Increased body temperature following subarachnoid haemorrhage : a retrospective correlational study

Introduction: Nursing clinicians are primarily responsible for the monitoring and treatment of increased body temperature. The body temperature of patients during their acute care hospital stay is measured at regular repeated intervals. In the event a patient is assessed with an elevated temperature, a multitude of decisions are required. The action of instigating temperature reducing strategies is based upon the assumption that elevated temperature is harmful and that the strategy employed will have some beneficial effect. Background and Significance: The potential harmful effects of increased body temperature (fever, hyperthermia) following neurological insult are well recognised. Although few studies have investigated this phenomenon in the diagnostic population of non-traumatic subarachnoid haemorrhage, it has been demonstrated that increased body temperature occurs in 41 to 72% of patients with poor clinical outcome. However, in the Australian context the frequency, or other characteristics of increased body temperature, as well as the association between increased body temperature with poor clinical outcome has not been established. Design: This study used a correlational study design to: describe the frequency, duration and timing of increased body temperature; determine the association between increased body temperature and clinical outcome; and describe the clinical interventions used to manage increased body temperature in patients with non-traumatic subarachnoid haemorrhage. A retrospective clinical chart audit was conducted on 43 patients who met the inclusion criteria. Findings: The major findings of this study were: increased body temperature occurred frequently; persisted for a long time; and onset did not occur until 20 hours after primary insult; increased body temperature was associated with death or dependent outcome; and no intervention was recorded in many instances. Conclusion: This study has quantified in a non-traumatic subarachnoid haemorrhage patient population the characteristics of increased body temperature, established an association between increased body temperature with death or dependent outcome and described the current management of elevated temperatures in the Australian context to improve nursing practice, education and research.

Space-time variation of malaria incidence in Yunnan province, China

Abstract Background Understanding spatio-temporal variation in malaria incidence provides a basis for effective disease control planning and monitoring. Methods Monthly surveillance data between 1991 and 2006 for Plasmodium vivax and Plasmodium falciparum malaria across 128 counties were assembled for Yunnan, a province of China with one of the highest burdens of malaria. County-level Bayesian Poisson regression models of incidence were constructed, with effects for rainfall, maximum temperature and temporal trend. The model also allowed for spatial variation in county-level incidence and temporal trend, and dependence between incidence in June–September and the preceding January–February. Results Models revealed strong associations between malaria incidence and both rainfall and maximum temperature. There was a significant association between incidence in June–September and the preceding January–February. Raw standardised morbidity ratios showed a high incidence in some counties bordering Myanmar, Laos and Vietnam, and counties in the Red River valley. Clusters of counties in south-western and northern Yunnan were identified that had high incidence not explained by climate. The overall trend in incidence decreased, but there was significant variation between counties. Conclusion Dependence between incidence in summer and the preceding January–February suggests a role of intrinsic host-pathogen dynamics. Incidence during the summer peak might be predictable based on incidence in January–February, facilitating malaria control planning, scaled months in advance to the magnitude of the summer malaria burden. Heterogeneities in county-level temporal trends suggest that reductions in the burden of malaria have been unevenly distributed throughout the province.

Effective communication in innovation processes

Innovation processes are rarely smooth and disruptions often occur at transition points were one knowledge domain passes the technology on to another domain. At these transition points communication is a key component in assisting the smooth hand over of technologies. However for smooth transitions to occur we argue that appropriate structures have to be in place and boundary spanning activities need to be facilitated. This paper presents three case studies of innovation processes and the findings support the view that structures and boundary spanning are essential for smooth transitions.

Necessary skills and practices required for effective participation in high bandwidth design team activities

Technology is continually changing, and evolving, throughout the entire construction industry; and particularly in the design process. One of the principal manifestations of this is a move away from team working in a shared work space to team working in a virtual space, using increasingly sophisticated electronic media. Due to the significant operating differences when working in shared and virtual spaces adjustments to generic skills utilised by members is a necessity when moving between the two conditions. This paper reports an aspect of a CRC-CI research project based on research of ‘generic skills’ used by individuals and teams when engaging with high bandwidth information and communication technologies (ICT). It aligns with the project’s other two aspects of collaboration in virtual environments: ‘processes’ and ‘models’. The entire project focuses on the early stages of a project (i.e. design) in which models for the project are being developed and revised. The paper summarises the first stage of the research project which reviews literature to identify factors of virtual teaming which may affect team member skills. It concludes that design team participants require ‘appropriate skills’ to function efficiently and effectively, and that the introduction of high band-width technologies reinforces the need for skills mapping and measurement.

Identifying effective leadership practices for implementing a new mathematics curriculum in Taipei

This study explores successful junior high school principals’ leadership practices for implementing the reformed mathematics curriculum in Taipei. Avolio and Bass’s (2002) full range leadership theory was used to record data through interviews and observations of five Taipei “Grade A” junior high school principals. Findings revealed that specific leadership practices linked to management by exception-active and contingent reward (transaction leadership), and individualised consideration and idealised influence (transformational) were considered effective for implementing reform measures. Ensuring principals are aware of effective measures may further assist reform agendas.

Cryoreservation of alginate-fibrin beads involving bone marrow derived mesenchymal stromal cells by vitrification

Application of cell-–biomaterial systems in regenerative medicine can be facilitated by their successful low temperature preservation. Vitrification, which avoids ice crystal formation by amorphous solidification, is an emerging approach to cryopreservation. Developing vitrification strategy, effective cryopreservation of alginate–fibrin beads with porcine mesenchymal stromal cells has been achieved in this study. The cell–biomaterial constructs were pre-cultured for 20 days before cryopreservation, allowing for cell proliferation and construct stabilization. Ethylene glycol (EG) was employed as the basic cryoprotectant for two equilibration solutions. Successful cryopreservation of the constructs was achieved using vitrification solution composed of penetrating (EG MW 62 Da) and non-penetrating (sucrose MW 342 Da) cryoprotectants. Stepwise procedure of introduction to and removal of cryoprotectants was brief; direct plunging into liquid nitrogen was applied. Cell viability, evaluated by combining live/death staining and confocal laser microscopy, was similar for both control and vitrified cells in the beads. No detectable damage of microstructure of cryopreserved beads was found as shown by scanning electron microscopy. Both osteogenically induced control and vitrified cells in the constructs were equally capable of mineral production and deposition. There was no statistically significant difference in metabolic activity and proliferation between both groups during the entire culture period. Our study leads to the conclusion that the developed cryopreservation protocol allowed to maintain the integrity of the beads while preserving the ability of the pig bone marrow derived mesenchymal stromal cells to proliferate and subsequently differentiate; demonstrating that vitrification is a promising approach for cryopreser-vation of “ready-to-use” cell–biomaterial constructs.

Barriers to effective knowledge transfer in project-based organisations

Effective knowledge transfer can prevent the reinvention of systems and ideas as well as the repetition of errors. Doing so will save substantial time, as well as contribute to better performance of projects and project-based organisations (PBOs). Despite the importance of knowledge, PBOs face serious barriers to the effective transfer of knowledge, while their characteristics, such as unique and innovative approaches taken during every project, mean they have much to gain from knowledge transfer. As each new project starts, there is the strong potential to reinvent the process, rather than utilise learning from previous projects. In fact, rework is one of the primary factors contributing to construction industry's poor performance and productivity. Current literature has identified several barriers to knowledge transfer in organisational settings in general, and not specifically PBOs. However, PBOs significantly differ from other types of organisations. PBOs operate mainly on temporary projects, where time is a crucial factor and people are more mobile than in other organisational settings. The aim of this research is to identify the key barriers that prevent effective knowledge transfer for PBOs, exclusively. Interviews with project managers and senior managers of PBOs complement the analysis of the literature and provide professional expertise. This research is crucial to gaining a better understanding of obstacles that hinder knowledge transfer in projects. The main contribution of this research is exclusive for PBO, list of key barriers that organisation and project managers need to consider to ensure effective knowledge transfer and better project management.

Effective models of employment-based training

Australia needs highly skilled workers to sustain a healthy economy. Current employment-based training models have limitations in meeting the demands for highly skilled labour supply. The research explored current and emerging models of employment-based training to propose more effective models at higher VET qualifications that can maintain a balance between institution and work-based learning.

Achieving effective supervision

Supervision probably does have benefits both for the maintenance and improvement of clinical skills and for job satisfaction, but the data are very thin and almost non-existent in the area of alcohol and other drugs ser vices. Because of the potential complexity of objectives and roles in super vision, a structured agreement appears to be an important part of the effective supervision relationship. Because sessions can degenerate easily into unstructured socialization, agendas and session objectives may also be important. While a working alliance based on mutual respect and trust is an essential base for the supervision relationship, procedures for direct observation of clinical skills, demonstration of new procedures and skills practice with detailed feedback appear critical to super vision’s impact on practice. To ensure effective supervision, there needs not only to be a minimum of personnel and resources, but also a compatibility with the values and procedures of management and staff, access to supervision training and consultation and sufficient incentives to ensure it continues.

Key organizational elements for effective information and knowledge management

Effective information and knowledge management (IKM) is critical to corporate success; yet, its actual establishment and management is not yet fully understood. We identify ten organizational elements that need to be addressed to ensure the effective implementation and maintenance of information and knowledge management within organizations. We define these elements and provide key characterizations. We then discuss a case study that describes the implementation of an information system (designed to support IKM) in a medical supplies organization. We apply the framework of organizational elements in our analysis to uncover the enablers and barriers in this systems implementation project. Our analysis suggests that taking the ten organizational elements into consideration when implementing information systems will assist practitioners in managing information and knowledge processes more effectively and efficiently. We discuss implications for future research.

Temperature enhanced effects of ozone on cardiovascular mortality in 95 large US communities, 1987-2000 - assessment using the NMMAPS data

A few studies examined interactive effects between air pollution and temperature on health outcomes. This study is to examine if temperature modified effects of ozone and cardiovascular mortality in 95 large US cities. A nonparametric and a parametric regression models were separately used to explore interactive effects of temperature and ozone on cardiovascular mortality during May and October, 1987-2000. A Bayesian meta-analysis was used to pool estimates. Both models illustrate that temperature enhanced the ozone effects on mortality in the northern region, but obviously in the southern region. A 10-ppb increment in ozone was associated with 0.41 % (95% posterior interval (PI): -0.19 %, 0.93 %), 0.27 % (95% PI: -0.44 %, 0.87 %) and 1.68 % (95% PI: 0.07 %, 3.26 %) increases in daily cardiovascular mortality corresponding to low, moderate and high levels of temperature, respectively. We concluded that temperature modified effects of ozone, particularly in the northern region.

Uncertainty budget in the measurement of typical airborne number, surface area and mass particle distributions

The effects of particulate matter on environment and public health have been widely studied in recent years. A number of studies in the medical field have tried to identify the specific effect on human health of particulate exposure, but agreement amongst these studies on the relative importance of the particles’ size and its origin with respect to health effects is still lacking. Nevertheless, air quality standards are moving, as the epidemiological attention, towards greater focus on the smaller particles. Current air quality standards only regulate the mass of particulate matter less than 10 μm in aerodynamic diameter (PM10) and less than 2.5 μm (PM2.5). The most reliable method used in measuring Total Suspended Particles (TSP), PM10, PM2.5 and PM1 is the gravimetric method since it directly measures PM concentration, guaranteeing an effective traceability to international standards. This technique however, neglects the possibility to correlate short term intra-day variations of atmospheric parameters that can influence ambient particle concentration and size distribution (emission strengths of particle sources, temperature, relative humidity, wind direction and speed and mixing height) as well as human activity patterns that may also vary over time periods considerably shorter than 24 hours. A continuous method to measure the number size distribution and total number concentration in the range 0.014 – 20 μm is the tandem system constituted by a Scanning Mobility Particle Sizer (SMPS) and an Aerodynamic Particle Sizer (APS). In this paper, an uncertainty budget model of the measurement of airborne particle number, surface area and mass size distributions is proposed and applied for several typical aerosol size distributions. The estimation of such an uncertainty budget presents several difficulties due to i) the complexity of the measurement chain, ii) the fact that SMPS and APS can properly guarantee the traceability to the International System of Measurements only in terms of number concentration. In fact, the surface area and mass concentration must be estimated on the basis of separately determined average density and particle morphology. Keywords: SMPS-APS tandem system, gravimetric reference method, uncertainty budget, ultrafine particles.

Effective employment-based training models for childcare workers

Childcare workers play a significant role in the learning and development of children in their care. This has major implications for the training of workers. Under new reforms of the childcare industry the Australian government now requires all workers to obtain qualifications from a vocational education and training provider (eg. Technical and Further Education) or university. Effective models of employment-based training are critical to provide training to highly competent workers. This paper presents findings from a study that examined current and emerging models of employment-based training in the childcare sector, particularly at the Diploma level. Semi-structured interviews were conducted with a sample of 16 participants who represented childcare directors, employers, and workers located in childcare services in urban, regional and remote locations in the State of Queensland. The study proposes a ‘best-fit’ employment-based training approach that is characterised by a compendium of five models instead of a ‘one size fits all’. Issues with successful implementation of the EBT models are also discussed

An effective model of using negative relevance feedback for information filtering

Over the years, people have often held the hypothesis that negative feedback should be very useful for largely improving the performance of information filtering systems; however, we have not obtained very effective models to support this hypothesis. This paper, proposes an effective model that use negative relevance feedback based on a pattern mining approach to improve extracted features. This study focuses on two main issues of using negative relevance feedback: the selection of constructive negative examples to reduce the space of negative examples; and the revision of existing features based on the selected negative examples. The former selects some offender documents, where offender documents are negative documents that are most likely to be classified in the positive group. The later groups the extracted features into three groups: the positive specific category, general category and negative specific category to easily update the weight. An iterative algorithm is also proposed to implement this approach on RCV1 data collections, and substantial experiments show that the proposed approach achieves encouraging performance.