The 6-PACK programme to decrease fall-related injuries in acute hospitals: protocol for a cluster randomised controlled trial

Background and aims In-hospital fall-related injuries are a source of personal harm, preventable hospitalisation costs, and access block through increased length of stay. Despite increased fall prevention awareness and activity over the last decade, rates of reported fall-related fractures in hospitals appear not to have decreased. This cluster randomised controlled trial (RCT) aims to determine the efficacy of the 6-PACK programme for preventing fall-related injuries, and its generalisability to other acute hospitals.

Methods 24 acute medical and surgical wards from six to eight hospitals throughout Australia will be recruited for the study. Wards will be matched by type and fall-related injury rates, then randomly allocated to the 6-PACK intervention (12 wards) or usual care control group (12 wards). The 6-PACK programme includes a nine-item fall risk assessment and six nursing interventions: ‘falls alert’ sign; supervision of patients in the bathroom; ensuring patient’s walking aids are within reach; establishment of a toileting regime; use of a low-low bed; and use of bed/chair alarm. Intervention wards will be supported by a structured implementation strategy. The primary outcomes are fall and fall-related injury rates 12 months following 6-PACK implementation.

Discussion This study will involve approximately 16 000 patients, and as such is planned to be the largest hospital fall prevention RCT to be undertaken and the first to be powered for the important outcome of fall-related injuries. If effective, there is potential to implement the programme widely as part of daily patient care in acute hospital wards where fall-related injuries are a problem.

An investigation of the differences in ethical perceptions among construction managers and their peers

Previous research on ethical perceptions of managers and their peers show a consistent result, managers think they have higher ethical standards than their peers. The aim of this paper is to study the ethical perceptions of construction managers and their peers. The method for conducting the study is through a questionnaire survey among UK construction managers. Three hundred and seven questionnaires were distributed; ninety-three completed questionnaires were completed and returned. The overall results show that the construction mangers believe they have higher ethical standards than their peers. The ethical perceptions which are exceptions to this are cooperation between firms to establish common prices is an unfair act and whistleblowing, the respondents think their peers have higher ethical standards on these two issues. The managers in the current and previous studies think they are more ethical than their peers on dealing with the issue such as having low level of personal honesty. The difference between the current and previous studies is that the construction mangers think they have much higher ethical standards than their peers on the issue providing trade secrets in order to exchange for personal benefits.

Muslim personal law

The article examines the development of the legalism of Personal Law and provisions of community rights for disparate communities in modern India, and the role of religion and communal politics in their perpetuation. The case study undertaken here is specifically the Muslim community’s Constitutionally-sanctioned Personal law (MPL). MPL has not been without criticisms both from outside and within the community, particularly in respect of gendered disadvantages that arise within the provisions safeguarding the practices, which cover marriage, divorce, alimony, inheritance, custody, succession, and so forth.

The act of giving: a pilot and feasibility study of the My Life Story programme designed to foster positive mental health and well-being in adolescents and older adults

Twelve pairs of adolescent students were linked to an older adult in aged care in this pilot study on intergenerational interaction. Triads met weekly for eight weeks with the aim of writing a Life Review Book for the older adult. At the conclusion of the study, participants were interviewed to gain an understanding of their experiences and meaning of the programme. Thematic analysis of the interviews revealed four major themes: breaking down the stereotypes, recognition of heterogeneity, satisfaction from ‘making the effort’ and personal gain through making a contribution. Measures of psychological well-being were also administered pre- and post-delivery of the programme. This revealed that both age groups could and would complete all aspects of the programme. It was concluded from the findings that the intergenerational programme is feasible in the context of adolescent and older adult intergenerational relationships, and a potential influence on well-being for those who take part.

Putting the spoils of litigation into the shareholders’ pockets: when can shareholders bring a personal action against the directors of their company?

company is legally incorporated it must be treated like any other independent person with its rightsand liabilities appropriate to itself”.2 A consequence of this is the “proper plaintiff” principleestablished in Foss v Harbottle (1843) 2 Hare 461; 67 ER 189: the proper plaintiff in an action inrespect of a wrong done to a corporation is the corporation itself.3 It is also a “hallowed rule” thatdirectors owe their duties to the company, not the shareholders,4 and so any loss accruing to thecompany as a result of the directors’ breach of their duties is recoverable only by the company.5An obvious problem with this state of affairs is that a company will be unlikely to initiateproceedings against its directors when the company is controlled by those directors.6 While there aregood economic reasons for this division of management and ownership,7 shareholders are left with acritical question: under what circumstances can they initiate proceedings to recover loss suffered as aresult of company directors’ breach of their duties? Although one writer has referred to the“expansive statutory and common law arsenals” available to aggrieved shareholders,8 it seems ratherthe case that there are few effective remedies. For shareholders have no contractual relationship withdirectors,9 and the personal rights conferred on shareholders by statute or general law are largelyprocedural10 and seem a rather ineffective basis for “scrutinising directorial performance”.