The economic rationale for infection control in Australian hospitals

The objective of the present study was to predict the economic consequences of healthcare-acquired infections arising among admissions to Australian acute care hospitals. A quantitative algorithm informed by epidemiological and economic data was developed. All acute care hospitals in Australia were included in the study and the participants included all admissions to general medical and general surgical specialties. The main outcome measures were the numbers of cases of healthcare-acquired infection and bed days lost annually. It was estimated that there are 175 153 (95% credible interval 155 911 : 195 168) cases of healthcare-acquired infection among admissions to Australian hospitals annually, and the extra stay in hospital to treat symptoms accounts for 854 289 bed days (95% credible interval 645 091 : 1 096 244). If rates were reduced by 1%, then 150 158 bed days would be released for alternative uses. This would allow ~38 500 new admissions. Healthcare-acquired infections in patients cause bed blocks in Australian hospitals. The cost-effectiveness of hospital services might be improved by allocating more resources to infection control, releasing beds and allowing new admissions. There exists an opportunity to improve the efficiency of the Australian health care system.

Test architecture for prototyping automated dynamic airspace control

The automation of various aspects of air traffic management has many wide-reaching benefits including: reducing the workload for Air Traffic Controllers; increasing the flexibility of operations (both civil and military) within the airspace system through facilitating automated dynamic changes to en-route flight plans; ensuring safe aircraft separation for a complex mix of airspace users within a highly complex and dynamic airspace management system architecture. These benefits accumulate to increase the efficiency and flexibility of airspace use(1). Such functions are critical for the anticipated increase in volume of manned and unmanned aircraft traffic. One significant challenge facing the advancement of airspace automation lies in convincing air traffic regulatory authorities that the level of safety achievable through the use of automation concepts is comparable to, or exceeds, the accepted safety performance of the current system.

On feasibility of regional frequency-based emergency control plans

Decentralized and regional load-frequency control of power systems operating in normal and near-normal conditions has been well studied; and several analysis/synthesis approaches have been developed during the last few decades. However in contingency and off-normal conditions, the existing emergency control plans, such as under-frequency load shedding, are usually applied in a centralized structure using a different analysis model. This paper discusses the feasibility of using frequency-based emergency control schemes based on tie-line measurements and local information available within a control area. The conventional load-frequency control model is generalized by considering the dynamics of emergency control/protection schemes and an analytic approach to analyze the regional frequency response under normal and emergency conditions is presented.

Comparison of 3D finite element analysis derived stiffness and BMD to determine the failure load of the excised proximal femur

Introduction: Bone mineral density (BMD) is currently the preferred surrogate for bone strength in clinical practice. Finite element analysis (FEA) is a computer simulation technique that can predict the deformation of a structure when a load is applied, providing a measure of stiffness (Nmm−1). Finite element analysis of X-ray images (3D-FEXI) is a FEA technique whose analysis is derived froma single 2D radiographic image. Methods: 18 excised human femora had previously been quantitative computed tomography scanned, from which 2D BMD-equivalent radiographic images were derived, and mechanically tested to failure in a stance-loading configuration. A 3D proximal femur shape was generated from each 2D radiographic image and used to construct 3D-FEA models. Results: The coefficient of determination (R2%) to predict failure load was 54.5% for BMD and 80.4% for 3D-FEXI. Conclusions: This ex vivo study demonstrates that 3D-FEXI derived from a conventional 2D radiographic image has the potential to significantly increase the accuracy of failure load assessment of the proximal femur compared with that currently achieved with BMD. This approach may be readily extended to routine clinical BMD images derived by dual energy X-ray absorptiometry. Crown Copyright © 2009 Published by Elsevier Ltd on behalf of IPEM. All rights reserved

Hybrid system simulation of computer control applications over communication networks

Discrete event-driven simulations of digital communication networks have been used widely. However, it is difficult to use a network simulator to simulate a hybrid system in which some objects are not discrete event-driven but are continuous time-driven. A networked control system (NCS) is such an application, in which physical process dynamics are continuous by nature. We have designed and implemented a hybrid simulation environment which effectively integrates models of continuous-time plant processes and discrete-event communication networks by extending the open source network simulator NS-2. To do this a synchronisation mechanism was developed to connect a continuous plant simulation with a discrete network simulation. Furthermore, for evaluating co-design approaches in an NCS environment, a piggybacking method was adopted to allow the control period to be adjusted during simulations. The effectiveness of the technique is demonstrated through case studies which simulate a networked control scenario in which the communication and control system properties are defined explicitly.

Heavy truck suspension optimization based on modified skyhook damping control

This paper presents a multi-objective optimization strategy for heavy truck suspension systems based on modified skyhook damping (MSD) control, which improves ride comfort and road-friendliness simultaneously. A four-axle heavy truck-road coupling system model was established using functional virtual prototype technology; the model was then validated through a ride comfort test. As the mechanical properties and time lag of dampers were taken into account, MSD control of active and semi-active dampers was implemented using Matlab/Simulink. Through co-simulations with Adams and Matlab, the effects of passive, semi-active MSD control, and active MSD control were analyzed and compared; thus, control parameters which afforded the best integrated performance were chosen. Simulation results indicated that MSD control improves a truck’s ride comfort and roadfriendliness, while the semi-active MSD control damper obtains road-friendliness comparable to the active MSD control damper.

A study on matching and multi-objective fuzzy control strategy of heavy truck suspension system

Matching method of heavy truck-rear air suspensions is discussed, and a fuzzy control strategy which improves both ride comfort and road friendliness of truck by adjusting damping coefficients of the suspension system is found. In the first place, a Dongfeng EQ1141G7DJ heavy truck’s ten DOF whole vehicle-road model was set up based on Matlab/Simulink and vehicle dynamics. Then appropriate passive air suspensions were chosen to replace the original rear leaf springs of the truck according to truck-suspension matching criterions, consequently, the stiffness of front leaf springs were adjusted too. Then the semi-active fuzzy controllers were designed for further enhancement of the truck’s ride comfort and the road friendliness. After the application of semi-active fuzzy control strategy through simulation, is was indicated that both ride comfort and road friendliness could be enhanced effectively under various road conditions. The strategy proposed may provide theory basis for design and development of truck suspension system in China.

The NOURISH randomised control trial : positive feeding practices and food preferences in early childhood - a primary prevention program for childhood obesity

Background Primary prevention of childhood overweight is an international priority. In Australia 20-25% of 2-8 year olds are already overweight. These children are at substantially increased the risk of becoming overweight adults, with attendant increased risk of morbidity and mortality. Early feeding practices determine infant exposure to food (type, amount, frequency) and include responses (eg coercion) to infant feeding behaviour (eg. food refusal). There is correlational evidence linking parenting style and early feeding practices to child eating behaviour and weight status. A focus on early feeding is consistent with the national focus on early childhood as the foundation for life-long health and well being. The NOURISH trial aims to implement and evaluate a community-based intervention to promote early feeding practices that will foster healthy food preferences and intake and preserve the innate capacity to self-regulate food intake in young children. Methods/Design This randomised controlled trial (RCT) aims to recruit 820 first-time mothers and their healthy term infants. A consecutive sample of eligible mothers will be approached postnatally at major maternity hospitals in Brisbane and Adelaide. Initial consent will be for re-contact for full enrolment when the infants are 4-7 months old. Individual mother- infant dyads will be randomised to usual care or the intervention. The intervention will provide anticipatory guidance via two modules of six fortnightly parent education and peer support group sessions, each followed by six months of regular maintenance contact. The modules will commence when the infants are aged 4-7 and 13-16 months to coincide with establishment of solid feeding, and autonomy and independence, respectively. Outcome measures will be assessed at baseline, with follow up at nine and 18 months. These will include infant intake (type and amount of foods), food preferences, feeding behaviour and growth and self-reported maternal feeding practices and parenting practices and efficacy. Covariates will include sociodemographics, infant feeding mode and temperament, maternal weight status and weight concern and child care exposure. Discussion Despite the strong rationale to focus on parents’ early feeding practices as a key determinant of child food preferences, intake and self-regulatory capacity, prospective longitudinal and intervention studies are rare. This trial will be amongst to provide Level II evidence regarding the impact of an intervention (commencing prior to age 12 months) on children’s eating patterns and behaviours. Trial Registration: ACTRN12608000056392

The role of HPC facilies in development of a novel road safety barrier

Water-filled portable road safety barriers are a common fixture in road works, however their use of water can be problematic, both in terms of the quantity of water used and the transportation of the water to the installation site. This project aims to develop a new design of portable road safety barrier, which will make novel use of composite and foam materials in order to reduce the barrier’s reliance on water in order to control errant vehicles. The project makes use of finite element (FE) techniques in order to simulate and evaluate design concepts. FE methods and models that have previously been tested and validated will be used in combination in order to provide the most accurate numerical simulations available to drive the project forward. LS-DYNA code is as highly dynamic, non-linear numerical solver which is commonly used in the automotive and road safety industries. Several complex materials and physical interactions are to be simulated throughout the course of the project including aluminium foams, composite laminates and water within the barrier during standardised impact tests. Techniques to be used include FE, smoothed particle hydrodynamics (SPH) and weighted multi-parameter optimisation techniques. A detailed optimisation of several design parameters with specific design goals will be performed with LS-DYNA and LS-OPT, which will require a large number of high accuracy simulations and advanced visualisation techniques. Supercomputing will play a central role in the project, enabling the numerous medium element count simulations necessary in order to determine the optimal design parameters of the barrier to be performed. Supercomputing will also allow the development of useful methods of visualisation results and the production of highly detailed simulations for end-product validation purposes. Efforts thus far have been towards integrating various numerical methods (including FEM, SPH and advanced materials models) together in an efficient and accurate manner. Various designs of joining mechanisms have been developed and are currently being developed into FE models and simulations.

Self-referencing and consumer evaluations of larger-sized female models : a weight locus of control perspective

In two experiments, we show that the beliefs women have about the controllability of their weight (i.e., weight locus of control) influences their responses to advertisements featuring a larger-sized female model or a slim female model. Further, we examine self-referencing as a mechanism for these effects. Specifically, people who believe they can control their weight (“internals”), respond most favorably to slim models in advertising, and this favorable response is mediated by self-referencing. In contrast, people who feel powerless about their weight (“externals”), self-reference larger-sized models, but only prefer larger-sized models when the advertisement is for a non-fattening product. For fattening products, they exhibit a similar preference for larger-sized models and slim models. Together, these experiments shed light on the effect of model body size and the role of weight locus of control in influencing consumer attitudes.

Debate on statutory control of the surveying profession in Queensland : 1907 to 1975

This article was written in 1997. After a 2009 review the content was left mostly unchanged - apart from this re-written abstract, restructured headings and a table of contents. The article deals directly with professional registration of surveyors; but it also relates to government procurement of professional services. The issues include public service and professional ethics; setting of professional fees; quality assurance; official corruption; and professional recruitment, education and training. Debate on the Land Surveyors Act 1908 (Qld) and its amendments to 1916 occurred at a time when industrial unrest of the 1890s and common market principles of the new Commonwealth were fresh in peoples’ minds. Industrial issues led to a constitutional crisis in the Queensland’s then bicameral legislature and frustrated a first attempt to pass a Surveyors Bill in 1907. The Bill was re-introduced in 1908 after fresh elections and Kidston’s return as state premier. Co-ordinated immigration and land settlement polices of the colonies were discontinued when the Commonwealth gained power over immigration in 1901. Concerns shifted to protecting jobs from foreign competition. Debate on 1974 amendments to the Act reflected concerns about skill shortages and professional accreditation. However, in times of economic downturn, a so-called ‘chronic shortage of surveyors’ could rapidly degenerate into oversupply and unemployment. Theorists championed a naïve ‘capture theory’ where the professions captured governments to create legislative barriers to entry to the professions. Supposedly, this allowed rent-seeking and monopoly profits through lack of competition. However, historical evidence suggests that governments have been capable of capturing and exploiting surveyors. More enlightened institutional arrangements are needed if the community is to receive benefits commensurate with sizable co-investments of public and private resources in developing human capital.

Open and trusted information systems/health informatics access control (OTHIS/HIAC)

Information and Communications Technologies globally are moving towards Service Oriented Architectures and Web Services. The healthcare environment is rapidly moving to the use of Service Oriented Architecture/Web Services systems interconnected via this global open Internet. Such moves present major challenges where these structures are not based on highly trusted operating systems. This paper argues the need of a radical re-think of access control in the contemporary healthcare environment in light of modern information system structures, legislative and regulatory requirements, and security operation demands in Health Information Systems. This paper proposes the Open and Trusted Health Information Systems (OTHIS), a viable solution including override capability to the provision of appropriate levels of secure access control for the protection of sensitive health data.

Foldback current control for a DG to achieve Fast Arc Extinction in a distribution network

The distribution network reliability can be increased if distributed generators (DGs) are allowed to operate in both grid-connected and islanded operations when the network has a high DG penetration level. However, the current utility regulations do not allow for the islanded operation. The arc faults are the one of the major issues preventing the islanded operation, since the arc will not extinguish if the DGs are not disconnected. In this paper, the effect of a converter interfaced DG on an arc fault is investigated by considering different control strategies for the converter. The foldback current control characteristic is proposed to a converter interfaced DG to achieve quick arc extinction and self-restoration without disconnecting the DG in the event of an arc fault. The results are validated through PSCAD/EMTDC simulations.

Reducing MRI gradient coil vibration with rib stiffeners

This work investigates the effect of rib stiffeners on the free and forced vibration of a gradient coil in a Magnetic Resonance Imaging (MRI) scanner. Several reinforcement schemes are studied in this paper. One scheme utilizes the existing holes in the gradient coil structure (typically reserved for magnetic shims) to produce the reinforcement. Non-ferrous, non-magnetic carbon fibre rib stiffeners are employed to fill these holes in several ways to strengthen a gradient coil. Another scheme replaces the inner half of the gradient coil material with a grid of interconnected axial and circumferential rib stiffeners. It is found that the structural stiffness of the gradient coil increases substantially when the coil is reinforced by carbon fibre rib stiffeners. The reinforcement affects the noise and vibration response of the gradient coil structure in the following ways. It increases the frequency range of forced response of the gradient coil at low frequencies due to the increased resonant frequency of the fundamental mode of the coil. Secondly, it reduces the forced response amplitude of the coil structure (which is governed by the structural stiffness of the coil). Thirdly, it reduces the number of natural modes in the low and medium frequency range and therefore lessens the chance of the coil structure being excited resonantly by magnetic resonance signal acquisition sequences. It is shown that gradient coils modelled by solid finite element models have higher stiffness along the coil’s circumference and lower stiffness in the axial direction than those using shell finite element models.

Incomplete pregnancy and risk of ovarian cancer : results from two Australian case-control studies and systematic review

Although full-term pregnancies reduce the risk of ovarian cancer, it has not been conclusively established whether incomplete pregnancies also influence risk. We investigated the relationship between a history of incomplete pregnancy and incident epithelial ovarian cancer among over 4,500 women who participated in two large Australian population-based case-control studies in 1990-1993 and 2002-2005. They provided responses to detailed questions about their reproductive histories and other personal factors. Summary odds ratios (OR) and confidence intervals (CI) derived from each study using the same covariates were aggregated. We found no significant associations between the number of incomplete pregnancies and ovarian cancer, for parous (OR = 0.98, 95% CI: 0.89, 1.08) or nulliparous (OR = 1.06, 95% CI: 0.75, 1.48) women, nor for the number of spontaneous or induced abortions and ovarian cancer for parous women (OR = 0.95, 95% CI 0.82, 1.09; OR = 1.08, 95% CI: 0.86, 1.36) or nulliparous women (OR = 1.2, 95% CI: 0.6, 2.4; OR = 0.8, 95% CI: 0.47, 1.38), respectively. A systematic review of 37 previous studies of the topic confirmed our findings that a history of incomplete pregnancy does not influence a woman’s risk of epithelial ovarian cancer.