Peer-led diabetes self-management programme for community-dwelling older people in China : study protocol for a quasi-experimental design

Aim. A protocol for a new peer-led self-management programme for communitydwelling older people with diabetes in Shanghai, China. Background. The increasing prevalence of type 2 diabetes poses major public health challenges. Appropriate education programmes could help people with diabetes to achieve self-management and better health outcomes. Providing education programmes to the fast growing number of people with diabetes present a real challenge to Chinese healthcare system, which is strained for personnel and funding shortages. Empirical literature and expert opinions suggest that peer education programmes are promising. Design. Quasi-experimental. Methods. This study is a non-equivalent control group design (protocol approved in January, 2008). A total of 190 people, with 95 participants in each group, will be recruited from two different, but similar, communities. The programme, based on Social Cognitive Theory, will consist of basic diabetes instruction and social support and self-efficacy enhancing group activities. Basic diabetes instruction sessions will be delivered by health professionals, whereas social support and self-efficacy enhancing group activities will be led by peer leaders. Outcome variables include: self-efficacy, social support, self-management behaviours, depressive status, quality of life and healthcare utilization, which will be measured at baseline, 4 and 12 weeks. Discussion. This theory-based programme tailored to Chinese patients has potential for improving diabetes self-management and subsequent health outcomes. In addition, the delivery mode, through involvement of peer leaders and existing community networks,is especially promising considering healthcare resource shortage in China.

Teaching new product development to design led innovation

Recently many international tertiary educational programs have capitalised on the value design and business can have upon their interception (Martin, 2009; Brown, 2008; Bruce and Bessant, 2002; Manzini, 2009). This paper discusses the role that two teaching units – New Product Development and Design Led Innovation – play in forming an understanding of commercialisation needed in today’s Industrial Design education. These units are taught consecutively in the later years of the Bachelor of Industrial Design program at the Queensland University of Technology, Brisbane, Australia. In this paper, each teaching unit is discussed in detail and then as a conglomerate, in order to form a basis of knowledge students need in order to fully capitalise on the value design has in business, and to produce a more capable Industrial Design graduate of the future.

Impact of a novel nurse-led prechemotherapy education intervention (ChemoEd) on patient distress, symptom burden, and treatment-related information and support needs : results from a randomised, controlled trial

Background: High levels of distress and need for self-care information by patients commencing chemotherapy suggest that current prechemotherapy education is suboptimal. We conducted a randomised, controlled trial of a prechemotherapy education intervention (ChemoEd) to assess impact on patient distress, treatment-related concerns, and the prevalence and severity of and bother caused by six chemotherapy side-effects. Patients and methods: One hundred and ninety-two breast, gastrointestinal, and haematologic cancer patients were recruited before the trial closing prematurely (original target 352). ChemoEd patients received a DVD, question-prompt list, self-care information, an education consultation ≥24 h before first treatment (intervention 1), telephone follow-up 48 h after first treatment (intervention 2), and a face-to-face review immediately before second treatment (intervention 3). Patient outcomes were measured at baseline (T1: pre-education) and immediately preceding treatment cycles 1 (T2) and 3 (T3). Results: ChemoEd did not significantly reduce patient distress. However, a significant decrease in sensory/psychological (P = 0.027) and procedural (P = 0.03) concerns, as well as prevalence and severity of and bother due to vomiting (all P = 0.001), were observed at T3. In addition, subgroup analysis of patients with elevated distress at T1 indicated a significant decrease (P = 0.035) at T2 but not at T3 (P = 0.055) in ChemoEd patients. Conclusions: ChemoEd holds promise to improve patient treatment-related concerns and some physical/psychological outcomes; however, further research is required on more diverse patient populations to ensure generalisability.

Slow horizon

“Slow Horizon” is comprised of six lenticular panels hung in an even, horizontal sequence. As the viewer moves in front of the work, each panel alternates subtly between two vertical colour gradients. From left to right, the panels move through yellow, orange, magenta and violet to ‘midnight blue’. Together, the coloured panels comprise an abstract horizon line that references the changing nature of light at sunset. The scale, movement and chromatic qualities of the panels also allude to the formal characteristics of the screen technologies that pervade contemporary visual culture. “Slow Horizon” contributes to studies in the field of contemporary art. It is particularly concerned with the relationships between abstraction, colour, signification and perception. Since early Modernity, debates concerning representation and the formal qualities of the picture plane have been fundamental to art practice and theory. These debates have often dovetailed with questions of art’s capacity to generate shifts in thought and perception. Practitioners such as Ellsworth Kelly, James Turrell and Ed Ruscha have variously used block and blended colour to engage in these formal, symbolic and perceptual potentials of colour. Using a practice-led research methodology, “Slow Horizon” furthers this creative inquiry. By conflating the reductive visual logics of abstraction and minimalism with the iconic, romantic evocations of sunset imagery, it questions not only the contemporary relationship between abstraction and image-making, but also art’s ability to create moments of stillness and contemplation in a context significantly shaped by screen technologies. “Slow Horizon” has been exhibited internationally as part of “Supermassive” at LA Louver Gallery, Venice, California in 2013. The exhibition was reviewed in The Los Angeles Times.

Double blind : women as creative practice-led researchers

While the productive relationship between praxis and feminist research has been well established, the situation is more complicated for female artist/researchers in the fraught field of creative practice-led research. Firstly, their research is being conducted in the context of ongoing debate, as Andrea Phillips has summarized, over whether practice-led research has been embraced in order to potentially produce emancipatory knowledge, or whether it is simply the rationalization and quantification of creative processes. Secondly, there is a pervasive paradox whereby, rather than feeling empowered by the process of critical and reflective self-analysis, many women are inhibited by enduring insecurities about the value of their work and/or their ownership of it. The reasons for this appear to be twofold: they are disheartened by the ongoing disproportion of successful women artists, and they are intimidated by the fundamentally masculine discourse surrounding research in the university. Many of these anxieties appear to have been exacerbated by the research quality assessment process, the Excellence in Research for Australia Initiative (ERA). This collaborative paper draws on the authors' experiences as both artist-researchers and educators to contextualize this paradox and also discuss what forms of praxis intervention may be useful in the preparation for, and supervision of, creative practice-led research by women.

A methodological approach to modelling design led innovation across secondary education : an Australian case study

Incorporating design thinking as a generic capability at a school level is needed to ensure future generations are empowered for business innovation and active citizenship. This paper describes the methodology of an investigation into modelling design led innovation approaches from the business sector to secondary education, as part of a larger study. It builds on a previously discussed research agenda by outlining the scope, significance and limitations of currently available research in this area, examining an action research methodology utilising an Australian design immersion program case study, and discussing implications and future work. It employs a triangulated approach encompassing thematic analysis of qualitative data collection from student focus groups, semi-structured convergent interviews with teachers and facilitators, and student journals. Eventual outcomes will be reviewed and analysed within the framework of a proposed innovation matrix model for educational growth, synthesising principles responding to 21st century student outcomes. It is anticipated this research will inform a successful design led secondary education innovation model, facilitating new engagement frameworks between tertiary and secondary education sectors, as well as providing new insight into the suitability of action research in prototyping social innovation in Australia.

Context-aware device self-configuration using self-organizing maps

Modern mobile computing devices are versatile, but bring the burden of constant settings adjustment according to the current conditions of the environment. While until today, this task has to be accomplished by the human user, the variety of sensors usually deployed in such a handset provides enough data for autonomous self-configuration by a learning, adaptive system. However, this data is not fully available at certain points in time, or can contain false values. Handling potentially incomplete sensor data to detect context changes without a semantic layer represents a scientific challenge which we address with our approach. A novel machine learning technique is presented - the Missing-Values-SOM - which solves this problem by predicting setting adjustments based on context information. Our method is centered around a self-organizing map, extending it to provide a means of handling missing values. We demonstrate the performance of our approach on mobile context snapshots, as well as on classical machine learning datasets.

A prospective window into medical device-related pressure ulcers in intensive care

Objective: To determine the prevalence, severity, location, etiology, treatment, and healing of medical device-related pressure ulcers in intensive care patients for up to 7 days. Design: Prospective repeated measures study. Setting and participants: Patients in 6 intensive care units of 2 major medical centers, one each in Australia and the United States, were screened 1 day per month for 6 months. Those with device-related ulcers were followed daily up to 7 days. Outcome measures: Device-related ulcer prevalence, pain, infection, treatment, healing. Results: 15/483 patients had device-related ulcers and 9/15 with 11 ulcers were followed beyond screening. Their mean age was 60.5 years, most were men, over-weight, and at increased pressure ulcer risk. Endotracheal and nasogastric tubes were the cause of most device-related ulcers. Repositioning was the most frequent treatment. 4/11 ulcers healed within the 7 day observation period. Conclusion: Device-related ulcer prevalence was 3.1%, similar to that reported in the limited literature available, indicating an ongoing problem. Systematic assessment and repositioning of devices are the mainstays of care. We recommend continued prevalence determination and that nurses remain vigilant to prevent device-related ulcers, especially in patients with nasogastric and endotracheal tubes.

Multi-device key management using visual side channels in pervasive computing environments

In the modern connected world, pervasive computing has become reality. Thanks to the ubiquity of mobile computing devices and emerging cloud-based services, the users permanently stay connected to their data. This introduces a slew of new security challenges, including the problem of multi-device key management and single-sign-on architectures. One solution to this problem is the utilization of secure side-channels for authentication, including the visual channel as vicinity proof. However, existing approaches often assume confidentiality of the visual channel, or provide only insufficient means of mitigating a man-in-the-middle attack. In this work, we introduce QR-Auth, a two-step, 2D barcode based authentication scheme for mobile devices which aims specifically at key management and key sharing across devices in a pervasive environment. It requires minimal user interaction and therefore provides better usability than most existing schemes, without compromising its security. We show how our approach fits in existing authorization delegation and one-time-password generation schemes, and that it is resilient to man-in-the-middle attacks.

Can a “Blue Sky” return to Indian megacities?

Deterioration of air quality in Indian megacities (Delhi, Mumbai or Kolkata) is much more significant than that observed in the megacities of developed countries. Densely packed high-rise buildings restrict the self-cleaning capabilities of Indian megacities. Also, the ever growing number of on-road vehicles, resuspension of the dust, and anthropogenic activities exacerbate the levels of ambient air pollution, which is in turn breathed by urban dwellers. Pollution levels exceeding the standards on a regular basis often result in a notable increase in morbidity and mortality. This article discusses the challenges faced by Indian megacities in their quest for sustainable growth, without compromising the air quality and urban way of life.

Pt/anodized TiO2/SiC-based MOS device for hydrocarbon sensing

Pt/anodized TiO2/SiC based metal-oxide-semiconductor (MOS) devices were fabricated and characterized for their sensitivity towards propene (C3H6). Titanium (Ti) thin films were deposited onto the SiC substrates using a filtered cathodic vacuum arc (FCVA) method. Fluoride ions containing neutral electrolyte (0.5 wt% NH4F in ethylene glycol)were used to anodize the Ti films. The anodized films were subsequently annealed at 600 °C for 4 hrs in an oxygen rich environment to obtain TiO2. The current-voltage(I-V) characteristics of the Pt/TiO2/SiC devices were measured in different concentrations of propene. Exposure to the analyte gas caused a change in the Schottky barrier height and hence a lateral shift in the I-V characteristics. The effective change in the barrier height for 1% propene was calculated as 32.8 meV at 620°C. The dynamic response of the sensors was also investigated and a voltage shift of 157 mV was measured at 620°C during exposure to 1% propene.

A new model to study healing of a complex femur fracture with concurrent soft tissue injury in sheep

High energy bone fractures resulting from impact trauma are often accompanied by subcutaneous soft tissue injuries, even if the skin remains intact. There is evidence that such closed soft tissue injuries affect the healing of bone fractures, and vice versa. Despite this knowledge, most impact trauma studies in animals have focussed on bone fractures or soft tissue trauma in isolation. However, given the simultaneous impact on both tissues a better understanding of the interaction between these two injuries is necessary to optimise clinical treatment. The aim of this study was therefore to develop a new experimental model and characterise, for the first time, the healing of a complex fracture with concurrent closed soft tissue trauma in sheep. A pendulum impact device was designed to deliver a defined and standardised impact to the distal thigh of sheep, causing a reproducible contusion injury to the subcutaneous soft tissues. In a subsequent procedure, a reproducible femoral butterfly fracture (AO C3-type) was created at the sheep’s femur, which was initially stabilised for 5 days by an external fixator construct to allow for soft tissue swelling to recede, and ultimately in a bridging construct using locking plates. The combined injuries were applied to twelve sheep and the healing observed for four or eight weeks (six animals per group) until sacrifice. The pendulum impact led to a moderate to severe circumferential soft tissue injury with significant bruising, haematomas and partial muscle disruptions. Posttraumatic measurements showed elevated intra-compartmental pressure and circulatory tissue breakdown markers, with recovery to normal, pre-injury values within four days. Clinically, no neurovascular deficiencies were observed. Bi-weekly radiological analysis of the healing fractures showed progressive callus healing over time, with the average number of callus bridges increasing from 0.4 at two weeks to 4.2 at eight weeks. Biomechanical testing after sacrifice showed increasing torsional stiffness between four and eight weeks healing time from 10% to 100%, and increasing ultimate torsional strength from 10% to 64% (relative to the contralateral control limb). Our results demonstrate the robust healing of a complex femur fracture in the presence of a severe soft tissue contusion injury in sheep and demonstrate the establishment of a clinically relevant experimental model, for research aimed at improving the treatment of bone fractures accompanied by closed soft tissue injuries.