Measurement of environmental constructs in disability assessment instruments

The International Classification of Functioning, Disability and Health (ICF) assumes a biopsychosocial basis for disability and provides a framework for understanding how environmental factors contribute to the experience of disability. To determine the utility of prevalent disability assessment instruments, the authors examined the extent to which a range of such instruments addressed the impact of environmental factors on the individual and whether the instruments designed for different disability groups focused differentially on the environment. Items from 20 widely used disability assessment instruments were linked to the five chapters of the ICF environment component using standardized classification rules. Nineteen of the 20 instruments reviewed measured the environment to varying degrees. It was determined that environmental factors from the Natural Environment and Attitudes chapters were not well accommodated by the majority of instruments. Instruments developed for people with intellectual disabilities had the greatest environmental coverage. Only one instrument provided a relatively comprehensive and economical account of environmental barriers. The authors conclude that ICF classification of environmental factors provides a valuable resource for evaluating the environmental content of existing disability-related instruments, and that it may also provide a useful framework for revising instruments in use and for developing future disability assessment instruments.

The classic white formal shirt : a powerful emblem of social change

The classic white formal shirt is a widely and readily familiar object with considerable historical cultural significance to diverse social groups, and is therefore deserving of iconic status. For more than two hundred years, this singular item of apparel has been able to define and represent status, wealth, gender shifts and fashion norms. This garment, which has historically been relinquished to undergarment status, deserves an escalation of standing. The classic white formal shirt, for both men and women, can be used as a mirror to map considerable social change and the diversity of influence can be traced through many examples, including: Beau Brummell’s dandy status with his legendry white shirting; the Gibson Girl with her decorated white shirt style blouse defining ideals of female beauty; IBM business employees in the 1920s marketing trustworthiness through the uniformity of white shirts; the fictional advertising creation of the Arrow Collar Man, with his rigid white shirt, promoting American masculine ideals; and the iconic 1980s Hugo Boss style crisp white dress shirt symbolising power. The origins of the influence of the white shirt can be best traced in the Victorian era where it was an important symbol of wealth and class distinction and a powerful emblem of sobriety and uniformity for men. The pure white colour fulfilled masculine ideals of resolute austerity and the shirt, through its constancy, epitomised conformity and dependability. For women, the white cloth of the ‘shirt-waist’ from this period was also linked to ideals of cleanliness and purity and was seen as an iconic symbol of the new independent working class woman. This paper will propose that the classic white formal shirt, for both men and women, has been a powerful marker of social shifts in Western society and this underrated item of apparel, with limited scholarly writing, is worthy of iconic status. The discussion will trace the historical development of both the men’s and women’s white shirt, each with their own unique history, and in doing so highlight the considerable historical cultural significance associated with the white formal shirt. Discussed first will be the men’s white formal shirt.

Cascaded DC-DC converter connection of photovoltaic modules

New residential scale photovoltaic (PV) arrays are commonly connected to the grid by a single dc-ac inverter connected to a series string of pv panels, or many small dc-ac inverters which connect one or two panels directly to the ac grid. This paper proposes an alternative topology of nonisolated per-panel dc-dc converters connected in series to create a high voltage string connected to a simplified dc-ac inverter. This offers the advantages of a "converter-per-panel" approach without the cost or efficiency penalties of individual dc-ac grid connected inverters. Buck, boost, buck-boost, and Cu´k converters are considered as possible dc-dc converters that can be cascaded. Matlab simulations are used to compare the efficiency of each topology as well as evaluating the benefits of increasing cost and complexity. The buck and then boost converters are shown to be the most efficient topologies for a given cost, with the buck best suited for long strings and the boost for short strings. While flexible in voltage ranges, buck-boost, and Cu´k converters are always at an efficiency or alternatively cost disadvantage.

Late Oligocene to Middle Miocene rifting and synextensional magmatism in the southwestern Sierra Madre Occidental, Mexico : the beginning of the Gulf of California rift

Although Basin and Range–style extension affected large areas of western Mexico after the Late Eocene, most consider that extension in the Gulf of California region began as subduction waned and ended ca. 14–12.5 Ma. A general consensus also exists in considering Early and Middle Miocene volcanism of the Sierra Madre Occidental and Comondú Group as subduction related, whereas volcanism after ca. 12.5 Ma is extension related. Here we present a new regional geologic study of the eastern Gulf of California margin in the states of Nayarit and Sinaloa, Mexico, backed by 43 new Ar-Ar and U-Pb mineral ages, and geochemical data that document an earlier widespread phase of extension. This extension across the southern and central Gulf Extensional Province began between Late Oligocene and Early Miocene time, but was focused in the region of the future Gulf of California in the Middle Miocene. Late Oligocene to Early Miocene rocks across northern Nayarit and southern Sinaloa were affected by major approximately north-south– to north-northwest– striking normal faults prior to ca. 21 Ma. Between ca. 21 and 11 Ma, a system of north-northwest–south-southeast high angle extensional faults continued extending the southwestern side of the Sierra Madre Occidental. Rhyolitic domes, shallow intrusive bodies, and lesser basalts were emplaced along this extensional belt at 20–17 Ma. Rhyolitic rocks, in particular the domes and lavas, often show strong antecrystic inheritance but only a few Mesozoic or older xenocrysts, suggesting silicic magma generation in the mid-upper crust triggered by an extension induced basaltic infl ux. In northern Sinaloa, large grabens were occupied by huge volcanic dome complexes ca. 21–17 Ma and filled by continental sediments with interlayered basalts dated as 15–14 Ma, a stratigraphy and timing very similar to those found in central Sonora (northeastern Gulf of California margin). Early to Middle Miocene volcanism occurred thus in rift basins, and was likely associated with decompression melting of upper mantle (inducing crustal partial melting) rather than with fluxing by fluids from the young and slow subducting microplates. Along the eastern side of the Gulf of California coast, from Farallón de San Ignacio island offshore Los Mochis, Sinaloa, to San Blas, Nayarit, a strike distance of >700 km, flat lying basaltic lavas dated as ca. 11.5–10 Ma are exposed just above the present sea level. Here crustal thickness is almost half that in the unextended core of the adjacent Sierra Madre Occidental, implying signifi cant lithosphere stretching before ca. 11 Ma. This mafic pulse, with subdued Nb-Ta negative spikes, may be related to the detachment of the lower part of the subducted slab, allowing an upward asthenospheric flow into an upper mantle previously modified by fluid fluxes related to past subduction. Widespread eruption of very uniform oceanic island basalt–like lavas occurred by the late Pliocene and Pleistocene, only 20 m.y. after the onset of rifting and ~9 m.y. after the end of subduction, implying that preexisting subduction-modified mantle had now become isolated from melt source regions. Our study shows that rifting across the southern-central Gulf Extensional Province began much earlier than the Late Miocene and provided a fundamental control on the style and composition of volcanism from at least 30 Ma. We envision a sustained period of lithospheric stretching and magmatism during which the pace and breadth of extension changed ca. 20–18 Ma to be narrower, and again after ca. 12.5 Ma, when the kinematics of rifting became more oblique.

Buckling experiments on hollow flange beams with web stiffeners

The hollow flange beam (HFB) is a new cold-formed and resistance-welded section developed in Australia. Due to its unique geometry comprising two stiff triangular flanges and a slender web, the HFB is susceptible to a lateral-distortional buckling mode of failure involving web distortion. Investigation using finite-element analyses showed that the use of transverse web plate stiffeners effectively eliminated lateral-distortional buckling of HFBs and thus any associated reduction in flexural capacity. A detailed experimental investigation was then carried out to validate the results from the finite-element analysis and to improve the stiffener configuration further. This led to the development of a special stiffener that is screw-fastened to the flanges on alternate sides of the web. This paper presents the details of the experimental investigations, the results, and the final stiffener arrangement whereas the details of the finite-element analyses are presented in a companion paper.

Evolving progress in oncologic and operative outcomes for esophageal and junctional cancer : lessons from the experience of a high-volume center

Objective: Modern series from high-volume esophageal centers report an approximate 40% 5-year survival in patients treated with curative intent and postoperative mortality rates of less than 4%. An objective analysis of factors that underpin current benchmarks within high-volume centers has not been performed. Methods: Three time periods were studied, 1990 to 1998 (period 1), 1999 to 2003 (period 2), and 2004 to 2008 (period 3), in which 471, 254, and 342 patients, respectively, with esophageal cancer were treated with curative intent. All data were prospectively recorded, and staging, pathology, treatment, operative, and oncologic outcomes were compared. Results: Five-year disease-specific survival was 28%, 35%, and 44%, and in-hospital postoperative mortality was 6.7%, 4.4%, and 1.7% for periods 1 to 3, respectively (P < .001). Period 3, compared with periods 1 and 2, respectively, was associated with significantly (P < .001) more early tumors (17% vs 4% and 6%), higher nodal yields (median 22 vs 11 and 18), and a higher R0 rate in surgically treated patients (81% vs 73% and 75%). The use of multimodal therapy increased (P < .05) across time periods. By multivariate analysis, age, T stage, N stage, vascular invasion, R status, and time period were significantly (P < .0001) associated with outcome. Conclusions: Improved survival with localized esophageal cancer in the modern era may reflect an increase of early tumors and optimized staging. Important surgical and pathologic standards, including a higher R0 resection rate and nodal yields, and lower postoperative mortality, were also observed. Copyright © 2012 by The American Association for Thoracic Surgery.

Exposure to ambient heat and urolithiasis among outdoor workers in Guangzhou, China

Objectives: To assess the impact of exposure to ambient heat on urolithiasis among outdoor workers in a subtropical city of China. Methods: The 2003–2010 health check data of a shipbuilding company in Guangzhou, China were acquired. 190 cases and 760 matched controls were involved in this study. We assessed the relationship between exposure to ambient heat and urolithiasis for different occupations using conditional logistic regression. Results: Spray painters were most likely to develop urolithiasis (OR = 4.4; 95% CI: 1.7, 11.4), followed by smelter workers (OR = 4.0; 95% CI: 1.8, 9.2), welders (OR = 3.7; 95% CI: 1.9, 7.2), production security and quality inspectors (OR = 2.7; 95% CI: 1.4, 3.0), and assemblers (OR = 2.2; 95% CI: 1.1, 4.3). Overall, outdoor workers were more likely to present with urolithiasis compared with indoor employees (p b 0.05). In addition, workers with longer cumulative exposure time (OR = 1.5; 95% CI: 1.2, 1.8) and abnormal blood pressure (OR = 1.6; 95% CI: 1.0, 2.5) had higher risk for urolithiasis. Conclusions: Our findings demonstrate a significant association between exposure to ambient heat and urolithiasis among outdoor working populations. Public health intervention strategies should be developed to specifically target outdoor occupations.

The role of desire in understanding intentions to drink responsibly : an application of the model of goal-directed behaviour

This study models young people's moderate drinking decision-making using the Model of Goal-Directed Behaviour (MGB), thus presenting insights into young people's desires and intentions to drink responsibly. Testing the applicability of the MGB to quantitatively analyse responsible drinking, the explanatory sphere of the MGB is extended. An online survey resulted in 1522 completed questionnaires from respondents aged between 18 and 25 years. Collected data were analysed with structural equation modelling (SEM) using SPSS AMOS21 (IBM, New York, NY, USA) software. The key finding of this study is that an individual's desire to drink moderately is the most important predictor of young people's responsible drinking intentions. Our use of MGB provides further evidence that there is a strong distinction between consumer desires and intentions.

Supine to standing Cobb Angle change in idiopathic scoliosis: The effect of endplate preselection

Introduction Standing radiographs are the ‘gold standard’ for clinical assessment of adolescent idiopathic scoliosis (AIS), with the Cobb Angle used to measure the severity and progression of the scoliotic curve. Supine imaging modalities can provide valuable 3D information on scoliotic anatomy, however, due to changes in gravitational loading direction, the geometry of the spine alters between the supine and standing position which in turn affects the Cobb Angle measurement. Previous studies have consistently reported a 7-10° [1-3] Cobb Angle increase from supine to standing, however, none have reported the effect of endplate pre-selection and which (if any) curve parameters affect the supine to standing Cobb Angle difference. Methods Female AIS patients with right-sided thoracic major curves were included in the retrospective study. Clinically measured Cobb Angles from existing standing coronal radiographs and fulcrum bending radiographs [4] were compared to existing low-dose supine CT scans taken within 3 months of the reference radiograph. Reformatted coronal CT images were used to measure Cobb Angle variability with and without endplate pre-selection (end-plates selected on the radiographs used on the CT images). Inter and intra-observer measurement variability was assessed. Multi-linear regression was used to investigate whether there was a relationship between supine to standing Cobb Angle change and patient characteristics (SPSS, v.21, IBM, USA). Results Fifty-two patients were included, with mean age of 14.6 (SD 1.8) years; all curves were Lenke Type 1 with mean Cobb Angle on supine CT of 42° (SD 6.4°) and 52° (SD 6.7°) on standing radiographs. The mean fulcrum bending Cobb Angle for the group was 22.6° (SD 7.5°). The 10° increase from supine to standing is consistent with existing literature. Pre-selecting vertebral endplates was found to increase the Cobb Angle difference by a mean 2° (range 0-9°). Multi-linear regression revealed a statistically significant relationship between supine to standing Cobb Angle change with: fulcrum flexibility (p=0.001), age (p=0.027) and standing Cobb Angle (p<0.001). In patients with high fulcrum flexibility scores, the supine to standing Cobb Angle change was as great as 20°.The 95% confidence intervals for intra-observer and inter-observer measurement variability were 3.1° and 3.6°, respectively. Conclusion There is a statistically significant relationship between supine to standing Cobb Angle change and fulcrum flexibility. Therefore, this difference can be considered a measure of spinal flexibility. Pre-selecting vertebral endplates causes only minor changes.

Do children and adolescents with Down syndrome have deficits in motivation?

There appears to be a general acceptance that individuals with intellectual disability (ID) have deficits in motivation. Yet research with infants and young children has usually identified few differences in motivation for children with ID compared with those of the same mental age who are developing typically. Studies of motivation in children with ID in the middle years of childhood or adolescence are almost non-existent. However, research conducted more than 30 years ago (Harter & Zigler, 1974) continues to be cited as evidence of motivational deficits in those with ID even though the life experiences of people with ID have changed dramatically since that time.

Beyond blue gene: Intellectual property and bioinformatics

This article considers the challenges posed to intellectual property law by the emerging field of bioinformatics. It examines the intellectual property strategies of established biotechnology companies, such as Celera Genomics, and information technology firms entering into the marketplace, such as IBM. First this paper argues that copyright law is not irrelevant to biotechnology, as some commentators would suggest. It claims that the use of copyright law and contract law is fundamental to the protection of biomedical and genomic databases. Second this article questions whether biotechnology companies are exclusively interested in patenting genes and genetics sequences. Recent evidence suggests that biotechnology companies and IT firms are patenting bioinformatics software and Internet business methods, as well as underlying instrumentation such as microarrays and genechips. Finally, this paper evaluates what impact the privatisation of bioinformatics will have on public research and scientific communication. It raises important questions about integration, interoperability, and the risks of monopoly. It finally considers whether open source software such as the Ensembl Project and peer to peer technology like DSAS will be able to counter this trend of privatisation.

Low delta18O zircon grains in the Neoarchean Rum Jungle Complex, northern Australia: An indicator of emergent continental crust

The timing of widespread continental emergence is generally considered to have had a dramatic effect on the hydrological cycle, atmospheric conditions, and climate. New secondary ion mass spectrometry (SIMS) oxygen and laser-ablation–multicollector–inductively coupled plasma–mass spectrometry (LA-MC-ICP-MS) Lu-Hf isotopic results from dated zircon grains in the granitic Neoarchean Rum Jungle Complex provide a minimum time constraint on the emergence of continental crust above sea level for the North Australian craton. A 2535 ± 7 Ma monzogranite is characterized by magmatic zircon with slightly elevated δ18O (6.0‰–7.5‰ relative to Vienna standard mean ocean water [VSMOW]), consistent with some contribution to the magma from reworked supracrustal material. A supracrustal contribution to magma genesis is supported by the presence of metasedimentary rock enclaves, a large population of inherited zircon grains, and subchondritic zircon Hf (εHf = −6.6 to −4.1). A separate, distinct crustal source to the same magma is indicated by inherited zircon grains that are dominated by low δ18O values (2.5‰–4.8‰, n = 9 of 15) across a range of ages (3536–2598 Ma; εHf = −18.2 to +0.4). The low δ18O grains may be the product of one of two processes: (1) grain-scale diffusion of oxygen in zircon by exchange with a low δ18O magma or (2) several episodes of magmatic reworking of a Mesoarchean or older low δ18O source. Both scenarios require shallow crustal magmatism in emergent crust, to allow interaction with rocks altered by hydrothermal meteoric water in order to generate the low δ18O zircon. In the first scenario, assimilation of these altered rocks during Neoarchean magmatism generated low δ18O magma with which residual detrital zircons were able to exchange oxygen, while preserving their U-Pb systematics. In the second scenario, wholesale melting of the altered rocks occurred in several distinct events through the Mesoarchean, generating low δ18O magma from which zircon crystallized. Ultimately, in either scenario, the low δ18O zircons were entrained as inherited grains in a Neoarchean granite. The data suggest operation of a modern hydrological cycle by the Neoarchean and add to evidence for the increased emergence of continents by this time

A new multi-objective model to optimise rail transport scheduler

The sugarcane transport system plays a critical role in the overall performance of Australia’s sugarcane industry. An inefficient sugarcane transport system interrupts the raw sugarcane harvesting process, delays the delivery of sugarcane to the mill, deteriorates the sugar quality, increases the usage of empty bins, and leads to the additional sugarcane production costs. Due to these negative effects, there is an urgent need for an efficient sugarcane transport schedule that should be developed by the rail schedulers. In this study, a multi-objective model using mixed integer programming (MIP) is developed to produce an industry-oriented scheduling optimiser for sugarcane rail transport system. The exact MIP solver (IBM ILOG-CPLEX) is applied to minimise the makespan and the total operating time as multi-objective functions. Moreover, the so-called Siding neighbourhood search (SNS) algorithm is developed and integrated with Sidings Satisfaction Priorities (SSP) and Rail Conflict Elimination (RCE) algorithms to solve the problem in a more efficient way. In implementation, the sugarcane transport system of Kalamia Sugar Mill that is a coastal locality about 1050 km northwest of Brisbane city is investigated as a real case study. Computational experiments indicate that high-quality solutions are obtainable in industry-scale applications.

An operational-level multi-stage mine production timetabling model for optimally synchronising drilling, blasting and excavating operations

This paper proposes a new multi-stage mine production timetabling (MMPT) model to optimise open-pit mine production operations including drilling, blasting and excavating under real-time mining constraints. The MMPT problem is formulated as a mixed integer programming model and can be optimally solved for small-size MMPT instances by IBM ILOG-CPLEX. Due to NP-hardness, an improved shifting-bottleneck-procedure algorithm based on the extended disjunctive graph is developed to solve large-size MMPT instances in an effective and efficient way. Extensive computational experiments are presented to validate the proposed algorithm that is able to efficiently obtain the near-optimal operational timetable of mining equipment units. The advantages are indicated by sensitivity analysis under various real-life scenarios. The proposed MMPT methodology is promising to be implemented as a tool for mining industry because it is straightforwardly modelled as a standard scheduling model, efficiently solved by the heuristic algorithm, and flexibly expanded by adopting additional industrial constraints.

Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue Following Stroke practice guidelines, update 2015

Every year, approximately 62 000 people with stroke and transient ischemic attack are treated in Canadian hospitals, and the evidence suggests one-third or more will experience vascular-cognitive impairment, and/or intractable fatigue, either alone or in combination. The 2015 update of the Canadian Stroke Best Practice Recommendations: Mood, Cognition and Fatigue Module guideline is a comprehensive summary of current evidence-based recommendations for clinicians in a range of settings, who provide care to patients following stroke. The three consequences of stroke that are the focus of the this guideline (poststroke depression, vascular cognitive impairment, and fatigue) have high incidence rates and significant impact on the lives of people who have had a stroke, impede recovery, and result in worse long-term outcomes. Significant practice variations and gaps in the research evidence have been reported for initial screening and in-depth assessment of stroke patients for these conditions. Also of concern, an increased number of family members and informal caregivers may also experience depressive symptoms in the poststroke recovery phase which further impact patient recovery. These factors emphasize the need for a system of care that ensures screening occurs as a standard and consistent component of clinical practice across settings as stroke patients transition from acute care to active rehabilitation and reintegration into their community. Additionally, building system capacity to ensure access to appropriate specialists for treatment and ongoing management of stroke survivors with these conditions is another great challenge.