Increased body temperature following subarachnoid haemorrhage : a retrospective correlational study

Introduction: Nursing clinicians are primarily responsible for the monitoring and treatment of increased body temperature. The body temperature of patients during their acute care hospital stay is measured at regular repeated intervals. In the event a patient is assessed with an elevated temperature, a multitude of decisions are required. The action of instigating temperature reducing strategies is based upon the assumption that elevated temperature is harmful and that the strategy employed will have some beneficial effect. Background and Significance: The potential harmful effects of increased body temperature (fever, hyperthermia) following neurological insult are well recognised. Although few studies have investigated this phenomenon in the diagnostic population of non-traumatic subarachnoid haemorrhage, it has been demonstrated that increased body temperature occurs in 41 to 72% of patients with poor clinical outcome. However, in the Australian context the frequency, or other characteristics of increased body temperature, as well as the association between increased body temperature with poor clinical outcome has not been established. Design: This study used a correlational study design to: describe the frequency, duration and timing of increased body temperature; determine the association between increased body temperature and clinical outcome; and describe the clinical interventions used to manage increased body temperature in patients with non-traumatic subarachnoid haemorrhage. A retrospective clinical chart audit was conducted on 43 patients who met the inclusion criteria. Findings: The major findings of this study were: increased body temperature occurred frequently; persisted for a long time; and onset did not occur until 20 hours after primary insult; increased body temperature was associated with death or dependent outcome; and no intervention was recorded in many instances. Conclusion: This study has quantified in a non-traumatic subarachnoid haemorrhage patient population the characteristics of increased body temperature, established an association between increased body temperature with death or dependent outcome and described the current management of elevated temperatures in the Australian context to improve nursing practice, education and research.

Interpersonal coordination tendencies, decision-making and information governing dynamics in rugby union

In this chapter, ideas from ecological psychology and nonlinear dynamics are integrated to characterise decision-making as an emergent property of self-organisation processes in the interpersonal interactions that occur in sports teams. A conceptual model is proposed to capture constraints on dynamics of decisions and actions in dyadic systems, which has been empirically evaluated in simulations of interpersonal interactions in team sports. For this purpose, co-adaptive interpersonal dynamics in team sports such as rubgy union have been studied to reveal control parameter and collective variable relations in attacker-defender dyads. Although interpersonal dynamics of attackers and defenders in 1 vs 1 situations showed characteristics of chaotic attractors, the informational constraints of rugby union typically bounded dyadic systems into low dimensional attractors. Our work suggests that the dynamics of attacker-defender dyads can be characterised as an evolving sequence since players' positioning and movements are connected in diverse ways over time.

Interpersonal pattern dynamics and adaptive behavior in multiagent neurobiological systems : conceptual model and data

Ecological dynamics characterizes adaptive behavior as an emergent, self-organizing property of interpersonal interactions in complex social systems. The authors conceptualize and investigate constraints on dynamics of decisions and actions in the multiagent system of team sports. They studied coadaptive interpersonal dynamics in rugby union to model potential control parameter and collective variable relations in attacker–defender dyads. A videogrammetry analysis revealed how some agents generated fluctuations by adapting displacement velocity to create phase transitions and destabilize dyadic subsystems near the try line. Agent interpersonal dynamics exhibited characteristics of chaotic attractors and informational constraints of rugby union boxed dyadic systems into a low dimensional attractor. Data suggests that decisions and actions of agents in sports teams may be characterized as emergent, self-organizing properties, governed by laws of dynamical systems at the ecological scale. Further research needs to generalize this conceptual model of adaptive behavior in performance to other multiagent populations.

Unstructured strategic decision-making processes : CRE decision-making in the Italian consulting industry

This thesis aims at developing a better understanding of unstructured strategic decision making processes and the conditions for achieving successful decision outcomes. Specifically it focuses on the processes used to make CRE (Corporate Real Estate) decisions. The starting point for this thesis is that our knowledge of such processes is incomplete. A comprehensive study of the most recent CRE literature together with Behavioural Organization Theory has provided a research framework for the exploration of CRE recommended =best practice‘, and of how organizational variables impact on and shape these practices. To reveal the fundamental differences between CRE decision-making in practice and the prescriptive =best practice‘ advocated in the CRE literature, a study of seven Italian management consulting firms was undertaken addressing the aspects of content and process of decisions. This thesis makes its primary contribution by identifying the importance and difficulty of finding the right balance between problem complexity, process richness and cohesion to ensure a decision-making process that is sufficiently rich and yet quick enough to deliver a prompt outcome. While doing so, this research also provides more empirical evidence to some of the most established theories of decision-making while reinterpreting their mono-dimensional arguments in a multi-dimensional model of successful decision-making.

Withholding and withdrawing life-sustaining treatment : criminal responsibility for established medical practice?

The law recognises the right of a competent adult to refuse medical treatment even if this will lead to death. Guardianship and other legislation also facilitates the making of decisions to withhold or withdraw life-sustaining treatment in certain circumstances. Despite this apparent endorsement that such decisions can be lawful, doubts have been raised in Queensland about whether decisions to withhold or withdraw life-sustaining treatment would contravene the criminal law, and particularly the duty imposed by the Criminal Code (Qld) to provide the “necessaries of life”. This article considers this tension in the law and examines various arguments that might allow for such decisions to be made lawfully. It ultimately concludes, however, that criminal responsibility may still arise and so reform is needed.

Adults who lack capacity : substitute decision-making

• Mechanisms to facilitate consent to healthcare for adults who lack capacity are necessary to ensure that these adults can lawfully receive appropriate medical treatment when needed. • In Australia, the common law plays only a limited role in this context, through its recognition of advance directives and through the parens patriae jurisdiction of superior courts. • Substitute decision-making for adults who lack capacity is facilitated primarily by guardianship and other related legislation. This legislation, which has been enacted in all Australian States and Territories, permits a range of decision-makers to make different types of healthcare decisions. • Substitute decision-makers can be appointed by the adult or by a guardianship or other tribunal. Where there is no appointed decision-maker, legislation generally empowers those close to the adult to make the relevant decision. Most Australian jurisdictions have also provided for statutory advance directives. • For the most serious of decisions, such as non-therapeutic sterilisations, consent can only be provided by a Tribunal. Other decisions can generally be made by a range of substitute decision-makers. Some treatment, such as very minor treatment or that which is needed in an emergency, can be provided without consent. • Guardianship legislation generally establishes a set of principles and/or other criteria to guide healthcare decisions. Mechanisms to resolve disputes as to who is the appropriate decision-maker and how a decision should be made have also been established.

Peak power demand reduction under moving block signalling using an expert system

The concept of moving block signallings (MBS) has been adopted in a few mass transit railway systems. When a dense queue of trains begins to move from a complete stop, the trains can re-start in very close succession under MBS. The feeding substations nearby are likely to be overloaded and the service will inevitably be disturbed unless substations of higher power rating are used. By introducing starting time delays among the trains or limiting the trains’ acceleration rate to a certain extent, the peak energy demand can be contained. However, delay is introduced and quality of service is degraded. An expert system approach is presented to provide a supervisory tool for the operators. As the knowledge base is vital for the quality of decisions to be made, the study focuses on its formulation with a balance between delay and peak power demand.

Constitutional legitimacy : an international ill and gap in the literature?

The central argument of this work is that “democratic constitutional legitimacy”[2] probably does not currently exist in the politics of any country internationally. This inherent problem in constitutionalism is an endemic governance problem most citizenries should be dealing with, only that we are not in a large extent doing so and haven’t been historically. This position was ascertained using a form of Beck and Grande’s (2010) cosmopolitan methodology in my doctoral thesis (which we shall return to). It is argued that every constitution is in need of considerable rethinking so as to bring its statutes in line with the interests of the plurality of individuals it oversees. Finally, this work attempts to show that research in this area of democratic constitutional legitimacy is lacking in the literature as only a few scholars presently engage the issue (namely Simone Chambers).

Manipulating task constraints to improve tactical knowledge and collective decision-making in rugby union

In team sports such as rugby union, a myriad of decisions and actions occur within the boundaries that compose the performance perceptual- motor workspace. The way that these performance boundaries constrain decision making and action has recently interested researchers and has involved developing an understanding of the concept of constraints. Considering team sports as complex dynamical systems, signifies that they are composed of multiple, independent agents (i.e. individual players) whose interactions are highly integrated. This level of complexity is characterized by the multiple ways that players in a rugby field can interact. It affords the emergence of rich patterns of behaviour, such as rucks, mauls, and collective tactical actions that emerge due to players’ adjustments to dynamically varying competition environments. During performance, the decisions and actions of each player are constrained by multiple causes (e.g. technical and tactical skills, emotional states, plans, thoughts, etc.) that generate multiple effects (e.g. to run or pass, to move forward to tackle or maintain position and drive the opponent to the line), a prime feature in a complex systems approach to team games performance (Bar- Yam, 2004). To establish a bridge between the complexity sciences and learning design in team sports like rugby union, the aim of practice sessions is to prepare players to pick up and explore the information available in the multiple constraints (i.e. the causes) that influence performance. Therefore, learning design in training sessions should be soundly based on the interactions amongst players (i.e.teammates and opponents) that will occur in rugby matches. To improve individual and collective decision making in rugby union, Passos and colleagues proposed in previous work a performer- environment interaction- based approach rather than a traditional performer- based approach (Passos, Araújo, Davids & Shuttleworth, 2008).

What determines real-world meal size? Evidence for pre-meal planning

The customary approach to the study of meal size suggests that ‘events’ occurring during a meal lead to its termination. Recent research, however, suggests that a number of decisions are made before eating commences that may affect meal size. The present study sought to address three key research questions around meal size: the extent to which plate cleaning occurs; prevalence of pre-meal planning and its influence on meal size; and the effect of within-meal experiences, notably the development of satiation. To address these, a large-cohort internet-based questionnaire was developed. Results showed that plate cleaning occurred at 91% of meals, and was planned from the outset in 92% of these cases. A significant relationship between plate cleaning and meal planning was observed. Pre meal plans were resistant to modification over the course of the meal: only 18% of participants reported consumption that deviated from expected. By contrast, 28% reported continuing eating beyond satiation, and 57% stated that they could have eaten more at the end of the meal. Logistic regression confirmed pre-meal planning as the most important predictor of consumption. Together, our findings demonstrate the importance of meal planning as a key determinant of meal size and energy intake.

Detecting anomalous user activity

Systems, methods and articles for determining anomalous user activity are disclosed. Data representing a transaction activity corresponding to a plurality of user transactions can be received and user transactions can be grouped according to types of user transactions. The transaction activity can be determined to be anomalous in relation to the grouped user transactions based on a predetermined parameter.

Classifier selection using sequential error ratio criterion for multi-instance and multi-sample fusion

Classifier selection is a problem encountered by multi-biometric systems that aim to improve performance through fusion of decisions. A particular decision fusion architecture that combines multiple instances (n classifiers) and multiple samples (m attempts at each classifier) has been proposed in previous work to achieve controlled trade-off between false alarms and false rejects. Although analysis on text-dependent speaker verification has demonstrated better performance for fusion of decisions with favourable dependence compared to statistically independent decisions, the performance is not always optimal. Given a pool of instances, best performance with this architecture is obtained for certain combination of instances. Heuristic rules and diversity measures have been commonly used for classifier selection but it is shown that optimal performance is achieved for the `best combination performance' rule. As the search complexity for this rule increases exponentially with the addition of classifiers, a measure - the sequential error ratio (SER) - is proposed in this work that is specifically adapted to the characteristics of sequential fusion architecture. The proposed measure can be used to select a classifier that is most likely to produce a correct decision at each stage. Error rates for fusion of text-dependent HMM based speaker models using SER are compared with other classifier selection methodologies. SER is shown to achieve near optimal performance for sequential fusion of multiple instances with or without the use of multiple samples. The methodology applies to multiple speech utterances for telephone or internet based access control and to other systems such as multiple finger print and multiple handwriting sample based identity verification systems.

Designing REDD+ to be just : considerations for a legally binding instrument

The international climate regime is in the process of negotiating a legally binding instrument concerning Reducing Emissions from Deforestation and Degradation (REDD+). The paper starts by exploring the complex web of decisions and advices that currently regulate REDD+ initiatives within the international climate regime. This is followed by an analysis of justice issues raised by non-state actors in the REDD+ international negotiations. The paper concludes by building on this analysis to identify some relevant considerations when seeking to design a just and legally binding REDD+ instrument. These considerations include: the impact of market- versus fund-based investment channels, the importance of defining a clear objective; the inclusion and role of international principles such as sovereignty, preventative action, common but differentiated responsibility, sustainable development, and Free, Prior, and Informed Consent; the appropriate design of REDD+ safeguards and the inclusion of grievance mechanisms within the instrument which provide guidance on resolving disputes associated with REDD+ investment.

Challenges to Criminal Justice Reform

The Promise of Law Reform the most comprehensive examination of the institutions and processes of law reform published in the common law world and provides a rich source of information, inspiration and ideas. It is an edited collection of 30 essays published to celebrate the 30th anniversary of the Australian Law Reform Commission. The authors - law reform commissioners, judges, academics, politicians, government officials, and journalists - reflect the plurality of law reform styles and structures, within Australia and overseas. They cover the broad themes of the history, purpose and function of law reform; institutional design of law reform agencies; methodology and operations; how successful law reform should be assessed and judged; cooperation and mutual assistance; other law reform initiatives; and law reform in action.

Engagement as dialogue : presenting a pragmatic perspective

‘Engagement’ is one of the buzzwords of 21st century public relations theory and practice. Yet the concept of engagement remains frustratingly nebulous and intangible, lacking clear definition and consistent use. This paper suggests that the concept of dialogue can provide public relations practitioners and academics with a framework for defining engagement that allows deep insights into the range of ideas and contexts it covers. Specifically, this paper argues for the use of a pragmatic practitioner perspective on dialogue as a lens through which to study engagement. Current literature clearly articulates the normative and prescriptive perspectives on dialogue in public relations, but leaves the story of the reality of the practitioner experience of dialogue largely untold. New research tells this ‘missing’ story of the practitioner perspective on dialogue, which in turn offers some insights into the forms and functions of engagement in practice. Dialogue is seen as encompassing three different types of public relations practice: informing stakeholders of organisational decisions and receiving their feedback; consulting with stakeholders on the strategies and tactics used by organisations to achieve their chosen goals; and including stakeholder input in the making of decisions on what organisational goals should be. Adopting this pragmatic practitioner perspective on dialogue to view engagement provides scaffolding that is strong enough to encourage development of a consistent definition of its meaning; while still allowing the freedom and scope necessary to develop deep and rich understanding of the phenomenon.