523 resultados para Brooklyn State Hospital


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The aim of this paper is to describe the prevalence and perceptions of pain and pain management amongst hospital in-patients. A cross-sectional descriptive survey of 205 patients was conducted. Presence and severity of pain was assessed using verbal descriptor and visual analogue scales, and perceptions of pain were assessed using multi-item scales. Although the severity of pain reported was consistent across age groups and clinical areas, women in the study sample were significantly more likely to report high levels of pain than men. Differences in how men and women communicate their pain were observed, with women indicating that they were less willing to ask for help with their pain. Results suggest that pain continues to be an important problem for a large number of men and women in hospital, and that the experience of pain impacts negatively upon their well-being. Gender differences in the experience of and response to pain remain important considerations for clinical nurses who have major responsibilities for the management of pain in hospitalized patients.

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Background & aims The Australasian Nutrition Care Day Survey (ANCDS) ascertained if malnutrition and poor food intake are independent risk factors for health-related outcomes in Australian and New Zealand hospital patients. Methods Phase 1 recorded nutritional status (Subjective Global Assessment) and 24-h food intake (0, 25, 50, 75, 100% intake). Outcomes data (Phase 2) were collected 90-days post-Phase 1 and included length of hospital stay (LOS), readmissions and in-hospital mortality. Results Of 3122 participants (47% females, 65 ± 18 years) from 56 hospitals, 32% were malnourished and 23% consumed ≤ 25% of the offered food. Malnourished patients had greater median LOS (15 days vs. 10 days, p < 0.0001) and readmissions rates (36% vs. 30%, p = 0.001). Median LOS for patients consuming ≤ 25% of the food was higher than those consuming ≤ 50% (13 vs. 11 days, p < 0.0001). The odds of 90-day in-hospital mortality were twice greater for malnourished patients (CI: 1.09–3.34, p = 0.023) and those consuming ≤ 25% of the offered food (CI: 1.13–3.51, p = 0.017), respectively. Conclusion The ANCDS establishes that malnutrition and poor food intake are independently associated with in-hospital mortality in the Australian and New Zealand acute care setting.

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One aim of the Australasian Nutrition Care Day Survey (ANCDS) was to explore dietary intake and nutritional status of acute care hospital patients. Dietitians from 56 hospitals in Australia and New Zealand completed a 24-hour nutritional status and dietary intake audit of 3000 adult patients. Participants were evaluated for nutritional risk using the Malnutrition Screening Tool (MST). Those ‘at risk’ underwent nutritional assessment using Subjective Global Assessment (SGA). Dietitians observed participants’ dietary intake at each main meal and recorded mid-meal intake via participant interviews. Intakes were recorded as 0%, 25%, 50%, 75%, or 100% of that offered for each meal during the 24-hour audit. Preliminary results for 1550 participants (males = 853; females = 697), age = 64 ± 17 years and BMI = 27 ± 7 kg/m2. Fifty-five percent (n = 853) of the participants had BMI > 25 kg/m2. The MST identified 41% (n = 636) ‘at risk’ for malnutrition. Of those ‘at risk’, 70% were assessed as malnourished resulting in an overall malnutrition prevalence of 30% (25% moderately malnourished, 5% severely malnourished). One-quarter of malnourished participants (n = 118) were on standard hospital diets without additional nutritional support. Fifty percent of malnourished patients (n = 235) and 40% of all patients (n = 620) had an overall 24-hour food consumption of ≤50% during the 24-hour audit. The ANCDS found that skeletons in the hospital closet continue to exist and that acute care patients continue to have suboptimal dietary intake. The ANCDS provides valuable insight into gaps in existing nutrition care practices.

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Raman spectroscopy, X-ray diffraction (XRD), and scanning electron microscopy (SEM) have been used to compare samples of YBa2Cu3O7 (YBCO) synthesised by the solid-state method and a novel co-precipitation technique. XRD results indicate that YBCO prepared by these two methods are phase pure, however the Raman and SEM results show marked differences between these samples.

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Well-designed initialisation and keystream generation processes for stream ciphers should ensure that each key-IV pair generates a distinct keystream. In this paper, we analyse some ciphers where this does not happen due to state convergence occurring either during initialisation, keystream generation or both. We show how state convergence occurs in each case and identify two mechanisms which can cause state convergence.

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In recent years, some models have been proposed for the fault section estimation and state identification of unobserved protective relays (FSE-SIUPR) under the condition of incomplete state information of protective relays. In these models, the temporal alarm information from a faulted power system is not well explored although it is very helpful in compensating the incomplete state information of protective relays, quickly achieving definite fault diagnosis results and evaluating the operating status of protective relays and circuit breakers in complicated fault scenarios. In order to solve this problem, an integrated optimization mathematical model for the FSE-SIUPR, which takes full advantage of the temporal characteristics of alarm messages, is developed in the framework of the well-established temporal constraint network. With this model, the fault evolution procedure can be explained and some states of unobserved protective relays identified. The model is then solved by means of the Tabu search (TS) and finally verified by test results of fault scenarios in a practical power system.

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This paper introduces a high-speed, 100Hz, visionbased state estimator that is suitable for quadrotor control in close quarters manoeuvring applications. We describe the hardware and algorithms for estimating the state of the quadrotor. Experimental results for position, velocity and yaw angle estimators are presented and compared with motion capture data. Quantitative performance comparison with state-of-the-art achievements are also presented.

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Efficient state asset management is crucial for governments as they facilitate the fulfillment of their public functions, which include the provision of essential services and other public administration support. In recent times economies internationally and particularly in South east Asia, have displayed increased recognition of the importance of efficiencies across state asset management law, policies and practice. This has been exemplified by a surge in notable instances of reform in state asset management. A prominent theme in this phenomenon is the consideration of governance principles within the re-conceptualization of state asset management law and related policy, with many countries recognizing variability in the quality of asset governance and opportunities for profit as being critical factors. This issue is very current in Indonesia where a major reform process in this area has been confirmed by the establishment of a new Directorate of State Asset Management. The incumbent Director-General of State Asset Management has confirmed a re-emphasis on adherence to governance principles within applicable state asset management law and policy reform. This paper reviews aspects of the challenge of reviewing and reforming Indonesian practice within state asset management law and policy specifically related to public housing, public buildings, parklands, and vacant land. A critical issue in beginning this review is how Indonesia currently conceptualizes the notion of asset governance and how this meaning is embodied in recent changes in law and policy and importantly in options for future change. This paper discusses the potential complexities uniquely Indonesian characteristics such as decentralisation and regional autonomy regime, political history, and bureaucratic culture.

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This study seeks to answer the question of “why is policy innovation in Indonesia, in particular reformed state asset management laws and regulations, stagnant?” through an empirical and qualitative approach, identifying and exploring potential impeding influences to the full and equal implementation of said laws and regulations. The policies and regulations governing the practice of state asset management has emerged as an urgent question among many countries worldwide (Conway, 2006; Dow, Gillies, Nichols, & Polen, 2006; Kaganova, McKellar, & Peterson, 2006; McKellar, 2006b) for there is heightened awareness of the complex and crucial role that state assets play in public service provision. Indonesia is an example of such country, introducing a ‘big-bang’ reform in state asset management laws, policies, regulations, and technical guidelines. Two main reasons propelled said policy innovation: a) world-wide common challenges in state asset management practices - such as incomplete information system, accountability, and governance adherence/conceptualisation (Kaganova, McKellar and Peterson 2006); and b) unfavourable state assets audit results in all regional governments across Indonesia. The latter reasoning is emphasised, as the Indonesian government admits to past neglect in ensuring efficiency and best practice in its state asset management practices. Prior to reform there was euphoria of building and developing state assets and public infrastructure to support government programs of the day. Although this euphoria resulted in high growth within Indonesia, there seems to be little attention paid to how state assets bought/built is managed. Up until 2003-2004 state asset management is considered to be minimal; inventory of assets is done manually, there is incomplete public sector accounting standards, and incomplete financial reporting standards (Hadiyanto 2009). During that time transparency, accountability, and maintenance state assets was not the main focus, be it by the government or the society itself (Hadiyanto 2009). Indonesia exemplified its enthusiasm in reforming state asset management policies and practices through the establishment of the Directorate General of State Assets in 2006. The Directorate General of State Assets have stressed the new direction that it is taking state asset management laws and policies through the introduction of Republic of Indonesia Law Number 38 Year 2008, which is an amended regulation overruling Republic of Indonesia Law Number 6 Year 2006 on Central/Regional Government State Asset Management (Hadiyanto, 2009c). Law number 38/2008 aims to further exemplify good governance principles and puts forward a ‘the highest and best use of assets’ principle in state asset management (Hadiyanto, 2009a). The methodology of this study is that of qualitative case study approach, with a triangulated data collection method of document analysis (all relevant state asset management laws, regulations, policies, technical guidelines, and external audit reports), semi-structured interviews, and on-site observation. Empirical data of this study involved a sample of four Indonesian regional governments and 70 interviews, performed during January-July 2010. The analytical approach of this study is that of thematic analysis, in an effort to identify common influences and/or challenges to policy innovation within Indonesia. Based on the empirical data of this study specific impeding influences to state asset management reform is explored, answering the question why innovative policy implementation is stagnant. An in-depth analysis of each influencing factors to state asset management reform, and the attached interviewee’s opinions for each factor, suggests the potential of an ‘excuse rhetoric’; whereby the influencing factors identified are a smoke-screen, or are myths that public policy makers and implementers believe in; as a means to explain innovative policy stagnancy. This study offers insights to Indonesian policy makers interested in ensuring the conceptualisation and full implementation of innovative policies, particularly, although not limited to, within the context of state asset management practices.

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With the explosion of Web 2.0 application such as blogs, social and professional networks, and various other types of social media, the rich online information and various new sources of knowledge flood users and hence pose a great challenge in terms of information overload. It is critical to use intelligent agent software systems to assist users in finding the right information from an abundance of Web data. Recommender systems can help users deal with information overload problem efficiently by suggesting items (e.g., information and products) that match users’ personal interests. The recommender technology has been successfully employed in many applications such as recommending films, music, books, etc. The purpose of this report is to give an overview of existing technologies for building personalized recommender systems in social networking environment, to propose a research direction for addressing user profiling and cold start problems by exploiting user-generated content newly available in Web 2.0.

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This study was undertaken as one of the first investigations of nurses' smoking habits in Longkou city, Shandong Province, China. An anonymous cross-sectional survey was administered as part of a larger investigation of healthcare professionals at a university teaching hospital during 2008. A total of 88 nurses responded to the survey, from whom tobacco-related data were provided by 83 of them (94%). Their overall smoking rate was very low (1%), with no male nurses reporting themselves to be current tobacco users. Overall, the current study suggests that smoking rates are very low among Chinese nurses in Longkou city, Shandong Province. These results are also consistent with studies of nurses' tobacco use conducted in other regions of China.

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A number of security models have been proposed for RFID systems. Recent studies show that current models tend to be limited in the number of properties they capture. Consequently, models are commonly unable to distinguish between protocols with regard to finer privacy properties. This paper proposes a privacy model that introduces previously unavailable expressions of privacy. Based on the well-studied notion of indistinguishability, the model also strives to be simpler, easier to use, and more intuitive compared to previous models.

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Advances in solid-state switches and power electronics techniques have led to the development of compact, efficient and more reliable pulsed power systems. This paper proposes an efficient scheme that utilizes modular switch-capacitor units in obtaining high voltage levels with fast rise time (dv/dt) using low voltage solid-state switches. The proposed pulsed power supply has flexibility in terms of controlling energy and generating broad range of voltage levels. The energy flow can be controlled as the stored energy can be adjusted by a current source utilized at the first stage of the system. Desirable voltage level can be obtained by connecting adequate number of switch-capacitor units. Moreover, the proposed topology is load independent. Therefore it can easily supply wide range of applications especially the low impedance ones. The effectiveness of the proposed approach is verified by simulations

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This article explores the role of principal leadership in creating a thinking school. It contributes to the school leadership literature by exploring the intersection of two important areas of study in education - school leadership and education for thinking - which is a particularly apt area of study, because effective school leadership is crucial if students are to learn to be critical and creative thinkers, yet this connection has not be widely investigated. We describe how one principal, Hinton, turned around an underperforming school by using critical and creative philosophical thinking as the focus for students, staff and parents. Then, drawing on the school leadership literature, the article describes seven attributes of school leadership beginning with four articulated by Leithwood and colleagues (2006) (building vision and setting direction; redesigning the organisation; understanding and developing people; managing the teaching and learning program), and adding three others (influence; self-development; and responding to context). This framework is then used in a case study format in a collaboration between practitioner and researchers to first explore evidence from empirical studies and personal reflection about Hinton's leadership of Buranda State School, and second to illuminate how these general features of school leadership apply to creating a thinking school. Based on the case study and using the general characteristics of school leadership, a framework for leading a thinking school is described. Because the framework is based on a turnaround school, this framework has wide applicability: to schools that are doing well as an indication of how to implement a contemporary approach to curriculum and pedagogy; and to schools that are underperforming and want a rigorous, high expectation and contemporary way to improve student learning.

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A number of security models have been proposed for RFID systems. Recent studies show that current models tend to be limited in the number of properties they capture. Consequently, models are commonly unable to distinguish between protocols with regard to finer privacy properties. This paper proposes a privacy model that introduces previously unavailable expressions of privacy. Based on the well-studied notion of indistinguishability, the model also strives to be simpler, easier to use, and more intuitive compared to previous models.