Development and validation of anthropometric prediction equations for estimation of lean body mass and appendicular lean soft tissue in Indian men and women

Lean body mass (LBM) and muscle mass remains difficult to quantify in large epidemiological studies due to non-availability of inexpensive methods. We therefore developed anthropometric prediction equations to estimate the LBM and appendicular lean soft tissue (ALST) using dual energy X-ray absorptiometry (DXA) as a reference method. Healthy volunteers (n= 2220; 36% females; age 18-79 y) representing a wide range of body mass index (14-44 kg/m2) participated in this study. Their LBM including ALST was assessed by DXA along with anthropometric measurements. The sample was divided into prediction (60%) and validation (40%) sets. In the prediction set, a number of prediction models were constructed using DXA measured LBM and ALST estimates as dependent variables and a combination of anthropometric indices as independent variables. These equations were cross-validated in the validation set. Simple equations using age, height and weight explained > 90% variation in the LBM and ALST in both men and women. Additional variables (hip and limb circumferences and sum of SFTs) increased the explained variation by 5-8% in the fully adjusted models predicting LBM and ALST. More complex equations using all the above anthropometric variables could predict the DXA measured LBM and ALST accurately as indicated by low standard error of the estimate (LBM: 1.47 kg and 1.63 kg for men and women, respectively) as well as good agreement by Bland Altman analyses. These equations could be a valuable tool in large epidemiological studies assessing these body compartments in Indians and other population groups with similar body composition.

Validation of the interRAI Cognitive Performance Scale against independent clinical diagnosis and the Mini-Mental State Examination in older hospitalized patients

Objective To compare the diagnostic accuracy of the interRAI Acute Care (AC) Cognitive Performance Scale (CPS2) and the Mini-Mental State Examination (MMSE), against independent clinical diagnosis for detecting dementia in older hospitalized patients. Design, Setting, and Participants The study was part of a prospective observational cohort study of patients aged ≥70 years admitted to four acute hospitals in Queensland, Australia, between 2008 and 2010. Recruitment was consecutive and patients expected to remain in hospital for ≥48 hours were eligible to participate. Data for 462 patients were available for this study. Measurements Trained research nurses completed comprehensive geriatric assessments and administered the interRAI AC and MMSE to patients. Two physicians independently reviewed patients’ medical records and assessments to establish the diagnosis of dementia. Indicators of diagnostic accuracy included sensitivity, specificity, predictive values, likelihood ratios and areas under receiver (AUC) operating characteristic curves. Results 85 patients (18.4%) were considered to have dementia according to independent clinical diagnosis. The sensitivity of the CPS2 [0.68 (95%CI: 0.58–0.77)] was not statistically different to the MMSE [0.75 (0.64–0.83)] in predicting physician diagnosed dementia. The AUCs for the 2 instruments were also not statistically different: CPS2 AUC = 0.83 (95%CI: 0.78–0.89) and MMSE AUC = 0.87 (95%CI: 0.83–0.91), while the CPS2 demonstrated higher specificity [0.92 95%CI: 0.89–0.95)] than the MMSE [0.82 (0.77–0.85)]. Agreement between the CPS2 and clinical diagnosis was substantial (87.4%; κ=0.61). Conclusion The CPS2 appears to be a reliable screening tool for assessing cognitive impairment in acutely unwell older hospitalized patients. These findings add to the growing body of evidence supporting the utility of the interRAI AC, within which the CPS2 is embedded. The interRAI AC offers the advantage of being able to accurately screen for both dementia and delirium without the need to use additional assessments, thus increasing assessment efficiency.

Queensland diabetic foot hospitalisations (2005-10) : in what state is our foot hospital problem?

Background Diabetes foot complications are a leading cause of overall avoidable hospital admissions. Since 2006, the Queensland Diabetes Clinical Network has implemented programs aimed at reducing diabetes-related hospitalisation. The aim of this retrospective observational study was to determine the incidence of diabetes foot-related hospital admissions in Queensland from 2005 to 2010. Methods Data on all primary diabetes foot-related admissions in Queensland from 2005-2010 was obtained using diabetes foot-related ICD-10-AM (hospital discharge) codes. Queensland diabetes foot-related admission incidences were calculated using general population data from the Australian Bureau of Statistics. Furthermore, diabetes foot-related sub-group admissions were analysed. Chi-squared tests were used to assess changes in admissions over time. Results Overall, 24,917 diabetes foot-related admissions occurred, resulting in the use of 260,085 bed days or 1.4% of all available Queensland hospital bed days (18,352,152). The primary reasons for these admissions were foot ulcers (49.8%), cellulitis (20.7%), peripheral vascular disease (17.8%) and osteomyelitis (3.8%). The diabetes foot-related admission incidence among the general population (per 100,000) reduced by 22% (103.0 in 2005, to 80.7 in 2010, p < 0.001); bed days decreased by 18% (1,099 to 904, p < 0.001). Conclusion Diabetes foot complications appear to be the primary reason for 1.4 out of every 100 hospital beds used in Queensland. There has been a significant reduction in the incidence of diabetes foot-related admissions in Queensland between 2005 and 2010. This decrease has coincided with a corresponding decrease in amputations and the implementation of several diabetes foot clinical programs throughout Queensland.

Flag state responsibility for maritime terrorism

Modern international shipping is largely a flag state-based system. Only the flag state has complete authority over the vessels that fly its flag, and as a result, other states’ jurisdiction over these vessels is very limited. Against this backdrop, this article examines the flag state’s responsibility for maritime terrorism, a major security issue and vulnerability in the global supply chain. It is not an exaggeration that the global community’s repeated statements regarding the illegality of terrorism have created a customary international law obligation for states to take all possible steps for the prevention of terrorism. This article argues that providing flags to suspicious entities in an obscure registration system is not compatible with this obligation.

State responsibility for maritime terrorism

Maritime terrorism is one of the main maritime security issues in the contemporary world. The threat of maritime terrorism is more apparent than ever in the post-September 11 era. Although maritime terrorism is an old issue, the disastrous events of 11 September 2001 brought this issue again onto the global agenda. This incident brought to the forefront the longstanding concerns that terrorists could severely disrupt the global maritime supply chain by using shipping containers or vessels to attack major business centres, port facilities and offshore installations. A number of international criminal law studies have been conducted to identify international legal challenges in maritime security. Some of these works have critically examined the international legal framework for maritime security and identified the lacunas in the existing system. Some of these writings have also identified that emerging maritime terrorism issues are prompting States to introduce some stringent measures. Although the international legal regime related to maritime terrorism is a well-researched area, very little research work has explored the legal issues related to State responsibility for maritime terrorism. This article argues that, although the United Nations Convention on the Law of the Sea (UNCLOS) provisions related to maritime piracy may not be applicable for some dimensions of maritime violence, different provisions of UNCLOS may relevant in identifying State responsibility for maritime terrorism.

Development of empirical equations for irradiance profile of a standard parabolic trough collector using Monte Carlo ray tracing technique

Irradiance profile around the receiver tube (RT) of a parabolic trough collector (PTC) is a key effect of optical performance that affects the overall energy performance of the collector. Thermal performance evaluation of the RT relies on the appropriate determination of the irradiance profile. This article explains a technique in which empirical equations were developed to calculate the local irradiance as a function of angular location of the RT of a standard PTC using a vigorously verified Monte Carlo ray tracing model. A large range of test conditions including daily normal insolation, spectral selective coatings and glass envelop conditions were selected from the published data by Dudley et al. [1] for the job. The R2 values of the equations are excellent that vary in between 0.9857 and 0.9999. Therefore, these equations can be used confidently to produce realistic non-uniform boundary heat flux profile around the RT at normal incidence for conjugate heat transfer analyses of the collector. Required values in the equations are daily normal insolation, and the spectral selective properties of the collector components. Since the equations are polynomial functions, data processing software can be employed to calculate the flux profile very easily and quickly. The ultimate goal of this research is to make the concentrating solar power technology cost competitive with conventional energy technology facilitating its ongoing research.

The Australian welfare state : who benefits now?

This text outlines the links between Australian's conceptions about welfare and the redistributive outcomes of the welfare state, canvassing theoretical explanations about why many Australians develop and maintain misconceptions of the broad disyributive mechanisms of the Ayustralian welfare state and hold negative attitudes towards its social welfare element. The book is an indispensable resource for students undertaking studies in sociology, social policy, public administrion and social work.

Work and the Welfare State : Street-Level Organizations and Workfare Politics

Work and the Welfare State places street-level organizations at the analytic center of welfare state politics, policy and management. This volume offers a critical examination of efforts to change the welfare state to a workfare state by looking at on-the-ground issues in six countries: the United States, United Kingdom, Australia, Denmark, Germany and the Netherlands.

Material yielding by both axial and bending spring stiffness at elevated temperature

Material yielding is typically modeled either by plastic zone or plastic hinge methods under the context of geometric and material nonlinear finite element methods. In fire analysis of steel structures, the plastic zone method is widely used, but it requires extensively more computational efforts. The objective of this paper is to develop the nonlinear material model allowing for interaction of both axial force and bending moment, which relies on the plastic hinge method to achieve numerical efficiency and reduce computational effort. The biggest advantage of the plastic-hinge approach is its computational efficiency and easy verification by the design code formulae of the axial force–moment interaction yield criterion for beam–column members. Further, the method is reliable and robust when used in analysis of practical and large structures. In order to allow for the effect of catenary action, axial thermal expansion is considered in the axial restraint equations. The yield function for material yielding incorporated in the stiffness formulation, which allows for both axial force and bending moment effects, is more accurate and rational to predict the behaviour of the frames under fire. In the present fire analysis, the mechanical properties at elevated temperatures follow mainly the Eurocode 3 [Design of steel structures, Part 1.2: Structural fire design. European Committee for Standisation; 2003]. Example of a tension member at a steady state heating condition is modeled to verify the proposed spring formulation and to compare with results by others. The behaviour of a heated member in a highly redundant structure is also studied by the present approach.

A state-wide systems approach to embedding the learning and teaching of sustainability in teacher education

Education systems have a key role to play in preparing future citizens to engage in sustainable living practices and help create a more sustainable world. Many schools throughout Australia have begun to develop whole-school approaches to sustainability education that are supported by national and state policies and curriculum frameworks. Preservice teacher education, however, lags behind in building the capacity of new teachers to initiate and implement such approaches (ARIES, 2010). This proposed project seeks to develop a state-wide systems approach to embedding Education for Sustainability (EfS) in teacher education that is aligned with the Australian National Curriculum and the aspirations for EfS in the Melbourne Declaration and other national documents. Representatives from all teacher education institutions and other agents of change in the Queensland education system will be engaged in a multilevel systems approach, involving collaboration at the state, institutional and course levels, to develop curriculum practices that reflect a shared vision of EfS.

The Current State of BPM Education in Australia : Teaching and Research Challenges

As business processes, services and relationships, are now recognized as key organizational assets, the demand for the so-called boundaryspanning roles and process-aware professionals is continuing to grow. The world-wide demand for these roles will continue to increase, fueled by the unprecedented interest in Business Process Management (BPM) and the other emerging cross-functional disciplines. This, in turn, creates new opportunities, as well as some unforeseeable challenges for BPM education, both in university and industry. This paper reports on an analysis of the current BPM offerings of Australian universities. It presents a critical review of what is taught and how it is taught, and identifies a series of gaps and concerns. Explanations and recommendations are proposed and a call made for BPM educators worldwide, for urgent action.