Case-control study of early childhood caries in Australia

The aim of this case-control study of 617 children was to investigate early childhood caries (ECC) risk indicators in a non-fluoridated region in Australia. ECC cases were recruited from childcare facilities, public hospitals and private specialist clinics to source children from different socioeconomic backgrounds. Non-ECC controls were recruited from the same childcare facilities. A multinomial logistic modelling approach was used for statistical analysis. The results showed that a large percentage of children tested positive for Streptococcus mutans if their mothers also tested positive. A common risk indicator found in ECC children from childcare facilities and public hospitals was visible plaque (OR 4.1, 95% CI 1.0-15.9, and OR 8.7, 95% CI 2.3-32.9, respectively). Compared to ECC-free controls, the risk indicators specific to childcare cases were enamel hypoplasia (OR 4.2, 95% CI 1.0-18.3), difficulty in cleaning child's teeth (OR 6.6, 95% CI 2.2-19.8), presence of S. mutans (OR 4.8, 95% CI 0.7-32.6), sweetened drinks (OR 4.0, 95% CI 1.2-13.6) and maternal anxiety (OR 5.1, 95% CI 1.1-25.0). Risk indicators specific to public hospital cases were S. mutans presence in child (OR 7.7, 95% CI 1.3-44.6) or mother (OR 8.1, 95% CI 0.9-72.4), ethnicity (OR 5.6, 95% CI 1.4-22.1), and access of mother to pension or health care card (OR 20.5, 95% CI 3.5-119.9). By contrast, a history of chronic ear infections was found to be protective for ECC in childcare children (OR 0.28, 95% CI 0.09-0.82). The biological, socioeconomic and maternal risk indicators demonstrated in the present study can be employed in models of ECC that can be usefully applied for future longitudinal studies.

Factors contributing to successful public private partnership projects : comparing Hong Kong with Australia and the United Kingdom

Purpose: With the increasing interest in Public Private Partnership (PPP) there is a need to investigate the factors contributing to successful delivery of PPP projects. Design/methodology/approach: An empirical questionnaire survey was conducted in Hong Kong and Australia. The survey respondents were asked to rate eighteen factors which contribute to delivering successful PPP projects. Findings: The findings from this survey were further compared with the results achieved by a previous researcher (Li, 2003) in a similar survey conducted in the United Kingdom. The comparison showed that amongst the top five success factors ranked by Hong Kong respondents, three were also ranked highly by the Australians and British. These success factors included: ‘Commitment and responsibility of public and private sectors’; ‘Strong and good private consortium’; and ‘Appropriate risk allocation and risk sharing’. Originality/value: These success factors were therefore found to be important for contributing to successful PPP projects irrespective of geographical locations.

Social Participation of Community Dwelling Stroke Survivors [Published Abstract: From the Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke Conference 2009]

Disability following a stroke can impose various restrictions on patients’ attempts at participating in life roles. The measurement of social participation, for instance, is important in estimating recovery and assessing quality of care at the community level. Thus, the identification of factors influencing social participation is essential in developing effective measures for promoting the reintegration of stroke survivors into the community. Data were collected from 188 stroke survivors (mean age 71.7 years) 12 months after discharge from a stroke rehabilitation hospital. Of these survivors, 128 (61 %) had suffered a first ever stroke, and 81 (43 %) had a right hemisphere lesion. Most (n = 156, 83 %) were living in their own home, though 32 (17 %) were living in residential care facilities. Path analysis was used to test a hypothesized model of participation restriction which included the direct and indirect effects between social, psychological and physical outcomes and demographic variables. Participation restriction was the dependent variable. Exogenous independent variables were age, functional ability, living arrangement and gender. Endogenous independent variables were depressive symptoms, state self-esteem and social support satisfaction. The path coefficients showed functional ability having the largest direct effect on participation restriction. The results also showed that more depressive symptoms, low state self-esteem, female gender, older age and living in a residential care facility had a direct effect on participation restriction. The explanatory variables accounted for 71% of the variance in explaining participation restriction. Prediction models have empirical and practical applications such as suggesting important factors to be considered in promoting stroke recovery. The findings suggest that interventions offered over the course of rehabilitation should be aimed at improving functional ability and promoting psychological aspects of recovery. These are likely to enhance stroke survivors resume or maximize their social participation so that they may fulfill productive and positive life roles.

QUT Medical Engineering Research Facility (MERF) annual report 2009

DIRECTOR’S OVERVIEW by Professor Mark Pearcy This report for 2009 is the first full year report for MERF. The development of our activities in 2009 has been remarkable and is testament to the commitment of the staff to the vision of MERF as a premier training and research facility. From the beginnings in 2003, when a need was identified for the provision of specialist research and training facilities to enable close collaboration between researchers and clinicians, to the realisation of the vision in 2009 has been an amazing journey. However, we have learnt that there is much more that can be achieved and the emphasis will be on working with the university, government and external partners to realise the full potential of MERF by further development of the Facility. In 2009 we conducted 28 workshops in the Anatomical and Surgical Skills Laboratory providing training for surgeons in the latest techniques. This was an excellent achievement for the first full year as our reputation for delivering first class facilities and support grows. The highlight, perhaps, was a course run via our video link by a surgeon in the USA directing the participants in MERF. In addition, we have continued to run a small number of workshops in the operating theatre and this promises to be an avenue that will be of growing interest. Final approval was granted for the QUT Body Bequest Program late in 2009 following the granting of an Anatomical Accepting Licence. This will enable us to expand our capabilities by provide better material for the workshops. The QUT Body Bequest Program will be launched early in 2010. The Biological Research Facility (BRF) conducted over 270 procedures in 2009. This is a wonderful achievement considering less then 40 were performed in 2008. The staff of the BRF worked very hard to improve the state of the old animal house and this resulted in approval for expanded use by the ethics committees of both QUT and the University of Queensland. An external agency conducted an Occupational Health and Safety Audit of MERF in 2009. While there were a number of small issues that require attention, the auditor congratulated the staff of MERF on achieving a good result, particularly for such an early stage in the development of MERF. The journey from commissioning of MERF in 2008 to the full implementation of its activities in 2009 has demonstrated the potential of this facility and 2010 will be an exciting year as its activities are recognised and further expanded building development is pursued.

The effect of traffic lane widths on the safety of cyclists in urban areas

This literature review examines the relationship between traffic lane widths on the safety of road users. It focuses on the impacts of lane widths on motor vehicle behaviour and cyclists’ safety. The review commenced with a search of available databases. Peer reviewed articles and road authority reports were reviewed, as well as current engineering guidelines. Research shows that traffic lane width influences drivers’ perceived difficulty of the task, risk perception and possibly speed choices. Total roadway width, and the presence of onroad cycling facilities, influence cyclists’ positioning on the road. Lateral displacement between bicycles and vehicles is smallest when a marked bicycle facility is present. Reduced motor vehicle speeds can significantly improve the safety of vulnerable road users, particularly pedestrians and cyclists. It has been shown that if road lane widths on urban roads were reduced, through various mechanisms, it could result in a safety environment for all road users.

Multi-events stadium Buchanan Park redevelopment

Multi-purpose Community Entertainment and Recreation Venue, catering for the Mount Isa Rodeo; including campdraft, equine sports, shows, exhibition, trade events, concerts and other community activities. The design involved redevelopment of a portion of the Buchanan Park Race Course located in Mount Isa. The project included community infrastructure planning, major landscaping and the construction of built facilities.

Therapeutic relationships in specialist palliative care nursing practice.

There has been limited research into the scope or standards of specialist palliative care nursing practice in an Australian context. This study sought to develop a competency framework that described the core domains of specialist palliative care nursing. This article explores one key domain of specialist palliative care nursing practice - therapeutic relationships - that was identified as underpinning other domains of practice. A mixed method was used, involving a literature review, a survey including practice exemplars and an interview of specialist palliative care nurses. Seventy-four registered nurses working in designated specialist palliative care nursing roles from each Australian state and mainland territory were involved. The nurses represented metropolitan, regional, rural and remote communities, various inpatient facilities and community practice settings. Five core domains of specialist palliative care nursing practice were identified: complex supportive care, collaborative practice, leadership, improving practice and therapeutic relationships. Therapeutic relationships were identified as the central domain of specialist palliative care nursing practice to which all other domains were inextricably linked.

Audit of the Care of the Dying in a Network of Hospitals and Institutions in Queensland

Background: Most Australians die in institutions and there is evidence to suggest that the care of these patients is not always optimal. Care pathways for the dying have been designed to transfer benchmarked hospice care to other settings (e.g. acute hospitals and residential age-care facilities) by defining goals of best care, providing guidelines to provide that care and documenting outcome. Method: A retrospective audit was undertaken across a network of health-care institutions in Queensland. The 18 goals considered essential for the care of the dying within the Liverpool Care Pathway were taken as a benchmark. Documentation of achievement of each of these goals was sought. Results: The notes of 160 patients who had died in eight institutions (four hospitals, three hospices, one nursing home) were reviewed. Several areas for improvement were identified, particularly in those goals relating to communication, resuscitation orders and care after death. Few units documented the provision of written information to families. Most patients were prescribed medications in anticipation of pain and agitation but less were prescribed drugs for other common symptoms in the dying. Most of the goals were achieved in a higher percentage of cases in hospice units. Marked differences in practice were noted between different institutions. Conclusion: The audit identified several aspects in the care of the terminally ill that could be improved. End-stage pathways may provide a model for improving the care of patients dying in hospitals and institutions in Australia.

Enterprise systems in universities : a teaching case

This teaching case aims to contribute to understanding the phenomenon of Enterprise Systems (ES) implementations in universities. Through this case, students will gain understanding of the importance of ‘contextual elements’ for large scale information systems (IS) implementations, in particular ES. This teaching case illustrates how these contextual factors contribute to the success or failure of such implementations, and how they can influence the decisions that dictate the lifecycle of such systems. The case describes ES implementations at a leading Australian university, and presents a rich account of the institutional, national and industry-sector contexts that have influenced the directions and decisions taken. The journey encountered with the main Enterprise Systems that support Financials, Human Resources and Facilities are described suggesting the lifecycle phases, critical success factors and lessons learnt.

On the optimal capacity expansion of electric power systems

The analysis of investment in the electric power has been the subject of intensive research for many years. The efficient generation and distribution of electrical energy is a difficult task involving the operation of a complex network of facilities, often located over very large geographical regions. Electric power utilities have made use of an enormous range of mathematical models. Some models address time spans which last for a fraction of a second, such as those that deal with lightning strikes on transmission lines while at the other end of the scale there are models which address time horizons consisting of ten or twenty years; these usually involve long range planning issues. This thesis addresses the optimal long term capacity expansion of an interconnected power system. The aim of this study has been to derive a new, long term planning model which recognises the regional differences which exist for energy demand and which are present in the construction and operation of power plant and transmission line equipment. Perhaps the most innovative feature of the new model is the direct inclusion of regional energy demand curves in the nonlinear form. This results in a nonlinear capacity expansion model. After review of the relevant literature, the thesis first develops a model for the optimal operation of a power grid. This model directly incorporates regional demand curves. The model is a nonlinear programming problem containing both integer and continuous variables. A solution algorithm is developed which is based upon a resource decomposition scheme that separates the integer variables from the continuous ones. The decompostion of the operating problem leads to an interactive scheme which employs a mixed integer programming problem, known as the master, to generate trial operating configurations. The optimum operating conditions of each trial configuration is found using a smooth nonlinear programming model. The dual vector recovered from this model is subsequently used by the master to generate the next trial configuration. The solution algorithm progresses until lower and upper bounds converge. A range of numerical experiments are conducted and these experiments are included in the discussion. Using the operating model as a basis, a regional capacity expansion model is then developed. It determines the type, location and capacity of additional power plants and transmission lines, which are required to meet predicted electicity demands. A generalised resource decompostion scheme, similar to that used to solve the operating problem, is employed. The solution algorithm is used to solve a range of test problems and the results of these numerical experiments are reported. Finally, the expansion problem is applied to the Queensland electricity grid in Australia.

On the optimal capacity expansion of electric power systems

The analysis of investment in the electric power has been the subject of intensive research for many years. The efficient generation and distribution of electrical energy is a difficult task involving the operation of a complex network of facilities, often located over very large geographical regions. Electric power utilities have made use of an enormous range of mathematical models. Some models address time spans which last for a fraction of a second, such as those that deal with lightning strikes on transmission lines while at the other end of the scale there are models which address time horizons consisting of ten or twenty years; these usually involve long range planning issues. This thesis addresses the optimal long term capacity expansion of an interconnected power system. The aim of this study has been to derive a new, long term planning model which recognises the regional differences which exist for energy demand and which are present in the construction and operation of power plant and transmission line equipment. Perhaps the most innovative feature of the new model is the direct inclusion of regional energy demand curves in the nonlinear form. This results in a nonlinear capacity expansion model. After review of the relevant literature, the thesis first develops a model for the optimal operation of a power grid. This model directly incorporates regional demand curves. The model is a nonlinear programming problem containing both integer and continuous variables. A solution algorithm is developed which is based upon a resource decomposition scheme that separates the integer variables from the continuous ones. The decompostion of the operating problem leads to an interactive scheme which employs a mixed integer programming problem, known as the master, to generate trial operating configurations. The optimum operating conditions of each trial configuration is found using a smooth nonlinear programming model. The dual vector recovered from this model is subsequently used by the master to generate the next trial configuration. The solution algorithm progresses until lower and upper bounds converge. A range of numerical experiments are conducted and these experiments are included in the discussion. Using the operating model as a basis, a regional capacity expansion model is then developed. It determines the type, location and capacity of additional power plants and transmission lines, which are required to meet predicted electicity demands. A generalised resource decompostion scheme, similar to that used to solve the operating problem, is employed. The solution algorithm is used to solve a range of test problems and the results of these numerical experiments are reported. Finally, the expansion problem is applied to the Queensland electricity grid in Australia

Port of Brisbane stormwater quality : stage 1 rainfall simulation to evaluate pollutant build-up and wash-off from selected land uses

Background: The quality of stormwater runoff from ports is significant as it can be an important source of pollution to the marine environment. This is also a significant issue for the Port of Brisbane as it is located in an area of high environmental values. Therefore, it is imperative to develop an in-depth understanding of stormwater runoff quality to ensure that appropriate strategies are in place for quality improvement. ---------------- The Port currently has a network of stormwater sample collection points where event based samples together with grab samples are tested for a range of water quality parameters. Whilst this information provides a ‘snapshot’ of the pollutants being washed from the catchment/s, it does not allow for a quantifiable assessment of total contaminant loads being discharged to the waters of Moreton Bay. It also does not represent pollutant build-up and wash-off from the different land uses across a broader range of rainfall events which might be expected. As such, it is difficult to relate stormwater quality to different pollutant sources within the Port environment. ----------------- Consequently, this would make the source tracking of pollutants to receiving waters extremely difficult and in turn the ability to implement appropriate mitigation measures. Also, without this detailed understanding, the efficacy of the various stormwater quality mitigation measures implemented cannot be determined with certainty. --------------- Current knowledge on port stormwater runoff quality Currently, little knowledge exists with regards to the pollutant generation capacity specific to port land uses as these do not necessarily compare well with conventional urban industrial or commercial land use due to the specific nature of port activities such as inter-modal operations and cargo management. Furthermore, traffic characteristics in a port area are different to a conventional urban area. Consequently, as data inputs based on an industrial and commercial land uses for modelling purposes is questionable. ------------------ A comprehensive review of published research failed to locate any investigations undertaken with regards to pollutant build-up and wash-off for port specific land uses. Furthermore, there is very limited information made available by various ports worldwide about the pollution generation potential of their facilities. Published work in this area has essentially focussed on the water quality or environmental values in the receiving waters such as the downstream bay or estuary. ----------------- The Project: The research project is an outcome of the collaborative Partnership between the Port of Brisbane Corporation (POBC) and Queensland University of Technology (QUT). A key feature of this Partnership is the undertaking of ‘cutting edge’ research to strengthen the environmental custodianship of the Port area. This project aims to develop a port specific stormwater quality model to allow informed decision making in relation to stormwater quality improvement in the context of the increased growth of the Port. --------------- Stage 1 of the research project focussed on the assessment of pollutant build-up and wash-off using rainfall simulation from the current Port of Brisbane facilities with the longer-term objective of contributing to the development of ecological risk mitigation strategies for future expansion scenarios. Investigation of complex processes such as pollutant wash-off using naturally occurring rainfall events has inherent difficulties. These can be overcome using simulated rainfall for the investigations. ----------------- The deliverables for Stage 1 included the following: * Pollutant build-up and wash-off profiles for six primary land uses within the Port of Brisbane to be used for water quality model development. * Recommendations with regards to future stormwater quality monitoring and pollution mitigation measures. The outcomes are expected to deliver the following benefits to the Port of Brisbane: * The availability of Port specific pollutant build-up and wash-off data will enable the implementation of customised stormwater pollution mitigation strategies. * The water quality data collected would form the baseline data for a Port specific water quality model for mitigation and predictive purposes. * To be at the cutting-edge in terms of water quality management and environmental best practice in the context of port infrastructure. ---------------- Conclusions: The important conclusions from the study are: * It confirmed that the Port environment is unique in terms of pollutant characteristics and is not comparable to typical urban land uses. * For most pollutant types, the Port land uses exhibited lower pollutant concentrations when compared to typical urban land uses. * The pollutant characteristics varied across the different land uses and were not consistent in terms of the land use. Hence, the implementation of stereotypical structural water quality improvement devices could be of limited value. * The <150m particle size range was predominant in suspended solids for pollutant build-up as well as wash-off. Therefore, if suspended solids are targeted as the surrogate parameter for water quality improvement, this specific particle size range needs to be removed. ------------------- Recommendations: Based on the study results the following preliminary recommendations are made: * Due to the appreciable variation in pollutant characteristics for different port land uses, any water quality monitoring stations should preferably be located such that source areas can be easily identified. * The study results having identified significant pollutants for the different land uses should enable the development of a more customised water quality monitoring and testing regime targeting the critical pollutants. * A ‘one size fits all’ approach may not be appropriate for the different port land uses due to the varying pollutant characteristics. As such, pollution mitigation will need to be specifically tailored to suit the specific land use. * Any structural measures implemented for pollution mitigation to be effective should have the capability to remove suspended solids of size <150m. * Based on the results presented and the particularly the fact that the Port land uses cannot be compared to conventional urban land uses in relation to pollutant generation, consideration should be given to the development of a port specific water quality model.

Low moisture mud from solid bowl decanters

The high moisture content of mill mud (typically 75–80% for Australian factories) results in high transportation costs for the redistribution of mud onto cane farms. The high transportation cost relative to the nutrient value of the mill mud results in many milling companies subsidising the cost of this recycle to ensure a wide distribution across the cane supply area. An average mill would generate about 100 000 t of mud (at 75% moisture) in a crushing season. The development of mud processing facilities that will produce a low moisture mud that can be effectively incorporated into cane land with existing or modified spreading equipment will improve the cost efficiency of mud redistribution to farms; provide an economical fertiliser alternative to more farms in the supply area; and reduce the potential for adverse environmental impacts from farms. A research investigation assessing solid bowl decanter centrifuges to produce low moisture mud with low residual pol was undertaken and the results compared to the performance of existing rotary vacuum filters in factory trials. The decanters were operated on filter mud feed in parallel with the rotary vacuum filters to allow comparisons of performance. Samples of feed, mud product and filtrate were analysed to provide performance indicators. The decanter centrifuge could produce mud cakes with very low moistures and residual pol levels. Spreading trials in cane fields indicated that the dry cake could be spread easily by standard mud trucks and by trucks designed specifically to spread fertiliser.