337 research outputs found

    A COMPARISON OF RESAMPLING TECHNIQUES WHEN PARAMETERS ARE ON A BOUNDARY: THE BOOTSTRAP, SUBSAMPLE BOOTSTRAP, AND SUBSAMPLE JACKKNIFE

    Get PDF
    This paper compares the finite sample performance of subsample bootstrap and subsample jackknife techniques to the traditional bootstrap method when parameters are constrained to be on some boundary. To assess how these three methods perform in an empirical application, a negative semi-definite translog cost function is estimated using U.S. manufacturing data.Research Methods/ Statistical Methods,

    THE ALMOST IDEAL SUPPLY SYSTEM AND AGRICULTURAL PRODUCTION IN THE UNITED STATES

    Get PDF
    This paper estimates an Almost Ideal Supply System using aggregate U.S. agricultural data. Share equations derived from an indirect production function yield elasticities that are consistent with production theory. A nested test comparing the Almost Ideal Supply System to the Translog Production Function finds little difference between the two models.Research Methods/ Statistical Methods,

    An Examination of the Feasibility of Linear Deterministic Sea Wave Prediction in Multi-Directional Seas Using Wave Profiling Radar: Theory, Simulation and Sea Trials

    Get PDF
    This is the final version of the article. Available from the American Meteorological Society via the DOI in this record.For a number of maritime tasks there is a short time period, typically only a few tens of seconds, where a critical event occurs which defines a limiting wave height for the whole operation. Examples are the recovery of fixed and rotary winged aircraft, cargo transfers, final pipe mating in fluid transfer operations and launch/recovery of small craft. The recovery of a 30 ton rescue submersible onto a mother ship in the NATO Submarine Rescue System is a prime example. In such applications short term Deterministic Sea Wave Prediction (DSWP) can play a vital role in extending the sea states under which the system can be safely deployed. DSWP also has great potential in conducting experimental sea wave research at full scale. This report explores the feasibility of using data from an experimental wave profiling radar in achieving DSWP. The report includes theory, simulation and field testing. Two forms of DSWP are employed, a fixed point system based upon a restricted set of wave directions, from which we obtain some success, and the other a fully two dimensional technique, which requires further development. The main finding is that using wave profiling radar for DSWP offers promise but requires improvements both to the spatial reliability and resolution of the wave profiling radar, and to the temporal resolution of its sweep before the technique can be considered to be viable as a usable tool.The authors acknowledge funding from the European Union FP7 and U.K. Ministry of Defence NSRS projects

    Drug Burden Index is a Modifiable Predictor of 30-Day-Hospitalization in Community-Dwelling Older Adults with Complex Care Needs:Machine Learning Analysis of InterRAI Data

    Get PDF
    BACKGROUND: Older adults (≥ 65 years) account for a disproportionately high proportion of hospitalization and in-hospital mortality, some of which may be avoidable. Although machine learning (ML) models have already been built and validated for predicting hospitalization and mortality, there remains a significant need to optimise ML models further. Accurately predicting hospitalization may tremendously impact the clinical care of older adults as preventative measures can be implemented to improve clinical outcomes for the patient.METHODS: In this retrospective cohort study, a dataset of 14,198 community-dwelling older adults (≥ 65 years) with complex care needs from the Inter-Resident Assessment Instrument database was used to develop and optimise three ML models to predict 30-day-hospitalization. The models developed and optimized were Random Forest (RF), XGBoost (XGB), and Logistic Regression (LR). Variable importance plots were generated for all three models to identify key predictors of 30-day-hospitalization.RESULTS: The area under the receiver operating characteristics curve for the RF, XGB and LR models were 0.97, 0.90 and 0.72, respectively. Variable importance plots identified the Drug Burden Index and alcohol consumption as important, immediately potentially modifiable variables in predicting 30-day-hospitalization.CONCLUSIONS: Identifying immediately potentially modifiable risk factors such as the Drug Burden Index and alcohol consumption is of high clinical relevance. If clinicians can influence these variables, they could proactively lower the risk of 30-day-hospitalization. ML holds promise to improve the clinical care of older adults. It is crucial that these models undergo extensive validation through large-scale clinical studies before being utilized in the clinical setting.</p

    The association between benzodiazepine use and sleep quality in residential aged care facilities: a cross-sectional study

    Get PDF
    BACKGROUND: Benzodiazepines are commonly prescribed in residential aged care facilities (RACFs) for their sedative and anxiolytic effects. The objective of this study was to investigate the association between benzodiazepine use and sleep quality in residents of RACFs. METHODS: A cross-sectional study involving 383 participants was conducted in six Australian RACFs. Night-time sleep quality, day-time drowsiness and day-time napping behavior were assessed using a validated questionnaire. Logistic regression was used to compute adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for the association between benzodiazepine use and sleep quality. Covariates included pain, dementia severity, depression, insomnia and other sedative use. RESULTS: Of the 383 residents (mean age 87.5 years, 77.5% female), 96(25.1%) used a benzodiazepine on a regular basis. Residents who used long-acting benzodiazepines on a regular basis had higher night-time sleep quality than non-users (AOR = 4.00, 95%CI 1.06 - 15.15). Residents who used short-acting benzodiazepines on a PRN only basis had longer daytime napping times than non-users (AOR = 1.77, 95%CI 1.01 - 3.08). No benzodiazepine category was associated with day-time drowsiness. CONCLUSIONS: The association between benzodiazepine use and sleep quality is dependent on the half-life and prescribing pattern of the benzodiazepine. Short-acting PRN benzodiazepines were associated with lower night time sleep quality and longer day-time napping compared to long-acting regular benzodiazepines. Longitudinal studies are needed to determine whether these findings reflect channeling of short-acting agents to residents at higher risk of sleep disorders.Lynna Chen, J. Simon Bell, Renuka Visvanathan, Sarah N. Hilmer, Tina Emery, Leonie Robson, Jessica M. Hughes and Edwin C. K. Ta

    Anticholinergic burden in older women: not seeing the wood for the trees?

    Get PDF
    Objectives: To identify medicines contributing to and describe predictors of anticholinergic burden among community-dwelling older Australian women. Design, setting and participants: Retrospective longitudinal analysis of data from the Australian Longitudinal Study on Women's Health linked to Pharmaceutical Benefits Scheme medicines data from 1 January 2008 to 30 December 2010; for 3694 women born in 1921–1926. Main outcome measures: Anticholinergic burden calculated from Anticholinergic Drug Scale (ADS) scores derived from ADS levels (0 to 3) for all medicines used by each woman, summed over each 6-month period (semester), medicines commonly used by women with high semester ADS scores (defined as 75th percentile of scores). Results: 1126 women (59.9%) used at least one medicine with anticholinergic properties. The median ADS score was 4 or 5 across all semesters. Most anticholinergic medicines used by women who had a high anticholinergic burden (ADS score, = 9) had a low anticholinergic potency (ADS level 1). Increasing age, cardiovascular disease, and number of other medicines used were predictive of a higher anticholinergic burden. Conclusions: A high anticholinergic medicines burden in this group was driven by the use of multiple medicines with lower anticholinergic potency rather than the use of medicines with higher potency. This is a novel and important finding for clinical practice as doctors would readily identify the risk of a high anticholinergic burden for patients using high potency medicines, but may be less likely to identify this risk for users of multiple medicines with low anticholinergic potency

    Concurrent use of prescription drugs and herbal medicinal products in older adults: A systematic review

    Get PDF
    This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.The use of herbal medicinal products (HMPs) is common among older adults. However, little is known about concurrent use with prescription drugs as well as the potential interactions associated with such combinations. Objective Identify and evaluate the literature on concurrent prescription and HMPs use among older adults to assess prevalence, patterns, potential interactions and factors associated with this use. Methods Systematic searches in MEDLINE, PsycINFO, EMBASE, CINAHL, AMED, Web of Science and Cochrane from inception to May 2017 for studies reporting concurrent use of prescription medicines with HMPs in adults (≥65 years). Quality was assessed using the Joanna Briggs Institute checklists. The Evidence for Policy and Practice Information and Co-ordinating Centre (EPPI-Centre) three stage approach to mixed method research was used to synthesise data. Results Twenty-two studies were included. A definition of HMPs or what was considered HMP was frequently missing. Prevalence of concurrent use by older adults varied widely between 5.3% and 88.3%. Prescription medicines most combined with HMPs were antihypertensive drugs, beta blockers, diuretics, antihyperlipidemic agents, anticoagulants, analgesics, antihistamines, antidiabetics, antidepressants and statins. The HMPs most frequently used were: ginkgo, garlic, ginseng, St John’s wort, Echinacea, saw palmetto, evening primrose oil and ginger. Potential risks of bleeding due to use of ginkgo, garlic or ginseng with aspirin or warfarin was the most reported herb-drug interaction. Some data suggests being female, a lower household income and less than high school education were associated with concurrent use. Conclusion Prevalence of concurrent prescription drugs and HMPs use among older adults is substantial and potential interactions have been reported. Knowledge of the extent and manner in which older adults combine prescription drugs will aid healthcare professionals can appropriately identify and manage patients at risk.Peer reviewedFinal Published versio

    Analgesic use, pain and daytime sedation in people with and without dementia in aged care facilities: a cross-sectional, multisite, epidemiological study protocol

    Get PDF
    INTRODUCTION: People living with dementia may experience and express pain in different ways to people without dementia. People with dementia are typically prescribed fewer analgesics than people without dementia indicating a potential difference in how pain is identified and treated in these populations. The objectives of this study are to (1) investigate the prevalence of analgesic load, pain and daytime sedation in people with and without dementia in Australian residential aged care facilities (RACFs), and (2) investigate the clinical and diagnostic associations between analgesic load, pain and daytime sedation in people with and without dementia in Australian RACFs. METHODS/ANALYSIS: This will be a cross-sectional study of 300 permanent residents of up to 10 low-level and high-level RACFs in South Australia with and without dementia. Trained study nurses will administer validated and dementia-specific assessments of self-reported and clinician-observed pain, sedation and other clinical and humanistic outcomes. Medicine-use data will be extracted directly from each resident's medication administration chart. Binary and multinominal logistic regression will be used to compute unadjusted and adjusted ORs and 95% CIs for factors associated with pain, analgesic load and daytime sedation. These factors will include dementia severity, behavioural and psychological symptoms, quality of life, resident satisfaction, attitudes towards medicines, activities of daily living and nutritional status. ETHICS AND DISSEMINATION: Institutional ethics approval has been granted. The findings will be disseminated through public lectures, professional and scientific conferences and in peer-reviewed journal articles. The findings of this study will allow for a better understanding of the prevalence and factors associated with analgesic use, pain and other outcomes in residential care. The findings of this study will be used to inform the development and implementation of strategies to improve the quality of life of people with dementia.Edwin C K Tan, Renuka Visvanathan, Sarah N Hilmer, Agnes I Vitry, Tara Quirke, Tina Emery, Leonie Robson, Terry Shortt, Simon Sheldrick, Sunny, Soon Won, Lee, Robyn Clothier, Emily Reeve, Danijela Gnjidic, Jenni Ilomäki, J Simon Bel

    A germanate transparent conductive oxide

    Get PDF
    Wide bandgap conductors such as In2O3 and ZnO are used as transparent conducting oxides (TCOs). To date, TCOs are realized using post transition metal cations with largely spread s-orbitals such as In3+, Sn4+, Zn2+ and Cd2+. On the other hand, no good electronic conductor has been realized in oxides of Al, Si and Ge. Here we report the conversion of an oxide of Ge into a good electronic conductor by employing the concept of superdegeneracy. We find that cubic SrGeO3, synthesized under high pressure, displays a direct bandgap of 3.5 eV, a carrier mobility of 12 cm2(Vs)−1, and conductivities of 3 Scm−1 (DC) and 400 Scm−1 (optical conductivity). This is the first Ge-based electronic conductive oxide, and expands the family of TCOs from ionic oxides to covalent oxides
    corecore