Effectiveness of nurse-led preoperative assessment services for elective surgery : a systematic review

Background--The admission and assessment of patients for elective procedures is a task faced by all healthcare organisations that provide elective surgical services. Several different strategies have been used to facilitate the management of these tasks. Nurse-led preadmission clinics or services have been implemented in many health services as one of these management strategies; however their effectiveness has not been established. Objectives--The objective of this review was to examine the available research on the effectiveness of nurse-led elective surgery preoperative assessment clinics or services on patient outcomes.--Results--Of the 19 included articles, there were 10 audits of patient and hospital data, 3 surveys or questionnaires, 3 descriptive studies, 1 action research design, 1 prospective observational study and 1 RCT. Five of ten studies reporting data on cancellations rates found that nurse-led preadmission services reduced the number of day-of-surgery cancellations. Non-attendance for surgery was also reduced, with nine studies reporting decreases in the number of patients failing to attend. Eight studies reporting data on patient or parent satisfaction found high levels of satisfaction with nurse-led preadmission services. Three of four studies investigating the effect of the nurse-led preadmission service on patient anxiety found a reduction in reported anxiety levels. Three studies found that preoperative preparation was enhanced by the use of a nurse-led preadmission service.--Conclusions--While all included studies reported evidence of effectiveness for nurse-led preadmission services on a wide range of outcomes for elective surgery patients, the lack of experimental trials means that the level of evidence is low, and further research is needed.--Implications for practice--Nurse-led preadmission services may be an effective strategy for reducing procedural cancellations, failure to attend for procedures, and patient anxiety, however currently the evidence level is low.

Ontology-based image annotation

With regard to the long-standing problem of the semantic gap between low-level image features and high-level human knowledge, the image retrieval community has recently shifted its emphasis from low-level features analysis to high-level image semantics extrac- tion. User studies reveal that users tend to seek information using high-level semantics. Therefore, image semantics extraction is of great importance to content-based image retrieval because it allows the users to freely express what images they want. Semantic content annotation is the basis for semantic content retrieval. The aim of image anno- tation is to automatically obtain keywords that can be used to represent the content of images. The major research challenges in image semantic annotation are: what is the basic unit of semantic representation? how can the semantic unit be linked to high-level image knowledge? how can the contextual information be stored and utilized for image annotation? In this thesis, the Semantic Web technology (i.e. ontology) is introduced to the image semantic annotation problem. Semantic Web, the next generation web, aims at mak- ing the content of whatever type of media not only understandable to humans but also to machines. Due to the large amounts of multimedia data prevalent on the Web, re- searchers and industries are beginning to pay more attention to the Multimedia Semantic Web. The Semantic Web technology provides a new opportunity for multimedia-based applications, but the research in this area is still in its infancy. Whether ontology can be used to improve image annotation and how to best use ontology in semantic repre- sentation and extraction is still a worth-while investigation. This thesis deals with the problem of image semantic annotation using ontology and machine learning techniques in four phases as below. 1) Salient object extraction. A salient object servers as the basic unit in image semantic extraction as it captures the common visual property of the objects. Image segmen- tation is often used as the �rst step for detecting salient objects, but most segmenta- tion algorithms often fail to generate meaningful regions due to over-segmentation and under-segmentation. We develop a new salient object detection algorithm by combining multiple homogeneity criteria in a region merging framework. 2) Ontology construction. Since real-world objects tend to exist in a context within their environment, contextual information has been increasingly used for improving object recognition. In the ontology construction phase, visual-contextual ontologies are built from a large set of fully segmented and annotated images. The ontologies are composed of several types of concepts (i.e. mid-level and high-level concepts), and domain contextual knowledge. The visual-contextual ontologies stand as a user-friendly interface between low-level features and high-level concepts. 3) Image objects annotation. In this phase, each object is labelled with a mid-level concept in ontologies. First, a set of candidate labels are obtained by training Support Vectors Machines with features extracted from salient objects. After that, contextual knowledge contained in ontologies is used to obtain the �nal labels by removing the ambiguity concepts. 4) Scene semantic annotation. The scene semantic extraction phase is to get the scene type by using both mid-level concepts and domain contextual knowledge in ontologies. Domain contextual knowledge is used to create scene con�guration that describes which objects co-exist with which scene type more frequently. The scene con�guration is represented in a probabilistic graph model, and probabilistic inference is employed to calculate the scene type given an annotated image. To evaluate the proposed methods, a series of experiments have been conducted in a large set of fully annotated outdoor scene images. These include a subset of the Corel database, a subset of the LabelMe dataset, the evaluation dataset of localized semantics in images, the spatial context evaluation dataset, and the segmented and annotated IAPR TC-12 benchmark.

Assessment of the influence of cultural barriers to HDR supervision of non-English speaking background (NESD) students in engineering and information technology (IT) disciplines

The paper details the results of the first phase of an on-going research into the sociocultural factors that influence the supervision of higher degrees research (HDR) engineering students in the Faculty of Built Environment and Engineering (BEE) and Faculty of Science and Technology (FaST) at Queensland University of Technology. A quantitative analysis was performed on the results from an online survey that was administered to 179 engineering students. The study reveals that cultural barriers impact their progression and developing confidence in their research programs. We argue that in order to assist international and non-English speaking background (NESB) research students to triumph over such culturally embedded challenges in engineering research, it is important for supervisors to understand this cohort's unique pedagogical needs and develop intercultural sensitivity in their pedagogical practice in postgraduate research supervision. To facilitate this, the governing body (Office of Research) can play a vital role in not only creating the required support structures but also their uniform implementation across the board.

Talking the talk : oracy demands in first year university assessment tasks

With more constructivist approaches to learning in higher education and more value on teamwork skills, students’ oracy (speaking and listening) features more prominently in curriculum, pedagogy and assessment. The paper reports on a study of two first-year Australian university courses in disciplines with explicit industry orientations and high proportions of international students. Drawing on classroom observations and interviews with the lecturers, this paper investigates their pedagogical designs on oracy and the oracy demands of their assessment tasks. The study found that talk-based assessment tasks (a group project and a group oral presentation) featured in both courses but the two courses treated students’ oracy differently: as product or process. The contrast between the two assessment designs explicates issues around EAL student needs, authentic links to industry, the provenance of criteria used to assess performance, perceptions about the relevance of talk and the ‘hidden assessment’ of oracy.

Simulated cataract and low contrast stimuli impair cognitive performance in older adults : implications for neuropsychological assessment and everyday function

Objective: To investigate how age-related declines in vision (particularly contrast sensitivity), simulated using cataract-goggles and low-contrast stimuli, influence the accuracy and speed of cognitive test performance in older adults. An additional aim was to investigate whether declines in vision differentially affect secondary more than primary memory. Method: Using a fully within-subjects design, 50 older drivers aged 66-87 years completed two tests of cognitive performance - letter matching (perceptual speed) and symbol recall (short-term memory) - under different viewing conditions that degraded visual input (low-contrast stimuli, cataract-goggles, and low-contrast stimuli combined with cataract-goggles, compared with normal viewing). However, presentation time was also manipulated for letter matching. Visual function, as measured using standard charts, was taken into account in statistical analyses. Results: Accuracy and speed for cognitive tasks were significantly impaired when visual input was degraded. Furthermore, cognitive performance was positively associated with contrast sensitivity. Presentation time did not influence cognitive performance, and visual gradation did not differentially influence primary and secondary memory. Conclusion: Age-related declines in visual function can impact on the accuracy and speed of cognitive performance, and therefore the cognitive abilities of older adults may be underestimated in neuropsychological testing. It is thus critical that visual function be assessed prior to testing, and that stimuli be adapted to older adults' sensory capabilities (e.g., by maximising stimuli contrast).

Complete Nucleotide Sequence of Rice Tungro Spherical Virus Genome of a Highly Virulent Strain Vt6

The complete nucleotide sequence of rice tungro spherical virus (RTSV) strain Vt6, originally from Mindanao, the Philippines, with higher virulence to resistant rice cultivars, was determined and compared with the published sequence for the Philippine-type strain A (RTSV-A-Shen). It was reported that RTSV-A was not able to infect a rice resistant cultivar TKM 6 (10). RTSV-Vt6 and RTSV-A-Shen share 90% and 95% homology at nucleotide and amino-acid levels, respectively. The N-terminal leader sequence of RTSV-Vt6 contained a 39-amino acids-region (positions 65 to 103) which was totally different from that of RTSV-A-Shen; the difference resulted from frame shifting by nucleotide insertions and deletions. To confirm the amino-acid sequence differences of the leader polypeptide, the same region was cloned and sequenced using a newly obtained variant of RTSV-type 6, which had been collected in the field of IRRI, and seven field isolates from Mindanao, the Philippines. Since all the sequences of the target region are identical to that of the Vt6 leader polypeptide, the sequence difference in the leader region seems not to correlate with the virulence of Vt6.

Environmental health risk assessment of dioxin exposure through foods in a Dioxin hot spot—Bien Hoa City, Vietnam

This study used the Australian Environmental Health Risk Assessment Framework to assess the human health risk of dioxin exposure through foods for local residents in two wards of Bien Hoa City, Vietnam. These wards are known hot-spots for dioxin and a range of stakeholders from central government to local levels were involved in this process. Publications on dioxin characteristics and toxicity were reviewed and dioxin concentrations in local soil, mud, foods, milk and blood samples were used as data for this risk assessment. A food frequency survey of 400 randomly selected households in these wards was conducted to provide data for exposure assessment. Results showed that local residents who had consumed locally cultivated foods, especially fresh water fish and bottom-feeding fish, free-ranging chicken, duck, and beef were at a very high risk, with their daily dioxin intake far exceeding the tolerable daily intake recommended by the WHO. Based on the results of this assessment, a multifaceted risk management program was developed and has been recognized as the first public health program ever to have been implemented in Vietnam to reduce the risks of dioxin exposure at dioxin hot-spots.

Sustainability and mandatory disclosure in Queensland : an assessment of the impact on home buyer patterns

Sustainability Declarations were introduced by the Queensland State Government on 1 January 2010 as a compulsory measure for all dwelling sales. The purpose of this policy decision was to improve the relevance of sustainability in the home ownership decision making process. This paper assesses the initial impact of this initiative over its first year in operation. In partnership with the Real Estate Institute of Queensland, real estate agents and salespeople in Queensland were surveyed to determine what impact the Sustainability Declaration has had on home buyer decision making. The level of compliance by the real estate industry was also reviewed. These preliminary findings indicate a high level of compliance from the real estate industry, however results confirm that sustainability is yet to become a criterion of relevance to the majority of home buyers in Queensland. The Sustainability Declarations are a first step in raising awareness in home owners of the importance of sustainability in housing. Further monitoring of this impact will be carried out over time.

A virtual test assessment tool for second year signal processing students

The development and use of a virtual assessment tool for a signal processing unit is described. It allows students to take a test from anywhere using a web browser to connect to the university server that hosts the test. While student responses are of the multiple choice type, they have to work out problems to arrive at the answer to be entered. CGI programming is used to verify student identification information and record their scores as well as provide immediate feedback after the test is complete. The tool has been used at QUT for the past 3 years and student feedback is discussed. The virtual assessment tool is an efficient alternative to marking written assignment reports that can often take more hours than actual lecture hall contact from a lecturer or tutor. It is especially attractive for very large classes that are now the norm at many universities in the first two years.

Networked robotic sensor platform deployments for use in coastal environmental assessment in southern California

Mobile sensor platforms such as Autonomous Underwater Vehicles (AUVs) and robotic surface vessels, combined with static moored sensors compose a diverse sensor network that is able to provide macroscopic environmental analysis tool for ocean researchers. Working as a cohesive networked unit, the static buoys are always online, and provide insight as to the time and locations where a federated, mobile robot team should be deployed to effectively perform large scale spatiotemporal sampling on demand. Such a system can provide pertinent in situ measurements to marine biologists whom can then advise policy makers on critical environmental issues. This poster presents recent field deployment activity of AUVs demonstrating the effectiveness of our embedded communication network infrastructure throughout southern California coastal waters. We also report on progress towards real-time, web-streaming data from the multiple sampling locations and mobile sensor platforms. Static monitoring sites included in this presentation detail the network nodes positioned at Redondo Beach and Marina Del Ray. One of the deployed mobile sensors highlighted here are autonomous Slocum gliders. These nodes operate in the open ocean for periods as long as one month. The gliders are connected to the network via a Freewave radio modem network composed of multiple coastal base-stations. This increases the efficiency of deployment missions by reducing operational expenses via reduced reliability on satellite phones for communication, as well as increasing the rate and amount of data that can be transferred. Another mobile sensor platform presented in this study are the autonomous robotic boats. These platforms are utilized for harbor and littoral zone studies, and are capable of performing multi-robot coordination while observing known communication constraints. All of these pieces fit together to present an overview of ongoing collaborative work to develop an autonomous, region-wide, coastal environmental observation and monitoring sensor network.

Assessment of commercial network RTK user positioning performance over long inter-station distances

The paper provides an assessment of the performance of commercial Real Time Kinematic (RTK) systems over longer than recommended inter-station distances. The experiments were set up to test and analyse solutions from the i-MAX, MAX and VRS systems being operated with three triangle shaped network cells, each having an average inter-station distance of 69km, 118km and 166km. The performance characteristics appraised included initialization success rate, initialization time, RTK position accuracy and availability, ambiguity resolution risk and RTK integrity risk in order to provide a wider perspective of the performance of the testing systems. ----- ----- The results showed that the performances of all network RTK solutions assessed were affected by the increase in the inter-station distances to similar degrees. The MAX solution achieved the highest initialization success rate of 96.6% on average, albeit with a longer initialisation time. Two VRS approaches achieved lower initialization success rate of 80% over the large triangle. In terms of RTK positioning accuracy after successful initialisation, the results indicated a good agreement between the actual error growth in both horizontal and vertical components and the accuracy specified in the RMS and part per million (ppm) values by the manufacturers. ----- ----- Additionally, the VRS approaches performed better than the MAX and i-MAX when being tested under the standard triangle network with a mean inter-station distance of 69km. However as the inter-station distance increases, the network RTK software may fail to generate VRS correction and then may turn to operate in the nearest single-base RTK (or RAW) mode. The position uncertainty reached beyond 2 meters occasionally, showing that the RTK rover software was using an incorrect ambiguity fixed solution to estimate the rover position rather than automatically dropping back to using an ambiguity float solution. Results identified that the risk of incorrectly resolving ambiguities reached 18%, 20%, 13% and 25% for i-MAX, MAX, Leica VRS and Trimble VRS respectively when operating over the large triangle network. Additionally, the Coordinate Quality indicator values given by the Leica GX1230 GG rover receiver tended to be over-optimistic and not functioning well with the identification of incorrectly fixed integer ambiguity solutions. In summary, this independent assessment has identified some problems and failures that can occur in all of the systems tested, especially when being pushed beyond the recommended limits. While such failures are expected, they can offer useful insights into where users should be wary and how manufacturers might improve their products. The results also demonstrate that integrity monitoring of RTK solutions is indeed necessary for precision applications, thus deserving serious attention from researchers and system providers.

Molecular evolutionary dynamics of Ross River virus and implications for vaccine efficacy

Ross River virus (RRV) is a mosquito-borne member of the genus Alphavirus that causes epidemic polyarthritis in humans, costing the Australian health system at least US$10 million annually. Recent progress in RRV vaccine development requires accurate assessment of RRV genetic diversity and evolution, particularly as they may affect the utility of future vaccination. In this study, we provide novel RRV genome sequences and investigate the evolutionary dynamics of RRV from time-structured E2 gene datasets. Our analysis indicates that, although RRV evolves at a similar rate to other alphaviruses (mean evolutionary rate of approx. 8x10(-4) nucleotide substitutions per site year(-1)), the relative genetic diversity of RRV has been continuously low through time, possibly as a result of purifying selection imposed by replication in a wide range of natural host and vector species. Together, these findings suggest that vaccination against RRV is unlikely to result in the rapid antigenic evolution that could compromise the future efficacy of current RRV vaccines.

Cytochrome p450 isozyme protein verified in the skin of southern hemisphere humpback whales (megaptera novaeangliae) : implications for biochemical biomarker assessment

Large mysticete whales represent a unique challenge for chemical risk assessment. Few epidemiological investigations are possible due to the low incidence of adult stranding events. Similarly their often extreme life-history adaptations of prolonged migration and fasting challenge exposure assumptions. Molecular biomarkers offer the potential to complement information yielded through tissue chemical analysis, as well as providing evidence of a molecular response to chemical exposure. In this study we confirm the presence of cytochrome P450 reductase (CPR) and cytochrome P450 isoenzyme 1A1 (CYP1A1) in epidermal tissue of southern hemisphere humpback whales (Megaptera novaeangliae). The detection of CYP1A1 in the integument of the humpback whale affords the opportunity for further quantitative non-destructive investigations of enzyme activity as a function of chemical stress.

Incorporating parameter uncertainty into quantitative microbial risk assessment (QMRA)

Modern statistical models and computational methods can now incorporate uncertainty of the parameters used in Quantitative Microbial Risk Assessments (QMRA). Many QMRAs use Monte Carlo methods, but work from fixed estimates for means, variances and other parameters. We illustrate the ease of estimating all parameters contemporaneously with the risk assessment, incorporating all the parameter uncertainty arising from the experiments from which these parameters are estimated. A Bayesian approach is adopted, using Markov Chain Monte Carlo Gibbs sampling (MCMC) via the freely available software, WinBUGS. The method and its ease of implementation are illustrated by a case study that involves incorporating three disparate datasets into an MCMC framework. The probabilities of infection when the uncertainty associated with parameter estimation is incorporated into a QMRA are shown to be considerably more variable over various dose ranges than the analogous probabilities obtained when constants from the literature are simply ‘plugged’ in as is done in most QMRAs. Neglecting these sources of uncertainty may lead to erroneous decisions for public health and risk management.

ATM mediated phosphorylation of CHD4 contributes to genome maintenance

Background: In order to maintain cellular viability and genetic integrity cells must respond quickly following the induction of cytotoxic double strand DNA breaks (DSB). This response requires a number of processes including stabilisation of the DSB, signalling of the break and repair. It is becoming increasingly apparent that one key step in this process is chromatin remodelling. Results: Here we describe the chromodomain helicase DNA-binding protein (CHD4) as a target of ATM kinase. We show that ionising radiation (IR)-induced phosphorylation of CHD4 affects its intranuclear organization resulting in increased chromatin binding/retention. We also show assembly of phosphorylated CHD4 foci at sites of DNA damage, which might be required to fulfil its function in the regulation of DNA repair. Consistent with this, cells overexpressing a phospho-mutant version of CHD4 that cannot be phosphorylated by ATM fail to show enhanced chromatin retention after DSBs and display high rates of spontaneous damage. Conclusion: These results provide insight into how CHD4 phosphorylation might be required to remodel chromatin around DNA breaks allowing efficient DNA repair to occur.