The STRATIFY tool and clinical judgment were poor predictors of falling in an acute hospital setting

Objective: To compare the effectiveness of the STRATIFY falls tool with nurses’ clinical judgments in predicting patient falls. Study Design and Setting: A prospective cohort study was conducted among the inpatients of an acute tertiary hospital. Participants were patients over 65 years of age admitted to any hospital unit. Sensitivity, specificity, and positive predictive value (PPV) and negative predictive values (NPV) of the instrument and nurses’ clinical judgments in predicting falls were calculated. Results: Seven hundred and eighty-eight patients were screened and followed up during the study period. The fall prevalence was 9.2%. Of the 335 patients classified as being ‘‘at risk’’ for falling using the STRATIFY tool, 59 (17.6%) did sustain a fall (sensitivity50.82, specificity50.61, PPV50.18, NPV50.97). Nurses judged that 501 patients were at risk of falling and, of these, 60 (12.0%) fell (sensitivity50.84, specificity50.38, PPV50.12, NPV50.96). The STRATIFY tool correctly identified significantly more patients as either fallers or nonfallers than the nurses (P50.027). Conclusion: Considering the poor specificity and high rates of false-positive results for both the STRATIFY tool and nurses’ clinical judgments, we conclude that neither of these approaches are useful for screening of falls in acute hospital settings.

Consumers' accounts of perceived risk online and the influence of communication sources

The purpose of this paper is to extend marketing knowledge into perceived risk in online transactions beyond the current positivistic, hypotheses-driven research by providing qualitative insights into how individuals construct their accounts of perceived risk online. Additionally, the study reported in this paper aims to explore how communication sources influence both these subjective constructions and individuals' behavioural experiences with transaction activity on the web. Design/methodology/approach - The study was developed within a grounded theory method.Ten in-depth interviews were conducted which were analysed using constant comparison of incidents procedures to provide rich descriptions of the interviewees' subjective perceptions and lived experiences with online transaction activity. Findings - The findings provide insights into how the human clement is present in individuals'perceptions and constructions of their accounts of the risk involved online.The findings also identify the influence of mass communication sources on the construction of these accounts. The study provides insights into whether change agent communication sources, such as marketers or web designers,influence consumers' behaviours towards online transaction activity through mediating their perceptions of the risks involved. The study also reveals how social communication networks influence the interviewees' decisions to use the web (or transaction activities, in particular online purchasing, and how the group in this study might act as a communication source to influence others. Research limitations/Implications - While the findings cannot be generalised to the internet population overall, the sample used was able to provide relevant information regarding the phenomenon of interest. Future research should continue to examine perceived risk and the influence of communications sources, such as e-mail, discussion groups and virtual communities. Originality/value - The value of the paper lies in permitting the participants to account for perceived risk for themselves. The findings ex.plore what this means at increasing levels of personal relevance and the influence of communication sources to create, sustain or mediate perceptions of this phenomenon.

New media policies

This chapter explores the influence of economic ideas on media policies, particularly the work of John Maynard Keynes, Joseph Schumpeter and Karl Marx. It critically appraises the development of new media policies, and arguments that neo-liberal principles have been the primary driver of such policies.

The S.T.A.B. Trial - Standardised Testing of Artificial Blood. A comparative study of various products that may be used as artificial blood for high fidelity simulation training in the critical care setting

Aim: In the current climate of medical education, there is an ever-increasing demand for and emphasis on simulation as both a teaching and training tool. The objective of our study was to compare the realism and practicality of a number of artificial blood products that could be used for high-fidelity simulation. Method: A literature and internet search was performed and 15 artificial blood products were identified from a variety of sources. One product was excluded due to its potential toxicity risks. Five observers, blinded to the products, performed two assessments on each product using an evaluation tool with 14 predefined criteria including color, consistency, clotting, and staining potential to manikin skin and clothing. Each criterion was rated using a five-point Likert scale. The products were left for 24 hours, both refrigerated and at room temperature, and then reassessed. Statistical analysis was performed to identify the most suitable products, and both inter- and intra-rater variability were examined. Results: Three products scored consistently well with all five assessors, with one product in particular scoring well in almost every criterion. This highest-rated product had a mean rating of 3.6 of 5.0 (95% posterior Interval 3.4-3.7). Inter-rater variability was minor with average ratings varying from 3.0 to 3.4 between the highest and lowest scorer. Intrarater variability was negligible with good agreement between first and second rating as per weighted kappa scores (K = 0.67). Conclusion: The most realistic and practical form of artificial blood identified was a commercial product called KD151 Flowing Blood Syrup. It was found to be not only realistic in appearance but practical in terms of storage and stain removal.

Raman spectroscopic study of the magnesium carbonate minerals– artinite and dypingite

Magnesium minerals are important in the understanding of the concept of geosequestration. The two hydrated hydroxy magnesium carbonate minerals artinite and dypingite have been studied by Raman spectroscopy. Intense bands are observed at 1092 cm-1 for artinite and at 1120 cm-1 for dypingite attributed CO32- ν1 symmetric stretching mode. The CO32- ν3 antisymmetric stretching vibrations are extremely weak and are observed at1412 and 1465 cm-1 for artinite and at 1366, 1447 and 1524 cm-1 for dypingite. Very weak Raman bands at 790 cm-1 for artinite and 800 cm-1 for dypingite are assigned to the CO32- ν2 out-of-plane bend. The Raman band at 700 cm-1 of artinite and at 725 and 760 cm-1 of dypingite are ascribed to CO32- ν2 in-plane bending mode. The Raman spectrum of artinite in the OH stretching region is characterised by two sets of bands: (a) an intense band at 3593 cm-1 assigned to the MgOH stretching vibrations and (b) the broad profile of overlapping bands at 3030 and 3229 cm-1 attributed to water stretching vibrations. X-ray diffraction studies show the minerals are disordered. This is reflected in the difficulty of obtaining Raman spectra of reasonable quality and explains why the Raman spectra of these minerals have not been previously or sufficiently described.

Management of sharps in ambulance care : a state-wide survey of paramedic knowledge and reported practice

Paramedics are at high risk of exposure to infectious diseases because they frequently undertake procedures such as the use and disposal of sharps as components of everyday practice. While the literature demonstrates that the management of sharps is problematic across all health disciplines, there is a paucity of research examining sharps management practices in the Australian pre-hospital paramedic context. This study examines knowledge and practices of sharps control among paramedics in Queensland, Australia. A mail survey focusing on infection control knowledge and practices was sent to all clinical personnel of the Queensland Ambulance Service (QAS) (N = 2274). A total of 1258 surveys were returned, a response rate of 55.3%. Participants responded to 12 true/false statements on the management of sharps and three questions about recapping practices. Most respondents were knowledgeable about the correct management of sharps, with a mean of 11.28 (out of 12, SD = 1.32). When gauging reported practices, more than half (59.1%, n = 736) of participants reported recapping a needle, and 38.5% (n = 479) reported never having done so. These results reflect good knowledge of general management of sharps among respondents, but suggest deficits regarding reported practices. The results suggest that a comprehensive ambulance in-service education programme focusing particularly on sharps management is required. The study highlights the need for further research on sharps management practices in the field, identification of barriers to safe sharps practices in pre-hospital settings, and 'best practice' for translating good sharps management knowledge into practice.

Realising competitive advantage through HRM in New Zealand service industries

An emerging source of competitive advantage for service industries is the knowledge, skills and attitudes of their employees. Indeed, achievement of a 'service quality' culture, considered imperative for competitive advantage in service organisations, supposedly results from the use of best practice human resource management (HRM), and from a strategic approach to their implementation. This paper empirically explores the use of these dimensions of HRM as a source of competitive advantage. It finds high-performing service organisations actively engage best practices across the areas of recruitment and selection, training and development, communication and team working. Evidence of a strategic approach to the implementation of these practices is also found.

De-colonising Shakespeare? : Agency and (masculine) authority in Gregory Rogers's The Boy, The Bear, The Baron, The Bard

Underlying social space are territories, lands,geographical domains, the actual geographical underpinnings of the imperial, and also the cultural contest. To think about distant places, to colonize them, to populate or depopulate them: all of this occurs on, about, or because of land. […] Imperialism and the culture associated with it affirm both the primacy of geography and an ideology about control of territory.

Confirmatory factor analysis of the Way of Coping Checklist-Revised (WCCL-R) in the Asian context

Industrial employment growth has been one of the most dynamic areas of expansion in Asia; however, current trends in industrialised working environments have resulted in greater employee stress. Despite research showing that cultural values affect the way people cope with stress, there is a dearth of psychometrically established tools for use in non-Western countries to measure these constructs. Studies of the "Way of Coping Checklist-Revised" (WCCL-R) in the West suggest that the WCCL-R has good psychometric properties, but its applicability in the East is still understudied. A confirmatory factor analysis (CFA) is used to validate the WCCL-R constructs in an Asian population. This study used 1,314 participants from Indonesia, Sri Lanka, Singapore, and Thailand. An initial exploratory factor analysis revealed that original structures were not confirmed; however, a subsequent EFA and CFA showed that a 38-item, five-factor structure model was confirmed. The revised WCCL-R in the Asian sample was also found to have good reliability and sound construct and concurrent validity. The 38-item structure of the WCCL-R has considerable potential in future occupational stress-related research in Asian countries.

The role of product involvement in e-service evaluations

This paper provides conceptual and empirical insights into consumers’ evaluations of online services and their consequent behavioural intentions. We show that behavioural intentions in online contexts are driven primarily by two factors, namely online service satisfaction and perceived service quality. Perceived sacrifice and service quality are found to have an indirect effect on online service satisfaction through their influences on perceived value associated with the online service. In addition, we examine the moderating effects of product involvement and discuss the implications of our research findings.

Measuring school-related stressors in adolescents

Some 1620 high school students responded to 68 items that measure adolescent stressors. Thirty-five of the items were based on J. P. Kohn and G. H. Frazer's Academic Stress Scale [1(1986) An Academic Stress Scale: Identification and Rated Importance of Academic Stressors, Psychological Reports, Vol. 59, pp. 415–426] developed in the United States, while the remaining 33 items were developed from P. Strutynski's [(1985) A Survey of Queensland Year 10, 11 and 12 Student Attitudes to Schools and Schooling, State Planning Committee, International Youth Year, Brisbane] lists of the most frequently named problems of 2336 Australian high school students. Confirmatory Factor Analysis was used to test and develop a measurement model developed from an extensive review of previous scales. The High School Stressors Scale emerged from the analytic process and measures nine school-related stressors. For researchers focusing on school-related problems and stressors among adolescents, the HSSS promises to be a very useful instrument. It has sound construct and predictive validity and adequate reliability, as demonstrated by the goodness-of-fit indices the squared multiple correlations.

Cognitive behaviour therapy vs rational-emotive education : impact on children's self-talk, self-esteem and irrational beliefs

This study investigated the impact of Cognitive-Behavioural Therapy (CBT) and Rational~Emotive Education (REE) self-enhancement programs on children's self-talk, self-esteem and irrational beliefs. A total of 116 children (50.9% girls) with a mean age of 9.8 years attending Years 4 and 6 at two primary schools participated in the study. eBT resulted in a reduction in negative self-talk while REE seemed to enhance independence beliefs. Both programs were associated with increased positive self-talk and with having increased rationality in Conformity and Discomfort Intolerance beliefs.

Suicide and community psychiatric care

A preliminary survey of 34 suicides among patients attending community services for the chronically mentally ill revealed a rate of 520 per 100,000 admitted. In contrast to earlier hospital surveys, no risk variables were identified for patients dying by suicide. Thirty-four percent of suicides occurred within one week of the last treatment and 59% within 3 months of service entry. It appears that early and intensive follow-up may be necessary to prevent suicide among patients receiving community psychiatric care.