273 resultados para ICD-10 codes


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Purpose This paper describes the implementation and evaluation of an intervention aimed at increasing the dog-walking behaviour of residents from a community of approximately 60,000. This intervention was a sub strategy of the 10 000 Steps Rockhampton project – a community intervention aimed at decreasing sedentary behaviour in the adult population. Methods Brochures and posters were developed that promoted dog walking as a means to improve both human and canine health. The brochures were distributed by the local council to over 8 000 homes with the annual dog-renewal registrations. Results Evaluation of the intervention included a telephone survey of a randomly selected sample of Rockhampton residents (n=420) four-months post intervention. Although 63.6% of participants reported that owning a dog increased their physical activity levels, 40% of dog-owners did not walk their dog at all in the last week. The outcome evaluation of the intervention showed that 20.2% of dog-owners recalled receiving the brochure. Overall 15.3% of respondents with a dog in their household reported an increase in their physical activity levels since the intervention, 8.4% reported a decrease. Conclusions The intervention was an innovative and cost-effective way to tap into a section of the population that can benefit from engaging in regular walking behaviour. It was also a unique and useful way to engage local council in physical activity health promotion as part of a larger ongoing community-wide intervention.

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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.

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A set system (X, F ) with X= {x 1,...,x m}) and F = {B1...,B n }, where B i ⊆ X, is called an (n, m) cover-free set system (or CF set system) if for any 1 ≤ i, j, k ≤ n and j ≠ k, |B i >2 |B j ∩ B k | +1. In this paper, we show that CF set systems can be used to construct anonymous membership broadcast schemes (or AMB schemes), allowing a center to broadcast a secret identity among a set of users in a such way that the users can verify whether or not the broadcast message contains their valid identity. Our goal is to construct (n, m) CF set systems in which for given m the value n is as large as possible. We give two constructions for CF set systems, the first one from error-correcting codes and the other from combinatorial designs. We link CF set systems to the concept of cover-free family studied by Erdös et al in early 80’s to derive bounds on parameters of CF set systems. We also discuss some possible extensions of the current work, motivated by different application.

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Cumulative arrays have played an important role in the early development of the secret sharing theory. They have not been subject to extensive study so far, as the secret sharing schemes built on them generally result in much larger sizes of shares, when compared with other conventional approaches. Recent works in threshold cryptography show that cumulative arrays may be the appropriate building blocks in non-homomorphic threshold cryptosystems where the conventional secret sharing methods are generally of no use. In this paper we study several extensions of cumulative arrays and show that some of these extensions significantly improve the performance of conventional cumulative arrays. In particular, we derive bounds on generalised cumulative arrays and show that the constructions based on perfect hash families are asymptotically optimal. We also introduce the concept of ramp perfect hash families as a generalisation of perfect hash families for the study of ramp secret sharing schemes and ramp cumulative arrays.

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Thunderstorm downbursts are important for wind engineers as they have been shown to produce the design wind speeds for mid to high return periods in many regions of Australia [1]. In structural design codes (e.g. AS/NZS1170.02-02) an atmospheric boundary layer (ABL) is assumed, and a vertical profile is interpolated from recorded 10 m wind speeds. The ABL assumption is however inaccurate when considering the complex structure of a thunderstorm outflow, and its effects on engineered structures. Several researchers have shown that the downburst, close to its point of divergence is better represented by an impinging wall jet profile than the traditional ABL. Physical modelling is the generally accepted approach to estimate wind loads on structures and it is therefore important to physically model the thunderstorm downburst so that its effects on engineered structures may be studied. An advancement on the simple impinging jet theory, addressed here is the addition of a pulsing mechanism to the jet which allows not only the divergent characteristics of a downburst to be produced, but also it allows the associated leading ring vortex to be developed. The ring vortex modelling is considered very important for structural design as it is within the horizontal vortex that the largest velocities occur [2]. This paper discusses the flow field produced by a pulsed wall jet, and also discusses the induced pressures that this type of flow has on a scaled tall building.

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We consider the problem of increasing the threshold parameter of a secret-sharing scheme after the setup (share distribution) phase, without further communication between the dealer and the shareholders. Previous solutions to this problem require one to start off with a non-standard scheme designed specifically for this purpose, or to have communication between shareholders. In contrast, we show how to increase the threshold parameter of the standard Shamir secret-sharing scheme without communication between the shareholders. Our technique can thus be applied to existing Shamir schemes even if they were set up without consideration to future threshold increases. Our method is a new positive cryptographic application for lattice reduction algorithms, inspired by recent work on lattice-based list decoding of Reed-Solomon codes with noise bounded in the Lee norm. We use fundamental results from the theory of lattices (Geometry of Numbers) to prove quantitative statements about the information-theoretic security of our construction. These lattice-based security proof techniques may be of independent interest.

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An anonymous membership broadcast scheme is a method in which a sender broadcasts the secret identity of one out of a set of n receivers, in such a way that only the right receiver knows that he is the intended receiver, while the others can not determine any information about this identity (except that they know that they are not the intended ones). In a w-anonymous membership broadcast scheme no coalition of up to w receivers, not containing the selected receiver, is able to determine any information about the identity of the selected receiver. We present two new constructions of w-anonymous membership broadcast schemes. The first construction is based on error-correcting codes and we show that there exist schemes that allow a flexible choice of w while keeping the complexities for broadcast communication, user storage and required randomness polynomial in log n,. The second construction is based on the concept of collision-free arrays, which is introduced in this paper. The construction results in more flexible schemes, allowing trade-offs between different complexities.

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The power of sharing computation in a cryptosystem is crucial in several real-life applications of cryptography. Cryptographic primitives and tasks to which threshold cryptosystems have been applied include variants of digital signature, identification, public-key encryption and block ciphers etc. It is desirable to extend the domain of cryptographic primitives which threshold cryptography can be applied to. This paper studies threshold message authentication codes (threshold MACs). Threshold cryptosystems usually use algebraically homomorphic properties of the underlying cryptographic primitives. A typical approach to construct a threshold cryptographic scheme is to combine a (linear) secret sharing scheme with an algebraically homomorphic cryptographic primitive. The lack of algebraic properties of MACs rules out such an approach to share MACs. In this paper, we propose a method of obtaining a threshold MAC using a combinatorial approach. Our method is generic in the sense that it is applicable to any secure conventional MAC by making use of certain combinatorial objects, such as cover-free families and their variants. We discuss the issues of anonymity in threshold cryptography, a subject that has not been addressed previously in the literature in the field, and we show that there are trade-offis between the anonymity and efficiency of threshold MACs.

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Purpose My aim is to introduce, in the project management field, an Aristotelian ethics lens moving beyond the classical deontological and consequentialism approaches underlying the current ethical practices and codes of ethics and professional conducts. In doing so, I wish to pose the premises of a debate on the implications of a conscious ethical perspective for the structure and agency relationship within the project management field Design/methodology/approach Project management is a knowledge field on its own right. However the current perspectives applied to make sense and develop the field (modernism vs. postmodernism) leads to dichotomous thinking rather than recognizing the merits and contextual validity of both sides. I call for Aristotelian Ethics as a way of moving beyond this dichotomous thinking. I introduce briefly Aristotelian Ethics and its consequences in term of relation theory – practice, means and ends, facts and values, and finally politics (i.e. being part of a community of practitioners). Then I illustrate some consequences for the field taking PMI Code of Ethics and Professional Conduct and APM Code of Professional Conduct as supports for discussion Findings I suggest a need for revisiting and/or redesigning the codes of ethics and professional conducts for project management according to an Aristotelian perspective, in order to move beyond the normative limitations of classical deontological (conflict between competing duties, exemplified by PMI Code) or consequentialism (focusing on the "right" outcome to the detriment of duties, exemplified by APM Code) approaches (both, in fact, leading to a disconnection means and ends, and facts and values). This implicates shifting our view from the question "what is my duty?" to the questions "why should I undertake my duty?" and "how ought I act in this situation?" Practical implications Raising Professional Bodies, Industry and Education institutions awareness and consciousness and leading them to rethink about codes of ethics and the implications for the way they conceive practice and research, bodies of knowledge, credentialing, education... Originality/value To the best of my knowledge, this kind of discussion has not yet been conducted within the project management field, and considering the implication of project management in our life and for the well being of the society, an ethical debate may present some value(s)

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Twenty-three non-methane hydrocarbons were captured from the exhaust of a car operating on unleaded petrol (ULP) and 10% ethanol fuels at steady speed on a chassis dynamometer. The compounds were identified and quantified by GC/MS/FID and their emission concentrations at 60 km/h, 80km/h and idle speed were evaluated. The most abundant compounds in the exhaust included n-hexane, n-heptane, benzene, toluene, ethyl benzene, m- and p-xylenes, and methylcyclopentane. Because of the large number of compounds involved, no attempt was made to compare the emission concentrations of the compounds. Rather the sum of the emission concentrations for the suite of compounds identified was compared when the car was powered by ULP and 10% ethanol fuel. It was evident from the results that the emission concentrations and factors were generally higher with ULP than with 10% ethanol fuel. The total emission concentrations with the ULP fuel were 2.8, 4.2 and 2.6 times the corresponding values for the 10% ethanol fuel at 60km/h, 80km/h and idle speed, respectively. The implications of the results on the environment are discussed in the paper.

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A Monte Carlo model of an Elekta iViewGT amorphous silicon electronic portal imaging device (a-Si EPID) has been validated for pre-treatment verification of clinical IMRT treatment plans. The simulations involved the use of the BEAMnrc and DOSXYZnrc Monte Carlo codes to predict the response of the iViewGT a-Si EPID model. The predicted EPID images were compared to the measured images obtained from the experiment. The measured EPID images were obtained by delivering a photon beam from an Elekta Synergy linac to the Elekta iViewGT a-Si EPID. The a-Si EPID was used with no additional build-up material. Frame averaged EPID images were acquired and processed using in-house software. The agreement between the predicted and measured images was analyzed using the gamma analysis technique with acceptance criteria of 3% / 3 mm. The results show that the predicted EPID images for four clinical IMRT treatment plans have a good agreement with the measured EPID signal. Three prostate IMRT plans were found to have an average gamma pass rate of more than 95.0 % and a spinal IMRT plan has the average gamma pass rate of 94.3 %. During the period of performing this work a routine MLC calibration was performed and one of the IMRT treatments re-measured with the EPID. A change in the gamma pass rate for one field was observed. This was the motivation for a series of experiments to investigate the sensitivity of the method by introducing delivery errors, MLC position and dosimetric overshoot, into the simulated EPID images. The method was found to be sensitive to 1 mm leaf position errors and 10% overshoot errors.

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The introduction of Building Information Modelling (BIM) to the design, construction and operation of buildings is changing the way that the building construction industry works. BIM involves the development of a full 3D virtual model of a building which not only contains the 3D information necessary to show the building as it will appear, but also contains significant additional data about each component in the building. BIM represents both physical and virtual objects in a building. This includes the rooms and spaces within and around the building. The additional data stored on each part of the building can support building maintenance opera- tions and, more importantly from the perspective of this paper, support the generation and running of simula- tions of the operation of the building and behaviour of people within it under both normal and emergency scenarios. The initial discussion is around the use of BIM to support the design of resilient buildings which references the various codes and standards that define current best practice. The remainder of the discussion uses various recent events as the basis for discussion on how BIM could have been used to support rapid recovery and re- building.

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Objective: In response to concerns about the health consequences of high-risk drinking by young people, the Australian Government increased the tax on pre-mixed alcoholic beverages ('alcopops') favoured by this demographic. We measured changes in admissions for alcohol-related harm to health throughout Queensland, before and after the tax increase in April 2008. Methods: We used data from the Queensland Trauma Register, Hospitals Admitted Patients Data Collection, and the Emergency Department Information System to calculate alcohol-related admission rates per 100,000 people, for 15 - 29 year-olds. We analysed data over 3 years (April 2006 - April 2009), using interrupted time-series analyses. This covered 2 years before, and 1 year after, the tax increase. We investigated both mental and behavioural consequences (via F10 codes), and intentional/unintentional injuries (S and T codes). Results: We fitted an auto-regressive integrated moving average (ARIMA) model, to test for any changes following the increased tax. There was no decrease in alcohol-related admissions in 15 - 29 year-olds. We found similar results for males and females, as well as definitions of alcohol-related harms that were narrow (F10 codes only) and broad (F10, S and T codes). Conclusions: The increased tax on 'alcopops' was not associated with any reduction in hospital admissions for alcohol-related harms in Queensland 15 - 29 year-olds.

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Objective Exercise has the potential to offer a range of health benefits in addition to improving healing outcomes for people with venous leg ulcers. However despite evidence based recommendations, most of these individuals do not engage in regular exercise. The aim of this study was to gain an understanding of the perspectives of adults with venous leg ulcers, in relation to exercise. Method This was a qualitative design using semi-structured interviews and discussions. Ten participants with venous leg ulceration volunteered to participate. Recruitment was through a specialist wound clinic. Verbatim data were collected by an experienced moderator using a semi-structured guide. Data saturation was reached after three group discussions and two interviews. A random selection of transcripts was sent back to the participants for verification. Thematic content analysis was used to determine major themes and categories. Two transcripts were independently analysed, categories and themes independently developed, cross checked and found comparable. Remaining transcripts were analysed using developed categories and codes. Results Regardless of their current exercise routine, participants reported exercising prior to venous leg ulceration and expressed an interest in either becoming active or maintaining an active lifestyle. Overall four themes emerged from the findings: i) participant understanding of the relationship between chronic venous insufficiency and exercise patterns, ii) fear of harm impacts upon positive beliefs and attitudes to exercise, iii) perceived factors limit exercise and iv) structured management facilitates exercise. Conclusion The value of exercise in improving outcomes in venous leg ulcers lies in its capacity to promote venous return and reduce the risk of secondary conditions in this population. Despite motivation and interest in being exercise active, people with venous leg ulcers report many obstacles. Further exploration of mechanisms that assist this patient population and promote understanding about management of barriers, coupled with promotion of enabling factors is vital for improving their exercise participation.