Feasibility of a stepped wedge cluster RCT and concurrent observational sub-study to evaluate the effects of modified ward night lighting on inpatient fall rates and sleep quality: A protocol for a pilot trial

Background: Falls among hospitalised patients impose a considerable burden on health systems globally and prevention is a priority. Some patient-level interventions have been effective in reducing falls, but others have not. An alternative and promising approach to reducing inpatient falls is through the modification of the hospital physical environment and the night lighting of hospital wards is a leading candidate for investigation. In this pilot trial, we will determine the feasibility of conducting a main trial to evaluate the effects of modified night lighting on inpatient ward level fall rates. We will test also the feasibility of collecting novel forms of patient level data through a concurrent observational sub-study. Methods/design: A stepped wedge, cluster randomised controlled trial will be conducted in six inpatient wards over 14 months in a metropolitan teaching hospital in Brisbane (Australia). The intervention will consist of supplementary night lighting installed across all patient rooms within study wards. The planned placement of luminaires, configurations and spectral characteristics are based on prior published research and pre-trial testing and modification. We will collect data on rates of falls on study wards (falls per 1000 patient days), the proportion of patients who fall once or more, and average length of stay. We will recruit two patients per ward per month to a concurrent observational sub-study aimed at understanding potential impacts on a range of patient sleep and mobility behaviour. The effect on the environment will be monitored with sensors to detect variation in light levels and night-time room activity. We will also collect data on possible patient-level confounders including demographics, pre-admission sleep quality, reported vision, hearing impairment and functional status. Discussion: This pragmatic pilot trial will assess the feasibility of conducting a main trial to investigate the effects of modified night lighting on inpatient fall rates using several new methods previously untested in the context of environmental modifications and patient safety. Pilot data collected through both parts of the trial will be utilised to inform sample size calculations, trial design and final data collection methods for a subsequent main trial.

Outdoor group portrait of attendees of the International Meeting of the World Union for Progressive Judaism; London.

Includes Rabbi Leo Baeck, E.L. Ehrlich of Basel, Herbert Strauss of Bern, and Rabbi Eugen Messinger of Bern

Chinese cultural competency and Australian law students: Reflections on the design of short term mobility programs

There is an emerging need for Australia’s law graduates to better understand the unique challenges and opportunities in our largest trading partner, China. Similarly, as China opens up to the world, its graduates are increasingly well-poised to make an indelible mark on Chinese-Australian relations, particularly in the areas of finance, property, trade and commerce. Chinese and Australian law schools must urgently develop a deeper awareness of each other’s language, culture and political systems in their graduates. The purpose of this article is to highlight the importance of Chinese cultural competency to Australian legal education and reflect on projects that enable students to attain a level of cultural competency over a short period. We do this by considering a recent ‘short term mobility project’ in Wuhan, China.

Dining experience in elsewhere

Globalisation leads people getting a chance to move to a different place, to dine in a different context and to experience a different lifestyle. This paper evaluates the designs which offer dining experience in elsewhere, a changed context. A logical narrative review of literature has been conducted to clarify the patterns that restaurant practitioners, designers and social science researchers used for developing dining experience in elsewhere. The paper defines two hourglass balance pattern via food between diner and dining experience providers, as well as a set of interactive strategies in dining experience design. The former can be regarded as an example of the latter pattern. The findings indicate an empathetic setting design framework is needed in future research. This is the first paper that examines the dining experience in light of the atmosphere caused by people’s physical and psychological mobility flow in modern society. The findings provide an access to establish dining experience design framework in future research, that is, achieve various levels of diners’ needs in dining setting design by distributing the multisensory effects to activate diners’ involvement in the dining experience.

Electrophoretic mobility of cell nuclei (EMN index) as a biomarker of the biological aging process: Considering the association between EMN index and age

The present study examined whether a specific property of cell microstructures may be useful as a biomarker of aging. Specifically, the association between age and changes of cellular structures reflected in electrophoretic mobility of cell nuclei index (EMN index) values across the adult lifespan was examined. This report considers findings from cross sections of females (n = 1273) aged 18–98 years, and males (n = 506) aged 19–93 years. A Biotest apparatus was used to perform intracellular microelectrophoresis on buccal epithelial cells collected from each individual. EMN index was calculated on the basis of the number of epithelial cells with mobile nuclei in reference to the cells with immobile nuclei per 100 cells. Regression analyses indicated a significant negative association between EMN index value and age for men (r = −0.71, p < 0.001) and women (r = −0.60, p < 0.001); demonstrating a key requirement that must be met by a biomarker of aging. The strength of association observed between EMN index and age for both men and women was encouraging and supports the potential use of EMN index for determining a biological age of an individual (or a group). In this study, a new attempt of complex explanation of cellular mechanisms contributing to age related changes of the EMN index was made. In this study, a new attempt of complex explanation of cellular mechanisms contributing to age related changes of the EMN index was made. EMN index has demonstrated potential to meet criteria proposed for biomarkers of aging and further investigations are necessary.

Now the real international fight begins for the Trans-Pacific Partnership

In Atlanta, the trade ministers of a dozen countries across the Pacific Rim announced that they had successfully reached a concluded agreement upon the Trans-Pacific Partnership. The debate over the TPP will now play out in legislatures across the Pacific Rim, where sentiment towards the deal is much more mixed. The ministers insisted: “After more than five years of intensive negotiations, we have come to an agreement that will support jobs, drive sustainable growth, foster inclusive development, and promote innovation across the Asia-Pacific region … The agreement achieves the goal we set forth of an ambitious, comprehensive, high standard and balanced agreement that will benefit our nation’s citizens … We expect this historic agreement to promote economic growth, support higher-paying jobs; enhance innovation, productivity and competitiveness; raise living standards; reduce poverty in our countries; and to promote transparency, good governance, and strong labor and environmental protections.” But there has been fierce criticism of the Trans-Pacific Partnership, because of both its secrecy and its substance. Nobel Laureate Professor Joseph Stiglitz has warned that the agreement is not about free trade, but about the protection of corporate monopolies. The intellectual property chapter provides for longer and stronger protection of intellectual property rights. The investment chapter provides foreign investors with the power to challenge governments under an investor-state dispute settlement (ISDS) regime. The environment chapter is weak and toothless, and seems to be little more than an exercise in greenwashing. The health annex — and many other parts of the agreement — strengthen the power of pharmaceutical companies and biotechnology developers. The text on state-owned enterprises raises concerns about public ownership of postal services, broadcasters and national broadband services.

Evaluating the effects of international exposure from networks ties and mimetic pressure on clustered SMEs in Brazil

Research on the internationalisation of small and medium-sized enterprises (SMEs) has received increasing attention in recent years due to the important role they play in today’s economic environment. Internationalisation prompting, or awareness, is an already recognised phase of the innovation-related stages model (I-model). This phase of awareness is closely related to the international exposure that a firm may experience during the occasion when it realises its competitors are already internationalising. Although the literature has discussed the various forms in which international exposure may happen, there has been limited attention given to the extent of its effect on the internationalisation of clustered SMEs that behave according to the I-Model. This study will assess the applicability of the I-Model in a dynamic, competitive and co-operative setting of an industrial cluster. It also evaluates the impact (if any) of international exposure derived from networks and the mimetic pressure that these firms may experience due to their embeddedness in an industrial cluster. Results from this study will indicate the effectiveness of the improved adapted model that will provide a richer insight for both academic researchers and policy makers.

Efficient Content-based Routing, Mobility-aware Topologies, and Temporal Subspace Matching

Event-based systems are seen as good candidates for supporting distributed applications in dynamic and ubiquitous environments because they support decoupled and asynchronous many-to-many information dissemination. Event systems are widely used, because asynchronous messaging provides a flexible alternative to RPC (Remote Procedure Call). They are typically implemented using an overlay network of routers. A content-based router forwards event messages based on filters that are installed by subscribers and other routers. The filters are organized into a routing table in order to forward incoming events to proper subscribers and neighbouring routers. This thesis addresses the optimization of content-based routing tables organized using the covering relation and presents novel data structures and configurations for improving local and distributed operation. Data structures are needed for organizing filters into a routing table that supports efficient matching and runtime operation. We present novel results on dynamic filter merging and the integration of filter merging with content-based routing tables. In addition, the thesis examines the cost of client mobility using different protocols and routing topologies. We also present a new matching technique called temporal subspace matching. The technique combines two new features. The first feature, temporal operation, supports notifications, or content profiles, that persist in time. The second feature, subspace matching, allows more expressive semantics, because notifications may contain intervals and be defined as subspaces of the content space. We also present an application of temporal subspace matching pertaining to metadata-based continuous collection and object tracking.

IP Mobility in Wireless Operator Networks

Wireless network access is gaining increased heterogeneity in terms of the types of IP capable access technologies. The access network heterogeneity is an outcome of incremental and evolutionary approach of building new infrastructure. The recent success of multi-radio terminals drives both building a new infrastructure and implicit deployment of heterogeneous access networks. Typically there is no economical reason to replace the existing infrastructure when building a new one. The gradual migration phase usually takes several years. IP-based mobility across different access networks may involve both horizontal and vertical handovers. Depending on the networking environment, the mobile terminal may be attached to the network through multiple access technologies. Consequently, the terminal may send and receive packets through multiple networks simultaneously. This dissertation addresses the introduction of IP Mobility paradigm into the existing mobile operator network infrastructure that have not originally been designed for multi-access and IP Mobility. We propose a model for the future wireless networking and roaming architecture that does not require revolutionary technology changes and can be deployed without unnecessary complexity. The model proposes a clear separation of operator roles: (i) access operator, (ii) service operator, and (iii) inter-connection and roaming provider. The separation allows each type of an operator to have their own development path and business models without artificial bindings with each other. We also propose minimum requirements for the new model. We present the state of the art of IP Mobility. We also present results of standardization efforts in IP-based wireless architectures. Finally, we present experimentation results of IP-level mobility in various wireless operator deployments.

Editorial of "International Journal of Critical Indigenous Studies Volume 1, Number 1, 2008"

We perceive the epistemological boundaries of Critical Indigenous Studies as marked by analyses of contemporary colonising power in its multiple forms in different contexts. This first issue brings together a diverse group of international Indigenous scholars who are politically and intellectually engaged in theorising from their respective standpoints as well as spatial and geographic locations. As such these essays enable dialogue across and within different colonial power contexts addressing epistemological ethical and methodological concerns within the broad field of Indigenous studies. In each essay a connecting theme is the need for intercultural and comparative work and to import Indigenous agency in the writing of history...

Editorial of "International Journal of Critical Indigenous Studies Volume 2, Number 1, 2009"

Over the past two decades neo liberalism has shaped global economic activity. The international reach of the current economic crisis propelled by the subprime mortgage meltdown in the United States has affected Indigenous communities in different ways to those whose investments were depleted by the Wall Street activities of an unregulated corporate and banking sector. Throughout this roller coaster economic ride the low socio-economic position of Indigenous peoples continued in Canada, the United States of America, New Zealand, Hawaii and Australia. The logic, or illogic of capital, failed to extend the boom of the economic upturn to Indigenous peoples, but is poised to extend the repercussions of the current downturn deep into Indigenous lives. The consistency of the Indigenous socio-economic position across these countries, even where treaties exist, indicates that the phenomenon is based on a shared Indigenous reality. In this special edition, the commonality in the way in which Indigenous people are engaged in and positioned by market forces and regulation by their respective nation states is proposed as one of the foundation plates of that Indigenous positioning...

Editorial of "International Journal of Critical Indigenous Studies Volume 2, Number 2, 2009"

This edition of the International Critical Indigenous Studies Journal, our second for 2009 takes alternative understandings as its theme. All four articles in this edition attend to citizenship and Indigenous sovereignty though in different ways...

Editorial of "International Journal of Critical Indigenous Studies Volume 3, Number 1, 2010"

The articles in this edition of the International Journal of Critical Indigenous Studies engage collectively with how different epistemologies and cultural values inform power relations in different locations, situations and contemporary contexts. As a group, these articles demonstrate, over varying facets, how meaning, communicative intent and interpretive effect are constitutive of power relations between Indigenous people and non Indigenous people. Jackie Grey discusses the labour of belonging as played out in a dispute over Indigenous fishing rights in a small New England town of Aquinnah, located on Noepe Island the traditional lands of the Wampanoag in the United States of America. She reveals the ways in which the jurisdiction of non Indigenous belonging operates discursively and materially to preclude Indigenous rights and self determination. Grey's analysis highlights the incommensurability of Indigenous and non Indigenous belonging that are played out in power relations born of colonisation.

Editorial of "International Journal of Critical Indigenous Studies Volume 3, Number 2, 2010"

In this of the International Journal of Critical Indigenous Studies, the articles reveal how competing economies of knowledge, capital and values are operationalised through colonising power within inter-subjective relations. Writing in the Australian context, Greg Blyton demonstrates how tobacco was used by colonists as a means of control and exchange in their relations with Indigenous people. He focuses on the Hunter region of New South Wales, Australia, in the early to mid-nineteenth century to reveal how colonists exchanged tobacco for food, safe passage and Indigenous services. Blyton suggests that these colonial practices enabled tobacco addiction to spread throughout the region, passing from one generation of Indigenous people to another. He asks us to consider the link between the colonial generation of Indigenous tobacco consumption and addiction, and Indigenous mortality rates today whereby twenty percent of deaths are attributed to smoking.