Outcomes for elderly patients with mental illness following relocation from a stand-alone psychiatric hospital to community-based extended care units

Objective: To assess the outcomes for a group of elderly patients with mental illness following their discharge from a stand-alone psychiatric facility to seven extended care units (ECUs). Method: All patients (n = 60) who were relocated to the ECUs were assessed using a number of standardized clinical and general functioning instruments at 6 months and 6 weeks pre-move, and again at 6 weeks, 6 months and 18 months post-move. Results: By 18 months post-discharge, 13 of the 60 patients (21.7%) had died and seven others had been transferred to nursing homes. Those who died were older and had significantly higher levels of physical ill health when compared to those who did not die. Changes on measures of clinical and behavioural functioning in those who remained in the study did not reach statistical significance by 18 months post-move. However, participants did demonstrate improvements in quality of life with significantly higher scores on measures of social contact and community access. Conclusions: The mortality observed in the follow-up period is likely to be related to physical ill health and old age rather than the trauma associated with relocation. While overall functioning did not improve following relocation, patients had more independence and greater access to community-based activities.

Innovation management using logical framework in hospital-based healthcare units

Innovation is part and parcel of any service in today's environment, so as to remain competitive. Quality improvement in healthcare services is a complex, multi-dimensional task. This study proposes innovation management in healthcare services using a logical framework. A problem tree and an objective tree are developed to identify and mitigate issues and concerns. A logical framework is formulated to develop a plan for implementation and monitoring strategies, potentially creating an environment for continuous quality improvement in a specific unit. We recommend logical framework as a valuable model for innovation management in healthcare services. Copyright © 2006 Inderscience Enterprises Ltd.

Self-Learning Fuzzy Spiking Neural Network as a Nonlinear Pulse-Position Threshold Detection Dynamic System Based on Second-Order Critically Damped Response Units

Architecture and learning algorithm of self-learning spiking neural network in fuzzy clustering task are outlined. Fuzzy receptive neurons for pulse-position transformation of input data are considered. It is proposed to treat a spiking neural network in terms of classical automatic control theory apparatus based on the Laplace transform. It is shown that synapse functioning can be easily modeled by a second order damped response unit. Spiking neuron soma is presented as a threshold detection unit. Thus, the proposed fuzzy spiking neural network is an analog-digital nonlinear pulse-position dynamic system. It is demonstrated how fuzzy probabilistic and possibilistic clustering approaches can be implemented on the base of the presented spiking neural network.

High performance liquid level monitoring system based on polymer fiber Bragg gratings embedded in silicone rubber diaphragm

Liquid-level sensing technologies have attracted great prominence, because such measurements are essential to industrial applications, such as fuel storage, flood warning and in the biochemical industry. Traditional liquid level sensors are based on electromechanical techniques; however they suffer from intrinsic safety concerns in explosive environments. In recent years, given that optical fiber sensors have lots of well-established advantages such as high accuracy, costeffectiveness, compact size, and ease of multiplexing, several optical fiber liquid level sensors have been investigated which are based on different operating principles such as side-polishing the cladding and a portion of core, using a spiral side-emitting optical fiber or using silica fiber gratings. The present work proposes a novel and highly sensitive liquid level sensor making use of polymer optical fiber Bragg gratings (POFBGs). The key elements of the system are a set of POFBGs embedded in silicone rubber diaphragms. This is a new development building on the idea of determining liquid level by measuring the pressure at the bottom of a liquid container, however it has a number of critical advantages. The system features several FBG-based pressure sensors as described above placed at different depths. Any sensor above the surface of the liquid will read the same ambient pressure. Sensors below the surface of the liquid will read pressures that increase linearly with depth. The position of the liquid surface can therefore be approximately identified as lying between the first sensor to read an above-ambient pressure and the next higher sensor. This level of precision would not in general be sufficient for most liquid level monitoring applications; however a much more precise determination of liquid level can be made by linear regression to the pressure readings from the sub-surface sensors. There are numerous advantages to this multi-sensor approach. First, the use of linear regression using multiple sensors is inherently more accurate than using a single pressure reading to estimate depth. Second, common mode temperature induced wavelength shifts in the individual sensors are automatically compensated. Thirdly, temperature induced changes in the sensor pressure sensitivity are also compensated. Fourthly, the approach provides the possibility to detect and compensate for malfunctioning sensors. Finally, the system is immune to changes in the density of the monitored fluid and even to changes in the effective force of gravity, as might be obtained in an aerospace application. The performance of an individual sensor was characterized and displays a sensitivity (54 pm/cm), enhanced by more than a factor of 2 when compared to a sensor head configuration based on a silica FBG published in the literature, resulting from the much lower elastic modulus of POF. Furthermore, the temperature/humidity behavior and measurement resolution were also studied in detail. The proposed configuration also displays a highly linear response, high resolution and good repeatability. The results suggest the new configuration can be a useful tool in many different applications, such as aircraft fuel monitoring, and biochemical and environmental sensing, where accuracy and stability are fundamental. © (2015) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE). Downloading of the abstract is permitted for personal use only.

Managing supply chain knowledge-based linkages for improving operational performance

Purpose: This paper aims to explore the role of internal and external knowledgebased linkages across the supply chain in achieving better operational performance. It investigates how knowledge is accumulated, shared, and applied to create organization-specific knowledge resources that increase and sustain the organization's competitive advantage. Design/methodology/approach: This paper uses a single case study with multiple, embedded units of analysis, and the social network analysis (SNA) to demonstrate the impact of internal and external knowledge-based linkages across multiple tiers in the supply chain on the organizational operational performance. The focal company of the case study is an Italian manufacturer supplying rubber components to European automotive enterprises. Findings: With the aid of the SNA, the internal knowledge-based linkages can be mapped and visualized. We found that the most central nodes having the most connections with other nodes in the linkages are the most crucial members in terms of knowledge exploration and exploitation within the organization. We also revealed that the effective management of external knowledge-based linkages, such as buyer company, competitors, university, suppliers, and subcontractors, can help improve the operational performance. Research limitations/implications: First, our hypothesis was tested on a single case. The analysis of multiple case studies using SNA would provide a deeper understanding of the relationship between the knowledge-based linkages at all levels of the supply chain and the integration of knowledge. Second, the static nature of knowledge flows was studied in this research. Future research could also consider ongoing monitoring of dynamic linkages and the dynamic characteristic of knowledge flows. Originality/value: To the best of our knowledge, the phrase 'knowledge-based linkages' has not been used in the literature and there is lack of investigation on the relationship between the management of internal and external knowledge-based linkages and the operational performance. To bridge the knowledge gap, this paper will show the importance of understanding the composition and characteristics of knowledge-based linkages and their knowledge nodes. In addition, this paper will show that effective management of knowledge-based linkages leads to the creation of new knowledge and improves organizations' operational performance.

Tailoring Magnetic, Mechanical and Dielectric Properties of Magnetorheological Elastomers based on Natural Rubber and Iron by Magnetic Field Assisted Curing for Possible Applications

If magnetism is universal in nature, magnetic materials are ubiquitous. A life without magnetism is unthinkable and a day without the influence of a magnetic material is unimaginable. They find innumerable applications in the form of many passive and active devices namely, compass, electric motor, generator, microphone, loud speaker, maglev train, magnetic resonance imaging, data recording and reading, hadron collider etc. The list is endless. Such is the influence of magnetism and magnetic materials in ones day to day life. With the advent of nanoscience and nanotechnology, along with the emergence of new areas/fields such as spintronics, multiferroics and magnetic refrigeration, the importance of magnetism is ever increasing and attracting the attention of researchers worldwide. The search for a fluid which exhibits magnetism has been on for quite some time. However nature has not bestowed us with a magnetic fluid and hence it has been the dream of many researchers to synthesize a magnetic fluid which is thought to revolutionize many applications based on magnetism. The discovery of a magnetic fluid by Jacob Rabinow in the year 1952 paved the way for a new branch of Physics/Engineering which later became magnetic fluids. This gave birth to a new class of material called magnetorheological materials. Magnetorheological materials are considered superior to electrorheological materials in that magnetorheology is a contactless operation and often inexpensive.Most of the studies in the past on magnetorheological materials were based on magnetic fluids. Recently the focus has been on the solid state analogue of magnetic fluids which are called Magnetorheological Elastomers (MREs). The very word magnetorheological elastomer implies that the rheological properties of these materials can be altered by the influence of an external applied magnetic field and this process is reversible. If the application of an external magnetic field modifies the viscosity of a magnetic fluid, the effect of external magnetic stimuli on a magnetorheological elastomer is in the modification of its stiffness. They are reversible too. Magnetorheological materials exhibit variable stiffness and find applications in adaptive structures of aerospace, automotive civil and electrical engineering applications. The major advantage of MRE is that the particles are not able to settle with time and hence there is no need of a vessel to hold it. The possibility of hazardous waste leakage is no more with a solid MRE. Moreover, the particles in a solid MRE will not affect the performance and durability of the equipment. Usually MR solids work only in the pre yield region while MR fluids, typically work in the post yield state. The application of an external magnetic field modifies the stiffness constant, shear modulus and loss modulus which are complex quantities. In viscoelastic materials a part of the input energy is stored and released during each cycle and a part is dissipated as heat. The storage modulus G′ represents the capacity of the material to store energy of deformation, which contribute to material stiffness. The loss modulusG′′ represents the ability of the material to dissipate the energy of deformation. Such materials can find applications in the form of adaptive vibration absorbers (ATVAs), stiffness tunable mounts and variable impedance surfaces. MREs are an important material for automobile giants and became the focus of this research for eventual automatic vibration control, sound isolation, brakes, clutches and suspension systems

User-centered, research-based design of futuristic intensive care units

Flexible and rigid amine-functionalized microporous frameworks based on different secondary building units: supramolecular isomerism, selective CO₂ capture, and catalysis

We report the synthesis, structural characterization, and porous properties of two isomeric supramolecular complexes of ([Cd(NH₂—bdc)(bphz)_0.5 ]⋅DMF⋅H₂O}_n (NH₂ —bdc=2-aminobenzenedicarboxylic acid, bphz=1,2-bis(4-pyridylmethylene)hydrazine) composed of a mixed-ligand system. The first isomer, with a paddle-wheel-type Cd₂ (COO)₄ secondary building unit (SBU), is flexible in nature, whereas the other isomer has a rigid framework based on a μ-oxo-bridged Cd₂(μ-OCO)₂ SBU. Both frameworks are two-fold interpenetrated and the pore surface is decorated with pendant -NH₂ and =N—N= functional groups. Both the frameworks are nonporous to N₂ , revealed by the type II adsorption profiles. However, at 195 K, the first isomer shows an unusual double-step hysteretic CO₂ adsorption profile, whereas the second isomer shows a typical type I CO₂ profile. Moreover, at 195 K, both frameworks show excellent selectivity for CO₂ among other gases (N₂ , O₂ , H₂ , and Ar), which has been correlated to the specific interaction of CO₂ with the -NH₂ and =N—N= functionalized pore surface. DFT calculations for the oxo-bridged isomer unveiled that the -NH₂ group is the primary binding site for CO₂ . The high heat of CO₂ adsorption (ΔH_ads =37.7 kJ mol^-1) in the oxo-bridged isomer is realized by NH₂ ⋅⋅⋅CO₂ /aromatic π⋅⋅⋅CO₂ and cooperative CO₂ ⋅⋅⋅CO₂ interactions. Further, postsynthetic modification of the -NH₂ group into -NHCOCH₃ in the second isomer leads to a reduced CO₂ uptake with lower binding energy, which establishes the critical role of the -NH₂ group for CO₂ capture. The presence of basic -NH₂ sites in the oxo-bridged isomer was further exploited for efficient catalytic activity in a Knoevenagel condensation reaction.

Real world contexts in PISA science : implications for context-based science education

The PISA assessment instruments for students’ scientific literacy in 2000, 2003 and 2006 have each consisted of units made up of a real world context involving Science and Technology, about which students are asked a number of cognitive and affective questions. This paper discusses a number of issues from this use of S&T contexts in PISA and the implications they have for the current renewed interest in context-based science education. Suitably chosen contexts can engage both boys and girls. Secondary analyses of the students’ responses using the contextual sets of items as the unit of analysis provides new information about the levels of performance in PISA 2006 Science. .Embedding affective items in the achievement test did not lead to gender/context interactions of significance, and context interactions were less than competency ones. A number of implications for context-based science teaching and learning are outlined and the PISA 2006 Science test is suggested as a model for its assessment.

Multidisciplinary students on Property core units : comparative analysis of introductory and advanced units

The composition of many professional services firms in the Urban Development area has moved away from a discipline specific ‘silo’ structure to a more multidisciplinary environment. The benefits of multidisciplinarity have been seen in industry by providing synergies across many of the related disciplines. Similarly, the Queensland University of Technology, Bachelor of Urban Development degree has sought to broaden the knowledge base of students and achieve a greater level of synergy between related urban development disciplines through the introduction of generic and multidisciplinary units. This study aims to evaluate the effectiveness of delivering core property units in a multidisciplinary context. A comparative analysis has been undertaken between core property units and more generic units offered in a multidisciplinary context from introductory, intermediate and advanced years within the property program. This analysis was based on data collected from course performance surveys, student performance results, a student focus group and was informed by a reflective process from the student perspective and lecturer/ tutor feedback. The study showed that there are many benefits associated with multidisciplinary unit offerings across the QUT Urban Development program particularly in the more generic units. However, these units require a greater degree of management. It is more difficult to organise, teach and coordinate multidisciplinary student cohorts due to a difference in prior knowledge and experience between each of the discipline groups. In addition, the interaction between lecturers/ tutors and the students frequently becomes more limited. A perception exists within the student body that this more limited face to face contact with academic staff is not valuable which may be exacerbated by the quality of complimentary online teaching materials. For many academics, non-attendance at lectures was coupled with an increase in email communication. From the limited data collected during the study there appears to be no clear correlation between large multidisciplinary student classes and student academic performance or satisfaction.

Creating and enabling opportunities for increased student participation in experience based learning in professional practice

This paper explores models for enabling increased participation in experience based learning in legal professional practice. Legal placements as part of “for-credit” units offer students the opportunity to develop their professional skills in practice, reflect on their learning and job performance and take responsibility for their career development and planning. In short, work integrated learning (WIL) in law supports students in making the transition from university to practice. Despite its importance, WIL has traditionally taken place in practical legal training courses (after graduation) rather than during undergraduate law courses. Undergraduate WIL in Australian law schools has generally been limited to legal clinics which require intensive academic supervision, partnerships with community legal organisations and government funding. This paper will propose two models of WIL for undergraduate law which may overcome many of the challenges to engaging in WIL in law (which are consistent with those identified generally by the WIL Report). The first is a virtual law placement in which students use technology to complete a real world project in a virtual workplace under the guidance of a workplace supervisor. The second enables students to complete placements in private legal firms, government legal offices, or community legal centres under the supervision of a legal practitioner. The units complement each other by a) creating and enabling placement opportunities for students who may not otherwise have been able to participate in work placement by reason of family responsibilities, financial constraints, visa restrictions, distance etc; and b) enabling students to capitalise on existing work experience. This paper will report on the pilot offering of the units in 2008, the evaluation of the models and changes implemented in 2009. It will conclude that this multi-pronged approach can be successful in creating opportunities for, and overcoming barriers to participation in experiential learning in legal professional practice.

Testing the effectiveness of a Practice Development intervention on changing the culture of evidence based practice in an acute care environment

In this age of evidence-based practice, nurses are increasingly expected to use research evidence in a systematic and judicious way when making decisions about patient care practices. Clinicians recognise the role of research when it provides valid, realistic answers in practical situations. Nonetheless, research is still perceived by some nurses as external to practice and implementing research findings into practice is often difficult. Since its conceptual platform in the 1960s, the emergence and growth of Nursing Development Units, and later, Practice Development Units has been described in the literature as strategic, organisational vehicles for changing the way nurses think about nursing by promoting and supporting a culture of inquiry and research-based practice. Thus, some scholars argue that practice development is situated in the gap between research and practice. Since the 1990s, the discourse has shifted from the structure and outcomes of developing practice to the process of developing practice, using a Practice Development methodology; underpinned by critical social science theory, as a vehicle for changing the culture and context of care. The nursing and practice development literature is dominated by descriptive reports of local practice development activity, typically focusing on reflection on processes or outcomes of processes, and describing perceived benefits. However, despite the volume of published literature, there is little published empirical research in the Australian or international context on the effectiveness of Practice Development as a methodology for changing the culture and context of care - leaving a gap in the literature. The aim of this study was to develop, implement and evaluate the effectiveness of a Practice Development model for clinical practice review and change on changing the culture and context of care for nurses working in an acute care setting. A longitudinal, pre-test/post-test, non-equivalent control group design was used to answer the following research questions: 1. Is there a relationship between nurses' perceptions of the culture and context of care and nurses' perceptions of research and evidence-based practice? 2. Is there a relationship between engagement in a facilitated process of Practice Development and change in nurses' perceptions of the culture and context of care? 3. Is there a relationship between engagement in a facilitated process of Practice Development and change in nurses' perceptions of research and evidence-based practice? Through a critical analysis of the literature and synthesis of the findings of past evaluations of Nursing and Practice Development structures and processes, this research has identified key attributes consistent throughout the chronological and theoretical development of Nursing and Practice Development that exemplify a culture and context of care that is conducive to creating a culture of inquiry and evidence-based practice. The study findings were then used in the development, validation and testing of an instrument to measure change in the culture and context of care. Furthermore, this research has also provided empirical evidence of the relationship of the key attributes to each other and to barriers to research and evidence-based practice. The research also provides empirical evidence regarding the effectiveness of a Practice Development methodology in changing the culture and context of care. This research is noteworthy in its contribution to advancing the discipline of nursing by providing evidence of the degree to which attributes of the culture and context of care, namely autonomy and control, workplace empowerment and constructive team dynamics, can be connected to engagement with research and evidence-based practice.

Adaptive dual control of topic-based information retrieval

Information Retrieval is an important albeit imperfect component of information technologies. A problem of insufficient diversity of retrieved documents is one of the primary issues studied in this research. This study shows that this problem leads to a decrease of precision and recall, traditional measures of information retrieval effectiveness. This thesis presents an adaptive IR system based on the theory of adaptive dual control. The aim of the approach is the optimization of retrieval precision after all feedback has been issued. This is done by increasing the diversity of retrieved documents. This study shows that the value of recall reflects this diversity. The Probability Ranking Principle is viewed in the literature as the “bedrock” of current probabilistic Information Retrieval theory. Neither the proposed approach nor other methods of diversification of retrieved documents from the literature conform to this principle. This study shows by counterexample that the Probability Ranking Principle does not in general lead to optimal precision in a search session with feedback (for which it may not have been designed but is actively used). Retrieval precision of the search session should be optimized with a multistage stochastic programming model to accomplish the aim. However, such models are computationally intractable. Therefore, approximate linear multistage stochastic programming models are derived in this study, where the multistage improvement of the probability distribution is modelled using the proposed feedback correctness method. The proposed optimization models are based on several assumptions, starting with the assumption that Information Retrieval is conducted in units of topics. The use of clusters is the primary reasons why a new method of probability estimation is proposed. The adaptive dual control of topic-based IR system was evaluated in a series of experiments conducted on the Reuters, Wikipedia and TREC collections of documents. The Wikipedia experiment revealed that the dual control feedback mechanism improves precision and S-recall when all the underlying assumptions are satisfied. In the TREC experiment, this feedback mechanism was compared to a state-of-the-art adaptive IR system based on BM-25 term weighting and the Rocchio relevance feedback algorithm. The baseline system exhibited better effectiveness than the cluster-based optimization model of ADTIR. The main reason for this was insufficient quality of the generated clusters in the TREC collection that violated the underlying assumption.