Identification of reduced models of power system areas using phasor measurement units

In this paper an approach is presented for identification of a reduced model for coherent areas in power systems using phasor measurement units to represent the inter-area oscillations of the system. The generators which are coherent in a wide range of operating conditions form the areas in power systems and the reduced model is obtained by representing each area by an equivalent machine. The reduced nonlinear model is then identified based on the data obtained from measurement units. The simulation is performed on three test systems and the obtained results show high accuracy of identification process.

Load leveling in LV network using coordianted Energy Storage Units

This paper proposes a new distributed coordination approach to make load leveling, using Energy Storage Units (ESUs) in LV network. The proposed distributed control strategy is based on consensus algorithm which shares the required active power equally among the ESUs with respect to their rating. To show the effectiveness of the proposed approach, a typical radial LV network is simulated as a case study.

Use of hospital emergency departments by immigrants from non-English speaking backgrounds in Queensland

This study aimed to examine the use of hospital emergency departments and to investigate the level of satisfaction with the emergency department service among patients from a non-English-speaking background compared to those of patients from an English-speaking background in Queensland. The findings of this study might inform health professionals and policy planners to develop educational interventions and policies to ensure equitable use of emergency services among the populations.

Evaluation of the Mater Mothers' Hospital refugee antenatal clinic

This report describes the evaluation of the Refugee Antenatal Clinic (Mater Mothers' Hospital, Brisbane) which was established in November 2008

Increasing incidence of Clostridium difficile infection, Australia, 2011–2012

Objectives: To report the quarterly incidence of hospital-identified Clostridium difficile infection (HI-CDI) in Australia, and to estimate the burden ascribed to hospital-associated (HA) and community-associated (CA) infections. Design, setting and patients: Prospective surveillance of all cases of CDI diagnosed in hospital patients from 1 January 2011 to 31 December 2012 in 450 public hospitals in all Australian states and the Australian Capital Territory. All patients admitted to inpatient wards or units in acute public hospitals, including psychiatry, rehabilitation and aged care, were included, as well as those attending emergency departments and outpatient clinics. Main outcome measures: Incidence of HI-CDI (primary outcome); proportion and incidence of HA-CDI and CA-CDI (secondary outcomes). Results: The annual incidence of HI-CDI increased from 3.25/10 000 patient-days (PD) in 2011 to 4.03/10 000 PD in 2012. Poisson regression modelling demonstrated a 29% increase (95% CI, 25% to 34%) per quarter between April and December 2011, with a peak of 4.49/10 000 PD in the October–December quarter. The incidence plateaued in January–March 2012 and then declined by 8% (95% CI, − 11% to − 5%) per quarter to 3.76/10 000 PD in July–September 2012, after which the rate rose again by 11% (95% CI, 4% to 19%) per quarter to 4.09/10 000 PD in October–December 2012. Trends were similar for HA-CDI and CA-CDI. A subgroup analysis determined that 26% of cases were CA-CDI. Conclusions: A significant increase in both HA-CDI and CA-CDI identified through hospital surveillance occurred in Australia during 2011–2012. Studies are required to further characterise the epidemiology of CDI in Australia.

Electrocoagulation as a pre-treatment stage to reverse osmosis units

Reverse osmosis (RO) is used by coal seam gas (CSG) operators to treat produced water as it is a well-established and proven technology worldwide. Despite the suitability of RO, there are problems associated with RO technology such as membrane fouling which although not preventing use of RO does decrease effectiveness and increase operating costs. Hence, effective pre-treatment of water samples is essential. Electrocoagulation (EC) potentially can provide improved water purification compared to conventional coagulation prior to an RO unit. This paper provides the first reported study of EC for CSG water pre-treatment and compares the performance to a range of aluminium and iron based coagulants. It was found that EC was superior in terms of removal of silica, calcium, magnesium, barium and strontium in the produced water.

Reflections on tomorrow’s menu : evidence for inpatient meal preferences at a large tertiary public hospital

There are limited studies that describe patient meal preferences in hospital; however this data is critical to develop menus that address satisfaction and nutrition whilst balancing resources. This quality study aimed to determine preferences for meals and snacks to inform a comprehensive menu revision in a large (929 bed) tertiary public hospital. The method was based on Vivanti et al. (2008) with data collected by two final year dietetic students. The first survey comprised 72 questions, achieved a response rate of 68% (n = 192), with the second more focused at 47 questions achieving a higher response rate of 93% (n = 212). Findings showed over half the patients reporting poor or less than normal appetite, 20% describing taste issues, over a third with a LOS >7 days, a third with a MST _ 2 and less than half eating only from the general menu. Soup then toast was most frequently reported as eaten at home when unwell, and whilst most reported not missing any foods when in hospital (25%), steak was most commonly missed. Hot breakfasts were desired by the majority (63%), with over half preferring toast (even if cold). In relation to snacks, nearly half (48%) wanted something more substantial than tea/coffee/biscuits, with sandwiches (54%) and soup (33%) being suggested. Sandwiches at the evening meal were not popular (6%). Difficulties with using cutlery and meal size selection were identified as issues. Findings from this study had high utility and supported a collaborative and evidenced based approach to a successful major menu change for the hospital.

Let them eat steak : food preferences of patients in a tertiary public hospital

Information on foods patients like and dislike is the essential basis for planning menus which are acceptable to patients and promote adequate consumption. The aim of this study was to obtain quantitative data on the food preferences of inpatients at a large metropolitan public hospital for use in menu planning. Methodology was based on a study by Williams et al (1988), and included additional questions about appetite and taste changes. The survey used a 9 point hedonic scale to rate foods listed in random order and was modified to incorporate more contemporary foods than those used in the originalWilliams study. Surveys were conducted by final year University of Queensland dietetics students on Food Service Practicum at the Royal Brisbane and Women’s Hospital (929 beds) in 2012. The first survey (220 questions, n = 157) had a response rate of 61%. The second included more sandwich fillings and salads (231 questions, n = 219, response rate 67%). Total number surveyed was 376. Results showed the most preferred foods were roast potato, grilled steak, ice cream, fresh strawberries, roast lamb, roast beef, grapes and banana. The least preferred foods were grapefruit, soybeans, lentils, sardines, prune juice and grapefruit juice. Patients who reported taste changes (10%) had similar food preferences to those who didn’t report taste changes. Patients who reported poor/very poor appetite (10%) generally scored foods lower than those who reported OK (22%), good/very good appetite (65%). The results of this study informed planning for a new patient menu at the RBWH in December 2012.

Distinguishing between task and contextual performance for nurses : development of a job performance scale

Aim. This paper is a report of a development and validation of a new job performance scale based on an established job performance model. Background. Previous measures of nursing quality are atheoretical and fail to incorporate the complete range of behaviours performed. Thus, an up-to-date measure of job performance is required for assessing nursing quality. Methods. Test construction involved systematic generation of test items using focus groups, a literature review, and an expert review of test items. A pilot study was conducted to determine the multidimensional nature of the taxonomy and its psychometric properties. All data were collected in 2005. Findings. The final version of the nursing performance taxonomy included 41 behaviours across eight dimensions of job performance. Results from preliminary psychometric investigations suggest that the nursing performance scale has good internal consistency, good convergent validity and good criterion validity. Conclusion. The findings give preliminary support for a new job performance scale as a reliable and valid tool for assessing nursing quality. However, further research using a larger sample and nurses from a broader geographical region is required to cross-validate the measure. This scale may be used to guide hospital managers regarding the quality of nursing care within units and to guide future research in the area.

Functional independence following subacute inpatient rehabilitation was not affected by age among older patients recovering from cardiac-related hospital admissions

Introduction Older people recovering from cardiac events requiring an acute hospital admission may experience a decline in physical function limiting their ability to return home to their previous accommodation. Subacute inpatient rehabilitation therapies have potential to assist recovery of physical functioning. However, it is unknown whether age influences the length of stay or physical functioning at discharge from subacute inpatient rehabilitation for this population. Objectives This study examined the outcomes of a cohort of older patients recovering from a cardiac event requiring hospitalisation to investigate the association between age and physical function at discharge, as well as age and length of rehabilitation stay. Methods Participants included 145 consecutive inpatient admissions to a subacute geriatric assessment and rehabilitation unit with a cardiac condition as their primary reason for hospital admission. Participants were required to complete a multi-disciplinary physical functioning assessment within 72 hours of admission to the unit, and again within 72 hours prior to discharge from the unit. The primary outcome measure was the Functional Independence Measure motor score. Demographic and clinical information, including length of stay and discharge destination, were also recorded. Results A total n=126 (87%) participants, with a mean (standard deviation) age of 79 (10) years, had both assessments completed and were included in analyses. Participants who had passed away (n=4, 3%), or did not have both assessments completed per protocol were excluded from analyses. Discharge destinations included home (n=101, 80%), residential aged care (n=17, 13%) and another hospital (n=8, 6%). The (median, interquartile range) Functional Independence Measure motor score was higher at discharge (79, 71 to 84) than admission (61, 48 to 71); z=7.75 p<0.001. Age was not associated with Functional Independence Measure motor score at discharge (t= -0.18, p=0.86), or length of stay in the rehabilitation unit (t= -0.52, 0.60). Conclusion Any perception that age may be associated with longer lengths of stay and reduced physical function outcomes among patients with cardiac conditions admitted for subacute inpatient rehabilitation for older adults is not supported data from this investigation. Older age should not be considered a disincentive when considering the suitability of patients with cardiac diagnoses for this type of inpatient rehabilitation or their potential physical functioning outcome.

Skill development in first year law students : an evaluation of peer assisted learning across two law units

Universities no longer equip graduates solely with the content knowledge of their discipline, but also with prospective employment skills. Professions also seek graduates who can ‘collaborate, share skills and knowledge, and communicate their ideas effectively’ (Kruck and Reif, 2001, p 37). However, as admission to university does not always guarantee that one is well equipped for the task, first year students also need guidance in the development of academic skills. This session describes two models of peer assisted learning embedded within the Torts and Legal Foundations B units at the Faculty of Law, Queensland University of Technology, and how they are used to supplement student understanding of substantive law with the development of academic and work-related skills. Student perceptions of the programs developed are considered, together with the challenges faced. Session participants will be asked to contribute to a discussion of these challenges and to offer ideas on their redress.

The once-and-for-all withdrawal of the Liverpool Care Pathway in the UK : what are the implications for Australia?

This Perspective reflects on the withdrawal of the Liverpool Care Pathway in the UK, and its implications for Australia. Integrated care pathways are documents which outline the essential steps of multidisciplinary care in addressing a specific clinical problem. They can be used to introduce best clinical practice, to ensure that the most appropriate management occurs at the most appropriate time and that it is provided by the most appropriate health professional. By providing clear instructions, decision support and a framework for clinician-patient interactions, care pathways guide the systematic provision of best evidence-based care. The Liverpool Care Pathway (LCP) is an example of an integrated care pathway, designed in the 1990s to guide care for people with cancer who are in their last days of life and are expected to die in hospital. This pathway evolved out of a recognised local need to better support non-specialist palliative care providers’ care for patients dying of cancer within their inpatient units. Historically, despite the large number of people in acute care settings whose treatment intent is palliative, dying patients receiving general hospital acute care tended to lack sufficient attention from senior medical staff and nursing staff. The quality of end-of-life care was considered inadequate, therefore much could be learned from the way patients were cared for by palliative care services. The LCP was a strategy developed to improve end-of-life care in cancer patients and was based on the care received by those dying in the palliative care setting.

Validation of a framework for measuring hospital disaster resilience using factor analysis

Hospital disaster resilience can be defined as “the ability of hospitals to resist, absorb, and respond to the shock of disasters while maintaining and surging essential health services, and then to recover to its original state or adapt to a new one.” This article aims to provide a framework which can be used to comprehensively measure hospital disaster resilience. An evaluation framework for assessing hospital resilience was initially proposed through a systematic literature review and Modified-Delphi consultation. Eight key domains were identified: hospital safety, command, communication and cooperation system, disaster plan, resource stockpile, staff capability, disaster training and drills, emergency services and surge capability, and recovery and adaptation. The data for this study were collected from 41 tertiary hospitals in Shandong Province in China, using a specially designed questionnaire. Factor analysis was conducted to determine the underpinning structure of the framework. It identified a four-factor structure of hospital resilience, namely, emergency medical response capability (F1), disaster management mechanisms (F2), hospital infrastructural safety (F3), and disaster resources (F4). These factors displayed good internal consistency. The overall level of hospital disaster resilience (F) was calculated using the scoring model: F = 0.615F1 + 0.202F2 + 0.103F3 + 0.080F4. This validated framework provides a new way to operationalise the concept of hospital resilience, and it is also a foundation for the further development of the measurement instrument in future studies.

Evaluation of public hospital performance in Khanh Hoa Province : Vietnam in connection with patient and staff satisfaction surveys

This research aimed to develop a framework for performance evaluation of public hospitals in Vietnam that is culturally, socially, and politically appropriate. The research included both qualitative and quantitative methods and identified and validated novel instruments to measure patient satisfaction and job satisfaction of hospital staff and to determine a set of hospital indicators that reflect the quality of hospital performance. New models for understanding the determinants of patient and staff satisfaction were developed along with a new performance indicator framework for hospital performance. These instruments will now be applied to the evaluation of hospital services in Khanh Hoa Province, permitting longer term evaluation of their effectiveness in changing system wide performance and satisfaction.

Survival models of community tenure and length of hospital stay for the seriously mentally ill : a 10-year perspective

Objective: To examine the effects of personal and community characteristics, specifically race and rurality, on lengths of state psychiatric hospital and community stays using maximum likelihood survival analysis with a special emphasis on change over a ten year period of time. Data Sources: We used the administrative data of the Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services (DMHMRSAS) from 1982-1991 and the Area Resources File (ARF). Given these two sources, we constructed a history file for each individual who entered the state psychiatric system over the ten year period. Histories included demographic, treatment, and community characteristics. Study Design: We used a longitudinal, population-based design with maximum likelihood estimation of survival models. We presented a random effects model with unobserved heterogeneity that was independent of observed covariates. The key dependent variables were lengths of inpatient stay and subsequent length of community stay. Explanatory variables measured personal, diagnostic, and community characteristics, as well as controls for calendar time. Data Collection: This study used secondary, administrative, and health planning data. Principal Findings: African-American clients leave the community more quickly than whites. After controlling for other characteristics, however, race does not affect hospital length of stay. Rurality does not affect length of community stays once other personal and community characteristics are controlled for. However, people from rural areas have longer hospital stays even after controlling for personal and community characteristics. The effects of time are significantly smaller than expected. Diagnostic composition effects and a decrease in the rate of first inpatient admissions explain part of this reduced impact of time. We also find strong evidence for the existence of unobserved heterogeneity in both types of stays and adjust for this in our final models. Conclusions: Our results show that information on client characteristics available from inpatient stay records is useful in predicting not only the length of inpatient stay but also the length of the subsequent community stay. This information can be used to target increased discharge planning for those at risk of more rapid readmission to inpatient care. Correlation across observed and unobserved factors affecting length of stay has significant effects on the measurement of relationships between individual factors and lengths of stay. Thus, it is important to control for both observed and unobserved factors in estimation.