Can the Cardiac ARIA Index Improve Cardiac Care for Australia's Indigenous Population?

Background: Timely access to appropriate cardiac care is critical for optimising outcomes. Our aim was to derive an objective, comparable, geographic measure reflecting access to cardiac services for Australia's 20,387 population locations. Methods: An expert panel defined a single patient care pathway. Using geographic information systems (GIS) the numeric/alpha index was modelled in two phases. The acute phase index (numeric) ranged from 1 (access to tertiary centre with PCI ≤1 h) to 8 (no ambulance service, >3 h to medical facility, air transport required). The aftercare index was modelled into 5 alphabetic categories; A (Access to general practitioner, pharmacy, cardiac rehabilitation, pathology ≤1 h) to E (no services available within 1 h). Results: Approximately 70% or 13.9 million people lived within a CardiacARIAindex category 1A location. Disparity continues in access to category 1A cardiac services for 5.8 million (30%) of all Australians, 60% of Aboriginal and Torres Strait Islander people and 32% of people over 65 years of age. In a cardiac emergency only 40% of the Indigenous population reside within one hour of category 1 hospital. Approximately 30% (81,491 Indigenous persons) are more than one to three hours from basic cardiac services. Conclusion: Geographically, the majority of Australian's have timely access for survival of a cardiac event. The CardiacARIAindex objectively demonstrates that the healthcare system may not be providing for the needs of 60% of Indigenous people residing outside the 1A geographic radius. Innovative clinical practice maybe required to address these disparities.

Child Victims of Sexual Abuse: Children's Experience of the Investigative Process in the Criminal Justice System

This paper is a selected review of research on issues surrounding the investigation of intra-familial child sexual abuse for children aged eight and above, in the criminal justice system. Particular attention is paid to features of the investigative interview in relation to the child's level of understanding, ability to report and likely emotional response when the proceedings take place. Best practice by police and social care agencies involves establishing valid and reliable information from children while attending to their developmental level and emotional state. The review aims to distil principles optimising this process from both the investigative judicial perspective and the child's focus, as well as from the inter-agency perspective and information sharing. Recommendations are made for improving the interview process based on research and methods from a range of disciplines and to optimise information recording in a format easily shared between agencies. Updated and ongoing training procedures are key to successful practice with training shared across police and social work agencies. The focus of this review is informed by preliminary findings from pilot research in progress on behalf of the Metropolitan Police Child Abuse Investigation Command.

Genetic algorithms to schedule container transfers at multimodal terminals

Optimising the container transfer schedule at the multimodal terminals is known to be NP-hard, which implies that the best solution becomes computationally infeasible as problem sizes increase. Genetic Algorithm (GA) techniques are used to reduce container handling/transfer times and ships' time at the port by speeding up handling operations. The GA is chosen due to the relatively good results that have been reported even with the simplest GA implementations to obtain near-optimal solutions in reasonable time. Also discussed, is the application of the model to assess the consequences of increased scheduled throughput time as well as different strategies such as the alternative plant layouts, storage policies and number of yard machines. A real data set used for the solution and subsequent sensitivity analysis is applied to the alternative plant layouts, storage policies and number of yard machines.

Innovative damage assessment of steel truss bridges using modal strain energy correlation

As a part of vital infrastructure and transportation network, bridge structures must function safely at all times. Bridges are designed to have a long life span. At any point in time, however, some bridges are aged. The ageing of bridge structures, given the rapidly growing demand of heavy and fast inter-city passages and continuous increase of freight transportation, would require diligence on bridge owners to ensure that the infrastructure is healthy at reasonable cost. In recent decades, a new technique, structural health monitoring (SHM), has emerged to meet this challenge. In this new engineering discipline, structural modal identification and damage detection have formed a vital component. Witnessed by an increasing number of publications is that the change in vibration characteristics is widely and deeply investigated to assess structural damage. Although a number of publications have addressed the feasibility of various methods through experimental verifications, few of them have focused on steel truss bridges. Finding a feasible vibration-based damage indicator for steel truss bridges and solving the difficulties in practical modal identification to support damage detection motivated this research project. This research was to derive an innovative method to assess structural damage in steel truss bridges. First, it proposed a new damage indicator that relies on optimising the correlation between theoretical and measured modal strain energy. The optimisation is powered by a newly proposed multilayer genetic algorithm. In addition, a selection criterion for damage-sensitive modes has been studied to achieve more efficient and accurate damage detection results. Second, in order to support the proposed damage indicator, the research studied the applications of two state-of-the-art modal identification techniques by considering some practical difficulties: the limited instrumentation, the influence of environmental noise, the difficulties in finite element model updating, and the data selection problem in the output-only modal identification methods. The numerical (by a planer truss model) and experimental (by a laboratory through truss bridge) verifications have proved the effectiveness and feasibility of the proposed damage detection scheme. The modal strain energy-based indicator was found to be sensitive to the damage in steel truss bridges with incomplete measurement. It has shown the damage indicator's potential in practical applications of steel truss bridges. Lastly, the achievement and limitation of this study, and lessons learnt from the modal analysis have been summarised.

Impact and energy absorption of road safety barriers by coupled SPH/FEM

Road safety barriers are used to minimise the severity of road accidents and protect lives and property. There are several types of barrier in use today. This paper reports the initial phase of research carried out to study the impact response of portable water-filled barrier (PWFB) which has the potential to absorb impact energy and hence provide crash mitigation under low to moderate speeds. Current research on the impact and energy absorption capacity of water-filled road safety barriers is limited due to the complexity of fluid-structure interaction under dynamic impact. In this paper, a novel fluid-structure interaction method is developed based on the combination of Smooth Particle Hydrodynamics (SPH) and Finite Element Method (FEM). The sloshing phenomenon of water inside a PWFB is investigated to explore the energy absorption capacity of water under dynamic impact. It was found that water plays an important role in energy absorption. The coupling analysis developed in this paper will provide a platform to further the research in optimising the behaviour of the PWFB. The effect of the amount of water on its energy absorption capacity is investigated and the results have practical applications in the design of PWFBs.

Simulation-based comparison of pull-push system in motorcycle assembly line

To investigate the effects of adopting a pull system in assembly lines in contrast to a push system, simulation software called “ARENA” is used as a tool in order to present numerical results from both systems. Simulation scenarios are created to evaluate the effects of attributes changing in assembly systems, with influential factors including the change of manufacturing system (push system to pull system) and variation of demand. Moreover, pull system manufacturing consists of the addition attribute, which is the number of buffer storage. This paper will provide an analysis based on a previous case study, hence process time and workflow refer to the journal name “Optimising and simulating the assembly line balancing problem in a motorcycle manufacturing company: a case study” [2]. The implementation of the pull system mechanism is to produce a system improvement in terms of the number of Work-In-Process (WIP), total time of products in the system, and the number of finished product inventory, while retaining the same throughput.

A framework for cost-aware process management : generation of accurate and timely management accounting cost reports

Organisations are constantly seeking efficiency improvements for their business processes in terms of time and cost. Management accounting enables reporting of detailed cost of operations for decision making purpose, although significant effort is required to gather accurate operational data. Business process management is concerned with systematically documenting, managing, automating, and optimising processes. Process mining gives valuable insight into processes through analysis of events recorded by an IT system in the form of an event log with the focus on efficient utilisation of time and resources, although its primary focus is not on cost implications. In this paper, we propose a framework to support management accounting decisions on cost control by automatically incorporating cost data with historical data from event logs for monitoring, predicting and reporting process-related costs. We also illustrate how accurate, relevant and timely management accounting style cost reports can be produced on demand by extending open-source process mining framework ProM.

Assembly line balancing the comparison of COMSOAL and MSNSH technique in Motorcycle manufacturing company

Today’s highly competitive market influences the manufacturing industry to improve their production systems to become the optimal system in the shortest cycle time as possible. One of most common problems in manufacturing systems is the assembly line balancing problem. The assembly line balancing problem involves task assignments to workstations with optimum line efficiency. The line balancing technique, namely “COMSOAL”, is an abbreviation of “Computer Method for Sequencing Operations for Assembly Lines”. Arcus initially developed the COMSOAL technique in 1966 [1], and it has been mainly applied to solve assembly line balancing problems [6]. The most common purposes of COMSOAL are to minimise idle time, optimise production line efficiency, and minimise the number of workstations. Therefore, this project will implement COMSOAL to balance an assembly line in the motorcycle industry. The new solution by COMSOAL will be used to compare with the previous solution that was developed by Multi‐Started Neighborhood Search Heuristic (MSNSH), which will result in five aspects including cycle time, total idle time, line efficiency, average daily productivity rate, and the workload balance. The journal name “Optimising and simulating the assembly line balancing problem in a motorcycle manufacturing company: a case study” will be used as the case study for this project [5].

Using social media to facilitate knowledge transfer in complex engineering environments : a primer for educators

While highly cohesive groups are potentially advantageous they are also often correlated with the emergence of knowledge and information silos based around those same functional or occupational clusters. Consequently, an essential challenge for engineering organisations wishing to overcome informational silos is to implement mechanisms that facilitate, encourage and sustain interactions between otherwise disconnected groups. This paper acts as a primer for those seeking to gain an understanding of the design, functionality and utility of a suite of software tools generically termed social media technologies in the context of optimising the management of tacit engineering knowledge. Underpinned by knowledge management theory and using detailed case examples, this paper explores how social media technologies achieve such goals, allowing for the transfer of knowledge by tapping into the tacit and explicit knowledge of disparate groups in complex engineering environments.

ASAP ECMO : antibiotic, sedative and analgesic pharmacokinetics during extracorporeal membrane oxygenation : a multi-centre study to optimise drug therapy during ECMO

BACKGROUND: Given the expanding scope of extracorporeal membrane oxygenation (ECMO) and its variable impact on drug pharmacokinetics as observed in neonatal studies, it is imperative that the effects of the device on the drugs commonly prescribed in the intensive care unit (ICU) are further investigated. Currently, there are no data to confirm the appropriateness of standard drug dosing in adult patients on ECMO. Ineffective drug regimens in these critically ill patients can seriously worsen patient outcomes. This study was designed to describe the pharmacokinetics of the commonly used antibiotic, analgesic and sedative drugs in adult patients receiving ECMO. METHODS: This is a multi-centre, open-label, descriptive pharmacokinetic (PK) study. Eligible patients will be adults treated with ECMO for severe cardiac and/or respiratory failure at five Intensive Care Units in Australia and New Zealand. Patients will receive the study drugs as part of their routine management. Blood samples will be taken from indwelling catheters to investigate plasma concentrations of several antibiotics (ceftriaxone, meropenem, vancomycin, ciprofloxacin, gentamicin, piperacillin-tazobactum, ticarcillin-clavulunate, linezolid, fluconazole, voriconazole, caspofungin, oseltamivir), sedatives and analgesics (midazolam, morphine, fentanyl, propofol, dexmedetomidine, thiopentone). The PK of each drug will be characterised to determine the variability of PK in these patients and to develop dosing guidelines for prescription during ECMO. DISCUSSION: The evidence-based dosing algorithms generated from this analysis can be evaluated in later clinical studies. This knowledge is vitally important for optimising pharmacotherapy in these most severely ill patients to maximise the opportunity for therapeutic success and minimise the risk of therapeutic failure

A novel testing system for a Cycloidal drive

At present, for mechanical power transmission, Cycloidal drives are most preferred - for compact, high transmission ratio speed reduction, especially for robot joints and manipulator applications. Research on drive-train dynamics of Cycloidal drives is not well-established. This paper presents a testing rig for Cycloidal drives, which would produce data for development of mathematical models and investigation of drive-train dynamics, further aiding in optimising its design

Data requirements and graph data structures for a multi-modal, multi-objective trip planner

Traffic congestion has a significant impact on the economy and environment. Encouraging the use of multimodal transport (public transport, bicycle, park’n’ride, etc.) has been identified by traffic operators as a good strategy to tackle congestion issues and its detrimental environmental impacts. A multi-modal and multi-objective trip planner provides users with various multi-modal options optimised on objectives that they prefer (cheapest, fastest, safest, etc) and has a potential to reduce congestion on both a temporal and spatial scale. The computation of multi-modal and multi-objective trips is a complicated mathematical problem, as it must integrate and utilize a diverse range of large data sets, including both road network information and public transport schedules, as well as optimising for a number of competing objectives, where fully optimising for one objective, such as travel time, can adversely affect other objectives, such as cost. The relationship between these objectives can also be quite subjective, as their priorities will vary from user to user. This paper will first outline the various data requirements and formats that are needed for the multi-modal multi-objective trip planner to operate, including static information about the physical infrastructure within Brisbane as well as real-time and historical data to predict traffic flow on the road network and the status of public transport. It will then present information on the graph data structures representing the road and public transport networks within Brisbane that are used in the trip planner to calculate optimal routes. This will allow for an investigation into the various shortest path algorithms that have been researched over the last few decades, and provide a foundation for the construction of the Multi-modal Multi-objective Trip Planner by the development of innovative new algorithms that can operate the large diverse data sets and competing objectives.

Robust aerodynamic design optimisation of morphing aerofoil/wing using distributed moga

In this paper, the shape design optimisation using morphing aerofoil/wing techniques, namely the leading and/or trailing edge deformation of a natural laminar flow RAE 5243 aerofoil is investigated to reduce transonic drag without taking into account of the piezo actuator mechanism. Two applications using a Multi-Objective Genetic Algorithm (MOGA)coupled with Euler and boundary analyser (MSES) are considered: the first example minimises the total drag with a lift constraint by optimising both the trailing edge actuator position and trailing edge deformation angle at a constant transonic Mach number (M! = 0.75)and boundary layer transition position (xtr = 45%c). The second example consists of finding reliable designs that produce lower mean total drag (μCd) and drag sensitivity ("Cd) at different uncertainty flight conditions based on statistical information. Numerical results illustrate how the solution quality in terms of mean drag and its sensitivity can be improved using MOGA software coupled with a robust design approach taking account of uncertainties (lift and boundary transition positions) and also how transonic flow over aerofoil/wing can be controlled to the best advantage using morphing techniques.

Not all systematic reviews are systematic : a meta-review of the quality of systematic reviews for non-invasive remote monitoring in heart failure

Remote monitoring for heart failure has been evaluated in numerous systematic reviews. The aim of this meta-review was to appraise their quality and synthesise results. We electronically searched online databases, performed a forward citation search and hand-searched bibliographies. Systematic reviews of remote monitoring interventions that were used for surveillance of heart failure patients were included. Seven (41%) systematic reviews pooled results for meta-analysis. Eight (47%) considered all non-invasive remote monitoring strategies. Five (29%) focused on telemonitoring. Four (24%) included both non-invasive and invasive technologies. According to AMSTAR criteria, ten (58%) systematic reviews were of poor methodological quality. In high quality reviews, the relative risk of mortality in patients who received remote monitoring ranged from 0.53 (95% CI=0.29-0.96) to 0.88 (95% CI=0.76-1.01). High quality reviews also reported that remote monitoring reduced the relative risk of all-cause (0.52; 95% CI=0.28-0.96 to 0.96; 95% CI=0.90–1.03) and heart failure-related hospitalizations (0.72; 95% CI=0.64–0.81 to RR 0.79; 95% CI=0.67-0.94) and, as a consequence, healthcare costs. As the high quality reviews reported that remote monitoring reduced hospitalizations, mortality and healthcare costs, research efforts should now be directed towards optimising these interventions in preparation for more widespread implementation.

Urban transit quality of service : user perception and behaviour

Despite its potential multiple contributions to sustainable policy objectives, urban transit is generally not widely used by the public in terms of its market share compared to that of automobiles, particularly in affluent societies with low-density urban forms like Australia. Transit service providers need to attract more people to transit by improving transit quality of service. The key to cost-effective transit service improvements lies in accurate evaluation of policy proposals by taking into account their impacts on transit users. If transit providers knew what is more or less important to their customers, they could focus their efforts on optimising customer-oriented service. Policy interventions could also be specified to influence transit users’ travel decisions, with targets of customer satisfaction and broader community welfare. This significance motivates the research into the relationship between urban transit quality of service and its user perception as well as behaviour. This research focused on two dimensions of transit user’s travel behaviour: route choice and access arrival time choice. The study area chosen was a busy urban transit corridor linking Brisbane central business district (CBD) and the St. Lucia campus of The University of Queensland (UQ). This multi-system corridor provided a ‘natural experiment’ for transit users between the CBD and UQ, as they can choose between busway 109 (with grade-separate exclusive right-of-way), ordinary on-street bus 412, and linear fast ferry CityCat on the Brisbane River. The population of interest was set as the attendees to UQ, who travelled from the CBD or from a suburb via the CBD. Two waves of internet-based self-completion questionnaire surveys were conducted to collect data on sampled passengers’ perception of transit service quality and behaviour of using public transit in the study area. The first wave survey is to collect behaviour and attitude data on respondents’ daily transit usage and their direct rating of importance on factors of route-level transit quality of service. A series of statistical analyses is conducted to examine the relationships between transit users’ travel and personal characteristics and their transit usage characteristics. A factor-cluster segmentation procedure is applied to respodents’ importance ratings on service quality variables regarding transit route preference to explore users’ various perspectives to transit quality of service. Based on the perceptions of service quality collected from the second wave survey, a series of quality criteria of the transit routes under study was quantitatively measured, particularly, the travel time reliability in terms of schedule adherence. It was proved that mixed traffic conditions and peak-period effects can affect transit service reliability. Multinomial logit models of transit user’s route choice were estimated using route-level service quality perceptions collected in the second wave survey. Relative importance of service quality factors were derived from choice model’s significant parameter estimates, such as access and egress times, seat availability, and busway system. Interpretations of the parameter estimates were conducted, particularly the equivalent in-vehicle time of access and egress times, and busway in-vehicle time. Market segmentation by trip origin was applied to investigate the difference in magnitude between the parameter estimates of access and egress times. The significant costs of transfer in transit trips were highlighted. These importance ratios were applied back to quality perceptions collected as RP data to compare the satisfaction levels between the service attributes and to generate an action relevance matrix to prioritise attributes for quality improvement. An empirical study on the relationship between average passenger waiting time and transit service characteristics was performed using the service quality perceived. Passenger arrivals for services with long headways (over 15 minutes) were found to be obviously coordinated with scheduled departure times of transit vehicles in order to reduce waiting time. This drove further investigations and modelling innovations in passenger’ access arrival time choice and its relationships with transit service characteristics and average passenger waiting time. Specifically, original contributions were made in formulation of expected waiting time, analysis of the risk-aversion attitude to missing desired service run in the passengers’ access time arrivals’ choice, and extensions of the utility function specification for modelling passenger access arrival distribution, by using complicated expected utility forms and non-linear probability weighting to explicitly accommodate the risk of missing an intended service and passenger’s risk-aversion attitude. Discussions on this research’s contributions to knowledge, its limitations, and recommendations for future research are provided at the concluding section of this thesis.