Causes of injuries resulting in hospitalisation in Australia : assessing coder agreement on external causes

Objective: To assess extent of coder agreement for external causes of injury using ICD-10-AM for injury-related hospitalisations in Australian public hospitals. Methods: A random sample of 4850 discharges from 2002 to 2004 was obtained from a stratified random sample of 50 hospitals across four states in Australia. On-site medical record reviews were conducted and external cause codes were assigned blinded to the original coded data. Code agreement levels were grouped into the following agreement categories: block level, 3-character level, 4-character level, 5th-character level, and complete code level. Results: At a broad block level, code agreement was found in over 90% of cases for most mechanisms (eg, transport, fall). Percentage disagreement was 26.0% at the 3-character level; agreement for the complete external cause code was 67.6%. For activity codes, the percentage of disagreement at the 3-character level was 7.3% and agreement for the complete activity code was 68.0%. For place of occurrence codes, the percentage of disagreement at the 4-character level was 22.0%; agreement for the complete place code was 75.4%. Conclusions: With 68% agreement for complete codes and 74% agreement for 3-character codes, as well as variability in agreement levels across different code blocks, place and activity codes, researchers need to be aware of the reliability of their specific data of interest when they wish to undertake trend analyses or case selection for specific causes of interest.

Research Monograph: Constructing online collaborative environmental decision making systems

The use of computing to support environmental planning and the development of land use models dates back to the late 1950s. The main thrust of computing applications, which by the early 1980s increasingly included the use of geospatial technologies, is their contribution to better planning and decision making. The computing tools and technologies are designed to enhance the planners’ capability to deal with complex environments and to plan for prosperous and livable communities. This paper examines the role of Information Technologies (IT) and particularly Internet Based Geographic Information Systems (Internet GIS) as spatial decision support systems to aid community based local decision making. The paper also covers the advantages and challenges of these internet based mapping applications and tools for collaborative decision making on the environment.

Topological SLAM Using Fast Vision Techniques

In this paper we propose a method for vision only topological simultaneous localisation and mapping (SLAM). Our approach does not use motion or odometric information but a sequence of colour histograms from visited places. In particular, we address the perceptual aliasing problem which occurs using external observations only in topological navigation. We propose a Bayesian inference method to incrementally build a topological map by inferring spatial relations from the sequence of observations while simultaneously estimating the robot's location. The algorithm aims to build a small map which is consistent with local adjacency information extracted from the sequence measurements. Local adjacency information is incorporated to disambiguate places which otherwise would appear to be the same. Experiments in an indoor environment show that the proposed technique is capable of dealing with perceptual aliasing using visual observations only and successfully performs topological SLAM.

The cost-effectiveness of routine follow-up after primary total hip arthroplasty

Routine postsurgery assessment of primary total hip arthroplasty (THA) is recommended in many countries. Whether the benefits of this activity are justified by the costs is not known. We used a decision-analytic Markov model to compare the costs and health outcomes of 3 different follow-up strategies after primary THA. If there is no routine follow-up of patients for 7 years after primary THA, there would be cost savings between AU$6.5 and $11.9 million and gains of between 1.8 and 8.8 quality-adjusted life years. Policy makers should investigate less resource-intensive alternatives to common routine postsurgical assessment.

The development of a clinical learning environment scale

Within nursing, there is a strong demand for high-quality, cost-effective clinical education experiences that facilitate student learning in the clinical setting The clinical learning environment (CLE) is the interactive network of forces within the clinical setting that influence the students'clinical learning outcomes The identification of factors that characterize CLE could lead to strategies that foster the factors most predictive of desirable student learning outcomes and ameliorate those which may have a negative impact on student outcomes The CLE scale is a 23-item instrument with five subscales staff–student relationships, nurse manager commitment, patient relationships, interpersonal relationships, and student satisfaction These factors have strong substantive face validity and construct validity, as determined by confirmatory factor analysis Reliability coefficients range from high (0 85) to marginal (0 63) The CLE scale provides the educator with a valid and reliable instrument to evaluate affectively relevant factors in the CLE, direct resources to areas where improvement may be required, and nurture those areas functioning well It will assist in the application of resources in a cost-effective, efficient, productive manner, and will ensure that the clinical learning experience offers the nursing student the best possible learning outcomes

Location constraints in digital rights management

Digital rights management allows information owners to control the use and dissemination of electronic documents via a machine-readable licence. This paper describes the design and implementation of a system for creating and enforcing licences containing location constraints that can be used to restrict access to sensitive documents to a defined area. Documents can be loaded onto a portable device and used in the approved areas, but cannot be used if the device moves to another area. Our contribution includes a taxonomy for access control in the presence of requests to perform non-instantaneous controlled actions.

The Queensland study of melanoma : Environmental and genetic associations (Q-MEGA); Study design, baseline characteristics, and repeatability of phenotype and sun exposure measures

Cutaneous malignant melanoma (CMM) is a major health issue in Queensland, Australia, which has the world’s highest incidence. Recent molecular and epidemiologic studies suggest that CMM arises through multiple etiological pathways involving gene-environment interactions. Understanding the potential mechanisms leading to CMM requires larger studies than those previously conducted. This article describes the design and baseline characteristics of Q-MEGA, the Queensland Study of Melanoma: Environmental and Genetic Associations, which followed up 4 population-based samples of CMM patients in Queensland, including children, adolescents, men aged over 50, and a large sample of adult cases and their families, including twins. Q-MEGA aims to investigate the roles of genetic and environmental factors, and their interaction, in the etiology of melanoma. Three thousand, four hundred and seventy-one participants took part in the follow-up study and were administered a computer-assisted telephone interview in 2002-2005. Updated data on environmental and phenotypic risk factors, and 2777 blood samples were collected from interviewed participants as well as a subset of relatives. This study provides a large and well-described population-based sample of CMM cases with follow-up data. Characteristics of the cases and repeatability of sun exposure and phenotype measures between the baseline and the follow-up surveys, from 6 to 17 years later, are also described.

Sustainable water provision : alternative strategy and sources in the era of climate change

As a result of rapid urbanisation, population growth, change in lifestyles, pollution and the impacts of climate change, water provision has become a critical challenge for planners and policy-makers. In the wake of increasingly difficult water provision and drought, the notion that freshwater is a finite and vulnerable resources is increasingly being realised. Many city administrations around the World are struggling to provide water security for their residents to maintain lifestyle and economic grouth. This paper review the glocalalternatives to current water sources, including that of desalination, water transfers, recycling, and integrated water management. A comparative study on alternative resources is undertaken and the results are discussed.

'Homophobia' in the university classroom : law and justice students' conceptualizations of queer identity

Heteronormative discourses provide the most common lens through which sexuality is understood within university curricula. This means that sexuality is discussed in terms of categories of identity, with heterosexuality accorded primacy and all ‘others’ indeed ‘othered.’ This paper reports on research carried out by the authors in a core first year university justice class, in which students of law and/or justice were required to engage with, discuss, and reflect on discourses on sexuality. It uses a poststructural framework to identify how students understand non-heterosexualities and how they personally relate to queer identities, in the sense that it asks questions about gender and sexual identity, and the discourses surrounding them. It was found that strongly negative attitudes to non-heterosexualities are quite resistant to challenge, and that some students express being confronted with queerness as a deep-seated fear of being drawn into otherness against their will. The result was that, while many students were able to unpack their attitudes towards queerness and engage in critical reflection and re-evaluation of their attitudes, students with strongly negative views towards non-heterosexualities conversely refused to engage at all, typically perceiving even the engagement itself as a threat to their core heterosexual identity. However, the authors caution against relying on the idea that students are simply “homophobic” to explain this reluctance, as this term does not necessarily account for the complexity of the discourses that inform students’ reactions in this context. This “homophobia” may simply be related to a way of performing gender and sexual identity as opposed to overt discrimination and fear.

Soft-biometrics : unconstrained authentication in a surveillance environment

Soft biometrics are characteristics that can be used to describe, but not uniquely identify an individual. These include traits such as height, weight, gender, hair, skin and clothing colour. Unlike traditional biometrics (i.e. face, voice) which require cooperation from the subject, soft biometrics can be acquired by surveillance cameras at range without any user cooperation. Whilst these traits cannot provide robust authentication, they can be used to provide coarse authentication or identification at long range, locate a subject who has been previously seen or who matches a description, as well as aid in object tracking. In this paper we propose three part (head, torso, legs) height and colour soft biometric models, and demonstrate their verification performance on a subset of the PETS 2006 database. We show that these models, whilst not as accurate as traditional biometrics, can still achieve acceptable rates of accuracy in situations where traditional biometrics cannot be applied.

Novel ruthenium bipyridyl dyes with s-donor ligands and their application in dye-sensitized solar cells

Two series of novel ruthenium bipyridyl dyes incorporating sulfur-donor bidentate ligands with general formula \[Ru(R-bpy)2C2N2S2] and \[Ru(R-bpy)2(S2COEt)]\[NO3] (where R =H, CO2Et, CO2H; C2N2S2 = cyanodithioimidocarbonate and S2COEt = ethyl xanthogenate) have been synthesized and characterized spectroscopically, electrochemically and computationally. The acid derivatives in both series (C2N2S2 3 and S2COEt 6) were used as a photosensitizer in a dye-sensitized solar cell (DSSC) and the incident photo-to-current conversion efficiency (IPCE), overall efficiency (_) and kinetics of the dye/TiO2 system were investigated. It was found that 6 gave a higher efficiency cell than 3 despite the latter dye’s more favorable electronic properties, such as greater absorption range, higher molar extinction coefficient and large degree of delocalization of the HOMO. The transient absorption spectroscopy studies revealed that the recombination kinetics of 3 were unexpectedly fast, which was attributed to the terminal CN on the ligand binding to the TiO2, as evidenced by an absorption study of R =H and CO2Et dyes sensitized on TiO2, and hence leading to a lower efficiency DSSC.

Self-efficacy, outcome expectations and self-care behaviour in people with type 2 diabetes in Taiwan

Aims. To explore differences in self-care behaviour according to demographic and illness characteristics; and relationships among self-care behaviour and demographic and illness characteristics, efficacy expectations and outcome expectations of people with type 2 diabetes in Taiwan. Background. Most people with diabetes do not control their disease appropriately in Taiwan. Enhanced self-efficacy towards managing diseases can be an effective way of improving disease control as proposed by the self-efficacy model which provides a useful framework for understanding adherence to self-care behaviours. Design and methods. The sample comprised 145 patients with type 2 diabetes aged 30 years or more from diabetes outpatient clinics in Taipei. Data were collected using a self-administered questionnaire for this study. One-way anova, t-tests, Pearson product moment correlation and hierarchical regression were analysed for the study. Results. Significant differences were found: between self-care behaviour and complications (t = −2·52, p < 0·01) and patient education (t = −1·96, p < 0·05). Self-care behaviour was significantly and positively correlated with duration of diabetes (r = 0·36, p < 0·01), efficacy expectations (r = 0·54, p < 0·01) and outcome expectations (r = 0·44, p < 0·01). A total of 39·1% of variance in self-care behaviour can be explained by duration of diabetes, efficacy expectations and outcome expectations. Conclusions. Findings support the use of the self-efficacy model as a framework for understanding adherence to self-care behaviour. Relevance to clinical practice. Using self-efficacy theory when designing patient education interventions for people with type 2 diabetes will enhance self-management routines and assist in reducing major complications in the future.

Delaying mismatched field multiplications in pairing computations

Miller’s algorithm for computing pairings involves perform- ing multiplications between elements that belong to different finite fields. Namely, elements in the full extension field Fpk are multiplied by elements contained in proper subfields F pk/d , and by elements in the base field Fp . We show that significant speedups in pairing computations can be achieved by delaying these “mismatched” multiplications for an optimal number of iterations. Importantly, we show that our technique can be easily integrated into traditional pairing algorithms; implementers can exploit the computational savings herein by applying only minor changes to existing pairing code.

Strategic infrastructure asset management : a conceptual framework to identify capabilities

Purpose – The purpose of this paper is to develop a conceptual framework that can be used to identify capabilities needed in the management of infrastructure assets. Design/methodology/approach – This paper utilises a qualitative approach to analyse secondary data in order to develop a conceptual framework that identifies capabilities for strategic infrastructure asset management. Findings – In an external business environment that is undergoing rapid change, it is more appropriate to focus on factors internal to the organisation such as resources and capabilities as a basis to develop competitive advantage. However, there is currently very little understanding of the internal capabilities that are appropriate for infrastructure asset management. Therefore, a conceptual framework is needful to guide infrastructure organisations in the identification of capabilities. Research limitations/implications – This is a conceptual paper and future empirical research should be conducted to validate the propositions made in the paper. Practical implications – The paper clearly argues the need for infrastructure organisations to adopt a systematic approach to identifying the capabilities needed in the management of strategic infrastructure assets. The discussion on the impact of essential capabilities is useful in providing the impetus for managers who operate in a deregulated infrastructure business landscape to review their existing strategies. Originality/value – The paper provides a new perspective on how asset managers can create value for their organisations by investing in the relevant capabilities.