Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care

Dehydration has been associated with increased morbidity and mortality. Dehydration risk increases with advancing age, and will progressively become an issue as the aging population increases. Worldwide, those aged 60 years and over are the fastest growing segment of the population. The study aimed to develop a clinically practical means to identify dehydration amongst older people in the clinical care setting. Older people aged 60 years or over admitted to the Geriatric and Rehabilitation Unit (GARU) of two tertiary teaching hospitals were eligible for participation in the study. Ninety potential screening questions and 38 clinical parameters were initially tested on a single sample (n=33) with the most promising 11 parameters selected to undergo further testing in an independent group (n=86). Of the almost 130 variables explored, tongue dryness was most strongly associated with poor hydration status, demonstrating 64% sensitivity and 62% specificity within the study participants. The result was not confounded by age, gender or body mass index. With minimal training, inter-rater repeatability was over 90%. This study identified tongue dryness as a potentially practical tool to identify dehydration risk amongst older people in the clinical care setting. Further studies to validate the potential screen in larger and varied populations of older people are required

A discrete-trial approach to the functional analysis of aggressive behaviour in two boys with autism

Intervention to reduce challenging behaviour may be enhanced when based on a prior functional analysis. The present study describes a discrete-trial approach for the functional analysis of aggressive behaviour in two boys with autism. Twenty brief assessment trials were conducted in the classroom by the teacher under each of three conditions (i.e., attention, task and tangible). The results showed a clear pattern to each child's aggressive behaviour and suggested logical intervention strategies, although the study is limited because it involved only two children. The discrete-trial approach would appear to represent a practical and ecologically valid technique for conducting a functional analysis of challenging behaviour in applied settings

The costs arising from pressure ulcers attributable to malnutrition

Aim To estimate the economic consequences of pressure ulcers attributable to malnutrition. Method Statistical models were developed to predict the number of cases of pressure ulcer, associated bed days lost and the dollar value of these losses in public hospitals in 2002/2003 in Queensland, Australia. The following input parameters were specified and appropriate probability distributions fitted • Number of at risk discharges per annum • Incidence rate for pressure ulcer • Attributable fraction of malnutrition in the development of pressure ulcer • Independent effect of pressure ulcer on length of hospital stay • Opportunity cost of hospital bed day One thousand random re-samples were made and the results expressed as (output) probabilistic distributions. Results The model predicts a mean 16060 (SD 5 671) bed days lost and corresponding mean economic cost of AU$12 968 668 (SD AU$4 924 148) (EUROS 6 925 268 SD 2 629 495; US$ 7 288 391 SD 2 767 371) of pressure ulcer attributable to malnutrition in 2002/2003 in public hospitals in Queensland, Australia. Conclusion The cost of pressure ulcer attributable to malnutrition in bed days and dollar terms are substantial. The model only considers costs of increased length of stay associated with pressure ulcer and not other factors associated with care.

Age-related maculopathy : linking aetiology and pathophysiological changes to the ischaemia hypothesis

Age-related maculopathy (ARM) has remained a challenging topic with respect to its aetiology, pathomechanisms, early detection and treatment since the late 19th century when it was first described as its own entity. ARM was previously considered an inflammatory disease, a degenerative disease, a tumor and as the result of choroidal hemodynamic disturbances and ischaemia. The latter processes have been repeatedly suggested to have a key role in its development and progression. In vivo experiments under hypoxic conditions could be models for the ischaemic deficits in ARM. Recent research has also linked ARM with gene polymorphisms. It is however unclear what triggers a person's gene susceptibility. In this manuscript, a linking hypothesis between aetiological factors including ischaemia and genetics and the development of early clinicopathological changes in ARM is proposed. New clinical psychophysical and electrophysiological tests are introduced that can detect ARM at an early stage. Models of early ARM based upon hemodynamic, photoreceptor and post-receptoral deficits are described and the mechanisms by which ischaemia may be involved as a final common pathway are considered. In neovascular age-related macular degeneration (neovascular AMD), ischaemia is thought to promote release of vascular endothelial growth factor (VEGF) which induces chorioretinal neovascularisation. VEGF is critical in the maintenance of the healthy choriocapillaris. In the final section of the manuscript the documentation of the effect of new anti-VEGF treatments on retinal function in neovascular AMD is critically viewed.

A methodological approach to visceral hedonic rhetoric

One of the most important tasks as an industrial designer is to evoke specific affective responses via the creation of their designed products. This paper describes an investigation of visceral hedonic rhetoric through the study of interactive products. This research lays the foundation for this work by discussing the scope, significance and limitations of currently available research in the areas of visceral design, consumer hedonics and product rhetoric. Understanding why consumers respond to certain visceral hedonic rhetoric stimulus and what those stimuli are will provide further understanding into the field of emotional design. The study examines visceral hedonic responses given by consumers to three interactive products including mobile telephones, USB memory sticks and MP3 players. The methods used in this study will be discussed in further detail in this paper.

Multivariate methods to identify cancer-related symptom clusters

Multivariate methods are required to assess the interrelationships among multiple, concurrent symptoms. We examined the conceptual and contextual appropriateness of commonly used multivariate methods for cancer symptom cluster identification. From 178 publications identified in an online database search of Medline, CINAHL, and PsycINFO, limited to articles published in English, 10 years prior to March 2007, 13 cross-sectional studies met the inclusion criteria. Conceptually, common factor analysis (FA) and hierarchical cluster analysis (HCA) are appropriate for symptom cluster identification, not principal component analysis. As a basis for new directions in symptom management, FA methods are more appropriate than HCA. Principal axis factoring or maximum likelihood factoring, the scree plot, oblique rotation, and clinical interpretation are recommended approaches to symptom cluster identification.

Confidence to cook vegetables and the buying habits of Australian households

Cooking skills are emphasized in nutrition promotion but their distribution among population subgroups and relationship to dietary behavior is researched by few population-based studies. This study examined the relationships between confidence to cook, sociodemographic characteristics, and household vegetable purchasing. This cross-sectional study of 426 randomly selected households in Brisbane, Australia, used a validated questionnaire to assess household vegetable purchasing habits and the confidence to cook of the person who most often prepares food for these households. The mutually adjusted odds ratios (ORs) of lacking confidence to cook were assessed across a range of demographic subgroups using multiple logistic regression models. Similarly, mutually adjusted mean vegetable purchasing scores were calculated using multiple linear regression for different population groups and for respondents with varying confidence levels. Lacking confidence to cook using a variety of techniques was more common among respondents with less education (OR 3.30; 95% confidence interval [CI] 1.01 to 10.75) and was less common among respondents who lived with minors (OR 0.22; 95% CI 0.09 to 0.53) and other adults (OR 0.43; 95% CI 0.24 to 0.78). Lack of confidence to prepare vegetables was associated with being male (OR 2.25; 95% CI 1.24 to 4.08), low education (OR 6.60; 95% CI 2.08 to 20.91), lower household income (OR 2.98; 95% CI 1.02 to 8.72) and living with other adults (OR 0.53; 95% CI 0.29 to 0.98). Households bought a greater variety of vegetables on a regular basis when the main chef was confident to prepare them (difference: 18.60; 95% CI 14.66 to 22.54), older (difference: 8.69; 95% CI 4.92 to 12.47), lived with at least one other adult (difference: 5.47; 95% CI 2.82 to 8.12) or at least one minor (difference: 2.86; 95% CI 0.17 to 5.55). Cooking skills may contribute to socioeconomic dietary differences, and may be a useful strategy for promoting fruit and vegetable consumption, particularly among socioeconomically disadvantaged groups.

Australian student reactions to U.S. tourism advertising : a test of advertising as public diplomacy

A study among Australian college students gauged their reactions to a television commercial produced for the U.S. Commerce Department to bolster sagging tourism numbers among international visitors. In addition to using traditional measures applied to tourism advertisements, the student also concluded items to measure attitudes toward the U.S. government and its people Pre- and post-viewing results indicated that while the Hollywood-movie-themed commercial was not well received by the Australian students as a tourism message, it did result in more favorable attitudes toward the U.S. government, though not the U.S. people. The findings lend partial support for the potential of tourism advertising efforts to exert a "bleed-over effect" in terms of their contributions to overall attitudes toward a country, regardless of whether viewers plan to visit the country whose travel advertisements they see.

Australian student reactions to US tourism advertising : a test of advertising as public diplomacy

A study among Australian college students gauged their reactions to a television commercial produced for the US Commerce Department to bolster sagging tourism numbers among international visitors. In additional to using traditional measures applied to tourism advertisements, the study also included items to measure attitudes toward the US government and its people. Pre- and post-viewing results indicated that although the Hollywood-movie-themes commercial was not well received by the Australian students as a tourism message, it did result in more favourable attitudes toward the US government, although not the US people. The findings lend partial support for the potential of tourism advertising efforts to exert a 'bleed-over effect' in terms of their contribution to overall attitudes toward a country, regardless of whether viewers plan to visit the country whose travel advertisements of which they see.

Elastic lateral buckling of simply supported LiteSteel beams subject to transverse loading

The buckling strength of a new cold-formed hollow flange channel section known as LiteSteel beam (LSB) is governed by lateral distortional buckling characterised by simultaneous lateral deflection, twist and web distortion for its intermediate spans. Recent research has developed a modified elastic lateral buckling moment equation to allow for lateral distortional buckling effects. However, it is limited to a uniform moment distribution condition that rarely exists in practice. Transverse loading introduces a non-uniform bending moment distribution, which is also often applied above or below the shear centre (load height). These loading conditions are known to have significant effects on the lateral buckling strength of beams. Many steel design codes have adopted equivalent uniform moment distribution and load height factors to allow for these effects. But they were derived mostly based on data for conventional hot-rolled, doubly symmetric I-beams subject to lateral torsional buckling. The moment distribution and load height effects of transverse loading for LSBs, and the suitability of the current design modification factors to accommodate these effects for LSBs is not known. This paper presents the details of a research study based on finite element analyses on the elastic lateral buckling strength of simply supported LSBs subject to transverse loading. It discusses the suitability of the current steel design code modification factors, and provides suitable recommendations for simply supported LSBs subject to transverse loading.

Lateral buckling strength of simply supported LiteSteel beams subject to moment gradient effects

The flexural capacity of of a new cold-formed hollow flange channel section known as LiteSteel beam (LSB) is limited by lateral distortional buckling for intermediate spans, which is characterised by simultaneous lateral deflection, twist and web distortion. Recent research has developed suitable design rules for the member capacity of LSBs. However, they are limited to a uniform moment distribution that rarely exists in practice. Many steel design codes have adopted equivalent uniform moment distribution factors to accommodate the effect of non-uniform moment distributions in design. But they were derived mostly based on the data for conventional hot-rolled, doubly symmetric I-beams subject to lateral torsional buckling. The effect of moment distribution for LSBs, and the suitability of the current steel design code rules to include this effect for LSBs are not yet known. This paper presents the details of a research study based on finite element analyses of the lateral buckling strength of simply supported LSBs subject to moment gradient effects. It also presents the details of a number of LSB lateral buckling experiments undertaken to validate the results of finite element analyses. Finally, it discusses the suitability of the current design methods, and provides design recommendations for simply supported LSBs subject to moment gradient effects.

CTA1-DD is an effective adjuvant for targeting anti-chlamydial immunity to the murine genital mucosa

Chlamydia trachomatis is a significant human pathogen with potentially severe disease sequelae in the genital tract, including infertility. A successful vaccine will need to effectively target immunity to the genital mucosa. Intranasal immunisation with cholera toxin (CT) can target immunity to the genital tract, but has the potential to cause neurological side effects. CTA1-DD is a non-toxic potent mucosal adjuvant which combines the enzymatic properties of CT, with a B cell targeting moiety. Here, we demonstrate that intranasal immunisation with CTA1-DD and chlamydial Major Outer Membrane Protein (MOMP) results in the induction of neutralising systemic and mucosal antibodies, and reduces the level of chlamydial shedding following intravaginal challenge with Chlamydia muridarum. Thus, CTA1-DD is an effective adjuvant for vaccine development against Chlamydia trachomatis, and possibly also a range of other genital pathogens.

Leading indigenous education in a remote location : reflections on teaching to be "proud and deadly"

This thesis is a critical reflection of the author’s time as a Principal of an Indigenous state school from 2003-2004. The purpose is to reassess the impact of her principalship in terms of the staff, students and Community change that affected learning outcomes at the school and to reanalyse to what actions and to whom positive changes could be attributed. This thesis reflects and identifies, in light of the literature, strategies which were effective in enhancing student learning outcomes. The focus of this thesis was the Doongal State School*, its students, staff and facilities. The author will attempt to draw out theoretical frameworks in terms of: (1) what changed educationally in Doongal State School, (2) what seemed to be important in the Principal’s role, (3) the processes that took place, and (4) the effect of being non- Indigenous and a female. Overall, the author undertook this critical reflection in order to understand and embrace educational practices that will (a) lessen the gap between the academic outcomes achieved by Indigenous and non-Indigenous students, and (b) enhance life choices for Indigenous children. The findings indicate that principal leadership is critical for success in Indigenous schools and is the centrepiece of the models developed to explain improvement at Doongal State School. School factors, Principal Leadership factors, Change factors and factors relating to being a non-Indigenous female principal, which, when implemented, will lead to improved educational outcomes for Indigenous students, have evolved as a result of this thesis. Principal Leadership factors were found to be the enablers for the effective implementation of the key components for success.

Virtual mooting : using technology to enhance the mooting experience

While a range of benefits to students participating in mooting have been identified by the legal education literature, there are impediments to students participating in mooting that have been revealed by recent surveys of law students at QUT. These impediments include time, geographical location and a failure to perceive the benefits of mooting. This paper will explore the benefits of using technology to overcome these impediments, evaluate technological options to facilitate distance mooting, such as the use of Second Life, Elluminate and video conferencing, and will recommend a trial of these options.