Outcomes following inpatient rehabilitation : a seven year perspective

Introduction: Improving physical and cognitive functioning is a key objective of multi-disciplinary inpatient geriatric rehabilitation. Outcomes relevant to minimum functional ability required for older adults to successfully participate in the community have been reported. However, there has been little investigation reporting outcomes of older inpatients receiving multi-disciplinary rehabilitation being discharged home from geriatric rehabilitation units. This study aims to investigate characteristics and physical and cognitive outcomes of this cohort. Method: The Princess Alexandra Hospital Geriatric and Rehabilitation Unit is the largest rehabilitation unit in Queensland. Multidisciplinary health professionals enter admission and discharge functional and clinical outcomes along with demographic information into a purpose designed database for all patients. Data collected between 2005 and 2011 was analysed using descriptive statistics. Results: During the seven-year period, 4120 patients were admitted for rehabilitation; 2126 (52%) were female, mean age of 74 years (Standard Deviation 14). Primary reasons for admission were for reconditioning post medical illness or surgical admission (n = 1285, 31%), and 30% (n = 1233) admitted for orthopaedic reasons. Of these orthopaedic admissions, 6.6% (n = 82) were for elective surgery, and 46% (n = 565) were for fractured neck-of-femurs. 76% (n = 3130) of patients were discharged home, 13% (n = 552) to residential care facilities and 10% (n = 430) were discharged to an alternative hospital setting or passed away during their admission. Mean length of stay was 44 days (SD 39) Preliminary analysis of FIM outcomes shows a mean motor score of 53 (SD = 19) on admission which significantly improved to 71 (SD = 18) by discharge. There was no change on FIM cognitive score (28 (SD7) vs 29 (SD 6). Conclusion: Geriatric patients have significant functional limitations even on discharge from inpatient rehabilitation; though overall cognition is relatively intact. Orthopaedic conditions and general deconditioning from medical/surgical admissions are the main reasons for admission. The majority of people receiving rehabilitation are discharged home.

Outcomes following inpatient rehabilitation of lower limb amputees

Introduction: Lower-limb amputations are a serious adverse consequence of lifestyle related chronic conditions and a serious concern among the aging population in Australia. Lower limb amputations have severe personal, social and economic impacts on the individual, healthcare system and broader community. This study aimed to address a critical gap in the research literature by investigating the physical functioning and social characteristics of lower limb amputees at discharge from tertiary hospital inpatient rehabilitation. Method: A cohort study was implemented among patients with lower limb amputations admitted to a Geriatric Assessment and Rehabilitation Unit for rehabilitation at a tertiary hospital. Conventional descriptive statistics were used to examine patient demographic, physical functioning and social living outcomes recorded for patients admitted between 2005 and 2011. Results: A total of 423 admissions occurred during the study period, 313 (74%) were male. This sample included admissions for left (n = 189, 45%), right (n = 220, 52%) and bilateral (n = 14, 3%) lower limb amputations, with 15 (3%) patients dying whilst an inpatient. The mean (standard deviation) age was 65 (13.9) years. Amputations attributed to vascular causes accounted for 333 (78%) admissions; 65 (15%) of these had previously had an amputation. The mean (SD) length of stay in the rehabilitation unit was 56 (42) days. Prior to this admission, 123 (29%) patients were living alone, 289 (68%) were living with another and 3 (0.7%) were living in residential care. Following this amputation related admission, 89 (21%) patients did not return to their prior living situation. Of those admitted, 187 (44%) patients were discharged with a lower limb prosthesis. Conclusion: The clinical group is predominately older adults. The ratio of males to females was approximately 3:1. Over half did not return to walking and many were not able to return to their prior accommodation. However, few patients died during their admission.

Retirement villages : time for a change?

In retirement, many Australians relocate to a less onerous form of home occupation. Some downsize their house, or move to a strata title complex. Others, attracted by lifestyle perceptions, move into a retirement village. However, research shows Retirement Village documentation is complex and more analogous to commercial leasing than home ownership. The most recent government review by New South Wales, confirms the need for change. This paper identifies the current retirement village tenure models generally available in Australia. By comparing the various State/Territory systems the authors draw conclusions regarding the adoption of standardised documentation and uniform Australian Retirement Village legislation.

Managing intensified urban development and industrial uses in Qld : affected area notations

The Queensland government planning policies actively encourage increased dwelling density, sustainable infill development and transit oriented development to maximise land use and minimise urban sprawl. One of the detriments of such a policy is the potential for intensified residential development to create conflict between lawfully operating existing industrial uses and residences. In particular the government is concerned that intensified urban development will increase the risk of litigation from landowners and tenants detrimentally affected by the emission of aerosols, fumes, light, noise, odour, particles or smoke from existing industrial premises.

Self-proxy agreement and weekly school travel behaviour in a sectarian divided society

Proxy reports from parents and self-reported data from pupils have often been used interchangeably to identify factors influencing school travel behaviour. However, few studies have examined the validity of proxy reports as an alternative to self-reported data. In addition, despite research that has been conducted in a different context, little is known to date about the impact of different factors on school travel behaviour in a sectarian divided society. This research examines these issues using 1624 questionnaires collected from four independent samples (e.g. primary pupils, parent of primary pupils, secondary pupils, and parent of secondary pupils) across Northern Ireland. An independent sample t test was conducted to identify the differences in data reporting between pupils and parents for different age groups using the reported number of trips for different modes as dependent variables. Multivariate multiple regression analyses were conducted to then identify the impacts of different factors (e.g. gender, rural–urban context, multiple deprivations, and school management type, net residential density, land use diversity, intersection density) on mode choice behaviour in this context. Results show that proxy report is a valid alternative to self-reported data, but only for primary pupils. Land use diversity and rural–urban context were found to be the most important factors in influencing mode choice behaviour.

Ironmongeries life cycle costing and quality satisfaction

Most commonly, residents are always arguing about the satisfaction of sustainability and quality of their high rise residential property. This paper aim is to maintain the best quality satisfaction of the door hardware by introducing the whole life cycle costing approach to the property manager of the public housing in Johor. This paper looks into the current situation of ironmongeries (door hardware) of 2 public housings in Johor, Malaysia and testing the whole life cycle costing approach towards them. The calculation and the literature review are conducted. The questionnaire surveys of 2 public housings were conducted to make clear the occupants’ evaluation about the actual quality conditions of the ironmongeries in their house. As a result, the quality of door hardware based on the whole life cycle costing approach is one of the best among their previous decision making tool that have been applied. Practitioners can benefit from this paper as it provides information on calculating the whole life costing and making the decisions about ironmongeries selection of their properties.

Whole life cycle costing and quality satisfaction : public housing floor material

Most commonly, residents are always arguing about the satisfaction of sustainability and quality of their high rise residential property. This paper aim is to maintain the best quality satisfaction of the floor materials by introducing the whole life cycle costing approach to the property manager of the public housing in Johor. This paper looks into the current situation of floor material of two public housings in Johor, Malaysia and testing the whole life cycle costing approach towards them. The cost figures may be implemented to justify higher investments, for examples, in the quality or flexibility of building solutions through a long-term cost reduction. The calculation and the literature review are conducted. The questionnaire surveys of two public housings were conducted to make clear the occupants’ evaluation about the actual quality conditions of the floor material in their house. As a result, the quality of floor material based on the whole life cycle costing approach is one of the best among their previous decision making tool that was applied. Practitioners can benefit from this paper as it provides information on calculating the whole life costing and making the decisions for floor material selection for their properties.

Association between ambient ultraviolet radiation and risk of esophageal cancer

OBJECTIVES: Ecological studies have suggested an inverse relationship between latitude and risks of some cancers. However, associations between solar ultraviolet radiation (UVR) exposure and esophageal cancer risk have not been fully explored. We therefore investigated the association between nevi, freckles, and measures of ambient UVR over the life-course with risks of esophageal cancers. METHODS: We compared estimated lifetime residential ambient UVR among Australian patients with esophageal cancer (330 esophageal adenocarcinoma (EAC), 386 esophago-gastric junction adenocarcinoma (EGJAC), and 279 esophageal squamous cell carcinoma (ESCC)), and 1471 population controls. We asked people where they had lived at different periods of their life, and assigned ambient UVR to each location based on measurements from NASA's Total Ozone Mapping Spectrometer database. Freckling and nevus burden were self-reported. We used multivariable logistic regression models to estimate the magnitude of associations between phenotype, ambient UVR, and esophageal cancer risk. RESULTS: Compared with population controls, patients with EAC and EGJAC were less likely to have high levels of estimated cumulative lifetime ambient UVR (EAC odds ratio (OR) 0.59, 95% confidence interval (CI) 0.35-0.99, EGJAC OR 0.55, 0.34-0.90). We found no association between UVR and risk of ESCC (OR 0.91, 0.51-1.64). The associations were independent of age, sex, body mass index, education, state of recruitment, frequency of reflux, smoking status, alcohol consumption, and H. pylori serostatus. Cases with EAC were also significantly less likely to report high levels of nevi than controls. CONCLUSIONS: These data show an inverse association between ambient solar UVR at residential locations and risk of EAC and EGJAC, but not ESCC.

Chronological categorization and decomposition of customer loads

The majority of distribution utilities do not have accurate information on the constituents of their loads. This information is very useful in managing and planning the network, adequately and economically. Customer loads are normally categorized in three main sectors: 1) residential; 2) industrial; and 3) commercial. In this paper, penalized least-squares regression and Euclidean distance methods are developed for this application to identify and quantify the makeup of a feeder load with unknown sectors/subsectors. This process is done on a monthly basis to account for seasonal and other load changes. The error between the actual and estimated load profiles are used as a benchmark of accuracy. This approach has shown to be accurate in identifying customer types in unknown load profiles, and is used in cross-validation of the results and initial assumptions.

Exploring the effect of companion robots on emotional expression in older people with dementia : a pilot randomized controlled trial

This pilot study aimed to compare the effect of companion robots (PARO) to participation in an interactive reading group on emotions in people living with moderate to severe dementia in a residential care setting. A randomized crossover design, with PARO and reading control groups, was used. Eighteen residents with mid- to late-stage dementia from one aged care facility in Queensland, Australia, were recruited. Participants were assessed three times using the Quality of Life in Alzheimer’s Disease, Rating Anxiety in Dementia, Apathy Evaluation, Geriatric Depression, and Revised Algase Wandering Scales. PARO had a moderate to large positive influence on participants’ quality of life compared to the reading group. The PARO intervention group had higher pleasure scores when compared to the reading group. Findings suggest PARO may be useful as a treatment option for people with dementia; however, the need for a larger trial was identified.

Extreme architecture : can architects future proof us against fire and flood.

In the face of Australia’s disaster-prone environment, architects Ian Weir and James Davidson are reconceptualising how our residential buildings might become more resilient to fire, flood and cyclone. With their first-hand experience of natural disasters, James, director of Emergency Architects Australia (EAA), and Ian, one of Australia’s few ‘bushfire architects’, discuss the ways we can design with disaster in mind. Dr Ian Weir is one of Australia’s few ‘bushfire architects’. Exploring a holistic ‘ground up’ approach to bushfire where landscape, building design and habitation patterns are orchestrated to respond to site-specific fire characteristics. Ian’s research is developed through design studio teaching at QUT and through built works in Western Australia’s fire prone forests and heathlands.

Characterising metal build-up on urban road surfaces

Reliable approaches for predicting pollutant build-up are essential for accurate urban stormwater quality modelling. Based on the in-depth investigation of metal build-up on residential road surfaces, this paper presents empirical models for predicting metal loads on these surfaces. The study investigated metals commonly present in the urban environment. Analysis undertaken found that the build-up process for metals primarily originating from anthropogenic (copper and zinc) and geogenic (aluminium, calcium, iron and manganese) sources were different. Chromium and nickel were below detection limits. Lead was primarily associated with geogenic sources, but also exhibited a significant relationship with anthropogenic sources. The empirical prediction models developed were validated using an independent data set and found to have relative prediction errors of 12-50%, which is generally acceptable for complex systems such as urban road surfaces. Also, the predicted values were very close to the observed values and well within 95% prediction interval.

Determination of creep behaviour of concrete made by brick chips in Bangladesh

Concrete made of brick chips as coarse aggregate are extensively used in Bangladesh for construction of different types of structures from residential and commercial buildings to industrial complex. As creep is influenced among many factors including the constituents’ materials, relative humidity and temperature, it is essential to examine the creep behavior for Bangladeshi brick chips made concrete in Bangladeshi environment. In this work, investigation on the behaviour of creep in concrete of same grade made with brick chips collected from various locations under single stage loading was done. With these investigations, a formula was derived to get theoretical creep values for 24 MPa brick chips made concrete in Bangladeshi environment.

Inside the pleasure dome : cultural tourism on Australia’s Gold Coast

The City of the Gold Coast in Queensland, Australia, will host the Commonwealth Games in 2018. In advance of the Games, the City is beginning to reposition the traditional marketing programs that were based around the four S’s- ‘sun, sand, surf and sex.’ There is a new emphasis on urban sophistication, sport, science, education and the environment. At the same time, local communities are asking for renewed attention to residential issues, particularly relating to recognising the importance of culture to the region. In this paper I explore the development of integrated computer technologies (ICTs) as a way of linking tourism, culture and place in the experience economy of the Gold Coast. The discussion is framed by theories of the post-tourist, contemporary cultural tourism and the role of mobile technologies, and the figure of the ‘referential tourist.’ An examination of stakeholder responses to changing business and social frameworks on the Gold Coast shows how discussions about a range of issues coalesce around cultural tourism. Local communities have the opportunity to engage with the new tourist as they move quickly between leisure and cultural experiences, at once connected to tourist expectations but increasingly self-directed. The Surfers Paradise Nights campaign, which is based around social media, is a case in point. This campaign aims to interest visitors in becoming a part of a familiar third place, an online space, but one that will sustain an emotive connection to the physical location and events. The paper also draws on research carried out in Brisbane, Queensland, in relation to building connections between place and culture on designated, self-directed journeys via iPhone technology. Participant responses indicate the importance of narrative to developing cultural frameworks.

Numerical modelling and full scale testing of load bearing steel walls under real fires

Fire safety has become an important part in structural design due to the ever increasing loss of properties and lives during fires. Fire rating of load bearing wall systems made of Light gauge Steel Frames (LSF) is determined using fire tests based on the standard time-temperature curve given in ISO 834. However, modern residential buildings make use of thermoplastic materials, which mean considerably high fuel loads. Hence a detailed fire research study into the performance of load bearing LSF walls was undertaken using a series of realistic design fire curves developed based on Eurocode parametric curves and Barnett’s BFD curves. It included both full scale fire tests and numerical studies of LSF walls without any insulation, and the recently developed externally insulated composite panels. This paper presents the details of fire tests first, and then the numerical models of tested LSF wall studs. It shows that suitable finite element models can be developed to predict the fire rating of load bearing walls under real fire conditions. The paper also describes the structural and fire performances of externally insulated LSF walls in comparison to the non-insulated walls under real fires, and highlights the effects of standard and real fire curves on fire performance of LSF walls.