Investigation of fiducial marker and soft-tissue image guidance techniques in prostate radiation therapy

This thesis examines and compares imaging methods used during the radiotherapy treatment of prostate cancer. The studies found that radiation therapists were able to localise and target the prostate consistently with planar imaging techniques and that the use of small gold markers in the prostate reduced the variation in prostate localisation when using volumetric imaging. It was concluded that larger safety margins are required when using volumetric imaging without gold markers.

An external field prior for the hidden Potts model with application to cone-beam computed tomography

In images with low contrast-to-noise ratio (CNR), the information gain from the observed pixel values can be insufficient to distinguish foreground objects. A Bayesian approach to this problem is to incorporate prior information about the objects into a statistical model. A method for representing spatial prior information as an external field in a hidden Potts model is introduced. This prior distribution over the latent pixel labels is a mixture of Gaussian fields, centred on the positions of the objects at a previous point in time. It is particularly applicable in longitudinal imaging studies, where the manual segmentation of one image can be used as a prior for automatic segmentation of subsequent images. The method is demonstrated by application to cone-beam computed tomography (CT), an imaging modality that exhibits distortions in pixel values due to X-ray scatter. The external field prior results in a substantial improvement in segmentation accuracy, reducing the mean pixel misclassification rate for an electron density phantom from 87% to 6%. The method is also applied to radiotherapy patient data, demonstrating how to derive the external field prior in a clinical context.

Herds of methane chambers grazing bubbles

Water to air methane emissions from freshwater reservoirs can be dominated by sediment bubbling (ebullitive) events. Previous work to quantify methane bubbling from a number of Australian sub-tropical reservoirs has shown that this can contribute as much as 95% of total emissions. These bubbling events are controlled by a variety of different factors including water depth, surface and internal waves, wind seiching, atmospheric pressure changes and water levels changes. Key to quantifying the magnitude of this emission pathway is estimating both the bubbling rate as well as the areal extent of bubbling. Both bubbling rate and areal extent are seldom constant and require persistent monitoring over extended time periods before true estimates can be generated. In this paper we present a novel system for persistent monitoring of both bubbling rate and areal extent using multiple robotic surface chambers and adaptive sampling (grazing) algorithms to automate the quantification process. Individual chambers are self-propelled and guided and communicate between each other without the need for supervised control. They can maintain station at a sampling site for a desired incubation period and continuously monitor, record and report fluxes during the incubation. To exploit the methane sensor detection capabilities, the chamber can be automatically lowered to decrease the head-space and increase concentration. The grazing algorithms assign a hierarchical order to chambers within a preselected zone. Chambers then converge on the individual recording the highest 15 minute bubbling rate. Individuals maintain a specified distance apart from each other during each sampling period before all individuals are then required to move to different locations based on a sampling algorithm (systematic or adaptive) exploiting prior measurements. This system has been field tested on a large-scale subtropical reservoir, Little Nerang Dam, and over monthly timescales. Using this technique, localised bubbling zones on the water storage were found to produce over 50,000 mg m-2 d-1 and the areal extent ranged from 1.8 to 7% of the total reservoir area. The drivers behind these changes as well as lessons learnt from the system implementation are presented. This system exploits relatively cheap materials, sensing and computing and can be applied to a wide variety of aquatic and terrestrial systems.

Using a theory of planned behaviour framework to explore hand hygiene beliefs at the ‘5 critical moments’ among Australian hospital-based nurses

Background Improving hand hygiene among health care workers (HCWs) is the single most effective intervention to reduce health care associated infections in hospitals. Understanding the cognitive determinants of hand hygiene decisions for HCWs with the greatest patient contact (nurses) is essential to improve compliance. The aim of this study was to explore hospital-based nurses’ beliefs associated with performing hand hygiene guided by the World Health Organization’s (WHO) 5 critical moments. Using the belief-base framework of the Theory of Planned Behaviour, we examined attitudinal, normative, and control beliefs underpinning nurses’ decisions to perform hand hygiene according to the recently implemented national guidelines. Methods Thematic content analysis of qualitative data from focus group discussions with hospital-based registered nurses from 5 wards across 3 hospitals in Queensland, Australia. Results Important advantages (protection of patient and self), disadvantages (time, hand damage), referents (supportive: patients, colleagues; unsupportive: some doctors), barriers (being too busy, emergency situations), and facilitators (accessibility of sinks/products, training, reminders) were identified. There was some equivocation regarding the relative importance of hand washing following contact with patient surroundings. Conclusions The belief base of the theory of planned behaviour provided a useful framework to explore systematically the underlying beliefs of nurses’ hand hygiene decisions according to the 5 critical moments, allowing comparisons with previous belief studies. A commitment to improve nurses’ hand hygiene practice across the 5 moments should focus on individual strategies to combat distraction from other duties, peer-based initiatives to foster a sense of shared responsibility, and management-driven solutions to tackle staffing and resource issues. Hand hygiene following touching a patient’s surroundings continues to be reported as the most neglected opportunity for compliance.

Interpretation of morphological data to inform design Bridge to Bridge: Ridge to Ridge urban design workshop

The importance of design practice informed by urban morphology has led to intensification in interest, signalled by the formation of the ISUF Research and Practice Task Force and voiced through several recent academic publications cognisant of this current debate, this paper reports on a recent urban design workshop at which morphology was set as one of the key themes. Initially planned to be programmed as a augmented concurrent event to the 2013 20th ISUF conference held in Brisbane, the two day Bridge to Bridge: Ridge to Ridge urban design workshop nevertheless took place the following month, and involved over one hundred design professionals and academics. The workshop sought to develop several key urban design principles and recommendations addressing a major government development proposal sited in the most important heritage precinct of the city. The paper will focus specifically on one of the nine groups, in which the design proposal was purposefully guided by morphological input. The discussion will examine the design outcomes and illicit review and feedback from participants, shedding critical light on the issues that arise from such a design approach.

A randomized controlled trial of a program to reduce adolescent road-related medically-treated injuries

Background Injury is the leading cause of adolescent death and injury around the road is a common source of adolescent injuries. Skills for Preventing Injury in Youth (SPIY) is a comprehensive program developed in Australia for early adolescents (term-long curriculum, including looking out for friends, first-aid training coupled with teacher school-connectedness professional development). Jessors’ Protection-Risk Framework guided the program approach focusing on building protective relationships. Method A randomized controlled trial with 35 schools was undertaken. Students completed surveys at baseline, six-months post-intervention and twelve-months post intervention. There were 1686 students (56% female) who completed the twelve-month survey, including the Extended-Adolescent Injury Checklist whereby students self-report on medically-treated injuries over the previous three-months (only road-related items are reported in this study; cycling, motorcycle riding, pedestrian, and riding as a passenger). Randomly selected SPIY classes also participated in focus groups and reported on perceptions of SPIY and injury risk behavior. Results As a check of randomization baseline differences of the variables were examined, with no significant differences between intervention and control groups. At the 12-month follow-up, there were fewer medically-treated injuries among the intervention students compared with the control group, particularly associated with being a passenger. The process evaluation revealed students perceived change in injury risk and risk behaviors. Conclusions While data analyses are continuing, the results indicate that the program seeking to encourage adolescents to look out for their friends, build connections to school and provide first aid skills training goes some way to reducing self-reported medically-treated injuries around the road.

Optimal electricity distribution framework for public space: Assessing renewable energy proposals for Freshkills Park, New York City

Integrating renewable energy into public space is becoming more common as a climate change solution. However, this approach is often guided by the environmental pillar of sustainability, with less focus on the economic and social pillars. The purpose of this paper is to examine this issue in the speculative renewable energy propositions for Freshkills Park in New York City submitted for the 2012 Land Art Generator Initiative (LAGI) competition. This paper first proposes an optimal electricity distribution (OED) framework in and around public spaces based on relevant ecology and energy theory (Odum’s fourth and fifth law of thermodynamics). This framework addresses social engagement related to public interaction, and economic engagement related to the estimated quantity of electricity produced, in conjunction with environmental engagement related to the embodied energy required to construct the renewable energy infrastructure. Next, the study uses the OED framework to analyse the top twenty-five projects submitted for the LAGI 2012 competition. The findings reveal an electricity distribution imbalance and suggest a lack of in-depth understanding about sustainable electricity distribution within public space design. The paper concludes with suggestions for future research.

7-point Subjective Global Assessment is more time sensitive than conventional Subjective Global Assessment in detecting nutrition changes

Background: It is important for nutrition intervention in malnourished patients to be guided by accurate evaluation and detection of small changes in the patient’s nutrition status over time. However, the current Subjective Global Assessment (SGA) is not able to detect changes in a short period of time. The aim of the study was to determine whether 7-point SGA is more time sensitive to nutrition changes than the conventional SGA. Methods: In this prospective study, 67 adult inpatients assessed as malnourished using both the 7-point SGA and conventional SGA were recruited. Each patient received nutrition intervention and was followed up post-discharge. Patients were reassessed using both tools at 1, 3 and 5 months from baseline assessment. Results: It took significantly shorter time to see a one-point change using 7-point SGA compared to conventional SGA (median: 1 month vs. 3 months, p = 0.002). The likelihood of at least a one-point change is 6.74 times greater in 7-point SGA compared to conventional SGA after controlling for age, gender and medical specialties (odds ratio = 6.74, 95% CI 2.88-15.80, p<0.001). Fifty-six percent of patients who had no change in SGA score had changes detected using 7-point SGA. The level of agreement was 100% (k = 1, p < 0.001) between 7-point SGA and 3-point SGA and 83% (k=0.726, p<0.001) between two blinded assessors for 7-point SGA. Conclusion: The 7-point SGA is more time sensitive in its response to nutrition changes than conventional SGA. It can be used to guide nutrition intervention for patients.

An ePortfolio Approach: Supporting Critical Reflection for Pedagogic Innovation

This chapter investigates the capacity of a well-supported holistic ePortfolio program, the QUT Student ePortfolio Program (QSeP), to support critical reflection for pedagogic innovation in higher education, by exploring practice examples. The chapter looks across faculty and discipline areas to illustrate a range of ePortfolio learning case studies, which have led pedagogical innovation across a whole institution, to enhance student learning and support academic teaching. The ePortfolio strategies discussed support innovation in learning and teaching where academics use the ePortfolio approach in different ways to develop connectedness (productive pedagogies) within learning. Students are supported to develop awareness of the connections between formal and informal learning opportunities and between their learning and personal and professional goals. Students are guided to understand what they have learned and how they have learned in terms of generic employability skills or graduate attributes and also in relation to professional standards and competencies and personal goals. In essence, the ePortfolio-supported pedagogy creates capstone events enabling students to develop a professional identity and understanding of ongoing professional development. The examples are drawn from distinct discipline areas and illustrate the capacity of ePortfolio to underpin pedagogic innovation across discipline areas: • Bachelor of Information Technology—the ePortfolio approach supports students to explore the IT industry as a means of clarifying personal expectations and goals, thereby enhancing student potential in the course c• Bachelor of Nursing and Master of Nursing Science—students develop a professional ePortfolio to show development of the nursing competencies • Master of Information Technology—Library and Information students compile a Professional Portfolio for assessment in the Professional Practice subject • Bachelor of Laws—Virtual Law Placement (VLP) is a unit of study that challenges students to critically reflect on their performance and development duringthe work placement Each case study illustrates the academic teaching goal and student ePortfolio task in context. Issues, challenges and support strategies are identified. Comments from the students and their lecturers give an indication of the effectiveness of the ePortfolio approach to meet learning and teaching goals.

Heathcote’s practice-led teaching: Pioneering research as well as pioneering pedagogy

It is widely recognized that Dorothy Heathcote was a dynamic and radical teacher who transformed and continually reinvented drama teaching. She did this by allowing her emerging thinking and understandings to flow from, and be tested by, regular and intensive ‘practicing’ in the classroom. In this way theoretical claims were grounded and evidenced in authentic classroom practice. And yet, for all her impact, it is rare to hear the claim that Heathcote’s pedagogic breakthroughs resulted from a legitimate research methodology. Clever and charismatic teaching yes; research no. One of the world’s best teachers certainly, but not a researcher; even though every lesson was experimental and every classroom was a site for discovery. This paper investigates that conundrum firstly by acknowledging that Heathcote’s practice-led teaching approach to discovery did not map comfortably on to the established educational research traditions of the day. It argues that traditional research methodologies, with their well-established protocols and methods, could not understand or embrace a research process which does its work by creating ‘fictional realities’ of openness, allegory and uncertainty. In recent years however it can be seen that Heathcote’s practice led-teaching, so essential for advancing the field, closely aligns with what many contemporary researchers are now calling practice-led research or practice as research or, in many Nordic countries, artistic research. A form of performative research, practice-led research has not emerged from the field of education but rather from the creative arts. Seeking to develop ways of researching creative practice which is deeply sympathetic and respectful of that practice, artist-researchers have developed practice-led research “which is initiated in practice, where questions, problems, challenges are identified and formed by the needs of practice and practitioners” (Grey, 1996). This sits comfortably with Heathcote’s classroom priority of “discovering by trial, error and testing; using available materials with respect for their nature, and being guided by this appreciation of their potential” (Heathcote, 1967). The paper will conclude by testing the dynamics of Heathcote’s practice-led teaching against the six conditions of practice-led research (Haseman&Mafe, 2011), a testing which will allow for a re-interpretation and re-housing of Dorothy Heathcote’s classroom-based teaching methodology as a form of performative research in its own right.

Walking and talking with living texts: Breathing life against static standardisation

Current educational reform, policy and public discourse emphasise standardisation of testing, curricula and professional practice, yet the landscape of literacy practices today is fluid, interactive, multimodal, ever-changing, adaptive and collaborative. How then can English and literacy educators negotiate these conflicting terrains? The nature of today’s literacy practices is reflected in a concept of living texts which refers to experienced events and encounters that offer meaning-making that is fluid, interactive and changing. Literacy learning possibilities with living texts are described and discussed by the authors who independently investigated the place of living texts across two distinctly different learning contexts: a young people’s community arts project and a co-taught multiliteracies project in a high school. In the community arts project, young people created living texts as guided walks of urban spaces that adapt and change to varying audiences. In the multiliteracies project, two parents and a teacher created interactive spaces through co-teaching and cogenerative dialoguing. These spaces generate living texts that yield a purposefully connected curriculum rich in community-relevant and culturally significant texts. These two studies are shared with a view of bringing living texts into literacy education to loosen rigidity in standardisation.

Bayesian computational methods for spatial analysis of images

This thesis introduces a new way of using prior information in a spatial model and develops scalable algorithms for fitting this model to large imaging datasets. These methods are employed for image-guided radiation therapy and satellite based classification of land use and water quality. This study has utilized a pre-computation step to achieve a hundredfold improvement in the elapsed runtime for model fitting. This makes it much more feasible to apply these models to real-world problems, and enables full Bayesian inference for images with a million or more pixels.

Practices to enhance peer program implementation integrity to safeguard peer leaders and learners

The powerful influence of peers on fellow students’ learning engagement and their ability to foster self-efficacy is well recognised. A positive learner mindset can be fostered through establishment of guided meaningful relationships formed between peers. Recognising the value of peer connections in shaping the student learning experience, peer programs have been widely adopted by universities as a mechanism to facilitate these connections. While potentially beneficial, a lack of knowledge and inexperience by program implementers can lead to program outcomes being compromised. To mitigate this risk, QUT has established university wide systems and benchmarks for enacting peer programs. These measures aim to promote program implementation integrity by supporting and developing the knowledge and capabilities of peer leaders and program coordinators. This paper describes a range of measures that have been instigated to optimise the quality of programs and ensure outcomes are mutually constructive and beneficial for all stakeholders.

Randomized clinical trial of the timing it right stroke family support program: Research protocol

Background Family caregivers provide invaluable support to stroke survivors during their recovery, rehabilitation, and community re-integration. Unfortunately, it is not standard clinical practice to prepare and support caregivers in this role and, as a result, many experience stress and poor health that can compromise stroke survivor recovery and threaten the sustainability of keeping the stroke survivor at home. We developed the Timing it Right Stroke Family Support Program (TIRSFSP) to guide the timing of delivering specific types of education and support to meet caregivers' evolving needs. The objective of this multi-site randomized controlled trial is to determine if delivering the TIRSFSP across the stroke care continuum improves caregivers' sense of being supported and emotional well-being. Methods/design Our multi-site single-blinded randomized controlled trial will recruit 300 family caregivers of stroke survivors from urban and rural acute care hospitals. After completing a baseline assessment, participants will be randomly allocated to one of three groups: 1) TIRSFSP guided by a stroke support person (health care professional with stroke care experience), delivered in-person during acute care and by telephone for approximately the first six to 12 months post-stroke; 2) caregiver self-directed TIRSFSP with an initial introduction to the program by a stroke support person, or; 3) standard care receiving the educational resource "Let's Talk about Stroke" prepared by the Heart and Stroke Foundation. Participants will complete three follow-up quantitative assessments 3, 6, and 12-months post-stroke. These include assessments of depression, social support, psychological well-being, stroke knowledge, mastery (sense of control over life), caregiving assistance provided, caregiving impact on everyday life, and indicators of stroke severity and disability. Qualitative methods will also be used to obtain information about caregivers' experiences with the education and support received and the impact on caregivers' perception of being supported and emotional well-being. Discussion This research will determine if the TIRSFSP benefits family caregivers by improving their perception of being supported and emotional well-being. If proven effective, it could be recommended as a model of stroke family education and support that meets the Canadian Stroke Best Practice Guideline recommendation for providing timely education and support to families through transitions.

Knowledge, identity, and dilemmas of the self in physical education teacher education

This study draws on an eclectic range of influences. The early research was guided by the traditions of Personal Construct Theory. The study was later extended by drawing on theoretical tenets of social constructionism and the notion of the Saturated Self and Anthony Gidden's work on structuration and his later work on self identity. This has provided a new way of investigating how becoming a PE teacher through constructed knowledge established a professional identity. The data suggest that during the process of constructing professional knowledge, the students forge their identities by establishing 'position' and 'role'. In doing so, the participants in this study experienced a series of dilemmas of professional self. These dilemmas are a product of what Giddens calls high modernity and what Gergen refers to as postmodernity. It seems that to become a PE teacher, the dilemmas must be worked through until a position of ontological security has been achieved. For some this was profoundly difficult. In spite of this, the methods of study allowed the participants to begin to articulate their theories and visions of teaching physical education, and the therapeutic qualities of Kelly's theory encouraged many of the students to 'see it differently' (Rossi, 1997) and to begin to develop a rationale for professional work in physical education based on socially just practices.