Investigating the cost-effectiveness of video telephone based support for newly diagnosed paediatric oncology patients and their families: design of a randomised controlled trial

Background Providing ongoing family centred support is an integral part of childhood cancer care. For families living in regional and remote areas, opportunities to receive specialist support are limited by the availability of health care professionals and accessibility, which is often reduced due to distance, time, cost and transport. The primary aim of this work is to investigate the cost-effectiveness of videotelephony to support regional and remote families returning home for the first time with a child newly diagnosed with cancer Methods/design We will recruit 162 paediatric oncology patients and their families to a single centre randomised controlled trial. Patients from regional and remote areas, classified by Accessibility/Remoteness Index of Australia (ARIA+) greater than 0.2, will be randomised to a videotelephone support intervention or a usual support control group. Metropolitan families (ARIA+ ≤ 0.2) will be recruited as an additional usual support control group. Families allocated to the videotelephone support intervention will have access to usual support plus education, communication, counselling and monitoring with specialist multidisciplinary team members via a videotelephone service for a 12-week period following first discharge home. Families in the usual support control group will receive standard care i.e., specialist multidisciplinary team members provide support either face-to-face during inpatient stays, outpatient clinic visits or home visits, or via telephone for families who live far away from the hospital. The primary outcome measure is parental health related quality of life as measured using the Medical Outcome Survey (MOS) Short Form SF-12 measured at baseline, 4 weeks, 8 weeks and 12 weeks. The secondary outcome measures are: parental informational and emotional support; parental perceived stress, parent reported patient quality of life and parent reported sibling quality of life, parental satisfaction with care, cost of providing improved support, health care utilisation and financial burden for families. Discussion This investigation will establish the feasibility, acceptability and cost-effectiveness of using videotelephony to improve the clinical and psychosocial support provided to regional and remote paediatric oncology patients and their families.

Novel corrosion sensor based on carbon nanotube composites for structural health monitoring

Bridges are important infrastructures of all nations and are required for transportation of goods as well as human. A catastrophic failure can result in loss of lives and enormous financial hardship to the nation. Hence, there is an urgent need to monitor our infrastructures to prolong their life span, at the same time catering for heavier and faster moving traffics. Although various kinds of sensors are now available to monitor the health of the structures due to corrosion, they do not provide permanent and long term measurements. This paper investigates the fabrication of Carbon Nanotube (CNT) based composite sensors for structural health monitoring. The CNTs, a key material in nanotechnology has aroused great interest in the research community due to their remarkable mechanical, electrochemical, piezoresistive and other physical properties. Multi-wall CNT (MWCNT)/Nafion composite sensors were fabricated to evaluate their electrical properties when subjected to chemical solutions, to simulate a chemical reaction due to corrosion and real life corrosion experimental tests. The electrical resistance of the sensor electrode was dramatically changed due to corrosion. The novel sensor is expected to effectively detect corrosion in structures based on the measurement of electrical impedances of the CNT composite.

Aerial image analysis using spiking neural networks with application to power line corridor monitoring

Trees, shrubs and other vegetation are of continued importance to the environment and our daily life. They provide shade around our roads and houses, offer a habitat for birds and wildlife, and absorb air pollutants. However, vegetation touching power lines is a risk to public safety and the environment, and one of the main causes of power supply problems. Vegetation management, which includes tree trimming and vegetation control, is a significant cost component of the maintenance of electrical infrastructure. For example, Ergon Energy, the Australia’s largest geographic footprint energy distributor, currently spends over $80 million a year inspecting and managing vegetation that encroach on power line assets. Currently, most vegetation management programs for distribution systems are calendar-based ground patrol. However, calendar-based inspection by linesman is labour-intensive, time consuming and expensive. It also results in some zones being trimmed more frequently than needed and others not cut often enough. Moreover, it’s seldom practicable to measure all the plants around power line corridors by field methods. Remote sensing data captured from airborne sensors has great potential in assisting vegetation management in power line corridors. This thesis presented a comprehensive study on using spiking neural networks in a specific image analysis application: power line corridor monitoring. Theoretically, the thesis focuses on a biologically inspired spiking cortical model: pulse coupled neural network (PCNN). The original PCNN model was simplified in order to better analyze the pulse dynamics and control the performance. Some new and effective algorithms were developed based on the proposed spiking cortical model for object detection, image segmentation and invariant feature extraction. The developed algorithms were evaluated in a number of experiments using real image data collected from our flight trails. The experimental results demonstrated the effectiveness and advantages of spiking neural networks in image processing tasks. Operationally, the knowledge gained from this research project offers a good reference to our industry partner (i.e. Ergon Energy) and other energy utilities who wants to improve their vegetation management activities. The novel approaches described in this thesis showed the potential of using the cutting edge sensor technologies and intelligent computing techniques in improve power line corridor monitoring. The lessons learnt from this project are also expected to increase the confidence of energy companies to move from traditional vegetation management strategy to a more automated, accurate and cost-effective solution using aerial remote sensing techniques.

Measuring and monitoring soil organic carbon stocks in agricultural lands for climate mitigation

Policies that encourage greenhouse-gas emitters to mitigate emissions through terrestrial carbon (C) offsets – C sequestration in soils or biomass – will promote practices that reduce erosion and build soil fertility, while fostering adaptation to climate change, agricultural development, and rehabilitation of degraded soils. However none of these benefits will be possible until changes in C stocks can be documented accurately and cost-effectively. This is particularly challenging when dealing with changes in soil organic C (SOC) stocks. Precise methods for measuring C in soil samples are well established, but spatial variability in the factors that determine SOC stocks makes it difficult to document change. Widespread interest in the benefits of SOC sequestration has brought this issue to the fore in the development of US and international climate policy. Here, we review the challenges to documenting changes in SOC stocks, how policy decisions influence offset documentation requirements, and the benefits and drawbacks of different sampling strategies and extrapolation methods.

Is the iPhone an accurate and useful tool for the monitoring of spinal deformity?

The progression of spinal deformity is traditionally monitored by spinal surgeons using the Cobb method on hardcopy radiographs with a protractor and pencil. The rotation of the spine and ribcage (rib hump) in scoliosis is measured with a simple hand-held inclinometer (Scoliometer). The iPhone and other smart phones have the capability to accurately sense inclination, and can therefore be used to measure Cobb angles and rib hump angulation. The purpose of this study was to quantify the performance of the iPhone compared to a standard protractor for measuring Cobb angles and the Scoliometer for measuring rib humps. The study concluded that the iPhone is a clinically equivalent measuring tool to the traditional protractor and Scoliometer

Applying a social justice framework to ensure good practice in monitoring student learning engagement

A current Australian Learning and Teaching Council (ALTC) funded action research project aims to provide a set of practical resources founded on a social justice framework, to guide good practice for monitoring student learning engagement (MSLE) in higher education. The project involves ten Australasian institutions, eight of which are engaged in various MSLE type projects. A draft framework, consisting of six social justice principles which emerged from the literature has been examined with reference to the eight institutional approaches for MSLE in conjunction with the personnel working on these initiatives during the first action research cycle. The cycle will examine the strategic and operational implications of the framework in each of the participating institutions. Cycle 2 will also build capacity to embed the principles within the institutional MSLE program and will identify and collect examples and resources that exemplify the principles in practice. The final cycle will seek to pilot the framework to guide new MSLE initiatives. In its entirety, the project will deliver significant resources to the sector in the form of a social justice framework for MSLE, guidelines and sector exemplars for MSLE. As well as increasing the awareness amongst staff around the criticality of transition to university (thereby preventing attrition) and the significance of the learning and teaching agenda in enhancing student engagement, the project will build leadership capacity within the participating institutions and provide a knowledge base and institutional capacity for the Australasian HE sector to deploy the deliverables that will safeguard student learning engagement At this early stage of the project the workshop session provides an opportunity to discuss and examine the draft set of social justice principles and to discuss their potential value for the participants’ institutional contexts. Specifically, the workshop will explore critical questions associated with the principles.

An accessible method for teaching doctors about death certification

The World Health Organization recommends that data on mortality in its member countries are collected utilising the Medical Certificate of Cause of Death published in the instruction volume of the ICD-10. However, investment in health information processes necessary to promote the use of this certificate and improve mortality information is lacking in many countries. An appeal for support to make improvements has been launched through the Health Metrics Network’s MOVE-IT strategy (Monitoring of Vital Events – Information Technology) [World Health Organization, 2011]. Despite this international spotlight on the need for capture of mortality data and in the use of the ICD-10 to code the data reported on such certificates, there is little cohesion in the way that certifiers of deaths receive instruction in how to complete the death certificate, which is the main source document for mortality statistics. Complete and accurate documentation of the immediate, underlying and contributory causes of death of the decedent on the death certificate is a requirement to produce standardised statistical information and to the ability to produce cause-specific mortality statistics that can be compared between populations and across time. This paper reports on a research project conducted to determine the efficacy and accessibility of the certification module of the WHO’s newly-developed web based training tool for coders and certifiers of deaths. Involving a population of medical students from the Fiji School of Medicine and a pre and post research design, the study entailed completion of death certificates based on vignettes before and after access to the training tool. The ability of the participants to complete the death certificates and analysis of the completeness and specificity of the ICD-10 coding of the reported causes of death were used to measure the effect of the students’ learning from the training tool. The quality of death certificate completion was assessed using a Quality Index before and after the participants accessed the training tool. In addition, the views of the participants about accessibility and use of the training tool were elicited using a supplementary questionnaire. The results of the study demonstrated improvement in the ability of the participants to complete death certificates completely and accurately according to best practice. The training tool was viewed very positively and its implementation in the curriculum for medical students was encouraged. Participants also recommended that interactive discussions to examine the certification exercises would be an advantage.

Managing medical advice seeking in calls to Child Health Line

Child Health Line is a 24-hour Australian helpline that offers information and support for parents and families on child development and parenting. The helpline guidelines suggest that nurses should not offer medical advice, however they regularly receive calls seeking such advice. This paper examines how the service guidelines are talked into being through the nurses’ management of caller’s requests for medical advice and information, and shows how nurses orient to the boundaries of their professional role and institutionally regulated authority. Three ways in which the child health nurses manage medical advice and information seeking are discussed: using membership as a nurse to establish boundaries of expertise, privileging parental authority regarding decision making about seeking treatment for their child, and respecifying a ‘medical’ problem as a child development issue. The paper contributes to research on medical authority, and nurse authority in particular, by demonstrating the impact of institutional roles and guidelines on displays of knowledge and expertise. More generally, it contributes to an understanding of the interactional enactment and consequences of service guidelines for telehealth practice, with implications for training, policy and service delivery.