The decline in activities of daily living at discharge (DADLD) index : stratifying patients at lower and higher risk

Background: Decreased ability to perform Activities of Daily Living (ADLs) during hospitalisation has negative consequences for patients and health service delivery. Objective: To develop an Index to stratify patients at lower and higher risk of a significant decline in ability to perform ADLs at discharge. Design: Prospective two cohort study comprising a derivation (n=389; mean age 82.3 years; SD� 7.1) and a validation cohort (n=153; mean age 81.5 years; SD� 6.1). Patients and setting: General medical patients aged = 70 years admitted to three university-affiliated acute care hospitals in Brisbane, Australia. Measurement and main results: The short ADL Scale was used to identify a significant decline in ability to perform ADLs from premorbid to discharge. In the derivation cohort, 77 patients (19.8%) experienced a significant decline. Four significant factors were identified for patients independent at baseline: 'requiring moderate assistance to being totally dependent on others with bathing'; 'difficulty understanding others (frequently or all the time)'; 'requiring moderate assistance to being totally dependent on others with performing housework'; a 'history of experiencing at least one fall in the previous 90 days prior to hospital admission' in addition to 'independent at baseline', which was protective against decline at discharge. 'Difficulty understanding others (frequently or all the time)' and 'requiring moderate assistance to being totally dependent on others with performing housework' were also predictors for patients dependent in ADLs at baseline. Sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of the DADLD dichotomised risk scores were: 83.1% (95% CI 72.8; 90.7); 60.5% (95% CI 54.8; 65.9); 34.2% (95% CI 27.5; 41.5); 93.5% (95% CI 89.2; 96.5). In the validation cohort, 47 patients (30.7%) experienced a significant decline. Sensitivity, specificity, PPV and NPV of the DADLD were: 78.7% (95% CI 64.3; 89.3); 69.8% (95% CI 60.1, 78.3); 53.6% (95% CI 41.2; 65.7); 88.1% (95% CI 79.2; 94.1). Conclusions: The DADLD Index is a useful tool for identifying patients at higher risk of decline in ability to perform ADLs at discharge.

Prediction of age at menopause from assessment of ovarian reserve may be improved by using body mass index and smoking status

Objective: Menopause is the consequence of exhaustion of the ovarian follicular pool. AMH, an indirect hormonal marker of ovarian reserve, has been recently proposed as a predictor for age at menopause. Since BMI and smoking status are relevant independent factors associated with age at menopause we evaluated whether a model including all three of these variables could improve AMH-based prediction of age at menopause. Methods: In the present cohort study, participants were 375 eumenorrheic women aged 19–44 years and a sample of 2,635 Italian menopausal women. AMH values were obtained from the eumenorrheic women. Results: Regression analysis of the AMH data showed that a quadratic function of age provided a good description of these data plotted on a logarithmic scale, with a distribution of residual deviates that was not normal but showed significant leftskewness. Under the hypothesis that menopause can be predicted by AMH dropping below a critical threshold, a model predicting menopausal age was constructed from the AMH regression model and applied to the data on menopause. With the AMH threshold dependent on the covariates BMI and smoking status, the effects of these covariates were shown to be highly significant. Conclusions: In the present study we confirmed the good level of conformity between the distributions of observed and AMH-predicted ages at menopause, and showed that using BMI and smoking status as additional variables improves AMH-based prediction of age at menopause.

Towards the development of a best practice index for the disclosure of organisations' climate change-related corporate governance practices

The aim of this study is to develop a disclosure guide for climate-change-related corporate governance (CCCG) practices. Drawing from existing climate change policy guidelines together with content analysis of leading Australian companies’ disclosure practices, we develop a best practice index for the disclosure of CCCG practises. The best practice index is further informed, validated and refined by the contribution of experts from a range of stakeholder groups. Our index represents the most comprehensive list generated to date, utilising experts’ opinions, in relation to CCCG disclosure practices. This CCCG disclosure index would be useful for companies seeking to provide information in relation their CCCG practices

Strategies for gaining and maintaining academic support for the institutional open access repository

The impact of research can be measured by use or citation count. The more widely available that research outputs are; the more likely they are to be used, and the higher the impact. Making the author-manuscript version of research outputs freely available via the institutional repository greatly increases the availability of research outputs and can increase the impact. QUT ePrints, the open access institutional repository of research outputs at Queensland University of Technology (QUT), Australia, was established in 2003 and is managed by the QUT Library. The repository now contains over 39,000 records. More than 21,000 of these records have full-text copies attached as result of continuous effort to maintain momentum and encourage academic engagement. The full-text deposit rate has continued to increase over time and, in 2012 (August, at the time of writing), 88% of the records for works published in 2012 provide access to a full-text copy. Achieving success has required a long term approach to collaboration, open access advocacy, repository promotion, support for the deposit process, and ongoing system development. This paper discusses the various approaches adopted by QUT Library, in collaboration with other areas of the University, to achieve success. Approaches include mainstreaming the repository via having it report to the University Research and Innovation Committee; regular provision of deposit rate data to faculties; championing key academic supporters; and holding promotional competitions and events such as during Open Access Week. Support and training is provided via regular deposit workshops with academics and faculty research support groups and via the provision of online self-help information. Recent system developments have included the integration of citation data (from Scopus and Web of Science) and the development of a statistical reporting system which incentivise engagement.

Overcoming organisational resistance to sustainability innovations in Australian universities

Sustainability is becoming a guiding paradigm to industries, businesses and our societies. Higher education institutions have the potential to take an active part in creating a sustainable future, due to their moral responsibility, social obligation, and their own needs to adapt to new circumstances. By either signing declarations or making public statements, many universities in Australia have expressed their desires to become role models for enhancing sustainability. However, universities in general have been slow to implement sustainability innovations, sometimes even lagging behind private sectors. Accordingly, there is pressing need to promote innovations on campus in order to drive universities’ sustainability goals. Existing seminal literature tend to focus on technological issues. There has been very little research examining the fundamental problems from an organizational perspective. To address the deficiency, the authors designed and carried out 24 semi-structured interviews to investigate the general organizational environment of Australian universities and to identify organizational resistance to sustainability innovations. Based on the data analysis, a set of strategies to reduce or overcome organizational resistance are explored and developed. The expected outcome of this research is to develop a genetic framework to facilitate supportive decision making for promoting sustainability innovations on campus, as a vital step towards achieving sustainability in universities on a practical level.

Creative city index [Report]

The CCI Creative City Index (CCI-CCI) is a new approach to the measurement and ranking of creative global cities. It is constructed over eight principal dimensions, each with multiple distinct elements. Some of these dimensions are familiar from other global city indexes, such as the MORI or GaWC indexes, which account for the size of creative industries, the scale of cultural amenities, or the flows of creative people and global connectedness. In addition to these indicators, the CCI-CCI contributes several new dimensions. These measure the demand side of creative participation, the attention economy, user-created content, and the productivity of socially networked consumers. Global creative cities can often seem alike, in respect of per-capita measures of factors such as public spending on cultural amenities, or the number of hotels and restaurants. This is to be expected when people and capital are relatively free to move, and where economic and political institutions are broadly comparable. However, we find that different cities can register far larger differences at the level of consumer-co-creation and especially digital creative ‘microproductivity’. To explain this finding, we review the logic and rationale of creative and global city index construction and present a review of previous and contemporary indexes. We set out the case for our new model of a creative city index by showing why greater attention to consumer co-creation and microproductivity are important, as well as examining how these factors have been previously overlooked. We show how we have CCI-CCI Creative City Index measured these additional factors and indicate the effect they have on creative and global city indexes. We then present the findings from a pilot study of six cities, two Australian, two German and two from the UK, to indicate how the new index is calculated and applied. Our results indicate much greater variance arising from the new arguments between cities.

Creative city index 2012 - Data sources, calculation methods and tools [Report spreadsheet]

Spreadsheet for Creative City Index 2012

Technological innovation and operational effectiveness : their role in achieving performance improvements

The purpose of this article is to examine the role of the alignment between technological innovation effectiveness and operational effectiveness after the implementation of enterprise information systems, and the impact of this alignment on the improvement in operational performance. Confirmatory factor analysis was used to examine structural relationships between the set of observed variables and the set of continuous latent variables. The findings from this research suggest that the dimensions stemming from technological innovation effectiveness such as system quality, information quality, service quality, user satisfaction and the performance objectives stemming from operational effectiveness such as cost, quality, reliability, flexibility and speed are important and significantly well-correlated factors. These factors promote the alignment between technological innovation effectiveness and operational effectiveness and should be the focus for managers in achieving effective implementation of technological innovations. In addition, there is a significant and direct influence of this alignment on the improvement of operational performance. The principal limitation of this study is that the findings are based on investigation of small sample size.

Ab initio studies of hydrogen desorption from low index magnesium hydride surface

The low index Magnesium hydride surfaces, MgH2(0 0 1) and MgH2(1 1 0), have been studied by ab intio Density Functional Theory (DFT) calculations. It was found that the MgH2(1 1 0) surface is more stable than MgH2(0 0 1) surface, which is in good agreement with the experimental observation. The H2 desorption barriers vary depending on the crystalline surfaces that are exposed and also the specific H atom sites involved – they are found to be generally high, due to the thermodynamic stability of the MgH2 system, and are larger for the MgH2(0 0 1) surface. The pathway for recombinative desorption of one in-plane and one bridging H atom from the MgH2(1 1 0) surface was found to be the lowest energy barrier amongst those computed (172 KJ/mol) and is in good agreement with the experimental estimates.

Bringing skills and general competences back into technological education

In this paper we show that industry-based student training is not limited to work experience; work integrated learning, internship or extended vacation work. It is also about bringing back the lost parts of technological education. We experience the unilateral focus on theoretical knowledge at the expense of skills and general competences as one important challenge in technological education. The lacking facilitation and training of practical skills and general competences in the curricula and programs are identified, but many institutions have failed to address the problem. Today’s curricula in many ways reduce technology to abstract concepts, calculations and models, and create a gap between the academic programs and the practical applications in the society. We explore two (Australia and Norway) initiatives on industry-based student training and discuss how these initiatives address and bridge the gap. We argue that these initiatives of industry-based student training contribute to bringing skills and general competences back into technological education, and that the effects are not limited to increased employability, but also include increased academic performance.

Employees' adoption of enterprise web 2.0 : the role of technological attributes

Although the adoption of Enterprise Web 2.0 within organisations is beneficial, it could meet with employees’ resistance and the adoption process can be lengthy. The successful implementation of Enterprise Web 2.0 is based on employee involvement and adoption of such social technology. This paper is part of a larger research project that explored the adoption of Web 2.0 by individuals within enterprises. Using a qualitative study, the findings show that there are number of adoption influences including technological, individual and contextual issues. This paper presents Web 2.0 technological attributes that influence its adoption. The found attributes are: friendliness, reliability, mobility, technical compatibility, discoverability, transparency and Web 2.0 type.

In the blink of an eye : the circadian effects on ocular and subjective indices of driver sleepiness

Driver sleepiness contributes substantially to fatal and severe crashes and the contribution it makes to less serious crashes is likely to as great or greater. Currently, drivers’ awareness of sleepiness (subjective sleepiness) remains a critical component for the mitigation of sleep-related crashes. Nonetheless, numerous calls have been made for technological monitors of drivers’ physiological sleepiness levels so drivers can be ‘alerted’ when approaching high levels of sleepiness. Several physiological indices of sleepiness show potential as a reliable metric to monitor drivers’ sleepiness levels, with eye blink indices being a promising candidate. However, extensive evaluations of eye blink measures are lacking including the effects that the endogenous circadian rhythm can have on eye blinks. To examine the utility of ocular measures, 26 participants completed a simulated driving task while physiological measures of blink rate and duration were recorded after partial sleep restriction. To examine the circadian effects participants were randomly assigned to complete either a morning or an afternoon session of the driving task. The results show subjective sleepiness levels increased over the duration of the task. The blink duration index was sensitive to increases in sleepiness during morning testing, but was not sensitive during afternoon testing. This finding suggests that the utility of blink indices as a reliable metric for sleepiness are still far from specific. The subjective measures had the largest effect size when compared to the blink measures. Therefore, awareness of sleepiness still remains a critical factor for driver sleepiness and the mitigation of sleep-related crashes.

Security and privacy in eHealth : is it possible? A sociotechnical analysis

Advances in Information and Communication Technologies have the potential to improve many facets of modern healthcare service delivery. The implementation of electronic health records systems is a critical part of an eHealth system. Despite the potential gains, there are several obstacles that limit the wider development of electronic health record systems. Among these are the perceived threats to the security and privacy of patients’ health data, and a widely held belief that these cannot be adequately addressed. We hypothesise that the major concerns regarding eHealth security and privacy cannot be overcome through the implementation of technology alone. Human dimensions must be considered when analysing the provision of the three fundamental information security goals: confidentiality, integrity and availability. A sociotechnical analysis to establish the information security and privacy requirements when designing and developing a given eHealth system is important and timely. A framework that accommodates consideration of the legislative requirements and human perspectives in addition to the technological measures is useful in developing a measurable and accountable eHealth system. Successful implementation of this approach would enable the possibilities, practicalities and sustainabilities of proposed eHealth systems to be realised.

Something’s coming, something good: Identifying TPACK competence in pre-service teachers’ analyses of learning objects

There is a song at the beginning of the musical, West Side Story, where the character Tony sings that “something’s coming, something good.” The song is an anthem of optimism, brimming with promise. This paper is about the long-held promise of information and communication technology (ICT) to transform teaching and learning, to modernise the learning environment of the classroom, and to create a new digital pedagogy. But much of our experience to date in the schooling sector tells more of resistance and reaction than revolution, of more of the same but with a computer in the corner and of ICT activities as unwelcome time-fillers/time-wasters. Recently, a group of pre-service teachers in a postgraduate primary education degree in an Australian university were introduced to learning objects in an ICT immersion program. Their analyses and related responses, as recorded in online journals, have here been interpreted in terms of TPACK (Technological Pedagogical and Content Knowledge). Against contemporary observation, these students generally displayed high levels of competence and highly positive dispositions of students to the integration of ICT in their future classrooms. In short, they displayed the same optimism and confidence as the fictional “Tony” in believing that something good was coming.