Palliative care challenges : implications for nurses' practice in renal settings

The very act of withdrawing dialysis places renal nurses in a unique practice setting requiring a sudden shift in care delivery from one of providing Ife-sustaining, active treatment to that of palliation. The impact of this act on the renal nurse remains largely invisible. Minimal research has been conducted that explores the significant issues and challenges that exist for renal nurses in the delivery of palliation following withdrawal of dialysis treatment. This paper attempts to highlight the issues and challenges that do exist for renal nurses in providing palliation and the subsequent lack of available research knowledge to inform practice in the renal setting. It recommends further research be conducted into the renal setting so as to inform the development of appropriate education to support renal nurses practice in the future.

Minimising capacitive couplings and distributing copper losses in planar magnetic elements

Planar magnetic elements are becoming a replacement for their conventional rivals. Among the reasons supporting their application, is their smaller size. Taking less bulk in the electronic package is a critical advantage from the manufacturing point of view. The planar structure consists of the PCB copper tracks to generate the desired windings .The windings on each PCB layer could be connected in various ways to other winding layers to produce a series or parallel connection. These windings could be applied coreless or with a core depending on the application in Switched Mode Power Supplies (SMPS). Planar shapes of the tracks increase the effective conduction area in the windings, brings about more inductance compared to the conventional windings with the similar copper loss case. The problem arising from the planar structure of magnetic inductors is the leakage current between the layers generated by a pulse width modulated voltage across the inductor. This current value relies on the capacitive coupling between the layers, which in its turn depends on the physical parameters of the planar scheme. In order to reduce this electrical power dissipation due to the leakage current and Electromagnetic Interference (EMI), reconsideration in the planar structure might be effective. The aim of this research is to address problem of these capacitive coupling in planar layers and to find out a better structure for the planar inductance which offers less total capacitive coupling and thus less thermal dissipation from the leakage currents. Through Finite Element methods (FEM) several simulations have been carried out for various planar structures. The labs prototypes of these structures are built with the similar specification of the simulation cases. The capacitive couplings of the samples are determined with Spectrum Analyser whereby the test analysis verified the simulation results.

Understanding the role of knowledge in the practice of expert nephrology nurses in Australia

This paper, which is abstracted from a larger study into the acquisition and exercise of nephrology nursing expertise, aims to explore the role of knowledge in expert practice. Using grounded theory methodology, the study involved 17 registered nurses who were practicing in a metropolitan renal unit in New South Wales, Australia. Concurrent data collection and analysis was undertaken, incorporating participants' observations and interviews. Having extensive nephrology nursing knowledge was a striking characteristic of a nursing expert. Expert nurses clearly relied on and utilized extensive nephrology nursing knowledge to practice. Of importance for nursing, the results of this study indicate that domain-specific knowledge is a crucial feature of expert practice.

Group maintenance scheduling : a case study for a pipeline network

This paper presents a group maintenance scheduling case study for a water distributed network. This water pipeline network presents the challenge of maintaining aging pipelines with the associated increases in annual maintenance costs. The case study focuses on developing an effective maintenance plan for the water utility. Current replacement planning is difficult as it needs to balance the replacement needs under limited budgets. A Maintenance Grouping Optimization (MGO) model based on a modified genetic algorithm was utilized to develop an optimum group maintenance schedule over a 20-year cycle. The adjacent geographical distribution of pipelines was used as a grouping criterion to control the searching space of the MGO model through a Judgment Matrix. Based on the optimum group maintenance schedule, the total cost was effectively reduced compared with the schedules without grouping maintenance jobs. This optimum result can be used as a guidance to optimize the current maintenance plan for the water utility.

Application of Mesenchymal Stem Cells for repair and regeneration of cartilage and bone

Australian efforts to provide orthopaedic surgeons with living, load-bearing scaffolds suitable for current joint (knee and hip) replacement surgery, non-union fracture repair, and miniscal and growth plate cartilage regeneration are being lead by teams at the Institute for Medical and Veterinary Science and Women's and Children's Hospital in Adelaide; the Peter MacCallum and St Vincent's Medical Research Institutes in Melbourne; and the Mater Medical Research Institute and new Institute for Health and Biomedical Innovation at QUT, Brisbane. In each case multidisciplinary teams are attempting to develop autologous living tissue constructs, utilising mesenchymal stem cells (MSC), with the intention of effecting seamless repair and regeneration of skeletal trauma and defects. In this article we will briefly review current knowledge of the phenotypic properties of MSC and discuss the potential therapeutic applications of these cells as exemplified by their use in cartilage repair and tissue engineering based approaches to the treatment of skeletal defects.

Hormones down under: Hormone therapy use after the Women's Health Initiative

Aims:  The primary objective was to describe the usage pattern of hormone therapy (HT) in a sample of urban Australian women in 2001 and to assess the characteristics of users vs. non-users. The second objective was to determine whether there had been any change in usage since the publication of the results of the combined oestrogen plus progestagen arm of the Women's Health Initiative (WHI) in 2002. Methods:  A cohort of 374 postmenopausal women aged 50–80 years participated in this substudy of the LAW (Longitudinal Assessment of Ageing in Women) project: a 5-year multidisciplinary, observational study. Participants completed an annual medical assessment including details of the use of HT and the reasons for use, as well as demographic and psychosocial data. Results:  In December 2001, 30.8% of the participants were using HT, whereas 55.4% were ever users. The management of vasomotor symptoms and mood disturbance were the primary reasons for use. Of those who had been using HT in December 2001 (24.4%) women ceased using HT in the 3 months following publication of the WHI results. The percentage of women using HT in December 2003 (13.9%) was less than half of that of December 2001. Conclusion:  The rate of HT use and the reasons for use, in 2001 in Brisbane was similar to that of other Australian regions. Usage of HT decreased since the publication of the WHI results in 2002 which may reflect changing attitudes by patients and practitioners regarding HT.

A review of optimization techniques used in the design of fibre composite structures for civil engineering applications

Fibre composite structures have become the most attractive candidate for civil engineering applications. Fibre reinforced plastic polymer (FRP) composite materials have been used in the rehabilitation and replacement of the old degrading traditional structures or build new structures. However, the lack of design standards for civil infrastructure limits their structural applications. The majority of the existing applications have been designed based on the research and guidelines provided by the fibre composite manufacturers or based on the designer’s experience. It has been a tendency that the final structure is generally over-designed. This paper provides a review on the available studies related to the design optimization of fibre composite structures used in civil engineering such as; plate, beam, box beam, sandwich panel, bridge girder, and bridge deck. Various optimization methods are presented and compared. In addition, the importance of using the appropriate optimization technique is discussed. An improved methodology, which considering experimental testing, numerical modelling, and design constrains, is proposed in the paper for design optimization of composite structures.

Performance load testing and structural adequacy evaluation of road bridge decks

Many ageing road bridges, particularly timber bridges, require urgent improvement due to the demand imposed by the recent version of the Australian bridge loading code, AS 5100. As traffic volume plays a key role in the decision of budget allocations for bridge refurbishment/ replacement, many bridges in low volume traffic network remain in poor condition with axle load and/ or speed restrictions, thus disadvantaging many rural communities. This thesis examines an economical and environmentally sensible option of incorporating disused flat rail wagons (FRW) in the construction of bridges in low volume, high axle load road network. The constructability, economy and structural adequacy of the FRW road bridge is reported in the thesis with particular focus of a demonstration bridge commissioned in regional Queensland. The demonstration bridge comprises of a reinforced concrete slab (RCS) pavement resting on two FRWs with custom designed connection brackets at regular intervals along the span of the bridge. The FRW-RC bridge deck assembly is supported on elastomeric rubber pads resting on the abutment. As this type of bridge replacement technology is new and its structural design is not covered in the design standards, the in-service structural performance of the FRW bridge subjected to the high axle loadings prescribed in AS 5100 is examined through performance load testing. Both the static and the moving load tests are carried out using a fully laden commonly available three-axle tandem truck. The bridge deck is extensively strain gauged and displacement at several key locations is measured using linear variable displacement transducers (LVDTs). A high speed camera is used in the performance test and the digital image data are analysed using proprietary software to capture the locations of the wheel positions on the bridge span accurately. The wheel location is thus synchronised with the displacement and strain time series to infer the structural response of the FRW bridge. Field test data are used to calibrate a grillage model, developed for further analysis of the FRW bridge to various sets of high axle loads stipulated in the bridge design standard. Bridge behaviour predicted by the grillage model has exemplified that the live load stresses of the FRW bridge is significantly lower than the yield strength of steel and the deflections are well below the serviceability limit state set out in AS 5100. Based on the results reported in this thesis, it is concluded that the disused FRWs are competent to resist high axle loading prescribed in AS 5100 and are a viable alternative structural solution of bridge deck in the context of the low volume road networks.

Synthesis and thermal stability of hydrotalcites based upon gallium

Hydrotalcites based upon gallium as a replacement for aluminium in hydrotalcite over a Mg/Al ratio of 2:1 to 4:1 were synthesised. The d(003) spacing varied from 7.83 A ° for the 2:1 hydrotalcite to 8.15 A ° for the 3:1 gallium containing hydrotalcite. A comparison is made with the Mg Al hydrotalcite in which the d(003) spacing for the Mg/Al hydrotalcite varied from 7.62 A ° for the 2:1Mg hydrotalcite to 7.98 A ° for the 4:1 hydrotalcite. The thermal stability of the gallium containing hydrotalcite was determined using thermogravimetric analysis. Four mass loss steps at 77, 263–280,485 and 828 degrees C with mass losses of 10.23, 21.55, 5.20 and 7.58% are attributed to dehydration, dehydroxylation and decarbonation. The thermal stability of the galliumcontaining hydrotalcite is slightly less than the aluminium hydrotalcite.

Towards an accurate biomechanical model of the ankle

When compared with similar joint arthroplasties, the prognosis of Total Ankle Replacement (TAR) is not satisfactory although it shows promising results post surgery. To date, most models do not provide the full anatomical functionality and biomechanical range of motion of the healthy ankle joint. This has sparked additional research and evaluation of clinical outcomes in order to enhance ankle prosthesis design. However, the limited biomechanical data that exist in literature are based upon two-dimensional, discrete and outdated techniques1 and may be inaccurate. Since accurate force estimations are crucial to prosthesis design, a paper based on a new biomechanical modeling approach, providing three dimensional forces acting on the ankle joint and the surrounding tissues was published recently, but the identified forces were suspected of being under-estimated, while muscles were . The present paper reports an attempt to improve the accuracy of the analysis by means of novel methods for kinematic processing of gait data, provided in release 4.1 of the AnyBody Modeling System (AnyBody Technology, Aalborg, Denmark) Results from the new method are shown and remaining issues are discussed.

Modelling the interaction of keratinocytes and fibroblasts during normal and abnormal wound healing processes

The crosstalk between fibroblasts and keratinocytes is a vital component of the wound healing process, and involves the activity of a number of growth factors and cytokines. In this work, we develop a mathematical model of this crosstalk in order to elucidate the effects of these interactions on the regeneration of collagen in a wound that heals by second intention. We consider the role of four components that strongly affect this process: transforming growth factor-beta, platelet-derived growth factor, interleukin-1 and keratinocyte growth factor. The impact of this network of interactions on the degradation of an initial fibrin clot, as well as its subsequent replacement by a matrix that is mainly comprised of collagen, is described through an eight-component system of nonlinear partial differential equations. Numerical results, obtained in a two-dimensional domain, highlight key aspects of this multifarious process such as reepithelialisation. The model is shown to reproduce many of the important features of normal wound healing. In addition, we use the model to simulate the treatment of two pathological cases: chronic hypoxia, which can lead to chronic wounds; and prolonged inflammation, which has been shown to lead to hypertrophic scarring. We find that our model predictions are qualitatively in agreement with previously reported observations, and provide an alternative pathway for gaining insight into this complex biological process.

Weighted LDA techniques for I-vector based speaker verification

This paper introduces the Weighted Linear Discriminant Analysis (WLDA) technique, based upon the weighted pairwise Fisher criterion, for the purposes of improving i-vector speaker verification in the presence of high intersession variability. By taking advantage of the speaker discriminative information that is available in the distances between pairs of speakers clustered in the development i-vector space, the WLDA technique is shown to provide an improvement in speaker verification performance over traditional Linear Discriminant Analysis (LDA) approaches. A similar approach is also taken to extend the recently developed Source Normalised LDA (SNLDA) into Weighted SNLDA (WSNLDA) which, similarly, shows an improvement in speaker verification performance in both matched and mismatched enrolment/verification conditions. Based upon the results presented within this paper using the NIST 2008 Speaker Recognition Evaluation dataset, we believe that both WLDA and WSNLDA are viable as replacement techniques to improve the performance of LDA and SNLDA-based i-vector speaker verification.

Utilization of bio-oil for cooking and lighting

Among the available alternative sources of energy in Bangladesh bio-oil is recognized to be a promising alternative energy source. Bio-oil can be extracted by pyrolysis as well as expelling or solvent extractionmethod. In these days bio-oil is merely used in vehicles and power plants after some up gradation .However, it is not used for domestic purposes like cooking and lighting due to its high density and viscosity. This paper outlines the design of a gravity stove to use high dense and viscous bio-oil for cooking purpose. For this, Pongamia pinnata (karanj) oil extracted by solvent extraction method is used as fuel fed under gravity force. Efficiency of gravity stove with high dense and viscous bio-oil (karanj) is 11.81% which of kerosene stove is 17.80% also the discharge of karanj oil through gravity stove is sufficient for continuous burning. Thus, bio-oil can be effective replacement of kerosene for domestic purposes.