A multi-level ecological model of psychotropic prescribing to adults with intellectual disability

Purpose – Simple linear accounts of prescribing do not adequately address reasons “why” doctors prescribe psychotropic medication to people with intellectual disability (ID). Greater understanding of the complex array of factors that influence decisions to prescribe is needed. Design/methodology/approach – After consideration of a number of conceptual frameworks that have potential to better understand prescribing of psychotropic medication to adults with ID, an ecological model of prescribing was developed. A case study is used to outline how the model can provide greater understanding of prescribing processes. Findings – The model presented aims to consider the complexity and multi-dimensional nature of community-based psychotropic prescribing to adults with ID. The utility of the model is illustrated through a consideration of the case study. Research limitations/implications – The model presented is conceptual and is as yet untested. Practical implications – The model presented aims to capture the complexity and multi-dimensional nature of community-based psychotropic prescribing to adults with ID. The model may provide utility for clinicians and researchers as they seek clarification of prescribing decisions. Originality/value – The paper adds valuable insight into factors influencing psychotropic prescribing to adults with ID. The ecological model of prescribing extends traditional analysis that focuses on patient characteristics and introduces multi-level perspectives that may provide utility for clinicians and researchers.

Communicating engagement in corporate social responsibility : a meta-level construal of engagement

Organizations are increasingly seeking stakeholder support through engagement to demonstrate their corporate social responsibility (CSR) credentials. These credentials are in turn used to support claims of legitimacy for organizational operations. This paper uses a process model of antecedents, implementation, and consequences to study the connection between engagement and CSR. CSR reports show organizations perceive engagement in CSR as both communication and activities between organizations and their stakeholders; and as a second, meta-level of communication about that engagement with stakeholders beyond those directly involved, thereby broadening the scope of organizational claims to legitimacy. Understanding what engagement is and how and why it is carried out in CSR provides a framework for understanding engagement in public relations.

A three-level flying-capacitor rectifier based supercapacitor direct integration scheme for distributed generation systems

Supercapacitors are increasingly used as short term energy storage elements in distributed generation systems. The traditional approach in integrating them to the main system is the use of interfacing dc-dc converters which introduce additional costs and power losses. This paper therefore, presents a novel direct integration scheme for supercapacitors and thereby eliminates associated costs and power losses of interfacing converters. The idea is simply to replace ordinary capacitors of three-level flying-capacitor rectifiers with supercapacitors and operate them under variable voltage conditions. An analysis on the reduction of power losses by the proposed system is presented. Furthermore, supercapacitor sizing and implementation issues such as effects of the variable voltage operation and resistive behavior of supercapacitors at high frequencies are also discussed. Simulation results are presented to verify the efficacy of the proposed system in suppressing short term power fluctuations in wind generation system.

The impact of employment-level characteristics on work-life interference in school aged children

Work–life interference is important for school-aged workers because it influences their educational outcomes/career aspirations. Although research highlights the role of work hours in determining work–life interference for these workers, work/job-level characteristics have received limited attention. Using survey data from Queensland school students who work part-time, we assess the influence of a range of employment-level variables on work–life interference. The results of multiple regression analysis indicate work–life interference is exacerbated by having low trust in managers and limited scope to refuse work hours and stability in work hours, emphasising the importance of organisational variables in integrating work and non-work spheres for school-aged workers.

Battery clamped three-level inverter for renewable energy systems

This paper presents a novel battery direct integration scheme for renewable energy systems. The idea is to replace ordinary capacitors of a three-level flying-capacitor inverter by three battery banks to alleviate power fluctuations in renewable generation. This approach eliminates the need for interfacing dc-dc converters and thus considerably improves the overall efficiency. However, the major problem with this approach is the uneven distribution of space vectors which is due to unavoidable unbalance in clamping voltages. A detailed analysis on the effects of this issue and a novel carrier based pulse width modulation method, which can generate undistorted currents even in the presence of unevenly distributed space vectors, are presented in this paper. A charge/discharge controller is also proposed for power sharing and state of charge balancing of battery banks. Simulation results are presented to verify the efficacy of the proposed system, modulation method and power sharing controller.

An analysis on the possibility of using capacitors of a three-level capacitor clamped inverter as power smoothing elements for wind power systems

This paper presents a new direct integration scheme for supercapacitors that are used to mitigate short term power fluctuations in wind power systems. The idea is to replace ordinary capacitors of a 3-level flying capacitor inverter by supercapacitors and operate them under variable voltage conditions. This approach eliminates the need of interfacing dc-dc converters for supercapacitor integration and thus considerably improves the overall efficiency. However, the major problem of this unique system is the change of supercapacitor voltages. An analysis on the effects of these voltage variations are presented. A space vector modulation method, built from the scratch, is proposed to generate undistorted current even in the presence of dynamic changes in supercapacitor voltages. A supercapacitor voltage equalisation algorithm is also proposed. Furthermore, resistive behavior of supercapacitors at high frequencies and the need for a low pass filter are highlighted. Simulation results are presented to verify the efficacy of the proposed system in suppressing short term wind power fluctuations.

No genetic bottleneck in Plasmodium falciparum wild-type Pfcrt alleles reemerging in Hainan Island, China, following high-level chloroquine resistance

Chloroquine-resistant Plasmodium falciparum was highly prevalent in Hainan, China, in the 1970s. Twenty-five years after cessation of chloroquine therapy, the prevalence of P. falciparum wild-type Pfcrt alleles has risen to 36% (95% confidence interval, 22.1 to 52.4%). The diverse origins of wild-type alleles indicate that there was no genetic bottleneck caused by high chloroquine resistance.

HFL micro inverter with front-end diode clamped multi-level inverter and half-wave cycloconverter

A high-frequency-link (HFL) micro inverter with a front-end diode clamped multi-level inverter and a grid-connected half-wave cycloconverter is proposed. The diode clamped multi-level inverter with an auxiliary capacitor is used to generate high-frequency (HF) three level quasi square-wave output and it is fed into a series resonant tank to obtain high frequency continuous sinusoidal current. The obtained continuous sinusoidal current is modulated by using the grid-connected half-wave cycloconverter to obtain grid synchronized output current in phase with the grid voltage. The phase shift power modulation is used with auxiliary capacitor at the front-end multi-level inverter to have soft-switching. The phase shift between the HFL resonant current and half-wave cycloconverter input voltage is modulated to obtain grid synchronized output current.

Deconstructing antiobesity compound action : requirement of serotonin 5-HT2B receptors for dexfenfluramine anorectic effects

The now-banned anorectic molecule, dexfenfluramine, promotes serotonin release through a serotonin transporter-dependent mechanism, and it has been widely prescribed for the treatment of obesity. Previous studies have identified that 5-HT(2B) receptors have important roles in dexfenfluramine side effects, that is, pulmonary hypertension, plasma serotonin level regulation, and valvulopathy. We thus investigated a putative contribution of 5-HT(2B) receptors in dexfenfluramine-dependent feeding behavior in mice. Interestingly, the hypophagic response to dexfenfluramine (3-10 mg/kg) observed in wild-type mice (1-4 h) was eliminated in mice lacking 5-HT(2B) receptors (5-HT(2B)(-/-)). These findings were further validated by the lack of hypophagic response to dexfenfluramine in wild-type mice treated with RS127445, a highly selective and potent antagonist (pKi=8.22 ± 0.24). Using microdialysis, we observed that in 5-HT(2B)(-/-) awake mice, the dexfenfluramine-induced hypothalamic peak of serotonin release (1 h) was strongly reduced (fourfold) compared with wild type. Moreover, using hypothalamic synaptosomes, we established the serotonergic neuron autonomous properties of this effect: a strong serotonin release was observed upon dexfenfluramine stimulation of synaptosome preparation from wild type but not from mice lacking active 5-HT(2B) receptors. These findings strongly suggest that activation of presynaptic 5-HT(2B) receptors is a limiting step in the serotonin transporter dependent-releasing effect of dexfenfluramine, whereas other serotonin receptors act downstream with respect to feeding behavior.

Productivity and convergence in India : a state-level analysis

Total factor productivity plays an important role in the growth of the Indian economy. Using state-level data from 1993 to 2005 that were recently made available, we find widespread regional variation in productivity changes. In the years immediately following economic liberalization, productivity growth improved technical efficiency; however, in subsequent years, productivity growth was propelled by technological progress. We find a tendency toward convergence with regard to productivity growth among states; however, the states that were technically efficient when the economic reforms were instituted remained innovative in later years.

Connecting two wind turbine generators to the grid using only one three level NPC inverter

This paper explores the possibility of connecting two Wind Turbine Generators (WTG) to the grid using a single three level inverter. In the proposed system the rectified output of one WTG is connected across the upper dc-link capacitor of a standard diode clamped three level inverter. Similarly the rectified output of the other WTG is connected across the lower capacitor. This particular combination has several advantages such as, direct connection to the grid, reduced parts count, improved reliability and high power capacity. However, the major problem in the proposed system is the imminent imbalance of dc-link voltages. Under such conditions conventional modulation methods fail to produce desired voltage and current waveforms. A detailed analysis on this issue and a novel space vector modulation method, as the solution, are proposed in this paper. To track the Maximum power point of each WTG a power sharing algorithm is proposed. Simulation results are presented to attest the efficacy of the proposed system.

Space vector modulated cascade multi-level inverter for PMSG wind generation systems

Modulation and control of a cascade multilevel inverter, which has a high potential in future wind generation applications, are presented. The inverter is a combination of a high power, three level “bulk inverter” and a low power “conditioning inverter”. To minimize switching losses, the bulk inverter operates at a low frequency producing square wave outputs while high frequency conditioning inverter is used to suppress harmonic content produced by the bulk inverter output. This paper proposes an improved Space Vector Modulation (SVM) algorithm and a neutral point potential balancing technique for the inverter. Furthermore, a maximum power tracking controller for the Permanent Magnet Synchronous Generator (PMSG) is described in detail. The proposed SVM technique eliminates most of the computational burdens on the digital controller and renders a greater controllability under varying DC-link voltage conditions. The DC-link capacitor voltage balancing of both bulk and conditioning inverters is carried out using Redundant State Selection (RSS) method and is explained in detail. Experimental results are presented to verify the proposed modulation and control techniques.

Bayesian hierarchical models for analysing spatial point-based data at a grid level: A comparison of approaches

Spatial data are now prevalent in a wide range of fields including environmental and health science. This has led to the development of a range of approaches for analysing patterns in these data. In this paper, we compare several Bayesian hierarchical models for analysing point-based data based on the discretization of the study region, resulting in grid-based spatial data. The approaches considered include two parametric models and a semiparametric model. We highlight the methodology and computation for each approach. Two simulation studies are undertaken to compare the performance of these models for various structures of simulated point-based data which resemble environmental data. A case study of a real dataset is also conducted to demonstrate a practical application of the modelling approaches. Goodness-of-fit statistics are computed to compare estimates of the intensity functions. The deviance information criterion is also considered as an alternative model evaluation criterion. The results suggest that the adaptive Gaussian Markov random field model performs well for highly sparse point-based data where there are large variations or clustering across the space; whereas the discretized log Gaussian Cox process produces good fit in dense and clustered point-based data. One should generally consider the nature and structure of the point-based data in order to choose the appropriate method in modelling a discretized spatial point-based data.

Heat-related morbidity in Brisbane, Australia : spatial variation and area-level predictors

Background: Extreme heat is a leading weather-related cause of illness and death in many locations across the globe, including subtropical Australia. The possibility of increasingly frequent and severe heat waves warrants continued efforts to reduce this health burden, which could be accomplished by targeting intervention measures toward the most vulnerable communities. Objectives: We sought to quantify spatial variability in heat-related morbidity in Brisbane, Australia, to highlight regions of the city with the greatest risk. We also aimed to find area-level social and environmental determinants of high risk within Brisbane. Methods: We used a series of hierarchical Bayesian models to examine city-wide and intracity associations between temperature and morbidity using a 2007–2011 time series of geographically referenced hospital admissions data. The models accounted for long-term time trends, seasonality, and day of week and holiday effects. Results: On average, a 10°C increase in daily maximum temperature during the summer was associated with a 7.2% increase in hospital admissions (95% CI: 4.7, 9.8%) on the following day. Positive statistically significant relationships between admissions and temperature were found for 16 of the city’s 158 areas; negative relationships were found for 5 areas. High-risk areas were associated with a lack of high income earners and higher population density. Conclusions: Geographically targeted public health strategies for extreme heat may be effective in Brisbane, because morbidity risk was found to be spatially variable. Emergency responders, health officials, and city planners could focus on short- and long-term intervention measures that reach communities in the city with lower incomes and higher population densities, including reduction of urban heat island effects.

Effects of driver familiarity and prolonged or intermittent right-side failure on level crossing safety

This paper investigates the adverse effects of familiarity and human factors issues associated with the reliability of low-cost warning devices at level crossings. The driving simulator study featured a repetitive, low workload, monotonous driving task in which there were no failures of the level crossing (control) or prolonged or intermittent right-side failures (where the device reverts to a safe failure mode). The results of the experiment provided mixed support for the familiarity hypothesis. Four of the 23 participants collided with the train when it first appeared on trial 10 but safety margins increased from the first train to the next presentation of a train (trial 12). Contrary to expectations, the safety margins decreased with repeated right-side failure only for the intermittent condition. The limited head movement data showed that participants in the prolonged failure condition were more likely to turn their head to check for trains in the right-side failure trials than in earlier trials where there was no signal and no train. Few control participants turned their head to check for trains when no signal was presented. This research highlights the need to consider repetitive tasks and workload in experimental design and accident investigation at railway level crossings.