The prevalence and perception of pain amongst hospital in-patients

The aim of this paper is to describe the prevalence and perceptions of pain and pain management amongst hospital in-patients. A cross-sectional descriptive survey of 205 patients was conducted. Presence and severity of pain was assessed using verbal descriptor and visual analogue scales, and perceptions of pain were assessed using multi-item scales. Although the severity of pain reported was consistent across age groups and clinical areas, women in the study sample were significantly more likely to report high levels of pain than men. Differences in how men and women communicate their pain were observed, with women indicating that they were less willing to ask for help with their pain. Results suggest that pain continues to be an important problem for a large number of men and women in hospital, and that the experience of pain impacts negatively upon their well-being. Gender differences in the experience of and response to pain remain important considerations for clinical nurses who have major responsibilities for the management of pain in hospitalized patients.

Malnutrition and poor food intake are associated with prolonged hospital stay, frequent readmissions, and greater in-hospital mortality: Results from the Nutrition Care Day Survey 2010

Background & aims The Australasian Nutrition Care Day Survey (ANCDS) ascertained if malnutrition and poor food intake are independent risk factors for health-related outcomes in Australian and New Zealand hospital patients. Methods Phase 1 recorded nutritional status (Subjective Global Assessment) and 24-h food intake (0, 25, 50, 75, 100% intake). Outcomes data (Phase 2) were collected 90-days post-Phase 1 and included length of hospital stay (LOS), readmissions and in-hospital mortality. Results Of 3122 participants (47% females, 65 ± 18 years) from 56 hospitals, 32% were malnourished and 23% consumed ≤ 25% of the offered food. Malnourished patients had greater median LOS (15 days vs. 10 days, p < 0.0001) and readmissions rates (36% vs. 30%, p = 0.001). Median LOS for patients consuming ≤ 25% of the food was higher than those consuming ≤ 50% (13 vs. 11 days, p < 0.0001). The odds of 90-day in-hospital mortality were twice greater for malnourished patients (CI: 1.09–3.34, p = 0.023) and those consuming ≤ 25% of the offered food (CI: 1.13–3.51, p = 0.017), respectively. Conclusion The ANCDS establishes that malnutrition and poor food intake are independently associated with in-hospital mortality in the Australian and New Zealand acute care setting.

Do the skeletons in the hospital closet still exist? What do they eat?

One aim of the Australasian Nutrition Care Day Survey (ANCDS) was to explore dietary intake and nutritional status of acute care hospital patients. Dietitians from 56 hospitals in Australia and New Zealand completed a 24-hour nutritional status and dietary intake audit of 3000 adult patients. Participants were evaluated for nutritional risk using the Malnutrition Screening Tool (MST). Those ‘at risk’ underwent nutritional assessment using Subjective Global Assessment (SGA). Dietitians observed participants’ dietary intake at each main meal and recorded mid-meal intake via participant interviews. Intakes were recorded as 0%, 25%, 50%, 75%, or 100% of that offered for each meal during the 24-hour audit. Preliminary results for 1550 participants (males = 853; females = 697), age = 64 ± 17 years and BMI = 27 ± 7 kg/m2. Fifty-five percent (n = 853) of the participants had BMI > 25 kg/m2. The MST identified 41% (n = 636) ‘at risk’ for malnutrition. Of those ‘at risk’, 70% were assessed as malnourished resulting in an overall malnutrition prevalence of 30% (25% moderately malnourished, 5% severely malnourished). One-quarter of malnourished participants (n = 118) were on standard hospital diets without additional nutritional support. Fifty percent of malnourished patients (n = 235) and 40% of all patients (n = 620) had an overall 24-hour food consumption of ≤50% during the 24-hour audit. The ANCDS found that skeletons in the hospital closet continue to exist and that acute care patients continue to have suboptimal dietary intake. The ANCDS provides valuable insight into gaps in existing nutrition care practices.

Extreme architecture : can architects future proof us against fire and flood.

In the face of Australia’s disaster-prone environment, architects Ian Weir and James Davidson are reconceptualising how our residential buildings might become more resilient to fire, flood and cyclone. With their first-hand experience of natural disasters, James, director of Emergency Architects Australia (EAA), and Ian, one of Australia’s few ‘bushfire architects’, discuss the ways we can design with disaster in mind. Dr Ian Weir is one of Australia’s few ‘bushfire architects’. Exploring a holistic ‘ground up’ approach to bushfire where landscape, building design and habitation patterns are orchestrated to respond to site-specific fire characteristics. Ian’s research is developed through design studio teaching at QUT and through built works in Western Australia’s fire prone forests and heathlands.

Enacted Cartography : Formations - 2012 Venice Architecture Biennale

RESEARCH BACKGROUND Enacted Cartography documents 10 years of creative research practice by Ian Weir Research Architect and was developed as standalone exhibition to support Dr Weir’s selection by the Australian Institute of Architects to represent innovative architectural practice via the Institute’s review entitled Formations: New Practices in Australian Architecture – which took the form of an exhibition and book presented in Venice, Italy for 13th International Architecture Exhibition (Venice Architecture Biennale). All works exhibited in Enacted Cartography are original works by Dr Weir and are generated either from or for the remote biodiverse landscapes of the Fitzgerald Bioregion on the south coast of Western Australia. RESEARCH CONTRIBUTION As a creative work in its own right, the Enacted Cartography exhibition makes the following contributions to knowledge: 1. Expands understandings of architectural practice by presenting a geographically-specific but multimodal form of architectural practice - wherein practitioners cross over discipline boundaries into art practice, landscape representation, website design, undergraduate university teaching and community advocacy. 2. Contributes to understandings of how such a diverse multimodal form of practice might be represented through both digital media and traditional print media in an exhibition format. 3. Expands understandings of how architectural practitioners might work within a particular place to develop a geographically-specific sense of identity, a ‘landscape of resistance’. RESEARCH SIGNIFICANCE Enacted Cartography was presented to an international audience during the 13th International Architecture Exhibition (Venice Architecture Biennale). The significance of Dr Weir’s research is evidence by his selected by the Australian Institute of Architects to represent innovation in architectural practice for the Biennale. Enacted Cartography addresses problems of national and international importance including: 1. The sustainable development of biodiverse remote landscapes; 2. The reconciliation of bushfire safety and biodiversity conservation; 3. The necessity for rethinking of architectural design methodologies to meet the complexity of landscape management and design; 4. It challenges orthodox forms of landscape representation (aerial photography, for example) which are demonstrably inadequate registrations of biophysical and cultural landscapes.

What is the Architecture Studio?

What is the Architecture Studio? What is the studio? Where do architect’s make architecture? What happens in architecture studios at QUT? How does QUT architecture provide assessment feedback? Why is QUT architecture Experimenting with Change?

Design and modeling of collaboration architecture for security

Threats against computer networks evolve very fast and require more and more complex measures. We argue that teams respectively groups with a common purpose for intrusion detection and prevention improve the measures against rapid propagating attacks similar to the concept of teams solving complex tasks known from field of work sociology. Collaboration in this sense is not easy task especially for heterarchical environments. We propose CIMD (collaborative intrusion and malware detection) as a security overlay framework to enable cooperative intrusion detection approaches. Objectives and associated interests are used to create detection groups for exchange of security-related data. In this work, we contribute a tree-oriented data model for device representation in the scope of security. We introduce an algorithm for the formation of detection groups, show realization strategies for the system and conduct vulnerability analysis. We evaluate the benefit of CIMD by simulation and probabilistic analysis.

Smoking rates among hospital nurses in Longkou city, China

This study was undertaken as one of the first investigations of nurses' smoking habits in Longkou city, Shandong Province, China. An anonymous cross-sectional survey was administered as part of a larger investigation of healthcare professionals at a university teaching hospital during 2008. A total of 88 nurses responded to the survey, from whom tobacco-related data were provided by 83 of them (94%). Their overall smoking rate was very low (1%), with no male nurses reporting themselves to be current tobacco users. Overall, the current study suggests that smoking rates are very low among Chinese nurses in Longkou city, Shandong Province. These results are also consistent with studies of nurses' tobacco use conducted in other regions of China.

National architecture conference 2012

May was a particularly busy month with lots of exciting architectural things happening in Brisbane, including the sell-out 2012 National Architecture Conference. The total number of conference attendees was 1,625, which was the largest number of attendees to any Australian National Architecture Conference to date. This was the first time that the National Architecture Conference had been held in Brisbane in over 20 years, and the enormous turnout of 947 Queenslanders to the conference was testament to the positive decision to include Brisbane as a conference venue. The theme of this year’s conference was ‘experience’. Building on ideas introduced in the recent ‘natural artifice’ conference, creative directors Shane Thompson, Michael Rayner and Peter Skinner focused closely on the real, sensed experience of architecture within its natural and constructed settings and the experience of designing and making architecture. The conference attracted a variety of high profile international speakers, including architect and professor, Wang Shu, the 2012 Pritzker Architecture Prize Laureate and co-founder of the Amateur Architecture Studio in China. Other highlights included presentations from Peter Rich [South Africa], Kathryn Findlay [United Kingdom], Rachel Neeson [Australia], Anuradha Mathur & Dilip da Cunha [United States] and Kjetil Thorsen [Norway]. QUT had a strong presence at the conference. In addition to pleasing attendance rates from QUT School of Design students and staff, our Head-of-School Professor Paul Sanders, was given the honourable task of introducing keynote speaker Peter Rich, and facilitating the Q&A session after his presentation, which received a standing ovation. There were many events organised for students and young architects by QUT’s SONA reps, including a masterclass, opening party, collaborative design and construction of the SONA Pavilion, and finally, organisation of the all important SONA Hangover Breakfast, the morning after the closing party. The 2012 National Architecture Conference was truly memorable and an experience not to have been missed. I encourage anyone with a passion for architecture and a desire to be completely inspired by current and emerging leaders in our exciting profession, to start making plans to attend next year’s conference.

Communicating in the pre-hospital emergency environment

Aim. To develop and evaluate the implementation of a communication board for paramedics to use with patients as an augmentative or alternative communication tool to address communication needs of patients in the pre-hospital setting. Method. A double-sided A4-size communication board was designed specifically for use in the pre-hospital setting by the Queensland Ambulance Service and Disability and Community Care Services. One side of the board contains expressive messages that could be used by both the patient and paramedic. The other side contains messages to support patients’ understanding and interaction tips for the paramedic. The communication board was made available in every ambulance and patient transport vehicle in the Brisbane Region. Results. A total of 878 paramedics completed a survey that gauged which patient groups they might use the communication board with. The two most common groups were patients from culturally and linguistically diverse backgrounds and children. Staff reported feeling confident in using the board, and 72% of interviewed paramedics agreed that the communication board was useful for aiding communication with patients. Feedback from paramedics suggests that the board is simple to use, reduces patient frustration and improves communication. Conclusion. These results suggest that a communication board can be applied in the pre-hospital setting to support communication success with patients. What is known about the topic? It is imperative that communication between patient and paramedic is clear and effective. Research has shown that communication boards have been effective with people with temporary or permanent communication difficulties. What does this paper add? This is the first paper outlining the development and use of a communication board by paramedics in the pre-hospital setting in Australia. The paper details the design of the communication board for the unique pre-hospital environment. The paper provides some preliminary data on the use of the communication board with certain patient groups and its effectiveness as an alternative communication tool. What are the implications for practitioners? The findings support the use of the tool as a viable option in supporting the communication between paramedics and a range of patients. It is not suggested that this communication board will meet the complete communication needs of any individual in this environment, but it is hoped that the board’s presence within the Queensland Ambulance Service may result in paramedics introducing the board on occasions where communication with a patient is challenging.

A comparative analysis of the integration of SOA elements in widely-used enterprise architecture frameworks

In recent years, enterprise architecture (EA) has captured increasing interest as a means to systematically consolidate and manage various enterprise artefacts in order to provide holistic decision support for business/IT alignment and business/IT landscapes management. To provide a holistic perspective on the enterprise over time, EA frameworks need to co-evolve with the changes in the enterprise and its IT over time. In this paper we focus on the emergence of Service-Oriented Architecture (SOA). There is a need to integrate SOA with EA to keep EA relevant and to use EA products to help drive successful SOA. This paper investigates and compares the integration of SOA elements in five widely used EA frameworks: Archimate, The Open Group Architecture Framework (TOGAF), Federal Enterprise Architecture Framework (FEAF), Department of Defence Architecture Framework (DoDAF) and the Ministry of Defence Architecture Framework (MODAF). It identifies what SOA elements are considered and their relative position in the overall structure. The results show that services and related elements are far from being well-integrated constructs in current EA frameworks and that the different EA frameworks integrated SOA elements in substantially different ways. Our results can support the academic EA and SOA communities with a closer and more consistent integration of EA and SOA and support practitioners in identifying an EA framework that provides the SOA support that matches their requirements.

Effects of scaffold architecture on cranial bone healing

Scaffolds for bone tissue engineering should be designed to optimize cell migration, enhance new bone formation and give mechanical support. In the present study, we used polycaprolactone-tricalciumphosphate (PCL/TCP) scaffolds with two different fibre lay down patterns which were coated with hydroxyapatite and gelatine as an approach for optimizing bone regeneration in a critical sized calvarial defect. After 12 weeks bone regeneration was quantified using microCT analysis, biomechanical testing and histological evaluation. Notably, the experimental groups containing coated scaffolds showed lower bone formation and lower biomechanical properties within the defect compared to the uncoated scaffolds. Surprisingly, the different lay down pattern of the fibres resulted in different bone formation and biomechanical properties; namely 0/60/120° scaffolds revealed lower bone formation and biomechanical properties compared to the 0/90° scaffolds in all the experimental groups. The different architecture of the scaffold fibres may have an effect on nutrition supply as well as the attachment of the newly formed matrix to the scaffold. Therefore, future bone regeneration strategies utilising scaffolds should consider scaffold architecture as an important factor during the scaffold optimisation stages in order to move closer to a clinical application.

Simulation architecture for the design of cooperative collision warning systems

Simulation has been widely used to estimate the benefits of Cooperative Systems (CS) based on Inter-Vehicular Communications (IVC). This paper presents a new architecture built with the SiVIC simulator and the RTMaps™ multisensors prototyping platform. We introduce several improvements from a previous similar architecture, regarding IVC modelisation and vehicles’ control. It has been tuned with on-road measurements to improve fidelity. We discuss the results of a freeway emergency braking scenario (EEBL) implemented to validate our architecture’s capabilities.