‘True Blood’ the critical care story: An audit of blood sampling practice across three adult, paediatric and neonatal intensive care settings

Background Anaemia is common in critically ill patients, and has a significant negative impact on patients' recovery. Blood conservation strategies have been developed to reduce the incidence of iatrogenic anaemic caused by sampling for diagnostic testing. Objectives Describe practice and local guidelines in adult, paediatric and neonatal Australian intensive care units (ICUs) regarding blood sampling and conservation strategies. Methods Cross-sectional descriptive study, conducted July 2013 over one week in single adult, paediatric and neonatal ICUs in Brisbane. Data were collected on diagnostic blood samples obtained during the study period, including demographic and acuity data of patients. Institutional blood conservation practice and guidelines were compared against seven evidence-based recommendations. Results A total of 940 blood sampling episodes from 96 patients were examined across three sites. Arterial blood gas was the predominant reason for blood sampling in each unit, accounting for 82% of adult, 80% of paediatric and 47% of neonatal samples taken (p <. 0.001). Adult patients had significantly more median [IQR] samples per day in comparison to paediatrics and neonates (adults 5.0 [2.4]; paediatrics 2.3 [2.9]; neonatal 0.7 [2.7]), which significantly increased median [IQR] blood sampling costs per day (adults AUD$101.11 [54.71]; paediatrics AUD$41.55 [56.74]; neonatal AUD$8.13 [14.95]; p <. 0.001). The total volume of samples per day (median [IQR]) was also highest in adults (adults 22.3. mL [16.8]; paediatrics 5.0. mL [1.0]; neonates 0.16. mL [0.4]). There was little information about blood conservation strategies in the local clinical practice guidelines, with the adult and neonatal sites including none of the seven recommendations. Conclusions There was significant variation in blood sampling practice and conservation strategies between critical care settings. This has implications not only for anaemia but also infection control and healthcare costs.

Development and characterisation of tri- and tetra-nucleotide polymorphic microsatellite markers for skipjack tuna (Katsuwonus pelamis)

Skipjack tuna (katsuwonus pelamis) (SJT) is the largest tuna fishery in all the major oceans around the world, and the largest marine fishery in Sri Lanka. Knowledge of genetic population structure and effective population size of SJT in the Indian Ocean and other major oceans, however, is still lacking for better management practices and conservation strategies. We developed microsatellite genetic markers using SJT around Sri Lanka in the Indian Ocean, and characterise one tri- and seven tetra-nucleotide microsatellite loci isolated from enriched genomic libraries from SJT, to provide tools for addressing both conservation and fisheries management questions. An analysis of these eight microsatellite markers in two populations of SJT from eastern Sri Lanka (n = 44) and the Maldives Islands (n = 53) showed that all eight microsatellites were polymorphic with an average number of alleles per locus of 11.80 (range 5-27). Expected heterozygosities at marker loci ranged from 0.450 to 0.961. These markers are being used currently to characterise population structure and extent of natural gene flow in SJT populations from the eastern and western Indian Ocean. No significant linkage disequilibrium was detected among any loci pairs.

Benefits of integrating complementarity into priority threat management

Conservation decision tools based on cost-effectiveness analysis are used to assess threat management strategies for improving species persistence. These approaches rank alternative strategies by their benefit to cost ratio but may fail to identify the optimal sets of strategies to implement under limited budgets because they do not account for redundancies. We devised a multi objective optimization approach in which the complementarity principle is applied to identify the sets of threat management strategies that protect the most species for any budget. We used our approach to prioritize threat management strategies for 53 species of conservation concern in the Pilbara, Australia. We followed a structured elicitation approach to collect information on the benefits and costs of implementing 17 different conservation strategies during a 3-day workshop with 49 stakeholders and experts in the biodiversity, conservation, and management of the Pilbara. We compared the performance of our complementarity priority threat management approach with a current cost-effectiveness ranking approach. A complementary set of 3 strategies: domestic herbivore management, fire management and research, and sanctuaries provided all species with >50% chance of persistence for $4.7 million/year over 20 years. Achieving the same result cost almost twice as much ($9.71 million/year) when strategies were selected by their cost-effectiveness ranks alone. Our results show that complementarity of management benefits has the potential to double the impact of priority threat management approaches.

Is lek breeding rare in bats?

Bats (Mammalia: Chiroptera) are among the most successful mammals and likely display the widest range of mating systems within the Class. One mating system that is underrepresented in the Chiroptera is lek breeding, which is characterized by aggregations of sexually displaying males that are visited by receptive females who appraise male displays and actively choose mates, yet receive no direct benefits such as assistance in parenting. Leks are thought to form when males can defend neither resources nor females, making it more economical to establish small breeding territories and self-advertise through sexual displays. Lekking is rare in mammals, and it has been suggested that a lack in the mobility required by females to economically seek out aggregations of sexually displaying males may explain this rarity. Bats, like birds, do not suffer reduced mobility and yet out of over a thousand described species, only one has been confirmed to breed in leks. We examine the rarity of lekking in bats by providing an overview on the current state of knowledge of their mating systems and discuss the ecological and social determinants for the observed trends, contrasted with the prerequisites of lek-breeding behaviour. We use the breeding behaviour of New Zealand's lesser short-tailed bat Mystacina tuberculata, which is believed to be a lek breeder, as a case study for the examination of potential lekking behaviour in bats, and highlight the importance of such research for the development of effective conservation strategies.

Using Bayesian Mixture Models That Combine Expert Knowledge and GIS Data to Define Ecoregions

Conservation planning and management programs typically assume relatively homogeneous ecological landscapes. Such “ecoregions” serve multiple purposes: they support assessments of competing environmental values, reveal priorities for allocating scarce resources, and guide effective on-ground actions such as the acquisition of a protected area and habitat restoration. Ecoregions have evolved from a history of organism–environment interactions, and are delineated at the scale or level of detail required to support planning. Depending on the delineation method, scale, or purpose, they have been described as provinces, zones, systems, land units, classes, facets, domains, subregions, and ecological, biological, biogeographical, or environmental regions. In each case, they are essential to the development of conservation strategies and are embedded in government policies at multiple scales.

Eco-crime and freshwater

The unsustainable and exploitative use of one of the most important but scarce resources on the planet - freshwater - continues to create conflict and human dislocation on a grand scale. Instead of witnessing nation-states adopting more equitable and efficient conservation strategies, powerful corporations are permitted to privatise and monopolise diminishing water reservoirs based on flawed neo-liberal assumptions and market models of the ‘global good’. The commodification of water has enabled corporate monopolies and corrupt states to exploit a fundamental human right, and in the process have created new forms of criminality. In recent years, affluent industrialised nations have experienced violent rioting as protestors express opposition to government ‘freshwater taxes’ and to corporate investors seeking to privatise drinking water. These water conflicts have included unprecedented clashes with police and deaths of innocent civilians in South Africa (BBC News, 2014a); the United Nations intervention in Detroit USA after weeks of public protest (Burns, 2014); and the hundreds of thousands of people protesting in Ireland (BBC News, 2014,b; Irish Times 2015). Subsequently, the commodification of freshwater has become a criminological issue for water-abundant rich states, as well as for the highly indebted water-scarce nations.

The commodification and exploitation of fresh water: Property, human rights and green criminology

In recent years, both developing and industrialised societies have experienced riots and civil unrest over the corporate exploitation of fresh water. Water conflicts increase as water scarcity rises and the unsustainable use of fresh water will continue to have profound implications for sustainable development and the realisation of human rights. Rather than states adopting more costly water conservation strategies or implementing efficient water technologies, corporations are exploiting natural resources in what has been described as the “privatization of water”. By using legal doctrines, states and corporations construct fresh water sources as something that can be owned or leased. For some regions, the privatization of water has enabled corporations and corrupt states to exploit a fundamental human right. Arguing that such matters are of relevance to criminology, which should be concerned with fundamental environmental and human rights, this article adopts a green criminological perspective and draws upon Treadmill of Production theory.

What's in it for me? Virtual conspicuous donation strategies as a source of value in blood donation

Providing an incentive is becoming common practice among blood service organisations. Driven by self-orientated motives rather than pure philanthropic intentions, research is showing that people increasingly want something in return for their support. It is contended that individuals donate conspicuously with the hope it will improve their social standing. Yet there is limited evidence for the effectiveness of conspicuous recognition strategies, and no studies, to the researcher’s knowledge, that have examined conspicuous donation strategies in an online social media context. There is a need to understand what value drives individuals to donate blood, and whether conspicuous donation strategies are a source of such value post blood donation. The purpose of this paper is to conceptualise how conspicuous donation strategies, in the form of virtual badges on social media sites, can be applied to the social behaviour of blood donation, as a value-adding tool, to encourage repeat behaviour.

Repeat participation in colorectal cancer screening utilizing fecal occult blood testing : a community-based project in a rural setting

Background and Aim: To investigate participation in a second round of colorectal cancer screening using a fecal occult blood test (FOBT) in an Australian rural community, and to assess the demographic characteristics and individual perspectives associated with repeat screening. ---------- Methods: Potential participants from round 1 (50–74 years of age) were sent an intervention package and asked to return a completed FOBT (n = 3406). Doctors of participants testing positive referred to colonoscopy as appropriate. Following screening, 119 participants completed qualitative telephone interviews. Multivariable logistic regression models evaluated the association between round-2 participation and other variables.---------- Results: Round-2 participation was 34.7%; the strongest predictor was participation in round 1. Repeat participants were more likely to be female; inconsistent screeners were more likely to be younger (aged 50–59 years). The proportion of positive FOBT was 12.7%, that of colonoscopy compliance was 98.6%, and the positive predictive value for cancer or adenoma of advanced pathology was 23.9%. Reasons for participation included testing as a precautionary measure or having family history/friends with colorectal cancer; reasons for non-participation included apathy or doctors’ advice against screening.---------- Conclusion: Participation was relatively low and consistent across rounds. Unless suitable strategies are identified to overcome behavioral trends and/or to screen out ineligible participants, little change in overall participation rates can be expected across rounds.

Sustainable water provision : challenges, alternative strategies and sources in the era of climate change

As a result of rapid urbanisation, population growth, changes in lifestyle, pollution and the impacts of climate change, water provision has become a critical challenge for planners and policy-makers. In the wake of increasingly difficult water provision and drought, the notion that freshwater is a finite and vulnerable resource is increasingly being realised. Many city administrations around the world are struggling to provide water security for their residents to maintain lifestyle and economic growth. This chapter reviews the global challenge of providing freshwater to sustain lifestyles and economic growth, and the contributing challenges of climate change, urbanisation, population growth and problems in rainfall distribution. The chapter proceeds to evaluate major alternatives to current water sources such as conservation, recycling and reclamation, and desalination. Integrated water resource management is briefly looked at to explore its role in complementing water provision. A comparative study on alternative resources is undertaken to evaluate their strengths, weaknesses, opportunities and constraints, and the results are discussed.

Sustainable water provision : challenges, alternative strategies and sources in the ERA of climate change

As a result of rapid urbanisation, population growth, changes in lifestyle, pollution and the impacts of climate change, water provision has become a critical challenge for planners and policy-makers. In the wake of increasingly difficult water provision and drought, the notion that freshwater is a finite and vulnerable resource is increasingly being realised. Many city administrations around the world are struggling to provide water security for their residents to maintain lifestyle and economic growth. This chapter reviews the global challenge of providing freshwater to sustain lifestyles and economic growth, and the contributing challenges of climate change, urbanisation, population growth and problems in rainfall distribution. The chapter proceeds to evaluate major alternatives to current water sources such as conservation, recycling and reclamation, and desalination. Integrated water resource management is briefly looked at to explore its role in complementing water provision. A comparative study on alternative resources is undertaken to evaluate their strengths, weaknesses, opportunities and constraints, and the results are discussed.

Alcohol-related driving offences, crashes, and traffic policing strategies in Zhejiang Province, China

Context Alcohol-related traffic offences and associated trauma have attracted attention in China in recent years, culminating in changes to national legislation in May 2011. Harsher penalties were introduced, particularly for offences where blood alcohol concentration (BAC) levels above 80mg/100mL are recorded. Deemed to be drunk under the law, this is now a criminal offence attracting penalties including large monetary fines, licence suspension for 5 years and imprisonment. Objective This paper outlines key statistics about alcohol-related road trauma in Zhejiang Province and strategies used to combat drink- and drunk-driving. Key Outcomes Zhejiang Province, in China’s south east, has a population of approximately 54, 426,000; 22.36% hold a driving licence. Rapid motorisation is occurring there. In 2011, 1,383,318 new licences were issued, representing a 16.78% increase from the previous year. In 2012, there were a total of 65,000 police officers throughout the Province, 12,307 of whom (18.9%) were traffic police. Responsibility for conducting alcohol testing is the responsibility of all traffic police. The number of alcohol breath tests conducted per year was not available. However, traffic police are actively enforcing alcohol-related laws. In 2011, 89,228 drivers were charged with drink-driving (DUI;20-80mg/100 mL) and 10,014 with the more serious drunk-driving offence (DWI;>80mg/100mL) (Zhejiang Traffic Management Department, 2012). These numbers decreased from the previous year (221,262 and 26,390 respectively). For all crashes recorded in 2011 (n=20,176), 2% involved alcohol-impaired road users. Information on the role of alcohol in crashes from previous years was not available. Discussion Various strategies are employed to detect alcohol-impaired drivers including: targeting vehicles from hotels/restaurants; using sense of smell to screen drivers for further testing; passive alcohol sensors to test drivers; and blood tests for crash-involved drivers where a fatality occurred. Although resources to promote road safety are limited, various government initiatives promote awareness of the dangers of alcohol-related driving and more are needed in future.

Give some, get some: investigating the relationship between conspicuous donation behaviour on social media and customer value in a blood donation context

Previous research has questioned the role of altruism in charitable donation and suggests that such behaviour is also motivated by self-interest, such as public recognition or emotional satisfaction. Recognising this, not-for-profit organisations have developed strategies that allow individuals to donate conspicuously, and are at an embryonic stage of turning to social media to provide such recognition. Under investigation in this paper, is the relationship between conspicuous donation behaviour (CDB) on social media and customer value, in blood donation. Online survey results, from a sample of 186 Australian blood donors, support the proposed framework. Significant relationships between self-orientated CDB and emotional value, and other-orientated CDB and social value are demonstrated. The findings provide valuable insights into the use of conspicuous donation strategies on social media as a means to add value to the donation experience, and contribute to our understanding into the under-researched areas of CDB and customer value.

Identifying belief targets to increase bone marrow registry participation among students who have never donated blood

New members on bone marrow registries worldwide are needed to allow sufficient diversity in the donor pool to meet patient needs. We used the theory of planned behaviour belief-basis and surveyed students who had not donated blood previously (i.e. non-donors) (N = 150) about the behavioural, normative, and control beliefs informing their intentions to join the Australian Bone Marrow Donor Registry. Key beliefs predicting non-donors’ intentions included: viewing bone marrow donation as an invasion of the body (β = −.35), normative support from parents (β = .40), anticipating pain/side effects from giving blood (β = −.27), and lack of knowledge about how to register (β  = −.30). Few non-donors endorsed these beliefs, suggesting they are ideal targets for change in strategies encouraging bone marrow donor registration.

Donating blood and organs : using an extended theory of planned behavior perspective to identify similarities and differences in individual motivations to donate

Due to the critical shortage and continued need of blood and organ donations (ODs), research exploring similarities and differences in the motivational determinants of these behaviors is needed. In a sample of 258 university students, we used a cross-sectional design to test the utility of an extended theory of planned behavior (TPB) including moral norm, self-identity and in-group altruism (family/close friends and ethnic group), to predict people’s blood and OD intentions. Overall, the extended TPB explained 77.0% and 74.6% of variance in blood and OD intentions, respectively. In regression analyses, common contributors to intentions across donation contexts were attitude, self-efficacy and self-identity. Normative influences varied with subjective norm as a significant predictor related to OD intentions but not blood donation intentions at the final step of regression analyses. Moral norm did not contribute significantly to blood or OD intentions. In-group altruism (family/close friends) was significantly related to OD intentions only in regressions. Future donation strategies should increase confidence to donate, foster a perception of self as the type of person who donates blood and/or organs, and address preferences to donate organs to in-group members only.