Barriers and enablers to implementing police mental health co-responder programs: A qualitative study using the consolidated framework for implementation research

Background

Police and mental health co-responder programs operate internationally and can be effective in providing timely and appropriate assessment, brief intervention, and referral services for people experiencing mental health crises. However, these models vary greatly, and little is known about how the design and implementation of these programs impacts their effectiveness.

Method

This study was a qualitative, post hoc implementation determinant evaluation of mental health co-responder units in Brisbane, Australia, comprising of verbal or written interviews with police and mental health staff with an on-road role in the co-responder units, and their managers. The Consolidated Framework for Implementation Research was used to identify barriers and enablers to the program's implementation and effectiveness.

Results

Participants (n = 30) from all groups felt strongly that the co-responder units are a substantial improvement over the usual police management of mental health crisis cases, and lead to better outcomes for consumers and the service. Enablers included an information-sharing agreement; the Mental Health Co-Responder (MHCORE) program's compatibility with existing police and mental health services; and the learning opportunity for both organizations. Barriers included cultural differences between the organizations, particularly risk-aversion to suicidality for police and a focus on least-restrictive practices for health; extensive documentation requirements for health; and a lack of specific mental health training for police.

Conclusions

Using an evidence-based implementation science framework enabled identification of a broad range of contextual barriers and enablers to implementation of police mental health co-responder programs. Adapting the program to address these barriers and enablers during the planning, implementation, monitoring, and evaluation phases increases the likelihood of the service's effectiveness. These findings will inform the spread and scale of the co-responder program across Queensland, and will be relevant to police districts internationally considering implementing a co-responder program.

First Dark Matter Search Results from the LUX-ZEPLIN (LZ) Experiment

The LUX-ZEPLIN experiment is a dark matter detector centered on a dual-phase xenon time projection chamber operating at the Sanford Underground Research Facility in Lead, South Dakota, USA. This Letter reports results from LUX-ZEPLIN's first search for weakly interacting massive particles (WIMPs) with an exposure of 60 live days using a fiducial mass of 5.5 t. A profile-likelihood ratio analysis shows the data to be consistent with a background-only hypothesis, setting new limits on spin-independent WIMP-nucleon, spin-dependent WIMP-neutron, and spin-dependent WIMP-proton cross sections for WIMP masses above 9  GeV/c^{2}. The most stringent limit is set for spin-independent scattering at 36  GeV/c^{2}, rejecting cross sections above 9.2×10^{-48}  cm at the 90% confidence level.

JAG consensus statements for training and certification in flexible sigmoidoscopy

Introduction

Joint Advisory Group (JAG) certification in endoscopy is awarded when trainees attain minimum competency standards for independent practice. A national evidence-based review was undertaken to update standards for training and certification in flexible sigmoidoscopy (FS).

Methods

A modified Delphi process was conducted between 2019 and 2020 with multisociety representation from experts and trainees. Following literature review and Grading of Recommendations, Assessment, Development and Evaluations appraisal, recommendation statements on FS training and certification were formulated and subjected to anonymous voting to obtain consensus. Accepted statements were peer-reviewed by national stakeholders for incorporation into the JAG FS certification pathway.

Results

In total, 41 recommendation statements were generated under the domains of: definition of competence (13), acquisition of competence (17), assessment of competence (7) and postcertification support (4). The consensus process led to revised criteria for colonoscopy certification, comprising: (A) achieving key performance indicators defined within British Society of Gastroenterology standards (ie, rectal retroversion >90%, polyp retrieval rate >90%, patient comfort <10% with moderate-severe discomfort); (B) minimum procedure count ≥175; (C) performing 15+ procedures over the preceding 3 months; (D) attendance of the JAG Basic Skills in Lower gastrointestinal Endoscopy course; (E) satisfying requirements for formative direct observation of procedural skill (DOPS) and direct observation of polypectomy skill (SMSA level 1); (F) evidence of reflective practice as documented on the JAG Endoscopy Training System reflection tool and (G) successful performance in summative DOPS.

Conclusion

The UK standards for training and certification in FS have been updated to support training, uphold standards in FS and polypectomy, and provide support to the newly independent practitioner.

JAG consensus statements for training and certification in colonoscopy

Introduction

In the UK, endoscopy certification is awarded when trainees attain minimum competency standards for independent practice. A national evidence-based review was undertaken to update and develop standards and recommendations for colonoscopy training and certification.

Methods

Under the oversight of the Joint Advisory Group (JAG), a modified Delphi process was conducted between 2019 and 2020 with multisociety expert representation. Following literature review and Grading of Recommendations, Assessment, Development and Evaluations appraisal, recommendation statements on colonoscopy training and certification were formulated and subjected to anonymous voting to obtain consensus. Accepted statements were peer reviewed by JAG and relevant stakeholders for incorporation into the updated colonoscopy certification pathway.

Results

In total, 45 recommendation statements were generated under the domains of: definition of competence (13), acquisition of competence (20), assessment of competence (8) and postcertification support (4). The consensus process led to revised criteria for colonoscopy certification, comprising: (1) achieving key performance indicators defined within British Society of Gastroenterology standards (ie, unassisted caecal intubation rate >90%, rectal retroversion >90%, polyp detection rate >15%+, polyp retrieval rate >90%, patient comfort <10% with moderate–severe discomfort); (2) minimum procedure count 280+; (3) performing 15+ procedures over the preceding 3 months; (4) attendance of the JAG Basic Skills in Colonoscopy course; (5) terminal ileal intubation rates of 60%+ in inflammatory bowel disease; (6) satisfying requirements for formative direct observation of procedure skills (DOPS) and direct observation of polypectomy skills (Size, Morphology, Site, Access (SMSA) level 2); (7) evidence of reflective practice as documented on the JAG Endoscopy Training System reflection tool; (8) successful performance in summative DOPS.

Conclusion

The UK standards for training and certification in colonoscopy have been updated, culminating in a single-stage certification process with emphasis on polypectomy competency (SMSA Level 2+). These standards are intended to support training, improve standards of colonoscopy and polypectomy, and provide support to the newly independent practitioner.

P-330 The immune cell population of the human fallopian tubes in health and benign pathology: a systematic review

Study question

What is the immune cell profile of the human fallopian tube in health and in benign pathological conditions?

Summary answer

The fallopian tubes have a distinct population of immune cells from the innate and adaptive subsystems. Variations have been observed in several tubal pathologies.

What is known already

The fallopian tubes play a key role in fertility; up to 30% of infertility cases have been reported due to tubal pathologies, which have been neglected due to the success of in vitro fertilisation (IVF). The fallopian tubes have been shown to harbour immune cell populations with the involvement of both the innate and adaptive arms of the immune system that provide surveillance against several pathogens.

Therefore, characterisation of this population is vital in promoting a better understanding of tubal pathogenesis, and its influence on infertility, leading to improvements in the sexual and reproductive health of women.

Study design, size, duration

This systematic review was conducted on the 1st November 2021 and reported in accordance to PRISMA statement, and preceded by a prospectively written protocol registered with PROSPERO (registration number: CRD42021288257). CINAHL, EMBASE and EMCARE, Scopus and PubMed databases were searched for relevant published material. All studies that concerning the immune cells of human fallopian tubes in health or benign pathology of pre-menopausal, pregnant and/or post-menopausal women that published in English language were included.

Participants/materials, setting, methods

The predefined search strategy identified 3767 publications. Following screening, a total of 42 studies were included and data was extracted. The findings are thematically reported based on: (1) menopausal status and/or cycle phase; (2) pathophysiology; (3) immune cell types. A risk of bias assessment was performed using Newcastle-Ottawa scale (NOS) and a modified version for case studies.

Main results and the role of chance

T lymphocytes, predominantly CD8+ cytotoxic T cells, represent the most abundant immune cell population within the healthy fallopian tube. B lymphocytes, macrophages, natural killer (NK) cells and dendritic cells have also been identified. The number of macrophages demonstrated a consistent and significant increase during the progesterone-dominant secretory phase compared to the proliferative phase. A similar distribution of lymphocytes was reported in tubal ectopic pregnancies to that in healthy tubes. Macrophages, dendritic cells, and natural killer (NK) cells were observed in tubal pregnancies with a significant increase in the number of CD56+ and CD3+ cells in cases of tubal rupture.

Salpingitis, hydrosalpinx and endometriosis are all characterised by an increased population of macrophages in comparison to healthy fallopian tubes.

Limitations, reasons for caution

Some studies scored poorly on the NOS, suggesting their findings to be treated with caution. The deficiency in published research into common tubal pathologies and inconsistent findings presented between studies only allowed limited conclusions to be formulated regarding these immune cell populations.

Wider implications of the findings

Comprehensive knowledge of the immune cell profile of the human fallopian tubes will provide greater understanding into the pathophysiology of common tubal disorders, potentially leading to innovative treatments in the future.

Trial registration number

not applicable

Behcet's Disease (BD) Presenting as a Cerebral Venous Sinus Thrombosis (CVST)

Presentation 20 year old Caucasian male presented to eye casualty 4 weeks post initial diagnosis of bilateral acute anterior uveitis (AAU), with a three-week history of a progressively worsening headache associated with nausea and vomiting. Diagnosis Non-contrast Computed Topography of the head and Magnetic Resonance venogram revealed a cerebral venous sinus thrombosis (CVST). He had a long-standing history of intermittent oral ulceration, and was diagnosed with Neuro Behcet's Disease (NBD). Treatment The patient was commenced on a therapeutic dose of enoxaparin and prednisolone, and was discharged on enoxaparin, warfarin, tapering prednisolone and azathioprine. Discussion/Conclusion NBD is a rare, but serious manifestation of BD. BD is an important differential diagnosis in a young patient presenting with CVST or bilateral AAU.

Time domain optical imaging device based on a commercial time-to-digital converter

Time-domain diffuse optical imaging is a noninvasive technique that uses pulsed near-infrared light as the interrogation source to produce quantitative images displaying the variation in blood volume and oxygenation in the human brain. Measuring the times of flights of photons provides information on the photon pathlengths in tissue, which enables absolute concentrations of the oxygenated and deoxygenated forms of hemoglobin to be estimated. Recent advances in silicon electronics have enabled the development of time-domain systems, which are lightweight and low cost, potentially enabling the imaging technique to be applied to a far greater cohort of subjects in a variety of environments. While such technology usually depends on customized circuits, in this article, we present a system assembled from commercially available components, including a low-cost time-to-digital converter and a silicon photomultiplier detector. The system is able to generate histograms of photon flight times at a rate of 81-90 kS/s and with a sampled bin width of 54 ps. The linearity and performance of the system are presented, and its potential as the basis for a modular multi-detector imaging system is explored.

Evaluating the potential utility of three-dimensional printed models in preoperative planning and patient consent in gastrointestinal cancer surgery

INTRODUCTION

The Future of Surgery report from the Royal College of Surgeons of England acknowledges the important role that three-dimensional imaging will play in support of personalised surgical interventions. One component of this is preoperative planning. We investigated surgeons' and patients' perceptions of this evolving technology.

MATERIALS AND METHODS

Ethical approval was obtained. From a normal computed tomography scan, three-dimensional models of the stomach, pancreas and rectum were rendered and printed on an Ultimaker™ three-dimensional printer. Semi-structured interviews were performed with surgeons and patients to explore perceived model effectiveness and utility. Likert scales were used to grade responses (1 = strongly disagree; 10 = strongly agree) and qualitative responses recorded.

RESULTS

A total of 26 surgeons (9 rectal, 9 oesophagogastric, 8 pancreatic) and 30 patients (median age 62 years, interquartile range, IQR, 68-72 years; 57% male) were recruited. Median surgeon scores were effectiveness for preoperative planning, 6 (IQR 3-7), authenticity, 5 (IQR 3-6), likability, 6 (IQR 4-7), promoting learning, 7 (IQR 5-8), utility, 6 (IQR 5-7) and helping patients, 7 (IQR 5-8). Median patient scores were usefulness to the surgeon, 8 (IQR 7-9), authenticity, 8 (IQR 6-8), likability, 8 (IQR 7-8), helping understanding of condition, 8 (IQR 8-9), helping understanding of surgery, 8 (IQR 7-9) and feeling uncomfortable, 1 (IQR 1-4). Median overall decisional conflict score (0 = no; 100 = high) was 22 (IQR 19-28) and decision effectiveness was 25 (IQR 19-30).

DISCUSSION

Overall, patients and surgeons considered that three-dimensional printed models were effective and had potential utility in education and, to a lesser extent, preoperative planning. Patient decisional conflict and effectiveness scores were weighted towards certainty in decision making but had room for improvement, which three-dimensional models may help to facilitate.

International, inter-university transferability of a student health surveillance system (SuSy) tool

Introduction

While university students are known to face major life transition challenges with the risk to engage in potentially undesirable health-related habits, there are very few attempts to monitor students’ health behaviour on a regular long-term basis. Even in cross-sectional designs, students from the field of Public Health and/or Health Sciences are rarely investigated. Here, a cross-university students’ health behaviour surveillance system is presented.

Methods

A students’ health and health behaviour surveillance system (SuSy) has been implemented in Hamburg University of Applied Sciences in 2014, collecting and analysing data of health sciences students twice a year since. After Manchester Metropolitan University joined the project and adapted SuSy to its specific context in 2016, data of both SuSy settings were compared using logistic regression models. In addition, focus groups were carried out in both universities in order to assess the perception and acceptance of the tool.

Results

After eight elicitations with total sample of 1366 responses, a decreasing trend of smoking and increasing trend of cannabis consumption can be observed among Hamburg students. In comparison, Manchester students tend to smoke significantly more (OR = 3.74, 95%CI 1.95-7.17), but consume less cannabis (OR = 0.51, 95%CI 0.14-0.9). Trends in physical activity and healthy food consumption complete the overview. Focus groups revealed that SuSy is perceived as an appealing, useful and recognisable tool among students from both universities.

Discussion

While being easily adapted in content and delivery, SuSy allows for the provision helpful, comparable information about students’ health behaviours as well as for the observation of time trends. These findings underline SuSy’s potential in promoting university students’ health.

Key messages

The student health surveillance system (SuSy) tool allows comparable information about students’ health behaviours as well as the observation of time trends. SuSy is perceived as an appealing, useful and recognisable tool among students from both universities.

Abstract P4-04-01: The landscape of somatic genetic alterations in breast cancers from CHEK2 germline mutation carriers

Introduction: Checkpoint kinase 2 (CHEK2) is a tumor suppressor gene, which regulates cell cycle in response to DNA damage response. Selected CHEK2 germline mutations have been shown to confer an increased risk of breast cancer development. Multiple founder mutations in CHEK2 have been identified, and meta analyses have shown that CHEK2 truncating variants confer a higher breast cancer risk than missense variants. Here, we assessed the phenotype and repertoire of genetic alterations of breast cancers from 33 patients with CHEK2 pathogenic germline variants.

Materials and methods: We performed targeted capture massively parallel sequencing (≥410 genes) of tumor and normal samples from 13 patients with CHEK2 pathogenic germline variants, and retrieved whole exome sequencing (WES) data (BAM files) of tumor and normal samples from 20 patients with CHEK2 germline pathogenic variants included in the TCGA breast cancer study. In addition, we retrieved WES data of BRCA1, BRCA2 and ATM associated breast cancers from TCGA and Weigelt et al. (JNCI 2018). Somatic mutations, copy number alterations, mutational signatures and large-scale transitions (LSTs) were defined using state-of-the-art bioinformatics algorithms.

Results: Of the 33 CHEK2-associated breast cancers included in this study, 21 had missense and 12 had loss-of-function (LoF) germline mutations, and 81% were ER-positive and 12% HER2-positive. CHEK2-associated breast cancers statistically significantly less frequently displayed an ER-negative/HER2-negative phenotype (0%) than BRCA1- (80%) or BRCA2-associated (33%) breast cancers (BRCA1, p&lt;0.0001 for both comparisons), but were similar to ATM-associated breast cancers. Biallelic inactivation of CHEK2 through loss of heterozygosity (LOH) of the wild-type allele was present in 17 of 33 samples (52%). LOH of the CHEK2 wild-type allele was significantly more frequent in tumors with LOF mutations than in those with missense mutations (78% vs 36%, respectively; p=0.0394). PIK3CA (36%) and GATA3 (33%) were the two most recurrently mutated genes in these samples. TP53 somatic mutations were detected in five cases, four of which harbored missense CHEK2 germline mutations. Unlike BRCA1- and BRCA2-associated breast cancers, but akin to ATM-associated breast cancers, CHEK2-associated breast cancers lacked the mutational signature associated with homologous recombination (HR) DNA repair defects (i.e. signature 3) and only five cases displayed high LST scores.

Conclusion:CHEK2-associated breast cancers are phenotypically and genetically distinct from BRCA1- and BRCA2-associated breast cancers, but similar to ATM-associated breast cancers. Akin to ATM-associated breast cancers, CHEK2-associated breast cancers are preferentially ER-positive, lack genomics features consistent with defective HR, and have a repertoire of somatic genetic alterations similar to those of non-BRCA1/2 ER-positive breast cancers. Our results suggest that either CHEK2 germline mutations contribute to an increased risk of breast cancer independently of the HR DNA repair defects or that the mutational signatures caused by CHEK2 pathogenic germline mutations differ from those caused by pathogenic germline mutations affecting bona fide HR-related genes (e.g. BRCA1, BRCA2 and PALB2).

Citation Format: Kumar R, Pei X, Selenica P, Wen HY, Powell S, Robson M, Riaz N, Reis-Filho JS, Weigelt B, Mandelker D. The landscape of somatic genetic alterations in breast cancers from CHEK2 germline mutation carriers [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-04-01.

Maternal influences on beef calf rumen microbiome in the first 4 wk of life

The preruminant microbiome has the potential to set the stage for later life feed efficiency and is critical to proper development within the rumen. We hypothesized that the rumen microbiome is established at or near birth and is subject to maternal influences that can influence preruminant and postruminant microbial profiles. Our objective was to determine how mode of delivery and rearing affected the development of the rumen microbiome. Bred mature Charolais cows were randomly allocated to one of the three treatment groups: control (CON; n = 8), bottle reared (BOT; n = 8), and caesarian section (CSET; n = 8), where CON was vaginal birth and raised by their dam; BOT was vaginal birth, then removed 24-h post-parturition, and raised on commercial milk replacer; and CSET was born via caesarian section and raised by their respective dams. Calf rumen fluid was collected from calves at 1, 3, and 28 d of age via oral lavage and metagenomic shotgun sequencing was performed using the Illumina NextSeq 500 platform. Sequence data were analyzed utilizing Metataxa2 for taxonomic assignment followed by QIIME to determine α- and β-diversity differences. A total of 1,113 taxa had differential abundance when comparing day while 66 taxa had differential abundance across treatment groups. There were no differences across treatment group richness (P > 0.05), but day 28 was significantly more rich (P = 0.003) compared with days 1 and 3 with no difference between days 1 and 3 (P = 0.58). No differences in β-diversity were detected across treatment group with the exception of greater variance in the BOT and CSET compared with the CON (P = 0.048). Microbial profiles of day 1 are more similar to each other than day 3 or 28 (P = 0.03); day 3 is more similar to each other than day 1 or 28 (P = 0.03); and day 28 is more similar to each other than day 1 or 3 (P = 0.03). These data suggest that while treatment group did not have a large impact on microbial diversity, several specific taxa were affected by treatment group. Day affects the microbial diversity both within and among samples. Understanding how these profiles shift with age is critical to understanding key intervention periods for optimal alteration of the microbiome.

A systematic review of patient-reported outcome measures in paediatric otolaryngology

BACKGROUND

Recently, there has been increased emphasis on the development and application of patient-reported outcome measures. This drive to assess the impact of illness or interventions, from the patient's perspective, has resulted in a greater number of available questionnaires. The importance of selecting an appropriate patient-reported outcome measure is specifically emphasised in the paediatric population. The literature on patient-reported outcome measures used in paediatric otolaryngology was reviewed.

METHODS

A comprehensive literature search was conducted using the databases Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, and PsycInfo, using the terms: 'health assessment questionnaire', 'structured questionnaire', 'questionnaire', 'patient reported outcome measures', 'PROM', 'quality of life' or 'survey', and 'children' or 'otolaryngology'. The search was limited to English-language articles published between 1996 and 2016.

RESULTS

The search yielded 656 articles, of which 63 were considered relevant. This included general paediatric patient-reported outcome measures applied to otolaryngology, and paediatric otolaryngology disease-specific patient-reported outcome measures.

CONCLUSION

A large collection of patient-reported outcome measures are described in the paediatric otolaryngology literature. Greater standardisation of the patient-reported outcome measures used in paediatric otolaryngology would assist in pooling of data and increase the validation of tools used.

Relational conflict and outcomes from an online divorce education program

The impact of conflict on co-parenting outcomes of divorce education programs is not widely explored in the literature despite the prevalence of conflict in divorce. This study used outcome data from a sample of participants (N=272) who took the online Parents Forever™ course between 2012 and 2014. Participants were asked questions about positive and negative co-parenting behaviors as well their levels of conflict before and after the divorce or separation. There was on average a slight increase in conflict from post to follow-up (M=-0.397, SD=1.54). Simple linear regression analyses indicated that change in conflict explained a significant proportion of the variance in positive co-parenting scores, R²=0.07, F(1, 270)=19.98, p<0.001 and negative co-parenting scores, R²=0.08, F(1, 270)=23.78, p<0.001. Results suggest that conflict significantly impacts co-parenting behaviors targeted in the Parents Forever ™ course.

Organ boundary NAC-domain transcription factors are implicated in the evolution of petal fusion

Research rationale: Evolution of fused petals (sympetaly) is considered to be an important innovation that has repeatedly led to increased pollination efficiency, resulting in accelerated rates of plant diversification. Although little is known about the underlying regulation of sympetaly, genetic pathways ancestrally involved in organ boundary establishment (e.g. CUP SHAPED COTYLEDON [CUC] 1-3 genes) are strong candidates. In sympetalous petunia, mutations in the CUC1/2-like orthologue NO APICAL MERISTEM (NAM) inhibit shoot apical meristem formation. Despite this, occasional 'escape shoots' develop flowers with extra petals and fused inter-floral whorl organs. Central methods: To To determine if petunia CUC-like genes regulate additional floral patterning, we used virus-induced silencing (VIGS) following establishment of healthy shoot apices to re-examine the role of NAM in petunia petal development, and uniquely characterise the CUC3 orthologue NH16.

KEY RESULTS

Confirming previous results, we found that reduced floral NAM/NH16 expression caused increased petal-stamen and stamen-carpel fusion, and often produced extra petals. However, further to previous results, all VIGS plants infected with NAM or NH16 constructs exhibited reduced fusion in the petal whorl compared to control plants.

MAIN CONCLUSIONS

Together with previous data, our results demonstrate conservation of petunia CUC-like genes in establishing inter-floral whorl organ boundaries, as well as functional evolution to affect the fusion of petunia petals.

Effect of Paroven on Skin Oxygenation in Patients with Varicose Veins

A double blind placebo-controlled clinical trial was undertaken to investigate the effect of 500 mg bd of Paroven taken for four weeks on the tissue oxygenation, ankle oedema and calf pump function of 48 patients with chronic venous disease.

There was no evidence that Paroven reduced ankle swelling or improved calf pump function, but it did cause a significant improvement in transcutaneous oxygen levels measured in the calf skin of the ulcer hearing area ( p = 0.026) which was confirmed when the oxygen levels of the active and placebo treated groups were compared at the end of four weeks treatment ( p = 0.02). This improvement in tissue oxygenation may be the result of alterations in the capillary exchange produced by the drug and may account for the symptomatic benefit associated with its use.

Including sheath effects in the interpretation of planar retarding potential analyzer's low-energy ion data

The interpretation of planar retarding potential analyzers (RPA) during ionospheric sounding rocket missions requires modeling the thick 3D plasma sheath. This paper overviews the theory of RPAs with an emphasis placed on the impact of the sheath on current-voltage (I-V) curves. It then describes the Petite Ion Probe (PIP) which has been designed to function in this difficult regime. The data analysis procedure for this instrument is discussed in detail. Data analysis begins by modeling the sheath with the Spacecraft Plasma Interaction System (SPIS), a particle-in-cell code. Test particles are traced through the sheath and detector to determine the detector's response. A training set is constructed from these simulated curves for a support vector regression analysis which relates the properties of the I-V curve to the properties of the plasma. The first in situ use of the PIPs occurred during the MICA sounding rocket mission which launched from Poker Flat, Alaska in February of 2012. These data are presented as a case study, providing valuable cross-instrument comparisons. A heritage top-hat thermal ion electrostatic analyzer, called the HT, and a multi-needle Langmuir probe have been used to validate both the PIPs and the data analysis method. Compared to the HT, the PIP ion temperature measurements agree with a root-mean-square error of 0.023 eV. These two instruments agree on the parallel-to-B plasma flow velocity with a root-mean-square error of 130 m/s. The PIP with its field of view aligned perpendicular-to-B provided a density measurement with an 11% error compared to the multi-needle Langmuir Probe. Higher error in the other PIP's density measurement is likely due to simplifications in the SPIS model geometry.

Report summary. Seniors' Falls in Canada: Second Report: key highlights

Injury in Canada is a serious public health concern. Injuries are a leading cause of hospitalization for children, young adults and seniors and a major cause of disability and death. Falls remain the leading cause of injury-related hospitalizations among Canadian seniors, and data from the Canadian Community Health Survey - Healthy Aging indicate that 20% of seniors living in the community reported a fall in the previous year, with a higher prevalence among older seniors, i.e., those aged over 80 years. Falls and associated outcomes not only harm the injured individuals but also affect their families, friends and care providers; they also place considerable pressure on the health care system. However, we do know that these personal and economic costs can be avoided through injury prevention activities. The Seniors' Falls in Canada: Second Report provides policy makers, researchers, community programmers and practitioners with current data and trends on falls, injuries and hospitalizations among Canadian adults aged 65 years and over. This report is intended for use in public health research, policy development and practice.