Challenging the distal-to-proximal cannulation technique for administration of anti-cancer therapies : a prospective cohort study

Background: Distal-to-proximal technique has been recommended for anti-cancer therapy administration. There is no evidence to suggest that a 24-hour delay of treatment is necessary for patients with a previous uncomplicated venous puncture proximal to the administration site. Objectives: This study aims to identify if the practice of 24-hour delay between a venous puncture and subsequent cannulation for anti-cancer therapies at a distal site is necessary for preventing extravasation. Methods: A prospective cohort study was conducted with 72 outpatients receiving anti-cancer therapy via an administration site distal to at least one previous uncomplicated venous puncture on the same arm in a tertiary cancer centre in Australia. Participants were interviewed and assessed at baseline data before treatment and on day 7 for incidence of extravasation/phlebitis. Results: Of 72 participants with 99 occasions of treatment, there was one incident of infiltration (possible extravasation) at the venous puncture site proximal to the administration site and two incidents of phlebitis at the administration site. Conclusions: A 24 hour delay is unnecessary if an alternative vein can be accessed for anti-cancer therapy after a proximal venous puncture. Implications for practice: Extravasation can occur at a venous puncture site proximal to an administration site in the same vein. However, the nurse can administer anti-cancer therapy at a distal site if the nurse can confidently determine the vein of choice is not in any way connected to the previous puncture site through visual inspection and palpation.

Can we safely deform a plate to fit every bone? Population-based fit assessment and finite element deformation of a distal tibial plate

Anatomically precontoured plates are commonly used to treat periarticular fractures. A well-fitting plate can be used as a tool for anatomical reduction of the fractured bone. Recent studies highlighted that some plates fit poorly for many patients due to considerable shape variations between bones of the same anatomical site. While it is impossible to design one shape that fits all, it is also burdensome for the manufacturers and hospitals to produce, store and manage multiple plate shapes without the certainty of utilization by a patient population. In this study, we investigated the number of shapes required for maximum fit within a given dataset, and if they could be obtained by manually deforming the original plate. A distal medial tibial plate was automatically positioned on 45 individual tibiae, and the optimal deformation was determined iteratively using finite element analysis simulation. Within the studied dataset, we found that: (i) 89% fit could be achieved with four shapes, (ii) 100% fit was impossible through mechanical deformation, and (iii) the deformations required to obtain the four plate shapes were safe for the stainless steel plate for further clinical use. The proposed framework is easily transferable to other orthopaedic plates.

Final report : offsite manufacture in Australia Final report off-site manufacture in Australia

Off-site Manufacture (OSM) has long been recognised, both in Australia and internationally, as offering numerous benefits to all parties in the construction process. More importantly, it is recognised as a key vehicle for driving improvement within the construction industry. The uptake of OSM in construction is however limited, despite well documented benefits. The research aims to determine the ‘state-of-the-art’ of OSM in Australia. It confirms the benefits and identifies the real and perceived barriers to the widespread adoption of OSM. Further the project identifies opportunities for future investment and research. Although numerous reports have been produced in the UK on the state of OSM adoption within that region, no prominent studies exist for the Australian context. This scoping study is an essential component upon which to build any initiatives that can take advantage of the benefits of OSM in construction. The Construction 2020 report predicted that OSM is set to increase in use over the next 5-15 years, further justifying the need for such a study. The long-term goal of this study is to contribute to the improvement of the Australian construction industry through a realisation of the potential benefits of OSM.

Off-site Manufacture in Australia : Current State and Future Directions

Off-site manufacture (OSM) offers numerous benefits to all parties in the construction process. The uptake of OSM in Australia has, however, been limited. This limited uptake corresponds to similar trends in the UK and US, although the level of OSM there appears to be increasing. This project undertook three workshops — one each in Victoria, Queensland and Western Australia — and 18 interviews with key stakeholders to assist in identifying the general benefits and barriers to OSM uptake in the Australian construction industry. Seven case studies were also undertaken, involving construction projects that used OSM, ranging from civil projects through to residential. Each of these case studies has been analysed to identify what worked and what didn’t, and suggest the lessons to be learned from each project.

Drivers constraints and the future of off-site manufacture in Australia.

Much has been written on Off-site Manufacture (OSM) in construction, particularly regarding the perceived benefits and barriers to implementation. However, very little understanding of the state of OSM in the Australian construction industry exists. A ‘scoping study' has recently been undertaken to determine the ‘state-of-the-art’ of OSM in Australia. This involved several industry workshops, interviews and case studies across four major states of Australia. The study surveyed a range of suppliers across the construction supply-chain, incorporating the civil, commercial and housing segments of the market. This revealed that skills shortages and lack of adequate OSM knowledge are generally the greatest issues facing OSM in Australia. The drivers and constraints that emerged from the research were, in large measure, consistent with those found in the US and UK, although some Australian anomalies are evident, such as the geographical disparity of markets. A comparative analysis with similar studies in the UK and US is reported, illustrating both the drivers and constraints confronting the industry in Australia. OSM uptake into the future is however dependent on many factors, not least of which is a better understanding of the construction process and its associated costs.

Site survey and analysis of highway trucks overloading status quo in Anhui

In 2004, with the increasing overloading restriction requirements of society in Anhui, a provincial comprehensive overloading transportation survey has been developed to take evaluations on overloading actuality and enforcement efficiency with the support of the World Bank. A total of six site surveys were conducted at Hefei, Fuyang, Luan, Wuhu, Huainan and Huangshan Areas with four main contents respectively: traffic volume, axle load, freight information and registration information. Via statistical analysis on the survey data, conclusions were gained that: vehicle overloading are very universal and serious problems at arterial highways in Anhui now. The traffic loads have far exceeded the designed endure capacity of highways and have caused prevalent premature pavement damage, especially for rigid pavement. The overloading trucks are unimpeded engaged in highway freight transportation actually due to the disordered overloading enforcement strategies and the deficient inspecting technologies.

The role of sensation seeking and need for cognition on web-site evaluations : a resource-matching perspective

The Internet theoretically enables marketers to personalize a Website to an individual consumer. This article examines optimal Website design from the perspective of personality trait theory and resource-matching theory. The influence of two traits relevant to Internet Web-site processing—sensation seeking and need for cognition— were studied in the context of resource matching and different levels of Web-site complexity. Data were collected at two points of time: personality-trait data and a laboratory experiment using constructed Web sites. Results reveal that (a) subjects prefer Web sites of a medium level of complexity, rather than high or low complexity; (b)high sensation seekers prefer complex visual designs, and low sensation seekers simple visual designs, both in Web sites of medium complexity; and (c) high need-for-cognition subjects evaluated Web sites with high verbal and low visual complexity more favourably.

Spectrometric and voltammetric studies of the interaction between quercetin and bovine serum albumin using warfarin as site marker with the aid of chemometrics

The interaction of quercetin, which is a bioflavonoid, with bovine serum albumin (BSA) was investigated under pseudo-physiological conditions by the application of UV–vis spectrometry, spectrofluorimetry and cyclic voltammetry (CV). These studies indicated a cooperative interaction between the quercetin–BSA complex and warfarin, which produced a ternary complex, quercetin–BSA–warfarin. It was found that both quercetin and warfarin were located in site I. However, the spectra of these three components overlapped and the chemometrics method – multivariate curve resolution-alternating least squares (MCR-ALS) was applied to resolve the spectra. The resolved spectra of quercetin–BSA and warfarin agreed well with their measured spectra, and importantly, the spectrum of the quercetin–BSA–warfarin complex was extracted. These results allowed the rationalization of the behaviour of the overlapping spectra. At lower concentrations ([warfarin] < 1 × 10−5 mol L−1), most of the site marker reacted with the quercetin–BSA, but free warfarin was present at higher concentrations. Interestingly, the ratio between quercetin–BSA and warfarin was found to be 1:2, suggesting a quercetin–BSA–(warfarin)2 complex, and the estimated equilibrium constant was 1.4 × 1011 M−2. The results suggest that at low concentrations, warfarin binds at the high-affinity sites (HAS), while low-affinity binding sites (LAS) are occupied at higher concentrations.