Advances and future directions for management of trauma patients with musculoskeletal injuries

Musculoskeletal injuries are the most common reason for operative procedures in severely injured patients and are major determinants of functional outcomes. In this paper, we summarise advances and future directions for management of multiply injured patients with major musculoskeletal trauma. Improved understanding of fracture healing has created new possibilities for management of particularly challenging problems, such as delayed union and non union of fractures and large bone defects. Optimum timing of major orthopaedic interventions is guided by increased knowledge about the immune response after injury. Individual treatment should be guided by trading off the benefits of early definitive skeletal stabilisation, and the potentially life-threatening risks of systemic complications such as fat embolism, acute lung injury, and multiple organ failure. New methods for measurement of fracture healing and function and quality of life outcomes pave the way for landmark trials that will guide the future management of musculoskeletal injuries.

Evaluation of the quality of diverse teaching practice in higher education research methods

The purpose of this paper is to report on a methods research project investigating the evaluation of diverse teaching practice in Higher Education. The research method is a single site case study of an Australian university with data collected through published documents, surveys, interviews and focus groups. This project provides evidence of the wide variety of evaluation practice and diverse teaching practice across the university. This breadth identifies the need for greater flexibility of evaluation processes, tools and support to assist teaching staff to evaluate their diverse teaching practice. The employment opportunities for academics benchmark the university nationally and position the case study in the field. Finally this reaffirms the institutional responsibility for services to support teaching staff in an ongoing manner.

The Donald Mackay Churchill Fellowship to study methods of preventing and supporting victims of online fraud

Every day inboxes are being flooded with invitations to invest money in overseas schemes, notifications of overseas lottery wins and inheritances, as well as emails from banks and other institutions asking for customers to confirm information about their identity and account details. While these requests may seem outrageous, many believe the request to be true and respond, through the sending of money or personal details. This can have devastating consequences, financially, emotionally and physically. While enforcement action is important, greater success is likely to come in the area of prevention, which avoids victim losses in the first place. Considerable victim support is also required by victims who have suffered significant losses, in trying to get their lives back on track. This project examined fraud prevention strategies and support services for victims of online fraud across the United Kingdom, United States of America and Canada. While much work has already been undertaken in Queensland, there is considerable room for improvement and a great deal can be learnt from these overseas jurisdictions. There are several examples of innovative and effective responses, particularly in the area of victim support, that are highlighted throughout this report. It is advocated that Australia can continue to improve its position regarding the prevention and support of online fraud victims, by applying the knowledge and expertise learnt overseas to a local context.

Refraction in children : a comparison of two methods of accommodation control

Purpose: The prevalence of refractive errors in children has been extensively researched. Comparisons between studies can, however, be compromised because of differences between accommodation control methods and techniques used for measuring refractive error. The aim of this study was to compare spherical refractive error results obtained at baseline and using two different accommodation control methods – extended optical fogging and cycloplegia, for two measurement techniques – autorefraction and retinoscopy. Methods: Participants comprised twenty-five school children aged between 6 and 13 years (mean age: 9.52 ± 2.06 years). The refractive error of one eye was measured at baseline and again under two different accommodation control conditions: extended optical fogging (+2.00DS for 20 minutes) and cycloplegia (1% cyclopentolate). Autorefraction and retinoscopy were both used to measure most plus spherical power for each condition. Results: A significant interaction was demonstrated between measurement technique and accommodation control method (p = 0.036), with significant differences in spherical power evident between accommodation control methods for each of the measurement techniques (p < 0.005). For retinoscopy, refractive errors were significantly more positive for cycloplegia compared to optical fogging, which were in turn significantly more positive than baseline, while for autorefraction, there were significant differences between cycloplegia and extended optical fogging and between cycloplegia and baseline only. Conclusions: Determination of refractive error under cycloplegia elicits more plus than using extended optical fogging as a method to relax accommodation. These findings support the use of cycloplegic refraction compared with extended optical fogging as a means of controlling accommodation for population based refractive error studies in children.

More is not necessarily better. A biomechanical study on distal screw numbers in volar locking distal radius plates

INTRODUCTION: Currently available volar locking plates for the treatment of distal radius fractures incorporate at least two distal screw rows for fixation of the metaphyseal fragment and have a variable-angle locking mechanism which allows placement of the screws in various directions There is, however no evidence that these plates translate into better outcomes or have superior biomechanical properties to first generation plates, which had a single distal screw row and fixed-angle locking. The aim of our biomechanical study was to compare fixed-angle single-row plates with variable-angle multi-row plates to clarify the optimal number of locking screws. MATERIALS AND METHODS: Five different plate-screw combinations of three different manufacturers were tested, each group consisting of five synthetic fourth generation distal radius bones. An AO type C2 fracture was created and the fractures were plated according to each manufacturer's recommendations. The specimens then underwent cyclic and load-to-failure testing. An optical motion analysis system was used to detect displacement of fragments. RESULTS: No significant differences were detected after cyclic loading as well as after load-to-failure testing, neither in regard to axial deformation, implant rigidity or maximum displacement. The fixed-angle single-row plate showed the highest pre-test rigidity, least increase in post-testing rigidity and highest load-to-failure rigidity and least radial shortening. The radial shortening of plates with two distal screw rows was 3.1 and 4.3 times higher, respectively, than that of the fixed-angle single-row plate. CONCLUSION: The results of our study indicate that two distal screw rows do not add to construct rigidity and resistance against loss of reduction. Well conducted clinical studies based on the findings of biomechanical studies are necessary to determine the optimal number of screws necessary to achieve reproducibly good results in the treatment of distal radius fractures.

Training program impact on thermoplastic immobilization for head and neck radiation therapy

Purpose: To determine whether uniform guidelines and training in the stabilization and formation of thermoplastic shells can improve the reproducibility of set-up for Head and Neck cancer patients. Methods and materials: Image based measurements of the planning and treatment positions for 35 head and neck cancer patients undergoing radical radiotherapy were analysed to provide a baseline of the reproducibility of thermoplastic immobilization. Radiation therapists (RT) were surveyed to establish a perception of their confidence in thermoplastic procedures. An evidence based staff training program was created and implemented. Set-up reproduction and staff perception were reviewed to measure the impact of the training program. Results: The mean (SD) 3D vectors of anatomical displacement, measured on the patient images, improved from 4.64 (2.03) for the baseline group compared to 3.02 (1.65) following training (p < 0.01). The proportion of 3D displacements of patient data exceeding 5 mm 3D vector was decreased from 37.1% to 5.7% (p < 0.001) and the 3 mm vector from 85.7% to 42.9% (p < 0.001). The post-training survey scores demonstrated improved confidence in reproducibility of set-up for head and neck patients. Conclusion: The Thermoplastic Shells Training Program has been found to improve the treatment reproducibility for head and neck radiation therapy patients. Uniform guidelines have increased RT confidence in thermoplastic procedures.

Calculation of volume from crank angle using reconfigurable hardware

Fast calculation of quantities such as in-cylinder volume and indicated power is important in internal combustion engine research. Multiple channels of data including crank angle and pressure were collected for this purpose using a fully instrumented diesel engine research facility. Currently, existing methods use software to post-process the data, first calculating volume from crank angle, then calculating the indicated work and indicated power from the area enclosed by the pressure-volume indicator diagram. Instead, this work investigates the feasibility of achieving real-time calculation of volume and power via hardware implementation on Field Programmable Gate Arrays (FPGAs). Alternative hardware implementations were investigated using lookup tables, Taylor series methods or the CORDIC (CoOrdinate Rotation DIgital Computer) algorithm to compute the trigonometric operations in the crank angle to volume calculation, and the CORDIC algorithm was found to use the least amount of resources. Simulation of the hardware based implementation showed that the error in the volume and indicated power is less than 0.1%.

Measurement of structural changes to a food material during dehydration

Rates of dehydration/rehydration are important quality parameters for dried products. Theoretically, if there are no adverse effects on the integrity of the tissue structure, it should absorb water to the same moisture content of the initial product before drying.The purpose of this work is to semi-automate the process of detection of cell structure boundaries as a food is dehydrated and rehydrated. This will enable food materials researchers to quantify changes to material’s structure as these processes take place. Images of potato cells as they were dehydrated and rehydrated were taken using an electron microscope. Cell boundaries were detected using an image processing algorithm. Average cell area and perimeter at each stage of dehydration were calculated and plotted versus time. The results show that the algorithm can successfully identify cell boundaries.

An introduction to mixed methods research for nephrology nurses

Mixed methods research is the use of qualitative and quantitative methods in the same study to gain a more rounded and holistic understanding of the phenomena under investigation. This type of research approach is gaining popularity in the nursing literature as a way to understand the complexity of nursing care and as a means to enhance evidenced-based practice. This paper introduces nephrology nurses to mixed methods research, its terminology and application to nephrology nursing. Five common mixed methods designs will be described highlighting the purposes, strengths and weaknesses of each design. Examples of mixed methods research will be given to illustrate the wide application of mixed methods research to nursing and its usefulness in nephrology nursing research.

The effect of ribbing on the energy flow between two rectangular plates coupled at right angle

This paper presents an analytical model to study the effect of stiffening ribs on vibration transmission between two rectangular plates coupled at right angle. Interesting wave attenuation patterns were observed by placing the stiffening rib either on the source or on the receiving plate. The result can be used to improve the understanding of vibration and for vibration control of more complex structures such as transformer tanks and machine covers.

Quantitative evaluation of matching methods and validity measures for stereo vision

The authors present a qualitative and quantitative comparison of various similarity measures that form the kernel of common area-based stereo-matching systems. The authors compare classical difference and correlation measures as well as nonparametric measures based on the rank and census transforms for a number of outdoor images. For robotic applications, important considerations include robustness to image defects such as intensity variation and noise, the number of false matches, and computational complexity. In the absence of ground truth data, the authors compare the matching techniques based on the percentage of matches that pass the left-right consistency test. The authors also evaluate the discriminatory power of several match validity measures that are reported in the literature for eliminating false matches and for estimating match confidence. For guidance applications, it is essential to have and estimate of confidence in the three-dimensional points generated by stereo vision. Finally, a new validity measure, the rank constraint, is introduced that is capable of resolving ambiguous matches for rank transform-based matching.

Modeling heat and mass transfer process during convection drying of fruit

Fruit drying is a process of removing moisture to preserve fruits by preventing microbial spoilage. It increases shelf life, reduce weight and volume thus minimize packing, storage, and transportation cost and enable storage of food under ambient environment. But, it is a complex process which involves combination of heat and mass transfer and physical property change and shrinkage of the material. In this background, the aim of this paper to develop a mathematical model to simulate coupled heat and mass transfer during convective drying of fruit. This model can be used predict the temperature and moisture distribution inside the fruits during drying. Two models were developed considering shrinkage dependent and temperature dependent moisture diffusivity and the results were compared. The governing equations of heat and mass transfer are solved and a parametric study has been done with Comsol Multiphysics 4.3. The predicted results were validated with experimental data.

Mixed methods research approach to the development and review of competency standards for dietitians

Aim: Competency standards support a range of professional activities including the accreditation of university courses. Reviewing these standards is essential to ensure universities continue to produce well equipped graduates, who can meet the challenge of changing workforce requirements. This paper has two aims: a) to provide an overview of the methodological approaches utilised for compilation and review of the Competency Standards for Dietetics and b) to evaluate the Dietitians Association of Australia’s Competency Standards and capture emerging and contemporary dietetic practice. Methods: A literature review of the methods used to develop Competency Standards for dietitians in Australia, including entry level, advanced level and DAA Fellow competencies and other specific areas of competency, such as public health nutrition and nutrition education is outlined and compared to other allied health professions. The mixed methods methodology used in the most recent review is described in more detail. Results: The history of Dietetic Competency Standards development and review in Australia is compared to dietetic Competency Standards internationally and within other health professions in Australia. The political context in which these standards have been developed in Australia and which has determined their format is also discussed. The results of the most recent Competency Standards review are reported to highlight emerging practice in Australia. Conclusion: The mixed methods approach used in this review provides rich data about contemporary dietetic practice. Our view supports a planned review of all Competency Standards to ensure practice informs education and credentialling and we recommend the Dietitians Association of Australia consider this in future

A coupled SPH-DEM model for fluid and solid mechanics of apple parenchyma cells during drying

A coupled SPH-DEM based two-dimensional (2-D) micro-scale single cell model is developed to predict basic cell-level shrinkage effects of apple parenchyma cells during air drying. In this newly developed drying model, Smoothed Particle Hydrodynamics (SPH) is used to model the low Reynolds Number fluid motions of the cell protoplasm, and a Discrete Element Method (DEM) is employed to simulate the polymer-like cell wall. Simulations results reasonably agree with published experimental drying results on cellular shrinkage properties such as cellular area, diameter and perimeter. These preliminary results indicate that the model is effective for the modelling and simulation of apple parenchyma cells during air drying.

A particle-based micromechanics approach to simulate structural changes of plant cells during drying

This paper is concerned with applying a particle-based approach to simulate the micro-level cellular structural changes of plant cells during drying. The objective of the investigation was to relate the micro-level structural properties such as cell area, diameter and perimeter to the change of moisture content of the cell. Model assumes a simplified cell which consists of two basic components, cell wall and cell fluid. The cell fluid is assumed to be a Newtonian fluid with higher viscosity compared to water and cell wall is assumed to be a visco-elastic solid boundary located around the cell fluid. Cell fluid is modelled with Smoothed Particle Hydrodynamics (SPH) technique and for the cell wall; a Discrete Element Method (DEM) is used. The developed model is two-dimensional, but accounts for three-dimensional physical properties of real plant cells. Drying phenomena is simulated as fluid mass reductions and the model is used to predict the above mentioned structural properties as a function of cell fluid mass. Model predictions are found to be in fairly good agreement with experimental data in literature and the particle-based approach is demonstrated to be suitable for numerical studies of drying related structural deformations. Also a sensitivity analysis is included to demonstrate the influence of key model parameters to model predictions.