Advanced arterial blood gas analysis in septic shock : a Singaporean nursing case review.

Introduction The admission to the Intensive Care Unit with a diagnosis of sepsis and/or septic shock is not uncommon. The aim of this article is to present a nursing case review of a patient admitted to the intensive care unit with a diagnosis of septic shock and the use of bedside acid–base formulae to inform clinical decision making. Method We chose to use a case review. This method is useful in reporting unusual or rare cases and is typically seen more in medicine than in nursing. Discussion The gentleman in question was a self-presentation with a short history of fever and worsening shortness of breath. His condition worsened where he required admission to the intensive care unit. The use of ‘advanced’ acid–base interpretation to guide his nursing care provided a platform from which to advance a deeper understanding of the intricacies the critically ill patient often presents. Conclusion The use of case review is enlightening in understanding the disease process and the decision-making that accompanies this. The lessons learnt are applicable to a wider nursing audience because understanding acid–base physiology is beneficial in supporting and advancing critical care nursing practice.

Challenges of recruiting hospice patients with advanced cancer to research : reflections on a delirium screening study

Introduction Delirium research in palliative care, particularly in the dying phase, is possible but is frequently met with ethical and methodological challenges. This paper describes the challenges faced in a previous delirium screening study. Methods Within 72 hours of admission to an acute inpatient specialist palliative care unit one hundred consecutive patients over 18 years of age with advanced cancer were invited to be screened for delirium using validated screening tools. Results Of the 100 consecutive admissions 49 patients were unable to participate including seven who did not meet the inclusion criteria and nine (six families and three patients) who withheld consent. The remaining 33 patients were more unwell and closer to death than those who were recruited. Reasons for non- participation included being too unwell (ten), unresponsive (nine), died (two) or discharged (three) before recruitment and exceeding the 72hour time limit (nine). Conclusion Gate keeping and physical condition of patients were the main obstacles to recruitment and is consistent with barriers faced in previous studies involving palliative care and dying patients. While it is possible and necessary to conduct studies in palliative care, including the terminal phase, as reflective practitioners we must maintain the balance between the demands for evidence-based practice and our compassion and respect for our most vulnerable of patients.

Impact of passenger group dynamics on an airport evacuation process using an agent-based model

The safety of passengers is a major concern to airports. In the event of crises, having an effective and efficient evacuation process in place can significantly aid in enhancing passenger safety. Hence, it is necessary for airport operators to have an in-depth understanding of the evacuation process of their airport terminal. Although evacuation models have been used in studying pedestrian behaviour for decades, little research has been done in considering the evacuees’ group dynamics and the complexity of the environment. In this paper, an agent-based model is presented to simulate passenger evacuation process. Different exits were allocated to passengers based on their location and security level. The simulation results show that the evacuation time can be influenced by passenger group dynamics. This model also provides a convenient way to design airport evacuation strategy and examine its efficiency. The model was created using AnyLogic software and its parameters were initialised using recent research data published in the literature.

Characteristics of spatial variation, size distribution, formation and growth of particles in urban environments

This thesis is the first comprehensive study of important parameters relating to aerosols' impact on climate and human health, namely spatial variation, particle size distribution and new particle formation. We determined the importance of spatial variation of particle number concentration in microscale environments, developed a method for particle size parameterisation and provided knowledge about the chemistry of new particle formation. This is a significant contribution to our understanding of processes behind the transformation and dynamics of urban aerosols. This PhD project included extensive measurements of air quality parameters using state of the art instrumentation at each of the 25 sites within the Brisbane metropolitan area and advanced statistical analysis.

Exploring board dynamics : director participation during board meetings

Despite board meetings representing the main arena where directors discharge their duties and make critical corporate decisions, we know little about what occurs in the boardroom. Consequently, there is increasing academic interest in understanding how meetings are run and how directors participate. This study contributes to this emerging literature by exploring the impact of board meeting arrangements on directors’ interactions and perceptions of meeting effectiveness. We video-taped board meetings at two Australian corporations operating in the same industry and use an in-depth analysis of interactions and board processes to reveal that a rather small difference in meeting arrangements (i.e. the timing and length of meetings) had a significant influence on interaction patterns. Specifically, given significant amounts of environmental turbulence in the sector, director inclusiveness and participation were reduced as time pressure increased due to shorter meetings, lowering director perceptions of meeting effectiveness.

Dynamics of affordances and implications for design

Affordance is an important concept in HCI. There are various interpretations of affordances but it has been difficult to use this concept for design purposes. Often the treatment of affordances in the current HCI literature has been as a one-to-one relationship between a user and an artefact. According to our views, affordance is a dynamic, always emerging relationship between a human and his environment. We believe that the social and cultural contexts within which an artefact is situated affect the way in which the artefact is used. Using a Structuration Theory approach, we argue that affordances need also be treated at a much broader level, encompassing social and cultural aspects. We suggest that affordances should be seen at three levels: single user, organizational (or work group) and societal. Focusing on the organizational level affordances, we provide details of several important factors that affect the emergence of affordances.

Status of the world's remaining closed forests : an assessment using satellite data and policy options

Historically, it appears that some of the WRCF have survived because i) they lack sufficient quantity of commercially valuable species; ii) they are located in remote or inaccessible areas; or iii) they have been protected as national parks and sanctuaries. Forests will be protected when people who are deciding the fate of forests conclude than the conservation of forests is more beneficial, e.g. generates higher incomes or has cultural or social values, than their clearance. If this is not the case, forests will continue to be cleared and converted. In the future, the WRCF may be protected only by focused attention. The future policy options may include strategies for strong protection measures, the raising of public awareness about the value of forests, and concerted actions for reducing pressure on forest lands by providing alternatives to forest exploitation to meet the growing demands of forest products. Many areas with low population densities offer an opportunity for conservation if appropriate steps are taken now by the national governments and international community. This opportunity must be founded upon the increased public and government awareness that forests have vast importance to the welfare of humans and ecosystems' services such as biodiversity, watershed protection, and carbon balance. Also paramount to this opportunity is the increased scientific understanding of forest dynamics and technical capability to install global observation and assessment systems. High-resolution satellite data such as Landsat 7 and other technologically advanced satellite programs will provide unprecedented monitoring options for governing authorities. Technological innovation can contribute to the way forests are protected. The use of satellite imagery for regular monitoring and Internet for information dissemination provide effective tools for raising worldwide awareness about the significance of forests and intrinsic value of nature.

Self-management associated with fatigue in patients with advanced cancer : a prospective longitudinal study

Cancer-related fatigue is one of the most distressing symptoms experienced by patients with advanced cancer. This doctoral study identified that patients with advanced cancer commonly use a number of self-management strategies in response to fatigue, although these strategies had varying levels of effectiveness in reducing the symptom. The study identified that enhancing self-efficacy and managing depressive symptoms are important factors to consider in the design of future interventions to support fatigue self-management.

Molecular dynamics simulation of mechanical behavior of osteopontin-hydroxyapatite interfaces

Bone is characterized with an optimized combination of high stiffness and toughness. The understanding of bone nanomechanics is critical to the development of new artificial biological materials with unique properties. In this work, the mechanical characteristics of the interfaces between osteopontin (OPN, a noncollagenous protein in extrafibrillar protein matrix) and hydroxyapatite (HA, a mineral nanoplatelet in mineralized collagen fibrils) were investigated using molecular dynamics method. We found that the interfacial mechanical behaviour is governed by the electrostatic attraction between acidic amino acid residues in OPN and calcium in HA. Higher energy dissipation is associated with the OPN peptides with a higher number of acidic amino acid residues. When loading in the interface direction, new bonds between some acidic residues and HA surface are formed, resulting in a stick-slip type motion of OPN peptide on the HA surface and high interfacial energy dissipation. The formation of new bonds during loading is considered to be a key mechanism responsible for high fracture resistance observed in bone and other biological materials.

Visualization : A powerful tool for effective teaching of dynamics

Dynamics is an essential core engineering subject and it is considered as one of the hardest subjects in the engineering discipline. Many students acknowledged that Dynamics is very hard to understand and comprehend the abstract concepts through traditional teaching methods with normal tutorials and assignments. In this study, we conducted an investigation on the application of visualization technique to help students learning the unit with the fundamental theory displayed in the physical space. The research was conducted based on the following five basic steps of Action Learning Cycle including: Identifying problem, Planning action, Implementing, Evaluating, and Reporting. Through our studies, we have concluded that visualization technique can definitely help students in learning and comprehending the abstract theories and concepts of Dynamics.

Using visualization tool to help engineering students learning dynamics

Dynamics is an essential core engineering subject. It includes high level mathematical and theoretical contents, and basic concepts which are abstract in nature. Hence, Dynamics is considered as one of the hardest subjects in the engineering discipline. To assist our students in learning this subject, we have conducted a Teaching & Learning project to study ways and methods to effectively teach Dynamics based on visualization techniques. The research project adopts the five basic steps of Action Learning Cycle. It is found that visualization technique is a powerful tool for students learning Dynamics and helps to break the barrier of students who perceived Dynamics as a hard subject.

The identification and rapid extraction of hydrocarbons from Nicotiana glauca : A potential advanced renewable biofuel source

Declining fossil fuels reserves, a need for increased energy security and concerns over carbon emissions from fossil fuel use are the global drivers for alternative, renewable, biosources of fuels and chemicals. In the present study the identification of long chain (C29–C33) saturated hydrocarbons from Nicotiana glauca leaves is reported. The occurrence of these hydrocarbons was detected by gas chromatography–mass spectrometry (GC–MS) and identification confirmed by comparison of physico-chemical properties displayed by the authentic standards available. A simple, robust procedure was developed to enable the generation of an extract containing a high percentage of hydrocarbons (6.3% by weight of dried leaf material) higher than previous reports in other higher plant species consequently, it is concluded that N. glauca could be a crop of greater importance than previously recognised for biofuel production. The plant can be grown on marginal lands, negating the need to compete with food crops or farmland, and the hydrocarbon extract can be produced in a non-invasive manner, leaving remaining biomass intact for bioethanol production and the generation of valuable co-products.

Regulation and integral control of an underactuated robotic system using IDA-PBC with dynamic extension

This paper proposes a method for design of a set-point regulation controller with integral action for an underactuated robotic system. The robot is described as a port-Hamiltonian system, and the control design is based on a coordinate transformation and a dynamic extension. Both the change of coordinates and the dynamic extension add extra degrees of freedom that facilitate the solution of the matching equation associated with interconnection and damping assignment passivity-based control designs (IDA-PBC). The stability of the controlled system is proved using the closed loop Hamiltonian as a Lyapunov candidate function. The performance of the proposed controller is shown in simulation.