Management of delirium in medicine : experience of a close observation unit

Objective(s): A new model of care for the management of patients with delirium was developed and evaluated. Method: A 4-bedded Close Observation Unit (COU) was introduced. The model comprised an education strategy for assistants in nursing (AIN), environmental adaptations and AIN to patient ratio of 1:4. Outcomes in all patients with delirium before and after introduction of the new model of care were compared. Results: 105 patients were admitted to COU, of whom 100 (95%) were diagnosed with delirium. In-hospital mortality improved after introduction of the unit (15% versus 5%; p=0.002) without significant change in length of stay, discharge destination or falls frequency. Conclusion: A dedicated unit for delirium management within medicine achieved a reduction in mortality.

Application of Resilience concept for enhanced management of water supply systems

This paper presents an approach to developing indicators for expressing resilience of a generic water supply system. The system is contextualised as a meta-system consisting of three subsystems to represent the water catchment and reservoir, treatment plant and the distribution system supplying the end-users. The level of final service delivery to end-users is considered as a surrogate measure of systemic resilience. A set of modelled relationships are used to explore relationships between system components when placed under simulated stress. Conceptual system behaviour of specific types of simulated pressure is created for illustration of parameters for indicator development. The approach is based on the hypothesis that an in-depth knowledge of resilience would enable development of decision support system capability which in turn will contribute towards enhanced management of a water supply system. In contrast to conventional water supply system management approaches, a resilience approach facilitates improvement in system efficiency by emphasising awareness of points-of-intervention where system managers can adjust operational control measures across the meta-system (and within subsystems) rather than expansion of the system in entirety in the form of new infrastructure development.

Smart demand side management of low-voltage distribution networks using multi-objective decision making

A novel intelligent online demand side management system is proposed for peak load management in low-voltage distribution networks. This method uses low-cost controllers with low-bandwidth two-way communication installed in custumers’ premises and at distribution transformers to manage the peak load while maximising customer satisfaction. A multi-objective decision making process is proposed to select the load(s) to be delayed or controlled. The efficacy of the proposed control system is verified by simulation of three different feeder types.

Thermal performance of composite panels under fire conditions using numerical studies : plasterboards, rockwool, glass fibre and cellulose insulations

In recent times, light gauge steel frame (LSF) wall systems are increasingly used in the building industry. They are usually made of cold-formed and thin-walled steel studs that are fire-protected by two layers of plasterboard on both sides. A composite LSF wall panel system was developed recently, where an insulation layer was used externally between the two plasterboards to improve the fire performance of LSF wall panels. In this research, finite element thermal models of the new composite panels were developed using a finite element program, SAFIR, to simulate their thermal performance under both standard and Eurocode design fire curves. Suitable apparent thermal properties of both the gypsum plasterboard and insulation materials were proposed and used in the numerical models. The developed models were then validated by comparing their results with available standard fire test results of composite panels. This paper presents the details of the finite element models of composite panels, the thermal analysis results in the form of time-temperature profiles under standard and Eurocode design fire curves and their comparisons with fire test results. Effects of using rockwool, glass fibre and cellulose fibre insulations with varying thickness and density were also investigated, and the results are presented in this paper. The results show that the use of composite panels in LSF wall systems will improve their fire rating, and that Eurocode design fires are likely to cause severe damage to LSF walls than standard fires.

Management of heterogeneous UAVs through a capability framework of UAV’s functional autonomy

An increased interest in utilising groups of Unmanned Aerial Vehicles (UAVs) with heterogeneous capabilities and autonomy is presenting the challenge to effectively manage such during missions and operations. This has been the focus of research in recent years, moving from a traditional UAV management paradigm of n-to-1 (n operators for one UAV, with n being at least two operators) toward 1-to-n (one operator, multiple UAVs). This paper has expanded on the authors’ previous work on UAV functional capability framework, by incorporating the concept of Functional Level of Autonomy (F-LOA) with two configurations: The lower F-LOA configuration contains sufficient information for the operator to generate solutions and make decisions to address perturbation events. Alternatively, the higher F-LOA configuration presents information reflecting on the F-LOA of the UAV, allowing the operator to interpret solutions and decisions generated autonomously, and decide whether to veto from this decision.

Studies on self-assembly hydrothermal fabrication and thermal stability of Chromium oxyhydroxide nanomaterials synthesised from Chromium oxide colloids

Chromium oxyhydroxide nanomaterials with narrow size-distribution were synthesised through a simple hydrothermal method. Experimental conditions, such as reaction duration and pH values of the precipitation process and hydrothermal treatment played important roles in determining the nature of the final product chromium oxyhydroxide nanomaterials. The effect of these synthesis parameters were studied with the assistance of X-ray diffraction, scanning electron microscopy, X-ray photoelectron spectroscopy and thermogravimetric analyses. This research has developed a controllable synthesis of Chromium oxyhydroxide nanomaterials from Chromium oxide colloids.

Application of TG-FTIR to study SO2 evolved during the thermal decomposition of coal-derived pyrite

The thermal decomposition of the coal-derived pyrite was studied using thermogravimetry combining with Fourier-transform infrared spectroscopy (TG-FTIR) techniques to gain knowledge on the SO2 gas evolution process and formation mechanism during the thermal decomposition of the coal-derived pyrite. The results showed that the thermal decomposition of the coal-derived pyrite which started at about 400 ◦C was complete at 600 ◦C; the gas evolved can be established by combining the DTG peak, the Gram–Schmidt curve and in situ FTIR spectroscopic evolved gas analysis. It can be observed from the spectra that the pyrolysis products for the sample mainly vary in quantity, but not in species. It was proposed that the oxidation of the coal-derived pyrite started at about 400 ◦C and that pyrrhotite and hematite were formed as primary products. The SO2 released by the thermal decomposition of the coal-derived pyrite mainly occurred in the first pyrolysis stage between 410 and 470 ◦C with the maximum rate at 444 ◦C. Furthermore, the SO2 gas evolution and formation mechanism during the thermal decomposition of the coal-derived pyrite has been proposed.

Identity, forgiveness and power in the management of child sexual abuse by personnel in Christian Institutions

The ongoing crises of child sexual abuse by Christian institutions leaders across the Anglophone world continue to attract public attention and public inquiries. The pervasiveness of this issue lends credence to the argument that the prevailing ethos functioning within some Christian Institutions is one which exercises influence to repeatedly mismanage allegations of child sexual abuse by Church leaders. This work draws on semistructured interviews conducted with 15 Personnel in Christian Institutions (PICIs) in Australia who were identified as being pro-active in their approach to addressing child sexual abuse by PICIs. From these data, themes of power and forgiveness are explored through a Foucaultian conceptualising of pastoral power and ‘truth’ construction. Forgiveness is viewed as a discourse which can have the power effect of either silencing or empowering victim/survivors. The study concludes that individual PICIs’ understandings of the role ofpower in their praxis influences outcomes from the deployment of forgiveness.

3D thermal mapping of building interiors using an RGB-D and thermal camera

The building sector is the dominant consumer of energy and therefore a major contributor to anthropomorphic climate change. The rapid generation of photorealistic, 3D environment models with incorporated surface temperature data has the potential to improve thermographic monitoring of building energy efficiency. In pursuit of this goal, we propose a system which combines a range sensor with a thermal-infrared camera. Our proposed system can generate dense 3D models of environments with both appearance and temperature information, and is the first such system to be developed using a low-cost RGB-D camera. The proposed pipeline processes depth maps successively, forming an ongoing pose estimate of the depth camera and optimizing a voxel occupancy map. Voxels are assigned 4 channels representing estimates of their true RGB and thermal-infrared intensity values. Poses corresponding to each RGB and thermal-infrared image are estimated through a combination of timestamp-based interpolation and a pre-determined knowledge of the extrinsic calibration of the system. Raycasting is then used to color the voxels to represent both visual appearance using RGB, and an estimate of the surface temperature. The output of the system is a dense 3D model which can simultaneously represent both RGB and thermal-infrared data using one of two alternative representation schemes. Experimental results demonstrate that the system is capable of accurately mapping difficult environments, even in complete darkness.

An overview of level I evidence for the management of radiation dermatitis literature

Background: Despite the technologic advances, radiation dermatitis is still a prevalent and distressing symptom in patients with cancer undergoing radiotherapy. Systematic reviews (SRs) are regarded as level I evidence providing direction for clinical practice and guidelines. This overview aims to provide a critical appraisal of SRs published on interventions for the prevention/management of radiation dermatitis. Methodology: We searched the following electronic databases: MEDLINE, CINAHL, EMBASE, and the Cochrane Library (up to Feb 2012). We also hand-searched reference lists of potentially eligible articles and a number of key journals in the area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using the “A Measurement Tool to Assess Systematic Reviews” (AMSTAR). Results: Of 1837 potential titles, six SRs were included. A number of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/non-steroidal topical agents, systematic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews may create biases to the overall results or recommendations for clinical practice. Conclusions and implications: An up-to-date high quality SR in preventing/managing radiation dermatitis is needed to guide practice and direction for future research. Clinicians or guideline developers are recommended to critically evaluate the information of SRs in their decision making.