What kind of sick person would see a Foot Doctor! The Foot Disease in Inpatients Study (FDIS)

Background Many different guidelines recommend people with foot complications, or those at risk, should attend multiple health professionals for foot care each year. However, few studies have investigated the characteristics of those attending health professionals for foot care and if those characteristics match those requiring foot care as per guideline recommendations. The aim of this paper was to determine the associated characteristics of people who attended a health professional for foot care in the year prior to their hospitalisation. Methods Eligible participants were all adults admitted overnight, for any reason, into five diverse hospitals on one day; excluding maternity, mental health and cognitively impaired patients. Participants underwent a foot examination to clinically diagnose different foot complications; including wounds, infections, deformity, peripheral arterial disease and peripheral neuropathy. They were also surveyed on social determinant, medical history, self-care, foot complication history, and, past health professional attendance for foot care in the year prior to hospitalisation. Results Overall, 733 participants consented; mean(±SD) age 62(±19) years, 408 (55.8%) male, 172 (23.5%) diabetes. Two hundred and fifty-six (34.9% (95% CI) (31.6-38.4)) participants had attended a health professional for foot care; including attending podiatrists 180 (24.5%), GPs 93 (24.6%), and surgeons 36 (4.9%). In backwards stepwise multivariate analyses attending any health professional for foot care was independently associated (OR (95% CI)) with diabetes (3.0 (2.1-4.5)), arthritis (1.8 (1.3-2.6)), mobility impairment (2.0 (1.4-2.9)) and previous foot ulcer (5.4 (2.9-10.0)). Attending a podiatrist was independently associated with female gender (2.6 (1.7-3.9)), increasing years of age (1.06 (1.04-1.08), diabetes (5.0 (3.2-7.9)), arthritis (2.0 (1.3-3.0)), hypertension (1.7 (1.1-2.6) and previous foot ulcer (4.5 (2.4-8.1). While attending a GP was independently associated with having a foot ulcer (10.4 (5.6-19.2). Conclusions Promisingly these findings indicate that people with a diagnosis of diabetes and arthritis are more likely to attend health professionals for foot care. However, it also appears those with active foot complications, or significant risk factors, may not be more likely to receive the multi-disciplinary foot care recommended by guidelines. More concerted efforts are required to ensure all people with foot complications are receiving recommended foot care.

An investigation into the thermophysical and rheological properties of nanofluids for solar thermal applications

Considered to be the next generation of heat transfer fluids, nanofluids have been receiving a growing amount of attention in the past decade despite the controversy and inconsistencies that have been reported. Nanofluids have great potential in a wide range of fields, particularly for solar thermal applications. This paper presents a comprehensive review of the literature on the enhancements in thermophysical and rheological properties resulting from experimental works conducted on molten salt nanofluids that are used in solar thermal energy systems. It was found that an increase in specific heat of 10–30% was achieved for most nanofluids and appeared independent of particle size and to an extent mass concentration. The specific heat increase was attributed to the formation of nanostructures at the solid–liquid interface and it was also noted that the aggregation of nanoparticles has detrimental effects on the specific heat increase. Thermal conductivity was also found to increase, though less consistently, ranging from 3% to 35%. Viscosity was seen to increase with the addition of nanoparticles and is dependent on the amount of aggregation of the particles. An in-depth micro level analysis of the mechanisms behind the thermophysical property changes is presented in this paper. In addition, possible trends are discussed relating to current theorised mechanisms in an attempt to explain the behaviour of molten salt nanofluids.

Development of an efficiency equation for solar evaporator- collectors

Considering the growing energy needs and concern for environmental degradation, clean and inexhaustible energy sources, e.g solar energy are receiving greater attention for various applications. The use of solar energy systems for low temperature applications reduces the burden on conventional fossil fuels and has little or no harmful effects on the environment. The performance of a solar system depends to a great extent on the collector used for the conversion of solar radiant energy to thermal energy. A solar evaporatorcollector (SEC) is basically an unglazed flat plate collector where refrigerant, like R134a, is used as the working fluid. As the operating temperature of SEC is very low, it collects energy both from solar irradiation and ambient energy leading to a much higher efficiency than the conventional collectors. The capability of SEC to utilize ambient energy also enables the system to operate at night. Therefore it is not appropriate to use for the evaluation of performance of SEC by conventional efficiency equation where ambient energy and condensation is not considered as energy input in addition to irradiation. In the National University of Singapore, several Solar Assisted Heat Pump (SAHP) systems were built for the evaluation of performance under the metrological condition of Singapore for thermal applications of desalination and SEC was the main component to harness renewable energy. In this paper, the design and performance of SEC are explored. Furthermore, an attempt is made to develop an efficiency equation for SEC and maximum efficiency attained 98% under the meteorological condition of Singapore.

The development and preliminary evaluation of an education intervention to prevent driveway run-over incidents

Objective While driveway run-over incidents continue to be a cause of serious injury and deaths among young children in Australia, few empirically evaluated educational interventions have been developed which address these incidents. Addressing this gap, this study describes the development and evaluation of a paper-based driveway safety intervention targeting caregivers of children aged 5 years or younger. Design Cross-sectional survey. Method and setting Informed by previous research, the intervention targeted key caregiver safety behaviours that address driveway risks. To assess the impact of the intervention, 137 Queensland (Australia) caregivers (95.0% women; mean age = 34.97 years) were recruited. After receiving the intervention, changes to a number of outcomes such as caregiver risk perception, safety knowledge and behavioural intentions were measured. Results Findings indicated that the intervention had increased general and specific situational risk awareness and safety knowledge among a substantial proportion of participants. Close to one-quarter of the sample strongly agreed that the intervention had increased these outcomes. In addition, 71.6% of the sample reported that they intended to make changes to their routine in and around the driveway, as a result of reading the intervention material and a further, quarter of the participants strongly agreed that the information provided would be a help both to themselves (26.5%) and other caregivers (33.8%) to keep their children safe in the driveway. Conclusion: While the educational intervention requires further validation, findings from this study suggest that intervention content and format increases driveway safety.

Impact of chemotherapy on cancer-related fatigue and cytokines in 1312 patients: A systematic review of quantitative studies

Purpose of review: Cancer-related fatigue (CRF) is the most common psychosomatic distress experienced by cancer patients before, during and after chemotherapy. Its impact on functional status and Health Related Quality of Life is a great concern among patients, healthcare professionals and researchers. The primary objective of this systematic review is to determine whether the different chemotherapies affect the association of CRF with individual pro- and anti-inflammatory cytokines. The PRISMA statement guideline has been followed to systematically search and screen article from PubMed and Embase. Recent findings: This review has examined 14 studies which included a total of 1312 patients. These studies assayed 20 different kinds of cytokines. The cytokines interleukin-6, interleukin-1RA, TGF-[beta] and sTNF-R2 were associated with CRF in patients receiving anthracycline-based chemotherapy. However, only interleukin-13 was identified in the taxane-based chemotherapy. Similarly, different sets of cytokines were linked with CRF in patients with chemotherapy regimens containing platinum, cyclophosphamides, topotecan or bleomycin. Summary: This review has identified that cytokines are differentially linked with CRF according to the various types of chemotherapy regimens.

Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) is a valid screening tool in chemotherapy outpatients

Purpose In the oncology population where malnutrition prevalence is high, more descriptive screening tools can provide further information to assist triaging and capture acute change. The Patient-Generated Subjective Global Assessment Short Form (PG-SGA SF) is a component of a nutritional assessment tool which could be used for descriptive nutrition screening. The purpose of this study was to conduct a secondary analysis of nutrition screening and assessment data to identify the most relevant information contributing to the PG-SGA SF to identify malnutrition risk with high sensitivity and specificity. Methods This was an observational, cross-sectional study of 300 consecutive adult patients receiving ambulatory anti-cancer treatment at an Australian tertiary hospital. Anthropometric and patient descriptive data were collected. The scored PG-SGA generated a score for nutritional risk (PG-SGA SF) and a global rating for nutrition status. Receiver operating characteristic curves (ROC) were generated to determine optimal cut-off scores for combinations of the PG-SGA SF boxes with the greatest sensitivity and specificity for predicting malnutrition according to scored PG-SGA global rating. Results The additive scores of boxes 1–3 had the highest sensitivity (90.2 %) while maintaining satisfactory specificity (67.5 %) and demonstrating high diagnostic value (AUC = 0.85, 95 % CI = 0.81–0.89). The inclusion of box 4 (PG-SGA SF) did not add further value as a screening tool (AUC = 0.85, 95 % CI = 0.80–0.89; sensitivity 80.4 %; specificity 72.3 %). Conclusions The validity of the PG-SGA SF in chemotherapy outpatients was confirmed. The present study however demonstrated that the functional capacity question (box 4) does not improve the overall discriminatory value of the PG-SGA SF.

Selecting rainfall events for effective Water Sensitive Urban Design: A case study in Gold Coast City, Australia

The current approach for protecting the receiving water environment from urban stormwater pollution is the adoption of structural measures commonly referred to as Water Sensitive Urban Design (WSUD). The treatment efficiency of WSUD measures closely depends on the design of the specific treatment units. As stormwater quality is influenced by rainfall characteristics, the selection of appropriate rainfall events for treatment design is essential to ensure the effectiveness of WSUD systems. Based on extensive field investigations in four urban residential catchments based at Gold Coast, Australia, and computer modelling, this paper details a technically robust approach for the selection of rainfall events for stormwater treatment design using a three-component model. The modelling results confirmed that high intensity-short duration events produce 58.0% of TS load while they only generated 29.1% of total runoff volume. Additionally, rainfall events smaller than 6-month average recurrence interval (ARI) generates a greater cumulative runoff volume (68.4% of the total annual runoff volume) and TS load (68.6% of the TS load exported) than the rainfall events larger than 6-month ARI. The results suggest that for the study catchments, stormwater treatment design could be based on the rainfall which had a mean value of 31 mm/h average intensity and 0.4 h duration. These outcomes also confirmed that selecting smaller ARI rainfall events with high intensity-short duration as the threshold for treatment system design is the most feasible approach since these events cumulatively generate a major portion of the annual pollutant load compared to the other types of events, despite producing a relatively smaller runoff volume. This implies that designs based on small and more frequent rainfall events rather than larger rainfall events would be appropriate in the context of efficiency in treatment performance, cost-effectiveness and possible savings in land area needed.