Prevalence of active foot disease and foot disease risk factors in a subacute inpatient rehabilitation facility: a cross-sectional prevalence study

Background Australian subacute inpatient rehabilitation facilities face significant challenges from the ageing population and the increasing burden of chronic disease. Foot disease complications are a negative consequence of many chronic diseases. With the rapid expansion of subacute rehabilitation inpatient services, it seems imperative to investigate the prevalence of foot disease and foot disease risk factors in this population. The primary aim of this cross-sectional study was to determine the prevalence of active foot disease and foot disease risk factors in a subacute inpatient rehabilitation facility. Methods Eligible participants were all adults admitted at least overnight into a large Australian subacute inpatient rehabilitation facility over two different four week periods. Consenting participants underwent a short non-invasive foot examination by a podiatrist utilising the validated Queensland Health High Risk Foot Form to collect data on age, sex, medical co-morbidity history, foot disease risk factor history and clinically diagnosed foot disease complications and foot disease risk factors. Descriptive statistics were used to determine the prevalence of clinically diagnosed foot disease complications, foot disease risk factors and groups of foot disease risk factors. Logistic regression analyses were used to investigate any associations between defined explanatory variables and appropriate foot disease outcome variables. Results Overall, 85 (88%) of 97 people admitted to the facility during the study periods consented; mean age 80 (±9) years and 71% were female. The prevalence (95% confidence interval) of participants with active foot disease was 11.8% (6.3 – 20.5), 32.9% (23.9 – 43.5) had multiple foot disease risk factors, and overall, 56.5% (45.9 – 66.5) had at least one foot disease risk factor. A self-reported history of peripheral neuropathy diagnosis was independently associated with having multiple foot disease risk factors (OR 13.504, p = 0.001). Conclusion This study highlights the potential significance of the burden of foot disease in subacute inpatient rehabilitation facilities. One in eight subacute inpatients were admitted with active foot disease and one in two with at least one foot disease risk factor in this study. It is recommended that further multi-site studies and management guidelines are required to address the foot disease burden in subacute inpatient rehabilitation facilities. Keywords: Subacute; Inpatient; Foot; Complication; Prevalence

Analyzing busway station potential capacity under mixed stopping and non-stopping operation

Busway stations are the interface between passengers and services. The station is crucial to line operation as it is typically the only location where buses can pass each other. Congestion may occur here when buses manoeuvring into and out of the platform lane interfere with bus flow, or when a queue of buses forms upstream of the platform lane blocking the passing lane. Further, some systems include operation where express buses do not observe the station, resulting in a proportion of non-stopping buses. It is important to understand the operation of the station under this type of operation and its effect on busway capacity. This study uses microscopic simulation to treat the busway station operation and to analyse the relationship between station potential capacity where all buses stop, and Mixed Potential Capacity where there is a mixture of stopping and non-stopping buses. First, the micro simulation technique is used to analyze the All Stopping Buses (ASB) scenario and then statistical model is tuned and calibrated for a specified range of controlled scenarios of dwell time characteristics Subsequently, a mathematical model is developed for Mixed Stopping Buses (MSB) Potential Capacity by introducing different proportions of express (or non-stopping) buses. The proposed models for a busway station bus capacity provide a better understanding of operation and are useful to transit agencies in busway planning, design and operation.

Analysing busway station capacity under mixed stopping and non-stopping operation

Busway stations are the interface between passengers and services. The station is crucial to line operation as it is typically the only location where buses can pass each other. Congestion may occur here when buses manoeuvring into and out of the platform lane interfere with bus flow, or when a queue of buses forms upstream of the platform lane blocking the passing lane. Further, some systems include operation where express buses do not observe the station, resulting in a proportion of non-stopping buses. It is important to understand the operation of the station under this type of operation and its effect on busway capacity. This study uses microscopic simulation to treat the busway station operation and to analyse the relationship between station potential capacity where all buses stop, and Mixed Potential Capacity where there is a mixture of stopping and non-stopping buses. First, the micro simulation technique is used to analyze the All Stopping Buses (ASB) scenario and then statistical model is tuned and calibrated for a specified range of controlled scenarios of dwell time characteristics Subsequently, a mathematical model is developed for Mixed Stopping Buses (MSB) Potential Capacity by introducing different proportions of express (or non-stopping) buses. The proposed models for a busway station bus capacity provide a better understanding of operation and are useful to transit agencies in busway planning, design and operation.

A call for better care: the impact of postnatal contact services on women’s parenting confidence and experiences of postpartum care in Queensland, Australia

Background Universal postnatal contact services are provided in several Australian states, but their impact on women’s postnatal care experience has not been evaluated. Furthermore, there is lack of evidence or consensus about the optimal type and amount of postpartum care after hospital discharge for maternal outcomes. This study aimed to assess the impact of providing Universal Postnatal Contact Service (UPNCS) funding to public birthing facilities in Queensland, Australia on women’s postnatal care experiences, and associations between amount and type (telephone or home visits) of contact on parenting confidence, and perceived sufficiency and quality of postnatal care. Methods Data collected via retrospective survey of postnatal women (N = 3,724) were used to compare women who birthed in UPNCS-funded and non-UPNCS-funded facilities on parenting confidence, sufficiency of postnatal care, and perceived quality of postnatal care. Associations between receiving telephone and home visits and the same outcomes, regardless of UPNCS funding, were also assessed. Results Women who birthed in an UPNCS-funded facility were more likely to receive postnatal contact, but UPNCS funding was not associated with parenting confidence, or perceived sufficiency or perceived quality of care. Telephone contact was not associated with parenting confidence but had a positive dose–response association with perceived sufficiency and quality. Home visits were negatively associated with parenting confidence when 3 or more were received, had a positive dose–response association with perceived sufficiency and were positively associated with perceived quality when at least 6 were received. Conclusions Funding for UPNCS is unlikely to improve population levels of maternal parenting confidence, perceived sufficiency or quality of postpartum care. Where only minimal contact can be provided, telephone may be more effective than home visits for improving women’s perceived sufficiency and quality of care. Additional service initiatives may be needed to improve women’s parenting confidence.

"It broke our hearts": Understanding parents' lived experiences of their child's admission to an acute mental health care facility

This article reports the evaluative findings of an Early Psychosis Education Program (EPEP) designed to support parents caring for their child who was recently admitted to the psychiatric intensive care unit of an inpatient mental health care facility in Australia. The EPEP offered education on mental illness, treatment options, and medication, as well as information on the recovery model of care. The EPEP was facilitated by two RNs and was evaluated for educational effectiveness using a simple pre- and postevaluation questionnaire. The evaluation revealed two themes expressed by parents: "We didn't see it coming," and "Hopelessness and helplessness." The themes highlighted the parents' lack of mental health care knowledge prior to the EPEP, which had a significant impact on the parents' experiences and well-being. The evaluative findings highlighted a need for a nurse-led EPEP within the community. A community EPEP has the potential to strengthen the partnership between parents, families, and mental health service providers and to help with the provision of a recovery framework of care.

Report on Red Light Camera Program: Operation from July 1988 to December 1989

EXECUTIVE SUMMARY (excerpts) The red light camera (RLC) program commenced in July 1988, with five cameras operating at 15 sites in metropolitan Adelaide. This report deals with the first eighteen months of operation, to December 1989. A number of recommendations have been made… PROGRAM EVALUATION … In 1989 dollars, the program was estimated to have achieved an accident reduction benefit of $1.4m in the first 12 months of operation, which is almost twice the benefit expected using the assumptions made when selecting the sites. (There are 8 recommendations, mostly specific to the particular program characteristics)

Random Breath Testing Operation and Effectiveness in 1987

• In December 1986 funds were approved to double the intensity of random breath testing (RBT) and provide publicity support for police efforts. These changes were considered necessary to make RBT effective. • RBT methods were changed in the metropolitan area to enable block testing (pulling over a block of traffic rather than one or two cars), deployment of police to cut off escape routes, and testing by traffic patrols in all police subdivisions. Additional operators were trained for country RBT. • A publicity campaign was developed, aimed mainly at male drivers aged 18-50. The campaign consisted of the “cardsharp” television commercials, radio commercials, newspaper articles, posters and pamphlets. • Increased testing and the publicity campaigns were launched on 10 April 1987. • Police tests increased by 92.5% in May – December 1987, compared with the same period in the previous four years. • The detection rate for drinking drivers picked up by police who were cutting off escape routes was comparatively high, indicating that drivers were attempting to avoid RBT, and that this police method was effective at detecting these drivers. • A telephone survey indicated that drivers were aware of the messages of the publicity campaign. • The telephone survey also indicated that the target group had been exposed to high levels of RBT, as planned, and that fear of apprehension was the major factor deterring them from drink driving. • A roadside survey of driver blood alcohol concentrations (BACs) by the University of Adelaide’s Road Accident Research Unit (RARU) showed that, between 10p.m. and 3a.m., the proportion of drivers in Adelaide with a BAC greater than or equal to 0/08 decreased by 42%. • Drivers under 21 were identified as a possible problem area. • Fatalities in the twelve month period commencing May 1987 decreased by 18% in comparison with the previous twelve month period, and by 13% in comparison with the average of the previous two twelve month periods (commencing May 1985 and May 1986). There are indications that this trend is continuing. • It is concluded that the increase in RBT, plus publicity, was successful in achieving its aims of reductions in drink driving and accidents.

Random Breath Testing Operation and Effectiveness in 1985

Random breath testing (RBT) was introduced in South Australia in 1981 with the intention of reducing the incidence of accidents involving alcohol. In April 1985, a Select Committee of the Upper House which had been established to “review the operation of random breath testing in this State and any other associated matters and report accordingly” presented its report. After consideration of this report, the Government introduced extensive amendments to those sections of the Motor Vehicles Act (MVA) and Road Traffic Act (RTA) which deal with RBT and drink driving penalties. The amended section 47da of the RTA requires that: “(5) The Minister shall cause a report to be prepared within three months after the end of each calendar year on the operation and effectiveness of this section and related sections during that calendar year. (6) The Minister shall, within 12 sitting days after receipt of a report under subsection (5), cause copies of the report to be laid before each House of Parliament.” This is the first such report. Whilst it deals with RBT over a full year, the changed procedures and improved flexibility allowed by the revision to the RTA were only introduced late in 1985 and then only to the extent that the existing resources would allow.

Discovering behavioural interfaces for overloaded web services

The growth of APIs and Web services on the Internet, especially through larger enterprise systems increasingly being leveraged for Cloud and software-as-a-service opportuni- ties, poses challenges to improving the efficiency of integration with these services. Interfaces of enterprise systems are typically larger, more complex and overloaded, with single operation having multiple data entities and parameter sets, supporting varying requests, and reflecting versioning across different system releases, compared to fine-grained operations of contemporary interfaces. We propose a technique to support the refactoring of service interfaces by deriving business entities and their relationships. In this paper, we focus on the behavioural aspects of service interfaces, aiming to discover the sequential dependencies of operations (otherwise known as protocol extraction) based on the entities and relationships derived. Specifically, we propose heuristics according to these relationships, and in turn, deriving permissible orders in which operations are invoked. As a result of this, service operations can be refactored on business entity CRUD lines, with explicit behavioural protocols as part of an interface definition. This supports flexible service discovery, composition and integration. A prototypical implementation and analysis of existing Web services, including those of commercial logistic systems (Fedex), are used to validate the algorithms proposed through the paper.

How do customers of a financial services institution judge its communications

Communications are important for relationships within a marketing channel from both a theoretical and managerial perspective. Yet it is a problematic area for scholars. Thus, this research addresses the problem of how do customers of a financial services institution perceive communications with an ideal institution? This study's case research methodology used in-depth interviews with 34 carefully selected customers of a building society. The factors that make up customers' attitudes about corporate communications for an ideal financial services institution were identified and actual perceptions were compared against that ideal. The findings confirmed the importance of communications for customers in a relationship with a financial services provider and suggested communication priorities for customers in this context. In addition, the findings suggested sources of communication dissatisfaction for customers. These findings build upon the literature that speculates about customer perceptions of communications with organizations but provides little evidence to support hypotheses. The contributions arose from the emphasis on the customers' own attitudes and the patterns found within them.