An investigation into the effectiveness of sensory modulation in reducing seclusion within an acute mental health unit

In this paper we report the findings from an evaluation of the introduction of sensory modulation (SM) in an acute mental health inpatient unit. It was expected that SM could be used to help settle patients experiencing high levels of disturbance and that as a result, there would be less need for use of more restrictive seclusion practices. The evaluation took place in a hospital in south-east Queensland, Australia. SM was introduced in one acute unit while the other served as a control. The evaluation comprised two studies. In the first study we aimed to determine whether SM reduced the level of disturbance among patients given the opportunity to use it. In the second study we aimed to find out whether the introduction of SM reduced the frequency and duration of seclusion. In study 1, we found that most patients reported marked reduction in disturbance after using SM and there was a very large effect size for the group as a whole. In study 2, we found that frequency of seclusion dropped dramatically in the unit that introduced SM but rose slightly in the unit that did not have access to SM. The change in seclusion rate was highly significant (χ2 = 49.1, df = 1, p < 0.001). Results are discussed, having reference to the limitations inherent in a naturalistic study.

A suitable method for journal bearing wear measurement

Purpose – Ideally, there is no wear in hydrodynamic lubrication regime. A small amount of wear occurs during start and stop of the machines and the amount of wear is so small that it is difficult to measure with accuracy. Various wear measuring techniques have been used where out-of-roundness was found to be the most reliable method of measuring small wear quantities in journal bearings. This technique was further developed to achieve higher accuracy in measuring small wear quantities. The method proved to be reliable as well as inexpensive. The paper aims to discuss these issues. Design/methodology/approach – In an experimental study, the effect of antiwear additives was studied on journal bearings lubricated with oil containing solid contaminants. The test duration was too long and the wear quantities achieved were too small. To minimise the test duration, short tests of about 90 min duration were conducted and wear was measured recording changes in variety of parameters related to weight, geometry and wear debris. The out-of-roundness was found to be the most effective method. This method was further refined by enlarging the out-of-roundness traces on a photocopier. The method was proved to be reliable and inexpensive. Findings – Study revealed that the most commonly used wear measurement techniques such as weight loss, roughness changes and change in particle count were not adequate for measuring small wear quantities in journal bearings. Out-of-roundness method with some refinements was found to be one of the most reliable methods for measuring small wear quantities in journal bearings working in hydrodynamic lubrication regime. By enlarging the out-of-roundness traces and determining the worn area of the bearing cross-section, weight loss in bearings was calculated, which was repeatable and reliable. Research limitations/implications – This research is a basic in nature where a rudimentary solution has been developed for measuring small wear quantities in rotary devices such as journal bearings. The method requires enlarging traces on a photocopier and determining the shape of the worn area on an out-of-roundness trace on a transparency, which is a simple but a crude method. This may require an automated procedure to determine the weight loss from the out-of-roundness traces directly. This method can be very useful in reducing test duration and measuring wear quantities with higher precision in situations where wear quantities are very small. Practical implications – This research provides a reliable method of measuring wear of circular geometry. The Talyrond equipment used for measuring the change in out-of-roundness due to wear of bearings indicates that this equipment has high potential to be used as a wear measuring device also. Measurement of weight loss from the traces is an enhanced capability of this equipment and this research may lead to the development of a modified version of Talyrond type of equipment for wear measurements in circular machine components. Originality/value – Wear measurement in hydrodynamic bearings requires long duration tests to achieve adequate wear quantities. Out-of-roundness is one of the geometrical parameters that changes with progression of wear in a circular shape components. Thus, out-of-roundness is found to be an effective wear measuring parameter that relates to change in geometry. Method of increasing the sensitivity and enlargement of out-of-roundness traces is original work through which area of worn cross-section can be determined and weight loss can be derived for materials of known density with higher precision.

UWB channel measurement and data transfer analysis for multiuser Infostation applications

In this paper, the results of the time dispersion parameters obtained from a set of channel measurements conducted in various environments that are typical of multiuser Infostation application scenarios are presented. The measurement procedure takes into account the practical scenarios typical of the positions and movements of the users in the particular Infostation network. To provide one with the knowledge of how much data can be downloaded by users over a given time and mobile speed, data transfer analysis for multiband orthogonal frequency division multiplexing (MB-OFDM) is presented. As expected, the rough estimate of simultaneous data transfer in a multiuser Infostation scenario indicates dependency of the percentage of download on the data size, number and speed of the users, and the elapse time.

Social Media Audience Metrics as a New Form of TV Audience Measurement

Digital media have contributed to significant disruptions in the business of audience measurement. Television broadcasters have long relied on simple and authoritative measures of who is watching what. The demand for ratings data, as a common currency in transactions involving advertising and program content, will likely remain, but accompanying measurements of audience engagement with media content would also be of value. Today's media environment increasingly includes social media and second-screen use, providing a data trail that affords an opportunity to measure engagement. If the limitations of using social media to indicate audience engagement can be overcome, social media use may allow for quantitative and qualitative measures of engagement. Raw social media data must be contextualized, and it is suggested that tools used by sports analysts be incorporated to do so. Inspired by baseball's Sabremetrics, the authors propose Telemetrics in an attempt to separate actual performance from contextual factors. Telemetrics facilitates measuring audience activity in a manner controlling for factors such as time slot, network, and so forth. It potentially allows both descriptive and predictive measures of engagement.

Implementing a context-based environmental science unit in the middle years: Teaching and learning at the creek

Engaging middle-school students in science continues to be a challenge in Australian schools. One initiative that has been tried in the senior years but is a more recent development in the middle years is the context-based approach. In this ethnographic study, we researched the teaching and learning transactions that occurred in one 9th grade science class studying a context-based Environmental Science unit that included visits to the local creek for 11 weeks. Data were derived from field notes, audio and video recorded conversations, interviews, student journals and classroom documents with a particular focus on two selected groups of students. This paper presents two assertions that highlight pedagogical approaches that contributed to learning. Firstly, spontaneous teaching episodes created opportunities for in-the-moment questioning by the teacher that led to students’ awareness of environmental issues and the scientific method; secondly, group work using flip cameras afforded opportunities for students to connect the science concepts with the context. Furthermore, students reported positively about the unit and expressed their appreciation for the opportunity to visit the creek frequently. This findings from this study should encourage teachers to take students into the real-world field for valuable teaching and learning experiences that are not available in the formal classroom.

Adolescent sexual behavioral intentions measurement: A gender approach in the Colombian Caribbean region [Medición de la Intención en la Actividad Sexual en Adolescentes: una Aproximación de Acuerdo al Género del Caribe Colombiano]

The study of 1777 male and female adolescent students of 11-19 years in the Colombian Caribbean had two objectives: development and validation of two reproductive health intention scales and analyze gender differences. The pilot of the scale consisted of 8 items and was reduced to 6, to check the reliability and validity using factor analysis and principal components with VARIMAX rotation yielded two factors: Intention and Intention Risk Protection, explained between 69.4% and 70% respectively. In the male Protection Intent (M = 3.87 and SD = 1.29) and risk (M = 2.56 and SD = 1.18) obtained an alpha between 0.74 and 0.86, and in Protection of Intent to female (M = 3.49 and SD = 1.35) and risk (M = 1.50 and SD = 0.89) ranged between 0.78 and 086. In conclusion, the reliability and structural stability are adequate and there are gender differences in the scales.

The measurement of intraocular pressure over positive soft contact lenses by rebound tonometry [Medición de la presión intraocular sobre lentes de contacto blandas positivas, mediante tonometría de rebote]

Purpose To investigate if the accuracy of intraocular pressure (IOP) measurements using rebound tonometry over disposable hydrogel (etafilcon A) contact lenses (CL) is affected by the positive power of the CLs. Methods The experimental group comprised 26 subjects, (8 male, 18 female). IOP measurements were undertaken on the subjects’ right eyes in random order using a Rebound Tonometer (ICare). The CLs had powers of +2.00D and +6.00D. Measurements were taken over each contact lens and also before and after the CLs had been worn. Results The IOP measure obtained with both CLs was significantly lower compared to the value without CLs (t test; p<0.001) but no significant difference was found between the two powers of CLs. Conclusions Rebound tonometry over positive hydrogel CLs leads to a certain degree of IOP underestimation. This result didn’t change for the two positive lenses used in the experiment, despite their large difference in power and therefore in lens thickness. Optometrists should bear this in mind when measuring IOP with the rebound tonometer over plus power contact lenses.

Label-free isolation of a prostate cancer cell among blood cells and the single-cell measurement of drug accumulation using an integrated microfluidic chip

Circulating tumor cells (CTCs) are found in the blood of patients with cancer. Although these cells are rare, they can provide useful information for chemotherapy. However, isolation of these rare cells from blood is technically challenging because they are small in numbers. An integrated microfluidic chip, dubbed as CTC chip, was designed and fabricated for conducting tumor cell isolation. As CTCs usually show multidrug resistance (MDR), the effect of MDR inhibitors on chemotherapeutic drug accumulation in the isolated single tumor cell is measured. As a model of CTC isolation, human prostate tumor cells were mixed with mouse blood cells and the labelfree isolation of the tumor cells was conducted based on cell size difference. The major advantages of the CTC chip are the ability for fast cell isolation, followed by multiple rounds of single-cell measurements, suggesting a potential assay for detecting the drug responses based on the liquid biopsy of cancer patients.

Communicating consequences with costs: A commentary on Corso et al's cost of injury

Estimating the economic burden of injuries is important for setting priorities, allocating scarce health resources and planning cost-effective prevention activities. As a metric of burden, costs account for multiple injury consequences—death, severity, disability, body region, nature of injury—in a single unit of measurement. In a 1989 landmark report to the US Congress, Rice et al1 estimated the lifetime costs of injuries in the USA in 1985. By 2000, the epidemiology and burden of injuries had changed enough that the US Congress mandated an update, resulting in a book on the incidence and economic burden of injury in the USA.2 To make these findings more accessible to the larger realm of scientists and practitioners and to provide a template for conducting the same economic burden analyses in other countries and settings, a summary3 was published in Injury Prevention. Corso et al reported that, between 1985 and 2000, injury rates declined roughly 15%. The estimated lifetime cost of these injuries declined 20%, totalling US$406 billion, including US$80 billion in medical costs and US$326 billion in lost productivity. While incidence reflects problem size, the relative burden of injury is better expressed using costs.

Measurement of transit network accessibility based on access stop choice behaviour

This research improved the measurement of public transport accessibility by capturing; travellers' behaviour; diversity of public transport mode; and the subjectivity of travellers' decision in the complex transport networks. The results of this research not only highlighted the importance of considering public transport network characteristics but also, revealed the impact of public transport diversity in the modelling of public transport accessibility. The research developed a hybrid discrete choice model with a nested logit structure to treat the correlation among the public transport mode choices and, a logit correction factor to rectify the correlation among the stop choices.

MRI-based measurement of carotid mechanical properties in asymptomatic patients

Arterial mechanical property may be a potential variable for risk stratification. Large artery and central arterial compliance have been shown not only to correlate well with overall cardiovascular outcome in large epidemiological studies [1, 2] but also to correlate with coronary atherosclerotic burden as measured by conventional angiography [3]. Until recently, real-time B-mode ultrasound combined with simultaneous blood pressure measurements have been used to assess large artery compliance [4]. These techniques have an excellent temporal resolution but are unable to provide adequate spatial resolution to determine changes in vessel area as opposed to diameter and make the assumption that the vessel is perfectly round. Attempts to use MR imaging to measure large artery compliance have been published previously [5]. However, they have not utilised simultaneous blood pressure measurements during sequence acquisition. We report a technique using regular and simultaneous blood pressure measurement during 2 dimensional phase contrast magnetic resonance imaging 2DPC-MRI to determine local carotid compliance.

Experimental measurement of the mechanical properties of carotid atherothrombotic plaque fibrous cap

Eleven carotid atherothrombotic plaque samples were harvested from patients. Three samples that were highly calcified were discarded, while eight yielded results. The elastic properties of the material were estimated by fitting the measured indentation response to finite element simulations. The methodology was refined and its accuracy quantified using a synthetic rubber. The neo-Hookean form of the material model gave a good fit to the measured response of the tissue. The inferred shear modulus μ was found to be in the range 7-100 kPa, with a median value of 11 kPa. A review of published materials data showed a wide range of material properties for human atherothrombotic tissue. The effects of anisotropy and time dependency in these published results were highlighted. The present measurements were comparable to the static radial compression tests of Lee et al, 1991 [Structure-dependent dynamic behaviour of fibrous caps from human atherosclerotic plaques. Circulation 83, 1764-1770].

Measurement of stenotic carotid arterial compliance with MRI

Arterial compliance has been shown to correlate well with overall cardiovascular outcome and it may also be a potential risk factor for the development of atheromatous disease. This study assesses the utility of 2-D phase contrast Magnetic Resonance (MR) imaging with intra-sequence blood pressure measurement to determine carotid compliance and distensibility. 20 patients underwent 2-D phase contrast MR imaging and also ultrasound-based wall tracking measurements. Values for carotid compliance and distensibility were derived from the two different modalities and compared. Linear regression analysis was utilised to determine the extent of correlation between MR and ultrasound derived parameters. In those variables that could be directly compared, an agreement analysis was undertaken. MR measures of compliance showed a good correlation with measures based on ultrasound wall-tracking (r=0.61, 95% CI 0.34 to 0.81 p=0.0003). Vessels that had undergone carotid endarterectomy previously were significantly less compliant than either diseased or normal contralateral vessels (p=0.04). Agreement studies showed a relatively poor intra-class correlation coefficient (ICC) between diameter-based measures of compliance through either MR or ultrasound (ICC=0.14). MRI based assessment of local carotid compliance appears to be both robust and technically feasible in most subjects. Measures of compliance correlate well with ultrasound-based values and correlate best when cross-sectional area change is used rather than derived diameter changes. If validated by further larger studies, 2-D phase contrast imaging with intra-sequence blood pressure monitoring and off-line radial artery tonometry may provide a useful tool in further assessment of patients with carotid atheroma.

In vivo positive contrast IRON sequence and quantitative T2* measurement confirms inflammatory burden in a patient with asymptomatic carotid atheroma after USPIO-enhanced MR Imaging

The authors report an in vivo human examination of carotid atheroma by using the inversion-recovery ON resonance (IRON) sequence, which is able to produce positive contrast after the infusion of an ultrasmall super paramagnetic iron oxide (USPIO) contrast medium. This technique provides a method of potentially identifying inflammatory burden within carotid atheroma. This may be particularly useful in patients who currently do not meet criteria for intervention (ie, moderate symptomatic stenosis or <70% asymptomatic stenosis) to further risk-stratify this important patient cohort. A 63-year-old man was imaged at 1.5 T before and 36 hours after USPIO infusion by using the IRON sequence. Regions of interest showing profound signal loss at T2*-weighted imaging corresponded well with regions of positive contrast at IRON imaging after the administration of USPIO. These regions also showed a profound decrease in T2* measurements after USPIO infusion, whereas surrounding tissue did not. It has been shown that such strong signal loss on T2*-weighted images after USPIO infusion is indicative of USPIO uptake.

The introduction of an Inter-professional learning unit: staff and student perspectives

Background The School of Clinical Sciences comprises a number of health disciplines including podiatry, paramedic science, pharmacy, medical imaging and radiation therapy. A new inter-professional unit was introduced in 2014, which covered key introductory learnings applicable for future health practitioners. This study examined teaching staff and student perspectives about their experience with the new unit for first year students. Methods Qualitative interviews with teaching staff (n=9) and focus group interviews with students (5 groups which ranged in size from 4-30) were conducted. Extensive notes were taken during the interviews Issues emerging from the interviews were identified and organised according to themes and subthemes. Results Four major themes were identified namely: Something new; To be or not to be that is the question; Advantages of the new unit; and Areas for improvement. Previous staff experience with inter-professional learning (IPL) had been ad-hoc, whereas the new unit brought together several disciplines in a planned and deliberate way. There was strong philosophical agreement about the value of IPL but some debate about the extent to which the unit provided IPL experience. The unit was seen as assisting students’ social and academic adjustment to university and provided opportunity for professional socialisation, exposure to macro and micro aspects of the Australian health care system and various types of communication. For podiatry students it was their first opportunity to formally meet and work with other podiatry students and moved their identity from ‘university student’ to ‘podiatry student’. Other positives included providing the opportunity for staff and students to interact at an early stage with the perceived benefit of reducing attrition. Areas for unit improvement included institutional arrangements, unit administration aspects and assessment. Conclusion The unit was seen as beneficial by staff and students however, students were more polarised in their views than staff. There was a tension between feeling apart of and learning about one's own profession and feeling apart of and learning about the roles of other health professionals in relation to patient care and the health care system.