Fall risk factors and the nature of falls in inpatient oncology and palliative care settings

Using a prospective design, this study examined falls risk factors and the nature of patient falls in oncology and palliative care settings. Two hundred and twenty seven patients admitted to the oncology and palliative care units at a private hospital participated in this study. Of these, 34 patients had a fall and 193 patients did not have a fall. Twenty-four nurses who attended to patients who fell were interviewed. Findings revealed that, when compared to patients who did not fall, fallers had a significantly higher mean age; were assessed as more physically dependent using the Eastern Cooperative Oncology Group scale; were less alert and more confused; were more likely to have responded incorrectly to orientation to person, time and place; were weaker pre-fall in arm muscle strength; and were more fatigued. These factors are worthy of further exploration to determine whether they are more sensitive than the currently used falls risk factors used in oncology and palliative care settings.

A clinical nursing leadership model for enhancing continence care for older adults in a subacute inpatient care setting

This article describes the application and evaluation of a clinical nursing leadership model to enhance continence care in an inpatient rehabilitation setting for older adults. Multiple strategies were employed to optimize the uptake and sustainability of 3 practice initiatives: (1)  establishment of an enhanced role for wardbased nurses to provide clinical support to patients and other staff for the management of incontinence, (2) a new method for nursing assessment and management of bowel elimination, and (3) a framework for improved discharge care of patients with incontinence. Evaluation data indicated a high level of acceptance of the role of the ward-based continence resource nurses, improved assessment and management of bowel elimination, and enhanced discharge care for patients with incontinence. These initiatives were sustainable during a 2-year period after their introduction, despite the gradual withdrawal of the clinical leader.

User mobility prediction in hybrid and ad hoc wireless networks

Next Generation Networks will employ hybrid network architectures using both cellular and ad hoc networking concepts. The vision of real-time
multimedia services requires that mobility management be addressed in a proactive manner. If the user movements can be predicted accurately in a
hybrid network environment then handoff/cluster change, resource reservation and context transfer procedures can be efficiently completed as required by node mobility. In this work we propose a sectorized ad hoc mobility prediction scheme for cluster change prediction. Simulation study of the scheme shows it to be efficient in terms of prediction accuracy and prediction related control overhead despite randomness in user movement.

Mobility modelling and trajectory prediction for cellular networks with mobile base stations

This paper provides mobility estimation and prediction for a variant of GSM network which resembles an adhoc wireless mobile network where base stations and users are both mobile. We propose using Robust Extended Kalman Filter (REKF)as a location heading altitude estimator of mobile user for next node (mobile-base station)in order to improve the connection reliability and bandwidth efficiency of the underlying system. Through analysis we demonstrate that our algorithm can successfully track the mobile users with less system complexity as it requires either one or two closest mobile-basestation measurements. Further, the technique is robust against system uncertainties due to inherent deterministic nature in the mobility model. Through simulation, we show the accuracy and simplicity in implementation of our prediction algorithm.

Mobility prediction based routing for minimizing control overhead in mobile ad hoc networks

Routing in ad hoc networks faces significant challenges due to node mobility and dynamic network topology. In this work we propose the use of mobility prediction to reduce the search space required for route discovery. A method of mobility prediction making use of a sectorized cluster structure is described with the proposal of the Prediction based Location Aided routing (P-LAR) protocol. Simulation study and analytical results of the of P-LAR find it to offer considerable saving in the amount of routing traffic generated during the route discovery phase.

A review of current mobility prediction techniques for ad hoc networks

Next Generation Networks (3G & beyond) will support real-time multimedia applications through traditional wide-area networking concepts as well as hot-spot (WLAN) and ad hoc networking concepts. In order to fulfil the vision of Next Generation Networks a method of maintaining a real-time flow despite frequent topology changes and irregularity in user movement is required. Mobility Prediction has been identified as having applications in the areas of link availability estimation and pro-active routing in ad hoc networks. In this work we present an overview of current mobility prediction schemes that have been proposed. Simulation results are also presented.

Mobility prediction for seamless mobility in wireless networks

One of the requirements for seamless mobility is efficient resource reservation and context transfer procedures during handoff. If context transfer and resource reservation can occur prior to handoff continuation of the same level of service as at the previous connection point is possible. Resource reservation is required to be non-aggressive for optimal use of limited bandwidth and a low call-blocking probability. In this work we present a method of mobility prediction that can aid in achieving seamless mobility. In order to optimise the efficiency of a resource reservation algorithm we believe accurate prediction of the future movements of the user is required.

A review on current work in mobility prediction for wireless networks

The vision of next generation networks (4G & beyond) is to make possible seamless mobility across heterogeneous networks and to support real-time multimedia services. This would require intra/inter-domain handovers and service reconfiguration procedures to be completed with minimum latency. Mobility Prediction has been identified as a key abettor to this goal. The increasing ease of coupling between the mobile user and the network requires that a mobility prediction scheme that is to be deployed in next generation networks be capable of high levels of prediction accuracy despite randomness in user movement. In this work we have presented a survey on mobility prediction schemes that have been proposed for wireless networks. The results of our simulation study focused on the robustness of different schemes to randomness in user movement are also presented.

Rules and resources: a structuration approach to understanding the coordination of childrens`s inpatient health care

Aim. This paper presents findings from a multi-method study exploring the process of care coordination in children's inpatient health care.

Background. Existing work on care coordination is typified by 'black-box' type studies that measure inputs to and outcomes of care coordination roles and practices, without addressing the process of coordination.

Method. Using questionnaires, interviews and observation to collect data in multiple sites in the United Kingdom and Denmark between 1999 and 2005, the study gathered the perceptions of staff and compared these with observed practice. Giddens' structuration theory was used to provide an analytical and explanatory framework.

Findings. Current care coordination practice is diverse and inconsistent. It involves a wide range of clinical and non-clinical staff, many of whom perceive a lack of clarity about who should perform specific coordination activities. Staff draw upon a wide range of different material and non-material resources in coordinating care, the use of which is governed by largely tacit and informal rules.

Conclusions. Care coordination can be usefully conceptualized as a 'structurated' process – one that is continually produced and reproduced by staff using rules and resources to 'instantiate' or bring about care coordination through action. Potentially negative implications of this are manifested in diversity and inconsistency in care coordination practice. However, positive aspects such as the opportunity this provides to tailor care to the needs of the individual patient can be realized.

Route maintenance using mobility prediction for mobile ad hoc networks

Next generation networks (3G & beyond) will support real-time multimedia applications through traditional wide-area networking concepts as well as hot-spot (WLAN) and ad hoc networking concepts. In order to fulfill the vision of next generation networks a method of maintaining a real-time flow despite frequent topology changes and irregularity in user movement is required. Mobility prediction has been identified as having applications in the areas of link availability estimation and pro-active routing in ad hoc networks. In this work we present the mobility prediction based algorithm for route maintenance in mobile ad hoc networks. Simulation study of the algorithm proves it to offer significant benefits to dynamic source routing (DSR)