Threat appraisal for harm from falls: Insights for development of education-based intervention

Objective: This study aims to describe how patients perceive the threat of falls in hospitals, to identify patient characteristics that are associated with greater or lesser perceptions of the threat of falls, and to examine whether there is a discord between the risk that patients perceive in general and the risk that they perceive for themselves personally. Method: A cross-sectional survey amongst geriatric rehabilitation inpatients in Brisbane, Australia, was implemented. The first component of the survey dealt with the ‘general’ nature of in-hospital falls and falls related risks while the second component of the survey was directed at identifying whether the patient held the same belief for themselves. Results: A total of 21 out of 125 participants (17%) indicated that they felt that they were at risk of falling during their hospitalisation and 28 (22%) felt that they would injure themselves if they were to fall. Self-perceived risk of falls was associated with decreasing age and lower cognitive function (Functional Independence Measure Cognitive score). A majority of patients felt that falls most commonly occur in the bathroom [n=67 (54%)] and that if they were to fall, they would fall in the bathroom [n=56 (45%)]. Discussion: Patients generally do not think they are at risk of falling while in hospital and this may contribute to poor adherence to falls prevention strategies. It is possible that raising patient perception of the risk of falls and injury from falls in hospitals may help improve adherence to falls prevention strategies in this setting.

A parent-led family-focused treatment program for overweight children aged 5 to 9 years : The PEACH RCT

OBJECTIVE: To evaluate a healthy lifestyle intervention to reduce adiposity in children aged 5 to 9 years and assess whether adding parenting skills training would enhance this effect. PARTICIPANTS AND METHODS: We conducted a single-blinded randomized controlled trial of prepubertal moderately obese (International Obesity Task Force cut points) children, aged 5 to 9 years. The 6-month program targeted parents as the agents of change for implementing family lifestyle changes. Only parents attended group sessions. We measured BMI and waist z scores and parenting constructs at baseline, 6, 12, 18, 24 months. RESULTS: Participants (n = 169; 56% girls) were randomized to a parenting skills plus healthy lifestyle group (n = 85) or a healthy lifestyle–only group (n = 84). At final 24-month assessment 52 and 54 children remained in the parenting skills plus healthy lifestyle and the healthy lifestyle–only groups respectively. There were reductions (P < .001) in BMI z score (0.26 [95% confidence interval: 0.22–0.30]) and waist z score (0.33 [95% confidence interval: 0.26–0.40]). There was a 10% reduction in z scores from baseline to 6 months that was maintained to 24 months with no additional intervention. Overall, there was no significant group effect. A similar pattern of initial improvement followed by stability was observed for parenting outcomes and no group effect. CONCLUSIONS: Using approaches that specifically target parent behavior, relative weight loss of ∼10% is achievable in moderately obese prepubertal children and can be maintained for 2 years from baseline. These results justify an investment in treatment as an effective secondary obesity-prevention strategy.

Four obstacles facing the management accounting professionals as they seek to step up as global leaders

No matter how aspirational they are, management accountants face a series of roadblocks in the course of building careers in organisations. Experts reveal the four key obstacles that need to be addressed in the course of becoming global leaders.

Contributors to life satisfaction in parents of an adult child with Down syndrome

Aim: This study investigated: (1) concurrent relationships between measures of family life and parental satisfaction with life in parents of an adult with Down syndrome and (2) influence of early family functioning on current parental satisfaction. Method: Sixty-two families were interviewed using a semi-structured interview, and responded to a series of questionnaires related to family functioning when their child with Down syndrome was between 7 and 15 years. Fifteen years later parents were asked to provide data on their current situation, including mental health, and satisfaction and difficulties with respect to care-giving in relation to their adult child. Results: Over half the families provided data to the second phase of the study. Life circumstances were appreciably worse for a small group of families than had been the case 15 years previously; however, these changes were generally unrelated to their parenting role. Overall, parents reported experiencing satisfaction from their care-giving role and did not report high levels of difficulties emanating from this role. Conclusions: Most parents demonstrated good levels of personal functioning, although there was a small group for whom this was not the case. Earlier functioning did not make a strong contribution to current levels of life satisfaction.

International pre-service teachers' self-confidence in critical reflective thinking and writing through an intercultural Patches program

This paper describes part of an action research study that was designed to explore the outcomes of an ongoing program in which the participants, a group of domestic and international pre-service teachers and lecturers, worked together in reflective writing workshops. While the primary long-term goal of the program was to develop the intercultural competence and understanding of all of the participants through social activities, the development of social relationships was initiated and supported by involving the participants in weekly writing workshops that focused on shared salient skills of critical reflective thinking and writing. The focus of this paper is upon the outcomes for the international students, a cohort of second year pre-service teachers from Malaysia. Findings indicated that the program was successful in developing the Malaysian pre-service teachers’ self-confidence in perceiving themselves as writers and future teachers of writing, in shifting their focus from writing product to writing process and content, and in increasing the depth of their critical reflective thinking and writing

Multiple cameras for audio-visual speech recognition in an automotive environment

Audio-visualspeechrecognition, or the combination of visual lip-reading with traditional acoustic speechrecognition, has been previously shown to provide a considerable improvement over acoustic-only approaches in noisy environments, such as that present in an automotive cabin. The research presented in this paper will extend upon the established audio-visualspeechrecognition literature to show that further improvements in speechrecognition accuracy can be obtained when multiple frontal or near-frontal views of a speaker's face are available. A series of visualspeechrecognition experiments using a four-stream visual synchronous hidden Markov model (SHMM) are conducted on the four-camera AVICAR automotiveaudio-visualspeech database. We study the relative contribution between the side and central orientated cameras in improving visualspeechrecognition accuracy. Finally combination of the four visual streams with a single audio stream in a five-stream SHMM demonstrates a relative improvement of over 56% in word recognition accuracy when compared to the acoustic-only approach in the noisiest conditions of the AVICAR database.

Assessing the representativeness of a groundwater quality monitoring network

The monitoring sites comprising a state of the environment (SOE) network must be carefully selected to ensure that they will be representative of the broader resource. Hierarchical cluster analysis (HCA) is a data-driven technique that can potentially be employed to assess the representativeness of a SOE monitoring network. The objective of this paper is to explore the use of HCA as an approach for assessing the representativeness of the New Zealand National Groundwater Monitoring Programme (NGMP), which is comprised of 110 monitoring sites across the country.

Can Beijing become a global media capital?

The commercialization of Chinese media has taken place over the past two decades; it has become a significant force since 2001 when China joined the World Trade Organisation. With demand for original content increasing and China contemplating a cultural trade deficit in media content, there is much discussion of agglomeration and clustering. Beijing, as the national media centre of China, witnesses a process of media agglomeration while bearing the problem of cultural export during the media commercialization. Michael Curtin‟s idea of media capital, which absorbs media resources and personnel and exports media products transnationally, provides a dynamic perspective of understanding media agglomeration and dispersion under different political social and cultural circumstances. Hence the question whether Beijing is going to transform into a transnational media capital is worth studying, in order to observe and comprehend China‟s media industry in transition. Drawing on Michael Curtin‟s three media capital trajectories, the paper interprets tensions and challenges generated in the process of media industry agglomeration and growth in Beijing. Emphasis is placed on the third trajectory, socio-cultural variation.

Nanoparticles in European cities and associated health impacts

Atmospheric nanoparticles are one of those pollutants currently unregulated through ambient air quality standards. The aim of this chapter is to assess the environmental and health impacts of atmospheric nanoparticles in European environments. The chapter begins with the conventional information on the origin of atmospheric nanoparticles, followed by their physical and chemical characteristics. A brief overview of recently published review articles on this topic is then presented to guide those readers interested in exploring any specific aspect of nanoparticles in greater detail. A further section reports a summary of recently published studies on atmospheric nanoparticles in European cities. This covers a total of about 45 sampling locations in 30 different cities within 15 European countries for quantifying levels of roadside and urban background particle number concentrations (PNCs). Average PNCs at roadside and urban background sites were found to be 3.82±3.25 ×104 cm–3 and 1.63±0.82 ×104 cm–3, respectively, giving a roadside to background PNC ratio of ~2.4. Engineered nanoparticles are one of the key emerging categories of airborne nanoparticles, especially for the indoor environments. Their ambient concentrations may increase in future due to widespread use of nanotechnology integrated products. Evaluation of their sources and probable impacts on air quality and human health are briefly discussed in the following section. Respiratory deposition doses received by the public exposed to roadside PNCs in numerous European locations are then estimated. These were found to be in the 1.17–7.56 1010 h–1 range over the studied roadside European locations. The following section discusses the potential framework for airborne nanoparticle regulations in Europe and, in addition, the existing control measures to limit nanoparticle emissions at source. The chapter finally concludes with a synthesis of the topic areas covered and highlights important areas for further work.

Producing readings : freedom versus normativity?

The subject known as English has been framed in terms of a number of models which can be broadly defined through the literature as cultural heritage (associated with Matthew Arnold and F.R. Leavis), personal growth (associated with John Dixon and James Britton) and cultural studies (associated with Raymond Williams and Roland Barthes). Traditionally these models have been assumed to reflect different theories of English, each one being hailed as a radical break with the previous model. Taking the reading lesson as an example, the paper attempts to trouble the idea that the models of English are radically different, first by identifying an unhelpful dialectic that historically informs discussions of literature teaching and English and second, by exploring a circularity that characterises arguments used to justify the radical nature of cultural studies English.

The digital storyteller's stage: queer everyday activists negotiating privacy and publicness

This article explores how queer digital storytellers understand and mobilize concepts of privacy and publicness as they engage in everyday activism through creating and sharing personal stories designed to contribute to cultural and political debates. Through the pre-production, production, and distribution phases of digital storytelling workshops and participation in a related online community, these storytellers actively negotiate the tensions and continuua among visibility and hiddenness; secrecy and pride; finite and fluid renditions of self; and individual and collective constructions of identity. We argue that the social change they aspire to is at least partially achieved through “networked identity work” on and offline with both intimate and imagined publics.

Occupational Access and Wage Discrimination

This article presents a study on the quantification of the level of occupational access and wage discrimination in Great Britain. The traditional approach to quantifying the level of sex discrimination is to distinguish gender differences in productive characteristics from the unequal treatment of characteristics according to gender. The role of inter- versus intra-occupational effects in determining the magnitude of wage differences between men and women was examined. The econometric results provided estimates of the wage differential in six broad occupational classifications together with an aggregate picture of how important the occupational distribution of females is in explaining their lower average wage. In summary, the results of the study suggest that the vast majority of the male and female wage differential arises from intra-occupation effects. The results provide evidence to suggest that occupational segregation is not a major contributor to the observed male/female wage differential.

The adenine-rich tract in the 5ʹ-end of the hepatitis C virus ORF encodes a peptide regulating the binding of the C protein to RNA

Hepatitis C virus (HCV ) core (C) protein is thought to bind to viral RNA before it undergoes oligomerization leading to RNA encapsidation. Details of these events are so far unknown. The 5ʹ-terminal C protein coding sequence that includes an adenine (A)-rich tract is a part of an internal ribosome entry site(IRES). This nucleotide sequence but not the corresponding protein sequence is needed for proper initiation of translation of viral RNA by an IRES-dependent mechanism. In this study, we examined the importance of this sequence for the ability of the C protein to bind to viral RNA. Serially truncated C proteins with deletions from 10 up to 45 N-terminal amino acids were expressed in Escherichia coli, purified and tested for binding to viral RNA by a gel shift assay. The results showed that truncation of the C protein from its N-terminus by more than 10 amino acids abolished almost completely its expression in E. coli. The latter could be restored by adding a tag to the N-terminus of the protein. The tagged proteins truncated by 15 or more amino acids showed an anomalous migration in SDS-PAGE. Truncation by more than 20 amino acids resulted in a complete loss of ability of tagged C protein to bind to viral RNA. These results provide clues to the early events in the C protein - RNA interactions leading to C protein oligomerization, RNA encapsidation and virion assembly.

The effect of Tenofovir on vitamin D metabolism in HIV-infected adults is dependent on sex and ethnicity

Background: Tenofovir has been associated with renal phosphate wasting, reduced bone mineral density, and higher parathyroid hormone levels. The aim of this study was to carry out a detailed comparison of the effects of tenofovir versus non-tenofovir use on calcium, phosphate and, vitamin D, parathyroid hormone (PTH), and bone mineral density. Methods: A cohort study of 56 HIV-1 infected adults at a single centre in the UK on stable antiretroviral regimes comparing biochemical and bone mineral density parameters between patients receiving either tenofovir or another nucleoside reverse transcriptase inhibitor. Principal Findings: In the unadjusted analysis, there was no significant difference between the two groups in PTH levels (tenofovir mean 5.9 pmol/L, 95% confidence intervals 5.0 to 6.8, versus non-tenofovir; 5.9, 4.9 to 6.9; p = 0.98). Patients on tenofovir had significantly reduced urinary calcium excretion (median 3.01 mmol/24 hours) compared to non-tenofovir users (4.56; p,0.0001). Stratification of the analysis by age and ethnicity revealed that non-white men but not women, on tenofovir had higher PTH levels than non-white men not on tenofovir (mean difference 3.1 pmol/L, 95% CI 5.3 to 0.9; p = 0.007). Those patients with optimal 25-hydroxyvitamin D (.75 nmol/L) on tenofovir had higher 1,25-dihydroxyvitamin D [1,25(OH)2D] (median 48 pg/mL versus 31; p = 0.012), fractional excretion of phosphate (median 26.1%, versus 14.6;p = 0.025) and lower serum phosphate (median 0.79 mmol/L versus 1.02; p = 0.040) than those not taking tenofovir. Conclusions: The effects of tenofovir on PTH levels were modified by sex and ethnicity in this cohort. Vitamin D status also modified the effects of tenofovir on serum concentrations of 1,25(OH)2D and phosphate.