Outcomes following inpatient rehabilitation : a seven year perspective

Introduction: Improving physical and cognitive functioning is a key objective of multi-disciplinary inpatient geriatric rehabilitation. Outcomes relevant to minimum functional ability required for older adults to successfully participate in the community have been reported. However, there has been little investigation reporting outcomes of older inpatients receiving multi-disciplinary rehabilitation being discharged home from geriatric rehabilitation units. This study aims to investigate characteristics and physical and cognitive outcomes of this cohort. Method: The Princess Alexandra Hospital Geriatric and Rehabilitation Unit is the largest rehabilitation unit in Queensland. Multidisciplinary health professionals enter admission and discharge functional and clinical outcomes along with demographic information into a purpose designed database for all patients. Data collected between 2005 and 2011 was analysed using descriptive statistics. Results: During the seven-year period, 4120 patients were admitted for rehabilitation; 2126 (52%) were female, mean age of 74 years (Standard Deviation 14). Primary reasons for admission were for reconditioning post medical illness or surgical admission (n = 1285, 31%), and 30% (n = 1233) admitted for orthopaedic reasons. Of these orthopaedic admissions, 6.6% (n = 82) were for elective surgery, and 46% (n = 565) were for fractured neck-of-femurs. 76% (n = 3130) of patients were discharged home, 13% (n = 552) to residential care facilities and 10% (n = 430) were discharged to an alternative hospital setting or passed away during their admission. Mean length of stay was 44 days (SD 39) Preliminary analysis of FIM outcomes shows a mean motor score of 53 (SD = 19) on admission which significantly improved to 71 (SD = 18) by discharge. There was no change on FIM cognitive score (28 (SD7) vs 29 (SD 6). Conclusion: Geriatric patients have significant functional limitations even on discharge from inpatient rehabilitation; though overall cognition is relatively intact. Orthopaedic conditions and general deconditioning from medical/surgical admissions are the main reasons for admission. The majority of people receiving rehabilitation are discharged home.

Cooking enhances but the degree of ripeness does not affect provitamin A carotenoid bioavailability from bananas

Banana is a staple crop in many regions where vitamin A deficiency is prevalent, making it a target for provitamin A biofortification. However, matrix effects may limit provitamin A bioavailability from bananas. The retinol bioefficacies of unripe and ripe bananas (study 1A), unripe high-provitamin A bananas (study 1B), and raw and cooked bananas (study 2) were determined in retinol-depleted Mongolian gerbils (n = 97/study) using positive and negative controls. After feeding a retinol-deficient diet for 6 and 4 wk in studies 1 and 2, respectively, customized diets containing 60, 30, or 15% banana were fed for 17 and 13 d, respectively. In study 1A, the hepatic retinol of the 60% ripe Cavendish group (0.52 ± 0.13 μmol retinol/liver) differed from baseline (0.65 ± 0.15 μmol retinol/liver) and was higher than the negative control group (0.39 ± 0.16 μmol retinol/liver; P < 0.0065). In study 1B, no groups differed from baseline (0.65 ± 0.15 μmol retinol/liver; P = 0.20). In study 2, the 60% raw Butobe group (0.68 ± 0.17 μmol retinol/liver) differed from the 60% cooked Butobe group (0.87 ± 0.24 μmol retinol/liver); neither group differed from baseline (0.80 ± 0.27 μmol retinol/liver; P < 0.0001). Total liver retinol was higher in the groups fed cooked bananas than in those fed raw (P = 0.0027). Body weights did not differ even though gerbils ate more green, ripe, and raw bananas than cooked, suggesting a greater indigestible component. In conclusion, thermal processing, but not ripening, improves the retinol bioefficacy of bananas. Food matrix modification affects carotenoid bioavailability from provitamin A biofortification targets.

Normative requirements for business process compliance

Norms regulate the behaviour of their subjects and define what is legal and what is illegal. Norms typically describe the conditions under which they are applicable and the normative effects as a results of their applications. On the other hand, process models specify how a business operation or service is to be carried out to achieve a desired outcome. Norms can have significant impact on how business operations are conducted and they can apply to the whole or part of a business process. For example, they may impose conditions on the different aspects of a process (e.g., perform tasks in a specific sequence (control-flow), at a specific time or within a certain time frame (temporal aspect), by specific people (resources)). We propose a framework that provides the formal semantics of the normative requirements for determining whether a business process complies with a normative document (where a normative document can be understood in a very broad sense, ranging from internal policies to best practice policies, to statutory acts). We also present a classification of normal requirements based on the notion of different types of obligations and the effects of violating these obligations.

Risky driving behavior among university students and staff in the Sultanate of Oman

Background: There is a well developed literature on research investigating the relationship between various driving behaviours and road crash involvement. However, this research has predominantly been conducted in developed economies dominated by western types of cultural environments. To date no research has been published that has empirically investigated this relationship within the context of the emerging economies such as Oman. Objective: The present study aims to investigate driving behaviour as indexed in the Driving Behaviour Questionnaire (DBQ) among a group of Omani university students and staff. Methods: A convenience non-probability self- selection sampling approach was utilized with Omani university students and staff. Results: A total of 1003 Omani students (n= 632) and staff (n=371) participated in the survey. Factor analysis of the BDQ revealed four main factors that were errors, speeding violation, lapses and aggressive violation. In the multivariate logistic backward regression analysis, the following factors were identified as significant predictors of being involved in causing at least one crash: driving experience, history of offences and two DBQ components i.e. errors and aggressive violation. Conclusion: This study indicates that errors and aggressive violation of the traffic regulations as well as history of having traffic offences are major risk factors for road traffic crashes among the sample. While previous international research has demonstrated that speeding is a primary cause of crashing, in the current context, the results indicate that an array of factors is associated with crashes. Further research using more rigorous methodology is warranted to inform the development of road safety countermeasures in Oman that improves overall traffic safety culture.

A methodological evaluation of business process compliance management frameworks

Existing compliance management frameworks (CMFs) offer a multitude of compliance management capabilities that makes difficult for enterprises to decide on the suitability of a framework. Making a decision on the suitability requires a deep understanding of the functionalities of a framework. Gaining such an understanding is a difficult task which, in turn, requires specialised tools and methodologies for evaluation. Current compliance research lacks such tools and methodologies for evaluating CMFs. This paper reports a methodological evaluation of existing CMFs based on a pre-defined evaluation criteria. Our evaluation highlights what existing CMFs offer, and what they cannot. Also, it underpins various open questions and discusses the challenges in this direction.

Modeling obligations with event-calculus

Time plays an important role in norms. In this paper we start from our previously proposed classification of obligations, and point out some shortcomings of Event Calculus (EC) to represent obligations. We proposed an extension of EC that avoids such shortcomings and we show how to use it to model the various types of obligations.

Ongoing outbreak of dengue serotype 3 in Solomon Islands, January to May 2013

Introduction In January 2013, clinicians in Honiara, Solomon Islands noted several patients presenting with dengue-like illness. Serum from three cases tested positive for dengue by rapid diagnostic test. Subsequent increases in cases were reported, and the outbreak was confirmed as being dengue serotype-3 by further laboratory tests. This report describes the ongoing outbreak investigation, findings and response. Methods Enhanced dengue surveillance was implemented in the capital, Honiara, and in the provinces. This included training health staff on dengue case definitions, data collection and reporting. Vector surveillance was also conducted. Results From 3 January to 15 May 2013, 5254 cases of suspected dengue were reported (101.8 per 10 000 population), including 401 hospitalizations and six deaths. The median age of cases was 20 years (range zero to 90), and 86% were reported from Honiara. Both Aedes aegyti and Aedes albopictus were identified in Honiara. Outbreak response measures included clinical training seminars, vector control activities, implementation of diagnostic and case management protocols and a public communication campaign. Discussion This was the first large dengue outbreak documented in Solomon Islands. Factors that may have contributed to this outbreak include a largely susceptible population, the presence of a highly efficient dengue vector in Honiara, a high-density human population with numerous breeding sites and favourable weather conditions for mosquito proliferation. Although the number of cases has plateaued since 1 April, continued enhanced nationwide surveillance and response activities are necessary.

The pathobiology of mammographic density

High mammographic density confers a significantly increased risk of breast cancer. As it is relatively common in the normal population the risk of cancer attributable to increased mammographic density could potentially account for an important percentage of total BCa cases. The underlying cause for high mammographic density and its association with increased BCa risk and progression is unknown. In this review we describe the work that has been done to define the histopathological characteristics of mammographic density. Mammograms define breast tissues with areas of high density due to an increased amount of radio-opaque tissue (stromal and epithelial cells) and also less areas of radiolucent fat. Histological work however can define the roles played by each cell type. We review the work that has been performed assessing changes in epithelial cells, stromal cells, the extracellular matrix, and immune infiltrate. To determine how these changes may be increasing breast cancer risk we also discuss the roles of each of the cell types in breast cancer initiation and progression.

Setting the research agenda in IHRM

Firstly, on behalf of the secretariat that has coordinated these meetings every two years since 1985, our thanks to the organising committee here at the University of Economics in Cracow, Poland, for hosting this conference. I was asked to offer comment on the research agenda. There are many famous names to refer to. Two Australian colleagues here today are Peter Dowling and Helen De Cieri, longtime stalwarts of the field of IHRM. I acknowledge their contributions over many years, along with Randy Schuler and Denise Welch, and Dennis Briscoe. Other names such as Rosalie Tung, Pawan Bhudwhar, Michael Morley, Paul Sparrow and Wayne Cascio are known to us all. Their books have become classics. One example is the 700 page benchmark 2012 work by Chris Brewster and Wolfgang Mayrhofer, Handbook of Research on Comparative Human Resource Management (Brewster & Mayrhofer, 2012). More recently, in a book published by Cambridge University press in 2014, Mustafa Özbilgin, Dimitria Groutsis and William Harvey offer students a very accessible overview of the basics in IHRM (Ozbilgin, Groutsis, & Harvey, 2014). As for a research agenda, there are excellent literature reviews to which I would refer you, such as those by people who over the years have been frequent participants at this conference (Tarique & Schuler, 2010), (Farndale, Scullion, & Sparrow, 2010), and (Scullion & Collings, 2011).

Protection of intellectual property in Islamic Shari'a and the development of the Libyan intellectual property system

This thesis introduces a theory of intellectual property (IP) law informed by Islamic Shari'a. The sources and objectives of Islamic Shari'a support the theoretical framework underpinning IP laws. However, they strongly emphasise the importance of development goals in intellectual property policy making. This thesis argues that an optimal IP system from an Islamic perspective shall not overprotect IP holders but should instead endeavor to empower people to access knowledge resources to enhance access to education, public health and economic opportunities. Taking Libya as a case study, this thesis makes recommendations for the improvement of IP law that have important broader implications for developing countries.

Integrated approach to optimize open-pit mine block sequencing

Critical stage in open-pit mining is to determine the optimal extraction sequence of blocks, which has significant impacts on mining profitability. In this paper, a more comprehensive block sequencing optimisation model is developed for the open-pit mines. In the model, material characteristics of blocks, grade control, excavator and block sequencing are investigated and integrated to maximise the short-term benefit of mining. Several case studies are modeled and solved by CPLEX MIP and CP engines. Numerical investigations are presented to illustrate and validate the proposed methodology.

Standardising and assessing digital images for use in clinical trials : a practical, reproducible method that blinds the assessor to treatment allocation

With the increasing availability of high quality digital cameras that are easily operated by the non-professional photographer, the utility of using digital images to assess endpoints in clinical research of skin lesions has growing acceptance. However, rigorous protocols and description of experiences for digital image collection and assessment are not readily available, particularly for research conducted in remote settings. We describe the development and evaluation of a protocol for digital image collection by the non-professional photographer in a remote setting research trial, together with a novel methodology for assessment of clinical outcomes by an expert panel blinded to treatment allocation.

Normative requirements for regulatory compliance: An abstract formal framework

By definition, regulatory rules (in legal context called norms) intend to achieve specific behaviour from business processes, and might be relevant to the whole or part of a business process. They can impose conditions on different aspects of process models, e.g., control-flow, data and resources etc. Based on the rules sets, norms can be classified into various classes and sub-classes according to their effects. This paper presents an abstract framework consisting of a list of norms and a generic compliance checking approach on the idea of (possible) execution of processes. The proposed framework is independent of any existing formalism, and provides a conceptually rich and exhaustive ontology and semantics of norms needed for business process compliance checking. The possible uses of the proposed framework include to compare different compliance management frameworks (CMFs).

No time for compliance

In the past few years several business process compliance framework based on temporal logic have been proposed. In this paper we investigate whether the use of temporal logic is suitable for the task at hand: namely to check whether the specifications of a business process are compatible with the formalisation of the norms regulating the business process. We provide an example inspired by real life norms where the use of linear temporal logic produces a result that is not compatible with the legal understanding of the norms in the example.