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Investigating the actions required to effectively manage stakeholders in construction projects
No full textA Preliminary Numerical Study of Nasal Air Conditioning following Maxillary Sinus Stent Implantation
No full textThe relationship between sensory phenomena and interoception across the obsessive–compulsive spectrum: a systematic review
Get PDFUtilizing Artificial Intelligence (AI) for the optimal design of geothermal cogeneration systems in zero energy building
Get PDFSocioeconomic inequalities in physical function decline: multilevel longitudinal results from the HABITAT study
Get PDFBackground: Australia’s population is ageing, with a projected continued increase in the proportion of individuals aged 65 years and older. Good physical function is important to ensure independence and mobility among older adults. This study examined changes in physical function by socioeconomic indicators including education, occupation, household income and neighbourhood socioeconomic disadvantage. Methods: Data were from waves four (2013) and five (2016) (1,186 men and 1,673 women) of the HABITAT study, a multilevel longitudinal study of adults aged 40–65 at baseline (2007) living in 200 neighbourhoods in Brisbane, Australia. Individual-level socioeconomic indicators were self-reported and physical function was self-reported using the 10-item subscale of the Short-Form 36 survey, with scores ranging from 0 to 100. Neighbourhood socioeconomic disadvantage was obtained from a census-based Index of Relative Socioeconomic Disadvantage score. Data were analysed using multilevel linear regression. Results: Pooled analysis showed graded inequalities in physical function across all socioeconomic groups: those with lower levels of education, occupation and household income all had lower function, while residents of the most disadvantaged neighbourhoods had 8.16 lower function (95%CI: 10.21, 6.12) than those in the most advantaged neighbourhoods. Over the three-year period, there was a mean reduction in physical function scores of 1.97 (95%CI: -2.58, -1.36), though physical function inequalities did not widen over time between socioeconomic groups. Conclusion: There was little evidence of inequalities in the magnitude of decline in physical function across socioeconomic groups between the two time points. Future research should consider more objective performance-based measures to better understand the complexity of physical function among the ageing population
Comparative Effects of Different Exercise Types on Cardiovascular Health and Executive Function in Sedentary Young Individuals
Get PDFSuper-twisting nonsingular terminal sliding mode control for cyber physical system under FDI attacks
No full textThe effect of age on heart rate variability indices during and following high-intensity continuous exercise in masters and young cyclists
Get PDFPerformance Review of Emergency Care Management Plans Pre- and Post-Implementation of Electronic Records
No full textIntroduction: Patients who frequently present to the Emergency Department (ED) often have complex care needs, requiring substantial resources and resulting in longer stays. Emergency Care Management Plans (ECMPs) are designed to help clinicians adopt a person-centred approach, clarify goals, avoid unnecessary interventions, and reduce ED visit frequency and duration. ECMPs at our institution were previously stored in paper medical records, making timely access difficult. On April 2, 2012, ECMPs were scanned into the Electronic Medical Record (EMR), allowing easier access. This study assesses the impact of electronic ECMPs. Methods: Using a retrospective observational design guided by the STROBE checklist, we evaluated whether the introduction of electronic ECMPs reduced the frequency and duration of ED visits. Data from all ED patients with electronic ECMPs were extracted and analysed to compare variables pre- and post-implementation, including demographics, most common triage data, visit frequency, length of stay (LOS), and discharge diagnoses. Results: A total of 115 patients (mean age: 53) were included. Ambulance transport was the most common (64%), and Australasian Triage Scale (ATS) category 3 was the most frequent (57%). Post implementation the mean number of presentations reduced from 16 to 9, and ED LOS (EDLOS) decreased from 4676 to 2577 min (p < 0.001). Short Stay Unit LOS (SSULOS) decreased from 1359 to 638 min (p < 0.001), leading to an overall reduction of 2802 min (p < 0.001). Conclusion: ECMPs effectively reduced both the frequency and duration of ED visits. Further research is needed to explore patient experience and other outcome measures
Regime Change in Top of the Atmosphere Radiation Fluxes: Implications for Understanding Earth’s Energy Imbalance
Get PDFEarth’s energy imbalance (EEI) is a major indicator of climate change. Its metrics are top of the atmosphere radiation imbalance (EEI TOA) and net internal heat uptake. Both EEI and temperature are expected to respond gradually to forcing on annual timescales. This expectation was tested by analyzing regime changes in the inputs to EEI TOA along with increasing ocean heat content (OHC). Outward longwave radiation (OLR) displayed rapid shifts in three observational and two reanalysis records. The reanalysis records also contained shifts in surface fluxes and temperature. OLR, outward shortwave radiation (OSR) and TOA net radiation (Net) from the CERES Energy Balanced and Filled Ed-4.2.1 (2001–2023) record and from 27 CMIP5 historical and RCP4.5 forced simulations 1861–2100, were also analyzed. All variables from CERES contained shifts but the record was too short to confirm regime changes. Contributions of OLR and OSR to net showed high complementarity over space and time. EEI TOA was −0.47 ± 0.11 W m−2 in 2001–2011 and −1.09 ± 0.11 W m−2 in 2012–2023. Reduced OSR due to cloud feedback was a major contributor, coinciding with rapid increases in sea surface temperatures in 2014. Despite widely varying OLR and OSR, 26/27 climate models produced stable regimes for net radiation. EEI TOA was neutral from 1861, shifting downward in the 26 reliable records between 1963 and 1995, with 25 records showing it stabilizing by 2039. To investigate heat uptake, temperature and OHC 1955/57–2023 was analyzed for regime change in the 100 m, 700 m and 2000 m layers. The 100 m layer, about one third of total heat content, was dominated by regimes. Increases became more gradual with depth. Annual changes between the 700 m layer and 1300 m beneath were negatively correlated (−0.67), with delayed oscillations during lag years 2–9. Heat uptake at depth is dynamic. These changes reveal a complex thermodynamic response to gradual forcing. We outline a complex arrangement of naturally evolved heat engines, dominated by a dissipative heat engine nested within a radiative engine. EEI is a property of the dissipative heat engine. This far-from-equilibrium natural engine has evolved to take the path of least resistance while being constrained by its maximum power limit (~2 W m−2). It is open to the radiative engine, receiving solar radiation and emitting scattered shortwave and longwave radiation. Steady states maximize entropy within the dissipative engine by regulating spatial patterns in surface variables that influence outgoing OLR and OSR. Regime shifts to warmer climates balance the cost of greater irreversibility with increased energy rate density. The result is the regulation of EEI TOA through a form of thermodynamic metabolis