Medication incident reporting in residential aged care facilities: Limitations and risks to residents' safety

Background Medication incident reporting (MIR) is a key safety critical care process in residential aged care facilities (RACFs). Retrospective studies of medication incident reports in aged care have identified the inability of existing MIR processes to generate information that can be used to enhance residents’ safety. However, there is little existing research that investigates the limitations of the existing information exchange process that underpins MIR, despite the considerable resources that RACFs’ devote to the MIR process. The aim of this study was to undertake an in-depth exploration of the information exchange process involved in MIR and identify factors that inhibit the collection of meaningful information in RACFs. Methods The study was undertaken in three RACFs (part of a large non-profit organisation) in NSW, Australia. A total of 23 semi-structured interviews and 62 hours of observation sessions were conducted between May to July 2011. The qualitative data was iteratively analysed using a grounded theory approach. Results The findings highlight significant gaps in the design of the MIR artefacts as well as information exchange issues in MIR process execution. Study results emphasized the need to: a) design MIR artefacts that facilitate identification of the root causes of medication incidents, b) integrate the MIR process within existing information systems to overcome key gaps in information exchange execution, and c) support exchange of information that can facilitate a multi-disciplinary approach to medication incident management in RACFs. Conclusions This study highlights the advantages of viewing MIR process holistically rather than as segregated tasks, as a means to identify gaps in information exchange that need to be addressed in practice to improve safety critical processes.

Distributed Nonparametric Sequential Spectrum Sensing under Electromagnetic Interference

We propose a distributed sequential algorithm for quick detection of spectral holes in a Cognitive Radio set up. Two or more local nodes make decisions and inform the fusion centre (FC) over a reporting Multiple Access Channel (MAC), which then makes the final decision. The local nodes use energy detection and the FC uses mean detection in the presence of fading, heavy-tailed electromagnetic interference (EMI) and outliers. The statistics of the primary signal, channel gain and the EMI is not known. Different nonparametric sequential algorithms are compared to choose appropriate algorithms to be used at the local nodes and the Fe. Modification of a recently developed random walk test is selected for the local nodes for energy detection as well as at the fusion centre for mean detection. We show via simulations and analysis that the nonparametric distributed algorithm developed performs well in the presence of fading, EMI and outliers. The algorithm is iterative in nature making the computation and storage requirements minimal.

Improvements to Data Collection in Commercial Fisheries Using Electronic Reporting Methods: Cost/Efficiency and Implications for Use in Ecosystem Management.

Data have been collected on fisheries catch and effort trends since the latter half of the 1800s. With current trends in declining stocks and stricter management regimes, data need to be collected and analyzed over shorter periods and at finer spatial resolution than in the past. New methods of electronic reporting may reduce the lag time in data collection and provide more accurate spatial resolution. In this study I evaluated the differences between fish dealer and vessel reporting systems for federal fisheries in the US New England and Mid-Atlantic areas. Using data on landing date, report date, gear used, port landed, number of hauls, number of fish sampled and species quotas from available catch and effort records I compared dealer and vessel electronically collected data against paper collected dealer and vessel data to determine if electronically collected data are timelier and more accurate. To determine if vessel or dealer electronic reporting is more useful for management, I determined differences in timeliness and accuracy between vessel and dealer electronic reports. I also compared the cost and efficiency of these new methods with less technology intensive reporting methods using available cost data and surveys of seafood dealers for cost information. Using this information I identified potentially unnecessary duplication of effort and identified applications in ecosystem-based fisheries management. This information can be used to guide the decisions of fisheries managers in the United States and other countries that are attempting to identify appropriate fisheries reporting methods for the management regimes under consideration. (PDF contains 370 pages)

The quality of reporting of diagnostic accuracy studies in glaucoma using the Heidelberg retina tomograph

PURPOSE. Scanning laser tomography with the Heidelberg retina tomograph (HRT; Heidelberg Engineering, Heidelberg, Germany) has been proposed as a useful diagnostic test for glaucoma. This study was conducted to evaluate the quality of reporting of published studies using the HRT for diagnosing glaucoma. METHODS. A validated Medline and hand search of English-language articles reporting on measures of diagnostic accuracy of the HRT for glaucoma was performed. Two reviewers selected and appraised the papers independently. The Standards for Reporting of Diagnostic Accuracy (STARD) checklist was used to evaluate the quality of each publication. RESULTS. A total of 29 articles were included. Interobserver rating agreement was observed in 83% of items (? = 0.76). The number of STARD items properly reported ranged from 5 to 18. Less than a third of studies (7/29) explicitly reported more than half of the STARD items. Descriptions of key aspects of the methodology were frequently missing. For example, the design of the study (prospective or retrospective) was reported in 6 of 29 studies, and details of participant sampling (e.g., consecutive or random selection) were described in 5 of 29 publications. The commonest description of diagnostic accuracy was sensitivity and specificity (25/29) followed by area under the ROC curve (13/29), with 9 of 29 publications reporting both. CONCLUSIONS. The quality of reporting of diagnostic accuracy tests for glaucoma with HRT is suboptimal. The STARD initiative may be a useful tool for appraising the strengths and weaknesses of diagnostic accuracy studies. Copyright © Association for Research in Vision and Ophthalmology.

Broadside reporting the Fenian Invasion of Canada, June 2, 1866

The Fenians were a group intent on securing Irish independence from England. The movement had its origins in Ireland in1857, under the leadership of James Stephens, with the assistance of John O'Mahony, an American who had raised funds for the cause. The American branch of this movement was especially successful, having raised $500 000 and enlisting about 10 000 American Civil War veterans. The group split into two separate factions, one desiring an invasion of Canada and the other preferring an uprising in Ireland. It soon became apparent that an uprising in Ireland was not imminent, and a decision was made to invade Canada. In April, 1866, a raid was launched against New Brunswick. It proved unsuccessful, and another raid was attempted on June 1, 1866, this time in Ridgeway, near Fort Erie, Ontario. The Canadian militiamen were defeated, but the Fenians subsequently withdrew. A third incident occurred on June 7, this time at Missisquoi Bay in Quebec, when the Fenians crossed the border, remained there for 2 days, and withdrew. A failed uprising in Ireland in 1867 signaled the demise of the movement. The Fenian threat helped to promote a sense of union among Canadians and provided an incentive for Confederation.

Broadside reporting the Fenian Invasion of Canada, June 2, 1866

The Fenians were a group intent on securing Irish independence from England. The movement had its origins in Ireland in1857, under the leadership of James Stephens, with the assistance of John O'Mahony, an American who had raised funds for the cause. The American branch of this movement was especially successful, having raised $500 000 and enlisting about 10 000 American Civil War veterans. The group split into two separate factions, one desiring an invasion of Canada and the other preferring an uprising in Ireland. It soon became apparent that an uprising in Ireland was not imminent, and a decision was made to invade Canada. In April, 1866, a raid was launched against New Brunswick. It proved unsuccessful, and another raid was attempted on June 1, 1866, this time in Ridgeway, near Fort Erie, Ontario. The Canadian militiamen were defeated, but the Fenians subsequently withdrew. A third incident occurred on June 7, this time at Missisquoi Bay in Quebec, when the Fenians crossed the border, remained there for 2 days, and withdrew. A failed uprising in Ireland in 1867 signaled the demise of the movement. The Fenian threat helped to promote a sense of union among Canadians and provided an incentive for Confederation.

Metacognitive control over memory processes under auditory distraction

Decades of research attest that memory processes suffer under conditions of auditory distraction. What is however less well understood is whether people are able to modify how their memory processes are deployed in order to compensate for disruptive effects of distraction. The metacognitive approach to memory describes a variety of ways people can exert control over their cognitive processes to optimize performance. Here we describe our recent investigations into how these control processes change under conditions of auditory distraction. We specifically looked at control of encoding in the form of decisions about how long to study a word when it is presented and control of memory reporting in the form of decisions whether to volunteer or withhold retrieved details. Regarding control of encoding, we expected that people would compensate for disruptive effects of distraction by extending study time under noise. Our results revealed, however, that when exposed to irrelevant speech, people curtail rather than extend study. Regarding control of memory reporting, we expected that people would compensate for the loss of access to memory records by volunteering responses held with lower confidence. Our results revealed, however, that people’s reporting strategies do not differ when memory task is performed in silence or under auditory distraction, although distraction seriously undermines people’s confidence in their own responses. Together, our studies reveal novel avenues for investigating the psychological effects of auditory distraction within a metacognitive framework.

Manipulation in Newspaper Articles : A Political Discourse Analysis of Lexical Choice and Manipulation in Japanese Newspaper Crisis Reporting in the case of North Korea

This paper analyzes some forms of linguistic manipulation in Japanese in newspapers when reporting on North Korea and its nuclear tests. The focus lies on lexical ambiguity in headlines and journalist’s voices in the body of the articles, that results in manipulation of the minds of the readers. The study is based on a corpus of nine articles from two of Japan’s largest newspapers Yomiuri Online and Asahi Shimbun Digital. The linguistic phenomenon that contribute to create manipulation are divided into Short Term Memory impact or Long Term Memory impact and examples will be discussed under each of the categories.The main results of the study are that headlines in Japanese newspapers do not make use of an ambiguous, double grounded structure. However, the articles are filled with explicit and implied attitudes as well as attributed material from people of a high social status, which suggests that manipulation of the long term memory is a tool used in Japanese media.

Public reporting of nursing home quality of care : Lessons from the United States experience for Canadian policy discussion

While the demand for continuing care services in Canada grows, the quality of such services has come under increasing scrutiny. Consideration has been given to the use of public reporting of quality data as a mechanism to stimulate quality improvement and promote public accountability for and transparency in service quality. The recent adoption of the Resident Assessment Instrument (RAI) throughout a number of Canadian jurisdictions means that standardized quality data are available for comparisons among facilities across regions, provinces and nationally. In this paper, we explore current knowledge on public reporting in nursing homes in the United States to identify what lessons may inform policy discussion regarding potential use of public reporting in Canada. Based on these findings, we make recommendations regarding how public reporting should be progressed and managed if Canadian jurisdictions were to implement this strategy.

Intellectual capital reporting : an examination of local government in Victoria

The objective of this research is to examine how Victorian local government annual reports disclose information on intellectual capital. The idea of intellectual capital has become part of the working organisational vocabulary, and is widely held in management literature to be the pre-eminent economic resource and a key driver of efficiency, effectiveness and continual improvement in the private and public sectors. Under the recent Best Value Victoria policy, local governments are under increasing pressure to acquire and apply intellectual capital to improve responsiveness to community needs and meet cost and quality criteria. Annual reports exist as vehicles for communication, accountability and decision making. This study examines how the internal, external and human categories of intellectual capital are represented in the annual reports for the 2000 year for 77 of the 78 Victorian local
governments.

Using a matrix approach derived from Petty and Guthrie's (2000) framework, content analysis is employed to examine the incidence and intensity with which specific elements of intellectual capital are reported. This research indicates that generally the content of annual reports have not provided clear and coherent representations of how local government in Victoria are developing, applying and measuring intellectual capital. The nature and extent of intellectual capital reporting varies considerably between councils, and the disclosure of the human elements of intellectual capital is particularly underdeveloped. The findings suggest that more research in this area is needed to determine the extent to which intellectual capital should be disclosed and whether the current paucity of disclosure stems from disinterest or technical problems. There is also the need for further research into the need to identify and describe elements of intellectual capital, and into effective
reporting strategies and techniques. This may lead to the development of a 'best practice' reporting model for intellectual capital. Furthermore, the preliminary investigations indicate a perceived need to raise the consciousness of public sector
managers as to the existence of intellectual capital within their organisations, and ultimately lead to more informed and effective management of this asset.

Human rights performance reporting : a study of corporations within Australian financial sector

This paper investigates the human rights performance reporting practices of the top 50 Australian financial service companies listed in the Australian Stock Exchange. All corporate reporting media, including annual reports, Social Responsibility Reports (CSR) and company websites, were reviewed to document their disclosure practices for the current period (2009/2010). In considering a number of international voluntary guidelines on human rights, a content analysis instrument containing 80 specific human rights themes, under 10 general categories, was developed to examine corporate reporting media. The results remain intensely unimpressive. The number of companies that disclosed human rights items is extremely low; the majority of the items were not disclosed by any of the companies under investigation. However, compared to CSR reports and company websites, annual reports were the preferable media used to disclose human rights issues. The result indicates how ineffective the voluntary global guidelines are in ensuring that Australian financial corporations report on their human rights performances.

Analyses and comparison of counter-movement jump performance and self-rated recovery in state under-18s Australian Rules Football players during a national championship

Recovery of team sport athletes during multiple competitive games is an important area for strength and conditioning coaches to monitor as it facilitates for athletes to be ready to perform (11,13). Utilising athletic performance data in conjunction with self-rated reporting measures can help determine if in fact a player or team has recovered sufficiently or shown a trend towards recovery prior to a competitive match (11). Positive improvement in recovery variables can provide confidence in the effectiveness of recovery methods used and assist in determining the training schedule in order to positively manipulate the fitness-fatigue relationship (3).

Various methods of analysing the recovery of athletes have been reported in the literature and are available to the strength and conditioning coach. These include subjective, self-rated scales and perceived level of recovery questionnaires (11,12,13). Athletic performance measures during exercises such as the counter movement jump (CMJ) have also been analysed, predominantly utilising force plates to obtain kinetic data. (5,13,14). However, such equipment can be difficult to transport, requires continual calibration and is costly to purchase. A linear transducer can provide important information on CMJ variables in the assessment of athletic movements and due to its size and portability could serve as a valuable tool to assist strength and conditioning coaches, (8,10), and potentially enable the monitoring of recovery.

Previous studies have investigated the fatigue effects of competitive games in various sports (11,13,14) including Australian Rules Football (AFL) at the senior elite league level (5, 6). To the authors’ knowledge, however, there is yet to be a study investigating the recovery response in AFL players, specifically in players 18 years and under competing in the National Under 18s Championships. Australian Rules football is an extremely physically demanding and fatiguing sport where players participate in games time exceeding 120 minutes duration, covering large distances (~12-18km, position dependent) with many high intensity efforts performed at random times throughout the game (2,6,16). Hence, it would seem pertinent to analyse the fatigue effects of competitive matches in an Australian Rules Under-18’s National Championship and the subsequent recovery from these games.

The aim of this study was to analyse and compare two self-rated subjective measures of recovery; they being muscle soreness (MS) of the lower body, overall perceived total recovery (TR), and the performance measure of peak velocity (PV) obtained from a CMJ analysed with a linear transducer. Data collection occurred between rounds four and five of the Australian Football League Under-18’s National Championship, representing a four-day recovery analysis period between matches.

Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods

 Background: Efficient and reliable surveillance and notification systems are vital for monitoring public health and disease outbreaks. However, most surveillance and notification systems are affected by a degree of underestimation (UE) and therefore uncertainty surrounds the 'true' incidence of disease affecting morbidity and mortality rates. Surveillance systems fail to capture cases at two distinct levels of the surveillance pyramid: from the community since not all cases seek healthcare (under-ascertainment), and at the healthcare-level, representing a failure to adequately report symptomatic cases that have sought medical advice (underreporting). There are several methods to estimate the extent of under-ascertainment and underreporting. Methods. Within the context of the ECDC-funded Burden of Communicable Diseases in Europe (BCoDE)-project, an extensive literature review was conducted to identify studies that estimate ascertainment or reporting rates for salmonellosis and campylobacteriosis in European Union Member States (MS) plus European Free Trade Area (EFTA) countries Iceland, Norway and Switzerland and four other OECD countries (USA, Canada, Australia and Japan). Multiplication factors (MFs), a measure of the magnitude of underestimation, were taken directly from the literature or derived (where the proportion of underestimated, under-ascertained, or underreported cases was known) and compared for the two pathogens. Results: MFs varied between and within diseases and countries, representing a need to carefully select the most appropriate MFs and methods for calculating them. The most appropriate MFs are often disease-, country-, age-, and sex-specific. Conclusions: When routine data are used to make decisions on resource allocation or to estimate epidemiological parameters in populations, it becomes important to understand when, where and to what extent these data represent the true picture of disease, and in some instances (such as priority setting) it is necessary to adjust for underestimation. MFs can be used to adjust notification and surveillance data to provide more realistic estimates of incidence. © 2014 Gibbons et al.; licensee BioMed Central Ltd.

Does Internet reporting improve the accessibility of financial reporting in a global world? A comparative study of New Zealand and Indian companies

 The accessibility of business reporting, including financial reports on company websites is not necessarily increased by providing more information on websites. The quality of Internet-based information is affected by both the accessibility and quantity of information provided. However, the accessibility of the information is an under researched area. This paper contributes to the existing body of knowledge on webbased business reporting, by considering the dimension of accessibility in terms of website appearance and visual design from four different perspectives. The aim is to consider the differences that occur in website organisation as a way of considering the accessibility of information provided on company websites. The paper considers the differences in the accessibility of website information between New Zealand and Indian companies as a means of demonstrating the variation that can occur across countries as well as within the same reporting structure. We conclude that Internet financial reporting does provide the illusion of comparability but without a more sustained focus on the harmonisation of terminology and attributes included in Internet reporting, the potential for comparison is reduced.