Emergency department surge capacity : Recommendations of the Australasian surge strategy working group

Background For more than a decade emergency medicine organizations have produced guidelines, training and leadership for disaster management. However to date, there have been limited guidelines for emergency physicians needing to provide a rapid response to a surge in demand. The aim of this study is to identify strategies which may guide surge management in the Emergency Department. Method A working group of individuals experienced in disaster medicine from the Australasian College for Emergency Medicine Disaster Medicine Subcommittee (the Australasian Surge Strategy Working Group) was established to undertake this work. The Working Group used a modified Delphi technique to examine response actions in surge situations. The Working Group identified underlying assumptions from epidemiological and empirical understanding and then identified remedial strategies from literature and from personal experience and collated these within domains of space, staff, supplies, and system operation. Findings These recommendations detail 22 potential actions available to an emergency physician working in the context of surge. The Working Group also provides detailed guidance on surge recognition, triage, patient flow through the emergency department and clinical goals and practices. Discussion These strategies provide guidance to emergency physicians confronting the challenges of a surge in demand. The paper also identifies areas that merit future research including the measurement of surge capacity, constraints to strategy implementation, validation of surge strategies and measurement of strategy impacts on throughput, cost, and quality of care.

Embedded engagements : the challenge of creative practice research to the humanities

This article explores the opportunities and challenges surrounding a viable cross-disciplinary engagement between the Humanities disciplines and the Creative Practice disciplines within the innovative context of the Creative Industries Faculty at the Queensland University of Technology. This will involve a charting of the intersection of the emerging field of creative practice-led research with various disciplines in the Humanities such as cultural studies. The potential for a reciprocal, transformative process in these creative fields will be addressed. Several examples of postgraduate students’ research will be foregrounded as case studies of the issues involved in fostering a genuine cultural critique both within and through creative practice. Some observers may argue that the research higher degree creative practitioner in effect looks outward from the symbolic material forms being created, in search of an interpretative paradigm, thereby trawling the Humanities for a theory. Several current debates within the postgraduate research arena regarding the balance between the theoretical exegesis and the creative work (e.g. performance, drama, dance, visual art, creative writing, film and screen production, music, interactive media etc) will also be critically examined.

Enhancing the Stability of an Autonomous Microgrid using DSTATCOM

This paper proposes a method enhancing stability of an autonomous microgrid with distribution static compensator (DSTATCOM) and power sharing with multiple distributed generators (DG). It is assumed that all the DGs are connected through voltage source converter (VSC) and all connected loads are passive, making the microgrid totally inertia less. The VSCs are controlled by either state feedback or current feedback mode to achieve desired voltage-current or power outputs respectively. A modified angle droop is used for DG voltage reference generation. Power sharing ratio of the proposed droop control is established through derivation and verified by simulation results. A DSTATCOM is connected in the microgrid to provide ride through capability during power imbalance in the microgrid, thereby enhancing the system stability. This is established through extensive simulation studies using PSCAD.

Modelling water droplet movement on a leaf surface

Modelling droplet movement on leaf surfaces is an important component in understanding how water, pesticide or nutrient is absorbed through the leaf surface. A simple mathematical model is proposed in this paper for generating a realistic, or natural looking trajectory of a water droplet traversing a virtual leaf surface. The virtual surface is comprised of a triangular mesh structure over which a hybrid Clough-Tocher seamed element interpolant is constructed from real-life scattered data captured by a laser scanner. The motion of the droplet is assumed to be affected by gravitational, frictional and surface resistance forces and the innovation of our approach is the use of thin-film theory to develop a stopping criterion for the droplet as it moves on the surface. The droplet model is verified and calibrated using experimental measurement; the results are promising and appear to capture reality quite well.

Fuzzy logic traffic control at a road junction with time-varying flow rates

Fuzzy logic has been applied to control traffic at road junctions. A simple controller with one fixed rule-set is inadequate to minimise delays when traffic flow rate is time-varying and likely to span a wide range. To achieve better control, fuzzy rules adapted to the current traffic conditions are used.

Integrated Acquisition Engineering Model for acquiring heavy engineering assets

In asset intensive industries such as mining, oil & gas, utilities etc. most of the capital expenditure happens on acquiring engineering assets. Process of acquiring assets is called as “Procurement” or “Acquisition”. An asset procurement decision should be taken in consideration with the installation, commissioning, operational, maintenance and disposal needs of an asset or spare. However, such cross-functional collaboration and communication does not appear to happen between engineering, maintenance, warehousing and procurement functions in many asset intensive industries. Acquisition planning and execution are two distinct parts of asset acquisition process. Acquisition planning or procurement planning is responsible for determining exactly what is required to be purchased. It is important that an asset acquisition decision is the result of cross-functional decision making process. An acquisition decision leads to a formal purchase order. Most costly asset decisions occur even before they are acquired. Therefore, acquisition decision should be an outcome of an integrated planning & decision making process. Asset intensive organizations both, Government and non Government in Australia spent AUD 102.5 Billion on asset acquisition in year 2008-09. There is widespread evidence of many assets and spare not being used or utilized and in the end are written off. This clearly shows that many organizations end up buying assets or spares which were not required or non-conforming to the needs of user functions. It is due the fact that strategic and software driven procurement process do not consider all the requirements from various functions within the organization which contribute to the operation and maintenance of the asset over its life cycle. There is a lot of research done on how to implement an effective procurement process. There are numerous software solutions available for executing a procurement process. However, not much research is done on how to arrive at a cross functional procurement planning process. It is also important to link procurement planning process to procurement execution process. This research will discuss ““Acquisition Engineering Model” (AEM) framework, which aims at assisting acquisition decision making based on various criteria to satisfy cross-functional organizational requirements. Acquisition Engineering Model (AEM) will consider inputs from corporate asset management strategy, production management, maintenance management, warehousing, finance and HSE. Therefore, it is essential that the multi-criteria driven acquisition planning process is carried out and its output is fed to the asset acquisition (procurement execution) process. An effective procurement decision making framework to perform acquisition planning which considers various functional criteria will be discussed in this paper.

Influence of biochars on flux of N2O and CO2 from Ferrosol

Biochars produced by slow pyrolysis of greenwaste (GW), poultry litter (PL), papermill waste (PS), and biosolids (BS) were shown to reduce N₂O emissions from an acidic Ferrosol. Similar reductions were observed for the untreated GW feedstock. Soil was amended with biochar or feedstock giving application rates of 1 and 5%. Following an initial incubation, nitrogen (N) was added at 165 kg/ha as urea. Microcosms were again incubated before being brought to 100% water-filled porosity and held at this water content for a further 47 days. The flooding phase accounted for the majority (<80%) of total N₂O emissions. The control soil released 3165 mg N₂O-N/m², or 15.1% of the available N as N₂O. Amendment with 1 and 5% GW feedstock significantly reduced emissions to 1470 and 636 mg N₂O-N/m², respectively. This was equivalent to 8.6 and 3.8% of applied N. The GW biochar produced at 350°C was least effective in reducing emissions, resulting in 1625 and 1705 mg N₂O-N/m² for 1 and 5% amendments. Amendment with BS biochar at 5% had the greatest impact, reducing emissions to 518 mg N₂O-N/m², or 2.2% of the applied N over the incubation period. Metabolic activity as measured by CO₂ production could not explain the differences in N₂O emissions between controls and amendments, nor could NH₄⁺ or NO₃^– concentrations in biochar-amended soils. A decrease in NH₄⁺ and NO₃^– following GW feedstock application is likely to have been responsible for reducing N₂O emissions from this amendment. Reduction in N₂O emissions from the biochar-amended soils was attributed to increased adsorption of NO₃^–. Small reductions are possible due to improved aeration and porosity leading to lower levels of denitrification and N₂O emissions. Alternatively, increased pH was observed, which can drive denitrification through to dinitrogen during soil flooding.

The Metapopulation Dynamics of an Infectious Disease: Tuberculosis in Possums

An SEI metapopulation model is developed for the spread of an infectious agent by migration. The model portrays two age classes on a number of patches connected by migration routes which are used as host animals mature. A feature of this model is that the basic reproduction ratio may be computed directly, using a scheme that separates topography, demography, and epidemiology. We also provide formulas for individual patch basic reproduction numbers and discuss their connection with the basic reproduction ratio for the system. The model is applied to the problem of spatial spread of bovine tuberculosis in a possum population. The temporal dynamics of infection are investigated for some generic networks of migration links, and the basic reproduction ratio is computed—its value is not greatly different from that for a homogeneous model. Three scenarios are considered for the control of bovine tuberculosis in possums where the spatial aspect is shown to be crucial for the design of disease management operations

A mask-based approach for the geometric calibration of thermal-infrared cameras

Accurate and efficient thermal-infrared (IR) camera calibration is important for advancing computer vision research within the thermal modality. This paper presents an approach for geometrically calibrating individual and multiple cameras in both the thermal and visible modalities. The proposed technique can be used to correct for lens distortion and to simultaneously reference both visible and thermal-IR cameras to a single coordinate frame. The most popular existing approach for the geometric calibration of thermal cameras uses a printed chessboard heated by a flood lamp and is comparatively inaccurate and difficult to execute. Additionally, software toolkits provided for calibration either are unsuitable for this task or require substantial manual intervention. A new geometric mask with high thermal contrast and not requiring a flood lamp is presented as an alternative calibration pattern. Calibration points on the pattern are then accurately located using a clustering-based algorithm which utilizes the maximally stable extremal region detector. This algorithm is integrated into an automatic end-to-end system for calibrating single or multiple cameras. The evaluation shows that using the proposed mask achieves a mean reprojection error up to 78% lower than that using a heated chessboard. The effectiveness of the approach is further demonstrated by using it to calibrate two multiple-camera multiple-modality setups. Source code and binaries for the developed software are provided on the project Web site.

“They’re lunatics on the road” : Exploring the normative influences of parents, friends, and police on young novices’ risky driving decisions

Purpose: Young novice drivers experience significantly greater risk of being injured or killed in car crashes than older more experienced drivers. This research utilised a qualitative approach guided by the framework of Akers’ social learning theory. It explored young novice drivers’ perspectives on risky driving including rewards and punishments expected from and administered by parents, friends, and police, imitation of parents’ and friends’ driving, and advantages and disadvantages of risky driving. Methods: Twenty-one young drivers (12 females, 9 males) aged 16–25 years (M = 17.71 years, SD = 2.15) with a Learner (n = 11) or Provisional (n = 10) driver licence participated in individual or small group interviews. Findings and conclusions: Content analysis supported four themes: (1) rewards and (2) punishments for risky driving, and the influence of (3) parents and (4) friends. The young novice drivers differed in their vulnerability to the negative influences of friends and parents, with some novices advising they were able to resist risky normative influences whilst others felt they could not. The authority of the police as enforcers of road rules was either accepted and respected or seen as being used to persecute young novices. These findings suggest that road safety interventions should consider the normative influence of parents and friends on the risky and safe behaviour of young novices. Police were also seen as influential upon behaviour. Future research should explore the complicated relationship between parents, friends, the police, young novices, and their risky driving behaviour.

No cure for curiosity: Linking physical and digital urban layers

Although mobile phones are often used in public urban places to interact with one’s geographically dispersed social circle, they can also facilitate interactions with people in the same public urban space. The PlaceTagz study investigates how physical artefacts in public urban places can be utilised and combined with mobile phone technologies to facilitate interactions. Printed on stickers, PlaceTagz are QR codes linking to a digital message board enabling collocated users to interact with each other over time resulting in a place-based digital memory. This exploratory project set out to investigate if and how PlaceTagz are used by urban dwellers in a real world deployment. We present findings from analysing content received through PlaceTagz and interview data from application users. QR codes, which do not contain any contextual information, piqued the curiosity of users wondering about the embedded link’s destination and provoked comments in regards to people, place and technology.

Whole-body substrate metabolism is associated with disease severity in patients with non-alcoholic fatty liver disease

Objectives In non-alcoholic fatty liver disease (NAFLD), hepatic steatosis is intricately linked with a number of metabolic alterations. We studied substrate utilisation in NAFLD during basal, insulin-stimulated and exercise conditions, and correlated these outcomes with disease severity. Methods 20 patients with NAFLD (mean±SD body mass index (BMI) 34.1±6.7 kg/m2) and 15 healthy controls (BMI 23.4±2.7 kg/m2) were assessed. Respiratory quotient (RQ), whole-body fat (Fatox) and carbohydrate (CHOox) oxidation rates were determined by indirect calorimetry in three conditions: basal (resting and fasted), insulin-stimulated (hyperinsulinaemic–euglycaemic clamp) and exercise (cycling at an intensity to elicit maximal Fatox). Severity of disease and steatosis were determined by liver histology, hepatic Fatox from plasma β-hydroxybutyrate concentrations, aerobic fitness expressed as , and visceral adipose tissue (VAT) measured by computed tomography. Results Within the overweight/obese NAFLD cohort, basal RQ correlated positively with steatosis (r=0.57, p=0.01) and was higher (indicating smaller contribution of Fatox to energy expenditure) in patients with NAFLD activity score (NAS) ≥5 vs <5 (p=0.008). Both results were independent of VAT, % body fat and BMI. Compared with the lean control group, patients with NAFLD had lower basal whole-body Fatox (1.2±0.3 vs 1.5±0.4 mg/kgFFM/min, p=0.024) and lower basal hepatic Fatox (ie, β-hydroxybutyrate, p=0.004). During exercise, they achieved lower maximal Fatox (2.5±1.4 vs. 5.8±3.7 mg/kgFFM/min, p=0.002) and lower (p<0.001) than controls. Fatox during exercise was not associated with disease severity (p=0.79). Conclusions Overweight/obese patients with NAFLD had reduced hepatic Fatox and reduced whole-body Fatox under basal and exercise conditions. There was an inverse relationship between ability to oxidise fat in basal conditions and histological features of NAFLD including severity of steatosis and NAS

Mineralogy of chondritic interplanetary dust particles

From a mineralogical survey of approximately 30 chondritic micrometeorites collected from the lower stratosphere and studied in detail using current electron microscopy techniques, it is concluded that these particles represent a unique group of extraterrestrial materials. These micrometeorites differ significantly in form and texture from components of carbonaceous chondrites and contain some mineral assemblages which do not occur in any meteorite class. Electron microscope investigations of chondritic micrometeorites have established that these materials (1) are extraterrestrial in origin, (2) existed in space as small objects, (3) endured minimal alteration by planetary processes since formation, and (4) can suffer minimal pulse heating (<600°C) on entering earth's atmosphere. The probable sources for chondritic interplanetary dust particles (IDPs) are cometary and asteroidal debris and, perhaps to a lesser extent, interstellar regions. These sources have not been conclusively linked to any specific mineralogical subset of IDP, although the chondritic porous (CP) aggregate is considered of likely cometary origin. Chondritic IDPs occur in two predominant mineral assemblages: (1) carbonaceous phases and phyllosilicates and (2) carbonaceous phases and nesosilicates or inosilicates, although particles with both types of silicate assemblages are observed. Olivines, pyroxenes, layer silicates, and carbon-rich phases are the most commonly occurring minerals in many chondritic IDPs. Other phases often observed in variable proportions include sulphides, spinels, metals, metal carbides, carbonates, and minor amounts of sulphates and phosphates. Individual mineral grain sizes range from micrometers (primarily pyroxenes and olivines) to nanometers, with the predominant size for all phases less than 100 nm. Specific mineral characteristics for particular chondritic IDPs provide an indication of processes which may have occurred prior to collection in the earth's stratosphere. For example, pyroxene mineralogy in some chondritic aggregates is consistent with condensation from a vapor phase and, we consider, with condensation in a turbulent solar nebula at relatively low temperatures (<1000°C). Carbonaceous phases present in other CP aggregates have been used to imply low-temperature formation processes such as Fischer-Tropsch synthesis (∼530°C) or carbonization and graphitization (∼315°C). Alteration processes have been implicated in the formation of some layer silicates in CP aggregates and may have involved hydrocryogenic alteration at <0°C. In general, interpretations of transformation processes on submicrometer-size minerals in chondritic IDPs are consistent with formation at a radius equivalent to the asteroid belt or greater during the later stages of solar nebula evolution using currently available models.