Signal B) grow to high doses (>> 500 Gy). • D e underestimation suggests Signal B is unstable over geologic time. [ABSTRACT FROM AUTHOR]

Tartrate-resistant acid phosphatase (TRAP) is an iron-containing protein that is highly expressed by osteoclasts, macrophages, and dendritic cells. The enzyme is secreted by osteoclasts during bone resorption, and serum TRAP activity correlates with resorptive activity in disorders of bone metabolism. TRAP is essential for normal skeletal development. In knockout mice lacking TRAP, bone shape and modeling is altered with increased mineral density. Here, we report the effect of TRAP on the biochemical and biomechanical properties of collagen, the major protein constituting the bone matrix, using these mice. Femurs from TRAP-/- and wild-type mice were used in these studies. The biomechanical properties were investigated using a three-point bending technique. Collagen synthesis was determined by measuring cross-link content using high-performance liquid chromatography and amino acid analysis. Collagen degradation was determined by measuring matrix metalloproteinase-2 (MMP-2) activity. The rates of collagen synthesis and degradation were significantly greater in bones from TRAP-/- mice compared with wild type. At 8 weeks, there was an increase in the intermediate cross-links but no significant difference in animals aged 6 months. There was a significant increase in mature cross-links at both ages. A significant increase in MMP-2 production both pro and active was observed. A significant increase in ultimate stress and Young's modulus of elasticity was needed to fracture the bones from mice deficient in TRAP. We conclude that both synthesis as well as degradation of collagen are increased when TRAP is absent in mice at 8 weeks and 6 months of age, showing that TRAP has an important role in the metabolism of collagen. [ABSTRACT FROM AUTHOR]

Vasomotor symptoms (VMS), genito-urinary syndrome of menopause (GSM), sleep disturbance, sexual dysfunction and mood disturbance are common during the menopause transition. The degree of "bother" from symptoms should guide discussions about treatment. Moderate dose estrogen-containing hormone therapy (HT) is currently the most effective treatment for VMS and also improves vaginal dryness. The indication for HT is moderate to severe VMS in women without contraindications. It should not be prescribed or continued for the treatment of chronic disease. GSM can effectively be treated with vaginal (topical) estrogens. The dose, delivery system and duration of treatment for HT should be individualised to relieve symptoms. For most healthy women aged 50-59 years, the risks of HT are low. Several widely available non-hormonal agents can treat VMS for those who should avoid or do not wish to take estrogen. These include selected antidepressants and gaba-agonists. [ABSTRACT FROM AUTHOR]

Evaluations of ‘natural experiments’ in public policy are typically considered ‘weak’ evidence. Challenges include: making credible claims for causal inference (internal validity); generalizing beyond the case (external validity); and providing useful evidence for decision makers. In public health, where experimental evidence is encouraged by funders and enjoys a degree of rhetorical favour, in theory if not practice, current guidance for evaluating natural experiments focuses largely on methods for strengthening internal validity. Using a case study of the evaluation of free bus travel for young people in London, UK, we demonstrate a pragmatic approach to strengthening both internal and external validity in evaluations through integrating the logic of quasi-experimental methods with inductive qualitative analysis. Combining theoretical and inductive analysis in this way to address questions of policy interest through evaluations of natural experiments may be fruitful, and have methodological advantages over randomized designs. [ABSTRACT FROM AUTHOR]

Aim To investigate the chemotactic accuracy of peripheral blood neutrophils from patients with chronic periodontitis compared with matched healthy controls, before and after non-surgical periodontal therapy. Material & Methods Neutrophils were isolated from patients and controls ( n = 18) by density centrifugation. Using the Insall chamber and video microscopy, neutrophils were analysed for directional chemotaxis towards N-formyl-methionyl-leucyl-phenylalanine [fMLP (10 nM), or CXCL8 (200 ng/ml)]. Circular statistics were utilized for the analysis of cell movement. Results Prior to treatment, neutrophils from patients with chronic periodontitis had significantly reduced speed, velocity and chemotactic accuracy compared to healthy controls for both chemoattractants. Following periodontal treatment, patient neutrophils continued to display reduced speed in response to both chemoattractants. However, velocity and accuracy were normalized for the weak chemoattractant CXCL8 while they remained significantly reduced for fMLP. Conclusions Chronic periodontitis is associated with reduced neutrophil chemotaxis, and this is only partially restored by successful treatment. Dysfunctional neutrophil chemotaxis may predispose patients with periodontitis to their disease by increasing tissue transit times, thus exacerbating neutrophil-mediated collateral host tissue damage. [ABSTRACT FROM AUTHOR]

Aims and objectives. To determine the feasibility and acceptability of using trained volunteers as mealtime assistants for older hospital inpatients. Background. Poor nutrition among hospitalised older patients is common in many countries and associated with poor outcomes. Competing time pressures on nursing staff may make it difficult to prioritise mealtime assistance especially on wards where many patients need help. Design. Mixed methods evaluation of the introduction of trained volunteer mealtime assistants on an acute female medicine for older people ward in a teaching hospital in England. Methods. A training programme was developed for volunteers who assisted female inpatients aged 70 years and over on weekday lunchtimes. The feasibility of using volunteers was determined by the proportion recruited, trained, and their activity and retention over one year. The acceptability of the training and of the volunteers' role was obtained through interviews and focus groups with 12 volunteers, nine patients and 17 nursing staff. Results. Fifty-nine potential volunteers were identified: 38 attended a training session, of whom 29 delivered mealtime assistance, including feeding, to 3911 (76%) ward patients during the year (mean duration of assistance 5-5 months). The volunteers were positive about the practical aspects of training and ongoing support provided. They were highly valued by patients and ward staff and have continued to volunteer. Conclusions. Volunteers can be recruited and trained to help acutely unwell older female inpatients at mealtimes, including feeding. This assistance is sustainable and is valued. Relevance to clinical practice. This paper describes a successful method for recruitment, training and retention of volunteer mealtime assistants. It includes a profile of those volunteers who provided the most assistance, details of the training programme and role of the volunteers and could be replicated by nursing staff in other healthcare units. [ABSTRACT FROM AUTHOR]

Purpose: To assess the impact of visual impairment (VI) on utility values in Sub-Saharan Africa and compare findings with other studies from low- and high-income countries. Methods: Patients with normal vision and various levels of VI were recruited from a secondary eye clinic in rural Kenya and interviewed using time trade-off (TTO). VI was classified using the World Health Organization definition of (normal vision, visual acuity ≥20/60, VI 20/80-20/200, severe VI 20/240-20/400, and blindness <20/400). Results: Mean age of the total sample ( N = 303) was 50.3 years (standard deviation, SD, ±18.17 years), and 51.5% of patients were male. Most were small-scale farmers and illiteracy was high at 40%. Mean TTO scores per group were: normal vision 0.93 (SD ± 0.10), VI 0.88 (SD ± 0.14), severe VI 0.86 (SD ± 0.13), blindness 0.73 (SD ± 0.17; p ≤ 0.001). Lower TTO scores were independently associated with worse visual acuity ( p ≤ 0.001), longer duration of disease ( p ≤ 0.001) and illiteracy ( p = 0.011), but not with cause of VI, age, sex, marital status, socioeconomic status, or systemic comorbidities in multivariate analyses. Overall, TTO scores were considerably higher than those reported from high-income countries at similar levels of VI. Conclusion: In this rural African population, duration and extent of vision loss, rather than cause, socioeconomic factors and comorbidities affected vision-related quality of life. Our findings underline the importance of providing sight-restoring treatment as timely as possible and the necessity of enhancing rehabilitation efforts for those with non-curable eye diseases. [ABSTRACT FROM AUTHOR]

Sarcopenia, the loss of skeletal muscle mass and function with age, is common in older people. It is associated with increased morbidity and mortality, and a greater risk of admission to hospital and care homes. This article identifies the risk factors and consequences of sarcopenia, and describes how nurses and GPs can recognise patients at particular risk of developing the condition. Evidence for the management of sarcopenia is discussed with regard to lifestyle and potential future therapeutic developments. [ABSTRACT FROM AUTHOR]

Background: low muscle strength is central to geriatric syndromes including sarcopenia and frailty. It is well described in community-dwelling older people, but the epidemiology of grip strength of older people in rehabilitation or long-term care has been little explored.Objective: to describe grip strength of older people in rehabilitation and nursing home settings.Design: cross-sectional epidemiological study.Setting: three healthcare settings in one town.Subjects: hundred and one inpatients on a rehabilitation ward, 47 community rehabilitation referrals and 100 nursing home residents.Methods: grip strength, age, height, weight, body mass index, number of co-morbidities and medications, Barthel score, Mini-Mental State Examination (MMSE), nutritional status and number of falls in the last year were recorded.Results: grip strength differed substantially between healthcare settings for both men and women (P < 0.0001). Nursing home residents had the lowest age-adjusted mean grip strength and community rehabilitation referrals the highest. Broadly higher grip strength was associated in univariate analyses with younger age, greater height and weight, fewer comorbidities, higher Barthel score, higher MMSE score, better nutritional status and fewer falls. However, after mutual adjustment for these factors, the difference in grip strength between settings remained significant. The Barthel score was the characteristic most strongly associated with grip strength.Conclusions: older people in rehabilitation and care home settings had lower grip strength than reported for those living at home. Furthermore grip strength varied widely between healthcare settings independent of known major influences. Further research is required to ascertain whether grip strength may help identify people at risk of adverse health outcomes within these settings. [ABSTRACT FROM AUTHOR]

Background: low muscle strength is central to geriatric syndromes including sarcopenia and frailty. It is well described in community-dwelling older people, but the epidemiology of grip strength of older people in rehabilitation or long-term care has been little explored.Objective: to describe grip strength of older people in rehabilitation and nursing home settings.Design: cross-sectional epidemiological study.Setting: three healthcare settings in one town.Subjects: hundred and one inpatients on a rehabilitation ward, 47 community rehabilitation referrals and 100 nursing home residents.Methods: grip strength, age, height, weight, body mass index, number of co-morbidities and medications, Barthel score, Mini-Mental State Examination (MMSE), nutritional status and number of falls in the last year were recorded.Results: grip strength differed substantially between healthcare settings for both men and women (P < 0.0001). Nursing home residents had the lowest age-adjusted mean grip strength and community rehabilitation referrals the highest. Broadly higher grip strength was associated in univariate analyses with younger age, greater height and weight, fewer comorbidities, higher Barthel score, higher MMSE score, better nutritional status and fewer falls. However, after mutual adjustment for these factors, the difference in grip strength between settings remained significant. The Barthel score was the characteristic most strongly associated with grip strength.Conclusions: older people in rehabilitation and care home settings had lower grip strength than reported for those living at home. Furthermore grip strength varied widely between healthcare settings independent of known major influences. Further research is required to ascertain whether grip strength may help identify people at risk of adverse health outcomes within these settings. [ABSTRACT FROM AUTHOR]

Introduction. We know little about how environmental challenges beyond home exacerbate difficulty moving, leading to falls among people with Parkinson's (PwP). Aims. To survey falls beyond home, identifying challenges amenable to behaviour change. Methods. We distributed 380 questionnaires to PwP in Southern England, asking participants to count and describe falls beyond home in the previous 12 months. Results. Among 255 responses, 136 PwP (diagnosed a median 8 years) reported falling beyond home. They described 249 falls in detail, commonly falling forward after tripping in streets. Single fallers (one fall in 12 months) commonly missed their footing, walking, or changing position and recovered to standing alone or with unfamiliar help. Repeat fallers (median falls, two) commonly felt shaken or embarrassed and sought medical advice. Very frequent fallers (falling at least monthly; median falls beyond home, six) commonly fell backward, in shops and after collapse but often recovered to standing alone. Conclusion. Even independently active PwP who do not fall at home may fall beyond home, often after tripping. Falling beyond home may result in psychological and/or physical trauma (embarrassment if observed by strangers and/or injury if falling backwards onto a hard surface). Prevention requires vigilance and preparedness: slowing down and concentrating on a single task might effectively prevent falling. [ABSTRACT FROM AUTHOR]

Background: There appears to be considerable variation between different national jurisdictions and between different sectors of public policy in the use of evidence and particularly the use of randomised controlled trials (RCTs) to evaluate non-healthcare sector programmes. Methods: As part of a wider study attempting to identify RCTs of public policy sector programmes and the reasons for variation between countries and sectors in their use, we carried out a pilot study which interviewed 10 policy makers and researchers in six countries to elicit views on barriers to and facilitators of the use of RCTs for social programmes. Results: While in common with earlier studies, those interviewed expressed a need for unambiguous findings, timely results and significant effect sizes, users could, in fact, be ambivalent about robust methods and robust answers about what works, does not work or makes no difference, particularly where investment or a policy announcement was planned. Different national and policy sector cultures varied in their use of and support for RCTs. Conclusions: In order to maximise the use of robust evaluations of public programmes across the world it would be useful to examine, systematically, cross-national and cross-sectoral variations in the use of different methods including RCTs and barriers to and facilitators of their use. Sound research methods, whatever their scientific value, are no guarantee that findings will be useful or used. 'Stories' have been shown to influence policy; those advocating the use of RCTs may need to provide convincing narratives to avoid repetition about their value. [ABSTRACT FROM AUTHOR]

Abstract: Concern over anomalous fading has been the biggest single factor responsible for deterring the widespread use of the infra-red stimulated luminescence (IRSL) or thermoluminescence (TL) signal from feldspars for luminescence dating. There has therefore been great interest in the use of the recently proposed Post-IR IRSL signal, because it has been shown to significantly reduce the degree of anomalous fading observed in feldspars and therefore potentially provides a means of circumventing the issue. This study undertakes a systematic investigation into various preheat and Post-IR IRSL measurement conditions proposed in the literature, by using two samples from the Halfway House loess section in Alaska which bracket the Old Crow tephra which has been dated using fission track methods. Preheat plateau tests show a dramatic change in equivalent dose with Post-IR IRSL measurement conditions, and further tests reveal that these changes are driven by preheat temperature rather than Post-IR IR stimulation temperature. Dose recovery tests on laboratory-bleached material mimic the findings of the natural preheat plateau test data, and sensitivity change between the first and second Single Aliquot Regenerative dose (SAR) measurement cycle is found to be responsible. Comparison of the Post-IR IRSL ages with the independent age control shows that, for the samples in this study, the Post-IR IR signal stimulated at 290 °C is inappropriate for dating. However, use of lower preheat (250–300 °C) and Post-IR IR stimulation temperatures from 225 to 270 °C gave rise to ages which were in agreement with the independent age control. [Copyright &y& Elsevier]

Background: identification of patients at risk of prolonged hospital stay allows staff to target interventions, provide informed prognosis and manage healthcare resources. Admission grip strength is associated with discharge outcomes in acute hospital settings.Objective: to explore the relationship between grip strength and length of stay in older rehabilitation in-patients.Design: single-centre prospective cohort study.Setting: community hospital rehabilitation ward.Subjects: one hundred and ten patients aged 70 years and over.Methods: data on age, height, weight, body mass index (BMI), co-morbidities, medication, residence, grip strength, physical function, cognitive function, frailty, falls, discharge destination and length of stay were recorded.Results: higher grip strength was associated with reduced length of stay, characterised by an increased likelihood of discharge to usual residence among male rehabilitation in-patients (hazard ratio 1.09 (95% confidence interval 1.01, 1.17) per kilo increase in grip strength, P = 0.02) after adjustment for age and size.Conclusions: this is the first prospective study to show that stronger grip strength, particularly among male in-patients, is associated with a shorter length of stay in a rehabilitation ward. This is important because it demonstrates that grip strength can be discriminatory among frailer people. Further research into the clinical applications of grip strength measurement in rehabilitation settings is needed. [ABSTRACT FROM AUTHOR]

Purpose. To trial four-week's physiotherapy targeting chair transfers for people with Parkinson's disease (PwPD) and explore the feasibility of reliance on remote outcome measurement to preserve blinding. Scope. We recruited 47 PwPD and randomised 24 to a focused home physiotherapy programme (exercise, movement strategies, and cueing) and 23 to a control group. We evaluated transfers (plus mobility, balance, posture, and quality of life) before and after treatment and at followup (weeks 0, 4, 8, and 12) from video produced by, and questionnaires distributed by, treating physiotherapists. Participants fed back via end-of-study questionnaires. Thirty-five participants (74%) completed the trial. Excluding dropouts, 20% of questionnaire data and 9% of video data were missing or unusable; we had to evaluate balance in situ. We noted trends to improvement in transfers, mobility, and balance in the physiotherapy group not noted in the control group. Participant feedback was largely positive and assessor blinding was maintained in every case. Conclusions. Intense, focused physiotherapy at home appears acceptable and likely to bring positive change in those who can participate. Remote outcome measurement was successful; questionnaire followup and further training in video production would reduce missing data. We advocate a fully powered trial, designed to minimise dropouts and preserve assessor blinding, to evaluate this intervention. [ABSTRACT FROM AUTHOR]

There is widespread evidence both of the exclusion of older people from clinical research, and of under-recruitment to clinical trials. This review and opinion piece provides practical advice to assist researchers both to adopt realistic, achievable recruitment rates and to increase the number of older people taking part in research. It analyses 14 consecutive recently published trials, providing the number needed to be screened to recruit one older participant (around 3:1), numbers excluded (up to 49%), drop out rates (5–37%) and whether the planned power was achieved. The value of planning and logistics are outlined, and approaches to optimising recruitment in hospital, primary care and care home settings are discussed, together with the challenges of involving older adults with mental incapacity and those from minority groups in research. The increasingly important task of engaging older members of the public and older patients in research is also discussed. Increasing the participation of older people in research will improve the generalisability of research findings and inform best practice in the clinical management of the growing older population. [ABSTRACT FROM PUBLISHER]

Background: the European Working Group on Sarcopenia in Older People has developed a clinical definition of sarcopenia based on low muscle mass and reduced muscle function (strength or performance). Grip strength is recommended as a good simple measure of muscle strength when ‘measured in standard conditions’. However, standard conditions remain to be defined.Methods: a literature search was conducted to review articles describing the measurement of grip strength listed in Medline, Web of Science and Cochrane Library databases up to 31 December 2009.Results: there is wide variability in the choice of equipment and protocol for measuring grip strength. The Jamar hand dynamometer is the most widely used instrument with established test–retest, inter-rater and intra-rater reliability. However, there is considerable variation in how it is used and studies often provide insufficient information on the protocol followed making comparisons difficult. There is evidence that variation in approach can affect the values recorded. Furthermore, reported summary measures of grip strength vary widely including maximum or mean value, from one, two or three attempts, with either hand or the dominant hand alone.Conclusions: there is considerable variation in current methods of assessing grip strength which makes comparison between studies difficult. A standardised method would enable more consistent measurement of grip strength and better assessment of sarcopenia. Our approach is described. [ABSTRACT FROM PUBLISHER]

Abstract: Background: Many misconceptions still prevail about the appropriateness of use of the intrauterine device (IUD), particularly for younger women. This study examines the factors associated with post abortion IUD use as compared to the combined oral contraceptive pill (COC). It then examines the effect of type of post abortion contraception with the likelihood of seeking subsequent abortions. Study design: This prospective cohort study followed, for a period of 3 years, 1422 women who had a first trimester surgical abortion between November 2004 and January 2005 in Auckland''s public abortion clinic. Results: Compared to women who left the clinic with COC, those leaving with an IUD (OR 0.3) at baseline were less likely to return for a subsequent abortion. Among women who had not had a previous termination, younger women were less likely than older women to have had an IUD inserted post abortion. With every additional live birth, women were three times as likely to have left the abortion clinic with an IUD. Among women who had had a previous termination, age was no longer significantly associated with post abortion IUD insertion. However, parity was still significantly associated, as was having a negative sexually transmitted infection test. Conclusions: Young and nulliparous women are less likely to use an IUD as a method of contraception following an abortion. However, those women who have an IUD inserted following an abortion are much less likely to return for a subsequent abortion. IUDs are a safe and effective method of contraception that are currently still underused among the younger population. [Copyright &y& Elsevier]

Abstract: Objective: To review and summarise current evidence on the efficacy and safety of herbal medicinal products for the relief of hot flushes in women with previous breast cancer. Methods: A literature search was conducted in the databases of Medline, EMBASE, The Cochrane Central Register of Controlled Trials (CENTRAL), PSYCHINFO, AMED (Allied and Complementary Medicine), NCCAM (The National Centre for Complementary and Alternative Medicine). Results: Black cohosh and phytoestrogens have received the most research attention but there is currently insufficient evidence to recommend either for relief of flushes. Black cohosh use appears safe in women with previous breast cancer. Opposing advice has been given regarding the safety of dietary phytoestrogen use for women with previous breast cancer, but there is emerging data that soyfood phytoestrogen intake may have a beneficial effect on tumour recurrence. Conclusions: The majority of studies, regarding the efficacy of herbal treatments for hot flushes, have not been conducted in women with breast cancer and many are of short duration. Increased pharmacovigilance practices for herbal medicines are required with initiatives to stimulate reporting of suspected adverse reactions. [Copyright &y& Elsevier]

Purpose: To determine how much difference biometry makes to refractive outcomes in a population in Sub-Saharan Africa compared to using standard-power intraocular lenses (IOLs). Methods: In a secondary eye-clinic in Kenya, IOL-powers in half diopters (D) were implanted according to biometry prediction in patients undergoing routine cataract surgery with small-incision techniques. A model was generated to predict refractive outcomes if standard-IOLs had been used. Results: Three-hundred-twenty-five eyes of 290 patients were operated on; 232 (71%) using phacoemulsification, the remainder using manual small-incision cataract surgery. Two-hundred-sixty-seven eyes (82.2%) achieved corrected visual acuity (VA) ≥6/18 and 202 eyes (62%) uncorrected VA ≥6/18. Pre-existing comorbidity was the single most common reason for a worse postoperative VA. Restricting analysis to one eye per patient, with biometry 71.1% had a good refractive outcome (defined as +1 to -1.5 D spherical equivalent), 27.6% became more than −1.5 D myopic and 1.3% more than +1.00 D hyperopic. With standard-power-IOLs 57.3% would have had a good refractive outcome and 16% would have become >1 D hyperopic. Using the post-op refractive data for A-constant optimization could potentially further increase good refractive outcomes to over 80%. Conclusion: Biometry in combination with small-incision techniques improves refractive outcomes and decreases undesired postoperative hyperopia. Assuming good surgical skills, better outcomes with biometry justify cataract operation at an earlier stage, thereby reducing intra- and postoperative complications and avoiding years of visual disability. [ABSTRACT FROM AUTHOR]

Evidence about the cost-effectiveness of interventions in children's services can help decision-makers make more efficient use of scarce resources. We returned to six somewhat disparate interventions on which we had collated research evidence identified by service planners and practitioners as relevant to the well-being of children in the course of the Economic and Social Research Council-funded What Works for Children project. These are home visiting, parenting, cognitive–bahavioural therapy, mentoring, traffic calming and breakfast club interventions. We aimed to explore the nature and extent of evidence on cost-benefit and cost effectiveness for these measures. We conducted searches for studies that looked at the costs as well as the effectiveness of the six interventions and found 24 studies matching our inclusion criteria. The studies were diverse in terms of study design and economic methods (including economic modelling and willingness to pay). Studies relating to parenting programmes and traffic calming gave the most positive indication that the interventions may be cost-effective for the outcomes in question. The remainder of the studies did not give a clear picture, in large part because of a lack of demonstration that the intervention was effective. [ABSTRACT FROM AUTHOR]

Background: frailty, a multi-dimensional geriatric syndrome, confers a high risk for falls, disability, hospitalisation and mortality. The prevalence and correlates of frailty in the UK are unknown. [ABSTRACT FROM PUBLISHER]

Purpose: To determine possible differences in visual acuity, socio-demographic factors and vision-related Quality of Life (QoL) between people accepting and people refusing sponsored cataract surgery. Methods: Three hundred and fifty seven local residents with visually impairing cataract, presenting at screening sites in Kwale District, Kenya were clinically assessed and interviewed. The World Health Organization (WHO) QoL-questionnaire WHO/Prevention of Blindness and Deafness Visual Functioning Questionnaire 20 (PBD-VFQ20) was used to determine the vision-related QoL. A standardized questionnaire asked for socio-demographic data and prior cataract surgery in one eye. After interview, patients were offered free surgery. Primary outcome was the mean QoL-score between acceptors and non-acceptors. Secondary outcomes were visual acuity and socio-demographic factors and their contribution to QoL-scores and the decision on acceptance or refusal. Results: Fifty nine people (16.5%) refused and 298 accepted cataract surgery. Vision-related QoL was poorer in people accepting than in those refusing (mean score 51.54 and 43.12 respectively). People with poor visual acuity were only slightly more likely to accept surgery than people with better vision; the strongest predictors of acceptance were the QoL-score and gender. Men were twice as likely to accept compared to women. Of people who accepted surgery, 73.8% had best eye vision of 20/200 or better. Conclusion: In this population, visual acuity was of limited use to predict a person’s decision to accept or refuse cataract surgery. QoL-scores provide further insight into which individuals will agree to surgery and it might be useful to adapt the QoL-questions for field use. Gender inequities remain a matter of concern with men being more likely to get sight-restoring surgery. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is high on the policy agenda of wealthier nations, and many interventions have been developed to address it. This work describes an overview of schemes for obese and overweight children and young people in England, and the 'mapping' approach we used.Methods: Our search strategy, inclusion criteria and coding frame had to be suitable for describing a potentially large number of schemes within a short timeframe. Data were collected from key informants, scheme publicity and reports, and via a web-survey. To be included, schemes had to be based in England, follow a structured programme lasting at least two weeks, promote healthy weight, and be delivered exclusively to overweight and/or obese children and young people (age range 4-18). Data were entered into a coding frame recording similar information for each scheme, including any underpinning research evidence, evaluation or monitoring reports. Priority questions were identified in consultation with colleagues from the Department of Health and the Cross Government Obesity Unit.Results: Fifty-one schemes were identified. Some operated in multiple areas, and by using estimates of the number of schemes provided by multi-site scheme leads, we found that between 314 and 375 local programmes were running at any time. Uncertainty is largely due to the largest scheme provider undergoing rapid expansion at the time of the mapping exercise and therefore able to provide only an estimate of the number of programmes running. Many schemes were similar in their approach, had been recently established and were following NICE guidelines on interventions to promote healthy weight. Rigorous evaluation was rare.Conclusions: Our methods enabled us to produce a rapid overview of service activity across a wide geographic area and a range of organisations and sectors. In order to develop the evidence base for childhood obesity interventions, rigorous evaluation of these schemes is required. This overview can serve as a starting point for evaluations of interventions to address obesity. More generally, a rapid and systematic approach of this type is transferable to other types of service activity in health and social care, and may be a tool to inform public health planning. [ABSTRACT FROM AUTHOR]

Background: The experience of menstruation and reproductive health by adolescent girls has been poorly studied in New Zealand. Aims: To develop and pilot a Web-based survey of 16-year-olds’ experience of menstruation and reproductive health with the eventual objective of conducting a larger population-based survey. A secondary aim was to report on the experience of menstrual and reproductive health in a group of 16-year-old girls in an urban setting. Methods: A Web-based survey was developed and tested in 2006 with assistance of a multidisciplinary advisory group. The final version of the questionnaire had 146 questions in 11 sections and the topics were menstrual history, general health including use of medications, access to medical care or health information, sexual health, family history and personal information including smoking, height, weight, ethnicity, paid employment of parents, drug and alcohol use and exercise patterns. Results: Seventy-five 16-year-old students completed the survey. Twenty-five per cent considered that their periods were quite a bit or a lot of trouble and 10% avoided certain activities during their menstrual periods, nearly 50% of girls always experienced some pain with every period, and 30% had seen a health professional about their period pains. Thirty-three stated that menstruation was moderately to severely painful and that daily activity was affected. Fifty per cent of girls were sexually active and of these 80% described it as painful. Conclusions: The Web-based survey was a successful approach to collecting information and could be used in a larger study. [ABSTRACT FROM AUTHOR]

Abstract: Optically stimulated luminescence (OSL) dating of sediments is a lengthy, labour-intensive, and time-consuming procedure. However, in some situations a rough approximation of the OSL age is all that is necessary e.g. for a pilot field campaign, to plan a sampling strategy, or to determine the resolution required for a dating campaign. Thus, it would be useful to establish an approximate OSL age without the lengthy and involved processes normally used. This paper explores how the standard procedures involved in OSL age determinations can be simplified to yield range-finder ages. Three areas are examined, namely, laboratory preparation, D e estimation, and dose-rate determination. The consequences of circumventing some of the preparation and measurement steps of conventional OSL dating are examined for a variety of sediments, by comparing the OSL range-finder ages to those obtained using full quartz OSL preparation and measurement procedures. [Copyright &y& Elsevier]

Loess deposits preserve important records of Quaternary climate change and atmospheric dust flux; however, their full significance can only be revealed once a reliable chronology is established. Our understanding of loess-palaeosol sequences and the development of luminescence dating techniques have progressed hand-in-hand over the past 25 years, with each subject informing the advancement of the other. This article considers the development and application of luminescence dating techniques to loess deposits from the early days of thermoluminescence (TL) to the optically stimulated luminescence (OSL) methods utilized today. Recent technological and methodological advances have led to a step-change in the accuracy and precision of quartz OSL ages; this has led to an expansion of high-resolution luminescence studies, which in turn are informing loess studies and challenging some of the basic ideas regarding the nature of loess records, their formation and their significance. Future luminescence research efforts are likely to focus on extending the age range of luminescence techniques, possibly by utilizing new luminescence signals; this, again, will allow investigation of the long-term variability of loess records in comparison with other long records of climate change to which they are frequently compared. [ABSTRACT FROM AUTHOR]

Despite eastern Africa being a key location in the emergence of Homo sapiens and their subsequent dispersal out of Africa, there is a paucity of long, well-dated climate records in the region to contextualize this history. To address this issue, we dated a ∼293 m long composite sediment core from Chew Bahir, south Ethiopia, using three independent chronometers (radiocarbon, 40Ar/39Ar, and optically stimulated luminescence) combined with geochemical correlation to a known-age tephra. The site is located in a climatically sensitive region, and is close to Omo Kibish, the earliest documented Homo sapiens fossil site in eastern Africa, and to the proposed dispersal routes for H. sapiens out of Africa. The 30 ages generated by the various techniques are internally consistent, stratigraphically coherent, and span the full range of the core depth. A Bayesian age-depth model developed using these ages results in a chronology that forms one of the longest independently dated, high-resolution lacustrine sediment records from eastern Africa. The chronology illustrates that any record of environmental change preserved in the composite sediment core from Chew Bahir would span the entire timescale of modern human evolution and dispersal, encompassing the time period of the transition from Acheulean to Middle Stone Age (MSA), and subsequently to Later Stone Age (LSA) technology, making the core well-placed to address questions regarding environmental change and hominin evolutionary adaptation. The benefits to such studies of direct dating and the use of multiple independent chronometers are discussed. • Four independent dating methods applied to ∼293 m lake core from southern Ethiopia. • Reveals 620 ka high-resolution sedimentary record near key fossil hominin sites. • Mean accumulation rate of 0.47 mm/a comparable to other African lacustrine sediments. • Accumulation rate fell to 0.1 mm/a during MIS 2, likely due to reduced sediment supply. • Use of multiple independent chronometers is a powerful approach in lake settings. [ABSTRACT FROM AUTHOR]