Managing intravenous medications in the non-hospital setting: An ethnographic investigation

Little published information exists about the issues involved in conducting complex intravenous medication therapy in patients' homes. An ethnographic study of a local hospital-in-the-home program in the Australian Capital Territory explored this phenomenon to identify those factors that had an impact on the use of medicine in the home environment. This article focuses on one of the three themes identified in the study-Clinical Practice. Within this theme, topics related to the organization and management of intravenous medications, geography and diversity of patient caseload, and communication in the practice setting are discussed. These findings have important implications for policy development and establishment of a research agenda for hospital-in-the-home services.

Civil procedure : Commentary and materials

This book provides a comprehensive analysis of the practical and theoretical issues encountered in Australian civil procedure. Each chapter features in-depth questions and notes together with lists of further reading to aid understanding of the issue. It also examines and discusses each substantive and procedural step in the trial process. Topics include jurisdiction of a court to consider a matter, limitations of actions, commencing proceedings, service, interlocutory proceedings, pleading, gathering evidence, trial and appeal, costs and practice directions. Each of the state, territory and federal procedures is covered.

Civil Procedure : Commentary and Materials (2nd ed)

This book provides a comprehensive analysis of the practical and theoretical issues encountered in Australian civil procedure, including alternative dispute resolution. Each chapter features in-depth questions and notes together with lists of further reading to aid understanding of the issue. It also examines and discusses each substantive and procedural step in the trial process. Topics include jurisdiction of a court to consider a matter, court adjudication under an adversarial system, alternative dispute resolution. limitations of actions, commencing proceedings, pleading, gathering evidence, trial and appeal, costs and enforcement. Each of the state, territory and federal procedures is covered.

Can a community pharmacy sleep assessment tool aid the identification of patients at risk of sleep disorders in the community : a pilot study

Background: When experiencing sleep problems for the first time, consumers may often approach community pharmacists for advice as they are easily accessible health care professionals in the community. In Australian community pharmacies there are no specific tools available for use by pharmacists to assist with the assessment and handling of consumers with sleep enquiries. Objective: To assess the feasibility of improving the detection of sleep disorders within the community through the pilot of a newly developed Community Pharmacy Sleep Assessment Tool (COP-SAT). Method: The COP-SAT was designed to incorporate elements from a number of existing, standardized, and validated clinical screening measures. The COP-SAT was trialed in four Australian community pharmacies over a 4-week period. Key findings: A total of 241 community pharmacy consumers were assessed using the COP-SAT. A total of 74 (30.7%) were assessed as being at risk of insomnia, 26 (10.7%) were at risk of daytime sleepiness, 19 (7.9%) were at risk of obstructive sleep apnea, and 121 (50.2%) were regular snorers. A total of 116 (48.1%) participants indicated that they consume caffeine before bedtime, of which 55 (47%) had associated symptoms of sleep onset insomnia. Moreover, 85 (35%) consumed alcohol before bedtime, of which 50 (58%) experienced fragmented sleep, 50 (58%) were regular snorers, and nine (10.6%) had apnea symptoms. The COP-SAT was feasible in the community pharmacy setting. The prevalence of sleep disorders in the sampled population was high, but generally consistent with previous studies on the general population. Conclusion: A large proportion of participants reported sleep disorder symptoms, and a link was found between the consumption of alcohol and caffeine substances at bedtime and associated symptoms. While larger studies are needed to assess the clinical properties of the tool, the results of this feasibility study have demonstrated that the COP-SAT may be a practical tool for the identification of patients at risk of developing sleep disorders in the community.

Civil procedure : commentary and materials (3rd ed.)

This book provides a comprehensive analysis of the practical and theoretical issues encountered in Australian civil procedure, including alternative dispute resolution. Each chapter features in-depth questions and notes together with lists of further reading to aid understanding of the issue. It also examines and discusses each substantive and procedural step in the trial process. Topics include jurisdiction of a court to consider a matter, alternative dispute resolution. limitations of actions, commencing proceedings, pleading, gathering evidence, trial and appeal, costs and practice directions. The procedures in the Supreme Courts of each of the states and Territories are covered, as well as those of the Federal Court of Australia.

Civil procedure : commentary and materials (4th ed)

This book provides a comprehensive analysis of the practical and theoretical issues encountered in Australian civil procedure, including alternative dispute resolution. Each chapter features in-depth questions and notes together with lists of further reading to aid understanding of the issue. It also examines and discusses each substantive and procedural step in the trial process. Topics include jurisdiction of a court to consider a matter, alternative dispute resolution, limitations of actions, commencing proceedings, pleading, gathering evidence, trial and appeal, costs and practice directions. Each of the state, territory and federal procedures is covered.

iRAP Malaysia training course: Decade of Action for Road Safety. Report to Department of Foreign Affairs and Trade, Australia-Malaysia Institute

The International Road Assessment Program (iRAP) is a not-for-profit organisation that works in partnership with governments and non-government organisations in all parts of the world to make roads safe. The iRAP Malaysia pilot study on 3,700km of road identified the potential to save 31,800 deaths and serious injuries over the next 20 years from proven engineering improvements. To help ensure the iRAP data and results are available to planners and engineers, iRAP, together with staff from the Centre for Accident Research and Road Safety – Queensland (CARRS-Q) and the Malaysian Institute of Road Safety Research (MIROS) developed a 5-day iRAP training course that covers the background, theory and practical application of iRAP protocols, with a special focus on Malaysian case studies. Funding was provided by a competitive grant from the Australian-Malaysia Institute.

Integrated genomic characterization of endometrial carcinoma

We performed an integrated genomic, transcriptomic and proteomic characterization of 373 endometrial carcinomas using array- and sequencing-based technologies. Uterine serous tumours and ∼25% of high-grade endometrioid tumours had extensive copy number alterations, few DNA methylation changes, low oestrogen receptor/progesterone receptor levels, and frequent TP53 mutations. Most endometrioid tumours had few copy number alterations or TP53 mutations, but frequent mutations in PTEN, CTNNB1, PIK3CA, ARID1A and KRAS and novel mutations in the SWI/SNF chromatin remodelling complex gene ARID5B. A subset of endometrioid tumours that we identified had a markedly increased transversion mutation frequency and newly identified hotspot mutations in POLE. Our results classified endometrial cancers into four categories: POLE ultramutated, microsatellite instability hypermutated, copy-number low, and copy-number high. Uterine serous carcinomas share genomic features with ovarian serous and basal-like breast carcinomas. We demonstrated that the genomic features of endometrial carcinomas permit a reclassification that may affect post-surgical adjuvant treatment for women with aggressive tumours.

Integrating real time positioning systems to improve blind lifting and loading crane operations

Mobile/tower cranes are the most essential forms of construction plant in use in the construction industry but are also the subject of several safety issues. Of these, blind lifting has been found to be one of the most hazardous of crane operations. To improve the situation, a real-time monitoring system that integrates the use of a Global Positioning System (GPS) and Radio Frequency Identification (RFID) is developed. This system aims to identify unauthorized work or entrance of personnel within a pre-defined risk zone by obtaining positioning data of both site workers and the crane. The system alerts to the presence of unauthorized workers within a risk zone——currently defined as 3m from the crane. When this happens, the system suspends the power of the crane and a warning signal is generated to the safety management team. In this way the system assists the safety management team to manage the safety of hundreds of workers simultaneously. An onsite trial with debriefing interviews is presented to illustrate and validate the system in use.

Synergies and goal conflicts for climate change policy and spatial planning

The purpose of this paper is to identify goal conflicts – both actual and potential – between climate and social policies in government strategies in response to the growing significance of climate change as a socioecological issue (IPCC 2007). Both social and climate policies are political responses to long-term societal trends related to capitalist development, industrialisation, and urbanisation (Koch, 2012). Both modify these processes through regulation, fiscal transfers and other measures, thereby affecting conditions for the other. This means that there are fields of tensions and synergies between social policy and climate change policy. Exploring these tensions and synergies is an increasingly important task for navigating genuinely sustainable development. Gough et al (2008) highlight three potential synergies between social and climate change policies: First, income redistribution – a traditional concern of social policy – can facilitate use of and enhance efficiency of carbon pricing. A second area of synergy is housing, transport, urban policies and community development, which all have potential to crucially contribute towards reducing carbon emissions. Finally, climate change mitigation will require substantial and rapid shifts in producer and consumer behaviour. Land use planning policy is a critical bridge between climate change and social policy that provides a means to explore the tensions and synergies that are evolving within this context. This paper will focus on spatial planning as an opportunity to develop strategies to adapt to climate change, and reviews the challenges of such change. Land use and spatial planning involve the allocation of land and the design and control of spatial patterns. Spatial planning is identified as being one of the most effective means of adapting settlements in response to climate change (Hurlimann and March, 2012). It provides the instrumental framework for adaptation (Meyer, et al., 2010) and operates as both a mechanism to achieve adaptation and a forum to negotiate priorities surrounding adaptation (Davoudi, et al., 2009). The acknowledged role of spatial planning in adaptation however has not translated into comparably significant consideration in planning literature (Davoudi, et al., 2009; Hurlimann and March, 2012). The discourse on adaptation specifically through spatial planning is described as ‘missing’ and ‘subordinate’ in national adaptation plans (Greiving and Fleischhauer, 2012),‘underrepresented’ (Roggema, et al., 2012)and ‘limited and disparate’ in planning literature (Davoudi, et al., 2009). Hurlimann and March (2012) suggest this may be due to limited experiences of adaptation in developed nations while Roggema et al. (2012) and Crane and Landis (2010) suggest it is because climate change is a wicked problem involving an unfamiliar problem, various frames of understanding and uncertain solutions. The potential for goal conflicts within this policy forum seem to outweigh the synergies. Yet, spatial planning will be a critical policy tool in the future to both protect and adapt communities to climate change.

If you build it... film studios and the transformative effects of migrating media production

In the years since the release of the film Field of Dreams, the phrase “If you build it, they will come” has become a cliché beloved by journalists, boosters of speculative land developments or remediations and misty-eyed enthusiasts of a host of unlikely schemes. It is one of the articles of faith of the location interest, the coalition of actors motivated to work to attract film business to a particular place. The phrase is full of optimism and potential. It seeks to instill confidence that the construction of production infrastructure like studios and the nourishment of conditions for local service providers will drive the (economic) locomotive and open the (celebrity) stargate. Unfortunately sometimes, it is just a crazy dream.

Percutaneous patent foramen ovale closure : outcomes with the Premere and Amplatzer devices

BACKGROUND: Transcatheter closure of patent foramen ovale (PFO) has rapidly evolved as the preferred management strategy for the prevention of recurrent cerebrovascular events in patients with cryptogenic stroke and presumed paradoxical embolus. There is limited outcome data in patients treated with this therapy particularly for the newer devices. METHODS: Data from medical records, catheter, and echocardiography databases on 70 PFO procedures performed was collected prospectively. RESULTS: The cohort consisted of 70 patients (mean age 43.6 years, range 19 to 77 years), of whom 51% were male. The indications for closure were cryptogenic cerebrovascular accident (CVA) or transient ischemic attack (TIA) in 64 (91%) and peripheral emboli in two (2.8%) patients and cryptogenic ST-elevation myocardial infarction in one (1.4%), refractory migraine in one (1.4%), decompression sickness in one (1.4%), and orthodeoxia in one (1.4%) patient, respectively. All patients had demonstrated right-to-left shunting on bubble study. The procedures were guided by intracardiac echocardiography in 53%, transesophageal echocardiography in 39%, and the remainder by transthoracic echo alone. Devices used were the Amplatzer PFO Occluder (AGA Medical) (sizes 18-35 mm) in 49 (70%) and the Premere device (St. Jude Medical) in 21 (30%). In-hospital complications consisted of one significant groin hematoma with skin infection. Echocardiographic follow-up at 6 months revealed that most patients had no or trivial residual shunt (98.6%), while one patient (1.4%) had a mild residual shunt. At a median of 11 months' follow-up (range 1 month to 4.3 years), no patients (0%) experienced further CVA/TIAs or paradoxical embolic events during follow-up. CONCLUSION: PFO causing presumed paradoxical embolism can be closed percutaneously with a low rate of significant residual shunting and very few complications. Recurrent index events are uncommon at medium-term (up to 4 years) follow-up.