Using samples to estimate the sensitivity and specificity of a surveillance process

Determining sensitivity and specificity of a postoperative infection surveillance process is a difficult undertaking. Because postoperative infections are rare, vast numbers of negative results exist, and it is often not reasonable to assess them all. This study gives a methodological framework for estimating sensitivity and specificity by taking only a small sample of the number of patients who test negative and comparing their findings to the reference or “gold standard” rather than comparing the findings of all patients to the gold standard. It provides a formula for deriving confidence intervals for these estimates and a guide to minimum requirements for sampling results.

Central venous oxygen saturation monitoring

It has been established that mixed venous oxygen saturation (SvO2) reflects the balance between systemic oxygen deliver y and consumption. Literature indicates that it is a valuable clinical indicator and has good prognostic value early in patient course. This article aims to establish the usefulness of SvO2 as a clinical indicator. A secondary aim was to determine whether central venous oxygen saturation (ScvO2) and SvO2 are interchangeable. Of particular relevance to cardiac nurses is the link between decreased SvO2 and cardiac failure in patients with myocardial infarction, and with decline in myocardial function, clinical shock and arrhythmias. While absolute values ScvO2 and SvO2 are not interchangeable, ScvO2 and SvO2are equivalent in terms of clinical course. Additionally, ScvO2 monitoring is a safer and less costly alternative to SvO2 monitoring. It can be concluded that continuous ScvO2 monitoring should potentially be undertaken in patients at risk of haemodynamic instability.

`Getting the city right' : the city as crucible for social reform

The connection between social reform and urban management is evident throughout the history of the city. This article maps out how ideas about social reform and social housing were established historically, during the development of the nineteenth century city. The second part examines contemporary shifts in thinking about homelessness through a case study of two Brisbane City Council initiatives in Brisbane: The Homeless Shelter Trial and Footprints along Kurilpa.

Collaborative staff development across a diverse organisation

This paper examines the role of staff training and support in the experience of staff with online teaching at Australian Catholic University. Australian Catholic University’s online education is differentiated from other Australian universities for two reasons: 1) It has 6 nationally based campuses spread across a geographical reach of 2,500 kilometres, 2) It has no internal Flexible Learning or Distance Education unit as such, and out sources the provision of web based teaching and learning services to NextEd Pty Ltd, a commercial online education company. Both factors provide challenges and benefits to the effective training, support and coordination of online education in the university.

Up the e-learning curve : ensuring quality online education within an Australian university

The paper describes the implementation of a project within Australian Catholic University designed to launch the Faculties into online education in a manner which ensured quality in all aspects of the teaching-learning experiences of academics and students. Key elements of the strategic approach adopted by the project leaders, including the involvement of a specialist commercial provider of web-based delivery systems as a partner in the project, mechanisms to support the initiative through the first stages, careful choice of the programs offered online, and staff development matched to the emerging needs of those involved in the teaching of courses, are described. Challenges encountered in the implementation process, and the factors which assisted in overcoming these problems are identified. The paper draws upon this experience to raise some important issues relevant to the successful introduction of online education as an integral component of the teaching repertoire of Faculties.

Eat, drink and be civil

Brisbane is provincial city that has been developing rapidly since the early 1990s. The growth and development of its public and semi-public spaces means there are many more ways to engage with the city than was previously possible. --------- I suggest the city’s new and transformed spaces have enabled 2 important developments 1) a growth in forms of sociability and encounters with difference and 2) the negotiation of civic competencies. --------- The paper draws upon research conducted during a PhD project which used multi-method approaches - including qualitative [interviews] and quantitative data [surveys], psychoanalytic theory and text analysis.The study also made connections between the real city and the discursive city to argue that urban experience is constituted both materially and imaginatively.

Thermoanalytical studies of natural potassium, sodium and ammonium alunites

Dynamic and controlled rate thermal analysis (CRTA) has been used to characterise alunites of formula [M(Al)3(SO4)2(OH)6 ] where M+ is the cations K+, Na+ or NH4+. Thermal decomposition occurs in a series of steps. (a) dehydration, (b) well defined dehydroxylation and (c) desulphation. CRTA offers a better resolution and a more detailed interpretation of water formation processes via approaching equilibrium conditions of decomposition through the elimination of the slow transfer of heat to the sample as a controlling parameter on the process of decomposition. Constant-rate decomposition processes of water formation reveal the subtle nature of dehydration and dehydroxylation.

Transitions

Transitions represents a selection of works presented by 3rd year QUT design students undertaken as part of their coursework entitled "Environments in Transitions". The work focuses upon the migration of ideas and aesthetics from East to West, with particular consideration for the influence of Japanese woodblock prints, Wabi-Sabi themes and decorative motifs upon European design during the turn of the 19th century. The works exhibited included design artifacts of various themes, and associated print work which informed the design process. A small exhibition publication accompanied the exhibition and talk.

Intrinsically photosensitive melanopsin retinal ganglion cell contributions to the pupillary light reflex and circadian rhythm

Recently discovered intrinsically photosensitive melanopsin retinal ganglion cells contribute to the maintenance of pupil diameter, recovery and post-illumination components of the pupillary light reflex and provide the primary environmental light input to the suprachiasmatic nucleus for photoentrainment of the circadian rhythm. This review summarises recent progress in understanding intrinsically photosensitive ganglion cell histology and physiological properties in the context of their contribution to the pupillary and circadian functions and introduces a clinical framework for using the pupillary light reflex to evaluate inner retinal (intrinsically photosensitive melanopsin ganglion cell) and outer retinal (rod and cone photoreceptor) function in the detection of retinal eye disease.

Facilitating needs based cancer care for people with a chronic disease : evaluation of an intervention using a multi-centre interrupted time series design

Background: Palliative care should be provided according to the individual needs of the patient, caregiver and family, so that the type and level of care provided, as well as the setting in which it is delivered, are dependent on the complexity and severity of individual needs, rather than prognosis or diagnosis. This paper presents a study designed to assess the feasibility and efficacy of an intervention to assist in the allocation of palliative care resources according to need, within the context of a population of people with advanced cancer. ---------- Methods/design: People with advanced cancer and their caregivers completed bi-monthly telephone interviews over a period of up to 18 months to assess unmet needs, anxiety and depression, quality of life, satisfaction with care and service utilisation. The intervention, introduced after at least two baseline phone interviews, involved a) training medical, nursing and allied health professionals at each recruitment site on the use of the Palliative Care Needs Assessment Guidelines and the Needs Assessment Tool: Progressive Disease - Cancer (NAT: PD-C); b) health professionals completing the NAT: PD-C with participating patients approximately monthly for the rest of the study period. Changes in outcomes will be compared pre-and post-intervention.---------- Discussion: The study will determine whether the routine, systematic and regular use of the Guidelines and NAT: PD-C in a range of clinical settings is a feasible and effective strategy for facilitating the timely provision of needs based care.