Developing guidelines for syringe driver management

The aim of this project was to develop clinical practice guidelines for the use and administration of pharmacological agents for symptom control via syringe drivers within Australia. By developing evidence-based clinical practice guidelines for the use of this common device, this project aimed to improve patient outcomes, reduce practice variation, minimize errors and encourage more efficient use of resources. A literature review identified current literature regarding syringe driver management and an expert panel was assembled to assist in the development of the guidelines. The development of these practice guidelines provides an example of how palliative care practitioners can use a framework of contemporary evidence to enhance clinical practice.

Importance of literature profiling: An archival analysis with illustrative examples for IS researchers

The importance of a thorough and systematic literature review has long been recognised across academic domains as critical to the foundation of new knowledge and theory evolution. Driven by an exponentially growing body of knowledge in the IS discipline, there has been a recent influx of guidance on how to conduct a literature review. As literature reviews are emerging as a standalone research method in itself, increasingly these method focused guidelines are of great interest, receiving acceptance at top tier IS publication outlets. Nevertheless, the finer details which offer justification for the selected content, and the effective presentation of supporting data has not been widely discussed in these method papers to date. This paper addresses this gap by exploring the concept of ‘literature profiling’ while arguing that it is a key aspect of a comprehensive literature review. The study establishes the importance of profiling for managing aspects such as quality assurance, transparency and the mitigation of selection bias. And then discusses how profiling can provide a valid basis for data analysis based on the attributes of selected literature. In essence, this study has conducted an archival analysis of literature (predominately from the IS domain) to present its main argument; the value for literature profiling, with supporting exemplary illustrations.

Practical guidelines for planning and implementing fauna translocations

A successful translocation involves many complex factors, including a genetically appropriate source population that can sustain harvest, social and governmental support, assessment of disease transmission risk and a release site with appropriately secure habitat that can support population establishment and persistance. This information is typically discussed during staturory approval processes and can take considerable time. However, following approval, for translocations of most fauna, the initial critical step involves the inherently stressful process of capture, holding, transportation and release. This process is unpredictable and novel, and is especially challenging for wild animals when they are confined in close proximity to conspecifics and humans. In contrast, captive-reared animals have to cope with the unfamiliar challenges of finding food and shelter, along with coping with competition and predation. Little has been written in the scientific literature about the translocation process. This is unsurprising because this process has usually been the realm of skilled practioners, often with animal husbandry backgrounds, rather than research scientists. Highly skilled intuition, observation and the translocation practioner's equivalent of a 'green thumb' often guides the way. However, theory and experimentation, particularly on the effects of stress, is available and this work is invaluable for a successful translocation. Here, we provide a brief description of the translocation process, and discussion of what stress is and how it can be managed. We then provide practical guidelines for the successful translocation of invertebrates, lizards, turtles, passerine birds, marsupials and bats, using examples from Australia and New Zealand.

The ADMIN-ICU survey: A survey on antimicrobial dosing and monitoring in ICUs

Objectives: There is little evidence and few guidelines to inform the most appropriate dosing and monitoring for antimicrobials in the ICU. We aimed to survey current practices around the world. Methods: An online structured questionnaire was developed and sent by e-mail to obtain information on local antimicrobial prescribing practices for glycopeptides, piperacillin/tazobactam, carbapenems, aminoglycosides and colistin. Results: A total of 402 professionals from 328 hospitals in 53 countries responded, of whom 78% were specialists in intensive care medicine (41% intensive care, 30% anaesthesiology, 14% internal medicine) and 12% were pharmacists. Vancomycin was used as a continuous infusion in 31% of units at a median (IQR) daily dose of 25 (25–30) mg/kg. Piperacillin/tazobactam was used as an extended infusion by 22% and as a continuous infusion by 7%. An extended infusion of carbapenem (meropenem or imipenem) was used by 27% and a continuous infusion by 5%. Colistin was used at a daily dose of 7.5 (3.9–9) million IU (MIU)/day, predominantly as a short infusion. The most commonly used aminoglycosides were gentamicin (55%) followed by amikacin (40%), with administration as a single daily dose reported in 94% of the cases. Gentamicin was used at a daily dose of 5 (5–6) mg/day and amikacin at a daily dose of 15 (15–20) mg/day. Therapeutic drug monitoring of vancomycin, piperacillin/tazobactam and meropenem was used by 74%, 1% and 2% of the respondents, respectively. Peak aminoglycoside concentrations were sampled daily by 28% and trough concentrations in all patients by 61% of the respondents. Conclusions: We found wide variability in reported practices for antibiotic dosing and monitoring. Research is required to develop evidence-based guidelines to standardize practices.

A systematic review of hepatitis C clinical practice guidelines: Benefits, limitations and harms

Background Hepatitis C (HCV) was described as a “viral time bomb” due to its prevalence and potential for causing serious, life-threatening complications. The Australian’s National Hepatitis C Strategy calls for a coordinated, evidence-based approach to testing, management, care and support of HCV. This review aimed to systematically and comparatively appraise existing international HCV clinical guidelines. Methods A systematic search of bibliographic databases and reference lists from selected papers were the source of data. Inclusion criteria were latest clinical guidelines as defined by Institute of Medicine, published in English, between January 2002 and November 2014. Quality of the guidelines was independently assessed using the iCAHE instrument. Results Twenty-eight international clinical practice guidelines were included. The majority of the international guidelines were based on the same primary studies however clinical recommendations on pre- and in-treatment assessments, choice of pharmaceuticals, and dosages and duration of the same pharmaceutical agents varied considerably. This diversity was beyond what would be considered reasonable practice context variations. Furthermore, there is limited guidance on post-treatment surveillance and care. Conclusions/implications There is a need for a harmonised international consensus on the clinical management of HCV. Key message A lack of consistency among international HCV clinical guidelines may impede effective and efficient patient care.

Sports anti-siphoning laws and the controversy of sports broadcasting: A case study of Pakistan

Controversies between private and public broadcasters over the broadcasting of live sports, especially cricket, during important sports events have emerged as a serious legal issue in Pakistan. Controversy between Geo Super and Pakistan Television over live telecast of the ICC Cricket World Cup is a typical example of such controversies. An aggressive legal battle, during a most important cricketing event, not only hampered the enjoyment of cricket viewers across the country but also gave Pakistan a bad name across the globe. This article discusses in detail this controversy and highlights lacunas in the existing sports broadcasting regime of Pakistan. There are no clear and well defined sports broadcasting laws in Pakistan. The Pakistan Electronic Media Regulatory Authority (PEMRA) rules are of general nature. Secondly, PEMRA rules are not comprehensive and explicit enough to provide clear guidelines about sports broadcasting. This may be a possible reason why sports broadcasting controversies reach the highest court in Pakistan, the Supreme Court of Pakistan. Despite these ugly battles between broadcasters, the government of Pakistan has never given due importance to this issue and no efforts have been made at any level to come up with legislation on sports broadcasting to avoid such controversies or to resolve them amicably in the light of well-defined laws on this subject. The purpose of this article is to draw the attention of the concerned authorities towards this important issue because in future more such controversies may be expected in the absence of a sports broadcasting regime in the country.

Author's reply to: Ankylosing spondylitis: evidence for a non-HLA-B*27 protective effect, Sjef Van Der Linden, Desieree Van Der Heijde

As mentioned in the letter by van der Linden and van der Heijde, Jurgen Braun’s excellent recent paper describing a survey of blood donors by questionnaire, clinical, and magnetic resonance imaging examinations revealed a prevalence of ankylosing spondylitis in B27 positive blood donors (6.4%)1-1 very similar to that reported by Gran et al(6.7%).1-2 It is probable that some of the differences in reported prevalence of ankylosing spondylitis by the various studies are because of methodological differences.

Omission of author name in the article by Davidson et al (Arthritis Rheum, July 2013)

This article corrects: Brief Report: High-Throughput Sequencing of IL23R Reveals a Low-Frequency, Nonsynonymous Single-Nucleotide Polymorphism That Is Associated With Ankylosing Spondylitis in a Han Chinese Population Vol. 65, Issue 7, 1747–1752, Article first published online: 2 JUL 2013

Evaluation of immune responses to influenza vaccination in chronic obstructive pulmonary disease

Background: Given that viral infections are common triggers for exacerbations of Chronic Obstructive Pulmonary Disease (COPD), current clinical guidelines recommend that all patients receive annual influenza vaccinations. A detailed examination of the immune response to vaccination in COPD has not previously been undertaken, so this study aimed to compare immune responses to influenza vaccination between COPD patients and healthy subjects. Methods: Twenty one COPD patients and fourteen healthy subjects were recruited and cellular immune function was assessed pre- and post- vaccination with trivalent inactivated influenza vaccine. Results: One month after vaccination, H1N1 specific antibody titres were significantly lower in COPD patients than in healthy controls (p=0.02). Multivariate analysis demonstrated that post vaccination antibody titres were independently associated with COPD, but not with age or smoking status. Innate immune responses to the vaccine preparation did not differ between the two populations. Serum concentrations of IL-21, a cytokine that is important for B cell development and antibody synthesis, were also lower in COPD patients than in healthy subjects (p<0.01). In vitro functional differences were also observed, with fewer proliferating B cells expressing CD27 (p=0.04) and reduced T-cell IFN-γ synthesis (p<0.01) in COPD patients, relative to healthy subjects. Conclusions: In conclusion, COPD was associated with altered immune responses to influenza vaccination compared to healthy controls with reductions in both T-cell and B-cell function. These findings provide a foundation for future research aimed at optimising the effectiveness of influenza vaccination in COPD.

Human body stability in floodwaters: The 2011 flood in Brisbane CBD

The flooding of urbanised areas constitutes a hazard to the population and infrastructure. Floods through inundated urban environments have been studied recently and the potential impact of flowing waters on pedestrians is not well known. Herein the stability of individuals in floodwaters is reviewed based upon the re-analysis of detailed field measurements in an inundated section of the central business district of the City of Brisbane (Australia) during the 2011 flood. Detailed water elevation and velocity data were recorded. On-site observations showed some hydrodynamic instability linked to local topographic effects, in the form of a combination of fast turbulent fluctuations and (very) slow fluctuations of water level and velocity associated with surges. The flow conditions in Gardens Point Road was unsafe for individuals and a review of past guidelines suggests that many previous recommendations are over-optimistic and unsafe in real floodwaters.

ANF guidelines for healthy food choices

The Australian Nutrition Foundation (ANF) was one of the first community service organisations to work with food industry , having pioneered the concept of corporate membership since its inception in 1982. ANF has worked closely and successfully with industry - the development of the ANF Food Selection Guidelines for Children and Adolescents is one example of this collaboration. While the guidelines were initially developed for use in school canteens, they can be used in a range of institutions where caterers wish to have tender specifications for purchase of healthy food for children and adolescents.

Organisational driving safety systems analysis: Fleet safety situational issues and system gaps

The identification of safety hazards and risks and their associated control measures provides the foundation for any safety program and essentially determines the scope, content and complexity of an effective occupational health and safety management system. In the case of work-related road safety (WRRS), there is a gap within current knowledge, research and practice regarding the holistic assessment of WRRS safety systems and practice. In order to mitigate this gap, a multi-level process tool for assessing WRRS safety systems was developed from extensive consultation, practice and informed by theoretical models and frameworks. Data collection for the Organisational Driving Safety Systems Analysis (ODSSA) tool utilised a case study methodology and included multiple information sources: such as documents, archival records, interviews, direct observations, participant observations, and physical artefacts. Previous trials and application of the ODSSA has indicated that the tool is applicable to a wide range of organisational fleet environments and settings. This paper reports on the research results and effectiveness of the ODSSA tool to assess WRRS systems across a large organisation that recently underwent considerable organisational change, including amalgamation of multiple organisations. The outcomes of this project identified considerable differences in the degree by which the organisation addressed WRRS across their vehicle fleet operations and provided guidelines for improving organisations’ WRRS systems. The ODSSA tool was pivotal in determining WRRS system deficiencies and provided a platform to inform mitigation and improvement strategies.

Roundabout design guidelines and cycling safety

Review conducted as part of a Queensland Department of Transport and Main Roads funded project ‘Roundabout design review’. The project examined: - Design guidelines - Factors that affect safety at roundabouts

The Duet between the Author and the Translator: An Analysis of Style through Shifts in Literary Translation

The study proposes a method for identifying the personal imprint of literary translators in translated works of fiction. The initial assumption was that the style of a target text is not determined solely by the literary style of the author but also by features of its translator s idiolect. A method was developed for identifying the idiolectal features of individual translators, which were then used to describe personal translation styles. The method is not restricted to a particular language pair. To test the method and to establish the nature of the proposed personal imprint empirically, extracts from four English-language literary source texts (two novels by James Joyce and two by Ernest Hemingway) were first compared with their translations into Finnish (by four different translators) in order to identify changes, or shifts, that had taken place at the formal linguistic level in the translation process. To allow individual propensities to manifest themselves, only optional shifts in which the translators had a range of choices available to them were included in the study. In the second phase, extracts by different authors rendered into Finnish by the same translator were compared in order to gauge the extent of the potential impact of the author's style on the translator's work. In-depth analysis of the types of shifts made most frequently by the individual translators revealed further intersubjective differences, and the shifts were used to construct translation profiles for each of the translators. In order to determine the potential effects of frequently occurring shifts on the target text, some central concepts of narratology were adapted and used to establish an intermediate link between microlevel choices and macrolevel effects. In this way the propensity of an individual translator to opt for certain types of shift could be linked with the overall artistic effect of the target text.

Mediated music makers : Constructing author images in popular music

The subject of the thesis is the mediated construction of author images in popular music. In the study, the construction of images is treated as a process in which artists, the media and the members of the audience participate. The notions of presented, mediated and compiled author images are used in explaining the mediation process and the various authorial roles of the agents involved. In order to explore the issue more closely, I analyse the author images of a group of popular music artists representing the genres of rock, pop and electronic dance music. The analysed material consists mostly of written media texts through which the artists authorial roles and creative responsibilities are discussed. Theoretically speaking, the starting points for the examination lie in cultural studies and discourse analysis. Even though author images may be conceived as intertextual constructions, the artist is usually presented as a recognizable figure whose purpose is to give the music its public face. This study does not, then, deal with musical authors as such, but rather with their public images and mediated constructions. Because of the author-based functioning of popular music culture and the idea of the artist s individual creative power, the collective and social processes involved in the making of popular music are often superseded by the belief in a single, originating authorship. In addition to the collective practices of music making, the roles of the media and the marketing machinery complicate attempts to clarify the sharing of authorial contributions. As the case studies demonstrate, the differences between the examined author images are connected with a number of themes ranging from issues of auteurism and stardom to the use of masked imagery and the blending of authorial voices. Also the emergence of new music technologies has affected not only the ways in which music is made, but also how the artist s authorial status and artistic identity is understood. In the study at hand, the author images of auteurs, stars, DJs and sampling artists are discussed alongside such varied topics as collective authorship, evaluative hierarchies, visual promotion and generic conventions. Taken altogether, the examined case studies shed light on the functioning of popular music culture and the ways in which musical authorship is (re)defined.