Nurses’ views on the implementation of Individualised Medication Administration Guides in patients with dysphagia in care homes

As conditions such as stroke, cancer, Parkinson's disease and Huntingdon's chorea are commonly found in care homes between 15% and 30% of residents in care homes have been found to have difficulties in swallowing their medicines.To address the difficulties associated with administering medicines to patients who cannot swallow (with dysphagia), Individualised Medication Administration Guides (I-MAGs) were introduced by a specialised pharmacist in Care for Elderly wards in a general hospital in East Anglia. The guides contained detailed information about how to administer each medication and they were individualised to the needs of the patient. The I-MAGs were printed in green forms and attached to the medication chart in order to be used in conjunction with it. The ward nurses reported an increase in their confidence when administering medication when I-MAGs were present in the ward. Some patients with I-MAG were discharged to care homes where the I-MAG might have been equally useful. However, the design of such guides is not known to be suitable for care homes environment where they have never been used before. This study aims to explore the opinions of nurses and carers within care homes on the relevance and acceptability of individualised medication administration guides for patients with dysphagia (PWD).

A study on the evolution of regional structure of foreign engineering consultation industry in China [我国对外工程咨询业区域结构演变研究]

Based on the construction industry of 27 province over the period of 1995-2008,this paper analyzes the evolution of regional structure of foreign engineering consultation industry.It is found that this industry translates weak overall strength,unbalanced regional structure to a more developed and balanced status,keeps pushing this change can improve the strength of our country’s engineering consultation industry,improve the international competition of construction.

Left on the side of the road? A review of deterrence-based theoretical developments in road safety

Deterrence-based initiatives form a cornerstone of many road safety countermeasures. This approach is informed by Classical Deterrence Theory, which proposes that individuals will be deterred from committing offences if they fear the perceived consequences of the act, especially the perceived certainty, severity and swiftness of sanctions. While deterrence-based countermeasures have proven effective in reducing a range of illegal driving behaviours known to cause crashes such as speeding and drink driving, the exact level of exposure, and how the process works, remains unknown. As a result the current study involved a systematic review of the literature to identify theoretical advancements within deterrence theory that has informed evidence-based practice. Studies that reported on perceptual deterrence between 1950 and June 2015 were searched in electronic databases including PsychINFO and ScienceDirect, both within road safety and non-road safety fields. This review indicated that scientific efforts to understand deterrence processes for road safety were most intense during the 1970s and 1980s. This era produced competing theories that postulated both legal and non-legal factors can influence offending behaviours. Since this time, little theoretical progression has been made in the road safety arena, apart from Stafford and Warr's (1993) reconceptualisation of deterrence that illuminated the important issue of punishment avoidance. In contrast, the broader field of criminology has continued to advance theoretical knowledge by investigating a range of individual difference-based factors proposed to influence deterrent processes, including: moral inhibition, social bonding, self-control, tendencies to discount the future, etc. However, this scientific knowledge has not been directed towards identifying how to best utilise deterrence mechanisms to improve road safety. This paper will highlight the implications of this lack of progression and provide direction for future research.

Preliminary work on the detection of partial discharges in SF6 under impulse voltages

This paper presents preliminary results of an investigation into the detection of partial discharges on the rise of impulse voltages from a point-to-plane gap in SF6. A parallel RC detection impedance is placed in the earth path of a point. Computer simulations are done to determine the values of R and C that will result in the smallest impulse voltage signal and the largest discharge signal across the detection impedance. These simulations and the experimental work show that the impulse voltage signal can not be sufficiently attenuated during the rise time of the applied voltage impulse using the RC detection impedance alone. An alternative discharge detection method is proposed in which a resonant partial discharge coupler is used. Elimination of noise and the impulse voltage signal can be achieved by shorting the coupler plate to the ground plane in the middle of the disk. However, due to the bandwidth of the measuring equipment and noise from the impulse generator it was not possible to detect discharges on the rising edge of a 1.5s voltage impulse using a coupler shorted in the middle. It was found that for this particular coupler, with no shorting points, and if the rising edge of the voltage impulse is longer than 5us, (10us) PD activity can be detected on the rising edge.

Pivotal people, pivotal journeys: Interim report on the impact of a fundraising study tour on CEOs and their organisations

A longitudinal qualitative study was conducted with CEOs of 12 fundraising organisations across Australia to answer the question - how mights a change in the CEO's fundraising knowledge improve fundraising activity and outcomes for their organisation? The CEOs along with the inaugural Australian Grantmaker of the Year, Caitriona Fay from Perpetual and lead researcher Dr Wendy Scaife travelled to San Antonio, Texas, USA to attend the annual Association of Fundraising Professionals (AFP) conference in March 2014. Participants identified five main success factors for such group learning initiatives about fundraising: - Getting away from the day to day business of running the organisation - Informal, social time to debrief and get to know others - Diversity of organisations whereby no one was in direct competition to others - Commitment, openness and willingness of individuals to participate - Group facilitation This research has been supported by the Perpetual Foundation – Trustees Endowment, The Edward Corbould Charitable Trust, and the Samuel and Eileen Gluyas Charitable Trust under the management of Perpetual Trustee Company Ltd.

Estimates on the coverage of parameter space using populations of models

In this paper we provide estimates for the coverage of parameter space when using Latin Hypercube Sampling, which forms the basis of building so-called populations of models. The estimates are obtained using combinatorial counting arguments to determine how many trials, k, are needed in order to obtain specified parameter space coverage for a given value of the discretisation size n. In the case of two dimensions, we show that if the ratio (Ø) of trials to discretisation size is greater than 1, then as n becomes moderately large the fractional coverage behaves as 1-exp-ø. We compare these estimates with simulation results obtained from an implementation of Latin Hypercube Sampling using MATLAB.

The effects of gas and air flow distributions on the performance of the Farleigh No. 3 boiler

As more raw sugar factories become involved in the manufacture of by-products and cogeneration, bagasse is becoming an increasingly valuable commodity. However, in most factories, most of the bagasse produced is used to generate steam in relatively old and inefficient boilers. Efficient bagasse fired boilers are a high capital cost item and the cost of supplying the steam required to run a sugar factory by other means is prohibitive. For many factories a more realistic way to reduce bagasse consumption is to increase the efficiency of existing boilers. The Farleigh No. 3 boiler is a relatively old low efficiency boiler. Like many in the industry, the performance of this boiler has been adversely affected by uneven gas and air flow distributions and air heater leaks. The combustion performance and efficiency of this boiler have been significantly improved by making the gas and air flow distributions through the boiler more uniform and repairing the air heater. The estimated bagasse savings easily justify the cost of the boiler improvements.

The impact of wall shear stress and pressure drop on the stability of the atherosclerotic plaque

Rupture of vulnerable atheromatous plaque in the carotid and coronary arteries often leads to stroke and heart attack respectively. The mechanism of blood flow and plaque rupture in stenotic arteries is still not fully understood. A three dimensional rigid wall model was solved under steady state conditions and unsteady conditions by assuming a time-varying inlet velocity profile to investigate the relative importance of axial forces and pressure drops in arteries with asymmetric stenosis. Flow-structure interactions were investigated for the same geometry and the results were compared with those retrieved with the corresponding 2D cross-section structural models. The Navier-Stokes equations were used as the governing equations for the fluid. The tube wall was assumed hyperelastic, homogeneous, isotropic and incompressible. The analysis showed that the three dimensional behavior of velocity, pressure and wall shear stress is in general very different from that predicted by cross-section models. Pressure drop across the stenosis was found to be much higher than shear stress. Therefore, pressure may be the more important mechanical trigger for plaque rupture other than shear stress, although shear stress is closely related to plaque formation and progression.

Laboratory investigation on the effects of overburden pressure, water, and time on slaking induced material property degradation of coal mine spoil

In open-cut strip mining, waste material is placed in-pit to minimise operational mine costs. Slope failures in these spoil piles pose a significant safety risk to personnel, along with a financial risk from loss of equipment and scheduling delays. It has been observed that most spoil pile failures occur when the pit has been previously filled with water and then subsequently dewatered. The failures are often initiated at the base of spoil piles where the material can undergo significant slaking (disintegration) over time due to overburden pressure and water saturation. It is important to understand how the mechanical properties of base spoil material are affected by slaking when designing safe spoil pile slope angles, heights, and dewatering rates. In this study, fresh spoil material collected from a coal mine in Brown Basin Coalfield of Queensland, Australia was subjected to high overburden pressure (0 – 900 kPa) under saturated condition and maintained over a period of time (0 – 6 months) allowing the material to slake. To create the above conditions, laboratory designed pressure chambers were used. Once a spoil sample was slaked under certain overburden pressure over a period of time, it was tested for classification, permeability, and strength properties. Results of this testing program suggested that the slaking of saturated coal mine spoil increase with overburden pressure and the time duration over which the overburden pressure was maintained. Further, it was observed that shear strength and permeability of spoil decreased with increase in spoil slaking.