Compressive properties and energy absorption of hollow sphere aluminium

Manufactured cellular aluminums have been developed for a wide range of automotive applications where weight savings, improved safety, crashworthiness and comfort are required. The plateau deformation behavior of cellular aluminums under compressive loading makes this new class of lightweight materials suitable for energy absorption and comes close to ideal impact absorbers. In the present study, aluminum hollow hemispheres were firstly processed by pressing. Hollow sphere aluminum samples with a body-centered cubic (BCC) packing were then fabricated by bonding together single hollow spheres, which were prepared by adhering together hollow hemispheres. Hollow sphere aluminum samples with various kinds of sphere wall thicknesses of 0.1 mm, 0.3 mm and 0.5 mm but the same outside diameter of 4 mm were investigated by compressive tests. The effects of the sphere wall thickness on the mechanical properties and energy absorption characteristics were investigated.

Early childhood caries: current evidence for aetiology and prevention

Background: Despite the fact that it is largely preventable, dental caries (decay) remains one of the most common chronic diseases of early childhood. Dental decay in young children frequently leads to pain and infection necessitating hospitalization for dental extractions under general anaesthesia. Dental problems in early childhood have been shown to be predictive of not only future dental problems but also on growth and cognitive development by interfering with comfort nutrition, concentration and school participation. Objective: To review the current evidence base in relation to the aetiology and prevention of dental caries in preschool-aged children. Methods: A search of MEDLINE, CINALH and Cochrane electronic databases was conducted using a search strategy which restricted the search to randomized controlled trials, meta-analyses, clinical trials, systematic reviews and other quasi-experimental designs. The retrieved studies were then limited to articles including children aged 5 years and under and published in English. The evidence of effectiveness was then summarized by the authors. Conclusions: The review highlighted the complex aetiology of early childhood caries (ECC). Contemporary evidence suggests that potentially effective interventions should occur in the first 2 years of a child's life. Dental attendance before the age of 2 years is uncommon; however, contact with other health professionals is high. Primary care providers who have contact with children well before the age of the first dental visit may be well placed to offer anticipatory advice to reduce the incidence of ECC.

Sedation and analgesia management for mechanically ventilated adults: literature review, case study and recommentations for practice.

The quality of sedation management in mechanically ventilated patients has been a source of concern in recent years. This paper summarises the literature on the principles of optimal sedation, discusses the consequences of over and undersedation, highlighting the importance of appropriate pain management, and presents a case study using the results of an audit of 48 mechanically ventilated adults. As a result of the review and audit, we are implementing changes to practice.

The most important recommendations from the literature are the use of a sedation scale, setting of a goal sedation score, appropriate pain management and implementation of a nurse initiated sedation algorithm. Other recommendations include use of bolus rather than continuous sedative infusions and recommencing regular medications for anxiety, depression and other phychiatric disorders as soon as possible. A recommendation arising from our audit was the need to identify patients at high risk of oversedation and undersedation and adopt a proactive rather than reactive approach to management. The practice goal is to provide adequate and appropriate analgesia and anxiolysis for patients. This will improve patient comfort while reducing length of mechanical ventilation and minimising risk of complications.

Towards solutions for a liveable future: progress, practice, performance, people: Proceedings of the 41st Annual Conference of the Architectural Science Association ANZAScA

There is hope! Since Al Gore disclosed the inconvenient truth, the climate has changed. The time of denial is over; the era of well-informed action and sound development is with us. Sustainability has now moved from the fringe, into the mainstream of politics, society, architecture and building practice. In this new context architectural science will contribute to two main tasks: prevent further damage to our environment, and respond to challenges invoked by climate change.
The built environment and human activity within it account for a large part of the problem. Architectural science and architectural practice are part of the solution. The ANZAScA 2007 conference focuses on the solutions architectural science has to offer toward a liveable future through the following generic themes:
progress – the evaluation and improvement of built facilities, new and existing, in terms of energy intensity, financial reward and environmental impact.
practice – the relationship between our cultural heritage, new facility design, retrofit design and its realisation
through construction.
performance – the connection between building operation targets, validation of performance, and user comfort and interaction in new and existing environments.
people – the effect of space on user behaviour, user responsibility and social wealth.
In response to this challenge, architectural science researchers including students, educators, and practitioners at ANZAScA 2007, present a broad range of research activity and concern within the built environment from global issues down to the specific actions of individuals.

Daylight for sustainable regeneration of built heritage sites

Daylight is an essential contextual ingredient of place making. Research in daylighting has recently received major attention for its valuable contribution to the sustainability of the built environment. Previous research has investigated the role of daylighting in energy efficiency, its regional qualities in relation to the façade configuration, and its contribution to the sense of visual comfort. This paper argues that appropriate use of daylighting will ensure not only visual and thermal comfort in an urban setting, but also contributes to the place identity and hence sustainability of urban regeneration projects. The paper identifies the daylight variables that affect the success of the regeneration of heritage sites in Eastern Mediterranean. Daylight variables in public open spaces include a combination of sunlight, skylight and the reflected light from the facades and the ground. The Solar altitude, the geometry of sectional profiles, the reflectance of the opposing facades, the width of the street and the density of the urban built environment are examined to simulate the daylight performance in the selected heritage sites. Located in the historical Darb al-Ahmar district, Aslam Square is selected as part of one of the rehabilitation project in Cairo. This paper examines the photometric and morphological properties of the existing configuration using daylight simulation software. Various spherical projections were developed to represent full 3D visual environment. The paper calculates and analyses the direct radiation energy, the sky diffused energy and the reflected energy in the case study.

A development of environmental conscious design of prison buildings

Environmental conscious design refers to variety of approaches in architecture design that covers technical, behavioural, and functional aspects (Goulding et al, 1992). These approaches usually include contradictory measures with social indicators (Sykes, 1995; Norton, 1999). The contradiction is magnified in incarceration architecture, which is very specific type of buildings (McConville, 2000). Prison buildings represent the split between the society requirements and the needs for the users, in this case the prisoners, to have comfortable environment. Energy as an ultimate natural resource reflects both the cost to the society, in terms of cooling/ heating load and the need for comfort and rehabilitation of prisoners (Al-Hosany and Elkadi, 2000). Different energy codes tend to control the thermal behaviour of buildings in certain environment in order to maximise their energy efficiency (e.g. CIBSE, 1999). In prison buildings, some of the main variables of such code are not relevant. While energy codes, for example, regulate the use of glass in buildings by either minimise the openings size (prescriptive criteria) or by determine an overall limit of heat transfer (performance criteria), the objective in prison buildings is to minimise glass areas for security purposes. This leads in turn to reduction in visual and comfort levels in prison cells. The aim of this paper is to address the balance between the society requirements of reducing energy consumption in prison buildings and the need for humane and comfortable environment for prisoners in order to maintain sustainability. The paper investigates the possible role of façade technologies to bridge the gap between requirements of both society and prisoners.

Patients' experiences of cardiology procedures using minimal conscous sedation

Aim: The study's purpose was to describe patients' experiences of minimal conscious sedation during diagnostic and interventional cardiology procedures.

Methods: Over a 6-week period, 119 consecutive patients (10% of annual throughput) from a major metropolitan hospital in Melbourne, Australia, were interviewed using a modified version of the American Pain Society Patient Outcome Questionnaire. Patients identified pain severity using a 10-point visual analogue scale and rated their overall comfort on a 6-point Likert scale ranging from very comfortable to very uncomfortable.

Results: Patients were aged 67.6 years (standard deviation 11.1), 70.8% were male, and the mean body mass index was 27.7 (standard deviation 4.8). Patients underwent diagnostic coronary angiography (67.5%), percutaneous coronary interventions (13.3%), or combined procedures (19.2%). Most patients (65%) were comfortable in the context of low-dose conscious sedation. Slight discomfort was reported by 26% of patients; 9% reported feeling uncomfortable primarily as a result of a combination of musculoskeletal pain, angina, and vasovagal symptoms experienced during the procedure. There was significant correlation (rho = .25, P = .01) between procedure length and patients' report of overall comfort, suggesting longer procedures were less comfortable for patients.

Conclusions: The minimal sedation protocol was effective for the majority of patients; however, 9% of patients experienced significant discomfort related to preexisting conditions, highlighting the need for individual patient assessment before, during, and after the procedure.

Evaluation of nasopharyngeal oxygen, nasal prongs and facemask oxygen therapy devices in adult patients: a randomised crossover trial

Nasopharyngeal oxygen (NPO) therapy may overcome some of the difficulties associated with nasal prongs and facemask oxygen delivery devices. In response to a lack of published studies of NPO therapy in adults, we conducted a prospective randomised crossover trial to compare the effectiveness of NPO, nasal prongs (NP) and facemasks (FM) when used in an adult population (n=37) from the intensive care unit and general hospital wards. We measured oxygen saturation (Sp[O.sub.2]) using pulse oximetry, oxygen flow (litres per minute), respiration rate (per minute) and comfort using a horizontal visual analogue scale. All three devices were effective in maintaining a Sp[O.sub.2] of [greater than or equal to]95% (NP 97.0[+ or -]1.9, NPO 97.7[+ or -]1.7, FM 98.8[+ or -]1.3%). NPO therapy consumed less oxygen than NP and FM therapy (NP 2.6[+ or -]1.0, NPO 2.2[+ or -]0.9, FM 6.1[+ or -]0.4 l/min, P <0.001). There was no significant difference in patients' respiratory rates (NP 19.9[+ or -]3.2, NPO 19.9[+ or -]3.0, FM 19.8[+ or -]3.1 per minute, P=0.491). In terms of comfort, patients rated NP higher than NPO and FM using a horizontal visual analogue scale (100 mm=most comfortable) (NP 65.5[+ or -]14.3, NPO 62.8[+ or -]19.4, FM 49.4[+ or -]21.4 mm, P <0.001). We conclude that for adult patients, nasal prongs and nasopharyngeal oxygen therapy consume less oxygen and provide greater comfort than facemasks while still maintaining Sp[O.sub.2] [greater than or equal to]95%.

Objective and subjective measurements of office meeting rooms

This research is a preliminary investigation of the objective measurements ofthelmal comfort and C02 levels as well as subjective user evaluation surveys in six meeting rooms. The ongoing objective measurements were taken via thelmal comfort carts while the surveys evaluated parameters of temperature, lighting, air quality, meeting effectiveness etc. The outcomes are of particular interest since some of the objective measurements clearly to not support those of the users. In fact, the investigation has triggered off further interest in refining questionnaires to develop more precise indicators of 'discomfort'.
Furthelmore, meeting rooms present a challenge when it comes to conditioning spaces (HV AC design) which are sporadic in use and often with high occupancy for short periods. This paper investigates meeting rooms in four different buildings and their conditioning control concepts are discussed in relation to measured results.

A time for real building performance measurement

The Mobile Architecture and Built Environment Laboratory (MABEL) was conceived upon the principle of investigating building environmental performance in situ. MABEL provides the first means of integrated, on-site measurement of the key aspects of internal built environments; energy, lighting, air quality, ventilation, acoustics and comfort using state-ofthe- art technology and instrumentation. The intention of this paper is to explain the how and what need to be measured in our buildings if we are to search of a genuine performance answer as well as the information to provide a solution. Several results of real building measurement are provided here, suggesting that a national program on 'as performing' is required if we are to proceed in a sustainable manner.

Experimental and numerical evaluation of forming and fracture behaviour of high strength steel

Car manufacturers are under pressure to reduce vehicle mass while maintaining comfort and passenger safety for current and future vehicles. To meet this demand the steel industry has developed Advanced High Strength Steels (AHSS) that promise higher strength and improved formability compared to conventional steel grades. Even though significant research has already been performed to evaluate the material properties and forming behaviour of most AHSS types, only a limited literature is available on their necking and fracture behaviour and the effect on formability. This paper examines and compares the thinning, necking and fracture behaviour of two AHSS and one conventional steel type, namely TRIP, DP and HSLA. Uniaxial, plane and biaxial strain conditions are investigated by tensile, cup drawing and stretch forming tests and by using numerical methods. The test results indicate that significant differences exist in necking and fracture behaviour between all three steel types.

Patients and nurses' perspective on oxygen therapy : a qualitative study

Aim. This paper is a report of a study to describe patients' and nurses' perspectives on oxygen therapy.
Background. Failure to correct significant hypoxaemia may result in cardiac arrest, need for mechanical ventilation or death. Nurses frequently make clinical decisions about the selection and management of low-flow oxygen therapy devices. Better understanding of patients' and nurses' experiences of oxygen therapy could inform clinical decisions about oxygen administration using low-flow devices.
Methods. Face-to-face interviews with a convenience sample of 37 adult patients (17 cardio-thoracic: 20 medical surgical) and 25 intensive care unit nurses were conducted from February 2007 to September 2007. Interviews were audio-taped, transcribed verbatim and then analysed using a thematic analysis approach.
Findings. The patients identified three key factors that underpinned their compliance with oxygen therapy: (i) device comfort; (ii) ability to maintain activities of daily living; and (iii) therapeutic effect. The nurses identified factors, such as: (i) therapeutic effect, (ii) issues associated with compliance, (iii) strategies to optimize compliance, (iv) familiarity with device, (v) triggers for changing oxygen therapy devices, as being key to the effective management of oxygen therapy.
Conclusion. Differences between the patients' and nurses' perspective of oxygen therapy illustrate the variety of factors that impact on effective oxygen administration. Further research should seek to provide a further in-depth understanding of the current oxygen administration practices of nurses and the patient factors that enhance or hinder effectiveness of oxygen therapy. Detailed information about nurse and patient factors that influence oxygen therapy will inform a sound evidence base for nurses' oxygen administration decisions.

Enhancement of natural ventilation in high-rise residential buildings using stack system

This paper describes the feasibility study on the application of passive and active stack systems to enhance natural ventilation in public housing in Singapore. About 86% of the population is staying in high-rise public housing, known as Housing and Development Board (HDB) flats, which is designed for natural ventilation. The primary objective of this work is to assess the status of natural ventilation in a typical four-room HDB flat using scaled model in the wind tunnel, and to develop an effective passive or active stack system to enhance natural ventilation in the flat. Four numbers of stacks with different sizes were tested at two locations in the flat. The study shows that the passive stack, incorporating the principle of airflow due to buoyancy, does not enhance air velocity in the flat. However, the active stack which operates based on the suction effect induced by a fan fixed at the top of the stack leads to substantial increase in the air velocity at the room and thus meeting the human’s thermal comfort condition. It was noted that the velocities increase along with the increase in the stack size.

Women's views and outcomes of an educational intervention designed to enhance psychosocial support for women during pregnancy

Background: Identification of psychosocial issues in pregnant women by screening is difficult because of the lack of accuracy of screening tools, women's reluctance to disclose sensitive issues, and health care practitioner's reluctance to ask. This paper evaluates if a health professional education program, a new (ANEW) approach, improves pregnant women's ratings of care and practitioner's listening skills and comfort to disclose psychosocial issues.

Methods: Midwives and doctors from Mercy Hospital for Women, Melbourne, Australia, were trained from August to December 2002. English-speaking women (< 20 wks' gestation) were recruited at their first visit and mailed a survey at 30 weeks (early 2002) before and after (2003) the ANEW educational intervention. Follow-up was by postal reminder at 2 weeks and telephone reminder 2 weeks later.

Results: Twenty-one midwives and 5 doctors were trained. Of the eligible women, 78.2 percent (584/747) participated in a pre-ANEW survey and 73.3 percent (481/657) in a post-ANEW survey. After ANEW, women were more likely to report that midwives asked questions that helped them to talk about psychosocial problems (OR 1.45, CI 1.09–1.98) and that they would feel comfortable to discuss a range of psychosocial issues if they were experiencing them (coping after birth for midwives [OR 1.51, CI 1.10–2.08] and feeling depressed [OR 1.49, 1.16–1.93]; and concerns relating to sex [OR 1.35, CI 1.03–1.77] or their relationships [OR 1.36, CI 1.00–1.85] for doctors).

Conclusions: The ANEW program evaluation suggests trends of better communication by health professionals for pregnant women and should be evaluated using rigorous methods in other settings.

Putting woman-centered care into practice : a new (ANEW) approach to psychosocial risk assessment during pregnancy

Background: When antenatal care is provided, identification and management of challenging problems, such as depression, domestic violence, child abuse, and substance abuse, are absent from traditional midwifery and medical training. The main objective of this project was to provide an alternative to psychosocial risk screening in pregnancy by offering a training program (ANEW) in advanced communication skills and common psychosocial issues to midwives and doctors, with the aim of improving identification and support of women with psychosocial issues in pregnancy.

Methods: ANEW used a before‐and‐after survey design to evaluate the effects of a 6‐month educational intervention for health professionals. The setting for the project was the Mercy Hospital for Women in Melbourne, Australia. Surveys covered issues, such as perceived competency and comfort in dealing with specific psychosocial issues, self‐rated communication skills, and open‐ended questions about participants' experience of the educational program.

Results: Educational program participants (n = 22/27) completed both surveys. After the educational intervention, participants were more likely to ask directly about domestic violence (p = 0.05), past sexual abuse (p = 0.05), and concerns about caring for the baby (p = 0.03). They were less likely to report that psychosocial issues made them feel overwhelmed (p = 0.01), and they reported significant gains in knowledge of psychosocial issues, and competence in dealing with them. Participants were highly positive about the experience of participating in the program.

Conclusions:The program increased the self‐reported comfort and competency of health professionals to identify and care for women with psychosocial issues.