Treatment initiation for parkinson's disease in Australia 2013-2018 : a nation-wide study

Background Guidelines highlight the importance of an individualized approach to treatment initiation for Parkinson's disease. Our aim was to investigate initiation of anti-Parkinson medication in Australia from 2013-2018, and to determine factors predicting choice of initial treatment. Methods Cohort of new-users (N = 4,887) of anti-Parkinson medication aged >= 40 years were identified from a 10% random representative sample of national medication dispensing data from July-2013 to June-2018. Changes in treatment initiation were examined across the whole cohort and stratified by age and sex. Results Treatment initiation was most frequent with levodopa followed by non-ergot dopamine agonists (DAs) and anticholinergics. Two thirds initiated with levodopa across the study period. Initiation with non-ergot DAs increased from 22 to 27% (rate ratio, RR 1.23, 95% confidence interval, CI 1.02-1.47) and initiation with anticholinergics decreased from 6.9% to 2.4% (RR 0.34, 95% CI 0.21-0.55) from 2013-2018. Among persons aged >= 65 years, one third of women and one fourth of men initiated on levodopa. Among women aged = 65 years, consistent with current guidelines. Whilst the value of levodopa sparing strategies is unclear, treatment initiation with DA has become increasingly common relative to levodopa among women but not among men aged < 65 years.Peer reviewe

Impact of medication regimen simplification on medication incidents in residential aged care: Simpler randomized controlled trial

In the SImplification of Medications Prescribed to Long-tErm care Residents (SIMPLER) cluster-randomized controlled trial, we investigated the impact of a structured medication regimen simplification intervention on medication incidents in residential aged care facilities (RACFs) over a 12-month follow-up. A clinical pharmacist applied the validated 5-step Medication Regimen Simplification Guide for Residential Aged CarE (MRS GRACE) for 96 of the 99 participating residents in the four intervention RACFs. The 143 participating residents in the comparison RACFs received usual care. Over 12 months, medication incident rates were 95 and 66 per 100 resident-years in the intervention and comparison groups, respectively (adjusted incident rate ratio (IRR) 1.13; 95% confidence interval (CI) 0.53–2.38). The 12-month pre/post incident rate almost halved among participants in the intervention group (adjusted IRR 0.56; 95%CI 0.38–0.80). A significant reduction in 12-month pre/post incident rate was also observed in the comparison group (adjusted IRR 0.67, 95%CI 0.50–0.90). Medication incidents over 12 months were often minor in severity. Declines in 12-month pre/post incident rates were observed in both study arms; however, rates were not significantly different among residents who received and did not receive a one-off structured medication regimen simplification intervention

Simple Market Timing with Moving Averages

Consider using the simple moving average (MA) rule of Gartley (1935) to determine when to buy stocks, and when to sell them and switch to the risk-free rate. In comparison, how might the performance be affected if the frequency is changed to the use of MA calculations? The empirical results show that, on average, the lower is the frequency, the higher are average daily returns, even though the volatility is virtually unchanged when the frequency is lower. The volatility from the highest to the lowest frequency is about 30% lower as compared with the buy-and-hold strategy volatility, but the average returns approach the buy-and-hold returns when frequency is lower. The 30% reduction in volatility appears if we invest randomly half the time in stock markets and half in the risk-free rate

Market timing with moving averages

Consider using the simple moving average (MA) rule of Gartley to determine when to buy stocks, and when to sell them and switch to the risk-free rate. In comparison, how might the performance be affected if the frequency is changed to the use of MA calculations? The empirical results show that, on average, the lower is the frequency, the higher are average daily returns, even though the volatility is virtually unchanged when the frequency is lower. The volatility from the highest to the lowest frequency is about 30% lower as compared with the buy-and-hold strategy volatility, but the average returns approach the buy-and-hold returns when frequency is lower. The 30% reduction in volatility appears if we invest randomly half the time in stock markets and half in the risk-free rate

Implementing virtual collaborative inquiry practises in a middle-school context

The aim of the present study was to investigate the challenges that relate to the implementation of virtual inquiry practises in middle school. The case was a school course in which a group of Finnish students (N = 14) and teachers (N = 7) completed group inquiries through virtual collaboration, using a web-based learning environment. The task was to accomplish a cross-disciplinary inquiry into cultural issues. The students worked mainly at home and took much responsibility for their course achievements. The investigators analysed the pedagogical design of the course and the content of the participants' interaction patterns in the web-based environment, using qualitative content analysis and social network analysis. The findings suggest that the students succeeded in producing distinctive cultural products, and both the students and the teachers adopted novel roles during the inquiry. The web-based learning environment was used more as a coordination tool for organizing the collaborative work than as a forum for epistemic inquiry. The tension between the school curriculum and the inquiry practises was manifest in the participants' discussions of the assessment criteria of the course.The aim of the present study was to investigate the challenges that relate to the implementation of virtual inquiry practises in middle school. The case was a school course in which a group of Finnish students (N = 14) and teachers (N = 7) completed group inquiries through virtual collaboration, using a web-based learning environment. The task was to accomplish a cross-disciplinary inquiry into cultural issues. The students worked mainly at home and took much responsibility for their course achievements. The investigators analysed the pedagogical design of the course and the content of the participants' interaction patterns in the web-based environment, using qualitative content analysis and social network analysis. The findings suggest that the students succeeded in producing distinctive cultural products, and both the students and the teachers adopted novel roles during the inquiry. The web-based learning environment was used more as a coordination tool for organizing the collaborative work than as a forum for epistemic inquiry. The tension between the school curriculum and the inquiry practises was manifest in the participants' discussions of the assessment criteria of the course.The aim of the present study was to investigate the challenges that relate to the implementation of virtual inquiry practises in middle school. The case was a school course in which a group of Finnish students (N = 14) and teachers (N = 7) completed group inquiries through virtual collaboration, using a web-based learning environment. The task was to accomplish a cross-disciplinary inquiry into cultural issues. The students worked mainly at home and took much responsibility for their course achievements. The investigators analysed the pedagogical design of the course and the content of the participants' interaction patterns in the web-based environment, using qualitative content analysis and social network analysis. The findings suggest that the students succeeded in producing distinctive cultural products, and both the students and the teachers adopted novel roles during the inquiry. The web-based learning environment was used more as a coordination tool for organizing the collaborative work than as a forum for epistemic inquiry. The tension between the school curriculum and the inquiry practises was manifest in the participants' discussions of the assessment criteria of the course.Peer reviewe

Smoking and suicidality among adolescent psychiatric patients

Purpose: To investigate the relationship between smoking and suicidality among adolescent psychiatric patients in Finland. Methods: Data from 157 patients (aged 12-17 years) admitted to inpatient psychiatric hospitalization between April 2001 and July 2002 were collected. Logistic regression analyses were used to examine the association between regular daily smoking and suicidality. The data were adjusted for several sociodemographic and clinical characteristics. Results: The results showed over four-fold risk for definite and/or life-threatening suicide attempts among smoking adolescents in inpatient psychiatric facility compared with nonsmoking ones (OR 4.33, 95% CI 1.23-15.20). Also, the smoking adolescents had three times greater risk for occasional (OR 3.32, 95% CI 1.09-10.10) or frequent (OR 3.00, 95% CI 1.08-10.10) self-mutilation. Suicidality was more common among girls than boys and among those adolescents who suffered from depression. Conclusions: Among teens hospitalized for psychiatric illnesses, daily smoking was significantly related to suicide attempts and self-mutilation, even after controlling for several confounding factors, including psychiatric diagnosis. (C) Society for Adolescent Medicine, 2004.Peer reviewe

Predictability of boreal forest soil bearing capacity by machine learning

In forest harvesting, terrain trafficability is the key parameter needed for route planning. Advance knowledge of the soil bearing capacity is crucial for heavy machinery operations. Especially peatland areas can cause severe problems for harvesting operations and can result in increased costs. In addition to avoiding potential damage to the soil, route planning must also take into consideration the root damage to the remaining trees. In this paper we study the predictability of boreal soil load bearing capacity by using remote sensing data and field measurement data. We conduct our research by using both linear and nonlinear methods of machine learning. With the best prediction method, ridge regression, the results are promising with a C-index value higher than 0.68 up to 200 m prediction range from the closest point with known bearing capacity, the baseline value being 0.5. The load bearing classification of the soil resulted in 76% accuracy up to 60 m by using a multilayer perceptron method. The results indicate that there is a potential for production applications and that there is a great need for automatic real-time sensoring in order to produce applicable predictions. (C) 2016 ISTVS. Published by Elsevier Ltd. All rights reserved

Digital competence across boundaries - beyond a common Nordic model of the digitalisation of K-12 schools?

This paper explores policy related to digital competence and the digitalisation of Nordic K-12 schools. Anchored in some key transnational policies on digital competence, it describes some current Nordic movements in the national policies of Denmark, Finland, Norway and Sweden. The concept of boundary objects is used as an analytical lens, for understanding digital competence as a plastic and temporal concept that can be used to discuss the multi-dimensional translation of this concept in these Nordic countries. The paper ends with a discussion of the potential to view digital competence as a unifying boundary object that, with its plasticity, temporality and n-dimensionality, can show signs of common Nordic efforts in the K-12 school policy.Peer reviewe

Long run returns predictability and volatility with moving averages

This paper examines how the size of the rolling window, and the frequency used in moving average (MA) trading strategies, affects financial performance when risk is measured. We use the MA rule for market timing, that is, for when to buy stocks and when to shift to the risk-free rate. The important issue regarding the predictability of returns is assessed. It is found that performance improves, on average, when the rolling window is expanded and the data frequency is low. However, when the size of the rolling window reaches three years, the frequency loses its significance and all frequencies considered produce similar financial performance. Therefore, the results support stock returns predictability in the long run. The procedure takes account of the issues of variable persistence as we use only returns in the analysis. Therefore, we use the performance of MA rules as an instrument for testing returns predictability in financial stock markets

Assessing extraction trail trafficability using harvester CAN-bus data

Modern forest machines with a Controlled Area Network (CAN)-bus managed diesel engine and hydrostatic transmission can continuously measure power expended in traveling. At a constant speed on level ground, the power is expended in overcoming motion resistance, which is directly related to wheel sinkage and hence to site trafficability. In cut-to-length timber harvesting, the harvester precedes the forwarder on the site, making it feasible to utilize the harvester to collect data on site trafficability to produce a trafficability map for the forwarder. CAN-bus trafficability mapping was tested with an 8-wheeled Ponsse Scorpion King harvester and an 8-wheeled Ponsse Elk forwarder instrumented for collecting transmission power expenditure, in addition to appropriate available CAN-bus information. Trafficability was also mapped based solely on momentary engine power in order to eliminate the need for additional pressure transducers. The CANbus data showed good results for mapping site trafficability when compared to soil penetration resistance and harvesting machinery wheel rut depth measurements. Assessing harvester rolling resistance using CAN-bus data offers an interesting possibility to map harvesting site trafficability also in Big Data scale. Since modern harvesters are practically ready for indirect power recording, the additional cost of fully automated and comprehensive trafficability mapping as part of operative forestry is negligible