A prospective cohort study of geriatric syndromes among older medical patients admitted to acute care hospitals

OBJECTIVES: To identify the prevalence of geriatric syndromes in the premorbid for all syndromes except falls (preadmission), admission, and discharge assessment periods and the incidence of new and significant worsening of existing syndromes at admission and discharge. DESIGN: Prospective cohort study. SETTING: Three acute care hospitals in Brisbane, Australia. PARTICIPANTS: Five hundred seventy-seven general medical patients aged 70 and older admitted to the hospital. MEASUREMENTS: Prevalence of syndromes in the premorbid (or preadmission for falls), admission, and discharge periods; incidence of new syndromes at admission and discharge; and significant worsening of existing syndromes at admission and discharge. RESULTS: The most frequently reported premorbid syndromes were bladder incontinence (44%), impairment in any activity of daily living (ADL) (42%). A high proportion (42%) experienced at least one fall in the 90 days before admission. Two-thirds of the participants experienced between one and five syndromes (cognitive impairment, dependence in any ADL item, bladder and bowel incontinence, pressure ulcer) before, at admission, and at discharge. A majority experienced one or two syndromes during the premorbid (49.4%), admission (57.0%), or discharge (49.0%) assessment period.The syndromes with a higher incidence of significant worsening at discharge (out of the proportion with the syndrome present premorbidly) were ADL limitation (33%), cognitive impairment (9%), and bladder incontinence (8%). Of the syndromes examined at discharge, a higher proportion of patients experienced the following new syndromes at discharge (absent premorbidly): ADL limitation (22%); and bladder incontinence (13%). CONCLUSION: Geriatric syndromes were highly prevalent. Many patients did not return to their premorbid function and acquired new syndromes.

Police misconduct and crime : bad apples or systems failure?

There is a debate in the research literature whether to view police misconduct and crime as acts of individuals perceived as 'rotten apples' or as an indication of systems failure in the police force. Based on an archival analysis of court cases where police employees were prosecuted, this paper attempts to explore the extent of rotten apples versus systems failure in the police. Exploratory research of 57 prosecuted police officers in Norway indicate that there were more rotten apple cases than system failure cases. The individual failures seem to be the norm rather than the exception of ethical breaches, therefore enhancing the rotten apple theory. However as exploratory research, police crime may still be explained at the organizational level as well.

Human information behavior: Integrating diverse approaches and information use

For millennia humans have sought, organized, and used information as they learned and evolved patterns of human information behaviors to resolve their human problems and survive. However, despite the current focus on living in an "information age," we have a limited evolutionary understanding of human information behavior. In this article the authors examine the current three interdisciplinary approaches to conceptualizing how humans have sought information including (a) the everyday life information seeking-sense-making approach, (b) the information foraging approach, and (c) the problem-solution perspective on information seeking approach. In addition, due to the lack of clarity regarding the role of information use in information behavior, a fourth information approach is provided based on a theory of information use. The use theory proposed starts from an evolutionary psychology notion that humans are able to adapt to their environment and survive because of our modular cognitive architecture. Finally, the authors begin the process of conceptualizing these diverse approaches, and the various aspects or elements of these approaches, within an integrated model with consideration of information use. An initial integrated model of these different approaches with information use is proposed.

Sequential Monte Carlo for Bayesian sequentially designed experiments for discrete data

In this paper we present a sequential Monte Carlo algorithm for Bayesian sequential experimental design applied to generalised non-linear models for discrete data. The approach is computationally convenient in that the information of newly observed data can be incorporated through a simple re-weighting step. We also consider a flexible parametric model for the stimulus-response relationship together with a newly developed hybrid design utility that can produce more robust estimates of the target stimulus in the presence of substantial model and parameter uncertainty. The algorithm is applied to hypothetical clinical trial or bioassay scenarios. In the discussion, potential generalisations of the algorithm are suggested to possibly extend its applicability to a wide variety of scenarios

Monte Carlo verification of gel dosimetry measurements for stereotactic radiotherapy

The quality assurance of stereotactic radiotherapy and radiosurgery treatments requires the use of small-field dose measurements that can be experimentally challenging. This study used Monte Carlo simulations to establish that PAGAT dosimetry gel can be used to provide accurate, high resolution, three-dimensional dose measurements of stereotactic radiotherapy fields. A small cylindrical container (4 cm height, 4.2 cm diameter) was filled with PAGAT gel, placed in the parietal region inside a CIRS head phantom, and irradiated with a 12 field stereotactic radiotherapy plan. The resulting three-dimensional dose measurement was read out using an optical CT scanner and compared with the treatment planning prediction of the dose delivered to the gel during the treatment. A BEAMnrc DOSXYZnrc simulation of this treatment was completed, to provide a standard against which the accuracy of the gel measurement could be gauged. The three dimensional dose distributions obtained from Monte Carlo and from the gel measurement were found to be in better agreement with each other than with the dose distribution provided by the treatment planning system's pencil beam calculation. Both sets of data showed close agreement with the treatment planning system's dose distribution through the centre of the irradiated volume and substantial disagreement with the treatment planning system at the penumbrae. The Monte Carlo calculations and gel measurements both indicated that the treated volume was up to 3 mm narrower, with steeper penumbrae and more variable out-of-field dose, than predicted by the treatment planning system. The Monte Carlo simulations allowed the accuracy of the PAGAT gel dosimeter to be verified in this case, allowing PAGAT gel to be utilised in the measurement of dose from stereotactic and other radiotherapy treatments, with greater confidence in the future.

Music selection using a touch screen interface : effect of auditory and visual feedback on driving and usability

This study aimed to examine the effects on driving, usability and subjective workload of performing music selection tasks using a touch screen interface. Additionally, to explore whether the provision of visual and/or auditory feedback offers any performance and usability benefits. Thirty participants performed music selection tasks with a touch screen interface while driving. The interface provided four forms of feedback: no feedback, auditory feedback, visual feedback, and a combination of auditory and visual feedback. Performance on the music selection tasks significantly increased subjective workload and degraded performance on a range of driving measures including lane keeping variation and number of lane excursions. The provision of any form of feedback on the touch screen interface did not significantly affect driving performance, usability or subjective workload, but was preferred by users over no feedback. Overall, the results suggest that touch screens may not be a suitable input device for navigating scrollable lists.

Practice and procedure : an application under r367 of the Uniform Civil Procedure Rules may be of use in obtaining copies of otherwise unavailable documents held by government agencies.

In Bowenbrae Pty Ltd v Flying Fighters Maintenance and Restoration [2010] QDC 347 Reid DCJ made orders requiring the plaintiffs to make application under the Freedom of Information Act 1982 (Cth) (“the FOI Act”) for documents sought by the defendant.

Predictors of and reasons for pacifier use in first-time mothers : an observational study

Background: The use of pacifiers is commonplace in Australia and has been shown to be negatively associated with breastfeeding duration. In order to influence behaviour related to the use of pacifiers it is important to understand the reasons for their use. The primary aim of this observational study was to investigate who (if anyone) advises first-time mothers to give a pacifier and the reasons for which they first give (or try to give) a pacifier to their infant. Additionally, this study investigated the predictors of pacifier use and the relationship between pacifier use and breastfeeding duration. Methods: In total, 670 Australian first-time mothers recruited as part of the NOURISH trial completed a questionnaire regarding infant feeding and pacifier use. Results: Pacifiers were introduced by 79% of mothers, of whom 28.7% were advised to use a pacifier by their mother/mother-in-law with a further 22.7% being advised by a midwife. The majority of mothers used a pacifier in order to soothe their infant (78.3%), to help put them to sleep (57.4%) and to keep them comforted and quiet (40.4%). Pacifiers given to infants before four weeks (adjHR 3.67; 95%CI 2.14–6.28) and used most days (adjHR 3.28; 95%CI 1.92–5.61) were significantly associated with shorter duration of breastfeeding. Conclusions: This study identifies an opportunity for educating new mothers and their support network, particularly their infant’s grandmothers, with regards to potential risks associated with the early and frequent use of a pacifier, and alternative methods for soothing their infant, in order to reduce the use of pacifiers and their potentially negative effect on breastfeeding duration

Immobilised anatase on clay mineral particles as a photocatalyst for herbicides degradation

Materials consisting of anatase linked to Laponite particles were synthesized by the reaction of TiOSO4 with Laponite, and were used for the degradation of pesticides. All these materials were characterized by XRD, FTIR, Raman, TEM, specific surface area and porosity determinations. Based on the amount of photoactive phase per unit mass of the clay mineral, not based on the total weight of the catalysts, these porous catalysts were displaying a high degradation rate than commercial P25. The TiO2 immobilized clay mineral catalysts can sediment in few minutes and could be readily separated out from a slurry system after the photocatalytic reaction. Settling properties of these catalysts are enormously high in aqueous media in contrast to P25.

Futures languages in Taiwan

Taiwan is a rapidly changing society, facing many challenges. In this state of flux, it is important to step back and see the big picture. The NewFutures 2000 conference, which commemorated fifty years of the of Tamkang University, in TamShui (the northernmost tip), Taiwan (Republic of China) and was held on 5–7 November 2000, gave Taiwanese an opportunity to gain just such a perspective. The ostensible aim of the conference was to explore ‘transformations in education, culture and technology’. But numerous perspectives and academic approaches were explored; predictions, normative visions, probable futures, alternative futures, ethical futures, epistemological re-constructions, studies and deconstruction’s of images of the future, myth and worldview—all received attention, sometimes overwhelming the participants with contradictory and overbearing ideas. [introduction]

Response of a plastic pipe buried in expansive clay

Failure of buried pipes due to reactive soil movement (e.g. shrinking/swelling) is a common problem for water and gas pipe networks in Australia and the world. Soil movement is closely related to seasonal climatic change, and particularly to the moisture content of soil. Although some research has been carried out to understand the effect of freezing and thawing of soils and temperature effects in colder climates, very limited research has been undertaken to examine the possible failure mechanisms of pipes buried in reactive soils. This study reports the responses of a 2 m long polyethylene pipe buried in reactive clay in a box under laboratory conditions. The soil and pipe movements were measured as the soil was wetted from the bottom of the box. It was observed that the pipe underwent substantial deformation as the soil swelled with increase of the moisture content. The results are explained with a simplified numerical analysis.

Learning English in an English speaking world : examining opportunities for intercultural understandings and connectedness through representations of identities in English language textbooks

With the recognition that language both reflects and constructs culture and English now widely acknowledged as an international language, the cul-tural content of language teaching materials is now being problematised. Through a quantitative analysis, this chapter focuses on opportunities for intercultural understanding and connectedness through representations of the identities that appear in two leading English language textbooks. The analyses reveal that the textbooks orientate towards British and western identities with representations of people from non-European/non-Western backgrounds being notable for their absence, while others are hidden from view. Indeed there would appear to be a neocolonialist orientation in oper-ation in the textbooks, one that aligns English with the West. The chapter proposes arguments for the consideration of cultural diversity in English language teaching (ELT) textbook design, and promoting intercultural awareness and acknowledging the contexts in which English is now being used. It also offers ways that teachers can critically reflect on existing ELT materials and proposes arguments for including different varieties of Eng-lish in order to ensure a level of intercultural understanding and connect-edness.

Study of the effectiveness of outrigger system for high-rise composite buildings for cyclonic region

The demands of taller structures are becoming imperative almost everywhere in the world in addition to the challenges of material and labor cost, project time line etc. This paper conducted a study keeping in view the challenging nature of high-rise construction with no generic rules for deflection minimizations and frequency control. The effects of cyclonic wind and provision of outriggers on 28-storey, 42-storey and 57-storey are examined in this paper and certain conclusions are made which would pave way for researchers to conduct further study in this particular area of civil engineering. The results show that plan dimensions have vital impacts on structural heights. Increase of height while keeping the plan dimensions same, leads to the reduction in the lateral rigidity. To achieve required stiffness increase of bracings sizes as well as introduction of additional lateral resisting system such as belt truss and outriggers is required.