Linking scientific evidence and decision making : A case study of hand hygiene interventions

We consider how data from scientific research should be used for decision making in health services. Whether a hand hygiene intervention to reduce risk of nosocomial infection should be widely adopted is the case study. Improving hand hygiene has been described as the most important measure to prevent nosocomial infection. 1 Transmission of microorganisms is reduced, and fewer infections arise, which leads to a reduction in mortality2 and cost savings.3 Implementing a hand hygiene program is itself costly, so the extra investment should be tested for cost-effectiveness.4,5 The first part of our commentary is about cost-effectiveness models and how they inform decision making for health services. The second part is about how data on the effectiveness of hand hygiene programs arising from scientific studies are used, and 2 points are made: the threshold for statistical inference of .05 used to judge effectiveness studies is not important for decision making,6,7 and potentially valuable evidence about effectiveness might be excluded by decision makers because it is deemed low quality.8 The ideas put forward will help researchers and health services decision makers to appraise scientific evidence in a more powerful way.

Linking Karumba : Creating Sustainable Connections

Linking Karumba: Creating Sustainable Connections This exhibition showcases the work of 3rd -4th year undergraduate landscape architecture, architecture, Industrial Design, Environmental Engineering, Civil Engineering students in response to issues of sustainability in the Gulf of Carpentaria town of Karumba. It presented the work to the Karumba and Carpentaria Shire community. 16 students and four staff set off on a 2488km journey to undertake the first half of the Carpentaria Project: a fortnight-long strategic planning project entitled Linking Karumba to encourage social, economic, environmental and cultural linkages across the town. Karumba, along with the nearby town of Normanton, is one of Queensland’s most remote settlements. Its economy is based on fishing, tourism, and mining. It has two centres, 2.5km apart by river, or 9km by road. This physical disconnect was identified by Carpentaria Shire Council (CSC) and the Karumba Progress Association (KPA) as a source of socio-cultural disconnection, which formed the basis of our project brief. Student designs were highly responsive to the character of Karumba’s culture and environment, indicating remarkable levels of immersion, and attracting $830 000 in Qld. state government funding for implementation. The Exhibition Four groups of four students produced four strategic planning and design options toward this future: Make the Switch: Alice Anonuevo, Michael Marriott, Carla Priestley & Grant Harvey Realigning the Systems: Claudia Bergs, Rebecca Stephens, Anna Coulson & Lois Kerrigan Diversification of Experience: Rebecca North, Kyle Bush, Debra Sullivan & Jenna Green The River is the Main Street: Ashley Nicholson, Monica Kuiken, Dean Bowen & Bill Schild

QUT Linking Karumba Project

QUT Linking Karumba Project This exhibition showcases the work of 3rd -4th year undergraduate landscape architecture, architecture, Industrial Design, Environmental Engineering, Civil Engineering students in response to issues of sustainability in the Gulf of Carpentaria town of Karumba. It presented the final, polished set of work to the Karumba and Carpentaria Shire community, following revisions in line with feedback from the 2008 exhibition. 16 students and four staff set off on a 2488km journey to undertake the first half of the Carpentaria Project: a fortnight-long strategic planning project entitled Linking Karumba to encourage social, economic, environmental and cultural linkages across the town. Karumba, along with the nearby town of Normanton, is one of Queensland’s most remote settlements. Its economy is based on fishing, tourism, and mining. It has two centres, 2.5km apart by river, or 9km by road. This physical disconnect was identified by Carpentaria Shire Council (CSC) and the Karumba Progress Association (KPA) as a source of socio-cultural disconnection, which formed the basis of our project brief. Student designs were highly responsive to the character of Karumba’s culture and environment, indicating remarkable levels of immersion, and attracting $830 000 in Qld. state government funding for implementation. The Exhibition Four groups of four students produced four strategic planning and design options toward this future: Make the Switch: Alice Anonuevo, Michael Marriott, Carla Priestley & Grant Harvey Realigning the Systems: Claudia Bergs, Rebecca Stephens, Anna Coulson & Lois Kerrigan Diversification of Experience: Rebecca North, Kyle Bush, Debra Sullivan & Jenna Green The River is the Main Street: Ashley Nicholson, Monica Kuiken, Dean Bowen & Bill Schild

Design + ethics

The socio-cultural purpose of the university has been de-emphasised in recent decades, however, various community engagement projects that have been undertaken by design schools in higher education institutions are bringing this back into focus. Through the design skills of academic staff and students, a number of projects have been identified and undertaken in partnership with communities as well as the public and private sectors. The 2008 ‘Linking Karumba’ project, among others, shows that academy-based design and education professionals can contribute to social development through making good design accessible to disadvantaged communities.

Evaluation in health outcomes research : linking theories, methodologies and practice in health promotion.

Health outcomes research has developed as a means of evaluating the effectiveness of health care interventions and as an approach to informing resource allocation. The use of a health outcomes approach in health promotion has made increasing demands on evaluation methodologies to demonstrate program effectiveness. However, criticism of the contribution of health promotion to outcomes research has made several assumptions about the use of qualitative methodologies and the content of program objectives largely derived from a biomedical approach. In contrast to the measurement of biomedical interventions in clinical health care, health promotion practice involves social phenomena, wide-reaching cultural, psychological, political and ideological problems and issues. The integration of methodologies of health promotion evaluation will inform further conceptualisation of the health outcomes approach with the differentiation of three types of outcomes: health development outcomes; social health outcomes; and biomedical health outcomes. It is concluded that this differentiation moves away from dualist concepts that advocate the replacement of goals and targets with regional and locally based approaches. Rather, the future direction for health promotion evaluation needs to employ a framework that elaborates multiple methodologies and approaches necessary for establishing what relationships exist between morbidity, mortality, health advancement and equity.

Robust automatic speaker linking and attribution

This research makes a major contribution which enables efficient searching and indexing of large archives of spoken audio based on speaker identity. It introduces a novel technique dubbed as “speaker attribution” which is the task of automatically determining ‘who spoke when?’ in recordings and then automatically linking the unique speaker identities within each recording across multiple recordings. The outcome of the research will also have significant impact in improving the performance of automatic speech recognition systems through the extracted speaker identities.

Co-constructing decimal number knowledge

This mathematics education research provides significant insights for the teaching of decimals to children. It is well known that decimals is one of the most difficult topics to learn and teach. Annette’s research is unique in that it focuses not only on the cognitive, but also on the affective and conative aspects of learning and teaching of decimals. The study is innovative as it includes the students as co-constructors and co-researchers. The findings open new ways of thinking for educators about how students cognitively process decimal knowledge, as well as how students might develop a sense of self as a learner, teacher and researcher in mathematics.

trans-Polyacetylene on sodium and cesium mordenites: a resonance Raman spectroscopic study

Sodium and cesium mordenite (denoted NaM and CsM, respectively) were investigated as potential catalysts for the synthesis of polyacetylene ((CH) x). Both were successful in initiating polymerization of purified gaseous acetylene at room temperature as evidenced by Raman spectroscopic studies. The polyacetylene synthesised in this way exhibited resonance enhancement of the polyene skeletal vibrations. trans-Polyacetylene, but no cis-(CH) x, was detected. As no apparent coloration of the NaM and CsM substrates accompanied the formation of trans-(CH) x it was concluded that only small quantities of the polymer were present. The number of conjugated double bonds was estimated from the frequencies of the Raman active C-C and C=C stretching vibrations, and it was shown that the trans-(CH) x formed on CsM has a distribution of conjugation lengths ranging from less than 6 to at least 30 double bonds. The polyacetylene formed on NaM was significantly shorter and was produced in lower yields than that synthesized on CsM. "Sliced" resonance excitation profiles of polyacetylene formed on CsM were obtained using nearly 40 different excitation wavelengths and these confirmed that the adsorbed trans-(CH) x was composed of segments having a distribution of conjugated lengths. The architecture of the mordenite pore system permitted only a single polymer molecule per channel, thereby preventing cross-linking. Raman spectroscopic studies of the effects of exposure to air revealed that progressive oxidative degradation occurred with a reduction in the number of conjugated double bond

The linking of plate tectonics and evolutionary divergence

It is exciting to be living at a time when the big questions in biology can be investigated using modern genetics and computing [1]. Bauzà-Ribot et al.[2] take on one of the fundamental drivers of biodiversity, the effect of continental drift in the formation of the world’s biota 3 and 4, employing next-generation sequencing of whole mitochondrial genomes and modern Bayesian relaxed molecular clock analysis. Bauzà-Ribot et al.[2] conclude that vicariance via plate tectonics best explains the genetic divergence between subterranean metacrangonyctid amphipods currently found on islands separated by the Atlantic Ocean. This finding is a big deal in biogeography, and science generally [3], as many other presumed biotic tectonic divergences have been explained as probably due to more recent transoceanic dispersal events [4]. However, molecular clocks can be problematic 5 and 6 and we have identified three issues with the analyses of Bauzà-Ribot et al.[2] that cast serious doubt on their results and conclusions. When we reanalyzed their mitochondrial data and attempted to account for problems with calibration 5 and 6, modeling rates across branches 5 and 7 and substitution saturation [5], we inferred a much younger date for their key node. This implies either a later trans-Atlantic dispersal of these crustaceans, or more likely a series of later invasions of freshwaters from a common marine ancestor, but either way probably not ancient tectonic plate movements.

Resequencing and fine-mapping of the chromosome 12q13-14 locus associated with multiple sclerosis refines the number of implicated genes

Multiple sclerosis (MS) is a common chronic inflammatory disease of the central nervous system. Susceptibility to the disease is affected by both environmental and genetic factors. Genetic factors include haplotypes in the histocompatibility complex (MHC) and over 50 non-MHC loci reported by genome-wide association studies. Amongst these, we previously reported polymorphisms in chromosome 12q13-14 with a protective effect in individuals of European descent. This locus spans 288 kb and contains 17 genes, including several candidate genes which have potentially significant pathogenic and therapeutic implications. In this study, we aimed to fine-map this locus. We have implemented a two-phase study: a variant discovery phase where we have used next-generation sequencing and two target-enrichment strategies [long-range polymerase chain reaction (PCR) and Nimblegen's solution phase hybridization capture] in pools of 25 samples; and a genotyping phase where we genotyped 712 variants in 3577 healthy controls and 3269 MS patients. This study confirmed the association (rs2069502, P = 9.9 × 10−11, OR = 0.787) and narrowed down the locus of association to an 86.5 kb region. Although the study was unable to pinpoint the key-associated variant, we have identified a 42 (genotyped and imputed) single-nucleotide polymorphism haplotype block likely to harbour the causal variant. No evidence of association at previously reported low-frequency variants in CYP27B1 was observed. As part of the study we compared variant discovery performance using two target-enrichment strategies. We concluded that our pools enriched with Nimblegen's solution phase hybridization capture had better sensitivity to detect true variants than the pools enriched with long-range PCR, whilst specificity was better in the long-range PCR-enriched pools compared with solution phase hybridization capture enriched pools; this result has important implications for the design of future fine-mapping studies.

Speaker attribution of Australian broadcast news data

Speaker attribution is the task of annotating a spoken audio archive based on speaker identities. This can be achieved using speaker diarization and speaker linking. In our previous work, we proposed an efficient attribution system, using complete-linkage clustering, for conducting attribution of large sets of two-speaker telephone data. In this paper, we build on our proposed approach to achieve a robust system, applicable to multiple recording domains. To do this, we first extend the diarization module of our system to accommodate multi-speaker (>2) recordings. We achieve this through using a robust cross-likelihood ratio (CLR) threshold stopping criterion for clustering, as opposed to the original stopping criterion of two speakers used for telephone data. We evaluate this baseline diarization module across a dataset of Australian broadcast news recordings, showing a significant lack of diarization accuracy without previous knowledge of the true number of speakers within a recording. We thus propose applying an additional pass of complete-linkage clustering to the diarization module, demonstrating an absolute improvement of 20% in diarization error rate (DER). We then evaluate our proposed multi-domain attribution system across the broadcast news data, demonstrating achievable attribution error rates (AER) as low as 17%.

Spatio-temporal modelling of ultrafine particle number concentration

This thesis developed semi-parametric regression models for estimating the spatio-temporal distribution of outdoor airborne ultrafine particle number concentration (PNC). The models developed incorporate multivariate penalised splines and random walks and autoregressive errors in order to estimate non-linear functions of space, time and other covariates. The models were applied to data from the "Ultrafine Particles from Traffic Emissions and Child" project in Brisbane, Australia, and to longitudinal measurements of air quality in Helsinki, Finland. The spline and random walk aspects of the models reveal how the daily trend in PNC changes over the year in Helsinki and the similarities and differences in the daily and weekly trends across multiple primary schools in Brisbane. Midday peaks in PNC in Brisbane locations are attributed to new particle formation events at the Port of Brisbane and Brisbane Airport.

Mice selectively bred for High and Low fear behavior show differences in the number of pMAPK (p44/42 ERK) expressing neurons in lateral amygdala following Pavlovian fear conditioning

Individual variability in the acquisition, consolidation and extinction of conditioned fear potentially contributes to the development of fear pathology including posttraumatic stress disorder (PTSD). Pavlovian fear conditioning is a key tool for the study of fundamental aspects of fear learning. Here, we used a selected mouse line of High and Low Pavlovian conditioned fear created from an advanced intercrossed line (AIL) in order to begin to identify the cellular basis of phenotypic divergence in Pavlovian fear conditioning. We investigated whether phosphorylated MAPK (p44/42 ERK/MAPK), a protein kinase required in the amygdala for the acquisition and consolidation of Pavlovian fear memory, is differentially expressed following Pavlovian fear learning in the High and Low fear lines. We found that following Pavlovian auditory fear conditioning, High and Low line mice differ in the number of pMAPK-expressing neurons in the dorsal sub nucleus of the lateral amygdala (LAd). In contrast, this difference was not detected in the ventral medial (LAvm) or ventral lateral (LAvl) amygdala sub nuclei or in control animals. We propose that this apparent increase in plasticity at a known locus of fear memory acquisition and consolidation relates to intrinsic differences between the two fear phenotypes. These data provide important insights into the micronetwork mechanisms encoding phenotypic differences in fear. Understanding the circuit level cellular and molecular mechanisms that underlie individual variability in fear learning is critical for the development of effective treatment of fear-related illnesses such as PTSD.

Exploring CSR communication: Linking institutional pressures, legitimacy, and rhetoric

By presenting an overview of institutional theory, specifically the concepts of organizational fields, institutional pressures, and legitimacy, in addition to classical rhetoric, we have sought to highlight that there are links within the literature between the concepts of institutional theory and legitimacy, and also legitimacy and classical rhetoric. To date however, the three concepts – institutional pressures, legitimacy, and rhetoric – have not been explicitly linked. Through building on the current literature, and using the notion of legitimacy as the axis to connect institutional pressures with rhetoric, we argue that certain rhetorical devices may in fact be used to build and construct legitimacy in relation to the different institutional pressures an organization may face within a field. We believe that this preliminary framework may be useful to the field of CSR communication, whereby it may assist in constructing legitimate CSR communication in response to the various pressures an organization may face in relation to CSR.

Linking dynamic-capability portfolios and innovation outcomes

The objective of this paper is to explore the relationship between dynamic capabilities and different types of online innovations. Building on qualitative data from the publishing industry, our analysis revealed that companies that had relatively strong dynamic capabilities in all three areas (sensing, seizing and reconfiguration) seem to produce innovations that combine their existing capabilities on either the market or the technology dimension with new capabilities on the other dimension thus resulting in niche creation and revolutionary type innovations. Correspondingly, companies with a weaker or more one-sided set of dynamic capabilities seem to produce more radical innovations requiring both new market and technological capabilities. The study therefore provides an empirical contribution to the emerging work on dynamic capabilities through its in-depth investigation of the capabilities of the four case firms, and by mapping the patterns between the firm's portfolio of dynamic capabilities and innovation outcomes.