Patients Undergoing Subacute Physical Rehabilitation following an Acute Hospital Admission Demonstrated Improvement in Cognitive Functional Task Independence

Objective. This study investigated cognitive functioning among older adults with physical debility not attributable to an acute injury or neurological condition who were receiving subacute inpatient physical rehabilitation. Design. A cohort investigation with assessments at admission and discharge. Setting. Three geriatric rehabilitation hospital wards. Participants. Consecutive rehabilitation admissions () following acute hospitalization (study criteria excluded orthopaedic, neurological, or amputation admissions). Intervention. Usual rehabilitation care. Measurements. The Functional Independence Measure (FIM) Cognitive and Motor items. Results. A total of 704 (86.5%) participants (mean age = 76.5 years) completed both assessments. Significant improvement in FIM Cognitive items (-score range 3.93–8.74, all ) and FIM Cognitive total score (-score = 9.12, ) occurred, in addition to improvement in FIM Motor performance. A moderate positive correlation existed between change in Motor and Cognitive scores (Spearman’s rho = 0.41). Generalized linear modelling indicated that better cognition at admission (coefficient = 0.398, ) and younger age (coefficient = −0.280, ) were predictive of improvement in Motor performance. Younger age (coefficient = −0.049, ) was predictive of improvement in FIM Cognitive score. Conclusions. Improvement in cognitive functioning was observed in addition to motor function improvement among this population. Causal links cannot be drawn without further research.

An efficiency optimization scheme for bidirectional inductive power transfer systems

Unidirectional inductive power transfer (UIPT) systems allow loads to consume power while bidirectional IPT (BIPT) systems are more suitable for loads requiring two way power flow such as vehicle to grid (V2G) applications with electric vehicles (EVs). Many attempts have been made to improve the performance of BIPT systems. In a typical BIPT system, the output power is control using the pickup converter phase shift angle (PSA) while the primary converter regulates the input current. This paper proposes an optimized phase shift modulation strategy to minimize the coil losses of a series – series (SS) compensated BIPT system. In addition, a comprehensive study on the impact of power converters on the overall efficiency of the system is also presented. A closed loop controller is proposed to optimize the overall efficiency of the BIPT system. Theoretical results are presented in comparison to both simulations and measurements of a 0.5 kW prototype to show the benefits of the proposed concept. Results convincingly demonstrate the applicability of the proposed system offering high efficiency over a wide range of output power.

A communication model and partitioning algorithm for streaming applications for an embedded MPSoC

Energy efficient embedded computing enables new application scenarios in mobile devices like software-defined radio and video processing. The hierarchical multiprocessor considered in this work may contain dozens or hundreds of resource efficient VLIW CPUs. Programming this number of CPU cores is a complex task requiring compiler support. The stream programming paradigm provides beneficial properties that help to support automatic partitioning. This work describes a compiler for streaming applications targeting the self-build hierarchical CoreVA-MPSoC multiprocessor platform. The compiler is supported by a programming model that is tailored to fit the streaming programming paradigm. We present a novel simulated-annealing (SA) based partitioning algorithm, called Smart SA. The overall speedup of Smart SA is 12.84 for an MPSoC with 16 CPU cores compared to a single CPU implementation. Comparison with a state of the art partitioning algorithm shows an average performance improvement of 34.07%.

Perceived barriers and facilitators to increasing physical activity among people with musculoskeletal disorders : a qualitative investigation to inform intervention development

Purpose Musculoskeletal conditions can impair people’s ability to undertake physical activity as they age. The purpose of this qualitative study was to investigate perceived barriers and facilitators to undertaking physical activity reported by patients accessing ambulatory hospital clinics for musculoskeletal disorders. Patients and methods A questionnaire with open-ended items was administered to patients (n=217, 73.3% of 296 eligible) from three clinics providing ambulatory services for nonsurgical treatment of musculoskeletal disorders. The survey included questions to capture the clinical and demographic characteristics of the sample. It also comprised two open-ended questions requiring qualitative responses. The first asked the participant to describe factors that made physical activity more difficult, and the second asked which factors made it easier for them to be physically active. Participants’ responses to the two open-ended questions were read, coded, and thematically analyzed independently by two researchers, with a third researcher available to arbitrate any unresolved disagreement. Results The mean (standard deviation) age of participants was 53 (15) years; n=113 (52.1%) were male. A total of 112 (51.6%) participants reported having three or more health conditions; n=140 (64.5%) were classified as overweight or obese. Five overarching themes describing perceived barriers for undertaking physical activity were "health conditions", "time restrictions", "poor physical condition", "emotional, social, and psychological barriers", and "access to exercise opportunities". Perceived physical activity facilitators were also aligned under five themes, namely "improved health state", "social, emotional, and behavioral supports", "access to exercise environment", "opportunities for physical activities", and "time availability". Conclusion It was clear from the breadth of the data that meaningful supports and interventions must be multidimensional. They should have the capacity to address a variety of physical, functional, social, psychological, motivational, environmental, lifestyle, and other perceived barriers. It would appear that for such interventions to be effective, they should be flexible enough to address a variety of specific concerns.

Burden of decompensated cirrhosis and ascites on hospital services in a tertiary care facility: time for change?

Background Ascites, the most frequent complication of cirrhosis, is associated with poor prognosis and reduced quality of life. Recurrent hospital admissions are common and often unplanned, resulting in increased use of hospital services. Aims To examine use of hospital services by patients with cirrhosis and ascites requiring paracentesis, and to investigate factors associated with early unplanned readmission. Methods A retrospective review of the medical chart and clinical databases was performed for patients who underwent paracentesis between October 2011 and October 2012. Clinical parameters at index admission were compared between patients with and without early unplanned hospital readmissions. Results The 41 patients requiring paracentesis had 127 hospital admissions, 1164 occupied bed days and 733 medical imaging services. Most admissions (80.3%) were for management of ascites, of which 41.2% were unplanned. Of those eligible, 69.7% were readmitted and 42.4% had an early unplanned readmission. Twelve patients died and nine developed spontaneous bacterial peritonitis. Of those eligible for readmission, more patients died (P = 0.008) and/or developed spontaneous bacterial peritonitis (P = 0.027) if they had an early unplanned readmission during the study period. Markers of liver disease, as well as haemoglobin (P = 0.029), haematocrit (P = 0.024) and previous heavy alcohol use (P = 0.021) at index admission, were associated with early unplanned readmission. Conclusion Patients with cirrhosis and ascites comprise a small population who account for substantial use of hospital services. Markers of disease severity may identify patients at increased risk of early readmission. Alternative models of care should be considered to reduce unplanned hospital admissions, healthcare costs and pressure on emergency services.

Tobacco use in South Africans during 1998: The first demographic and health survey

Objective To determine smoking patterns in South Africa, and to identify groups requiring culturally appropriate smoking cessation programmes. Methods A random sample of 13 826 people (415 years), was interviewed to identify tobacco use patterns and respiratory symptoms. Peak expiratory flow rates were measured. Multinomial regression analyses identified sociodemographic factors related to tobacco use, and the latter’s association with respiratory conditions. Results In 1998, 24.6% adults (44.2% of males and 11.0% of females) smoked regularly. Coloured women had a higher rate (39%) than African women (5.4%). About 24% of the regular smokers had attempted to quit, with only 9.9% succeeding. African women (13.2%) used smokeless tobacco more frequently than others. Of the nonsmokers 28% and 19% were exposed to environmental tobacco smoke in their homes and workplaces, respectively. The regression analysis showed that the demographic characteristics of light smokers (1–14 tobacco equivalents per day) and heavy smokers (>=15 tobacco equivalents per day) differed. Light smoking occurred significantly more frequently in the poorest, least educated and urban people. The relative risk for light smoking was 18 in Coloured women compared with African women. Heavy smoking occurred most frequently in the highest educated group. A dose–response was observed between the amount smoked and the presence of respiratory diseases. Conclusions Smoking in South Africa is decreasing and should continue with the recently passed tobacco control legislation. Culturally appropriate tobacco cessation programmes for the identified target groups need to be developed.

Magnetic resonance imaging: An accurate, radiation-free, alternative to computed tomography for the primary imaging and three-dimensional reconstruction of the bony orbit

Purpose: To determine the extent to which the accuracy of magnetic resonance imaging (MRI) based virtual 3-dimensional (3D) models of the intact orbit can approach that of the gold standard, computed tomography (CT) based models. The goal was to determine whether MRI is a viable alternative to CT scans in patients with isolated orbital fractures and penetrating eye injuries, pediatric patients, and patients requiring multiple scans in whom radiation exposure is ideally limited. Materials and Methods: Patients who presented with unilateral orbital fractures to the Royal Brisbane and Women’s Hospital from March 2011 to March 2012 were recruited to participate in this cross-sectional study. The primary predictor variable was the imaging technique (MRI vs CT). The outcome measurements were orbital volume (primary outcome) and geometric intraorbital surface deviations (secondary outcome)between the MRI- and CT-based 3D models. Results: Eleven subjects (9 male) were enrolled. The patients’ mean age was 30 years. On average, the MRI models underestimated the orbital volume of the CT models by 0.50 0.19 cm3 . The average intraorbital surface deviation between the MRI and CT models was 0.34 0.32 mm, with 78 2.7% of the surface within a tolerance of 0.5 mm. Conclusions: The volumetric differences of the MRI models are comparable to reported results from CT models. The intraorbital MRI surface deviations are smaller than the accepted tolerance for orbital surgical reconstructions. Therefore, the authors believe that MRI is an accurate radiation-free alternative to CT for the primary imaging and 3D reconstruction of the bony orbit. �

BIM - Implications for government (Case Study No. 5 [2004-032-A + Case study no. 5])

BIM as a suite of technologies has been enabled by the significant improvements in IT infrastructure, the capabilities of computer hardware and software, the increasing adoption of BIM, and the development of Industry Foundation Classes (IFC) which facilitate the sharing of information between firms. The report highlights the advantages of BIM, particularly the increased utility and speed, better data quality and enhanced fault finding in all construction phases. Additionally BIM promotes enhanced collaborations and visualisation of data mainly in the design and construction phase. There are a number of barriers to the effective implementation of BIM. These include, somewhat paradoxically, a single detailed model (which precludes scenarios and development of detailed alternative designs); the need for three different interoperability standards for effective implementation; added work for the designer which needs to be recognised and remunerated; the size and complexity of BIM, which requires significant investment in human capital to enable the realisation of its full potential. There are also a number of challenges to implementing BIM. The report has identified these as a range of issues concerning: IP, liability, risks and contracts, and the authenticity of users. Additionally, implementing BIM requires investment in new technology, skills training and development of news ways of collaboration. Finally, there are likely to be Trade Practices concerns as requiring certain technology owned by relatively few firms may limit

Urban citizenship in a sensor rich society

Urban public spaces are sutured with a range of surveillance and sensor technologies that claim to enable new forms of ‘data based citizen participation’, but also increase the tendency for ‘function-creep’, whereby vast amounts of data are gathered, stored and analysed in a broad application of urban surveillance. This kind of monitoring and capacity for surveillance connects with attempts by civic authorities to regulate, restrict, rebrand and reframe urban public spaces. A direct consequence of the increasingly security driven, policed, privatised and surveilled nature of public space is the exclusion or ‘unfavourable inclusion’ of those considered flawed and unwelcome in the ‘spectacular’ consumption spaces of many major urban centres. In the name of urban regeneration, programs of securitisation, ‘gentrification’ and ‘creative’ and ‘smart’ city initiatives refashion public space as sites of selective inclusion and exclusion. In this context of monitoring and control procedures, in particular, children and young people’s use of space in parks, neighbourhoods, shopping malls and streets is often viewed as a threat to the social order, requiring various forms of remedial action. This paper suggests that cities, places and spaces and those who seek to use them, can be resilient in working to maintain and extend democratic freedoms and processes enshrined in Marshall’s concept of citizenship, calling sensor and surveillance systems to account. Such accountability could better inform the implementation of public policy around the design, build and governance of public space and also understandings of urban citizenship in the sensor saturated urban environment.

Shared values : diverse perspectives – engaging engineering educators in integrating Indigenous engineering knowledge into current curricula

BACKGROUND Engineering is a problem-based practically oriented discipline, whose practitioners aim to find effective solutions to engineering challenges, technically and economically. Engineering educators operate within a mandate to ensure that graduate engineers understand the practicalities and realities of good engineering practice. While this is a vital goal for the discipline, emerging influences are challenging the focus on ‘hard practicalities’ and requiring recognition of the cultural and social aspects of engineering. Expecting graduate engineers to possess communication skills essential for negotiating satisfactory outcomes in contexts of complex social beliefs about the impact of their work can be an unsettling and challenging prospect for engineering educators. This project identifies and addresses Indigenous engineering practices and principles, and their relevance to future engineering practices. PURPOSE This Office of Learning and Teaching (OLT) project proposes that what is known/discoverable about indigenous engineering knowledge and practices must be integrated into engineering curricula. This is an important aspect of ensuring that engineering as a profession responds competently to increasing demands for socially and environmentally responsible activity across all aspects of engineering activity. DESIGN/METHOD The project addresses i) means for appropriate inclusion of Indigenous students into usual teaching activities ii) assuring engineering educators have access to knowledge of Indigenous practices and skills relevant to particular engineering courses and topics iii) means for preparing all students to negotiate their way through issues of indigenous relationships with the land where engineering projects are planned. The project is undertaking wide-ranging research to collate knowledge about indigenous engineering principles and practices and develop relevant resource materials. RESULTS It is common to hear that such social issues as ‘Indigenous concerns’ are only of concern to environmental engineers. We challenge that perspective, and make the case that Indigenous knowledge is an important issue for all engineering educators in relation to effective integration of indigenous students and preparation of all engineering graduates to engage with indigenous communities. At the time of first contact, a rich and varied, technically literate, Indigenous social framework possessed knowledge of the environment that is not yet fully acknowledged in Australian society. A core outcome of the work will be development of resources relating to Indigenous engineering practices for inclusion in engineering core curricula. CONCLUSIONS A large body of technical knowledge was needed to survive and sustain human society in the complex environment that was Australia before 1788. This project is developing resource materials, and supporting documentation, about that knowledge to enable engineering educators to more easily integrate it into current curricula. The project also aims to demonstrate the importance for graduating engineers to appreciate the existence of diverse perspectives on engineering tasks and learn how to value - and employ - multiple paths to possible solutions.

Copycat firesetting : bridging two research areas

Deliberate firesetting costs our community in destruction to property and lives. Public concern heightens when similar fires occur in a series, raising the specter of copycat firesetting. Difficulties associated with researching copycat crimes in general mean that not a lot is known about copycat firesetting. As an initial step toward filling this research gap, we explore connections between research on copycat crime and research into deliberate firesetting. The intention is to extract salient features from what is known about the phenomena of deliberate firesetting and copycat crime, map them together, and point out shared and unique characteristics. It is argued that a “copycat firesetter” is likely to exist as a distinct subgroup and potentially requiring targeted interventions.

Locally weighted learning methods for non-rigid robot control

This thesis develops a novel approach to robot control that learns to account for a robot's dynamic complexities while executing various control tasks using inspiration from biological sensorimotor control and machine learning. A robot that can learn its own control system can account for complex situations and adapt to changes in control conditions to maximise its performance and reliability in the real world. This research has developed two novel learning methods, with the aim of solving issues with learning control of non-rigid robots that incorporate additional dynamic complexities. The new learning control system was evaluated on a real three degree-of-freedom elastic joint robot arm with a number of experiments: initially validating the learning method and testing its ability to generalise to new tasks, then evaluating the system during a learning control task requiring continuous online model adaptation.

Options for rehabilitation in interlock programs

This report examines the effectiveness of national and international programs that treat and rehabilitate drivers with alcohol dependence and the criteria used to approve the removal of interlocks. The project recommends a stepped care model which requires all participants to attend education and screening and then requires participants who fail to change their behaviour to attend increasingly intensive rehabilitation programs. Failure to complete an interlock program could result in participants having their licence revoked. This project was designed to inform action 36(d) of the National Road Safety Strategy 2011-2020: Investigate the option of requiring demonstrated rehabilitation from alcohol dependence before removal of interlock conditions.

Application of a Bayesian Network complex system model to a successful community electricity demand reduction program

Utilities worldwide are focused on supplying peak electricity demand reliably and cost effectively, requiring a thorough understanding of all the factors influencing residential electricity use at peak times. An electricity demand reduction project based on comprehensive residential consumer engagement was established within an Australian community in 2008, and by 2011, peak demand had decreased to below pre-intervention levels. This paper applied field data discovered through qualitative in-depth interviews of 22 residential households at the community to a Bayesian Network complex system model to examine whether the system model could explain successful peak demand reduction in the case study location. The knowledge and understanding acquired through insights into the major influential factors and the potential impact of changes to these factors on peak demand would underpin demand reduction intervention strategies for a wider target group.

The Lymphedema Evaluation in Gynecological cancer Study (LEGS): Design of a prospective, longitudinal, cohort study

Background The Lymphoedema Evaluation in Gynecological cancer Study (LEGS) was a longitudinal, observational, cohort study prospectively evaluating the incidence and risk factors of lower-limb lymphedema after treatment for gynecological cancer. Here we describe the study protocol and characteristics of the sample. Methods Women with a newly diagnosed gynecological cancer between June 1, 2008 and February 28, 2011, aged 18 years or older, and treated at one of six hospitals in Queensland, Australia, were eligible. Lymphedema was assessed by circumference measurements, bioimpedance spectroscopy, and self-reported swelling. LEGS incorporated a cohort of patients requiring surgery for benign gynecological conditions for comparison purposes. Data were collected prior to surgery and at regular intervals thereafter up to 2-years post-diagnosis. Results 546 women participated (408 cancer, 138 benign), with a 24-month retention rate of 78%. Clinical and treatment characteristics of participants were similar to the Queensland gynecological cancer population, except for a higher proportion of early-stage cervical cancers recruited to LEGS compared with Queensland proportions (89% versus 55%, respectively). Discussion Few imbalances were observed between participants with complete and incomplete follow-up data. The prospective design and collection of objective and patient-reported outcome data will allow comprehensive assessment of incidence and risk factors of lower-limb lymphedema.