The effectiveness of information-sharing interventions as a means to reduce anxiety in families waiting for surgical patients undergoing an elective surgical procedure : a systematic review protocol

Review question/objective What are the most effective information sharing strategies used to reduce anxiety in families of patients undergoing elective surgery? This review seeks to synthesize the best available evidence in relation to the most effective information-sharing intervention to reduce anxiety for families waiting for patients undergoing an elective surgical procedure. The specific objectives are to review the effectiveness of evidence of interventions designed to reduce the anxiety of families waiting whilst their loved one undergoes a surgical intervention. A variety of interventions exist and include surgical nurse liaison services, intraoperative reporting either by face-to-face or telephone delivery, informational cards, visual information screens, and intraoperative paging devices for families. Inclusion criteria Types of participants All studies of family members over 18 years of age waiting for patients undergoing an elective surgical procedure will be included, including those waiting for both adult and paediatric patients. Studies of families waiting for other patient populations, eg emergency surgery, chemotherapy or intensive care patients will be excluded. Types of intervention(s)/phenomena of interest All information-sharing Interventions for families of patients undergoing an elective surgical procedure will be included, including but not limited to: surgical nurse liaison services, in-person intraoperative reporting, visual information screens, paging devices, informational cards and telephone delivery of intraoperative progress reports. Interventions that take place during the intraoperative phase of care only will be included in the review. Preadmission information sharing interventions will be excluded. Types of outcomes The outcomes of interest include: Primary outcome: the level of anxiety amongst family members or close relatives whilst waiting for patients undergoing surgery, as measured by a validated instrument (such as the S-Anxiety portion of the State-Trait Anxiety Inventory).4 Secondary outcomes: family satisfaction and other measurements that may be considered indicators of stress and anxiety, such as mean arterial pressure (MAP) and heart rate.

Mechanical model and superelastic properties of carbon microcoils with circular cross-section

Here we report on an unconventional Ni-P alloy-catalyzed, high-throughput, highly reproducible chemical vapor deposition of ultralong carbon microcoils using acetylene precursor in the temperature range 700-750 °C. Scanning electron microscopy analysis reveals that the carbon microcoils have a unique double-helix structure and a uniform circular cross-section. It is shown that double-helix carbon microcoils have outstanding superelastic properties. The microcoils can be extended up to 10-20 times of their original coil length, and quickly recover the original state after releasing the force. A mechanical model of the carbon coils with a large spring index is developed to describe their extension and contraction. Given the initial coil parameters, this mechanical model can successfully account for the geometric nonlinearity of the spring constants for carbon micro- and nanocoils, and is found in a good agreement with the experimental data in the whole stretching process.

Web crippling behaviour of C-section beams with web ribs

SupaCee section is one of the cold-formed steel members which is increasingly used in the construction sector. It is characterized by unique ribbed web and curved lip elements, and is claimed to be more economical with extra strength than the traditional channel sections. SupaCee sections are widely used in Australia as floor joists, bearers, purlins and girts. Many experimental and numerical studies have been carried out to evaluate the behaviour and design of conventional channel beams subject to web crippling. To date, however, no investigation has been conducted into the web crippling behaviour and strength of SupaCee sections. Current cold-formed steel design equations do not include any design procedures for SupaCee sections. Hence experimental studies were conducted to assess the web crippling behaviour and strengths of SupaCee sections under ETF and ITF load cases. Thirty six web crippling tests were conducted and the capacity results were compared with the predictions from the AS/NZS 4600 and AISI design rules developed for conventional channel sections. Comparison of ultimate web crippling capacities from tests showed that AS/NZS 4600 and AISI design equations are unconservative for SupaCee sections under ETF load case, but are overly conservative for ITF load case. Hence new equations were proposed to determine the web crippling capacities of SupaCee sections based on the experimental results from this study. Suitable design rules were also developed within the direct strength method format. This paper presents the details of this experimental study of SupaCee sections subject to web crippling and the results.

A systematic review of the effectiveness of warming interventions for women undergoing cesarean section

Women undergoing cesarean section are vulnerable to adverse effects associated with inadvertent perioperative hypothermia, but there has been a lack of synthesized evidence for temperature management in this population. This systematic review aimed to synthesize the best available evidence in relation to preventing hypothermia in mothers undergoing cesarean section surgery.

Insurance and transport law : controlling insurance contract terms : Section 54 of the Insurance Contracts Act – compliance, recovery and accountability

Commonwealth legislation covering insurance contracts contains numerous provisions designed to control the operation and effect of terms in life and general insurance contracts. For example, the Life Insurance Act 1995 (Cth) contains provisions regulating the consequences attendant upon incorrect statements in proposals [1] and non-payment of premiums, [2] provides that an insurer may only exclude liability in the case of suicide if it has made express provision for such contingency in its policy, [3] and severely restricts the efficacy of conditions as to war risks. [4] The Insurance Contracts Act 1984 (Cth) is even more intrusive and has a major impact upon contractual provisions in the general insurance field. It is beyond the scope of this note to explore all of these provisions in any detail but examples of controls and constraints imposed upon the operation and effect of contractual provisions include the following. A party is precluded from relying upon a provision in a contract of insurance if such reliance would amount to a failure to act with the utmost good faith. [5] Similarly, a policy provision which requires differences or disputes arising out of the insurance to be submitted to arbitration is void, [6] unless the insurance is a genuine cover for excess of loss over and above another specified insurance. [7] Similarly clause such as conciliation clauses, [8] average clauses, [9] and unusual terms [10] are given qualified operation. [11] However the provision in the Insurance Contracts Act that has the greatest impact upon, and application to, a wide range of insurance clauses and claims is s 54. This section has already generated a significant volume of case law and is the focus of this note. In particular this note examines two recent cases. The first, Johnson v Triple C Furniture and Electrical Pty Ltd [2012] 2 Qd R 337, (hereafter the Triple C case), is a decision of the Queensland Court of Appeal; and the second, Matthew Maxwell v Highway Hauliers Pty Ltd [2013] WASCA 115, (hereafter the Highway Hauliers case), is a decision of the Court of Appeal in Western Australia. This latter decision is on appeal to the High Court of Australia. The note considers too the decision of the New South Wales Court of Appeal in Prepaid Services Pty Ltd v Atradius Credit Insurance NV [2013] NSWCA 252 (hereafter the Prepaid Services case).These cases serve to highlight the complex nature of s 54 and its application, as well as the difficulty in achieving a balance between an insurer and an insured's reasonable expectations.

The effectiveness of information-sharing interventions to reduce anxiety in families waiting for surgical patients undergoing an elective surgical procedure: A systematic review

Background Whilst waiting for patients undergoing surgery, a lack of information regarding the patient’s status and the outcome of surgery, can contribute to the anxiety experienced by family members. Effective strategies for providing information to families are therefore required. Objectives To synthesize the best available evidence in relation to the most effective information-sharing interventions to reduce anxiety for families waiting for patients undergoing an elective surgical procedure. Inclusion criteria Types of participants All studies of family members over 18 years of age waiting for patients undergoing an elective surgical procedure were included, including those waiting for both adult and pediatric patients.   Types of intervention All information-sharing interventions for families of patients undergoing an elective surgical procedure were eligible for inclusion in the review. Types of studies All randomized controlled trials (RCTs) quasi-experimental studies, case-controlled and descriptive studies, comparing one information-sharing intervention to another or to usual care were eligible for inclusion in the review. Types of outcomes Primary outcome: The level of anxiety amongst family members or close relatives whilst waiting for patients undergoing surgery, as measured by a validated instrument such as the S-Anxiety portion of the State-Trait Anxiety Inventory (STAI). Secondary outcomes: Family satisfaction and other measurements that may be considered indicators of stress and anxiety, such as mean arterial pressure (MAP) and heart rate. Search strategy A comprehensive search, restricted to English language only, was undertaken of the following databases from 1990 to May 2013: Medline, CINAHL, EMBASE, ProQuest, Web of Science, PsycINFO, Scopus, Dissertation and Theses PQDT (via ProQuest), Current Contents, CENTRAL, Google Scholar, OpenGrey, Clinical Trials, Science.gov, Current Controlled Trials and National Institute for Clinical Studies (NHMRC). Methodological quality Two independent reviewers critically appraised retrieved papers for methodological quality using the standardized critical appraisal instruments for randomized controlled trials and descriptive studies from the Joanna Briggs Institute Meta Analysis of Statistics Assessment and Review Instruments (JBI-MAStARI). Data extraction Two independent reviewers extracted data from included papers using a customized data extraction form. Data synthesis Statistical pooling was not possible, mainly due to issues with data reporting in two of the studies, therefore the results are presented in narrative form. Results Three studies with a total of 357 participants were included in the review. In-person reporting to family members was found to be effective in comparison with usual care in which no reports were provided. Telephone reporting was also found to be effective at reducing anxiety, in comparison with usual care, although not as effective as in-person reporting. The use of paging devices to keep family members informed were found to increase, rather than decrease anxiety. Conclusions Due to the lack of high quality research in this area, the strength of the conclusions are limited. It appears that in-person and telephone reporting to family members decreases anxiety, however the use of paging devices increases anxiety.

Durability study of CFRP strengthened steel circular hollow section members under marine environment

Galvanic corrosion is a common phenomenon in Carbon Fibre Reinforced Polymer (CFRP) strengthened steel structures in wet environments and submerged conditions, which reduces durability by weakening the bond between the CFRP and steel substrate. CFRP materials have already been proven to have superior resistance to corrosion and chemical attacks but the adhesive and steel are generally affected by long-term exposure to moisture, especially in conjunction with salts resulting from deicing of ocean spray. This paper presents the results of a research program to improve the durability of CFRP strengthened steel circular hollow section (CHS) members by treating the steel surface with an epoxy based adhesion promoter and inserting Glass Fibre Reinforced Polymer (GFRP) as a galvanic corrosion barrier against simulated sea water. It also presents the effects of accelerated corrosion on the bond of CFRP strengthened hollow steel members. The program consisted of four CFRP strengthened steel beams and one unstrengthened steel beam. Two strengthened beams were used as control while the other two beams were exposed to a highly corrosive environment to induce accelerated corrosion. The corrosion rate was considered 10% which represents a moderate level of loss in the cross-sectional area of the steel tube throughout its intended service life. The beams were then loaded to failure under four-point bending. The research findings indicate that the accelerated corrosion adversely affected the ultimate strength of the conditioned beams and the embedded glass fibre enhanced the bond durability.

Experimental studies of cold-formed steel hollow section columns at elevated temperatures

This paper reports the details of an experimental study of cold-formed steel hollow section columns at ambient and elevated temperatures. In this study the global buckling behaviour of cold-formed Square Hollow Section (SHS) slender columns under axial compression was investigated at various uniform elevated temperatures up to 700℃. The results of these column tests are reported in this paper, which include the buckling/failure modes at elevated temperatures, and ultimate load versus temperature curves. Finite element models of tested columns were also developed and their behaviour and ultimate capacities at ambient and elevated temperatures were studied. Fire design rules given in European and American standards including the Direct Strength Method (DSM) based design rules were used to predict the ultimate capacities of tested columns at elevated temperatures. Elevated temperature mechanical properties and stress-strain models given in European steel design standards and past researches were used with design rules and finite element models to investigate their effects on SHS column capacities. Comparisons of column capacities from tests and finite element analyses with those predicted by current design rules were used to determine the accuracy of currently available column design rules in predicting the capacities of SHS columns at elevated temperatures and the need to use appropriate elevated temperature material stress-strain models. This paper presents the important findings derived from the comparisons of these column capacities.

Experimental study of cold-formed steel floors made of hollow flange channel section joists under fire conditions

Fire safety plays a vital role in building design because appropriate level of fire safety is important to safeguard lives and property. Cold-formed steel channel sections along with fire-resistive plasterboards are used to construct light-gauge steel frame (LSF) floor systems to provide adequate fire resistance ratings (FRR). It is common practice to use lipped channel sections (LCS) as joists in LSF floor systems, and past research has only considered such systems. This research focuses on adopting improved joist sections such as hollow flange channel (HFC) sections to improve the structural performance and FRR of cold-formed LSF floor systems under standard fire conditions. The structural and thermal performances of LSF floor systems made of a welded HFC, LiteSteel Beams (LSB), with different plasterboard and insulation configurations, were investigated using four full-scale fire tests under standard fires. These fire tests showed that the new LSF floor system with LSB joists improved the FRR in comparison to that of conventional LCS joists. Fire tests have provided valuable structural and thermal performance data of tested floor systems that included time-temperature profiles and failure times, temperatures, and modes. This paper presents the details of the fire tests conducted in this study and their results along with some important findings.

Guest Editorial: Emerging Scholars' Section

This issue of the QUT Law Review features an Emerging Scholars’ section containing contributions from early career researchers and doctoral students. This section was conceived by the previous General Editor of the journal, Prof Dan Hunter, as a forum to showcase high-quality legal scholarship from emerging scholars. We are grateful to Prof Hunter for his work on this initiative.

Guest Editorial: Emerging Scholars' Section

This issue of the QUT Law Review also features an Emerging Scholars’ section containing contributions from early career researchers and doctoral students. This section was conceived by the previous General Editor of the journal, Prof Dan Hunter, as a forum to showcase high-quality legal scholarship from emerging scholars. We are grateful to Prof Hunter for his work on this initiative.