Discharge planning in the emergency department : a comprehensive approach

Discharge planning has become increasingly important, with current trends toward shorter hospital stays, increased health care costs, and more community-based health services. Effective discharge planning ensures the safety and ongoing care for patients,1 and it also benefits health care providers and organizations. It results in shorter hospital stays, fewer readmissions, higher access rates to post-hospitalization services, greater patient satisfaction with the discharge, and improved quality of life and continuity of care.[2] and [3] All acute care patients and their caregivers require some degree of preparation for discharge home—education about their health status, risks, and treatment; help setting health goals and maintaining a good level of self-care; information about community resources; and follow-up appointments and referrals to appropriate community health providers. Inadequate preparation exposes the patient to unnecessary risks of recurrence or complications of the acute complaint, neglect of nonacute comorbidities, mismanagement and side effects of medication, disruption of family and social life, emotional distress, and financial loss.[2], [3] and [4] The result may be re-presentation to the emergency department. It is noteworthy that up to 18% of ED presentations are revisits within 72 hours of the original visit5; many of these are considered preventable.6 It is a primary responsibility of nurses to ensure that patients return to the community adequately prepared and with appropriate support in place. Up to 65% of ED patients are discharged home from the emergency department,7 and the characteristics of the emergency department and its patient population make the provision of a high standard of discharge planning uniquely difficult. In addition, discharge planning is neglected in contemporary emergency nursing—there are no monographs devoted to the subject, and there is little published research. In this article 3 issues are explored: the importance of emergency nurses’ participation in the discharge-planning process, impediments to their participation; and strategies to improve discharge planning in the emergency department.

Peripheral higher order aberrations in emmetropes and myopes

Purpose: Poor image quality in the peripheral field may lead to myopia. Most studies measuring the higher order aberrations in the periphery have been restricted to the horizontal visual field. The purpose of this study was to measure higher order monochromatic aberrations across the central 42º horizontal x 32º vertical visual fields in myopes and emmetropes. ---------- Methods: We recruited 5 young emmetropes with spherical equivalent refractions +0.17 ± 0.45D and 5 young myopes with spherical equivalent refractions -3.9 ± 2.09D. Measurements were taken with a modified COAS-HD Hartmann-Shack aberrometer (Wavefront Sciences Inc). Measurements were taken while the subjects looked at 38 points arranged in a 7 x 6 matrix (excluding four corner points) through a beam splitter held between the instrument and the eye. A combination of the instrument’s software and our own software was used to estimate OSA Zernike coefficients for 5mm pupil diameter at 555nm for each point. The software took into account the elliptical shape of the off-axis pupil. Nasal and superior fields were taken to have positive x and y signs, respectively. ---------- Results: The total higher order RMS (HORMS) was similar on-axis for emmetropes (0.16 ± 0.02 μm) and myopes (0.17 ± 0.02 μm). There was no common pattern for HORMS for emmetropes across the visual field where as 4 out of 5 myopes showed a linear increase in HORMS in all directions away from the minimum. For all subjects, vertical and horizontal comas showed linear changes across the visual field. The mean rate of change of vertical coma across the vertical meridian was significantly lower (p = 0.008) for emmetropes (-0.005 ± 0.002 μm/deg) than for myopes (-0.013 ± 0.004 μm/deg). The mean rate of change of horizontal coma across the horizontal meridian was lower (p = 0.07) for emmetropes (-0.006 ± 0.003 μm/deg) than myopes (-0.011 ± 0.004 μm/deg). ---------- Conclusion: We have found differences in patterns of higher order aberrations across the visual fields of emmetropes and myopes, with myopes showing the greater rates of change of horizontal and vertical coma.

Benefit analysis of airborne GPS occultation approach : a case study for the Australian region

This paper aims to present a preliminary benefit analysis for airborne GPS occultation technique for the Australian region. The simulation studies are based on current domestic commercial flights between major Australian airports. With the knowledge of GPS satellite ephemeris data, occultation events for for any particular flight can be determined. Preliminary analysis shows a high resolution occultation observations can be achieved with this approach, for instance, about 15 occultation events for a Perth-to-Sydney flight. The simulation result agrees to the results published by other researchers for a different region. Of course, occultation observation during off-peak hours might be affected due to the limited flight activities. --------- High resolution occultation observations obtainable from airborne GPS occultation system provides an opportunity to improve the current global numerical weather prediction (NWP) models and ultimately improves the accuracy in weather forecasting. More intensive research efforts and experimental demonstrations are required in order to demonstrate the technical feasibility of the airborne GPS technology.

Sex trafficking : the global market in women and children

This book is one of a series on contemporary social issues. It provides a painstakingly researched analysis of the contemporary phenomenon of sex trafficking. As the author Kathryn Farr points out, the phenomenon is not all that contemporary, as women and children have historically been trafficked and enslaved for the purposes of prostitution, particularly during war: in World War II on the southern islands of Okinawa, the Philippines, Hawaii, Liberia, Japan, the Korean war, the Vietnam war, and more recently in Bosnia and Rwanda. Farr links the phenomenon to military socialization, especially to its patriarchal culture which celebrates hyper-masculinity, eroticizes violence, desensitizes soldiers to suffering and brutality and treats women as sex objects.

The evolution of tax morale in modern Spain

This paper studies the evolution of tax morale in Spain in the post-France era. In contrast to the previous tax compliance literature, the current paper investigates tax morale as the dependent variable and attempts to answer what actually shapes tax morale. Te analysis uses suevey data from two sources; the World Values Survey and the European Values Survey, allowing us to observe tax morale in Spain for the years 1981,1990, 1995 and 1999/2000. The sutudy of evolution of tax morale in Spain over nearly a 20-year span is particularly interesting because the political and fiscal system evolved very rapidly during this period.

Will the Australian national curriculum up the intellectual ante in classrooms?

A critical review of the current and potential impacts of the Australian National Curriculum on the enacted curriculum in primary schools, with specific attention to issues of equity and social justice.

The mobile Internet and small business : an exploratory study of needs, uses and adoption with full-adopters of technology

The technological environment in which contemporary small and medium-sized enterprises (SMEs) operate can only be described as dynamic. The exponential rate of technological change, characterised by perceived increases in the benefits associated with various technologies, shortening product life cycles and changing standards, provides for the SME a complex and challenging operational context. The primary aim of this research was to concentrate on those SMEs that had already adopted technology in order to identify their needs for the new mobile data technologies (MDT), the mobile Internet. The research design utilised a mixed approach whereby both qualitative and quantitative data was collected to address the question. Overall, the needs of these SMEs for MDT can be conceptualised into three areas where the technology will assist business practices; communication, eCommerce and security.

Business on-line? An empirical study of factors leading to the adoption of Internet technologies by Australian SMEs

E-commerce technologies such as a website, email and the use of web browsers enables access to large amounts of information, facilitates communication and provides niche companies with an effective mechanism for competing with larger organisations world-wide. However recent literature has shown Australian SMEs have been slow in the uptake of these technologies. The aim of this research was to determine which factors were important in impacting on small firms' decision making in respect of information technology and e-commerce adoption. Findings indicate that generally the more a firm was concerned about its competitive position such a firm was likely to develop a web site. Moreover the 'Industry and Skill Demands' dimension suggested that as the formal education of the owner/manager increased, coupled with the likelihood that the firm was in the transport and storage or communication services industries, and realising the cost of IT adoption was in effect an investment, then such a firm would be inclined to develop a web site.

Beyond the fashionable : strategic planning for critical information literacy education

The challenge for all educators is to fuse the learning of information literacy to an academic education in such a way that the outcome is systematic and sustainable learning for students. This challenge can be answered through long-term commitment to information literacy education bound to organisation-wide, renewable strategic planning and driven through systemic reform. This chapter seeks to explore the two sides of reforming information literacy education in an academic environment. Specifically, it will examine how one Australian university has undertaken the implementation of a rigorous strategic, systemic approach to information literacy learning and teaching.

Migrant and refugee children, their families, and early childhood education

One of the effects of globalization is the increasing movement of people around the globe. Transnational migration brings demographic changes that produce challenges for education and social services. While there is a growing body of literature about educational concerns associated with migrant and refugee children, young migrant children are not often included in this research because it concentrates on secondary and primary schooling. In this chapter we review the literature that relates to young migrant and refugee children, their families and early childhood education. More specifically, we synthesize the state of knowledge relating to curriculum, parents and teacher education. Following the analysis of recent research, the chapter concludes with some suggestions for further research, policy makers and practitioners.

Bronwyn Fredericks

Bronwyn Fredericks shares her thoughts on citizen advocacy as part of the 1999-2009 celebration of Capricorn Citizen Advocacy Inc.

Autonomous excavation using a rope shovel

This paper describes automation of the digging cycle of a mining rope shovel which considers autonomous dipper (bucket) filling and determining methods to detect when to disengage the dipper from the bank. Novel techniques to overcome dipper stall and the online estimation of dipper "fullness" are described with in-field experimental results of laser DTM generation, machine automation and digging using a 1/7th scale model rope shovel presented. © 2006 Wiley Periodicals, Inc.

Adaptive depth estimation in image based visual servo control of dynamic systems

This paper considers the question of designing a fully image based visual servo control for a dynamic system. The work is motivated by the ongoing development of image based visual servo control of small aerial robotic vehicles. The observed targets considered are coloured blobs on a flat surface to which the normal direction is known. The theoretical framework is directly applicable to the case of markings on a horizontal floor or landing field. The image features used are a first order spherical moment for position and an image flow measurement for velocity. A fully non-linear adaptive control design is provided that ensures global stability of the closed-loop system. © 2005 IEEE.

Phenyl-ring disorder in the two-dimensional hydrogen-bonded structure of the 1:1 proton-transfer salt of the diazo-dye precursor 4-(phenyldiazenyl)aniline (aniline yellow) with L-tartaric acid

The structure of the 1:1 proton-transfer compound from the reaction of L-tartaric acid with the azo-dye precursor aniline yellow [4-(phenylazo)aniline], 4-(phenyldiazenyl)anilinium hydrogen 2R,3R-tartrate C12H12N3+ . C4H6O6- has been determined at 200 K. The asymmetric unit of the compound contains two independent phenylazoanilinium cations and two hydrogen L-tartrate anions. The structure is unusual in that all four phenyl rings of both cations have identical 50% rotational disorder. The two hydrogen L-tartrate anions form independent but similar chains through head-to-tail carboxylic O--H...O~carboxyl~ hydrogen bonds [graph set C7] which are then extended into a two-dimensional hydrogen-bonded sheet structure through hydroxyl O--H...O hydrogen-bonding links. The anilinium groups of the phenyldiazenyl cations are incorporated into the sheets and also provide internal hydrogen-bonding extensions while their aromatic tails layer in the structure without significant interaction except for weak \p--\p interactions [minimum ring centroid separation, 3.844(3) \%A]. The hydrogen L-tartrate residues of both anions have the common short intramolecular hydroxyl O--H...O~carboxyl~ hydogen bonds. This work has provided a solution to the unusual disorder problem inherent in the structure of this salt as well as giving another example of the utility of the hydrogen tartrate in the generation of sheet substructures in molecular assembly processes.

Helicopter automation using a low-cost sensing system

This paper details the design of an autonomous helicopter control system using a low cost sensor suite. Control is maintained using simple nested PID loops. Aircraft attitude, velocity, and height is estimated using an in-house designed IMU and vision system. Information is combined using complimentary filtering. The aircraft is shown to be stabilised and responding to high level demands on all axes, including heading, height, lateral velocity and longitudinal velocity.