Inadvertent hypothermia after procedural sedation and analgesia in a cardiac catheterisation laboratory: A prospective observational study

Objective To identify the prevalence of and risk factors for inadvertent hypothermia after procedures performed with procedural sedation and analgesia in a cardiac catheterisation laboratory. Design Single-centre, prospective observational study. Setting Tertiary care private hospital in Australia. Participants A convenience sample of 399 patients undergoing elective procedures with procedural sedation and analgesia were included. Propofol infusions were used when an anaesthetist was present. Otherwise, bolus doses of either midazolam or fentanyl or a combination of these medications was used. Interventions None Measurements and main results Hypothermia was defined as a temperature <36.0° Celsius. Multivariate logistic regression was used to identify risk factors. Hypothermia was present after 23.3% (n=93; 95% confidence interval [CI] 19.2%-27.4%) of 399 procedures. Sedative regimens with the highest prevalence of hypothermia were any regimen that included propofol (n=35; 40.2%; 95% CI 29.9%-50.5%) and the use of fentanyl combined with midazolam (n=23; 20.3%; 95% CI 12.9%-27.7%). Difference in mean temperature from pre to post-procedure was -0.27°C (Standard deviation [SD] 0.45). Receiving propofol (odds ratio [OR] OR 4.6 95% CI 2.5-8.6), percutaneous coronary intervention (OR 3.2 95% CI 1.7-5.9), body mass index <25 (OR 2.5 95% CI 1.4-4.4) and being hypothermic prior to the procedure (OR 4.9; 95% CI 2.3-10.8) were independent predictors of post-procedural hypothermia. Conclusions A moderate prevalence of hypothermia was observed. The small absolute change in temperature observed may not be a clinically important amount. More research is needed to increase confidence in our estimates of hypothermia in sedated patients and its impact on clinical outcomes.

Systems-based approach to investigate unsafe pedestrian behaviour at level crossings

Crashes at level crossings are a major issue worldwide. In Australia, as well as in other countries, the number of crashes with vehicles has declined in the past years, while the number of crashes involving pedestrians seems to have remained unchanged. A systematic review of research related to pedestrian behaviour highlighted a number of important scientific gaps in current knowledge. The complexity of such intersections imposes particular constraints to the understanding of pedestrians’ crossing behaviour. A new systems-based framework, called Pedestrian Unsafe Level Crossing framework (PULC) was developed. The PULC organises contributing factors to crossing behaviour on different system levels as per the hierarchical classification of Jens Rasmussen’s Framework for Risk Management. In addition, the framework adapts James Reason’s classification to distinguish between different types of unsafe behaviour. The framework was developed as a tool for collection of generalizable data that could be used to predict current or future system failures or to identify aspects of the system that require further safety improvement. To give it an initial support, the PULC was applied to the analysis of qualitative data from focus groups discussions. A total number of 12 pedestrians who regularly crossed the same level crossing were asked about their daily experience and their observations of others’ behaviour which allowed the extraction and classification of factors associated with errors and violations. Two case studies using Rasmussen’s AcciMap technique are presented as an example of potential application of the framework. A discussion on the identified multiple risk contributing factors and their interactions is provided, in light of the benefits of applying a systems approach to the understanding of the origins of individual’s behaviour. Potential actions towards safety improvement are discussed.

Local Commons: A visual approach to collective city making through situated community engagement

Due to the numerous possibilities of voicing concerns and the flood of data we are exposed to, local issues are sometimes at risk of being overlooked. This study explores Local Commons, a design intervention in public space that combines situated digital and tangible media in order to engage communities in contributing and debating different perspectives on a given local issue. The intervention invited the community to submit images of their perspectives on the issue, which were displayed on a public screen. Via tangible buttons in front of the screen, community members then agree or disagree on the displayed perspectives, creating a space for deliberation. In a user study, we were specifically interested in testing three aspects of our intervention, which are discussed in this paper: The difference that situatedness, visual content, and tangible interaction can make to urban community engagement.

A new approach to presales?

The traditional residential development process uses pre-sales to manage risk and lock in demand so that development financiers can be kept happy. However, obtaining the requisite level of presales is an expensive business, a cost that is ultimately borne by the new home buyer. With housing affordability at the front of everyone’s mind, we ask: is there a better way? How can housing be supplied more innovatively? A research collaboration between QUT, Swinburne Social Research Unit and the Office of the Victorian Government has been investigating this very issue.

A blended learning approach to the teaching of professional practice in architecture

This paper reports on a number of blended learning activities conducted in two subjects of a Master of Architecture degree at a major Australian university. The subjects were related to “professional practice” and as such represent a little researched area of architectural curriculum. The research provides some insight into the student perceptions of learning opportunity and engagement associated with on-line delivery modes. Students from these two subjects were surveyed for their perceptions about the opportunity for learning afforded by the on-line components, and also for their perceived level of engagement. Responses to these perceptions of traditional and on-line modes of delivery are compared and analysed for significant differences. While students were generally positive in response to the learning experiences, analysis of the results shows that students found the traditional modes to assist in their learning significantly more than on-line modes. Students were neutral regarding the opportunity for engagement that on-line modes provided. Analysis of the students’ gender, age and hours of paid work was also conducted to ascertain any relationship with attitudes to the flexibility of on-line delivery; no significant relationship was detected. This study has shown that students were generally resistant to on-line engagement opportunities and their ability to support learning.

Zombies on the road: A holistic design approach to balancing gamification and safe driving

This paper explores novel driving experiences that make use of gamification and augmented reality in the car. We discuss our design considerations, which are grounded in road safety psychology and video game design theory. We aim to address the tension between safe driving practices and player engagement. Specifically, we propose a holistic, iterative thinking process inspired by game design cognition and share our insights generated through the application of this process. We present preliminary game concepts that blend digital components with physical elements from the driving environment. We further highlight how this design process helped us to iteratively evolve these concepts towards being safer while maintaining fun. These insights and game design cognition itself will be useful to the AutomotiveUI community investigating similar novel driving experiences.

A student-centred approach to support, reward and recognition of student peer ‘learnership’

The benefits for university graduates in growing skills and capabilities through volunteering experiences are gaining increased attention. Building leadership self-efficacy supports students develop their capacity for understanding, articulating and evidencing their learning. Reward and recognition is fundamental in the student’s journey to build self-efficacy. Through this research, concepts of reward and recognition have been explored and articulated through the experiences and perceptions of actively engaged student peer leaders. The research methodology has enabled a collaborative, student-centred approach in shaping an innovative Rewards Framework, which supports, recognises and rewards the learning journey from beginning peer leader to competent and confident graduate.

An evaluation of potential candidate genes involved in salinity tolerance in striped catfish (Pangasianodon hypopthalmus) using an RNA-SEQ approach

The project investigated the molecular response of Tra catfish (Pangasianodon hypophthalmus) to elevated salinity conditions. We employed Next generation sequencing platform to evaluate differential gene expression profiles of key genes under two salinity conditions. Results of the current project can form the basis for further studies to confirm the functional roles of specific genes that influence salinity tolerance in the target species and more broadly in other freshwater teleost fishes. Ultimately, the approach can contribute to developing superior culture stocks of the target species.

Infrastructure, investment and development evaluation: A Complex Stakeholder Perception Mapping approach for improving local and regional economic development outcomes

Partial evaluation of infrastructure investments have resulted in expensive mistakes, unsatisfactory outcomes and increased uncertainties for too many stakeholders, communities and economies in both developing and developed nations. "Complex Stakeholder Perception Mapping" (CSPM), is a novel approach that can address existing limitations by inclusively framing, capturing and mapping the spectrum of insights and perceptions using extended Geographic Information Systems. Maps generated in CSPM offer presentations of flexibly combined, complex perceptions of stakeholders on multiple aspects of development. CSPM extends the applications of GIS software in non-spatial mapping and of Multi-Criteria Analysis with a multidimensional evaluation platform and augments decision science capabilities in addressing complexities. Application of CSPM can improve local and regional economic gains from infrastructure projects and aid any multi-objective and multi-stakeholder decision situations.

Investigating a disciplinary approach to literacy learning in a secondary school

This paper presents findings from a Design-Based Research (DBR) project undertaken in a large regional high school in Queensland. The study focused on an intervention involving explicit teaching using systemic functional grammar in assessed writing across two Year 8 subjects: English and History. The study’s findings demonstrate that, despite efforts at the whole school and classroom level to support a disciplinary literacy approach to subject learning, there are considerable constraints that need to be considered and overcome in order for students to develop appropriate writing capabilities for particular discipline areas.

A novel approach to increasing inventory with the current panel: Increasing donation frequency by asking for a different blood product

BACKGROUND Ongoing shortages of blood products may be addressed through additional donations. However, donation frequency rates are typically lower than medically possible. This preliminary study aims to determine voluntary nonremunerated whole blood (WB) and plasmapheresis donors' willingness, and subsequent facilitators and barriers, to make additional donations of a different type. STUDY DESIGN AND METHODS Forty individual telephone interviews were conducted posing two additional donation pattern scenarios: first, making a single and, second, making multiple plasmapheresis donations between WB donations. Stratified purposive sampling was conducted for four samples varying in donation experience: no-plasma, new-to-both-WB-and-plasma, new-to-plasma, and plasma donors. Interviews were analyzed yielding excellent (κ values > 0.81) inter-rater reliability. RESULTS Facilitators were more endorsed than barriers for a single but not multiple plasmapheresis donation. More new-to-both donors (n = 5) were willing to make multiple plasma donations between WB donations than others (n = 1 each) and identified fewer barriers (n = 3) than those more experienced in donation (n = 8 no plasma, n = 10 new to both, n = 11 plasma). Donors in the plasma sample were concerned about the subsequent reduced time between plasma donations by adding WB donations (n = 3). The no-plasma and new-to-plasma donors were concerned about the time commitment required (n = 3). CONCLUSION Current donors are willing to add different product donations but donation history influences their willingness to change. Early introduction of multiple donation types, variation in inventory levels, and addressing barriers will provide blood collection agencies with a novel and cost-effective inventory management strategy.

Eruption centres of the Hamilton area of the Newer Volcanics Province, Victoria, Australia: Pinpointing volcanoes from a multifaceted approach to landform mapping

Volcanic eruption centres of the mostly 4.5 Ma-5000 BP Newer Volcanics Province in the Hamilton area of southeastern Australia were examined in detail using a multifaceted approach, including ground truthing and analysis of ArcGIS Total Magnetic Intensity and seamless geology data, NASA Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) digital elevation models and Google Earth satellite image interpretation. Sixteen eruption centres were recognised in the Hamilton area, including three previously unrecorded volcanoes-one of which, the Cas Maar, constitutes the northernmost maar-cone volcanic complex in the Western Plains subprovince. Seven previously allocated eruption centres were placed into question based on field and laboratory observations. Three phases of volcanic activity have been suggested by other authors and are interpreted to correlate with ages of >4 Ma, ca 2 Ma and <0.5 Ma, which may be further subdivided based on preservation of outcrop. Geochemical compositions of the dominantly basaltic products become increasingly alkaline and enriched in incompatible elements from Phases 1 to 2, with Phase 3 eruptions both covering the entire geochemical range and extending into increasingly enriched compositions. This research highlights the importance of a multifaceted approach to landform mapping and demonstrates that additional volcanic centres may yet be discovered in the Newer Volcanics Province