Changing learning to improve practice : hand hygiene education in Queensland medical schools

The aim of Queensland Health’s ‘Clean hands are life savers’ program is to change the culture and behaviour of healthcare workers related to hand hygiene. Hand hygiene is considered to be the most effective means of preventing pathogen cross-transmission and healthcare-associated infections. Most hospitals throughout Queensland as well as Australia now manage a hand hygiene program to increase the hand hygiene compliance of all healthcare workers. Reports taken from routine hand hygiene observations reveal that doctors are usually less compliant in their hand-washing practices than other healthcare worker groups. The Centre for Healthcare Related Infection Surveillance and Prevention (CHRISP) has attempted to have an impact on this challenging group through their Medical Leadership Initiative. With education as a core component of the program, efforts were made to ensure our future doctors were receiving information that aligned with Queensland Health standards during their formative years at medical school. CHRISP met with university instructors to understand what infection prevention education was currently included in the curriculum and support the introduction of new learning activities that specifically focused on hand hygiene. This prompted change to the existing curriculum and a range of interventions were employed with mixed success. Although met with challenges, methods to integrate more infection prevention teaching were found.

Fundamentals of business process management

Encompasses the whole BPM lifecycle, including process identification, modelling, analysis, redesign, automation and monitoring Class-tested textbook complemented with additional teaching material on the accompanying website Covers both relevant conceptual background, industrial standards and actionable skills Business Process Management (BPM) is the art and science of how work should be performed in an organization in order to ensure consistent outputs and to take advantage of improvement opportunities, e.g. reducing costs, execution times or error rates. Importantly, BPM is not about improving the way individual activities are performed, but rather about managing entire chains of events, activities and decisions that ultimately produce added value for an organization and its customers. This textbook encompasses the entire BPM lifecycle, from process identification to process monitoring, covering along the way process modelling, analysis, redesign and automation. Concepts, methods and tools from business management, computer science and industrial engineering are blended into one comprehensive and inter-disciplinary approach. The presentation is illustrated using the BPMN industry standard defined by the Object Management Group and widely endorsed by practitioners and vendors worldwide. In addition to explaining the relevant conceptual background, the book provides dozens of examples, more than 100 hands-on exercises – many with solutions – as well as numerous suggestions for further reading. The textbook is the result of many years of combined teaching experience of the authors, both at the undergraduate and graduate levels as well as in the context of professional training. Students and professionals from both business management and computer science will benefit from the step-by-step style of the textbook and its focus on fundamental concepts and proven methods. Lecturers will appreciate the class-tested format and the additional teaching material available on the accompanying website fundamentals-of-bpm.org.

Swept source OCT with air puff chamber for corneal dynamics measurements

None of currently used tonometers produce estimated IOP values that are free of errors. Measurement incredibility arises from indirect measurement of corneal deformation and the fact that pressure calculations are based on population averaged parameters of anterior segment. Reliable IOP values are crucial for understanding and monitoring of number of eye pathologies e.g. glaucoma. We have combined high speed swept source OCT with air-puff chamber. System provides direct measurement of deformation of cornea and anterior surface of the lens. This paper describes in details the performance of air-puff ssOCT instrument. We present different approaches of data presentation and analysis. Changes in deformation amplitude appears to be good indicator of IOP changes. However, it seems that in order to provide accurate intraocular pressure values an additional information on corneal biomechanics is necessary. We believe that such information could be extracted from data provided by air-puff ssOCT.

Business process management : an introduction to the special focus issue

The management and improvement of business processes are a core topic of the information systems discipline. The persistent demand in corporations within all industry sectors for increased operational efficiency and innovation, an emerging set of established and evaluated methods, tools, and techniques as well as the quickly growing body of academic and professional knowledge are indicative for the standing that Business Process Management (BPM) has nowadays. During the last decades, intensive research has been conducted with respect to the design, implementation, execution, and monitoring of business processes. Comparatively low attention, however, has been paid to questions related to organizational issues such as the adoption, usage, implications, and overall success of BPM approaches, technologies, and initiatives. This research gap motivated us to edit a corresponding special focus issue for the journal BISE/WIRTSCHAFTSINFORMATIK. We are happy that we are able to present a selection of three research papers and a state-of-the-art paper in the scientific section of the issue at hand. As these papers differ in the topics they investigate, the research method they apply, and the theoretical foundations they build on, the diversity within the BPM field becomes evident. The academic papers are complemented by an interview with Phil Gilbert, IBM’s Vice President for Business Process and Decision Management, who reflects on the relationship between business processes and the data flowing through them, the need to establish a process context for decision making, and the calibration of BPM efforts toward executives who see processes as a means to an end, rather than a first-order concept in its own right.

Time-varying bispectral analysis of visually evoked multi-channel EEG

Theoretical foundations of higher order spectral analysis are revisited to examine the use of time-varying bicoherence on non-stationary signals using a classical short-time Fourier approach. A methodology is developed to apply this to evoked EEG responses where a stimulus-locked time reference is available. Short-time windowed ensembles of the response at the same offset from the reference are considered as ergodic cyclostationary processes within a non-stationary random process. Bicoherence can be estimated reliably with known levels at which it is significantly different from zero and can be tracked as a function of offset from the stimulus. When this methodology is applied to multi-channel EEG, it is possible to obtain information about phase synchronization at different regions of the brain as the neural response develops. The methodology is applied to analyze evoked EEG response to flash visual stimulii to the left and right eye separately. The EEG electrode array is segmented based on bicoherence evolution with time using the mean absolute difference as a measure of dissimilarity. Segment maps confirm the importance of the occipital region in visual processing and demonstrate a link between the frontal and occipital regions during the response. Maps are constructed using bicoherence at bifrequencies that include the alpha band frequency of 8Hz as well as 4 and 20Hz. Differences are observed between responses from the left eye and the right eye, and also between subjects. The methodology shows potential as a neurological functional imaging technique that can be further developed for diagnosis and monitoring using scalp EEG which is less invasive and less expensive than magnetic resonance imaging.

Challenges facing carbon dioxide labelling of construction materials

In the absence of a benchmarking mechanism specifically designed for local requirements and characteristics, a carbon dioxide footprint assessment and labelling scheme for construction materials is urgently needed to promote carbon dioxide reduction in the construction industry. This paper reports on a recent interview survey of 18 senior industry practitioners in Hong Kong to elicit their knowledge and opinions concerning the potential of such a carbon dioxide labelling scheme. The results of this research indicate the following. A well-designed carbon dioxide label could stimulate demand for low carbon dioxide construction materials. The assessment of carbon dioxide emissions should be extended to different stages of material lifecycles. The benchmarks for low carbon dioxide construction materials should be based on international standards but without sacrificing local integrity. Administration and monitoring of the carbon dioxide labelling scheme could be entrusted to an impartial and independent certification body. The implementation of any carbon dioxide labelling schemes should be on a voluntary basis. Cost, functionality, quality and durability are unlikely to be replaced by environmental considerations in the absence of any compelling incentives or penalties. There are difficulties in developing and operating a suitable scheme, particularly in view of the large data demands involved, reluctance in using low carbon dioxide materials and limited environmental awareness.

Comparing child product safety concerns with injury incidents : does the evidence support the response?

Background Efficient effective child product safety (PS) responses require data on hazards, injury severity and injury probability. PS responses in Australia largely rely on reports from manufacturers/retailers, other jurisdictions/regulators, or consumers. The extent to which reactive responses reflect actual child injury priorities is unknown. Aims/Objectives/Purpose This research compared PS issues for children identified using data compiled from PS regulatory data and data compiled from health data sources in Queensland, Australia. Methods PS regulatory documents describing issues affecting children in Queensland in 2008–2009 were compiled and analysed to identify frequent products and hazards. Three health data sources (ED, injury surveillance and hospital data) were analysed to identify frequent products and hazards. Results/Outcomes Projectile toys/squeeze toys were the priority products for PS regulators with these toys having the potential to release small parts presenting choking hazards. However, across all health datasets, falls were the most common mechanism of injury, and several of the products identified were not subject to a PS system response. While some incidents may not require a response, a manual review of injury description text identified child poisonings and burns as common mechanisms of injuries in the health data where there was substantial documentation of product-involvement, yet only 10% of PS system responses focused on these two mechanisms combined. Significance/contribution to the field Regulatory data focused on products that fail compliance checks with ‘potential’ to cause harm, and health data identified actual harm, resulting in different prioritisation of products/mechanisms. Work is needed to better integrate health data into PS responses in Australia.

Juveniles in detention in Australia, 1981-2008

The Australian Institute of Criminology’s (AIC’s) national Juveniles in Detention Monitoring Program was established to contribute to the evidence base on juvenile detention in Australia, with a particular focus on Indigenous juveniles. Findings date back to 1981 and have been reported annually. This report provides an overview of the numbers and rates of juveniles in detention in Australia since 1981 and juveniles in detention for the financial year 2007–08. As with the AIC’s previous report on juveniles in detention (Taylor 2009), it also provides contextual information on young people sentenced in the children’s courts. The collation of data for these reports is supported by statutory juvenile justice agencies in each of Australia’s jurisdictions, as well as the NSW Department of Corrective Services. As described in more detail in this report, the Australian Institute of Health and Welfare (AIHW) administers the Juvenile Justice National Minimum Data Set and also reports annually on juveniles in detention. Given this development, the AIC is conducting a review of the Juveniles in Detention Monitoring Report in 2010–11, to ensure that AIC’s research and monitoring does not duplicate the AIHW’s work and that it makes a useful contribution to the field and enables more in-depth analysis of key issues.

Sensors for missions

An onboard payload may be seen in most instances as the “Raison d’Etre” for a UAV. It will define its capabilities, usability and hence market value. Large and medium UAV payloads exhibit significant differences in size and computing capability when compared with small UAVs. The latter have stringent size, weight, and power requirements, typically referred as SWaP, while the former still exhibit endless appetite for compute capability. The tendency for this type of UAVs (Global Hawk, Hunter, Fire Scout, etc.) is to increase payload density and hence processing capability. An example of this approach is the Northrop Grumman MQ-8 Fire Scout helicopter, which has a modular payload architecture that incorporates off-the-shelf components. Regardless of the UAV size and capabilities, advances in miniaturization of electronics are enabling the replacement of multiprocessing, power-hungry general-purpose processors for more integrated and compact electronics (e.g., FPGAs). Payloads play a significant role in the quality of ISR (intelligent, surveillance, and reconnaissance) data, and also in how quick that information can be delivered to the end user. At a high level, payloads are important enablers of greater mission autonomy, which is the ultimate aim in every UAV. This section describes common payload sensors and introduces two examples cases in which onboard payloads were used to solve real-world problems. A collision avoidance payload based on electro optical (EO) sensors is first introduced, followed by a remote sensing application for power line inspection and vegetation management.

The University of Queensland St Lucia campus 1.22 MW photovoltaic array

At the time of its official opening on 15 July 2011, The University of Queensland 1.22 MW array was the largest flat-panel PhotoVoltaic (PV) array in Australia. This PV array consists of over 5000 Trina Solar 240 Wp polycrystalline silicon PV modules installed across four rooftops at the St Lucia campus. Grid connection was achieved with 85 12.5 kW three phase and four 5 kW single phase grid connect inverters manufactured by Power-One. The site also includes one 8.4 kWp SolFocus concentrating solar 2 axis tracking PV array. Site wide monitoring and data logging of all DC, AC and environmental quantities will allow this array to be a rich source of research data. The site will also include a 200 kW 400 kWh zinc bromine energy storage system by Redflow, and associated power quality metering and monitoring. This paper presents highlights of the project feasibility study which included a site survey, shading analysis, and technology and triple bottom line assessment. A detailed description of the final technical implementation including discussion of alterative options considered is given. Finally, example initial data showing yield, trends and early example experimental results are presented.

Understanding pedestrian behaviour at railway level crossings : is there a need for more research?

Aim Collisions between trains and pedestrians are the most likely to result in severe injuries and fatalities when compared to other types of rail crossing accidents. Currently, there is a growing emphasis towards developing effective interventions designed to reduce the prevalence of train–pedestrian collisions. This paper reviews what is currently known regarding the personal and environmental factors that contribute to train–pedestrian collisions, particularly among high-risk groups. Method Studies that reported on the prevalence and characteristics of pedestrian accidents at railway crossings up until June 2012 were searched in electronic databases. Results Males, school children and older pedestrians (and those with disabilities) are disproportionately represented in fatality databases. However, a main theme to emerge is that little is known about the origins of train–pedestrian collisions (especially compared to train–vehicle collisions). In particular, whether collisions result from engaging in deliberate violations versus making decisional errors. This subsequently limits the corresponding development of effective and targeted interventions for high-risk groups as well as crossing locations. Finally, it remains unclear what combination of surveillance and deterrence-based and education-focused campaigns are required to produce lasting reductions in train–pedestrian fatality rates. This paper provides direction for future research into the personal and environmental origins of collisions as well as the development of interventions that aim to attract pedestrians’ attention and ensure crossing rules are respected.

Characterisation of microvasulature changes after closed soft tissue trauma by contrast enhanced micro-CT imaging

INTRODUCTION It is known that the vascular morphology and functionality are changed following closed soft tissue trauma (CSTT) [1], and bone fractures [2]. The disruption of blood vessels may lead to hypoxia and necrosis. Currently, most clinical methods for the diagnosis and monitoring of CSTT with or without bone fractures are primarily based on qualitative measures or practical experience, making the diagnosis subjective and inaccurate. There is evidence that CSTT and early vascular changes following the injury delay the soft tissue tissue and bone healing [3]. However, a precise qualitative and quantitative morphological assessment of vasculature changes after trauma is currently missing. In this research, we aim to establish a diagnostic framework to assess the 3D vascular morphological changes after standardized CSTT in a rat model qualitatively and quantitatively using contrast-enhanced micro-CT imaging. METHODS An impact device was used for the application of a controlled reproducible CSTT to the left thigh (Biceps Femoris) of anaesthetized male Wistar rats. After euthanizing the animals at 6 hours, 24 hours, 3 days, 7 days, or 14 days after trauma, CSTT was qualitatively evaluated by macroscopic visual observation of the skin and muscles. For visualization of the vasculature, the blood vessels of sacrificed rats were flushed with heparinised saline and then perfused with a radio-opaque contrast agent (Microfil, MV 122, Flowtech, USA) using an infusion pump. After allowing the contrast agent to polymerize overnight, both hind-limbs were dissected, and then the whole injured and contra-lateral control limbs were imaged using a micro-CT scanner (µCT 40, Scanco Medical, Switzerland) to evaluate the vascular morphological changes. Correlated biopsy samples were also taken from the CSTT region of both injured and control legs. The morphological parameters such as the vessel volume ratio (VV/TV), vessel diameter (V.D), spacing (V.Sp), number (V.N), connectivity (V.Conn) and the degree of anisotropy (DA) were then quantified by evaluating the scans of biopsy samples using the micro-CT imaging system. RESULTS AND DISCUSSION A qualitative evaluation of the CSTT has shown that the developed impact protocols were capable of producing a defined and reproducible injury within the region of interest (ROI), resulting in a large hematoma and moderate swelling in both lateral and medial sides of the injured legs. Also, the visualization of the vascular network using 3D images confirmed the ability to perfuse the large vessels and a majority of the microvasculature consistently (Figure 1). Quantification of the vascular morphology obtained from correlated biopsy samples has demonstrated that V.D and V.N and V.Sp were significantly higher in the injured legs 24 hours after impact in comparison with the control legs (p<0.05). The evaluation of the other time points is currently progressing. CONCLUSIONS The findings of this research will contribute to a better understanding of the changes to the vascular network architecture following traumatic injuries and during healing process. When interpreted in context of functional changes, such as tissue oxygenation, this will allow for objective diagnosis and monitoring of CSTT and serve as validation for future non-invasive clinical assessment modalities.

Can vasculature changes be characterised morphologically after closed soft tissue trauma?

INTRODUCTION Closed soft tissue trauma (CSTT) can be the result of a blunt impact, or a prolonged crush injury and involves damage to the skin, muscles and the neurovascular system. It causes a variety of symptoms such as haematoma and in severe cases may result in hypoxia and necrosis. There is evidence that early vasculature changes following the injury delays the tissue healing [1]. However, a precise qualitative and quantitative morphological assessment of vasculature changes after trauma and the effect of this on CSTT healing is currently missing. Research aims: Developing an experimental rat model to characterise the structural changes to the vasculature after trauma qualitatively and quantitatively using micro CT. MATERIAL AND METHODS An impact device was developed to apply a controlled reproducible CSTT to the left thigh (Biceps Femoris) of anaesthetised rats [3]. After euthanizing the animals at 6 hours after trauma, CSTT was qualitatively evaluated by macroscopic observations of the skin and muscles. For vasculature visualisation, the blood vessels of sacrificed rats were flushed with heparinised saline and then perfused with a radio-opaque contrast agent (Microfil) using an infusion pump (Figure 4). The overall changes to the vasculature as a result of impact trauma were characterised qualitatively based on the 3D reconstructed images of the vasculature (Figure 5). For a smaller region of interest, the morphological parameters such as vessel thickness (diameter), spacing, and average number per volume were quantified using the scanner’s software. RESULTS AND DISCUSSION Visual observation of CSTT has revealed a haematoma in some animals (Figure 3). Micro CT images indicate good perfusion of the vasculature with contrast agent, allowing the major vessels to be identified (Figure 5). Qualitatively and quantitatively, no differences between injured and non-injured legs were observed at 6 h after trauma. Further time points of 12h, 24h, 3 days and 14 days after trauma will be characterised for identifying temporal changes of the vasculature during healing. Histomorphometical studies are required for validation of the results derived from the micro CT imaging. CONCLUSION AND FUTURE DIRECTION Findings of this research may contribute towards the establishment of a fundamental basis for the quantitative assessment and monitoring of CSTT based on microvasculature changes after trauma, which will ultimately allow for optimising the clinical treatment and improve patient outcomes.

Superior piezoelectric composite films : taking advantage of carbon nanomaterials

Piezoelectric composites comprising an active phase of ferroelectric ceramic and a polymer matrix have recently attracted numerous sensory applications. However, it remains a major challenge to further improve their electromechanical response for advanced applications such as precision control and monitoring systems. We hereby investigated the incorporation of graphene platelets (GnPs) and multi-walled carbon nanotubes (MWNTs), each with various weight fractions, into PZT (lead zirconate titanate)/epoxy composites to produce three-phase nanocomposites. The nanocomposite films show markedly improved piezoelectric coefficients and electromechanical responses (50%) besides an enhancement of ~200% in stiffness. Carbon nanomaterials strengthened the impact of electric field on the PZT particles by appropriately raising the electrical conductivity of epoxy. GnPs have been proved far more promising in improving the poling behavior and dynamic response than MWNTs. The superior dynamic sensitivity of GnP-reinforced composite may be caused by GnPs’ high load transfer efficiency arising from their two-dimensional geometry and good compatibility with the matrix. Reduced acoustic impedance mismatch resulted from the improved thermal conductance may also contribute to the higher sensitivity of GnP-reinforced composite. This research pointed out the potential of employing GnPs to develop highly sensitive piezoelectric composites for sensing applications.

The threat of CHikungunya in Oceanea

The Oceania region, which includes Australia, New Zealand, Papua New Guinea and the islands of the tropical Pacific Ocean, has historically been free from chikungunya. However, the 2011 outbreak in New Caledonia and the ongoing outbreak in Papua New Guinea have highlighted the risk to other communities in Oceania where there are competent mosquito vectors and permissive social factors and environmental conditions. In this article we discuss the threat to this region that is posed by the recent evolution of the E1:A226V mutant strains of chikungunya virus (CHIKV).