Enhanced recovery after surgery program for elective adbominal surgery at three Victorian hospitals

The aim of this study was to evaluate the anaesthesia care of an enhanced recovery after surgery (ERAS) program for patients having abdominal surgical in Victorian hospitals. The man outcome measure was the number of ERAS items implemented following introduction of the ERAS program. Secondary endpoints included process of care measures, outcomes and hospital stay. We used a before-and-after design; the control group was a prospective cohort (n=154) representing pre-existing practice for elective abdominal surgical patients from July 2009. The introduction of a comprehensive ERAS program took place over two months and included the education of surgeons, anaesthetists, nurses and allied health professionals. A post-implementation cohort (n=169) was enrolled in early 2010. From a total of 14 ERAS-recommended items, there were significantly more implemented in the post-ERAS period, median 8 (interquartile range of 7 to 9) vs 9 (8 to 10), P <0.0001. There were, however, persistent low rates of intravenous fluid restriction (25%) and early removal of urinary catheter (31%) in the post-ERAS period. ERAS patients had less pain and faster recovery parameters, and this was associated with a reduced hospital stay, geometric mean (SD) 5.7 (2.5) vs 7.4 (2.1) days, P=0.006. We found that perioperative anaesthesia practices can be readily modified to incorporate an enhanced recovery program in Victorian hospitals.

Enhanced Recovery After Surgery program for elective abdominal surgery at three Victorian hospitals

The aim of this study was to evaluate the anaesthesia care of an enhanced recovery after surgery (ERAS) program for patients having abdominal surgical in Victorian hospitals. The main outcome measure was the number of ERAS items implemented following introduction of the ERAS program. Secondary endpoints included process of care measures, outcomes and hospital stay. We used a before-and-after design; the control group was a prospective cohort (n=154) representing pre-existing practice for elective abdominal surgical patients from July 2009. The introduction of a comprehensive ERAS program took place over two months and included the education of surgeons, anaesthetists, nurses and allied health professionals. A post-implementation cohort (n=169) was enrolled in early 2010. From a total of 14 ERAS-recommended items, there were significantly more implemented in the post-ERAS period, median 8 (interquartile range 7 to 9) vs 9 (8 to 10), P <0.0001. There were, however, persistent low rates of intravenous fluid restriction (25%) and early removal of urinary catheter (31%) in the post-ERAS period. ERAS patients had less pain and faster recovery parameters, and this was associated with a reduced hospital stay, geometric mean (SD) 5.7 (2.5) vs 7.4 (2.1) days, P=0.006. We found that perioperative anaesthesia practices can be readily modified to incorporate an enhanced recovery program in Victorian hospitals.

A study of plastic deformation during axisymmetric forward spiral extrusion and its subsequent mechanical property changes

Axisymmetric forward spiral extrusion (AFSE) accumulates large strains in its sample while extruding it through a die with engraved spiral grooves. A three-dimensional finite element model of AFSE has been developed using ABAQUS to investigate the deformation mode in detail, including the effect of groove geometry and the heterogeneity of plastic deformation. The numerical results demonstrated that the strain distribution in the AFSE sample cross section is linear in the radial direction within a concentric core while the distribution, outside the core, in the vicinity of the grooves is non-linear and non-axisymmetric. Mechanical properties and grain structure changes of the deformed sample were investigated. Improvements of mechanical properties in the processed samples can be attributed to the domination of the shear deformation mode in a plane normal to the extrusion axis and consequently the elongation of grains in the tangential direction

Engaging first year students through the use of ePortfolio

This paper describes how an ePortfolio was used with a group of Deakin University first year construction management students. The main objective of using the ePortfolio was to support and engage students in planning their tertiary education and enhance their learning experience. The paper outlines the challenges and issues faced in the implementation of the ePortfolio and discusses how academic staff and students were supported through the process of learning to use the ePortfolio.

The spectrum and the spectre of the public self : persona studies

One of the most intriguing elements of the study of celebrity is the complex relationship between the renowned individuals that have celebrity status and the populace. In past work, I have identified how celebrities “embody” audiences producing a kind of audience-subjectivity that is both collective and individual. If our media systems are producing slightly different collective configurations and quite different ways in which individuals exhibit and share, this relationship between the individual and the collective so foregrounded by celebrity culture may be differently constituted. This presentation will look at how the celebration of the self is played out now across culture in variations of the social and para-social structures of celebrity culture, in professional settings and what would be seen as forms of online leisure and recreational activities. In one sense, this is the spectre of celebrity that has now been virtualised by individuals and their forms of public display. In another sense, we now have a very diverse range and spectrum of public personalities which demands a more extensive analysis of the constitution of public persona, where the embodiment of collectives and the articulation of identity forms for different purposes and objectives produce via a series of micro-publics a substantially different public sphere.

A review of flight-initiation distances and their application to managing disturbance to Australian birds

Disturbance - the response of birds to a stimulus such as the presence of a person - is considered a conservation threat for some Australian birds. The distance at which a bird flees from perceived danger is defined as the flight-initiation distance (FID), and could be used to designate separation distances between birds and stimuli that might cause disturbance. We review the known FIDs for Australian birds, and report FIDs for 250 species. Most FIDs are from south-eastern Australia, and almost all refer to a single walker as the stimulus. Several prominent factors correlated with FID are discussed (e.g. body mass and the distance at which an approach begins). FIDs have not been used extensively in the management of disturbance, for a variety of reasons including lack and inaccessibility of available data. We call for standardised data collection and greater application of available data to the management of disturbance.

Potential of cottonseed oil as fish oil replacer in European Sea Bass feed formulation

Triplicate groups of 20 European sea bass (35 g) were fed five diets in which the added lipid was 100% fish oil (FO), 40% (CSO40), 60% (CSO60), 80% (CSO80) and 100% (CSO100) refined cottonseed oil (CSO), for a period of 120 days. Overall fish growth, feed conversion ratio and protein utilization were unaffected by dietary treatment, but hepatosomatic and visceral fat indexes increased with increasing dietary CSO. Fillet fatty acid composition of total lipids reflected the fatty acids in the test diets. The monounsaturated fatty acids were significantly higher in fillet of fish fed diet FO, CSO40 and CSO60 compared to other treatments while saturated and polyunsaturated fatty acids (PUFA) were not affected by the dietary treatment. Some fatty acids (18:0, 18:1n-9, 20:5n-3 and 22:6n-3) were present in higher concentration in fillet lipid than in the CSO100 dietary lipid indicating accumulation in fillet relative to test diets. Retention of n-3 LC-PUFA within the fillet was increasingly inefficient among fish fed increasing levels of FO. Thus, this study suggests that CSO can be considered as a relatively effective substitute for fish oil in European sea bass (35 g) in terms of growth performances and feed efficiency as far as fish meal is present in the diet.

Harnessing the potential of community-based participatory research approaches in bipolar disorder

BACKGROUND: Despite the rapid growth in the sophistication of research on bipolar disorder (BD), the field faces challenges in improving quality of life (QoL) and symptom outcomes, adapting treatments for marginalized communities, and disseminating research insights into real-world practice. Community-based participatory research (CBPR)-research that is conducted as a partnership between researchers and community members-has helped address similar gaps in other health conditions. This paper aims to improve awareness of the potential benefits of CBPR in BD research. METHODS: This paper is a product of the International Society for Bipolar Disorders (ISBD) Taskforce on Community Engagement which includes academic researchers, healthcare providers, people with lived experience of BD, and stakeholders from BD community agencies. Illustrative examples of CBPR in action are provided from two established centres that specialize in community engagement in BD research: the Collaborative RESearch Team to study psychosocial issues in BD (CREST.BD) in Canada, and the Spectrum Centre for Mental Health Research in the United Kingdom. RESULTS AND DISCUSSION: We describe the philosophy of CBPR and then introduce four core research areas the BD community has prioritized for research: new treatment approaches, more comprehensive outcome assessments, tackling stigma, and enhanced understanding of positive outcomes. We then describe ways in which CBPR is ideal for advancing each of these research areas and provide specific examples of ways that CBPR has already been successfully applied in these areas. We end by noting potential challenges and mitigation strategies in the application of CBPR in BD research. CONCLUSIONS: We believe that CBPR approaches have significant potential value for the BD research community. The observations and concerns of people with BD, their family members, and supports clearly represent a rich source of information. CBPR approaches provide a collaborative, equitable, empowering orientation to research that builds on the diversity of strengths amongst community stakeholders. Despite the potential merits of this approach, CBPR is as yet not widely used in the BD research field, representing a missed opportunity.

A kinematics study of variable lead axisymmetric forward spiral extrusion

Variable lead axi-symmetric forward spiral extrusion (VLAFSE) allows far more efficient strain accumulation than constant lead counterpart AFSE. It eliminates the rigid body rotation of the sample in an AFSE die which only causes frictional loss and has no contribution to the deformation. Based on a proposed velocity field, the kinematic formulation for VLAFSE is presented, utilized to predict strain components in the deformation zone and compared with experimental measurements. A simple closed form solution of the VLAFSE problem is presented which describes the flow of material inside the extrusion die. The results confirm that the effective strain of the process accumulates non-linearly in the both radial and extrusion directions.