412 resultados para requiring hospitalization


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Considerable work has been undertaken to determine an economical process to provide sugarcane trash as a fuel for cogeneration. This paper reviews efforts to provide that trash fuel by harvesting, transporting and processing the trash with the cane. Harvesting trash with the cane has the advantage that cane that would otherwise be lost by extracting it with the trash is captured and sugar can be produced from that cane. Transporting trash with the cane significantly reduces the bulk density of the cane, requiring substantial changes and costs to cane transport. Shredding the trash at the harvester and compacting the cane in the bin prior to transport are possible methods to increase the bulk density but both have considerable cost. Processing trash through the sugar factory with the cane significantly reduces sugar recovery and sugar quality. Although considerable knowledge has been gained of these effects and further analysis has provided insights into their causes, much more work is required before whole crop harvesting and transport is an economically viable means of trash recovery.

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Until the 1970s mining leases were issued by state governments subject to conditions that companies build or substantially finance local community infrastructure, including housing, streets, transport, schools, hospitals and recreation facilities. Townships and communities went hand in hand with mining development. However, in the past thirty years mining companies have moved progressively to an expeditionary strategy for natural resources extraction - operating a continuous production cycle of 12 hour shifts - increasingly reliant on non-resident, fly-in, fly-out or drive-in, drive-out (FIFO/DIDO) workers who typically work block rosters, reside in work camps adjacent to existing communities and travel large distances from their homes. This paper presents the key findings of our survey into the social impacts of this kind of mining development in Qld. Based on the results we argue that the social license to develop new mining projects is strong for projects requiring a 25% or less non-resident workforce, diminishes significantly thereafter and is very weak for projects planning to recruit a non-resident workforce in excess of 75%. This finding is significant because there are at least 67 new mining projects undergoing social impact assessment in Queensland, and many it appears are planning to hire significant proportions of non-resident workers. The paper considers the policy implications of this growing social justice issue concluding there is a clear need for national leadership in formulating a national policy framework for guiding socially responsible and sustainable mining development into the next millennium.

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With international and national policies requiring teachers to adopt inclusive practices worldwide, this paper examines the impact of transformational learning in a critical service-learning program on final-year pre-service teachers’ approaches to inclusive teaching. Data from emailed questionnaires and focus group interviews are analysed through a social, critical framework. The results indicate that the critical service-learning program provided the students with an opportunity to consider diversity and inclusion in selecting teaching strategies, and to enact values suitable to inclusive practices and appreciation of diversity in schools. In this paper we argue that transformative learning experiences about inclusivity and diversity are needed if pre-service teachers are to be challenged to adopt inclusive values and practice in schools. A critical service-learning program for pre-service teachers provides a solid foundation on which to develop or build on the ability to think and teach inclusively.

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Aim Low prevalence rates of malnutrition at 2.5% to 4% have previously been reported in two tertiary paediatric Australian hospitals. The current study is the first to measure the prevalence of malnutrition, obesity and nutritional risk of paediatric inpatients in multiple hospitals throughout Australia. Methods Malnutrition, obesity and nutritional risk prevalence were investigated in 832 and 570 paediatric inpatients, respectively, in eight tertiary paediatric hospitals and eight regional hospitals across Australia on a single day. Malnutrition and obesity prevalence was determined using z-scores and body mass index (BMI) percentiles. High nutritional risk was determined as a Paediatric Yorkhill Malnutrition Score of 2 or more. Results The prevalence rates of malnourished, wasted, stunted, overweight and obese paediatric patients were 15%, 13.8%, 11.9%, 8.8% and 9.9%, respectively. Patients who identified as Aboriginal and Torres Strait Islander were more likely to have lower height-for-age z-scores (P < 0.01); however, BMI and weight-for-age z-scores were not significantly different. Children who were younger, from regional hospitals or with a primary diagnosis of cardiac disease or cystic fibrosis had significantly lower anthropometric z-scores (P = 0.05). Forty-four per cent of patients were identified as at high nutritional risk and requiring further nutritional assessment. Conclusions The prevalence of malnutrition and nutritional risk of Australian paediatric inpatients on a given day was much higher when compared with the healthy population. In contrast, the proportion of overweight and obese patients was less.

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BACKGROUND Early detection by skin self-examination (SSE) could improve outcomes from melanoma. Mobile teledermoscopy may aid this process. OBJECTIVES To establish clinical accuracy of SSE plus mobile teledermoscopy compared to clinical skin examination (CSE) and test whether providing people with detailed SSE instructions improves accuracy. METHODS Men and women 50-64 years (n=58) performed SSE plus mobile teledermoscopy in their homes between May and November 2013 and were given technical instructions plus detailed SSE instructions (intervention) or technical instructions only (control). Within three months, they underwent a CSE. Outcome measures included: a) body sites examined, lesions photographed, and missed; b) sensitivityof SSE plus mobile teledermoscopy compared to in-person CSE using either patients or lesions as denominator, and; c) concordance of telediagnosis with CSE. RESULTS: 49 of 58 randomised participants completed the study, and submitted 309 lesions to the teledermatologist (156 intervention; 153 control group). Intervention group participants were more likely to submit lesions from their legs compared to control (p=0.03), no other differences between groups in number or site of missed lesions.11 participants (22%) did not photograph 14 pigmented lesions the dermatologist considered worthwhile photographing or requiring clinical monitoring. Sensitivity of SSE plus mobile teledermoscopy was 81.8% (95% confidence interval 64.5-93.0) using the patient as the denominator and 41.9 (27.6-56.2) using the lesion as denominator.-There was substantial agreement between telediagnosis and CSE (Kappa =0.90) accounting for differential diagnoses. CONCLUSIONS SSE plus mobile teledermoscopy is promising for surveillance of particular lesions even without provision of detailed SSE instructions, but in the format tested in this study, consumers may overlook lesions and send many non-pigmented lesions. This investigation demonstrates that high quality dermoscopic images can be taken by patients at home and for those sent, telediagnosis is highly accurate.

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Platelet-derived microparticles that are produced during platelet activation bind to traumatized endothelium. Such endothelial injury occurs during percutaneous transluminal coronary angioplasty. Approximately 20% of these patients subsequently develop restenosis, although this is improved by treatment with the anti-platelet glycoprotein IIb/IIIa receptor drug abciximab. As platelet activation occurs during angioplasty, it is likely that platelet-derived microparticles may be produced and hence contribute to restenosis. This study population consisted of 113 angioplasty patients, of whom 38 received abciximab. Paired peripheral arterial blood samples were obtained following heparinization and subsequent to all vessel manipulation. Platelet-derived microparticles were identified using an anti-CD61 (glycoprotein IIIa) fluorescence-conjugated antibody and flow cytometry. Baseline clinical characteristics between patient groups were similar. The level of platelet-derived microparticles increased significantly following angioplasty in the group without abciximab (paired t test, P 0.019). However, there was no significant change in the level of platelet-derived microparticles following angioplasty in patients who received abciximab, despite requiring more complex angioplasty procedures. In this study, we have demonstrated that the level of platelet-derived microparticles increased during percutaneous transluminal coronary angioplasty, with no such increase with abciximab treatment. The increased platelet-derived microparticles may adhere to traumatized endothelium, contributing to re-occlusion of the arteries, but this remains to be determined.

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This paper discusses Compulsory Income Management (CIM) in Australia and the implications of technology backed forms of surveillance and increasingly conditional benefit payments. The CIM project raises important questions about requiring people to take greater responsibility for their personal behaviour when they no longer have control over key financial aspects of their lives. Some Indigenous communities have resisted the BasicsCard, because CIM was imposed with little prior consultation or subsequent independent evaluation. The compulsory income management of individuals by a paternalist welfare state contradicts and undermines the purported policy aims that they become less welfare dependent and more positively engaged with the world of paid employment and does little to address the growing condition of poverty in Australia.

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Practical techniques to manage the dangers associated with sexually transmitted diseases have varied considerably both cross culturally and historically. Adopting a Foucauldian perspective, this article examines sociohistorical aspects of the governance of venereal disease in New South Wales between 1871 and 1916. Public debates and official documents are analysed to identify strategic shifts in practices associated with venereal disease management , especially in relation to prostitution. Particular attention is paid to the development of contagious disease legislation and its role in the regulation of venereal disease . It is argued that during the period in question, two distinct governmental regimes of disease control can be identified. In the first, medical policing managed venereal disease through the mobilisation of repressive controls, requiring the isolation and detention of polluting bodies. In the second, liberal governance adopted pedagogic practices to train populations perceived as either healthy or unhealthy. It is further argued that as liberal strategies of governance came to dominate the management of venereal disease , the association of prostitution with venereal disease began to weaken. Instead, authorities became increasingly concerned with populations whose behaviour was not traditionally linked with venereal disease , such as the young and the sexually inexperienced.

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Although driver aggression has been identified as contributing to crashes, current understanding of the fundamental causes of the behaviour is poor. Two key reasons for this are evident. Firstly, existing research has been largely atheoretical, with no unifying conceptual framework guiding investigation. Secondly, emphasis on observable behaviours has resulted in limited knowledge of the underlying thought processes that motivate behaviour. Since driving is fundamentally a social situation, requiring drivers to interpret on-road events, insight regarding these perception and appraisal processes is paramount in advancing understanding of the underlying causes. Thus, the current study aimed to explore the cognitive appraisal processes involved in driver aggression, using a conceptual model founded on the General Aggression Model (Anderson & Bushman, 2002). The present results reflect the first of several studies testing this model. Participants completed 3 structured driving diaries to explore perceptions and cognitions. Thematic analysis of diaries identified several cognitive themes. The first, ‘driving etiquette’ concerned an implied code of awareness and consideration for other motorists, breaches of which were strongly associated with reports of anger and frustration. Such breaches were considered intentional; attributed to dispositional traits of another driver, and precipitated the second theme, ‘justified retaliation’. This theme showed that drivers view their aggressive behaviour as warranted, to convey criticism towards another motorist’s etiquette violation. However, the third theme, ‘superiority’ suggested that those refraining from an aggressive response were motivated by a desire to perceive themselves as ‘better’ than the offending motorists. Collectively, the themes indicate deep-seated and complex thought patterns underlying driver aggression, and suggest the behaviour will be challenging to modify. Implications of these themes in relation to the proposed model will be discussed, and continued research will explore these cognitive processes further, to examine their interaction with person-related factors.

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Nursing was one of the last health professions to be established in the higher education sector. A lingering challence is the integration of bioscience into nursing curriculum. Research suggests that students perceive bioscience teaching to be difficult thereby contributing to heightened anxiety. It has been proposed that high content volume, lack of secondary school science, and predominance of science lectureres without clinical practice experience, may lead to a bioscience disconnet with curricula. To ascertain the extent of this problem, we undertook a cross-sectional designed study of commencing, second and third year undergraduate nursing students (n=566). They were surveyed about perceptions, knowledge and approaches to bioscience learning. Preliminary analysis revealed similar findings between the three different cohorts. Generally, sudents perceived bioscience subjects to be difficult, more challenging and requiring more study hours than clinical nursing subjects. Interestingly, the perception of difficulty and associated anxieties were found in both commencing and existing students. Moreover, students with secondary school biology combined with another science subject perceived bioscience teaching more favourably compared to those who had studied one secondary school science subject. University coursework needs to embed strategies to minimise anxieties about learning bioscience by using innovative deliveries and scaffolded assessments that target the learner's needs.

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This thesis demonstrates that robots can learn about how the world changes, and can use this information to recognise where they are, even when the appearance of the environment has changed a great deal. The ability to localise in highly dynamic environments using vision only is a key tool for achieving long-term, autonomous navigation in unstructured outdoor environments. The proposed learning algorithms are designed to be unsupervised, and can be generated by the robot online in response to its observations of the world, without requiring information from a human operator or other external source.

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Accurate process model elicitation continues to be a time consuming task, requiring skill on the part of the interviewer to extract explicit and tacit process information from the interviewee. Many errors occur in this elicitation stage that would be avoided by better activity recall, more consistent specification methods and greater engagement in the elicitation process by interviewees. Metasonic GmbH has developed a process elicitation tool for their process suite. As part of a research engagement with Metasonic, staff from QUT, Australia have developed a 3D virtual world approach to the same problem, viz. eliciting process models from stakeholders in an intuitive manner. This book chapter tells the story of how QUT staff developed a 3D Virtual World tool for process elicitation, took the outcomes of their research project to Metasonic for evaluation, and finally, Metasonic’s response to the initial proof of concept.

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Background: The introduction of Patient Group Directions (PGD) has changed significantly the way in which nurses can now administer prescription only medicines as a one-off for patients requiring this level of service. PGD’s are a written authority to administer drugs to patients that are not identified at the time of treatment. Aim: The aim of this project was to develop a PGD for use within an Outreach team to administer colloid boluses to patients presenting with hypovolemia. Method: Using a case exemplar this paper will discuss the development of a PGD using aspects of transitional change theory to highlight the potential barriers that were encountered. Implications for Practice: The implications for this PGD are wide reaching. First it now enables members from the nursing Outreach team to administer colloid fluid boluses to a prescribed patient cohort without the need for prescription. Second, it ensures the deteriorating patient has interventions initiated in a timely and appropriate manner to reduce inadvertent admission to high care areas. Last, it will improve inter-professional team-working and communication so much so that collaborative patient care reduces health costs and identifies earlier those patients requiring substantially greater nursing and medical input. Conclusion: The experience of developing a working PGD for fluid administration has meant that the Outreach team is able to respond to patients in a more effective way. In addition, it is the experience of developing this PGD that has enabled the team to contemplate other PGD’s in the execution of Outreach work.

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The aim of this ethnographic study was to understand welding practices in shipyard environments with the purpose of designing an interactive welding robot that can help workers with their daily job. The robot is meant to be deployed for automatic welding on jack-up rig structures. The design of the robot turns out to be a challenging task due to several problematic working conditions on the shipyard, such as dust, irregular floor, high temperature, wind variations, elevated working platforms, narrow spaces, and circular welding paths requiring a robotic arm with more than 6 degrees of freedom. Additionally, the environment is very noisy and the workers – mostly foreigners – have a very basic level of English. These two issues need to be taken into account when designing the interactive user interface for the robot. Ideally, the communication flow between the two parties involved should be as frictionless as possible. The paper presents the results of our field observations and welders’ interviews, as well as our robot design recommendation for the next project stage.

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BACKGROUND Prescribing is a complex task, requiring specific knowledge and skills combined with effective, context-specific clinical reasoning. Prescribing errors can result in significant morbidity and mortality. For all professions with prescribing rights, a clear need exists to ensure students graduate with a well-defined set of prescribing skills, which will contribute to competent prescribing. AIM To describe the methods employed to teach and assess the principles of effective prescribing across five non-medical professions at Queensland University of Technology. METHOD The NPS National Prescribing Competencies Framework (PCF) was used as the prescribing standard. A curriculum mapping exercise was undertaken to determine how well the PCF was addressed across the disciplines of paramedic science, pharmacy, podiatry, nurse practitioner and optometry. Identified gaps in teaching and/or assessment were noted. RESULTS Prescribing skills and knowledge are taught and assessed using a range of methods across disciplines. A multi-modal approach is employed by all disciplines. The Pharmacy discipline uses more tutorial sessions to teach prescribing principles and relies less on case studies and clinical appraisal to assess prescribing when compared to other disciplines. Within the pharmacy discipline approximately 90% of the PCF competencies are taught and assessed. This compares favourably with the other disciplines. CONCLUSION Further work is required to establish a practical, effective approach to the assessment of prescribing competence especially between the university and clinical settings. Effective and reliable assessment of prescribing undertaken by students in diverse settings remains challenging.