The beneficial effects of specialist thoracic surgery on the resection rate for non-small-cell lung cancer

We aimed to evaluate the effect of the appointment of a dedicated specialist thoracic surgeon on surgical practice for lung cancer previously served by cardio-thoracic surgeons. Outcomes were compared for the 240 patients undergoing surgical resection for lung cancer in two distinct 3-year periods: Group A: 65 patients, 1994-1996 (pre-specialist); Group B: 175 patients, 1997-1999 (post-specialist). The changes implemented resulted in a significant increase in resection rate (from 12.2 to 23.4%, P<0.001), operations in the elderly (over 75 years) and extended resections. There were no significant differences in stage distribution, in-hospital mortality or stage-specific survival after surgery. Lung cancer surgery provided by specialists within a multidisciplinary team resulted in increased surgical resection rates without compromising outcome. Our results strengthen the case for disease-specific specialists in the treatment of lung cancer. © 2004 Published by Elsevier Ireland Ltd.

A grand challenge : reflecting on university science curriculum design, collaborative partnerships and integration of information literacy skills

In 2012, Queensland University of Technology (QUT) committed to the massive project of revitalizing its Bachelor of Science (ST01) degree. Like most universities in Australia, QUT has begun work to align all courses by 2015 to the requirements of the updated Australian Qualifications Framework (AQF) which is regulated by the Tertiary Education Quality and Standards Agency (TEQSA). From the very start of the redesigned degree program, students approach scientific study with an exciting mix of theory and highly topical real world examples through their chosen “grand challenge.” These challenges, Fukushima and nuclear energy for example, are the lenses used to explore science and lead to 21st century learning outcomes for students. For the teaching and learning support staff, our grand challenge is to expose all science students to multidisciplinary content with a strong emphasis on embedding information literacies into the curriculum. With ST01, QUT is taking the initiative to rethink not only content but how units are delivered and even how we work together between the faculty, the library and learning and teaching support. This was the desired outcome but as we move from design to implementation, has this goal been achieved? A main component of the new degree is to ensure scaffolding of information literacy skills throughout the entirety of the three year course. However, with the strong focus on problem-based learning and group work skills, many issues arise both for students and lecturers. A move away from a traditional lecture style is necessary but impacts on academics’ workload and comfort levels. Therefore, academics in collaboration with librarians and other learning support staff must draw on each others’ expertise to work together to ensure pedagogy, assessments and targeted classroom activities are mapped within and between units. This partnership can counteract the tendency of isolated, unsupported academics to concentrate on day-to-day teaching at the expense of consistency between units and big picture objectives. Support staff may have a more holistic view of a course or degree than coordinators of individual units, making communication and truly collaborative planning even more critical. As well, due to staffing time pressures, design and delivery of new curriculum is generally done quickly with no option for the designers to stop and reflect on the experience and outcomes. It is vital we take this unique opportunity to closely examine what QUT has and hasn’t achieved to be able to recommend a better way forward. This presentation will discuss these important issues and stumbling blocks, to provide a set of best practice guidelines for QUT and other institutions. The aim is to help improve collaboration within the university, as well as to maximize students’ ability to put information literacy skills into action. As our students embark on their own grand challenges, we must challenge ourselves to honestly assess our own work.

Update on the inaugural Sydney Diabetic Foot Conference 2013

The first International Diabetic Foot Conference in Australia was hosted at Liverpool Hospital in Sydney during May 30-31, 2013. In response to the growing diabetes epidemic globally and more locally to Australia, the conference provided the perfect bridge for interaction between the multidisciplinary team members involved in diabetes care and the opportunity to assimilate the most up-to-date evidence-based medicine from some of the most respected researchers in the field.

Awareness of risky behaviour among Chinese drivers

Background In China, as in many developing countries, rapid increases in car ownership and new drivers have been coupled with a large trauma burden. The World Health Organization has identified key risk factors including speeding, drink-driving, helmet and restraint non-use, overloaded vehicles, and fatigued-driving in many rapidly motorising countries, including China. Levels of awareness of these risk factors among road users are not well understood. Although research identifies speeding as the major factor contributing to road crashes in China, there appears to be widespread acceptance of it among the broader community. Purpose To assess self-reported speeding and awareness of crash risk factors among Chinese drivers in Beijing. Methods Car drivers (n=299) were recruited from car washing locations and car parks to complete an anonymous questionnaire. Perceptions of the relative risk of drink-driving, fatigued-driving and speeding, and attitudes towards speeding and self-reported driving speeds were assessed. Results Overall, driving speeds of >10km/hr above posted limits on two road types (60 and 80 km/hour zones) were reported by more than one third of drivers. High-range speeding (i.e., >30 km/hour in a 60 km/hour zone and >40 km/hour in an 80 km/hour zone) was reported by approximately 5% of the sample. Attitudinal measures indicated that approximately three quarters of drivers reported attitudes that were not supportive of speeding. Drink-driving was identified as the most risky behaviour; 18% reported the perception that drink-driving had the same level of danger as speeding and 82% reported it as more dangerous. For fatigued-driving, 1% reported the perception that it was not as dangerous as speeding; 27.4% reported it as the same level and 71.6% perceived it as more dangerous. Conclusion Driving speeds well above posted speed limits were commonly reported by drivers. Speeding was rated as the least dangerous on-road behaviour, compared to drink-driving and fatigued-driving. One third of drivers reported regularly engaging in speeds at least 10km/hr above posted limits, despite speeding being the major reported contributor to crashes. Greater awareness of the risks associated with speeding is needed to help reduce the road trauma burden in China and promote greater speed limit compliance.

Dispensing doctor : an underutilise resource?

Introduction Multidisciplinary models of organising and providing care have been proposed to decrease the health services gap between urban and rural populations but health workforce shortages exist across most professions and are further exacerbated by maldistribution. Flexibility and expansion of the range of tasks that a health professional can undertake were proposed. Dispensing doctors (DDs) are such an example. As part of DDs’ routine medical practice, DDs are able to both prescribe and dispense medicines to their patients. The granting of a dispensing licence to a doctor is intended to improve rural community access to medicines where there is no pharmacy within a reasonable distance. Method An iterative, qualitative descriptive methodology was used to identify factors which influenced DDs’ practice. Qualitative data were collected by in-depth face-to-face and telephone interviews with DDs. A combination of processes: qualitative content analysis and constant comparison were used to analyse the interview transcripts thematically. Member checking and separate coding were utilised to ensure rigour. Result Thirty-one interviews were conducted. The respondents universally acknowledged that the main reason for dispensing were for the convenience and benefits of their patients and to ensure continuity of care. DDs’ communities were generally more isolated and smaller when compared to their non-dispensing counterparts. DD-respondents viewed their dispensary as a service to the community. Peer pressure on prescribing was a key factors in self-regulating prescribing and dispensing. Conclusion DDs fulfill an important area of unmet needs by providing continuity of pharmaceutical care but the practice is hindered by significant barriers

Introducing dynamics : a new approach to "new media" [Editorial]

The term ‘‘new media’’ has been in play for decades now, and one might be forgiven for wondering how much longer digital forms and platforms can really be called ‘‘new,’’ or even what the scholarship of new media contributes to knowledge. Is it possible to say new things about new media? We think so. This Companion not only demonstrates the variety, salience, and importance of new media studies but also proposes a distinctive approach to the topic : an approach we call ‘‘new media dynamics.’’ In this view, what’s interesting about ‘‘new media’’ is not novelty as such but dynamism. Capitalism, technology, social networks, and media all evolve and change, sometimes to our delight, sometimes our dismay. This incessant process of disruption, renewal, and eventual (if often partial) replacement is now one of humanity’s central experiences. This cutting-edge collection brings together a stellar array of the world’s top researchers, cultural entrepreneurs, and emerging scholars to give the dynamics of new media their first full-length, multidisciplinary, historical, and critical treatment. Across 34 chapters, an international line-up of the very best authors reflects on the historical, technical, cultural, and political changes that underlie the emergence of new media, as existing patterns and assumptions are challenged by the forces of ‘‘creative destruction’’ and innovation, both economic and cultural. At the same time they show that familiar themes and problems carry through from ‘‘old’’media – questions of identity, sexuality, politics, relationships, and meaning.

Rural people and the land

There is a long and fundamental connection between rural place and the land. Whereas land is simply the foundation for the construction of towns and cities, whose urban culture and economy thrives on human ingenuity and industry that may have little direct attachment to the physical ground over which it occurs, historical discourses of rurality place the land at the heart of the rural economy and society. Rural people, such discourses hold, live on the land, work the land, tend the land and know the land. The land formed not only the base of the rural economy (as ‘a physical, tangible resource which can be ploughed, sown, grazed, built upon’ (Macnaghten and Urry 1998, 200)), but also shaped rural culture and the rural calendar, and contributed to the constitution of the rural character (see Bell 1994). As such, the land is central to rural sense of place.

Ethnographic notes on visualization practices in tissue engineering

Visual information is central to several of the scientific disciplines. This paper studies how scientists working in a multidisciplinary field produce scientific evidence through building and manipulating scientific visualizations. Using ethnographic methods, we studied visualization practices of eight scientists working in the domain of tissue engineering research. Tissue engineering is an upcoming field of research that deals with replacing or regenerating human cells, tissues, or organs to restore or establish normal function. We spent 3 months in the field, where we recorded laboratory sessions of these scientists and used semi-structured interviews to get an insight into their visualization practices. From our results, we elicit two themes characterizing their visualization practices: multiplicity and physicality. In this article, we provide several examples of scientists’ visualization practices to describe these two themes and show that multimodality of such practices plays an important role in scientific visualization.

Competition Hertz : the culture and practice of car audio competitions

The present paper explores extreme car audio systems and the culture and practices that surround car audio competitions. I begin by examining whether, and how, car audio can be thought of as a 'music scene' and in what ways the culture and practice of car audio may fit within post-subcultural discourses. Following this, I offer a description of car audio competitions, revealing some of the practices that define this aspect of car audio scenes. In particular, I concentrate on sound pressure level (SPL) competitions and some of the interesting aspects of the SPL scene. Finally, I briefly examine how the powerful effects (and affects) of bass frequencies are an important part of the attraction of loud car audio systems and how car audio systems contribute to the territorializing of urban spaces.

Making the case for improved structural design : tornado outbreaks of 2011

A total of 1,625 tornadoes occurred in the United States in 2011, resulting in economic losses that exceeded $25 billion. Two tornado outbreaks stand out because they caused more than half of those losses. The tornadoes that cut through Tuscaloosa, Alabama, on April 27 and Joplin, Missouri, on May 22 were responsible for a combined 223 fatalities and more than 13,000 damaged buildings in the two cities. Although the economic losses associated with tornado damage are well documented, the writers argue that the overall impact should encompass longer term, broader considerations such as the social disruption and psychological effects that impact communities. This paper examines observations by tornado damage assessment teams led by the first author in these two medium-sized cities and suggests that the evolution of building codes and past approaches to construction have led to conditions that made this extent of damage possible. The authors outline a multidisciplinary path forward that incorporates engineering research and social and economic studies into a new design paradigm leading to building code changes and social practices that will improve resistance and mitigate future losses at a community level from tornadoes.

Sustaining safety and mobility amongst older adults : the multilevel older driver self-regulation model

This multidisciplinary research advanced the current understanding of self-regulation – a critical component in safe and sustainable mobility for older adults. It investigates the sociodemographic and psychosocial factors that underlies older adults' self-regulation, and examines their travel behaviours using a combination of self-report, in-vehicle and wearable devices. This research developed a novel theoretical model that significantly predicts self-regulation and objectively driving behaviours among older drivers.

Sports dietitians Australia position statement : sports nutrition for the adolescent athlete

It is the position of Sports Dietitians Australia (SDA) that adolescent athletes have unique nutritional requirements as a consequence of undertaking daily training and competition in addition to the demands of growth and development. As such, SDA established an expert multidisciplinary panel to undertake an independent review of the relevant scientific evidence and consulted with its professional members to develop sports nutrition recommendations for active and competitive adolescent athletes. The position of SDA is that dietary education and recommendations for these adolescent athletes should reinforce eating for long term health. More specifically, the adolescent athlete should be encouraged to moderate eating patterns to reflect daily exercise demands and provide a regular spread of high quality carbohydrate and protein sources over the day, especially in the period immediately after training. SDA recommends that consideration also be given to the dietary calcium, Vitamin D and iron intake of adolescent athletes due to the elevated risk of deficiency of these nutrients. In order to maintain optimal hydration, adolescent athletes should have access to fluids that are clean, cool and supplied in sufficient quantities before, during and after participation in sport. Finally, it is the position of SDA that use of nutrient needs should be met by core foods rather than supplements, as the recommendation of dietary supplements to developing athletes over-emphasises their ability to manipulate performance in comparison to other training and dietary strategies.

Prospects for studying how high-intensity compression waves cause damage in human blast injuries

Since World War I, explosions have accounted for over 70% of all injuries in conflict. With the development of improved personnel protection of the torso, improved medical care and faster aeromedical evacuation, casualties are surviving with more severe injuries to the extremities. Understanding the processes involved in the transfer of blast-induced shock waves through biological tissues is essential for supporting efforts aimed at mitigating and treating blast injury. Given the inherent heterogeneities in the human body, we argue that studying these processes demands a highly integrated approach requiring expertise in shock physics, biomechanics and fundamental biological processes. This multidisciplinary systems approach enables one to develop the experimental framework for investigating the material properties of human tissues that are subjected to high compression waves in blast conditions and the fundamental cellular processes altered by this type of stimuli. Ultimately, we hope to use the information gained from these studies in translational research aimed at developing improved protection for those at risk and improved clinical outcomes for those who have been injured from a blast wave.

Evolving a design driven ‘hybrid’ research approach to inform and advance sustainable outcomes in the built environment sector

A significant reduction in global greenhouse gas (GHG) emissions is a priority, and the preservation of existing building stock presents a significant opportunity to reduce the carbon footprint of our built environment. Within this ‘wicked’ problem context, and moving beyond the ad hoc and incremental performance improvements that have been made to date, collaborative and multidisciplinary efforts are required to find rapid and transformational solutions. Design has emerged as a strategic and redirective practice, and lessons can therefore be learned about transformation and potentially applied in the built environment. The purpose of this paper is to discuss a pragmatic and novel research approach for undertaking such applied design driven research. This paper begins with a discussion of key contributions from design science (rational) and action research (reflective) philosophies in creating an emerging methodological ‘hybrid design approach’. This research approach is then discussed in relation to its application to specific research exploring the processes, methods and lessons from design in heritage building retrofit projects. Drawing on both industry and academic knowledge to ensure relevance and rigour, it is anticipated that the hybrid design approach will be useful for others tackling such complex wicked problems that require context-specific solutions.

Developing transactive memory systems : theoretical contributions from a social identity perspective

Transactive memory system (TMS) theory explains how expertise is recognized and coordinated in teams. Extending current TMS research from a group information-processing perspective, our article presents a theoretical model that considers TMS development from a social identity perspective. We discuss how two features of communication (quantity and quality) important to TMS development are linked to TMS through the group identification mechanism of a shared common team identity. Informed by social identity theory, we also differentiate between intragroup and intergroup contexts and outline how, in multidisciplinary teams, professional identification and perceived equality of status among professional subgroups have a role to play in TMS development. We provide a theoretical discussion of future research directions aimed at testing and extending our model.