Health outcomes of adults 3 months after injury

Background: Injury is a leading cause of preventable mortality and morbidity in Australia and the world. Despite this there is little research examining the health related quality of life of adults following general trauma. Methods: A prospective cohort design was used to study adults who presented to hospital following injury. Data regarding injury and demographic details was collected through the routine operation of the Queensland Trauma Registry (QTR). In addition, the short form 36 (SF-36) was mailed to patients approximately 3 months following injury. Results: Participants included 339 injured patients who were hospitalised for ≥24 h in March-June 2003. A secondary group of 145 patients completed the SF-36, but did not have QTR data collected due to hospitalisation being <24 h. Both groups of participants reported significantly lower scores on all subscales of the SF-36 when compared to Australian norms. Conclusions: Health related quality of life of injured survivors is markedly reduced 3 months after injury. Ongoing treatment and support is necessary to improve these health outcomes.

Prognosis of bearing failure based on health state estimation

This paper proposes a new prognosis model based on the technique for health state estimation of machines for accurate assessment of the remnant life. For the evaluation of health stages of machines, the Support Vector Machine (SVM) classifier was employed to obtain the probability of each health state. Two case studies involving bearing failures were used to validate the proposed model. Simulated bearing failure data and experimental data from an accelerated bearing test rig were used to train and test the model. The result obtained is very encouraging and shows that the proposed prognostic model produces promising results and has the potential to be used as an estimation tool for machine remnant life prediction.

The role of periosteum : a neglected aspect of osteoporosis

Most current studies on the pathogenesis of osteoporosis emphasize the bone metabolic activities occurring on endosteal surfaces, whereas the periosteal aspect is somewhat neglected. In terms of bone physiology, periosteum plays a determining role in de novo cortical bone formation and cortical bone expansion through periosteum is the most efficient way of increasing bone strength against fractures. Despite the important role of periosteum in the pathogenesis and treatment of osteoporosis, little is known about the structural and cellular features of periosteum in osteoporosis. This chapter will focus on the major changes occurring in the periosteum of osteoporosis and possible implications of these changes in the pathogenesis of osteoporosis. The changes identified in the periosteum of osteoporosis are mainly located in the metaphyseal compartment, which include: (a) much thicker and more cellular cambial layer; (b) increased number of TRAP (tartrate resistant acid phosphatase), VEGF (vascular endothelial growth factor) cells and the degree of vascularization; and (c) enhanced expression of sympathetic nerve fibers. The structural and cellular changes of osteoporotic periosteum indicate that periosteum plays an important role in the cortical bone resorption in metaphyseal areas and this pathological process may be regulated by the sympathetic nervous system.

Knowing a donor and identifying as one : determinants of people's willingness for related and anonymous living donation in Australia

While LRD (living donation to a genetically/emotionally related recipient) is well established in Australia, LAD (living anonymous donation to a stranger) is rare. Given the increasing use of LAD overseas, Australia may likely follow suit. Understanding the determinants of people’s willingness for LAD is essential but infrequently studied in Australia. Consequently, we compared the determinants of people’s LRD and LAD willingness, and assessed whether these determinants differed according to type of living donation. We surveyed 487 health students about their LRD and LAD willingness, attitudes, identity, prior experience with blood and organ donation, deceased donation preference, and demographics. We used Structural Equation Modelling (SEM) to identify the determinants of willingness for LRD and LAD and paired sample t-tests to examine differences in LRD and LAD attitudes, identity, and willingness. Mean differences in willingness (LRD 5.93, LAD 3.92), attitudes (LRD 6.43, LAD 5.53), and identity (LRD 5.69, LAD 3.58) were statistically significant. Revised SEM models provided a good fit to the data (LRD: x2 (41) = 67.67, p = 0.005, CFI = 0.96, RMSEA = 0.04; LAD: x2 (40) = 79.64, p < 0.001, CFI = 0.95, RMSEA = 0.05) and explained 45% and 54% of the variation in LRD and LAD willingness, respectively. Four common determinants of LRD and LAD willingness emerged: identity, attitude, past blood donation, and knowing a deceased donor. Religious affiliation and deceased donation preference predicted LAD willingness also. Identifying similarities and differences in these determinants can inform future efforts aimed at understanding people’s LRD and LAD willingness and the evaluation of potential living donor motives. Notably, this study highlights the importance of people’s identification as a living donor as a motive underlying their willingness to donate their organs while living.

Determining heavy vehicle suspension health from vibratory wheel loads

A low-cost test bed was made from a modified heavy vehicle (HV) brake tester. By rotating a test HV’s wheel on an eccentric roller, a known vibration was imparted to the wheel under test. A control case for dampers in good condition was compared with two test cases of ineffective shock absorbers. Measurement of the forces at the bearings of the roller provided an indication of the HV wheel-forces. Where the level of serviceability of the shock absorbers varied, differences in wheel load provided a quality indicator corresponding to a change of damper characteristic. Conclusions regarding the levels of damper maintenance beyond which HV suspensions cause road damage and dynamic wheel forces at the threshold of tyre wear at which HV shock absorbers are normally replaced are presented.

Privacy and security in open and trusted health information systems

The Open and Trusted Health Information Systems (OTHIS) Research Group has formed in response to the health sector’s privacy and security requirements for contemporary Health Information Systems (HIS). Due to recent research developments in trusted computing concepts, it is now both timely and desirable to move electronic HIS towards privacy-aware and security-aware applications. We introduce the OTHIS architecture in this paper. This scheme proposes a feasible and sustainable solution to meeting real-world application security demands using commercial off-the-shelf systems and commodity hardware and software products.

Open and trusted information systems/health informatics access control (OTHIS/HIAC)

Information and Communications Technologies globally are moving towards Service Oriented Architectures and Web Services. The healthcare environment is rapidly moving to the use of Service Oriented Architecture/Web Services systems interconnected via this global open Internet. Such moves present major challenges where these structures are not based on highly trusted operating systems. This paper argues the need of a radical re-think of access control in the contemporary healthcare environment in light of modern information system structures, legislative and regulatory requirements, and security operation demands in Health Information Systems. This paper proposes the Open and Trusted Health Information Systems (OTHIS), a viable solution including override capability to the provision of appropriate levels of secure access control for the protection of sensitive health data.

Living walls - a way to green the built environment

Actions Towards Sustainable Outcomes Environmental Issues/Principal Impacts The increasing urbanisation of cities brings with it several detrimental consequences, such as: • Significant energy use for heating and cooling many more buildings has led to urban heat islands and increased greenhouse gas emissions. • Increased amount of hard surfaces, which not only contributes to higher temperatures in cities, but also to increased stormwater runoff. • Degraded air quality and noise. • Health and general well-being of people is frequently compromised, by inadequate indoor air quality. • Reduced urban biodiversity. Basic Strategies In many design situations, boundaries and constraints limit the application of cutting EDGe actions. In these circumstances, designers should at least consider the following: • Living walls are an emerging technology, and many Australian examples function more as internal feature walls. However,as understanding of the benefits and construction of living walls develops this technology could be part of an exterior facade that enhances a building’s thermal performance. • Living walls should be designed to function with an irrigation system using non-potable water. Cutting EDGe Strategies • Living walls can be part of a design strategy that effectively improves the thermal performance of a building, thereby contributing to lower energy use and greenhouse gas emissions. • Including living walls in the initial stages of design would provide greater flexibility to the design, especially of the facade, structural supports, mechanical ventilation and watering systems, thus lowering costs. • Designing a building with an early understanding of living walls can greatly reduce maintenance costs. • Including plant species and planting media that would be able to remove air impurities could contribute to improved indoor air quality, workplace productivity and well-being. Synergies and References • Living walls are a key research topic at the Centre for Subtropical Design, Queensland University of Technology: http://www.subtropicaldesign.bee.qut.edu.au • BEDP Environment Design Guide: DES 53: Roof and Facade Gardens • BEDP Environment Design Guide: GEN 4: Positive Development – Designing for Net Positive Impacts (see green scaffolding and green space frame walls). • Green Roofs Australia: www.greenroofs.wordpress.com • Green Roofs for Healthy Cities USA: www.greenroofs.org

Getting creative in health care

Health care accounts for a substantial and growing share of national expenditures, and Australia’s health-care system faces some unprecedented pressures. This paper examines the contribution of creative expertise and services to Australian health care. They are found to be making a range of contributions to the development and delivery of health-care goods and services, the initial training and ongoing professionalism of doctors and nurses, and the effective functioning of health-care buildings. Creative activities within health-care services are also undertaken by medical professionals and patients. Key functions that creative activities address are innovation and service delivery in information management and analysis, and making complex information comprehensible or more useful, assisting communication and reducing psycho-social and distance-mediated barriers, and improving the efficiency and effectiveness of services.

Patriarchal whiteness, self-determination and Indigenous women : the invisibilty of structural priviledge and the visability of oppression

Indigenous self-determination is the recognised right of all peoples to freely determine their political status, and pursue their economic, social and cultural development. Unfinished Constitutional Business? offers fresh insights into the ways communities can chart their own course and realise self-determination. Because the history of colonisation is emotionally charged, the issue has been clouded by a rhetoric that has sometimes obstructed analysis.

Science education policy-making : eleven emerging issues

The Perth Declaration on Science and Technology Education of 2007 expresses strong concern about the state of science and technology education worldwide and calls on governments to respond to a number of suggestions for establishing the structural conditions for their improved practice. The quality of school education in science and technology has never before been of such critical importance to governments. There are three imperatives for its critical importance. The first relates to the traditional role of science in schooling, namely the identification, motivation and initial preparation of those students who will go on to further studies for careers in all those professional fi elds that directly involve science and technology. A suffi cient supply of these professionals is vital to the economy of all countries and to the health of their citizens. In the 21st century they are recognised everywhere as key players in ensuring that industrial and economic development occurs in a socially and environmentally sustainable way. In many countries this supply is now falling seriously short and urgently needs to be addressed. The second imperative is that sustainable technological development and many other possible societal applications of science require the support of scientifically and technologically informed citizens. Without the support and understanding of citizens, technological development can all too easily serve short term and sectional interests. The longer term progress of the whole society is overlooked, citizens will be confused about what should, and what should not be supported, and reactive and the environment will continue to be destroyed rather than sustained. Sustainable development, and the potential that science and technology increasingly offers, involves societies in ways that can often interact strongly, with traditional values, and hence, making decisions about them involve major moral decisions. All students need to be prepared through their science and technology education to be able to participate actively as persons and as responsible citizens in these essential and exciting possibilities. This goal is far from being generally achieved at present, but pathways to it are now more clearly understood. The third imperative derives from the changes that are resulting from the application of digital technologies that are the most rapid, the most widespread, and probably the most pervasive influence that science has ever had on human society. We all, wherever we live, are part of a global communication society. Information exchange and access to it that have been hitherto the realm of the few, are now literally in the hands of individuals. This is leading to profound changes in the World of Work and in what is known as the Knowledge Society. Schooling is now being challenged to contribute to the development in students of an active repertoire of generic and subject-based competencies. This contrasts very strongly with existing priorities, in subjects like the sciences that have seen the size of a student’s a store of established knowledge as the key measure of success. Science and technology education needs to be a key component in developing these competencies. When you add to these imperatives, the possibility that a more effective education in science and technology will enable more and more citizens to delight in, and feel a share in the great human enterprise we call Science, the case for new policy decisions is compellingly urgent. What follows are the recommendations (and some supplementary notes) for policy makers to consider about more operational aspects for improving science and technology education. They are listed under headings that point to the issues within each of these aspects. In the full document, a background is provided to each set of issues, including the commonly current state of science and technology education. Associated with each recommendation for consideration are the positive Prospects that could follow from such decision making, and the necessary Prerequisites, if such bold policy decisions are to fl ow, as intended, into practice in science and technology classrooms.

Ageing, learning, technology, and health management

The world’s population is ageing rapidly. Ageing has an impact on all aspects of human life, including social, economic, cultural, and political. Understanding ageing is therefore an important issue for the 21st century. This chapter will consider the active ageing model. This model is based on optimising opportunities for health, participation, and security in order to enhance quality of life. There is a range of exciting options developing for personal health management, for and by the ageing population, that make use of computer technology, and these should support active ageing. Their use depends however on older people learning to use computer technology effectively. The ability to use such technology will allow them to access relevant health information, advice, and support independently from wherever they live. Such support should increase rapidly in the future. This chapter is a consideration of ageing and learning, ageing and use of computer technology, and personal health management using computers.

Reducing MRI gradient coil vibration with rib stiffeners

This work investigates the effect of rib stiffeners on the free and forced vibration of a gradient coil in a Magnetic Resonance Imaging (MRI) scanner. Several reinforcement schemes are studied in this paper. One scheme utilizes the existing holes in the gradient coil structure (typically reserved for magnetic shims) to produce the reinforcement. Non-ferrous, non-magnetic carbon fibre rib stiffeners are employed to fill these holes in several ways to strengthen a gradient coil. Another scheme replaces the inner half of the gradient coil material with a grid of interconnected axial and circumferential rib stiffeners. It is found that the structural stiffness of the gradient coil increases substantially when the coil is reinforced by carbon fibre rib stiffeners. The reinforcement affects the noise and vibration response of the gradient coil structure in the following ways. It increases the frequency range of forced response of the gradient coil at low frequencies due to the increased resonant frequency of the fundamental mode of the coil. Secondly, it reduces the forced response amplitude of the coil structure (which is governed by the structural stiffness of the coil). Thirdly, it reduces the number of natural modes in the low and medium frequency range and therefore lessens the chance of the coil structure being excited resonantly by magnetic resonance signal acquisition sequences. It is shown that gradient coils modelled by solid finite element models have higher stiffness along the coil’s circumference and lower stiffness in the axial direction than those using shell finite element models.

Long-term outcomes of seriously injured children : a study using the Child Health Questionnaire

Objective: To assess the health-related quality of life (HRQoL) in children 1-2 years after they had sustained an injury. Methods: Parents of all children who were identified by the Queensland Trauma Registry during their admission to either of the two paediatric specialty hospitals in Brisbane, Australia, for the treatment of an injury, were invited to participate in this study. Parents who consented to participation received a copy of the Child Health Questionnaire (CHQ) that required them to provide information regarding their child’s HRQoL following injury. The CHQ scores for the study respondents were compared with those of the Australian norms. This study was approved by the relevant ethics committees. Results: Two hundred and forty-one completed questionnaires were returned. The majority of cases were male (65%) and there was even representation across all age groups. The majority of injuries were considered to be minor (81%) and were predominantly the result of falls and cycling accidents causing mainly fractures and intracranial injury. On the majority of subscales of the CHQ, study participants recorded scores that were statistically significantly below those of the Australian norms. None of the relevant variables collected by the Queensland Trauma Registry were found to predict scores on the CHQ in this study (for those children hospitalized for >24 h). Conclusion: Injured children are worse off than their Australian counterparts in terms of HRQoL even up to 2 years following an injury. Further research needs to be undertaken to identify factors that predict lower HRQoL in order to reduce the burden of injury on children and their families.

Development of self-efficacy and expectancy measures for benzodiazepines

This study aimed to develop and assess the reliability and validity of a pair of self-report questionnaires to measure self-efficacy and expectancy associated with benzodiazepine use, the Benzodiazepine Refusal Self- Efficacy Questionnaire (BRSEQ) and the Benzodiazepine Expectancy Questionnaire (BEQ). Internal structure of the questionnaireswas established by principal component analysis (PCA) in a sample of 155 respondents, and verified by confirmatory factor analyses (CFA) in a second independent sample (n=139) using structural equation modeling. The PCA of the BRSEQ resulted in a 16-item, 4-factor scale, and the BEQ formed an 18-item, 2-factor scale. Both scales were internally reliable. CFA confirmed these internal structures and reduced the questionnaires to a 14-item self-efficacy scale and a 12-item expectancy scale. Lower self-efficacy and higher expectancy were moderately associated with higher scores on the SDS-B. The scales provide reliable measures for assessing benzodiazepine self-efficacy and expectancies. Future research will examine the utility of the scales in prospective prediction of benzodiazepine cessation.