Can the use of quality assurance tools reduce the impact of surgical complications on the well-being of obstetricians and gynaecologists in Australia and New Zealand?

Background While adverse events primarily affect the patient, surgeons involved can also experience considerable distress. Aims The aim of the survey was to assess the impact of complications on the day-to-day life, work and health of Australian and New Zealand obstetricians and gynaecologists and to evaluate existing support systems and coping strategies. Methods A 43-question survey on self-assessment, quality assurance (QA) tools, impact of complications on individuals’ health and relationships, and support available was emailed to fellows, trainees, subspecialists and subspecialty trainees of the Royal Australian and New Zealand College of Obstetrics and Gynaecology (RANZCOG). We collected 606 responses from a target population of 2296 (response rate 26.3%). Results When complications occur, sleep was affected of 80%, family and social relationships of 55% and physical health of 48% of respondents. The major sources of support were from colleagues (83%), family (82%) and medical defence organisations (73%), with professional bodies perceived as providing least support. Nearly 80% of respondents felt the need to talk to someone they trust during times of complications. Overall, 100% of respondents used at least one QA tool (62% used two, 26% three and 9% four QA strategies). There were significant differences between respondent groups in use of the QA tools. Conclusions Surgical complications have a significant impact on the well-being of Australian and New Zealand obstetricians and gynaecologists. Existing support comes from colleagues and family, but structured, unbiased support for surgeons from a professional source is urgently warranted.

Compliance with physical activity guidelines : prevalence in a population of children and youth

PURPOSE To use objective monitoring of physical activity to determine the percentages of children and youth in a population that met physical activity guidelines. METHODS A total of 375 students in grades 1–12 wore an accelerometer (CSA 7164) for seven consecutive days. Bouts of continuous activity and accumulation of minutes spent in physical activity at various intensities were calculated to determine how many students met three physical activity guidelines. RESULTS Over 90% of students met Healthy People 2010, Objective 22.6 and nearly 70% met the United Kingdom Expert Consensus Group guideline, both of which recommend daily accumulation of moderate physical activity. Less than 3% met Healthy People 2010, Objective 22.7, which calls for bouts of continuous vigorous physical activity. For the United Kingdom Expert Consensus Group guideline, compliance decreased markedly with age, but gender differences were not statistically significant. CONCLUSIONS Prevalence estimates for compliance with national physical activity guidelines varied markedly for the three guidelines examined. Objective monitoring of physical activity in youth appears to be feasible and may provide more accurate prevalence rates than self-report measures.

School physical education in the post-report era : an analysis from public health

The 1996 United States Surgeon General’s report on physical activity and health represents a watershed moment in the modern history of physical activity and public health. Based on a compelling body of scientific evidence from the fields of medicine, epidemiology, physiology, and health psychology, the Surgeon General’s report proclaimed that people of all ages could improve their health and quality of life through lifelong practice of moderate physical activity (United States Department of Health and Human Services [USDHHS], 1996). Physical Activity and Health: A Report of the Surgeon General was an especially important publication for school physical education. Not only did the report acknowledge the importance of regular physical activity during childhood and adolescence, it also identified school physical education as an important vehicle for promoting healthenhancing physical activity in young people. “With evidence that success in this arena is possible, every effort should be made to encourage schools to require daily physical education in each grade and to promote physical activities that can be enjoyed throughout life” (USDHHS, 1996, p. 6). The purpose of this article is to discuss the status of school physical education since the release of the Surgeon General’s report on physical activity and health nearly a decade ago. Specifically, the article will address four questions: 1) What has been the historical role of physical education in physical activity and public health? 2) What impact, if any, has the Surgeon General’s report has had on physical education programs? 3) What impact should physical education have on public health and physical activity? 4) What should teacher education programs in physical education do to prepare physical education teachers, given the current role of physical education?

Low-cost railway level crossings - breaking down the barriers

Level crossing risk continues to be a significant safety concern for the security of rail operations around the world. Over the last decade or so, a third of railway related fatalities occurred as a direct result of collisions between road and rail vehicles in Australia. Importantly, nearly half of these collisions occurred at railway level crossings with no active protection, such as flashing lights or boom barriers. Current practice is to upgrade level crossings that have no active protection. However, the total number of level crossings found across Australia exceed 23,500, and targeting the proportion of these that are considered high risk (e.g. public crossings with passive controls) would cost in excess of AU$3.25 billion based on equipment, installation and commissioning costs of warning devices that are currently type approved. Level crossing warning devices that are low-cost provide a potentially effective control for reducing risk; however, over the last decade, there have been significant barriers and legal issues in both Australia and the US that have foreshadowed their adoption. These devices are designed to have significantly lower lifecycle costs compared with traditional warning devices. They often make use of use of alternative technologies for train detection, wireless connectivity and solar energy supply. This paper describes the barriers that have been encountered for the adoption of these devices in Australia, including the challenges associated with: (1) determining requisite safety levels for such devices; (2) legal issues relating to duty of care obligations of railway operators; and (3) issues of Tort liability around the use of less than fail-safe equipment. This paper provides an overview of a comprehensive safety justification that was developed as part of a project funded by a collaborative rail research initiative established by the Australian government, and describes the conceptual framework and processes being used to justify its adoption. The paper provides a summary of key points from peer review and discusses prospective barriers that may need to be overcome for future adoption. A successful outcome from this process would result in the development of a guideline for decision-making, providing a precedence for adopting low-cost level crossing warning devices in other parts of the world. The framework described in this paper also provides relevance to the review and adoption of analogous technologies in rail and other safety critical industries.

Brca2 is involved in meiosis in Arabidopsis thaliana as suggested by its interaction with Dmc1

Two BRCA2-like sequences are present in the Arabidopsis genome. Both genes are expressed in flower buds and encode nearly identical proteins, which contain four BRC motifs. In a yeast two-hybrid assay, the Arabidopsis Brca2 proteins interact with Rad51 and Dmc1. RNAi constructs aimed at silencing the BRCA2 genes at meiosis triggered a reproducible sterility phenotype, which was associated with dramatic meiosis alterations. We obtained the same phenotype upon introduction of RNAi constructs aimed at silencing the RAD51 gene at meiosis in dmc1 mutant plants. The meiotic figures we observed strongly suggest that homologous recombination is highly disturbed in these meiotic cells, leaving aberrant recombination events to repair the meiotic double-strand breaks. The 'brca2' meiotic phenotype was eliminated in spo11 mutant plants. Our experiments point to an essential role of Brca2 at meiosis in Arabidopsis. We also propose a role for Rad51 in the dmc1 context.

Core-leaf onion-like carbon/MnO2 hybrid nano-urchins for rechargeable lithium-ion batteries

A hybrid nano-urchin structure consisting of spherical onion-like carbon and MnO2 nanosheets is synthesized by a facile and environmentally-friendly hydrothermal method. Lithium-ion batteries incorporating the hybrid nano-urchin anode exhibit reversible lithium storage with superior specific capacity, enhanced rate capability, stable cycling performance, and nearly 100% Coulombic efficiency. These results demonstrate the effectiveness of designing hybrid nano-architectures with uniform and isotropic structure, high loading of electrochemically-active materials, and good conductivity for the dramatic improvement of lithium storage.

Deterministic plasma-aided synthesis of high-quality nanoislanded nc-SiC films

Despite major advances in the fabrication and characterization of SiC and related materials, there has been no convincing evidence of the synthesis of nanodevice-quality nanoislanded SiC films at low, ultralarge scale integration technology-compatible process temperatures. The authors report on a low-temperature (400 °C) plasma-assisted rf magnetron sputtering deposition of high-quality nanocrystalline SiC films made of uniform-size nanoislands that almost completely cover the Si(100) surface. These nanoislands are chemically pure, highly stoichiometric, have a typical size of 20-35 nm, and contain small (∼5 nm) nanocrystalline inclusions. The properties of nanocrystalline SiC films can be effectively controlled by the plasma parameters.

Control of core-shell structure and elemental composition of binary quantum dots

The possibility of initial stage control of the elemental composition and core/shell structure of binary SiC quantum dots by optimizing temporal variation of Si and C incoming fluxes and surface temperatures is shown via hybrid numerical simulations. Higher temperatures and influxes encourage the formation of a stoichiometric outer shell over a small carbon-enriched core, whereas lower temperatures result in a larger carbon-enriched core, Si-enriched undershell, and then a stoichiometric SiC outer shell. This approach is generic and is applicable to a broad range of semiconductor materials and nanofabrication techniques. © 2007 American Institute of Physics.

Investigation on bioactivity of titanium dioxide thin films fabricated by electron cyclotron resonance plasma aided pulsed laser deposition

Titanium dioxide thin films with a rutile crystallinite size around 20 nm were fabricated by pulsed laser deposition (PLD) aided with an electron cyclotron resonance (ECR) plasma. With annealing treatment, the crystal size of the rutile crystallinite increased to 100 nm. The apatite-forming ability of the films as deposited and after annealing was investigated in a kind of simulated body fluid with ion concentrations nearly equal to those of human blood plasma. The results indicate that ECR aided PLD is an effective way both to fabricate bioactive titanium dioxide thin films and to optimize the bioactivity of titanium dioxide, with both crystal size and defects of the film taken into account.

Effect of elemental composition and size on electron confinement in self-assembled SiC quantum dots : a combinatorial approach

A high level of control over quantum dot (QD) properties such as size and composition during fabrication is required to precisely tune the eventual electronic properties of the QD. Nanoscale synthesis efforts and theoretical studies of electronic properties are traditionally treated quite separately. In this paper, a combinatorial approach has been taken to relate the process synthesis parameters and the electron confinement properties of the QDs. First, hybrid numerical calculations with different influx parameters for Si1-x Cx QDs were carried out to simulate the changes in carbon content x and size. Second, the ionization energy theory was applied to understand the electronic properties of Si1-x Cx QDs. Third, stoichiometric (x=0.5) silicon carbide QDs were grown by means of inductively coupled plasma-assisted rf magnetron sputtering. Finally, the effect of QD size and elemental composition were then incorporated in the ionization energy theory to explain the evolution of the Si1-x Cx photoluminescence spectra. These results are important for the development of deterministic synthesis approaches of self-assembled nanoscale quantum confinement structures.

Plasma-enabled growth of ultralong straight, helical, and branched silica photonic nanowires

This article reports on the lowerature inductively coupled plasma-enabled synthesis of ultralong (up to several millimeters in length) SiO2 nanowires, which were otherwise impossible to synthesize without the presence of a plasma. Depending on the process conditions, the nanowires feature straight, helical, or branched morphologies. The nanowires are amorphous, with a near-stoichiometric elemental composition ([O] / [Si] =2.09) and are very uniform throughout their length. The role of the ionized gas environment is discussed and the growth mechanism is proposed. These nanowires are particularly promising for nanophotonic applications where long-distance and channelled light transmission and polarization control are required.

Low-temperature plasma-assisted growth of optically transparent, highly oriented nanocrystalline AlN

Optically transparent, highly oriented nanocrystalline AlN(002) films have been synthesized using a hybrid plasma enhanced chemical vapor deposition and plasma-assisted radio frequency (rf) magnetron sputtering process in reactive Ar+ N2 and Ar+ N2 + H2 gas mixtures at a low Si(111)/glass substrate temperature of 350 °C. The process conditions, such as the sputtering pressure, rf power, substrate temperature, and N2 concentration were optimized to achieve the desired structural, compositional, and optical characteristics. X-ray diffractometry reveals the formation of highly c -oriented AlN films at a sputtering pressure of 0.8 Pa. Field emission scanning electron microscopy suggests the uniform distribution of AlN grains over large surface areas and also the existence of highly oriented in the (002) direction columnar structures of a typical length ∼100-500 nm with an aspect ratio of ∼7-15. X-ray photoelectron and energy dispersive x-ray spectroscopy suggest that films deposited at a rf power of 400 W feature a chemically pure and near stoichiometric AlN. The bonding states of the AlN films have been confirmed by Raman and Fourier transform infrared spectroscopy showing strong E2 (high) and E1 transverse optical phonon modes. Hydrogenated AlN films feature an excellent optical transmittance of ∼80% in the visible region of the spectrum, promising for advanced optical applications.

Surface fluxes of Si and C adatoms at initial growth stages of SiC quantum dots

Self-assembly of highly stoichiometric SiC quantum dots still remains a major challenge for the gas/plasma-based nanodot synthesis. By means of a multiscale hybrid numerical simulation of the initial stage (0.1-2.5 s into the process) of deposition of SiCSi (100) quantum dot nuclei, it is shown that equal Si and kst atom deposition fluxes result in strong nonstoichiometric nanodot composition due to very different surface fluxes of Si and C adatoms to the quantum dots. At this stage, the surface fluxes of Si and C adatoms to SiC nanodots can be effectively controlled by manipulating the SiC atom influx ratio and the Si (100) surface temperature. It is demonstrated that at a surface temperature of 800 K the surface fluxes can be equalized after only 0.05 s into the process; however, it takes more then 1 s at a surface temperature of 600 K. Based on the results of this study, effective strategies to maintain a stoichiometric ([Si] [C] =1:1) elemental ratio during the initial stages of deposition of SiCSi (100) quantum dot nuclei in a neutral/ionized gas-based process are proposed.

On natures of sub-gap photoelectric and optical spectra in nitrogen-contaminated nanocrystalline diamond

Experimentally observed optical and photoelectrical spectra of nitrogen-contaminated (unintentionally doped) nano-crystalline CVD diamond films are simulated using semi-empirical adiabatic General Skettrup Model (GSM), which presumes dominant contributions of defect states from sp 3-coordinated intra-granular carbon atoms to intra-band single electron spectrum N(E) of the material. This picture disagrees with a common viewpoint that the N(E) spectrum of the gap states in diamond powders and polycrystalline CVD films mainly originates from π and π* bonds of sp2-coordinated carbon atoms, which are distributed nearly uniformly over outer surfaces and/or interfaces of the diamond grains. The GSM predicts as well strong effect of granular morphology on the density of intra-band defect states in polycrystalline diamonds.

Controlling current and voltage type interfaces in power-hardware-in-the-loop simulations

The usual practice to study a large power system is through digital computer simulation. However, the impact of large scale use of small distributed generators on a power network cannot be evaluated strictly by simulation since many of these components cannot be accurately modelled. Moreover, the network complexity makes the task of practical testing on a physical network nearly impossible. This study discusses the paradigm of interfacing a real-time simulation of a power system to real-life hardware devices. This type of splitting a network into two parts and running a real-time simulation with a physical system in parallel is usually termed as power-hardware-in-the-loop (PHIL) simulation. The hardware part is driven by a voltage source converter that amplifies the signals of the simulator. In this paper, the effects of suitable control strategy on the performance of PHIL and the associated stability aspects are analysed in detail. The analyses are validated through several experimental tests using an real-time digital simulator.