Prevention of surgical site infection in total joint arthroplasty : an international tertiary care center survery

Background Prevention strategies are critical to reduce infection rates in total joint arthroplasty (TJA), but evidence-based consensus guidelines on prevention of surgical site infection (SSI) remain heterogeneous and do not necessarily represent this particular patient population. Questions/Purposes What infection prevention measures are recommended by consensus evidence-based guidelines for prevention of periprosthetic joint infection? How do these recommendations compare to expert consensus on infection prevention strategies from orthopedic surgeons from the largest international tertiary referral centers for TJA? Patients and Methods A review of consensus guidelines was undertaken as described by Merollini et al. Four clinical guidelines met inclusion criteria: Centers for Disease Control and Prevention's, British Orthopedic Association, National Institute of Clinical Excellence's, and National Health and Medical Research Council's (NHMRC). Twenty-eight recommendations from these guidelines were used to create an evidence-based survey of infection prevention strategies that was administered to 28 orthopedic surgeons from members of the International Society of Orthopedic Centers. The results between existing consensus guidelines and expert opinion were then compared. Results Recommended strategies in the guidelines such as prophylactic antibiotics, preoperative skin preparation of patients and staff, and sterile surgical attire were considered critically or significantly important by the surveyed surgeons. Additional strategies such as ultraclean air/laminar flow, antibiotic cement, wound irrigation, and preoperative blood glucose control were also considered highly important by surveyed surgeons, but were not recommended or not uniformly addressed in existing guidelines on SSI prevention. Conclusion Current evidence-based guidelines are incomplete and evidence should be updated specifically to address patient needs undergoing TJA.

Socio-technological phishing prevention

Phishing is deceptive collection of personal information leading to embezzlement, identity theft, and so on. Preventive and combative measures have been taken by banking institutions, software vendors, and network authorities to fight phishing. At the forefront of this resilience are consortiums such as APWG (Anti-Phishing Working Group) and PhishTank, the latter being a collaborative platform where everyone can submit potentially phishing web-pages and classify web-pages as either phish or genuine. PhishTank also has an API that the browsers use to notify users when she tries to load a phishing page. There are some organizations and individuals who are very active and highly accurate in classifying web-pages on PhishTank. In this paper, we propose a defense model that uses these experts to fight phishing.

The effectiveness of an intervention in reducing risk of dioxin exposure in Da Nang : changes in community knowledge, attitudes and prevention practices after 2.5 years

Introduction Environmental and biological samples taken around Da Nang Air Base have shown elevated levels of dioxin over many years [1-3]. A pre-intervention knowledge, attitudes and practices (KAP) survey (2009), a risk reduction program (2010) and a post intervention KAP survey (2011) were undertaken in four wards surrounding Danang Airbase. A follow-up evaluation was undertaken in 2013. Methods A KAP survey was implemented among 400 randomly selected food handlers. Eleven indepth interviews and four focus group discussions were also undertaken. Results The knowledge of respondents remained positive and/or improved at 2.5 years follow-up. There were no significant differences in attitudes toward preventing dioxin exposure across surveys; most respondents were positive in all three surveys. An increase in households (69.5%) undertaking measures to prevent exposure was observed, which was higher than in the pre-intervention survey (39.6%) and post- intervention survey (60.4%) (χ2 = 95.6; p < 0.001). The proportion of respondents practicing appropriate preventive measures was also significantly improved. Conclusions Despite most of the intervention program’s activities ceasing in 2010, the risk reduction program has resulted in positive outcomes over the longer-term, with many knowledge and attitude measures remaining stable or imporving. Some KAP indicators decreased, but these KAP indicators were still significantly higher than the pre-intervention levels.

Fire performance of cold-formed steel wall panels and prediction of their fire resistance rating

Recent research at the Queensland University of Technology has investigated the structural and thermal behaviour of load bearing Light gauge Steel Frame (LSF) wall systems made of 1.15 mm G500 steel studs and varying plasterboard and insulation configurations (cavity and external insulation) using full scale fire tests. Suitable finite element models of LSF walls were then developed and validated by comparing with test results. In this study, the validated finite element models of LSF wall panels subject to standard fire conditions were used in a detailed parametric study to investigate the effects of important parameters such as steel grade and thickness, plasterboard screw spacing, plasterboard lateral restraint, insulation materials and load ratio on their performance under standard fire conditions. Suitable equations were proposed to predict the time–temperature profiles of LSF wall studs with eight different plasterboard-insulation configurations, and used in the finite element analyses. Finite element parametric studies produced extensive fire performance data for the LSF wall panels in the form of load ratio versus time and critical hot flange (failure) temperature curves for eight wall configurations. This data demonstrated the superior fire performance of externally insulated LSF wall panels made of different steel grades and thicknesses. It also led to the development of a set of equations to predict the important relationship between the load ratio and the critical hot flange temperature of LSF wall studs. Finally this paper proposes a simplified method to predict the fire resistance rating of LSF walls based on the two proposed set of equations for the load ratio–hot flange temperature and the time–temperature relationships.

Evaluating NEXUS: A suicide prevention program for young people from refugee backgrounds (2007 – 2009)

Although suicide deaths in Australia continue to decline since the peak of 2,720 suicide deaths in 1997, youth suicide and self-harm are a major health issue. In 2006, in the 20 to 24 year age group, suicide accounted for approximately 21% of all male deaths and 14% of all female deaths. There is a lack of solid data on the rates of suicide and self-harm among young people from refugee backgrounds. However, this population faces a significant number of post-resettlement stressors that may add to their vulnerability and increase their risk of suicide and self-harm. The NEXUS program is an innovative strategy developed by the Queensland Program of Assistance to Survivors of Torture and Trauma (QPASTT) that aims to reduce risk factors for suicide and self-harm and to promote protective factors among youth from refugee backgrounds living in Brisbane and Toowoomba. QPASTT is a non-government organisation that provides culturally appropriate support services to refugee and humanitarian entrants to Australia. QPASTT’s primary function is to provide counselling, advocacy support and community development activities for survivors of torture and trauma at an individual, family and community level. Since 2002 the NEXUS program has been developed and implemented by QPASTT. Since then, this multi-component program has been funded by the Commonwealth Department of Health and Ageing through the National Suicide Prevention Strategy (NSPS). NSPS funding of local community suicide prevention activities will contribute to the outcomes specified in the strategic framework: Living is for Everyone (LIFE): A framework for prevention of suicide and self-harm in Australia. The focus of this report is the evaluation of the NEXUS program conducted by QPASTT between August 2007 and May 2009.

Educational programmes for primary prevention of skin cancer (Protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effects of education programmes for skin cancer prevention in the general population. Description of the condition Skin cancer is a term that includes both melanoma and keratinocyte cancer. Keratinocyte cancer (also known as nonmelanoma skin cancer) generally refers to basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), although it also includes other rare cutaneous neoplasms (Madan 2010). Skin cancer is the most common cancer in populations of predominantly fair-skinned people (Donaldson 2011; Lomas 2012; Stern 2010), with incidence increasing (Garbe 2009; Leiter 2012). There are variations in annual incidence rates between these populations, with Australia reporting the highest rate of skin cancer in the world (Lomas 2012). In 2012, the estimated age-standardised incidence rate for melanoma was almost 63 per 100,000 people for Australian men, and 40 per 100,000 people for Australian women (AIHW 2012). In Europe, incidence rates range from 10 to 15 per 100,000 people (Garbe 2009; Lasithiotakis 2006), with rates highest amongst men (Stang 2006). In the United States, incidence rates are approximately 18 per 100,000 people (Garbe 2009),with the highest rates reported forwomen (Bradford 2010). Keratinocyte cancer is much more common than melanoma. In 2012, the estimated Australian age-standardised rates for BCCand SCC were 884 and 387 per 100,000 people, respectively (Staples 2006). The cumulative three-year risk of developing a subsequent keratinocyte cancer is 18% for SCC and 44% for BCC (Marcil 2000).

Critical analysis of spam prevention techniques

E-mail spam has remained a scourge and menacing nuisance for users, internet and network service operators and providers, in spite of the anti-spam techniques available; and spammers are relentlessly circumventing these anti-spam techniques embedded or installed in form of software products on both client and server sides of both fixed and mobile devices to their advantage. This continuous evasion degrades the capabilities of these anti-spam techniques as none of them provides a comprehensive reliable solution to the problem posed by spam and spammers. Major problem for instance arises when these anti-spam techniques misjudge or misclassify legitimate emails as spam (false positive); or fail to deliver or block spam on the SMTP server (false negative); and the spam passes-on to the receiver, and yet this server from where it originates does not notice or even have an auto alert service to indicate that the spam it was designed to prevent has slipped and moved on to the receiver’s SMTP server; and the receiver’s SMTP server still fail to stop the spam from reaching user’s device and with no auto alert mechanism to inform itself of this inability; thus causing a staggering cost in loss of time, effort and finance. This paper takes a comparative literature overview of some of these anti-spam techniques, especially the filtering technological endorsements designed to prevent spam, their merits and demerits to entrench their capability enhancements, as well as evaluative analytical recommendations that will be subject to further research.

Heat transfer measurements on the first experimental layer of the FIRE II reentry vehicle in expansion tubes

The present study focused on simulating a trajectory point towards the end of the first experimental heatshield of the FIRE II vehicle, at a total flight time of 1639.53s. Scale replicas were sized according to binary scaling and instrumented with thermocouples for testing in the X1 expansion tube, located at The University of Queensland. Correlation of flight to experimental data was achieved through the separation, and independent treatment of the heat modes. Preliminary investigation indicates that the absolute value of radiant surface flux is conserved between two binary scaled models, whereas convective heat transfer increases with the length scale. This difference in the scaling techniques result in the overall contribution of radiative heat transfer diminishing to less than 1% in expansion tubes from a flight value of approximately 9-17%. From empirical correlation's it has been shown that the St √Re number decreases, under special circumstances, in expansion tubes by the percentage radiation present on the flight vehicle. Results obtained in this study give a strong indication that the relative radiative heat transfer contribution in the expansion tube tests is less than that in flight, supporting the analysis that the absolute value remains constant with binary scaling.

Performance-based structural fire design and testing of structures

Fire incident in buildings is common in Hong Kong and this could lead to heavy casualties due to its high population density, so the fire safety design of the framed structure is an important research topic. This paper describes a computer tool for determination of capacity of structural safety against various fire scenarios and the well-accepted second-order direct plastic analysis is adopted for simulation of material yielding and buckling. A computer method is developed to predict structural behaviour of bare steel framed structures at elevated temperatures but the work can be applied to structures made of other materials. These effects of thermal expansion and material degradation due to heating are required to be considered in order to capture the actual behavior of the structure under fire. Degradation of material strength with increasing temperature is included by a set of temperature-stress-strain curves according to BS5950 Part 8 mainly, which implicitly allows for creep deformation. Several numerical and experimental verifications of framed structures are presented and compared against solutions by other researchers. The proposed method allows us to adopt the truly performance-based structural fire analysis and design with significant saving in cost and time.

The prevention of childhood anxiety and promotion of resilience among preschool-aged children : a universal school based trial

This study is the first to examine the effectiveness of the Fun FRIENDS programme, a school-based, universal preventive intervention for early childhood anxiety and promotion of resilience delivered by classroom teachers. Participants (N = 488) included children aged 4–7 years attending 1 of 14 Catholic Education schools in Brisbane, Australia. The schools were randomly allocated to one of three groups, the intervention, active comparison and waitlist control group. Parents completed standardized measures of anxiety and behavioural inhibition (BI), resilience, social and emotional functioning and behaviour difficulties in addition to parental stress and anxiety, at pre- and post- and 12-month follow-up. Teachers also completed a parallel measure of social and emotional strength at the three time points. Comparable results were obtained for the intervention and comparison groups; however, the intervention group (IG) achieved greater reductions in BI, child behavioural difficulties and improvements in social and emotional competence. In addition, significant improvements in parenting distress and parent–child interactions were found for the IG, with gains maintained at 12-month follow-up. Teacher reports revealed more significant improvement in social and emotional competence for the IG. Clinical implications of the findings are discussed, along with limitations and directions for future research.

Developing a framework of effective prevention and response strategies in workplace sexual harassment

Sexual harassment remains a widespread workplace phenomenon, despite laws that proscribe it. Drawing initially on a typology from the violence prevention literature that conceptualizes prevention and response approaches according to when they occur, the paper synthesizes strategies identified in literature addressing workplace sexual harassment, as well as other workplace injustices or grievances. The paper utilizes this previous research to develop a framework of sexual harassment prevention strategies along two dimensions: functions and timing. The framework offers a research-informed set of organization-wide preventative and remedial approaches, a systemic approach to what is often seen as an individual problem, and a means to better focus interventions that are often disparate and unco-ordinated. The paper also highlights important areas for future research including a stronger focus on longer-term (tertiary) corrective actions.