bluuebunny/crossref_metadata_2025 huggingface dataset:
Building a partnership for social service delivery in Indonesia: state and faith‐based organisations
Authors: Sakai Minako
Published: December 2016

Contrary to the secularisation processes in modernisation theory, religions and faith‐based organisations (FBOs) are thriving in contemporary Indonesia. Strongly supported by community members, religious organisations have begun to extend their services beyond the traditional areas of education and health to operate in disaster relief and poverty alleviation programmes. These FBOs have been offering assistance to the disadvantaged whose needs have not been adequately met by the state. Social programmes run by the FBOs are an important safety net at the grass‐roots level in Indonesia; how to effectively coordinate and offer such services are important social policy issues. This paper will show that the Indonesian Government is keen to remain the key provider of social services and often perceives the services of FBOs as a threat. Some recent state policies to regulate the funding sources of Islamic organisations have posed a significant logistical challenge for their future operation. In addition, theological differences across various religious groups have made it difficult to form inclusive and extensive partnerships among the FBOs, who tend to compete with each another resulting in rivalry. These socio‐political contexts have limited the formation of effective partnerships for offering coordinated social services.
Interrogating the hybrid economy approach to Indigenous development
Authors: Curchin Katherine
Published: December 2016

In the contemporary debate about remote Indigenous economic development, Jon Altman's hybrid economy approach is the major alternative to the dominant neo‐liberal perspective. Altman's approach emphasises the continuing customary economic activity of remote‐living Indigenous Australians and their legitimate aspirations to live and work on their ancestral lands. Based on a close reading of Altman's writings, this paper analyses the hybrid economy model – which is grounded in Altman's observations of outstation life in Arnhem Land – and the approach to economic development Altman derives from it. It makes explicit the numerous assumptions underpinning the hybrid economy approach to Indigenous development. Some of these assumptions are more controversial than others. It is argued that while Altman's approach celebrates the unique skills and contributions of culturally‐connected Indigenous people, it is predicated on a pessimistic assessment of the likelihood of mainstream education and employment ‘closing the gap‘.
Are baby‐boomers healthy enough to keep working? Health as a mediator of extended labour force participation
Authors: Buckley Jennifer , O'Dwyer Lisel , Tucker Graeme , Adams Robert , Wittert Gary , Hugo Graeme
Published: December 2016

One strategy to reduce the economic impact of structural ageing is to increase and/or extend the workforce participation of older workers. Currently, a large proportion of this group consists of post‐World War II baby‐boomers (1946–1965) whose characteristics, experiences and attitudes differ markedly from their predecessors. Maintaining good health underpins strategies to extend workforce participation among baby‐boomers but there is little hard evidence supporting the assumption that baby‐boomers are generally in good health compared to previous generations and will, therefore, be able to work longer. Using a dataset that includes biomedical and self‐reported health for a representative sample of South Australian baby‐boomers, we analyse the extent to which current labour force participation is mediated by health. We find that health is a significant factor in workforce exits. Respondents with fair‐to‐poor self‐rated health, or with diabetes, arthritis, chronic obstructive pulmonary disease or cardiovascular disease, were more likely to be retired or unable to work, and around 10 per cent of older baby‐boomers (born 1946–1955) who have left the workforce rate their health as poor or fair. The data suggest that these patterns are likely to be replicated in younger baby‐boomers (born 1956–1965).
Family separation and the impacts on refugee settlement in Australia
Authors: Wilmsen Brooke
Published: December 2016

In recent years, governments, researchers, non‐government organisations, service providers and international institutions have become increasingly concerned with how to best support the settlement of refugees in UNHCR resettlement nations. Anxieties about the formation of a refugee underclass and the intergenerational impacts of social stratification motivate such inquiries. Settlement is often viewed through either of two lenses; the biomedical frame or the social inclusion frame. These frameworks are complementary rather than exclusive. It is from this combined theoretical perspective that this paper explores the impacts of family separation on the settlement of refugees in Australia. Drawing on focus groups and in‐depth interviews across three refugee background communities in metropolitan Melbourne, the paper finds that family separation has pervasive impacts on the wellbeing of the participants and on their capacity to participate and direct their own futures. Family separation is found to be a barrier to settlement and therefore a crucial consideration for the design and provision of settlement services to people with refugee backgrounds.
Policy agendas and immigration in Australia 1996 –2012
Authors: Boulus Paul , Dowding Keith , Pietsch Juliet
Published: December 2016

Immigration in Australia is inherently a controversial topic. Events such as the MV Tampa affair cause increased media and legislative attention but increased legislative attention in the policy area do not always follow such dramatic events. We analyse media and legislative attention in the area of immigration and show increased activity in parliament around both dramatic events discussed in the media and also over more technical issues. Increased attention within parliament sometimes occurs outside of the gaze of the media.
A prevalence study of children with imprisoned fathers: annual and lifetime estimates
Authors: Dennison Susan , Stewart Anna , Freiberg Kate
Published: December 2016

In Australia, data are not routinely collected on the parental status of prisoners, so there are no official nationwide figures and few State‐based figures. The current study uses data collected in Queensland over a six‐month period to estimate how many Queensland children, in one year and in their entire childhood, experience paternal imprisonment. Additional data were collected relating to the provision of care for the child prior to, and during, their father's imprisonment. Participants were 303 imprisoned fathers (51 per cent of Aboriginal and/or Torres Strait Islander origin) who reported a total of 753 children. Using these data and population statistics, it was estimated that 0.8 per cent of children in Queensland experienced paternal imprisonment in one year while approximately four per cent experience paternal imprisonment in their lifetime. Indigenous children were nine times more likely to experience paternal imprisonment in one year and four times more likely to experience paternal imprisonment in their lifetime compared to non‐Indigenous children. Approximately half of the children (48 per cent) lived with their father prior to his imprisonment. Results are discussed in relation to whether children were living with their father as well as the possibility of pre‐existing risks in children's lives that may subsequently interact with their father's imprisonment.
How has the relationship between parental education and child outcomes changed in Australia since the 1980s?
Authors: Redmond Gerry , Katz Ilan , Smart Diana , Gubhaju Bina
Published: December 2016

This paper examines how the relationship between parents' educational achievement (a marker of their socio‐economic status) and children's early developmental outcomes has evolved in Australia since the early 1980s. The specific focus of this paper is whether the gradient in children's early developmental outcomes by parents' education has changed since the 1980s. A comparative analysis of two surveys is undertaken that follows Australian cohorts of children through their early years – the Australian Temperament Project (following children born in Victoria in the early 1980s) and the Longitudinal Study of Australian Children (following a representative sample of children born in Australia in 1999). The analysis shows that the relationship between parental education and children's early developmental outcomes does not in general appear to have changed greatly over the years. The gradient associated with behaviour difficulties, persistence in behaviour difficulties over time, and in reading skills has either remained the same or strengthened somewhat, while the gradient associated with social skills has weakened. The paper concludes with a discussion of issues that might explain these trends.
Paternalism in Australian welfare policy
Authors: Mestan Kemran
Published: December 2016

Since at least the 1990s, policies comprising welfare reform in Australia have focused on securing employment for jobless people. This article demonstrates that these policies are highly paternalistic, and argues that despite the absence of the term ‘paternalism’ from relevant government discourse, paternalism is indeed a substantial characteristic of the policies. Such policies have been substantially justified through appealing to the objective of advancing the interests of those people subject to the policies while simultaneously involving compulsion. The research is based on evidence from 1996 to 2011. Through the analysis of government documents and interviews with policy makers, the presence of a benevolent justification is identified and analysed, focusing on two subordinate justifications: reducing welfare dependency, and promoting social inclusion. Policies aimed at getting people into work are then examined, where it is found that compulsion is the primary policy instrument. It is shown that the compulsive elements in workfare, when linked to the objective of helping workfare subjects, renders the policies implicitly paternalistic.
What has happened to Australia's public housing? Thirty years of policy and outcomes, 1981 to 2011
Authors: Groenhart Lucy , Burke Terry
Published: December 2016

This paper uses the release of the 2011 Australian Bureau of Statistics (ABS) census results and other recent and historical data sets to explore how Australian public housing has changed over the period 1981–2011. It summarises the contextual factors that have influenced housing provision and consumption in Australia over the past thirty years. The overall supply trends by tenure for Australia and each capital city are set out, followed by analysis of the demographics of public housing tenants, including age, household type, income, mobility, and workforce participation. Issues identified in the paper include insufficient stock and increasingly targeted households, representing a social and financial problem for housing agencies. The current stock is ill‐adapted to tenants' needs; if housing agencies re‐profile the housing to meet such needs, then they risk creating inflexible stock. The paper concludes with reflection on the future of public housing in Australia.
What is a person‐centred approach? Familiarity and understanding of individualised funding amongst carers in New South Wales
Authors: Broady Timothy
Published: December 2016

Person‐centred approaches place individuals with a disability at the centre of decision making, with their carers and family invited to be partners in the process. Rather than being required to fit within existing service programs, person‐centred approaches enable individuals to choose the support options that best meet their needs. In order to facilitate this, person‐centred approaches will be accompanied by the introduction of individualised funding. This means the individual will be provided with funding to purchase services of their choosing. Given these significant changes occurring in the disability sector, Carers NSW surveyed informal carers of people with a disability to identify what they knew about person‐centred approaches and how they felt about their introduction. Survey results indicate that there is a need to increase the capacity and willingness of carers significantly in order to engage with person‐centred approaches and individualised funding. Carers require targeted and comprehensive information about these concepts in order to understand fully the changes occurring within the disability sector. These findings also indicate specific areas that need to be addressed in order to increase carers' awareness of these concepts and also to address existing negativity and confusion.
Anglo‐Australian and non‐Anglophone middle classes: ‘foreign accent’ and social inclusion
Authors: Colic‐Peisker Val , Hlavac Jim
Published: December 2016

Building on the concept of ‘multicultural middle class’, this paper explores social inclusion of professionally educated and employed non‐Anglophone immigrants in Australia. We focus specifically on the perceptions and implications of ‘foreign accent’ in the interaction between two groups of middle‐class Australians: non‐Anglophone immigrants and Anglo‐Australians. ‘Non‐Anglophone immigrants’ are defined as those who arrived in Australia as adults, grew up speaking a language other than English, and therefore usually speak English with a ‘foreign accent’. ‘Anglo‐Australians’ are defined as people born in Australia who grew up in families/households where only English was spoken, therefore speaking with a ‘native Australian’ accent. Through a survey of a targeted sample of respondents, the two groups were asked about their intergroup communication, wider interaction (e.g., intermarriage, friendships and working together) and mutual perceptions. Our findings indicate high levels of agreement between the two groups that Anglophone/non‐Anglophone communication is minimally hindered by comprehension problems due to foreign‐accented speech and cultural differences. Although the positive picture that emerges may reflect specific experiences and attitudes of middle‐class professionals and may not be generalisable, increased contact of the 'multicultural middle class' with its Anglo‐Australian counterpart is likely to be a factor in dissociating foreign accent and negative stereotyping.
Towards better preparation and support for health and social care practitioners conducting specialised assessments in remote Indigenous contexts
Authors: Lindeman Melissa , Dingwall Kylie , Bell Di
Published: December 2016

Remote health professionals encounter many challenges associated with delivering care in poorly serviced remote locations and working across cultures. Despite an identified need for the assessment practices of health and social care professionals to accommodate cultural differences, and for staff training in the area, deficits in preparing the remote workforce for assessment remain. This paper combines the results of two qualitative studies to consider current and improved approaches to preparing and supporting staff for conducting assessments in remote and Indigenous settings. Study A focused on aged care assessment practices within the remote Aboriginal context of Central Australia, and Study B focused on the practice for assessing cognition among Aboriginal Australians in the Northern Territory. Our secondary analysis of these combined data sets provides valuable information to improve planning of approaches to preparing staff for assessments in these contexts. We report themes relating to three categories: the assessment workforce, current approaches to preparing assessment staff, and cross‐cultural knowledge/skill. We discuss which areas require more detailed attention to prepare staff for this work – such as critical reflection and cultural safety – as well as how this may best be achieved – such as through the inclusion of cultural supervisors in practitioners' supervision models, and in follow‐up components to workshop models.
Help or hindrance? Social policy and the ‘social determinants of health’
Authors: Carey Gemma , Crammond Brad
Published: December 2016

In recent years, public health research has become increasingly focused on issues of social inequality and social disadvantage. This is because social issues, such as poor housing and unemployment, have been found to impact health significantly, and are now referred to as ‘the social determinants of health‘. As a result of this shift, public health is now principally concerned with what are historically considered to be social policy issues. This paper discusses the confluence of public health and social policy; it examines the opportunities and risks posed by this convergence for those working in social policy seeking to reduce poverty and inequality. We argue that, while much can be gained in the two fields by working more closely together, there remain fundamental differences in perspectives and approaches. In order to maximise benefits, these points of difference need to be thought through sooner rather than later.
Care without coercion – mental health rights, personal recovery and trauma‐informed care
Authors: Watson Sandy , Thorburn Kath , Everett Michelle , Fisher Karen Raewyn
Published: December 2016

Australian mental health services continue to use involuntary measures in response to consumers' mental distress. Regardless of the intent behind these practices, the experience of being forced to receive treatment, be secluded or restrained is traumatic and can cause further distress and harm. Other parts of the health or social service system have shifted to approaches that emphasise agency, social context, prevention, and rights. Three frameworks currently used in mental health services – human rights, personal recovery, and trauma‐informed – are consistent with a shift away from the use of force. We applied these frameworks to the text of the National Standards for Mental Health Services 2010 to analyse the degree to which it reflects a shift. We also analysed the public text of speakers' notes from the Care Without Coercion Conference 2012 concerning lived experiences of force in mental health services. The analysis highlights force in many aspects of policy. The findings have implications for directions of change, including freedom from violence; support for decision making; access and choice about community and inpatient options; safety and risk management; and greater understanding of current policy frameworks through engagement with people with lived experience about the options and impact of support processes that exclude the use of force.
Juvenile Reoffending: a ten‐year retrospective cohort analysis
Authors: Payne Jason , Weatherburn Don
Published: December 2016

Criminologists and other developmental researchers have long acknowledged the importance of both continuity and change in antisocial and criminal behaviour over the life‐course. To the extent that young offenders having contact with the police will persist with offending into adulthood is an important social issue with significant implications for the ongoing development and implementation of early intervention and prevention programs. Using data from New South Wales, this paper tracks a cohort of 8,797 juvenile offenders over ten years and is among the first of its kind to use multivariate techniques to examine the long‐term outcomes of those who were cautioned, conferenced or convicted in that state. The study finds that just over half of all juvenile offenders were reconvicted in court of a further offence and that reconviction rates were higher for young males and Indigenous offenders than for females or non‐Indigneous offenders. In concluding, this paper draws attention to the need for improved assessment and early intervention efforts that more accurately target those young people most at risk of persisting with offending into adulthood.
New conditionality in Australian social security policy
Authors: Taylor David R , Gray Matthew , Stanton David
Published: December 2016

The past two decades have witnessed the application of new forms of conditionality to Australian social security policy. This paper argues that a distinctive feature has been the attempt to link receipt of government benefits to parental behaviour in order to address concerns about the welfare of children. With a view to providing a framework that can help to inform debates regarding the merits of these new forms of conditionality, this paper outlines the historical antecedents and philosophical framework of new conditionality. The paper also examines three pertinent Australian social security initiatives: the Maternity Immunisation Allowance, the Improving School Enrolment and Attendance through Welfare Reform Measure, and Compulsory Income Management. The paper concludes with some consideration of the potential pitfalls of new conditionality.
‘Reasonable and necessary’ care: the challenge of operationalising the NDIS policy principle in allocating disability care in Australia
Authors: Foster Michele , Henman Paul , Tilse Cheryl , Fleming Jennifer , Allen Shelley , Harrington Rosamund
Published: December 2016

Disability reform in Australia centres on a National Disability Insurance Scheme (NDIS), which aims to provide lifelong, individualised support based on the principle of ‘reasonable and necessary’ care. As a universal rights‐based scheme it represents a historical shift in allocation principles in Australia's disability policy. Nonetheless, attention will be on determining who receives what care given the diversity of personal and family contexts. The aim of this paper is to discuss the operational complexities of a principle of reasonable and necessary care with reference to the findings of a three‐year study on the experiences and perspectives of disability care of 25 adults with acquired disability, their 22 nominated family members and 18 service providers. Evidence from this study suggests enacting the principle of reasonable and necessary care and support will be problematic, in particular as it relates to personalising the level and scope of services, balancing formal and informal care, and principles of equity. The paper contributes to the literature about allocation principles in social policy and the challenges of implementation. Further, it provides an empirically informed discussion of some of the specific policy implementation challenges concerning the NDIS.
The challenge of keeping Japanese older people economically active
Authors: Fujimura Hiroyuki
Published: December 2016

Japanese society faces serious problems due to population ageing. Both the number and percentage of people aged 65 years old and over are increasing. The ratio of those aged 65+ was 17.3 per cent in 2000, but the estimate of the National Institute of Population and Social Security Research is that the ratio will become 28.7 per cent in 2025 and will reach 40 per cent in 2050. This article consists of four sections. In the first the characteristics of issues associated with population ageing in Japan are discussed. The actual situations of employment and lives of older workers are introduced. The second section analyses government policies to address the ageing of the population. The Japanese government is trying to address the issue through encouraging older people to work longer. The promotion of efforts to extend longer working lives is discussed. In the third section a rehiring system and two cases of Japanese firms are described. Those enterprises are effectively employing older workers. Their experiences would be interesting for those planning to hire older workers. The last section discusses how to resolve challenges associated with population ageing. It is shown that continuous training is one of the most important ways of keeping older people productive.
Achieving fuller working lives: labour market and policy issues in the United Kingdom
Authors: Phillipson Chris , Vickerstaff Sarah , Lain David
Published: December 2016

In the United Kingdom there has been a shift away from policies promoting early retirement towards an emphasis on extended, fuller working lives. This article examines the nature of policy change in this area and prospects for individuals remaining in work longer. Pension ages for men and women are rising rapidly and by 2028 are likely to reach 67 years. Cash benefits for those out of work before state pension age are becoming harder to access and incentives for working beyond 65 are being enhanced. In this context, restrictions have been placed on the use of mandatory retirement ages by employers. Employees have also been granted the right to request flexible employment. However, a lack of coordinated policy up until now means that important challenges exist with regard to extending working lives. Ill‐health and low levels of qualifications limit the employment prospects of many older people, particularly among those in the poorest segments. Likewise, retention rates of older workers may have improved, but prospects for recruitment in older age remain poor. Policies focusing on the individual have also not yet recognised the extent to which employment in older age is influenced by the household and wider family context.
Working late: policy relevance for older workers in the United States
Authors: Rix Sara E.
Published: December 2016

The United States has seen a sizable increase in older worker labour force participation, although how much of this is due to public policy is uncertain. In fact, outside of academic and policy research circles, there has been relatively little attention paid to older workers and the challenges of an aging workforce in that country. Public policymakers have not demonstrated the same interest in expanding employment opportunities for older workers that they have shown for other groups, or that has been seen in other countries. Still, a number of significant pieces of legislation have been enacted over the past several decades that should be making continued employment at later ages easier, more attractive, or more essential financially. This paper examines those policies. However, because of confounding and conflicting influences from elsewhere, public policy initiatives focusing on older worker employment do not appear to be major contributors to rising labour force participation rates at older ages.
Inhospitable workplaces? International students and paid work in food services
Authors: Campbell Iain , Boese Martina , Tham Joo‐Cheong
Published: December 2016

Most international students in Australia take up paid work during their studies, generally as part‐time employees in low‐wage, low‐skill labour markets. Though little is known about the detail of their work experiences, scattered reports suggest that wages and working conditions are often poor and pose significant issues of social justice. This article examines the characteristics of jobs held by one group of international students, drawing on in‐depth qualitative interviews that form part of a case study of Melbourne's café, restaurant and takeaway food services sector. The evidence indicates that precariousness in employment is widespread in this sector and that it centres on underpayment and non‐payment of wages, in breach of labour regulation. The article suggests that such illegal employer practices are facilitated by use of undeclared casual work. Underpayments are most severe in what are typically regarded as ethnic cafes and restaurants, which concentrate on employment of international students, but they are also widespread in mainstream cafes and restaurants, where international students share precarious work conditions with other workers. The findings underline the case for more concerted research and new policy initiatives.
Community worker perceptions of the Income Management regime in Shepparton
Authors: Banks Marcus , Tennant David
Published: December 2016

This paper focuses on how community workers in Shepparton viewed the impact of the Place Based Income Management (PBIM) trial on the lives of their clients, their clients' families, and the broader community. The paper responds to criticism that there has been a lack of community voices in the development of PBIM or of their inclusion in the formal evaluation framework, raised in Philip Mendes's 2013 study of this trial site. A key policy goal underlying Income Management is that the tool assists low income people to become better money managers. Our study found that Shepparton community workers also used the parlance of ‘tool’ to describe the programmatic value of the BasicsCard in their interactions with clients. However, the BasicsCard appeared marginal to their discussions. Three clear themes emerged from the interviews: Shepparton's focus on voluntary clients, and ascertaining why participation in the local trial had dropped; that support for IM centred on the voluntary measure and the extra resources available to assist clients; and pragmatically locating the program in the middle of a welfare continuum that stretched from the voluntary Centrepay at one end to the highly coercive and restrictive paternalism of State Trustees at the other.
A new uncertainty analysis in the climate change impact assessment
Authors: Lee Jae‐Kyoung , Kim Young‐Oh , Kim Yongdai
Published: December 2016

ABSTRACT

A majority of existing studies on uncertainties in climate change impact assessments carried out the uncertainty analysis independently at each stage without quantifying the total uncertainty and thus it was seldom possible to assess the relative contribution of each stage to the total uncertainty and also to see how the uncertainty is propagated as the stage proceeds. To overcome these shortcomings, this study proposes a simple yet new approach, which can quantify the total uncertainty as well as the incremental uncertainty at each stage. Employing the maximum entropy as an uncertainty measure, the new approach was applied to a case study that consists of two emission scenarios, four global climate model GCM scenarios, two downscaling techniques, and two hydrological models. The difference was noteworthy: in case of the water streamflow projection, the conventional approach identified the GCM stage as the largest contributor (89.34%) to the total uncertainty while this new approach concluded the emission scenario stage the largest (58.66%). In case of the precipitation projection, the downscaling stage produced the largest uncertainty indicating that the relative uncertainty contribution of each assessment stage can vary depending on the projection variable which of uncertainty is examined. The case study also compared the projection uncertainty with the natural variability that exists in the observed data and concluded that the uncertainty generated by the future climate change projection is about two times larger than that of the past natural variability.
A trial of pharmacy‐based testing for Chlamydia trachomatis using postal specimen kits
Authors: Debattista Joseph , Hayes Meghan , Marshall Penelope , Pouchkareff Nickolas , Gordon Rose , Priddle Alannah
Published: December 2016

Background

Chlamydia trachomatis infection is the most commonly notified sexually transmissible bacterial infection in the developed world. An effective approach to improve screening lies with programs that specifically target high risk populations through accessible testing strategies.

Objective

To pilot the distribution of chlamydia postal testing kits through a network of community pharmacies.

Methods

Chlamydia postal test kits, adapted from a current online service, were sold at a minimal price across 18 community pharmacies located in Brisbane. Samples, collected by Uri swab, were mailed to a centralised service for processing, and results directly communicated to clients.

Results

Over a 9‐month period, 333 test kits were made available through pharmacies, of which 109 (32.7% of total) were sold. Of these, 43 specimens were returned for processing, comprising 39.4% of sales, or 12.9% of total. Of these returned samples, seven (16.3% of specimens) returned a reactive result, 34 specimens were non‐reactive and one was invalid.

Conclusions

Despite a low specimen return rate (12.9% of total kits available, 39.4% of kits sold), a high reactivity rate (16.3%) for chlamydia was identified among those persons purchasing a kit and returning a sample, suggesting that the pharmacy program had been effectively targeted. Overall, this pilot has demonstrated the feasibility of a system for distributing chlamydia test kits through pharmacy and the use of the existing health infrastructure to follow up results and manage clients.
Anticholinergic burden: considerations for older adults
Authors: Kouladjian O'Donnell Lisa , Gnjidic Danijela , Nahas Rayan , Bell J. Simon , Hilmer Sarah N.
Published: December 2016

Anticholinergic medications are frequently used in older adults to manage a wide range of chronic diseases. Anticholinergic burden associated with the use of multiple medications with anticholinergic effects is cumulative within an individual, and older adults are particularly susceptible to the adverse effects of these medications. These include dry mouth resulting in poor oral health, constipation, urinary retention and confusion. Use of anticholinergic medications has been associated with impaired cognitive and physical function, increased risk of falls, vascular events and hospitalisation. Consideration of anticholinergic burden is an important component of medication management for older adults. Several measures have been developed and validated to quantify anticholinergic burden, such as the Anticholinergic Drug Scale, Anticholinergic Risk Scale and the Anticholinergic Cognitive Burden scale. However, the evidence for translation of these measures into clinical practice is limited. This narrative review provides a brief clinical overview of the pharmacology of anticholinergic medications in the context of older adults, summarises approaches to measure anticholinergic burden, reviews recent evidence of the clinical impact of anticholinergic medications and discusses deprescribing strategies to manage anticholinergic burden for older adults in clinical practice.
Heterostructured cube Au–Ag composites for rapid Raman detection of antibiotic ciprofloxacin
Authors: Li Menghua , Wu Hao , Wu Yiping , Ying Ye , Wen Ying , Guo Xiaoyu , Yang Haifeng
Published: December 2016

Abuse of synthetic antibiotic ciprofloxacin (CIP) caused the diffuse of drug resistant or even multidrug‐resistant pathogen strains. It called for a rapid technique to detect the CIP residue level in food products and environment. Highly sensitive surface enhanced Raman spectroscopy (SERS) offering intrinsic fingerprint information of molecule could be developed to become a quick method for detecting trace targeted species. In this work, the inositol hexakisphosphate as a stabilizing agent can be also used to synthesize Au–Ag bimetal heterostructured cubes. Heterostructured cubes were employed as highly active SERS substrate, and based on a portable Raman system, a simple and reliable SERS method was proposed for direct detection of trace CIP in water and chicken wings. Limits of detection of CIP in water and chicken wings were 8 × 10−8 and 2 × 10−7 M respectively. Copyright © 2016 John Wiley & Sons, Ltd.
Relevance of CEA and LDH in relation to KRAS status in patients with unresectable colorectal liver metastases
Authors: Connell Louise C. , Boucher Taryn M. , Chou Joanne F. , Capanu Marinela , Maldonado Stephanie , Kemeny Nancy E.
Published: December 2016

BACKGROUND

While the significance of carcinoembryonic antigen (CEA), lactate dehydrogenase (LDH), and Kirsten rat sarcoma (KRAS) status as individual prognostic factors for patients with metastatic colorectal cancer has been addressed, the relationship and interdependence between these prognostic factors on survival is limited.

METHODS

Patients with unresectable colorectal liver metastases with known KRAS status, and with baseline CEA and LDH levels who were treated with hepatic arterial infusion and systemic chemotherapy were identified. Patients were divided into two groups: hepatic‐only disease and extra‐hepatic disease.

RESULTS

A total of 193 patients were included: 121 with hepatic‐only and 72 with extra‐hepatic disease. In the hepatic‐only group, median overall survival (OS) was 55 months. On multivariate analysis, KRAS mutated tumors (HR 1.7, P < 0.05), LDH >200 U/L (HR 2.0, P < 0.05), and prior chemotherapy (HR 2.1, P < 0.05) had lower OS. In patients with extra‐hepatic disease, median OS was 32 months. On multivariate analysis, baseline CEA >200 ng/mL (HR 2.1, P = 0.051), LDH >200 U/L (HR 3.8, P < 0.05), and right‐sided tumors (HR 2.8, P < 0.05) had lower OS.

CONCLUSIONS

This analysis verifies two distinct patterns in terms of biomarkers in patients with unresectable colorectal liver metastases. In patients with hepatic‐only disease, KRAS mutation and elevated LDH negatively influenced survival. In patients with extra‐hepatic disease, elevated LDH negatively impacted survival.
Arterial ligation versus embolization in epistaxis management: Counterintuitive national trends
Authors: Sylvester Michael J. , Chung Sei Y. , Guinand Luis A. , Govindan Aparna , Baredes Soly , Eloy Jean Anderson
Published: December 2016

Objectives/Hypothesis

Arterial ligation and embolization are treatment modalities indicated in severe and refractory epistaxis. The purpose of this study was to examine temporal trends and compare outcomes in treatment of hospitalized epistaxis patients with ligation or embolization.

Methods

This retrospective cohort analysis utilized the 2008 to 2013 National Inpatient Sample to identify patients admitted with a primary diagnosis of epistaxis, and an associated procedure code for ligation or embolization.

Results

A total of 1,813 cases met the inclusion criteria, with 57.1% undergoing ligation. During the study period, treatment with ligation has trended downward, whereas treatment with embolization has remained constant. Overall, ligated patients were older (64.1 vs. 62.4 years; P = 0.027) and had higher rates of congestive heart failure (15.1% vs. 9.8%; P = 0.001). No significant differences in rates of chronic pulmonary disease, coagulopathy, liver disease, or hereditary hemorrhagic telangiectasia were observed between cohorts. No differences were observed in rates of blood transfusion, stroke, blindness, or in‐hospital mortality; however, ligated patients had lower rates of intubation/tracheostomy (2.8% vs. 5.3%; P = 0.009). Ligated patients also experienced shorter hospital stays (3.6 vs. 4.0 days; P = 0.014) and incurred lower hospital charges ($33,029 vs. $69,304; P < 0.001).

Conclusion

Compared to embolization, ligation is associated with significantly decreased hospital charges and shorter hospital stay, without an increase in complication rates. Counterintuitively, ligation appears to be trending downward nationally in its use relative to embolization.

Level of Evidence

2C Laryngoscope, 127:1017–1020, 2017
Outcomes of surgically treated human papillomavirus–related oropharyngeal squamous cell carcinoma with N3 disease
Authors: Zenga Joseph , Haughey Bruce H. , Jackson Ryan S. , Adkins Douglas R. , Aranake‐Chrisinger John , Bhatt Neel , Gay Hiram A. , Kallogjeri Dorina , Martin Eliot J. , Moore Eric J. , Paniello Randal C. , Rich Jason T. , Thorstad Wade L. , Nussenbaum Brian
Published: December 2016

Objectives/Hypothesis

To evaluate outcomes for patients with pathological N3 (pN3) neck disease from human papillomavirus (HPV)–related oropharyngeal squamous cell carcinoma (OPSCC) and determine variables predictive of survival.

Study Design

Retrospective case series with chart review.

Methods

This study was conducted between 1998 and 2013 and included patients with HPV‐related OPSCC treated with surgery with or without adjuvant therapy and who had pN3 nodal disease. The primary outcome was disease‐specific survival (DSS). Secondary outcomes included overall survival (OS), disease‐free survival (DFS), adverse events, and gastrostomy tube rates.

Results

Thirty‐nine patients were included, of whom 36 (90%) underwent adjuvant therapy. Median follow‐up was 39 months (range, 2–147 months). Mean age was 56 years, and 87% were male. Seventeen patients (44%) underwent selective neck dissection, whereas six (15%) underwent radical (n = 2) or extended radical (n = 4) neck dissection. Ninety‐two percent had extracapsular extension. Five‐year Kaplan‐Meier estimated DSS, OS, and DFS were 89% (95% confidence interval [CI]: 79%–99%), 87% (95% CI: 75%–99%), and 84% (95% CI: 72%–96%), respectively. The disease recurrence rate was 10% (5% regional, 5% distant metastasis). Patients with less than 5 pathologically positive lymph nodes (P = .041) had improved DFS.

Conclusions

Patients with HPV‐related OPSCC and pN3 nodal disease treated with surgery and adjuvant therapy have very favorable long‐term survival and regional control. Patients with five or more pathologically positive lymph nodes may be at higher risk for recurrence.

Level of Evidence

4. Laryngoscope, 127:2033–2037, 2017
Can response to locoregional therapy help predict longterm survival after liver transplantation for hepatocellular carcinoma? A systematic review
Authors: Morris Paul D. , Laurence Jerome M. , Yeo David , Crawford Michael , Strasser Simone I. , McCaughan Geoffrey W. , Sandroussi Charbel
Published: December 2016

For a selected group of patients with hepatocellular carcinoma (HCC), liver transplantation (LT) represents the best chance of a cure. Organ shortages necessitate an efficient allocation of resources and careful prioritization on the transplantation waiting list. In this review, we aim to collate and evaluate the published evidence for using response to locoregional therapies (LRTs), measured by modified Response Evaluation Criteria in Solid Tumors (mRECIST), as a predictor of longterm survival after LT. Our aim was to assess whether response to LRTs before LT for HCC, as measured by the Response Evaluation Criteria in Solid Tumors (RECIST) or mRECIST criteria, can help predict recurrence‐free and/or longterm survival outcomes. We searched MEDLINE, Embase, and the Cochrane database. We included randomized controlled trials (RCTs), cohort, case control, and case series studies. Poster and conference abstracts were included. Studies were required to use RECIST or mRECIST criteria when assessing tumor response and were limited to LT for HCC only. A total of 15 records were included in the final systematic review: 7 published manuscripts and 8 conference abstracts. No RCTs were identified. Several included articles were conference abstracts with limited data available. No RCTs were found, and no meta‐analysis was undertaken. Several retrospective cohort studies were identified that demonstrated statistically significant differences in survival and recurrence between different RECIST criteria after LT. Liver Transplantation 23 375–385 2017 AASLD.
Health‐related quality of life after pediatric liver transplantation: A systematic review
Authors: Parmar Arpita , Vandriel Shannon Marie , Ng Vicky Lee
Published: December 2016

With improved survival rates after pediatric liver transplantation (LT), attention is targeting improving the health‐related quality of life (HRQOL) as an outcome metric. We conducted a systematic review of the literature to examine HRQOL after pediatric LT, focusing on assessment tools and factors associated with HRQOL. A literature search was conducted through PubMed, Web of Science, Ovid, and Google Scholar for all studies matching the eligibility criteria between January 2004 and September 2016. Titles and abstracts were screened independently by 2 authors and consensus for included studies was achieved through discussion. A total of 25 (2 longitudinal, 23 cross‐sectional) studies were reviewed. HRQOL in pediatric LT recipients is lower than healthy controls, but it is comparable to children with chronic diseases or other pediatric solid organ transplant recipients. Domain scores were lowest in school functioning on the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scale 4.0 and general health perception on the Child Health Questionnaire, the 2 most commonly used generic HRQOL instruments. Identified predictors of poor HRQOL include sleep disturbances, medication adherence, and older age at transplantation. Two recently validated disease‐specific HRQOL tools, Pediatric Liver Transplant Quality of Life tool and the Pediatric Quality of Life Inventory 3.0 Transplant Module, have enabled enhanced representation of patient HRQOL, when used in conjugation with generic tools. Heterogeneity in study design and instruments prevented a quantitative, meta‐analysis of the data. In conclusion, continued optimization of durable outcomes for this population mandates prioritization of research focusing on the gap of targeted intervention studies aimed at specific HRQOL subdomains and longitudinal studies to predict the trajectory of HRQOL over time. Liver Transplantation 23 361–374 2017 AASLD.
Conjugated Linoleic Acid/Styrene/Butyl Acrylate Bulk and Emulsion Polymerization for Adhesive Applications
Authors: Roberge Stéphane , Dubé Marc A.
Published: December 2016

The incorporation of conjugated linoleic acid (CLA) into pressure sensitive adhesive (PSA) formulations was evaluated. First, a series of free radical bulk copolymerizations of CLA/styrene (Sty) and CLA/butyl acrylate (BA) were run for reactivity ratio estimation. This was followed by CLA/Sty/BA bulk terpolymerizations. Pseudo‐kinetic models were developed and validated with the copolymerization data and extended and validated for the CLA/Sty/BA terpolymerization case. The pseudo‐kinetic models incorporated the electron trapping effect of oleic acid, a common impurity found in CLA. A series of emulsion terpolymerizations of CLA/Sty/BA were then designed to investigate the influence of terpolymer composition, molecular weight, chain transfer agent concentration, cross‐linker concentration, latex viscosity and particle size on PSA performance (tack, peel strength and shear strength). Empirical PSA performance models were developed and expressed as 3D response surfaces for optimization of the PSA formulation. All experiments were performed at 80°C and monitored with attenuated total reflectance Fourier transform infrared (ATR‐FTIR) spectroscopy both off‐line (bulk experiments) and in‐line (emulsion experiments). Ultimately, the incorporation of 30 wt.% CLA into a practical PSA application suitable for removable adhesives was achieved.
Features of Emulsion Polymerization – How Does the Monomer Move from the Droplets into the Latex Particles?
Authors: Wei Chunxiang , Tauer Klaus
Published: December 2016

A series of rather unorthodox swelling experiments with the aid of a recently developed method proves the important influence of monomer droplets for polymer swelling under heterogeneous conditions. This assumption can be used consistently to explain former results of styrene emulsion polymerization in dependence on the stirring rate speed.
A novel design of ultra‐wideband quarter circular microstrip monopole antenna
Authors: Singh R.K. , Pujara Dhaval A.
Published: December 2016

This letter presents a specific design of an ultra‐wideband (UWB) microstrip monopole antenna of dimensions 35 × 25 × 1.6 mm3 realised on FR4 substrate. The UWB performance from 3.1 to 16.3 GHz is achieved with return‐loss better than 10 dB. To achieve UWB performance, a quarter circular patch with tapered microstrip feed line has been used. This antenna has compact and simple structure suitable for fabrication and integration with microwave integrated circuits (MIC). Effect of varying geometric parameters on return‐loss has been studied using Ansoft High Frequency Structure Simulator (HFSS) software. © 2016 Wiley Periodicals, Inc. Microwave Opt Technol Lett 59:225–229, 2017