Inappropriate formulation choices in the administration of medication to elderly patients with dysphagia in nursing homes

Inappropriate food or medication texture in patients with dysphagia is the most significant risk factor for pneumonia. Dysphagia is prevalent within care homes for the older person as it is largely found in conditions associated with ageing. This study was designed to determine the appropriateness of medication formulation choices in elderly patients with dysphagia in care homes.

Influence of kaolinite particle size on cross-link density, microstructure and mechanical properties of latex blending styrene butadiene rubber composites

Cross-link density, microstructure and mechanical properties of styrene butadiene rubber (SBR) composites filled with different particle sized kaolinites are investigated. With the increase of kaolinite particle size, the cross-link density of the filled SBR composites, the dispersibility and orientation degree of kaolinite particles gradually decrease. Some big cracks in filled rubber composites are distributed along the fringe of kaolinite aggregates, and the absorbance of all the absorption bands of kaolinites gradually increase with the increase of kaolinite particle size. All mechanical property indexes of kaolinite filled SBR composites decrease due to the decrease of cross-linking and reduction of interface interaction between filler and rubber matrix.

A determinism and desire: Some neurological processes in perceiving the design object

The environment moderates behaviour using a subtle language of ‘affordances’ and ‘behaviour-settings’. Affordances are environmental offerings. They are objects that demand action; a cliff demands a leap and binoculars demand a peek. Behaviour-settings are ‘places;’ spaces encoded with expectations and meanings. Behaviour-settings work the opposite way to affordances; they demand inhibition; an introspective demeanour in a church or when under surveillance. Most affordances and behaviour-settings are designed, and as such, designers are effectively predicting brain reactions. • Affordances are nested within, and moderated by behaviour-settings. Both trigger automatic neural responses (excitation and inhibition). These, for the best part cancel each other out. This balancing enables object recognition and allows choice about what action should be taken (if any). But when excitation exceeds inhibition, instinctive action will automatically commence. In positive circumstances this may mean laughter or a smile. In negative circumstances, fleeing, screaming or other panic responses are likely. People with poor frontal function, due to immaturity (childhood or developmental disorders) or due to hypofrontality (schizophrenia, brain damage or dementia) have a reduced capacity to balance excitatory and inhibitory impulses. For these people, environmental behavioural demands increase with the decline of frontal brain function. • The world around us is not only encoded with symbols and sensory information. Opportunities and restrictions work on a much more primal level. Person/space interactions constantly take place at a molecular scale. Every space we enter has its own special dynamic, where individualism vies for supremacy between the opposing forces of affordance-related excitation and the inhibition intrinsic to behaviour-settings. And in this context, even a small change–the installation of a CCTV camera can turn a circus to a prison. • This paper draws on cutting-edge neurological theory to understand the psychological determinates of the everyday experience of the designed environment.

Patients' outcomes related to person-centred nursing care in radiation oncology: A case study

Abstract Purpose The aim of this case study is to describe patients' responses to nursing care following the implementation of a person-centred model in a radiation oncology department. Method An instrumental case study design utilised surveys to collect data on a range of key patient outcomes: patient satisfaction (PSS), informational issues (RSEP), quality of life (FACT_G), comfort (RTCQ), and emotional status (HADS). This occurred at the beginning of, and twelve months following, the implementation of the new model of care. Results This study demonstrated that, although adverse effects of radiotherapy continue to affect patient well-being in the latter part of their course of radiation therapy, patients continue to be satisfied with nursing care. There were significant differences between groups in perceptions of the care environment and the use of the nurse as an acknowledged source of information are noteworthy, since these variables were key targets of the new model of care. The finding that nurses were seen by the post-implementation cohort as more likely to be a source of information is an important indicator that the nurses' presence was noted by patients, and they generally reported high levels of functioning despite undergoing a curative course of radiotherapy. Conclusion The person-centred nursing approach in the radiotherapy setting has contributed to some improvements in the provision of patient care. Aspects of this study may assist in planning further nursing interventions for patients undergoing radiotherapy for cancer, and continue to enhance the contribution of the radiation oncology nurse to improved patient outcomes.

Robust design and optimisation of a radial turbine within a supercritical CO2 solar Brayton Cycle

The generation of solar thermal power is dependent upon the amount of sunlight exposure,as influenced by the day-night cycle and seasonal variations. In this paper, robust optimisation is applied to the design of a power block and turbine, which is generating 30 MWe from a concentrated solar resource of 560oC. The robust approach is important to attain a high average performance (minimum efficiency change) over the expected operating ranges of temperature, speed and mass flow. The final objective function combines the turbine performance and efficiency weighted by the off-design performance. The resulting robust optimisation methodology as presented in the paper gives further information that greatly aids in the design of non-classical power blocks through considering off-design conditions and resultant performance.

Endurance exercise and DNA stability: Is there a link to duration and intensity?

It is commonly accepted that regular moderate intensity physical activity reduces the risk of developing many diseases. Counter intuitively, however, evidence also exists for oxidative stress resulting from acute and strenuous exercise. Enhanced formation of reactive oxygen and nitrogen species may lead to oxidatively modified lipids, proteins and nucleic acids and possibly disease. Currently, only a few studies have investigated the influence of exercise on DNA stability and damage with conflicting results, small study groups and the use of different sample matrices or methods and result units. This is the first review to address the effect of exercise of various intensities and durations on DNA stability, focusing on human population studies. Furthermore, this article describes the principles and limitations of commonly used methods for the assessment of oxidatively modified DNA and DNA stability. This review is structured according to the type of exercise conducted (field or laboratory based) and the intensity performed (i.e. competitive ultra/endurance exercise or maximal tests until exhaustion). The findings presented here suggest that competitive ultra-endurance exercise (>4h) does not induce persistent DNA damage. However, when considering the effects of endurance exercise (<4h), no clear conclusions could be drawn. Laboratory studies have shown equivocal results (increased or no oxidative stress) after endurance or exhaustive exercise. To clarify which components of exercise participation (i.e. duration, intensity and training status of subjects) have an impact on DNA stability and damage, additional carefully designed studies combining the measurement of DNA damage, gene expression and DNA repair mechanisms before, during and after exercise of differing intensities and durations are required.

Journal of Education and Work: Special Issue: Creative Graduate Pathways Within and Beyond the Creative Industries

This special issue explores the nuances of graduate creative work, the kinds of value that creative graduates add through work of various types, graduate employability issues for creative graduates, emerging and developing creative career identities and the implications for educators who are tasked with developing a capable creative workforce. Extant literature tends to characterise creative careers as either ‘precarious’ and insecure, or as the engine room of the creative economy. However, in actuality, the creative workforce is far more heterogeneous than either of these positions suggest, and creative careers are far more complex and diverse than previously thought. The task of creative educators is also much more challenging than previously supposed.

Searching for people using semantic soft biometric descriptions

It is not uncommon to hear a person of interest described by their height, build, and clothing (i.e. type and colour). These semantic descriptions are commonly used by people to describe others, as they are quick to communicate and easy to understand. However such queries are not easily utilised within intelligent video surveillance systems, as they are difficult to transform into a representation that can be utilised by computer vision algorithms. In this paper we propose a novel approach that transforms such a semantic query into an avatar in the form of a channel representation that is searchable within a video stream. We show how spatial, colour and prior information (person shape) can be incorporated into the channel representation to locate a target using a particle-filter like approach. We demonstrate state-of-the-art performance for locating a subject in video based on a description, achieving a relative performance improvement of 46.7% over the baseline. We also apply this approach to person re-detection, and show that the approach can be used to re-detect a person in a video steam without the use of person detection.

Study protocol of the YOU CALL - WE CALL TRIAL: Impact of a multimodal support intervention after a "mild" stroke

Background More than 60% of new strokes each year are "mild" in severity and this proportion is expected to rise in the years to come. Within our current health care system those with "mild" stroke are typically discharged home within days, without further referral to health or rehabilitation services other than advice to see their family physician. Those with mild stroke often have limited access to support from health professionals with stroke-specific knowledge who would typically provide critical information on topics such as secondary stroke prevention, community reintegration, medication counselling and problem solving with regard to specific concerns that arise. Isolation and lack of knowledge may lead to a worsening of health problems including stroke recurrence and unnecessary and costly health care utilization. The purpose of this study is to assess the effectiveness, for individuals who experience a first "mild" stroke, of a sustainable, low cost, multimodal support intervention (comprising information, education and telephone support) - "WE CALL" compared to a passive intervention (providing the name and phone number of a resource person available if they feel the need to) - "YOU CALL", on two primary outcomes: unplanned-use of health services for negative events and quality of life. Method/Design We will recruit 384 adults who meet inclusion criteria for a first mild stroke across six Canadian sites. Baseline measures will be taken within the first month after stroke onset. Participants will be stratified according to comorbidity level and randomised to one of two groups: YOU CALL or WE CALL. Both interventions will be offered over a six months period. Primary outcomes include unplanned use of heath services for negative event (frequency calendar) and quality of life (EQ-5D and Quality of Life Index). Secondary outcomes include participation level (LIFE-H), depression (Beck Depression Inventory II) and use of health services for health promotion or prevention (frequency calendar). Blind assessors will gather data at mid-intervention, end of intervention and one year follow up. Discussion If effective, this multimodal intervention could be delivered in both urban and rural environments. For example, existing infrastructure such as regional stroke centers and existing secondary stroke prevention clinics, make this intervention, if effective, deliverable and sustainable.

The issue of consent: For the plaintiff or defendant to prove in trespass to person?

In White v Johnston1 the vexed question of whether it is for a plaintiff to prove lack of consent to a trespass to person or for the defendant to establish consent as defence was considered. The court also considered the principles of assessing an award of exemplary damages...

Common Alzheimer's disease risk variant within the CLU gene affects white matter microstructure in young adults

There is a strong genetic risk for late-onset Alzheimer's disease (AD), but so far few gene variants have been identified that reliably contribute to that risk. A newly confirmed genetic risk allele C of the clusterin (CLU) gene variant rs11136000 is carried by ~88% of Caucasians. The C allele confers a 1.16 greater odds of developing late-onset AD than the T allele. AD patients have reductions in regional white matter integrity. We evaluated whether the CLU risk variant was similarly associated with lower white matter integrity in healthy young humans. Evidence of early brain differences would offer a target for intervention decades before symptom onset. We scanned 398 healthy young adults (mean age, 23.6 ± 2.2 years) with diffusion tensor imaging, a variation of magnetic resonance imaging sensitive to white matter integrity in the living brain. We assessed genetic associations using mixed-model regression at each point in the brain to map the profile of these associations with white matter integrity. Each C allele copy of the CLUvariant was associated with lower fractional anisotropy-a widely accepted measure of white matter integrity-in multiple brain regions, including several known to degenerate in AD. These regions included the splenium of the corpus callosum, the fornix, cingulum, and superior and inferior longitudinal fasciculi in both brain hemispheres. Young healthy carriers of the CLU gene risk variant showed a distinct profile of lower white matter integrity that may increase vulnerability to developing AD later in life.

Measuring sustainability performance within the Australian energy industry

Sustainability has become crucial for the energy industry as projects in this industry are extensively large and complex and have significant impacts on the environment, community and economy. It demands the energy industry to proactively incorporate sustainability ideas and commit to sustainable project development. This study aims to investigate how the Australian energy industry responds to sustainability requirements and in particular what indicators used to measure sustainability performance. To achieve this, content analysis of sustainability reports, vision statements and policy statements of Australian energy companies listed in the 2013 PLATTS Top 250 Global Energy Company Rankings and government reports relating to sustainability has been conducted. The findings show that the energy companies extensively discuss sustainability aspects within three dimensions, i.e. community, environment, and economy. Their primary goals in sustainability are supplying cleaner energy for future, and doing business in a way that improves outcomes for shareholders, employees, business partners and the communities. In particular, energy companies have valued the employees of the business as a one of the key area that needs to be considered. Furthermore, the energy industry has become increasingly aware of the importance of measuring sustainability performance to achieve sustainability goals. A number of sustainability indicators have been developed on the basis of the key themes beyond economic measures. It is envisaged that findings from this research will help stakeholders in the energy industry to adopt different indicators to evaluate and ultimately achieve sustainability performance.

‘A contributing life’: Living a contributing life as ‘a person’, ‘an artist’ and ‘an artist with a mental illness’

The Australian National Mental Health Commission, recently adopted a focus on ‘a contributing life’ to acknowledge the importance of full and meaningful participation in community life. This concept compels new conversations about the complex nature of every day and whole of life experiences for people with lived experience of mental illness. This article reflects on narratives by eight artists with lived experience of mental illness, in Australia to understand how opportunities are available through art for people with lived experience of mental illness to lead a contributing life. A twelve month study gained insight of how participants saw themselves, made meaning and sense of their experiences, and how each person asserted their choice to be an artist. This article shares a common premise held by the participants to choose a “way of life as ‘who I am’”. This declaration emphasised the relevance of living a contributing life as ‘a person’, ‘an artist’ and ‘an artist with a mental illness’. A number of conceptual issues are raised in light of the findings, not least how opportunities for participation are framed and available, or otherwise, to live a contributing life.

Performance pay for Australian teachers: A critical policy historiography

In May 2011, the Australian Federal Education Minister announced there would be a unique, innovative and new policy of performance pay for teachers, Rewards for Great Teachers (Garrett, 2011a). In response, this paper uses critical policy historiography to argue that the unintended consequences of performance pay for teachers makes it unlikely it will deliver improved quality or efficiency in Australian schools. What is new, in the Australian context, is that performance pay is one of a raft of education policies being driven by the federal government within a system that constitutionally and historically has placed the responsibility for schooling with the states and territories. Since 2008, a key platform of the Australian federal Labor government has been a commitment to an Education Revolution that would promote quality, equity and accountability in Australian schools. This commitment has resulted in new national initiatives impacting on Australian schools including a high-stakes testing regime 14 National Assessment Program 13 Literacy and Numeracy (NAPLAN) 14a mandated national curriculum (the Australian Curriculum), professional standards for teachers and teacher accreditation 14Australian Institute for Teaching and School Leadership (AITSL) 14and the idea of rewarding excellent teachers through performance pay (Garrett, 2011b). These reforms demonstrate the increased influence of the federal government in education policy processes and the growth of a 1Ccoercive federalism 1D that pits the state and federal governments against each other (Harris-Hart, 2010). Central to these initiatives is the measuring, or auditing, of educational practices and relationships. While this shift in education policy hegemony from state to federal governments has been occurring in Australia at least since the 1970s, it has escalated and been transformed in more recent times with a greater emphasis on national human capital agendas which link education and training to Australia 19s international economic competitiveness (Lingard & Sellar, in press). This paper uses historically informed critical analysis to critique claims about the effects of such policies. We argue that performance pay has a detailed and complex historical trajectory both internationally and within Australian states. Using Gale 19s (2001) critical policy historiography, we illuminate some of the effects that performance pay policies have had on education internationally and in particular within Australia. This critical historical lens also provides opportunities to highlight how teachers have, in the past, tactically engaged with such policies.

Compliance with seafood safety standards within the Vietnamese finfish capture distribution chain

This thesis examined the level of food safety compliance with government regulations and investigated routes of microbiological contaminations in raw finfish within Vietnamese domestic seafood distribution chains. Findings from direct observation, microbiological analysis and employee surveys were synthesized to identify the main factors affecting food safety and hygiene practices of fish distributors. The studies produced clear recommendations for food safety management in the domestic distribution chains. The findings may contribute to national efforts to decrease the risks of fish-borne illness for consumers in Vietnam.