Hospital in the Nursing Home program reduces emergency department presentations and hospital admissions from residential aged care facilities in Queensland, Australia: A quasi-experimental study

Background There has been considerable publicity regarding population ageing and hospital emergency department (ED) overcrowding. Our study aims to investigate impact of one intervention piloted in Queensland Australia, the Hospital in the Nursing Home (HiNH) program, on reducing ED and hospital attendances from residential aged care facilities (RACFs). Methods A quasi-experimental study was conducted at an intervention hospital undertaking the program and a control hospital with normal practice. Routine Queensland health information system data were extracted for analysis. Results Significant reductions in the number of ED presentations per 1000 RACF beds (rate ratio (95 % CI): 0.78 (0.67–0.92); p = 0.002), number of hospital admissions per 1000 RACF beds (0.62 (0.50–0.76); p < 0.0001), and number of hospital admissions per 100 ED presentations (0.61 (0.43–0.85); p = 0.004) were noticed in the experimental hospital after the intervention; while there were no significant differences between intervention and control hospitals before the intervention. Pre-test and post-test comparison in the intervention hospital also presented significant decreases in ED presentation rate (0.75 (0.65–0.86); p < 0.0001) and hospital admission rate per RACF bed (0.66 (0.54–0.79); p < 0.0001), and a non-significant reduction in hospital admission rate per ED presentation (0.82 (0.61–1.11); p = 0.196). Conclusions Hospital in the Nursing Home program could be effective in reducing ED presentations and hospital admissions from RACF residents. Implementation of the program across a variety of settings is preferred to fully assess the ongoing benefits for patients and any possible cost-savings.

Downstream processing of reverse osmosis brine: Characterisation of potential scaling compounds

Reverse osmosis (RO) brine produced at a full-scale coal seam gas (CSG) water treatment facility was characterized with spectroscopic and other analytical techniques. A number of potential scalants including silica, calcium, magnesium, sulphates and carbonates, all of which were present in dissolved and non-dissolved forms, were characterized. The presence of spherical particles with a size range of 10–1000 nm and aggregates of 1–10 microns was confirmed by transmission electron microscopy (TEM). Those particulates contained the following metals in decreasing order: K, Si, Sr, Ca, B, Ba, Mg, P, and S. Characterization showed that nearly one-third of the total silicon in the brine was present in the particulates. Further, analysis of the RO brine suggested supersaturation and precipitation of metal carbonates and sulphates during the RO process should take place and could be responsible for subsequently capturing silica in the solid phase. However, the precipitation of crystalline carbonates and sulphates are complex. X-ray diffraction analysis did not confirm the presence of common calcium carbonates or sulphates but instead showed the presence of a suite of complex minerals, to which amorphous silica and/or silica rich compounds could have adhered. A filtration study showed that majority of the siliceous particles were less than 220 nm in size, but could still be potentially captured using a low molecular weight ultrafiltration membrane.

Joint Regression and Association Models for Repeated Categorical Responses

The focus of this study is on statistical analysis of categorical responses, where the response values are dependent of each other. The most typical example of this kind of dependence is when repeated responses have been obtained from the same study unit. For example, in Paper I, the response of interest is the pneumococcal nasopharengyal carriage (yes/no) on 329 children. For each child, the carriage is measured nine times during the first 18 months of life, and thus repeated respones on each child cannot be assumed independent of each other. In the case of the above example, the interest typically lies in the carriage prevalence, and whether different risk factors affect the prevalence. Regression analysis is the established method for studying the effects of risk factors. In order to make correct inferences from the regression model, the associations between repeated responses need to be taken into account. The analysis of repeated categorical responses typically focus on regression modelling. However, further insights can also be gained by investigating the structure of the association. The central theme in this study is on the development of joint regression and association models. The analysis of repeated, or otherwise clustered, categorical responses is computationally difficult. Likelihood-based inference is often feasible only when the number of repeated responses for each study unit is small. In Paper IV, an algorithm is presented, which substantially facilitates maximum likelihood fitting, especially when the number of repeated responses increase. In addition, a notable result arising from this work is the freely available software for likelihood-based estimation of clustered categorical responses.

Allelopathy for weed control in agricultural systems

Weeds are a hidden foe for crop plants, interfering with their functions and suppressing their growth and development. Yield losses of ∼34 are caused by weeds among the major crops, which are grown worldwide. These yield losses are higher than the losses caused by other pests in the crops. Sustainable weed management is needed in the wake of a huge decline in crop outputs due to weed pressure. A diversity in weed management tools ensures sustainable weed control and reduces chances of herbicide resistance development in weeds. Allelopathy as a tool, can be importantly used to combat the challenges of environmental pollution and herbicide resistance development. This review article provides a recent update regarding the practical application of allelopathy for weed control in agricultural systems. Several studies elaborate on the significance of allelopathy for weed management. Rye, sorghum, rice, sunflower, rape seed, and wheat have been documented as important allelopathic crops. These crops express their allelopathic potential by releasing allelochemicals which not only suppress weeds, but also promote underground microbial activities. Crop cultivars with allelopathic potentials can be grown to suppress weeds under field conditions. Further, several types of allelopathic plants can be intercropped with other crops to smother weeds. The use of allelopathic cover crops and mulches can reduce weed pressure in field crops. Rotating a routine crop with an allelopathic crop for one season is another method of allelopathic weed control. Importantly, plant breeding can be explored to improve the allelopathic potential of crop cultivars. In conclusion, allelopathy can be utilized for suppressing weeds in field crops. Allelopathy has a pertinent significance for ecological, sustainable, and integrated weed management systems.

Pen parameters for improving the performance of sheep imported from Australia to Persian Gulf feedlots

Summer in the Persian Gulf region presents physiological challenges for Australian sheep that are part of the live export supply chain coming from the Australian winter. Many feedlots throughout the Gulf have very high numbers of animals during June to August in order to cater for the increased demand for religious festivals. From an animal welfare perspective it is important to understand the necessary requirements of feed and water trough allowances, and the amount of pen space required, to cope with exposure to these types of climatic conditions. This study addresses parameters that are pertinent to the wellbeing of animals arriving in the Persian Gulf all year round. Three experiments were conducted in a feedlot in the Persian Gulf between March 2010 and February 2012, totalling 44 replicate pens each with 60 or 100 sheep. The applied treatments covered animal densities, feed-bunk lengths and water trough lengths. Weights, carcass attributes and health status were the key recorded variables. Weight change results showed superior performance for animal densities of ≥1.2 m2/head during hot conditions (24-h average temperatures greater than 33 °C, or a diurnal range of around 29–37 °C). However the space allowance for animals can be decreased, with no demonstrated detrimental effect, to 0.6 m2/head under milder conditions. A feed-bunk length of ≥5 cm/head is needed, as 2 cm/head showed significantly poorer animal performance. When feeding at 90 ad libitum 10 cm/head was optimal, however under a maintenance feeding regime (1 kg/head/day) 5 cm/head was adequate. A minimum water trough allowance of 1 cm/head is required. However, this experiment was conducted during milder conditions, and it may well be expected that larger water trough lengths would be needed in hotter conditions. Carcass weights were determined mainly by weights at feedlot entry and subsequent weight gains, while dressing percentage was not significantly affected by any of the applied treatments. There was no demonstrated effect of any of the treatments on the number of animals that died, or were classified as unwell. However, across all the treatments, these animals lost significantly more weight than the healthy animals, so the above recommendations, which are aimed at maintaining weight, should also be applicable for good animal health and welfare. Therefore, best practice guidelines for managing Australian sheep in Persian Gulf feedlots in the hottest months (June–August) which present the greatest environmental and physical challenge is to allow feed-bunk length 5 cm/head on a maintenance-feeding program and 10 cm/head for 90 ad libitum feeding, and the space allowance per animal should be ≥1.2 m2/head. Water trough allocation should be at least 1 cm/head with provision for more in the summer when water intake potentially doubles.

Pen parameters for improving the performance of sheep imported from Australia to Persian Gulf feedlots

Summer in the Persian Gulf region presents physiological challenges for Australian sheep that are part of the live export supply chain coming from the Australian winter. Many feedlots throughout the Gulf have very high numbers of animals during June to August in order to cater for the increased demand for religious festivals. From an animal welfare perspective it is important to understand the necessary requirements of feed and water trough allowances, and the amount of pen space required, to cope with exposure to these types of climatic conditions. This study addresses parameters that are pertinent to the wellbeing of animals arriving in the Persian Gulf all year round. Three experiments were conducted in a feedlot in the Persian Gulf between March 2010 and February 2012, totalling 44 replicate pens each with 60 or 100 sheep. The applied treatments covered animal densities, feed-bunk lengths and water trough lengths. Weights, carcass attributes and health status were the key recorded variables. Weight change results showed superior performance for animal densities of ≥1.2 m2/head during hot conditions (24-h average temperatures greater than 33 °C, or a diurnal range of around 29–37 °C). However the space allowance for animals can be decreased, with no demonstrated detrimental effect, to 0.6 m2/head under milder conditions. A feed-bunk length of ≥5 cm/head is needed, as 2 cm/head showed significantly poorer animal performance. When feeding at 90% ad libitum 10 cm/head was optimal, however under a maintenance feeding regime (1 kg/head/day) 5 cm/head was adequate. A minimum water trough allowance of 1 cm/head is required. However, this experiment was conducted during milder conditions, and it may well be expected that larger water trough lengths would be needed in hotter conditions. Carcass weights were determined mainly by weights at feedlot entry and subsequent weight gains, while dressing percentage was not significantly affected by any of the applied treatments. There was no demonstrated effect of any of the treatments on the number of animals that died, or were classified as unwell. However, across all the treatments, these animals lost significantly more weight than the healthy animals, so the above recommendations, which are aimed at maintaining weight, should also be applicable for good animal health and welfare. Therefore, best practice guidelines for managing Australian sheep in Persian Gulf feedlots in the hottest months (June–August) which present the greatest environmental and physical challenge is to allow feed-bunk length 5 cm/head on a maintenance-feeding program and 10 cm/head for 90% ad libitum feeding, and the space allowance per animal should be ≥1.2 m2/head. Water trough allocation should be at least 1 cm/head with provision for more in the summer when water intake potentially doubles.

Impact of malnutrition on 12-month mortality following acute hip fracture

Background Studies investigating the relationship between malnutrition and post-discharge mortality following acute hip fracture yield conflicting results. This study aimed to determine whether malnutrition independently predicted 12-month post-fracture mortality after adjusting for clinically relevant covariates. Methods An ethics approved, prospective, consecutive audit was undertaken for all surgically treated hip fracture inpatients admitted to a dedicated orthogeriatric unit (November 2010–October 2011). The 12-month mortality data were obtained by a dual search of the mortality registry and Queensland Health database. Malnutrition was evaluated using the Subjective Global Assessment. Demographic (age, gender, admission residence) and clinical covariates included fracture type, time to surgery, anaesthesia type, type of surgery, post-surgery time to mobilize and post-operative complications (delirium, pulmonary and deep vein thrombosis, cardiac complications, infections). The Charlson Comorbidity Index was retrospectively applied. All diagnoses were confirmed by the treating orthogeriatrician. Results A total of 322 of 346 patients were available for audit. Increased age (P = 0.004), admission from residential care (P < 0.001), Charlson Comorbidity Index (P = 0.007), malnutrition (P < 0.001), time to mobilize >48 h (P < 0.001), delirium (P = 0.003), pulmonary embolism (P = 0.029) and cardiovascular complication (P = 0.04) were associated with 12-month mortality. Logistic regression analysis demonstrated that malnutrition (odds ratio (OR) 2.4 (95% confidence interval (CI) 1.3–4.7, P = 0.007)), in addition to admission from residential care (OR 2.6 (95% CI 1.3–5.3, P = 0.005)) and pulmonary embolism (OR 11.0 (95% CI 1.5–78.7, P = 0.017)), independently predicted 12-month mortality. Conclusions Findings substantiate malnutrition as an independent predictor of 12-month mortality in a representative sample of hip fracture inpatients. Effective strategies to identify and treat malnutrition in hip fracture should be prioritized.

Career Adapt-Abilities Scale—Iran Form: Psychometric properties and relationships with career satisfaction and entrepreneurial intentions

This study examined the psychometric properties of a Persian translation of the Career Adapt-Abilities Scale (CAAS—Iran Form) and its relationships with career satisfaction, business opportunity identification, and entrepreneurial intentions. It was hypothesized that career adaptability relates positively to these three outcomes, even when controlling for demographic and employment characteristics. Data were provided by 204 workers from Iran. Results showed that the overall CAAS score and sub-dimension scores (concern, control, curiosity, and confidence) were highly reliable. Moreover, confirmatory factor analyses indicated that the CAAS—Iran Form measures four distinct dimensions that can be combined into a higher-order career adaptability factor. Findings also demonstrated criterion-related validity of the scale with regard to career satisfaction and entrepreneurial intentions. In contrast, overall career adaptability was not significantly related to opportunity identification, while concern related positively, and control related negatively to opportunity identification. Overall, the CAAS—Iran Form has very good psychometric properties and predicts important career outcomes, suggesting that it can be used for career counseling and future research with Persian-speaking workers.

Critical Exponent β and Rectilinear Diameter of the Binary-Liquid System Carbon Disulfide + Nitromethane

The system CS2 + CH3NO2 shows β=0.315±0.004 over 10-6<ε=|T-Tc| / Tc<2�10-1 with no indication of a classical value ½ even far away from Tc. The diameter shows a curvature and is of the form �c+b ε+fε7 / 8exp(-gεh).

What does built environment research have to do with risk mitigation, resilience and disaster recovery?

One could argue that the nature of our housing stock is a key determining factor in the ability of our citizens to manage risk, be resilient to various natural and human events, and to recover from these events. Recent research has been examining current challenges posed by our housing stock and exploring potential solutions from a range of perspectives. The aim of this paper is to discuss key findings from recent built environment research in Australia to initiate cross-sectorial discussion and debate about the implications and opportunities for other sectors such as emergency management and insurance. Three recent building research projects are discussed: - Heat waves The impact of heat waves on houses and occupants, and proposed changes to building regulations, air conditioning standards and building design, to reduce risks associated with heat waves. - Net zero energy homes Exploration of the potential benefits of a strategic optimization of building quality, energy and water efficiency, and household or community level distributed energy and water services for disaster management and recovery. - Building information Mapping of the flow of information about residential buildings, and the potential for national or regional building files (in a similar manner to personal medical records) to assist all parties to make more informed decisions that impact on housing sustainability and community resilience. The paper discusses how sustainability, environmental performance and resilience are inter-related, and can be supported by building files. It concludes with a call for increased cross-sectorial collaboration to explore opportunities for a whole-of-systems approach to our built environment that addresses a range of economic and environmental challenges as well as disaster and emergency management.

Governing cloud computing services: Reconsideration of IT governance structures

There is an increase in the uptake of cloud computing services (CCS). CCS is adopted in the form of a utility, and it incorporates business risks of the service providers and intermediaries. Thus, the adoption of CCS will change the risk profile of an organization. In this situation, organizations need to develop competencies by reconsidering their IT governance structures to achieve a desired level of IT-business alignment and maintain their risk appetite to source business value from CCS. We use the resource-based theories to suggest that collaborative board oversight of CCS, competencies relating to CCS information and financial management, and a CCS-related continuous audit program can contribute to business process performance improvements and overall firm performance. Using survey data, we find evidence of a positive association between these IT governance considerations and business process performance. We also find evidence of positive association between business process performance improvements and overall firm performance. The results suggest that the suggested considerations on IT governance structures can contribute to CCS-related IT-business alignment and lead to anticipated business value from CCS. This study provides guidance to organizations on competencies required to secure business value from CCS.

Surface waves on the boundary of a magnetized plasma

Full dispersion curves including the effect of ions are presented for the electromagnetic surface waves propagating over a plasma-plasma interface in the direction perpendicular to the magnetic field which is parallel to the interface. The effect of ions and finite density ratio of the two media at the boundary give rise to various new features in the dispersion characteristics of these surface waves.

Critical Exponent β and Rectilinear Diameter of the Binary-Liquid System Carbon Disulfide + Nitromethane

The system CS2 + CH3NO2 shows β=0.315±0.004 over 10-6<ε=|T-Tc| / Tc<2-10-1 with no indication of a classical value ½ even far away from Tc. The diameter shows a curvature and is of the form - c+b ε+fε7 / 8exp(-gεh).

Tariff-tax reforms and market access

Reducing tariffs and increasing consumption taxes is a standard IMF advice to countries that want to open up their economy without hurting government finances. Indeed, theoretical analysis of such a tariff–tax reform shows an unambiguous increase in welfare and government revenues. The present paper examines whether the country that implements such a reform ends up opening up its markets to international trade, i.e. whether its market access improves. It is shown that this is not necessarily so. We also show that, comparing to the reform of only tariffs, the tariff–tax reform is a less efficient proposal to follow both as far as it concerns market access and welfare.

Contribution from unresolved discrete sources to the extragalactic gamma-ray background (EGRB)

The origin of the extragalactic gamma-ray background (EGRB) is still an open question, even nearly forty years after its discovery. The emission could originate either from truly diffuse processes or from unresolved point sources. Although the majority of the 271 point sources detected by EGRET (Energetic Gamma Ray Experiment Telescope) are unidentified, of the identified sources, blazars are the dominant candidates. Therefore, unresolved blazars may be considered the main contributor to the EGRB, and many studies have been carried out to understand their distribution, evolution and contribution to the EGRB. Considering that gamma-ray emission comes mostly from jets of blazars and that the jet emission decreases rapidly with increasing jet to line-of-sight angle, it is not surprising that EGRET was not able to detect many large inclination angle active galactic nuclei (AGNs). Though Fermi could only detect a few large inclination angle AGNs during the first three months of its survey, it is expected to detect many such sources in the near future. Since non-blazar AGNs are expected to have higher density as compared to blazars, these could also contribute significantly to the EGRB. In this paper, we discuss contributions from unresolved discrete sources including normal galaxies, starburst galaxies, blazars and off-axis AGNs to the EGRB.