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Objectives The Australian Ageing Semantic Differential (AASD) survey was developed to quantify medical student attitudes towards older people. The purpose of this study is to examine psychometric properties of the survey and confirm its factor structure of four composites. Design A cross-sectional study. Setting Three medical schools in three Australian states: Victoria, Western Australia and South Australia. Participants Third-year or fourth-year medical students (n=188, response rate=79%). Outcome measures In the previous AASD study, exploratory factor analysis supported a four-factor model consisting of ‘Instrumentality’ (I), ‘Personal Appeal’ (PA), ‘Experience’ (E) and ‘Sociability’ (S). Congeneric one-factor confirmatory factor analysis (CFA) were used to examine model fit for factors using a new student sample (n=188). Psychometric properties of survey items and factors. Post-hoc analysis of pooled data from this study and earlier AASD study (n=509). Results Indices of fit (Comparative Fit Index (CFI), TuckerLewis Index (TLI), root mean square error of approximation (RMSEA), standardised root mean square residual (SRMR)) for data to the factor model were: PA adequate fit (CFI=0.94, TLI=0.89, RMSEA=0.11 and SRMR=0.05), I good fit (CFI=0.99, TLI=0.99, RMSEA=0.04 and SRMR=0.03), S good fit (CFI=0.98, TLI=0.95, RMSEA=0.06 and SRMR=0.03) and E excellent fit (CFI=1.0, TLI=1.0, RMSEA=0.00 and SRMR=0.01). The AASD was internally consistent (Cronbach’s alpha=0.84), without difference in mean student scores by institution. Mean AASD score was positive for medical students outside New South Wales (73.2/114). Mean I score for all Australian students was negative, with female respondents’ mean E score significantly higher than their counterparts. A positive correlation between student age and I score was noted. Conclusions The AASD is internally consistent and generalisable within Australia, with acceptable structural validity for measuring medical student attitudes towards older people within a four-factor model. Student attitudes were positive globally and within all factors except I. Female students rated older persons E more positively. Older students recorded more positive attitudes towards I of older people. [ABSTRACT FROM AUTHOR]

Introduction: Frailty is a major concern due to its costly and widespread consequences, yet evidence of effective interventions to delay or reduce frailty is lacking. Our previous study found that a multifactorial intervention was feasible and effective in reducing frailty in older people who were already frail. Identifying and treating people in the pre-frail state may be an effective means to prevent or delay frailty. This study describes a randomised controlled trial that aims to evaluate the effectiveness of a multifactorial intervention on development of frailty in older people who are pre-frail. Methods and analysis: A single centre randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. Two hundred and thirty people aged above 70 who meet the Cardiovascular Health Study frailty criteria for prefrailty, reside in the community and are without severe cognitive impairment will be recruited. Participants will be randomised to receive a multifactorial intervention or usual care. The intervention group will receive a 12-month interdisciplinary intervention targeting identified characteristics of frailty and problems identified during geriatric assessment. Participants will be followed for a 12-month period. Primary outcome measures will be degree of frailty measured by the number of Cardiovascular Health Study frailty criteria present, and mobility measured with the Short Physical Performance Battery. Secondary outcomes will include measures of mobility, mood and use of health and community services. Ethics and dissemination: The study was approved by the Northern Sydney Local Health District Health Research Ethics Committee (1207-213M). The findings will be disseminated through scientific and professional conferences, and in peer-reviewed journals. [ABSTRACT FROM AUTHOR]

Presents letters between medical practitioners as of April 26, 2003. Consideration of the policies of boarding schools in the United Kingdom with regard to severe acute respiratory syndrome (SARS); Effectiveness of hip protectors; Quality of impact factors of general medical journals; Benefits from the shift from selective narrative to systemic review within medicine.

This article presents a look at how falls in elderly people can be prevented, particularly in hospitals and care homes in Great Britain. The authors suggest that such falls often lead to fractures and hip injury. They review the results of a Cochrane systematic review that considered the benefits of prevention programs.

In increasingly constrained health and aged care services, strategies are needed to improve quality and translate evidence into practice. In dementia care, recent failures in quality and safety have led the WHO to prioritise the translation of known evidence into practice. While quality improvement collaboratives have been widely used in healthcare, there are few examples in dementia care.We describe a recent quality improvement collaborative to improve dementia care across Australia and assess the implementation outcomes of acceptability and feasibility of this strategy to translate known evidence into practice. A realist-informed process evaluation was used to analyse how, why and under what circumstances a quality improvement collaborative built knowledge and skills in clinicians working in dementia care.This realist-informed process evaluation developed, tested and refined the programme theory of a quality improvement collaborative. Data were collected pre-intervention and post-intervention using surveys and interviews with participants (n=28). A combined inductive and deductive data analysis process integrated three frameworks to examine the context and mechanisms of knowledge and skill building in participant clinicians.A refined program theory showed how and why clinicians built knowledge and skills in quality improvement in dementia care. Six mechanisms were identified: motivation, accountability, identity, collective learning, credibility and reflective practice. These mechanisms, in combination, operated to overcome constraints, role boundaries and pessimism about improved practice in dementia care.A quality improvement collaborative designed for clinicians in different contexts and roles was acceptable and feasible in building knowledge, skills and confidence of clinicians to improve dementia care. Supportive reflective practice and a credible, flexible and collaborative process optimised quality improvement knowledge and skills in clinicians working with people with dementia. Trial registration number ACTRN12618000268246., Competing Interests: Competing interests: MCa has been employed in the last 5 years to assist with data collection for Alzheimer’s disease drug trials funded by Janssen and Merck., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)