(S,N)-implications on bounded lattices

Since the birth of the fuzzy sets theory several extensions have been proposed. For these extensions, different sets of membership functions were considered. Since fuzzy connectives, such as conjunctions, negations and implications, play an important role in the theory and applications of fuzzy logics, these connectives have also been extended. An extension of fuzzy logic, which generalizes the ones considered up to the present, was proposed by Joseph Goguen in 1967. In this extension, the membership values are drawn from arbitrary bounded lattices. The simplest and best studied class of fuzzy implications is the class of (S,N)-implications, and in this chapter we provide an extension of (S,N)-implications in the context of bounded lattice valued fuzzy logic, and we show that several properties of this class are preserved in this more general framework.

Exploring in-hospital adverse drug events using ICD-10 codes

 Abstract
Objective Adverse drug events (ADEs) during hospital admissions are a widespread problem associated with adverse patient outcomes. The ‘external cause’ codes in the International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) provide opportunities for identifying the incidence of ADEs acquired during hospital stays that may assist in targeting interventions to decrease their occurrence. The aim of the present study was to use routine administrative data to identify ADEs acquired during hospital admissions in a suburban healthcare network in Melbourne, Australia.

Methods Thirty-nine secondary diagnosis fields of hospital discharge data for a 1-year period were reviewed for ‘diagnoses not present on admission’ and assigned to the Classification of Hospital Acquired Diagnoses (CHADx) subclasses. Discharges with one or more ADE subclass were extracted for retrospective analysis.

Results From 57 205 hospital discharges, 7891 discharges (13.8%) had at least one CHADx, and 402 discharges (0.7%) had an ADE recorded. The highest proportion of ADEs was due to administration of analgesics (27%) and systemic antibiotics (23%). Other major contributors were anticoagulation (13%), anaesthesia (9%) and medications with cardiovascular side-effects (9%).

Conclusion Hospital data coded in ICD-10 can be used to identify ADEs that occur during hospital stays and also clinical conditions, therapeutic drug classes and treating units where these occur. Using the CHADx algorithm on administrative datasets provides a consistent and economical method for such ADE monitoring.

What is known about the topic? Adverse drug events (ADEs) can result in several different physical consequences, ranging from allergic reactions to death, thereby posing a significant burden on patients and the health system. Numerous studies have compared manual, written incident reporting systems used by hospital staff with computerised automated systems to identify ADEs acquired during hospital admissions. Despite various approaches aimed at improving the detection of ADEs, they remain under-reported, as a result of which interventions to mitigate the effect of ADEs cannot be initiated effectively.

What does this paper add? This research article demonstrates major methodological advances over comparable published studies looking at the effectiveness of using routine administrative data to monitor rates of ADEs that occur during a hospital stay and reviews the type of ADEs and their frequency patterns during patient admission. It also provides an insight into the effect of ADEs that occur within different hospital treating units. The method implemented in this study is unique because it uses a grouping algorithm developed for the Australian Commission on Safety and Quality in Health Care (ACSQHC) to identify ADEs not present on admission from patient data coded in ICD-10. This algorithm links the coded external causes of ADEs with their consequences or manifestations. ADEs identified through the use of programmed code based on this algorithm have not been studied in the past and therefore this paper adds to previous knowledge in this subject area.

What are the implications for health professionals? Although not all ADEs can be prevented with current medical knowledge, this study can assist health professionals in targeting interventions that can efficiently reduce the rate of ADEs that occur during a hospital stay, and improve information available for future medication management decisions.

Distribution grid codes : opportunities and challenges

Traditional distribution networks were not originally designed to accommodate power generation facilities. The installation of distributed generation (DG) units with significatn capacity in these passive networks can cause reverse power flows which will result in some conflicts with the operation of the existing protection system. In this context, utilities around the world have started establishing requirements to ensure safe and reliable interconnection of generators in low- and medium-voltage networks. Grid interconnection is presently one of the most important issues involving DG. This paper presents a critical review of the requirements adopted by distribution companies in selected countries such as the USA, the UK, germany and Australia to facilitate the connection of DG. Critical issues such as voltage regulation, islanding operation, dynamic interactions among DG and loads are discussed to identify a few points where attention is still needed to improve the reliability of distribution systems

A cross-cultural construct of the ethos of the corporate codes of ethics: Australia, Canada and Sweden

The objective of this paper is to develop and describe a construct of the ethos of the corporate codes of ethics (i.e. an ECCE construct) across three countries, namely Australia, Canada and Sweden. The introduced construct is rather unique as it is based on a cross-cultural sample seldom seen in the literature. While the outcome of statistical analyses indicated a satisfactory factor solution and acceptable estimates of reliability measures, some research limitations have been stressed. They provide a foundation for further research in the field and testing of the ECCE construct in other cultural and corporate settings. We believe that the ECCE construct makes a contribution to theory and practice in the field as it outlines a theoretical construct for the benefit of other researchers. It is also of managerial interest as it provides a grounded framework of areas to be considered in the implementation in organizations of corporate codes of ethics.

A cross cultural comparison of the contents of codes of ethics: USA, Canada and Australia

This paper examines the contents of the codes of ethics of 83 of the top 500 companies operating in the private sector in Australia in an attempt to discover whether there are national characteristics that differentiate the codes used by companies operating in Australia from codes used by companies operating in the American and Canadian systems. The studies that were used as a comparison were Mathews (1987) for the United States of America and Lefebvre and Singh (1992) for Canada. The major conclusion is that, whilst Australian codes do have some characteristics that differentiate them from the other two groups, it appears that companies in all three cultures are driven by the same motives to develop codes.

Signs and codes in early childhood: An investigation of young children’s creative approaches to communication

PEOPLE COMMUNICATE AND MAKE meaning through the use of the signs, codes and rules of their community and its language/s. On the way to learning these signs, codes and rules, children often create or invent their own unique and sometimes temporary systems of meaning making. In this paper we use Vygotsky’s concept of semiotic mediation and Bernstein’s code theory to reflect on some examples of children’s creative approaches to communication that involved the creation and use of signs. We will argue that young language learners’ invention of their own languages and creative use of drawing as a form of sign creation are symbolic expressions of their intent to generate and reinforce desired social and cultural situations of learning. We conclude that individuals mediate social and individual functioning in order to make meaning of their world, and argue for a move away from viewing second language learning and emergent writing as static sets of abilities to a more dynamic interpretation.