Aged disability and community care in Australia: issues for southern Africa

Disability among the aged is an issue of growing importance to southern Africa as it is throughout the world. New methods and debates about disability and ageing are illustrated by a discussion of the Australian situation. First, trends in mortality and life expectancy are outlined, and the debate about the compression of mortality critically examined. Second, the same techniques of analysis are applied to disability and handicap rates derived from national surveys. The hypothesis of compression of morbidity or illness is also critically examined. Third, the impact on the community of disability is discussed, and expectations of life "free of community services" and ''free of institutionalization" are calculated. Finally, trends in health-risk factors and the contributions of various diseases to health expectations are outlined. Southern African countries are also part of the movement to measure quality-of-life years-not only quantity - and need to develop their population monitoring of disability and demands for community care. The development will facilitate policy planning to improve the management of community services provided for the elderly by families, the community and formal providers

Gastroparesis secondary to a demyelinating disease: a case series

BACKGROUND: Gastroparesis has a number of etiologies. The main ones are secondary to a complication from diabetes mellitus, related to post vagotomy or post gastric surgical resections, or idiopathic when the etiology is unclear. Gastroparesis secondary to a demyelinating disease of the brain is unusual. CASE PRESENTATION: A 22-year-old woman was referred for acute onset of intractable nausea and vomiting. She also had cerebellar deficits, dysphagia and paresthesias. Magnetic resonance imaging (MRI) of the brain revealed an isolated area of demyelination in the medullary region. Another 24-year-old woman had a similar presentation with right hemiplegia and MRI of the brain revealed a distal medullary region. Both these patients had an abnormal gastric emptying test. Gastroparesis and neurological deficits improved with intravenous corticosteroids. While the former patient has had no further recurrences, the latter patient developed multiple sclerosis within three months of presentation. CONCLUSION: A demyelinating disease is a rare cause gastropareis, but should be suspected when symptoms of gastroparesis are associated with neurological deficits. MRI might help in the diagnosis and intravenous coriticosteroids can address the underlying disease process and improve gastric emptying, especially when used early during the course of the disease

Introducing Creativity In A Design Laboratory For A Freshman Level Electrical And Computer Engineering Course

In the electrical and computer engineering (ECE) curriculum at The University of Alabama, freshmen are introduced to fundamental electrical concepts and units, DC circuit analysis techniques, operational amplifiers, circuit simulation, design, and professional ethics. The two credit course has both lecture and laboratory components that address these topics. The laboratory has been used, in this project, to provide students an experience in design. In one of the laboratory assignments, students work in teams to design and build products giving attention to both function and aesthetics. Creativity is an important attribute for engineers practicing their profession in a global society. The creative process was exercised in the design lab by progressively engaging students through various stages including: brainstorming, formation of a construction plan, producing schematic representations, and implementing their design. In a two- year period, four laboratory exercises were developed to provide design experiences in our introductory ECE course. Assessment results show that the majority of students enjoy several aspects of the laboratory on design and creativity. At the same time, they consider this lab to be one of the most difficult ones due to its open-ended nature. Students who experienced the creative lab were somewhat more likely to state they would continue in their major. Overall, the project team concluded that the creative lab was valuable and did raise awareness of the creative process.

Sub-megahertz homogeneous linewidth for Er in Si via in situ single photon detection

We studied the optical properties of a resonantly excited trivalent Er ensemble in Si accessed via in situ single photon detection. A novel approach which avoids nanofabrication on the sample is introduced, resulting in a highly efficient detection of 70 excitation frequencies, of which 63 resonances have not been observed in literature. The center frequencies and optical lifetimes of all resonances have been extracted, showing that 5% of the resonances are within 1 GHz of our electrically detected resonances and that the optical lifetimes range from 0.5 ms up to 1.5 ms. We observed inhomogeneous broadening of less than 400 MHz and an upper bound on the homogeneous linewidth of 1.4 MHz and 0.75 MHz for two separate resonances, which is a reduction of more than an order of magnitude observed to date. These narrow optical transition properties show that Er in Si is an excellent candidate for future quantum information and communication applications.Comment: 12 pages, 13 figure

Hospital care for children and young adults in the last year of life: a population-based study

BACKGROUND: To help design population-based pediatric palliative care services, we sought to describe the hospital care received in the last year of life by children and young adults who died. We also determined the proportion with complex chronic conditions (CCCs) and tested whether the use of hospital services increased as the date of death drew nearer. METHODS: For all deaths occurring under 25 years of age from 1990 to 1996 in Washington State, USA, we linked death certificate information to hospital utilization records and analyzed the timing and duration of hospitalizations and the nature of hospital procedures during the year prior to death. RESULTS: Of the 8 893 deaths, 25 % had CCCs. Among infants with CCCs, 84 % were hospitalized at the time of death and 50 % had been mechanically ventilated during their terminal admission. Among the 458 CCC neonates dying under a week of age, 92% of all days of life were spent in the hospital; among the 172 CCC neonates dying during the second to fourth weeks of life, 85 % of all days of life were spent hospitalized; among the 286 CCC infants dying during the second to twelfth month of life, 41 % of all days of life were spent hospitalized. Among children and young adults with CCCs, 55 % were hospitalized at the time of death, and 19 % had been mechanically ventilated during their terminal admission. For these older patients, the median number of days spent in the hospital during the year preceding death was 18, yet less than a third of this group was hospitalized at any point in time until the last week of their lives. The rate of hospital use increased as death drew near. For subjects who had received hospital care, 44 % had governmental insurance as the source of primary payment. CONCLUSIONS: Infants who died spent a substantial proportion of their lives in hospitals, whereas children and adolescents who died from CCCs predominantly lived outside of the hospital during the last year of life. To serve these patients, pediatric palliative and end-of-life care will have to be provided in an integrated, coordinated manner both in hospitals and home communities

Millisecond electron spin coherence time for erbium ions in silicon

Spins in silicon that are accessible via a telecom-compatible optical transition are a versatile platform for quantum information processing that can leverage the well-established silicon nanofabrication industry. Key to these applications are long coherence times on the optical and spin transitions to provide a robust system for interfacing photonic and spin qubits. Here, we report telecom-compatible Er3+ sites with long optical and electron spin coherence times, measured within a nuclear spin-free silicon crystal (<0.01% 29Si) using optical detection. We investigate two sites and find 0.1 GHz optical inhomogeneous linewidths and homogeneous linewidths below 70 kHz for both sites. We measure the electron spin coherence time of both sites using optically detected magnetic resonance and observe Hahn echo decay constants of 0.8 ms and 1.2 ms at around 11 mT. These optical and spin properties of Er3+:Si are an important milestone towards using optically accessible spins in silicon for a broad range of quantum information processing applications.Comment: 14 pages, 6 figure

The AuScope geodetic VLBI array

The AuScope geodetic Very Long Baseline Interferometry array consists of three new 12-m radio telescopes and a correlation facility in Australia. The telescopes at Hobart (Tasmania), Katherine (Northern Territory) and Yarragadee (Western Australia) are co-located with other space geodetic techniques including Global Navigation Satellite Systems (GNSS) and gravity infrastructure, and in the case of Yarragadee, satellite laser ranging (SLR) and Doppler Orbitography and Radiopositioning Integrated by Satellite (DORIS) facilities. The correlation facility is based in Perth (Western Australia). This new facility will make significant contributions to improving the densification of the International Celestial Reference Frame in the Southern Hemisphere, and subsequently enhance the International Terrestrial Reference Frame through the ability to detect and mitigate systematic error. This, combined with the simultaneous densification of the GNSS network across Australia, will enable the improved measurement of intraplate deformation across the Australian tectonic plate. In this paper, we present a description of this new infrastructure and present some initial results, including telescope performance measurements and positions of the telescopes in the International Terrestrial Reference Frame. We show that this array is already capable of achieving centimetre precision over typical long-baselines and that network and reference source systematic effects must be further improved to reach the ambitious goals of VLBI2010