Clinically-indicated replacement versus routine replacement of peripheral venous catheters

BACKGROUND: US Centers for Disease Control guidelines recommend replacement of peripheral intravenous (IV) catheters no more frequently than every 72 to 96 hours. Routine replacement is thought to reduce the risk of phlebitis and bloodstream infection. Catheter insertion is an unpleasant experience for patients and replacement may be unnecessary if the catheter remains functional and there are no signs of inflammation. Costs associated with routine replacement may be considerable. This is an update of a review first published in 2010. OBJECTIVES: To assess the effects of removing peripheral IV catheters when clinically indicated compared with removing and re-siting the catheter routinely. SEARCH METHODS: For this update the Cochrane Peripheral Vascular Diseases (PVD) Group Trials Search Co-ordinator searched the PVD Specialised Register (December 2012) and CENTRAL (2012, Issue 11). We also searched MEDLINE (last searched October 2012) and clinical trials registries. SELECTION CRITERIA: Randomised controlled trials that compared routine removal of peripheral IV catheters with removal only when clinically indicated in hospitalised or community dwelling patients receiving continuous or intermittent infusions. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial quality and extracted data. MAIN RESULTS: Seven trials with a total of 4895 patients were included in the review. Catheter-related bloodstream infection (CRBSI) was assessed in five trials (4806 patients). There was no significant between group difference in the CRBSI rate (clinically-indicated 1/2365; routine change 2/2441). The risk ratio (RR) was 0.61 but the confidence interval (CI) was wide, creating uncertainty around the estimate (95% CI 0.08 to 4.68; P = 0.64). No difference in phlebitis rates was found whether catheters were changed according to clinical indications or routinely (clinically-indicated 186/2365; 3-day change 166/2441; RR 1.14, 95% CI 0.93 to 1.39). This result was unaffected by whether infusion through the catheter was continuous or intermittent. We also analysed the data by number of device days and again no differences between groups were observed (RR 1.03, 95% CI 0.84 to 1.27; P = 0.75). One trial assessed all-cause bloodstream infection. There was no difference in this outcome between the two groups (clinically-indicated 4/1593 (0.02%); routine change 9/1690 (0.05%); P = 0.21). Cannulation costs were lower by approximately AUD 7.00 in the clinically-indicated group (mean difference (MD) -6.96, 95% CI -9.05 to -4.86; P ≤ 0.00001). AUTHORS' CONCLUSIONS: The review found no evidence to support changing catheters every 72 to 96 hours. Consequently, healthcare organisations may consider changing to a policy whereby catheters are changed only if clinically indicated. This would provide significant cost savings and would spare patients the unnecessary pain of routine re-sites in the absence of clinical indications. To minimise peripheral catheter-related complications, the insertion site should be inspected at each shift change and the catheter removed if signs of inflammation, infiltration, or blockage are present. OBJECTIVES: To assess the effects of removing peripheral IV catheters when clinically indicated compared with removing and re-siting the catheter routinely. SEARCH METHODS: For this update the Cochrane Peripheral Vascular Diseases (PVD) Group Trials Search Co-ordinator searched the PVD Specialised Register (December 2012) and CENTRAL (2012, Issue 11). We also searched MEDLINE (last searched October 2012) and clinical trials registries. SELECTION CRITERIA: Randomised controlled trials that compared routine removal of peripheral IV catheters with removal only when clinically indicated in hospitalised or community dwelling patients receiving continuous or intermittent infusions. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial quality and extracted data. MAIN RESULTS: Seven trials with a total of 4895 patients were included in the review. Catheter-related bloodstream infection (CRBSI) was assessed in five trials (4806 patients). There was no significant between group difference in the CRBSI rate (clinically-indicated 1/2365; routine change 2/2441). The risk ratio (RR) was 0.61 but the confidence interval (CI) was wide, creating uncertainty around the estimate (95% CI 0.08 to 4.68; P = 0.64). No difference in phlebitis rates was found whether catheters were changed according to clinical indications or routinely (clinically-indicated 186/2365; 3-day change 166/2441; RR 1.14, 95% CI 0.93 to 1.39). This result was unaffected by whether infusion through the catheter was continuous or intermittent. We also analysed the data by number of device days and again no differences between groups were observed (RR 1.03, 95% CI 0.84 to 1.27; P = 0.75). One trial assessed all-cause bloodstream infection. There was no difference in this outcome between the two groups (clinically-indicated 4/1593 (0.02%); routine change 9/1690 (0.05%); P = 0.21). Cannulation costs were lower by approximately AUD 7.00 in the clinically-indicated group (mean difference (MD) -6.96, 95% CI -9.05 to -4.86; P ≤ 0.00001). AUTHORS' CONCLUSIONS: The review found no evidence to support changing catheters every 72 to 96 hours. Consequently, healthcare organisations may consider changing to a policy whereby catheters are changed only if clinically indicated. This would provide significant cost savings and would spare patients the unnecessary pain of routine re-sites in the absence of clinical indications. To minimise peripheral catheter-related complications, the insertion site should be inspected at each shift change and the catheter removed if signs of inflammation, infiltration, or blockage are present.

Re-contextualising and re-theorising cultural values in teacher education practices : a Samoan standpoint

This thesis explores the significance of Samoan cultural values in teacher education practices. The study examines the coexistence of traditional Samoan cultural values alongside values that have resulted through the influence of missionaries, colonisation, post-colonialism and globalisation.

Re-orientations : East Asian popular cultures in contemporary Vietnam

Vietnamese-Australians live in Australia, a large island continent. The physical contrast between Vietnam and Australia is remarked upon by many Vietnamese in their migration stories. Whereas Vietnam is remembered as an interlinked sensual and social world, Australia is often viewed as a harsh, spacious, empty, dry continent. Australia is located in a regional Asian context, but this location has always been culturally and politically problematic, as it historically attempted to define itself as a "white" European nation in the Southern Hemisphere (Ang, 2000, p. xiii; McNamara & Coughlan, 1997, p. 1). During the Gold Rush period in the late 1800s, when there was widespread opposition to Chinese labor, Australia implemented a "White Australia" policy, although there were historically a significant number of Australians of Asian background. This exclusionary immigration policy was effectively overturned in the 1970s with the acceptance of a large number of refugees from Vietnam, Cambodia, and Laos in 1975. Vietnamese-Australians live predominantly in urban areas with over three quarters living in Sydney and Melbourne, the two largest cities. Within these two cities they are also highly concentrated in ethnically diverse suburbs, most living in areas with more than 1,000 residents born in Vietnam (Viviani, 1996, p. 49). However, Jupp (Jupp et al., 1990; Jupp, 1993) has argued that these areas are also zones of transition, with much movement in and out.

Making the train : re-conceptualising accessibility for intra-urban rail travel

Australian authorities have set ambitious policy objectives to shift Australia’s current transport profile of heavy reliance on private motor cars to sustainable modes. Improving accessibility of public transport is a central component of that objective. Past studies on accessibility to public transport focus on walking time and/or waiting time. However, travellers’ perceptions of the interface leg journeys may depend not only on these direct and tangible factors but also on social and psychological factors. This paper extends previous research that identified five salient perspectives of rail access by means of a statement sorting activity and cluster analysis with a small sample of rail passengers in three Australian cities (Zuniga et al, 2013). This study collects a new data set including 144 responses from Brisbane and Melbourne to an online survey made up of a Likert-scaled statement sorting exercise and questionnaire. It employs factor analysis to examine the statement rankings and uncovers seven underlying factors in the exploratory manner, i.e., station, safety, access, transfer, service attitude, traveler’s physical activity levels, and environmental concern. Respondents from groups stratified by rail use frequency are compared in terms of their scores of those factors. Findings from this study indicate a need to re-conceptualize accessibility to intra-urban rail travel in agreement with current policy agenda, and to target behavioral intervention to multiple dimensions of accessibility influencing passengers’ travel choices. Arguments in this paper are not limited to intra-urban rail transit, but may also be relevant to public transport in general.

Making the train : re-conceptualising accessibility for intra-urban rail travel

Australian authorities have set ambitious policy objectives to shift Australia’s current transport profile of heavy reliance on private motor cars to sustainable modes. Improving accessibility of public transport is a central component of that objective. Past studies on accessibility to public transport focus on walking time and/or waiting time. However, travellers’ perceptions of the interface leg journeys may depend not only on these direct and tangible factors but also on social and psychological factors. This paper extends previous research that identified five salient perspectives of rail access by means of a statement sorting activity and cluster analysis with a small sample of rail passengers in three Australian cities (Zuniga et al, 2013). This study collects a new data set including 144 responses from Brisbane and Melbourne to an online survey made up of a Likert-scaled statement sorting exercise and questionnaire. It employs factor analysis to examine the statement rankings and uncovers seven underlying factors in the exploratory manner, i.e., station, safety, access, transfer, service attitude, traveler’s physical activity levels, and environmental concern. Respondents from groups stratified by rail use frequency are compared in terms of their scores of those factors. Findings from this study indicate a need to re-conceptualize accessibility to intra-urban rail travel in agreement with current policy agenda, and to target behavioral intervention to multiple dimensions of accessibility influencing passengers’ travel choices. Arguments in this paper are not limited to intra-urban rail transit, but may also be relevant to public transport in general.

Person re-identification using group information

After first observing a person, the task of person re-identification involves recognising an individual at different locations across a network of cameras at a later time. Traditionally, this task has been performed by first extracting appearance features of an individual and then matching these features to the previous observation. However, identifying an individual based solely on appearance can be ambiguous, particularly when people wear similar clothing (i.e. people dressed in uniforms in sporting and school settings). This task is made more difficult when the resolution of the input image is small as is typically the case in multi-camera networks. To circumvent these issues, we need to use other contextual cues. In this paper, we use "group" information as our contextual feature to aid in the re-identification of a person, which is heavily motivated by the fact that people generally move together as a collective group. To encode group context, we learn a linear mapping function to assign each person to a "role" or position within the group structure. We then combine the appearance and group context cues using a weighted summation. We demonstrate how this improves performance of person re-identification in a sports environment over appearance based-features.

Heat-producing crust regulation of subsurface temperatures : a stochastic model re-evaluation of the geothermal potential in western Queensland, Australia

A large subsurface, elevated temperature anomaly is well documented in Central Australia. High Heat Producing Granites (HHPGs) intersected by drilling at Innamincka are often assumed to be the dominant cause of the elevated subsurface temperatures, although their presence in other parts of the temperature anomaly has not been confirmed. Geological controls on the temperature anomaly remain poorly understood. Additionally, methods previously used to predict temperature at 5 km depth in this area are simplistic and possibly do not give an accurate representation of the true distribution and magnitude of the temperature anomaly. Here we re-evaluate the geological controls on geothermal potential in the Queensland part of the temperature anomaly using a stochastic thermal model. The results illustrate that the temperature distribution is most sensitive to the thermal conductivity structure of the top 5 km. Furthermore, the results indicate the presence of silicic crust enriched in heat producing elements between and 40 km.

Shadows : Re-visualising the shark. Developing a framework for hybrid photography in the illumination of nonhuman animal and ecological perspectives at Heron Island and Gladstone, Great Barrier Reef

This study investigated how and to what degree “hybrid photography”—the simultaneous use of indexical and fictional properties and strategies— innovates the representation of animals within animalcentric, ecocentric frameworks. Design theory structured this project’s Practice-led, Visual research methodology framework. Grounded theory processes articulated emerging categories of hybrid photography through systematically and comparatively treating animal photography works for reflexive analysis. Design theory then applied and clarified categories, developing practice that re-visualised shark perspectives as new ecological discourse. Shadows, a creative practice installation, realised a full-scale photographic investigation into shark and marine animal realities of a specific environment—Heron Island and Gladstone, Great Barrier Reef—facing ecological crisis from dredging and development at Gladstone Harbour. Works rendered and explored hybrid photography’s capacity for illuminating nonhuman animals, in particular, sharks, and comprise 65% of this project’s weighting. This exegetical paper offers a definition, strategies and evaluation of hybrid photography in unsettling animal perspectives as effective ecological discourse, and comprises 35%.

Enabling open access to and re-use of publicly funded research data in Malaysian public universities : a legal and policy analysis

Numerous statements and declarations have been made over recent decades in support of open access to research data. The growing recognition of the importance of open access to research data has been accompanied by calls on public research funding agencies and universities to facilitate better access to publicly funded research data so that it can be re-used and redistributed as public goods. International and inter-governmental bodies such as the ICSU/CODATA, the OECD and the European Union are strong supporters of open access to and re-use of publicly funded research data. This thesis focuses on the research data created by university researchers in Malaysian public universities whose research activities are funded by the Federal Government of Malaysia. Malaysia, like many countries, has not yet formulated a policy on open access to and re-use of publicly funded research data. Therefore, the aim of this thesis is to develop a policy to support the objective of enabling open access to and re-use of publicly funded research data in Malaysian public universities. Policy development is very important if the objective of enabling open access to and re-use of publicly funded research data is to be successfully achieved. In developing the policy, this thesis identifies a myriad of legal impediments arising from intellectual property rights, confidentiality, privacy and national security laws, novelty requirements in patent law and lack of a legal duty to ensure data quality. Legal impediments such as these have the effect of restricting, obstructing, hindering or slowing down the objective of enabling open access to and re-use of publicly funded research data. A key focus in the formulation of the policy was the need to resolve the various legal impediments that have been identified. This thesis analyses the existing policies and guidelines of Malaysian public universities to ascertain to what extent the legal impediments have been resolved. An international perspective is adopted by making a comparative analysis of the policies of public research funding agencies and universities in the United Kingdom, the United States and Australia to understand how they have dealt with the identified legal impediments. These countries have led the way in introducing policies which support open access to and re-use of publicly funded research data. As well as proposing a policy supporting open access to and re-use of publicly funded research data in Malaysian public universities, this thesis provides procedures for the implementation of the policy and guidelines for addressing the legal impediments to open access and re-use.

Knowledge management in criminal investigation : empirical examination and re-conceptualisation of dean's investigative thinking styles

This thesis explored the current state of knowledge management in policing. A psychometric instrument was created and validated for use within police agencies as a means of facilitating the capture and transferral of critical investigative knowledge. The aim is to ensure that investigative expertise is not lost when detectives retire or leave the service. Improved knowledge management strategies that rely on this psychometric instrument can lead to greater efficiency and effectiveness in criminal investigation.

"You’ve modelled and now what?" : Exploring determinants of process model re-use

Business process modelling as a practice and research field has received great attention over recent years. Organizations invest significantly into process modelling in terms of training, tools, capabilities and resources. The return on this investment is a function of process model re-use, which we define as the recurring use of process models to support organizational work tasks. While prior research has examined re-use as a design principle, we explore re-use as a behaviour, because evidence suggest that analysts’ re-use of process models is indeed limited. In this paper we develop a two-stage conceptualization of the key object-, behaviour- and socioorganization-centric factors explaining process model re-use behaviour. We propose a theoretical model and detail implications for its operationalization and measurement. Our study can provide significant benefits to our understanding of process modelling and process model use as key practices in analysis and design.

Teaching sociology within teacher education : revisiting, realigning and re-embedding

This paper uses theoretical resources from the sociology of education to consider the teaching of sociology in teacher education programs in Australia. Once a disciplinary ‘pillar’ of teacher education, sociology’s contribution has become less explicit while more integrated, with consequences for disciplinary identity. Here we explore how sociology is taught in teacher education curricula on two fronts. Firstly we outline how sociology is embedded as one of a number of competing perspectives in foundational studies, and its pedagogic consequences. Then we consider the powerful contribution of sociology in literacy studies, amidst public debate about literacy performance. The analysis draws on Bernstein’s (2000) distinction between singular disciplinary curriculum design and practically-oriented regional curriculum design. We seek to trouble the commonsense binary between theory and practice that structures debates around professional education in higher education more broadly, and to dignify service sociology as a valuable, generative site for the discipline’s future.

Policing Transnational Organized Crime and Corruption : Exploring the Role of Communication Interception Technology

Technology has advanced in such a manner that the world can now communicate in means previously never thought possible. These new technologies have not been overlooked by transnational organized crime groups and networks of corruption, and have been exploited for criminal success. This text explores the use of communication interception technology (CIT), such as phone taps or email interception, and its potential to cause serious disruption to these criminal enterprises. Exploring the placement of communication interception technology within differing policing frameworks, and how they integrate in a practical manner, the authors demonstrate that CIT is best placed within a proactive, intelligence-led policing framework. They also indicate that if law enforcement agencies in Western countries are serious about fighting transnational organized crime and combating corruption, there is a need to re-evaluate the constraints of interception technology, and the sceptical culture that surrounds intelligence in policing. Policing Transnational Organized Crime and Corruption will appeal to scholars of Law, Criminal Justice and Police Science as well as intelligence analysts and police and security intelligence professionals.

V: Rewriting and reclaiming history : an analysis of the emergence of restorative justice in western criminal justice systems

During the last three decades, restorative justice has emerged in numerous localities around the world as an accepted approach to responding to crime. This article, which stems from a doctoral study on the history of restorative justice, provides a critical analysis of accepted histories of restorative practices. It revisits the celebrated historical texts of the restorative justice movement, and re-evaluates their contribution to the emergence of restorative justice measures. It traces the emergence of the term 'restorative justice', and reveals that it emerged in much earlier writings than is commonly thought to be the case by scholars in the restorative justice field. It also briefly considers some 'power struggles' in relation to producing an accepted version of the history of restorative justice, and scholars' attempts to 'rewrite history' to align with current views on restorative justice. Finally, this article argues that some histories of restorative justice selectively and inaccurately portray key figures from the history of criminology as restorative justice supporters. This, it is argued, gives restorative justice a false lineage and operates to legitimise the widespread adoption of restorative justice around the globe.