Montgomery & Smithies: Public Policy

A Review of Public Policy Volume XIV. Edited by John D. Montgomery and Arthur Smithie

An educational durian? Issues in teacher education in international collaboration

This paper looks at an international collaborative project in teacher education between Malaysian Institutes of teacher training and an Australian university from the perspectives of four of the participants. Two of the stories are from participants who are co-ordinating aspects of the collaboration, and two stories come from participants who were involved closely in the curriculum and teaching aspects of the program. These personal stories reveal that international collaborative projects are indeed like the durian: there are both good and bad aspects. Our differing roles in the program allow us to provide rich insights into such an international collaboration that we believe will be of benefit to others attempting similar projects.<br /

Competition between Diffusion and Fragmentation: An Important Evolutionary Process of Nature

We investigate systems of nature where the common physical processes diffusion and fragmentation compete. We derive a rate equation for the size distribution of fragments. The equation leads to a third order differential equation which we solve exactly in terms of Bessel functions. The stationary state is a universal Bessel distribution described by one parameter, which fits perfectly experimental data from two very different system of nature, namely, the distribution of ice crystal sizes from the Greenland ice sheet and the length distribution of alpha-helices in proteins.Comment: 4 pages, 3 figures, (minor changes

Adaptation of the Bergen Social Media Addiction Scale (BSMAS) in Spanish

The impact of social networks on people's daily lives is worrisome, particularly in adolescents and young people, who seem to exceed the limits of normal use. Constant excessive use can lead to pathological behaviors linked to social media addiction (SMA). Our objectives were to 1) adapt the Bergen Social Media Addiction Scale (BSMAS) to Spanish and 2) evaluate its psychometric properties in a young population. The BSMAS was adapted to Spanish, involving experts on social media addiction and people from the target population during the adaptation process. For the psychometric evaluation, 650 Peruvian college students responded to the Spanish version (53.5 % women aged 18 to 40, M = 21.5 SD = 2.7). The one-dimensional measurement model proposed for the original BSMAS was confirmed for our version (X2(9) = 23.9315, CFI = 0.994, TLI = 0.990, SRMR = 0.032, RMSEA = 0.061). The reliability was good (α = 0.863; 95 % CI: 0.848–0.870; ω = 0.864; 95 % CI: 0.846–0.844), and the measurement invariance was confirmed for sex and age by fitting models. The concurrent validity with external social media addiction and mental health indicators was also confirmed. This study provides new and relevant information on the BSMAS validity and allows its application to Spanish-speaker college students from Peru and similar countries

Rates of referable eye disease in the Scottish National Diabetic Retinopathy Screening Programme

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.Peer reviewedPublisher PD

Prognosis for long-term survival and renal recovery in critically ill patients with severe acute renal failure: a population-based study

INTRODUCTION: Severe acute renal failure (sARF) is associated with considerable morbidity, mortality and use of healthcare resources; however, its precise epidemiology and long-term outcomes have not been well described in a non-specified population. METHODS: Population-based surveillance was conducted among all adult residents of the Calgary Health Region (population 1 million) admitted to multidisciplinary and cardiovascular surgical intensive care units between May 1 1999 and April 30 2002. Clinical records were reviewed and outcome at 1 year was assessed. RESULTS: sARF occurred in 240 patients (11.0 per 100,000 population/year). Rates were highest in males and older patients (≥65 years of age). Risk factors for development of sARF included previous heart disease, stroke, pulmonary disease, diabetes mellitus, cancer, connective tissue disease, chronic renal dysfunction, and alcoholism. The annual mortality rate was 7.3 per 100,000 population with rates highest in males and those ≥65 years. The 28-day, 90-day, and 1-year case-fatality rates were 51%, 60%, and 64%, respectively. Increased Charlson co-morbidity index, presence of liver disease, higher APACHE II score, septic shock, and need for continuous renal replacement therapy were independently associated with death at 1 year. Renal recovery occurred in 78% (68/87) of survivors at 1 year. CONCLUSION: sARF is common and males, older patients, and those with underlying medical conditions are at greatest risk. Although the majority of patients with sARF will die, most survivors will become independent from renal replacement therapy within a year

A comparison between the APACHE II and Charlson Index Score for predicting hospital mortality in critically ill patients

<p>Abstract</p> <p>Background</p> <p>Risk adjustment and mortality prediction in studies of critical care are usually performed using acuity of illness scores, such as Acute Physiology and Chronic Health Evaluation II (APACHE II), which emphasize physiological derangement. Common risk adjustment systems used in administrative datasets, like the Charlson index, are entirely based on the presence of co-morbid illnesses. The purpose of this study was to compare the discriminative ability of the Charlson index to the APACHE II in predicting hospital mortality in adult multisystem ICU patients.</p> <p>Methods</p> <p>This was a population-based cohort design. The study sample consisted of adult (>17 years of age) residents of the Calgary Health Region admitted to a multisystem ICU between April 2002 and March 2004. Clinical data were collected prospectively and linked to hospital outcome data. Multiple regression analyses were used to compare the performance of APACHE II and the Charlson index.</p> <p>Results</p> <p>The Charlson index was a poor predictor of mortality (C = 0.626). There was minimal difference between a baseline model containing age, sex and acute physiology score (C = 0.74) and models containing either chronic health points (C = 0.76) or Charlson index variations (C = 0.75, 0.76, 0.77). No important improvement in prediction occurred when the Charlson index was added to the full APACHE II model (C = 0.808 to C = 0.813).</p> <p>Conclusion</p> <p>The Charlson index does not perform as well as the APACHE II in predicting hospital mortality in ICU patients. However, when acuity of illness scores are unavailable or are not recorded in a standard way, the Charlson index might be considered as an alternative method of risk adjustment and therefore facilitate comparisons between intensive care units.</p

Determinants of response to a parent questionnaire about development and behaviour in 3 year olds: European multicentre study of congenital toxoplasmosis.

Background: We aimed to determine how response to a parent-completed postal questionnaire measuring development, behaviour, impairment, and parental concerns and anxiety, varies in different European centres. Methods: Prospective cohort study of 3 year old children, with and without congenital toxoplasmosis, who were identified by prenatal or neonatal screening for toxoplasmosis in 11 centres in 7 countries. Parents were mailed a questionnaire that comprised all or part of existing validated tools. We determined the effect of characteristics of the centre and child on response, age at questionnaire completion, and response to child drawing tasks. Results: The questionnaire took 21 minutes to complete on average. 67% (714/1058) of parents responded. Few parents (60/1058) refused to participate. The strongest determinants of response were the score for organisational attributes of the study centre (such as direct involvement in follow up and access to an address register), and infection with congenital toxoplasmosis. Age at completion was associated with study centre, presence of neurological abnormalities in early infancy, and duration of prenatal treatment. Completion rates for individual questions exceeded 92% except for child completed drawings of a man (70%), which were completed more by girls, older children, and in certain centres. Conclusion: Differences in response across European centres were predominantly related to the organisation of follow up and access to correct addresses. The questionnaire was acceptable in all six countries and offers a low cost tool for assessing development, behaviour, and parental concerns and anxiety, in multinational studies