Radiographer commenting of trauma radiographs : a survey of the benefits, barriers and enablers to participation in an Australian healthcare setting

Introduction Radiographer abnormality detection systems that highlight abnormalities on trauma radiographs (‘red dot’ system) have been operating for more than 30 years. Recently, a number of pitfalls have been identified. These limitations initiated the evolution of a radiographer commenting system, whereby a radiographer provides a brief description of abnormalities identified in emergency healthcare settings. This study investigated radiographers' participation in abnormality detection systems, their perceptions of benefits, barriers and enablers to radiographer commenting, and perceptions of potential radiographer image interpretation services for emergency settings. Methods A cross-sectional survey was implemented. Participants included radiographers from four metropolitan hospitals in Queensland, Australia. Conventional descriptive statistics, histograms and thematic analysis were undertaken. Results Seventy-three surveys were completed and included in the analysis (68% response rate); 30 (41%) of respondents reported participating in abnormality detection in 20% or less of examinations, and 26(36%) reported participating in 80% or more of examinations. Five overarching perceived benefits of radiographer commenting were identified: assisting multidisciplinary teams, patient care, radiographer ability, professional benefits and quality of imaging. Frequently reported perceived barriers included ‘difficulty accessing image interpretation education’, ‘lack of time’ and ‘low confidence in interpreting radiographs’. Perceived enablers included ‘access to image interpretation education’ and ‘support from radiologist colleagues’. Conclusions A range of factors are likely to contribute to the successful implementation of radiographer commenting in addition to abnormality detection in emergency settings. Effective image interpretation education amenable to completion by radiographers would likely prove valuable in preparing radiographers for participation in abnormality detection and commenting systems in emergency settings.

Using value-based partnerships to support community engaged learning : benefits, challenges, stakeholder perspectives

Increasingly, the not-for-profit sector, as an emerging contributor to the creative economy, is creating a context for engaging creative practitioners in developing solutions to complex problems, triggering a demand for skills and knowledge needed to address this complexity. Across the university and community contexts alternative models of engagement are emerging to support this dynamic. This paper presents a case study of a creative project in which a value-based approach is used to foster a collaborative partnership between community partners and a multidisciplinary team of final year Creative Industries students who in the course of the project developed a range of communication resources, including a social media campaign, an interactive game and a series of short films to support volunteer engagement and leadership initiatives. The paper considers the implications this values approach has for the design of service learning curriculum for multidisciplinary creative teams and the potential it has to support meaningful collaboration between creatives and the not-for-profit sector. It further explores how it impact on student and partner engagement, learning outcomes and the benefits for the partner organisation. The paper concludes that a value-based approach to university-community engagement has the potential to support and enable a greater degree of reciprocity, deeper engagement between stakeholders and greater relevance of the final outcome.

The project approach in early childhood education for sustainability : examplars from Korea and Australia

Sustainability is a global issue that urgently needs addressing, and for which the most serious consequences are for children and future generations. This insightful research text tackles one of the most significant contemporary issues of our times – the nexus between society and environment – and how early childhood education can contribute to sustainable living. By offering international and multidisciplinary research perspectives on Early Childhood Education for Sustainability, each chapter explores and investigates the complex topic of sustainability and its relationship to early childhood education. A particular emphasis that runs through this text is young children as empowered citizens, capable of both contributing to and creating change for sustainability. The chapter authors work from, or are aligned with, a transformative education paradigm that suggests the socio-constructivist frameworks currently underpinning Early Childhood Education require reframing in light of the social transformations necessary to address humanity’s unsustainable, unjust and unhealthy living patterns. This research text is designed to be provocative and challenging; in so doing it seeks to encourage exploration of current understandings about Early Childhood Education for Sustainability, offers new dimensions for more deeply informed practice, and proposes avenues for further research in this field.

The once-and-for-all withdrawal of the Liverpool Care Pathway in the UK : what are the implications for Australia?

This Perspective reflects on the withdrawal of the Liverpool Care Pathway in the UK, and its implications for Australia. Integrated care pathways are documents which outline the essential steps of multidisciplinary care in addressing a specific clinical problem. They can be used to introduce best clinical practice, to ensure that the most appropriate management occurs at the most appropriate time and that it is provided by the most appropriate health professional. By providing clear instructions, decision support and a framework for clinician-patient interactions, care pathways guide the systematic provision of best evidence-based care. The Liverpool Care Pathway (LCP) is an example of an integrated care pathway, designed in the 1990s to guide care for people with cancer who are in their last days of life and are expected to die in hospital. This pathway evolved out of a recognised local need to better support non-specialist palliative care providers’ care for patients dying of cancer within their inpatient units. Historically, despite the large number of people in acute care settings whose treatment intent is palliative, dying patients receiving general hospital acute care tended to lack sufficient attention from senior medical staff and nursing staff. The quality of end-of-life care was considered inadequate, therefore much could be learned from the way patients were cared for by palliative care services. The LCP was a strategy developed to improve end-of-life care in cancer patients and was based on the care received by those dying in the palliative care setting.

Molecular aspects of tissue engineering in the dental field

Tissue engineering is a multidisciplinary field with the potential to replace tissues lost as a result of trauma, cancer surgery, or organ dysfunction. The successful production, integration, and maintenance of any tissue-engineered product are a result of numerous molecular interactions inside and outside the cell. We consider the essential elements for successful tissue engineering to be a matrix scaffold, space, cells, and vasculature, each of which has a significant and distinct molecular underpinning (Fig. 1). Our approach capitalizes on these elements. Originally developed in the rat, our chamber model (Fig. 2) involves the placement of an arteriovenous loop (the vascular supply) in a polycarbonate chamber (protected space) with the addition of cells and an extracellular matrix such as Matrigel or endogenous fibrin (34, 153, 246, 247). This model has also been extended to the rabbit and pig (J. Dolderer, M. Findlay, W. Morrison, manuscript in preparation), and has been modified for the mouse to grow adipose tissue and islet cells (33, 114, 122) (Fig. 3)...

The continuing decline of science and mathematics enrolments in Australian high schools

Is there a crisis in Australian science and mathematics education? Declining enrolments in upper secondary Science and Mathematics courses have gained much attention from the media, politicians and high-profile scientists over the last few years, yet there is no consensus amongst stakeholders about either the nature or the magnitude of the changes. We have collected raw enrolment data from the education departments of each of the Australian states and territories from 1992 to 2012 and analysed the trends for Biology, Chemistry, Physics, two composite subject groups (Earth Sciences and Multidisciplinary Sciences), as well as entry, intermediate and advanced Mathematics. The results of these analyses are discussed in terms of participation rates, raw enrolments and gender balance. We have found that the total number of students in Year 12 increased by around 16% from 1992 to 2012 while the participation rates for most Science and Mathematics subjects, as a proportion of the total Year 12 cohort, fell (Biology (-10%), Chemistry (-5%), Physics (-7%), Multidisciplinary Science (-5%), intermediate Mathematics (-11%), advanced Mathematics (-7%) in the same period. There were increased participation rates in Earth Sciences (+0.3%) and entry Mathematics (+11%). In each case the greatest rates of change occurred prior to 2001 and have been slower and steadier since. We propose that the broadening of curriculum offerings, further driven by students' self-perception of ability and perceptions of subject difficulty and usefulness, are the most likely cause of the changes in participation. While these continuing declines may not amount to a crisis, there is undoubtedly serious cause for concern.

Graft versus host disease in oncology nursing practice

INTRODUCTION: Gastrointestinal graft-versus-host disease (GI-GvHD) is extremely debilitating and is multifactorial in its causative factors, management and treatment. It is an exaggeration of normal physiological mechanisms wherein the donor immune system attempts to rid itself of the host. The inflammatory process that follows has the benefit of providing an anti-tumour effect for many diseases, but unfortunately in patients undergoing human stem-cell transplantation, the nature of the inflammation can result in disability, wasting and death. AIM: The aim of this article is to discuss the pathophysiology of this often misunderstood or misdiagnosed condition, as well as its signs and symptoms, management and considerations for nursing care. Considerations for nursing practice: While the medical management is aimed at minimising GvHD through the reduction of T-cell production and proliferation and gastrointestinal decolonisation, the nursing care is often focused on the signs and symptoms that can have the most prominent impact on patients. CONCLUSION: GI-GvHD has serious life-threatening complications, namely wasting syndrome, diarrhoea and dehydration. The basis of signs and symptomology is easily recognisable owing to the stages of progression through the human stem-cell transplantation process. Oncology nurses are in a prime position to identify these serious risks, initiate treatment immediately and collaborate effectively within the multidisciplinary team to minimise GvHD onset and provide expert support to patients, family and caregivers.

Organizational work-related road safety situational analysis: More than just an audit tool

Although safety statistics indicate that road crashes are the most common form of work-related fatalities, many organizations fail to treat company vehicles in the same manner as other physical safety hazards within the workplace. Traditionally, work-related road safety has targeted primarily driver-related issues and not adequately addressed organizational processes, such as the organizations’ safety system and risk management processes and practice. This inadequacy generally stems from a lack of specific contextual knowledge and basic requirements to improve work-related road safety, including the supporting systems to ensure any intervention strategy or initiative’s ongoing effectiveness. Therefore, informed by previous research and based on a case study methodology, the Organizational Work-Related Road Safety Situational Analysis was developed to assess organizations’ current work-related road safety system, including policy, procedures, processes and practice. The situational analysis tool is similar to a safety audit however is more comprehensive in detail, application and provides sufficient evidence to enable organizations to mitigate and manage their work-related road safety risks. In addition, data collected from this process assists organizations in making informed decisions regarding intervention strategy design, development, implementation and ongoing effectiveness. This paper reports on the effectiveness of the situational analysis tool to assess WRRS systems across five differing and diverse organizations; including gas exploration and mining, state government, local government, and not for profit/philanthropy. The outcomes of this project identified considerable differences in the degree by which the organizations’ addressed work-related road safety across their vehicle fleet operations and provides guidelines for improving organizations’ work-related road safety systems.

Carbon nanostructures for hard tissue engineering

The primary goal in hard tissue engineering is to combine high-performance scaffold materials with living cells to develop biologically active substitutes that can restore tissue functions. This requires relevant knowledge in multidisciplinary fields encompassing chemical engineering, material science, chemistry, biology and nanotechnology. Here we present an overview on the recent progress of how two representative carbon nanostructures, namely, carbon nanotubes and graphene, aid and advance the research in hard tissue engineering. The article focuses on the advantages and challenges of integrating these carbon nanostructures into functional scaffolds for repairing and regenerative purposes. It includes, but is not limited to, the critical physico-chemical properties of carbon nanomaterials for enhanced cell interactions such as adhesion, morphogenesis, proliferation and differentiation; the novel designs of two- and three-dimensional nanostructured scaffolds; multifunctional hybrid materials; and the biocompatible aspects of carbon nanotubes and graphene. Perspectives on the future research directions are also given, in an attempt to shed light on the innovative and rational design of more effective biomedical devices in hard tissue engineering.

Control of energy and matter at nanoscales : challenges and opportunities for plasma nanoscience in a sustainability age

Plasma nanoscience is an emerging multidisciplinary research field at the cutting edge of a large number of disciplines including but not limited to physics and chemistry of plasmas and gas discharges, materials science, surface science, nanoscience and nanotechnology, solid-state physics, space physics and astrophysics, photonics, optics, plasmonics, spintronics, quantum information, physical chemistry, biomedical sciences and related engineering subjects. This paper examines the origin, progress and future perspectives of this research field driven by the global scientific and societal challenges. The future potential of plasma nanoscience to remain a highly topical area in the global research and technological agenda in the age of fundamental-level control for a sustainable future is assessed using a framework of the five Grand Challenges for Basic Energy Sciences recently mapped by the US Department of Energy. It is concluded that the ongoing research is very relevant and is expected to substantially expand to competitively contribute to the solution of all of these Grand Challenges. The approach to controlling energy and matter at nano- and subnanoscales is based on identifying the prevailing carriers and transfer mechanisms of the energy and matter at the spatial and temporal scales that are most relevant to any particular nanofabrication process. Strong accent is made on the competitive edge of the plasma-based nanotechnology in applications related to the major socio-economic issues (energy, food, water, health and environment) that are crucial for a sustainable development of humankind. Several important emerging topics, opportunities and multidisciplinary synergies for plasma nanoscience are highlighted. The main nanosafety issues are also discussed and the environment- and human health-friendly features of plasma-based nanotech are emphasized.

Plasma nanoscience : setting directions, tackling grand challenges

This review paper presents historical perspectives, recent advances and future directions in the multidisciplinary research field of plasma nanoscience. The current status and future challenges are presented using a three-dimensional framework. The first and the largest dimension covers the most important classes of nanoscale objects (nanostructures, nanofeatures and nanoassemblies/nanoarchitectures) and materials systems, namely carbon nanotubes, nanofibres, graphene, graphene nanoribbons, graphene nanoflakes, nanodiamond and related carbon-based nanostructures; metal, silicon and other inorganic nanoparticles and nanostructures; soft organic nanomaterials; nano-biomaterials; biological objects and nanoscale plasma etching. In the second dimension, we discuss the most common types of plasmas and plasma reactors used in nanoscale plasma synthesis and processing. These include low-temperature non-equilibrium plasmas at low and high pressures, thermal plasmas, high-pressure microplasmas, plasmas in liquids and plasma–liquid interactions, high-energy-density plasmas, and ionized physical vapour deposition as well as some other plasma-enhanced nanofabrication techniques. In the third dimension, we outline some of the 'Grand Science Challenges' and 'Grand Socio-economic Challenges' to which significant contributions from plasma nanoscience-related research can be expected in the near future. The urgent need for a stronger focus on practical, outcome-oriented research to tackle the grand challenges is emphasized and concisely formulated as from controlled complexity to practical simplicity in solving grand challenges.

Plasma nanoscience : from controlled complexity to practical simplicity

Plasma Nanoscience is a multidisciplinary research field which aims to elucidate the specific roles, purposes, and benefits of the ionized gas environment in assembling and processing nanoscale objects in natural, laboratory and technological situations. Compared to neutral gas-based routes, in low-temperature weakly-ionized plasmas there is another level of complexity related to the necessity of creating and sustaining a suitable degree of ionization and a much larger number of species generated in the gas phase. The thinner the nanotubes, the stronger is the quantum confinement of electrons and more unique size-dependent quantum effects can emerge. Furthermore, due to a very high mobility of electrons, the surfaces are at a negative potential compared to the plasma bulk. Therefore, there are non-uniform electric fields within the plasma sheath. The electric field lines start in the plasma bulk and converge to the sharp tips of the developing one-dimensional nanostructures.

Plasma Nanoscience : from nature's mastery to deterministic plasma-aided nanofabrication

This paper introduces the plasma-nanoscience research area and shows the way from Nature's mastery in assembling nanosized dust grains in the Universe to deterministic plasma-aided nanofabrication. The concept of deterministic nanoassembly is explained, and the multidisciplinary approach to bridge the spatial gap of nine orders of magnitude between the sizes of plasma reactors and atomic building units is discussed. Ongoing numerical simulation and experimental efforts on highly controlled synthesis of carbon nanotip and semiconducting quantum-dot structures show potential benefits of using ionized-gas environments in nanofabrication. © 2007 IEEE.

Late Pleistocene stratigraphy of IODP Site U1396 and compiled chronology offshore of south and south west Montserrat, Lesser Antilles

Marine sediments around volcanic islands contain an archive of volcaniclastic deposits, which can be used to reconstruct the volcanic history of an area. Such records hold many advantages over often incomplete terrestrial datasets. This includes the potential for precise and continuous dating of intervening sediment packages, which allow a correlatable and temporally-constrained stratigraphic framework to be constructed across multiple marine sediment cores. Here, we discuss a marine record of eruptive and mass-wasting events spanning ~250 ka offshore of Montserrat, using new data from IODP Expedition 340, as well as previously collected cores. By using a combination of high-resolution oxygen isotope stratigraphy, AMS radiocarbon dating, biostratigraphy of foraminifera and calcareous nannofossils and clast componentry, we identify five major events at Soufriere Hills volcano since 250 ka. Lateral correlation of these events across sediment cores collected offshore of the south and south west of Montserrat, have improved our understanding of the timing, extent and associations between events in this area. Correlations reveal that powerful and potentially erosive density-currents travelled at least 33 km offshore, and demonstrate that marine deposits, produced by eruption-fed and mass-wasting events on volcanic islands, are heterogeneous in their spatial distribution. Thus, multiple drilling/coring sites are needed to reconstruct the full chronostratigraphy of volcanic islands. This multidisciplinary study will be vital to interpreting the chaotic records of submarine landslides at other sites drilled during Expedition 340 and provides a framework that can be applied to the stratigraphic analysis of sediments surrounding other volcanic islands.

Electrochemistry

Electrochemistry is a truly multidisciplinary science which can be applied to a variety of fields within the physical, chemical and biological sciences. This topic chapter details a selection of areas including energy conversion and storage in particular fuel cells and Li ion batteries; electrosynthesis which covers both organic synthesis and the electrodeposition of homogeneous as well as nanostructured surfaces; corrosion; electroanalytical chemistry in the classic sense of analyte detection as well as probing mechanistic information regarding oxidation/reduction reactions of electroactive species at the nanoscale. Finally the applicability of electrochemistry to the biological sciences is briefly described.