Challenging the distal-to-proximal cannulation technique for administration of anti-cancer therapies : a prospective cohort study

Background: Distal-to-proximal technique has been recommended for anti-cancer therapy administration. There is no evidence to suggest that a 24-hour delay of treatment is necessary for patients with a previous uncomplicated venous puncture proximal to the administration site. Objectives: This study aims to identify if the practice of 24-hour delay between a venous puncture and subsequent cannulation for anti-cancer therapies at a distal site is necessary for preventing extravasation. Methods: A prospective cohort study was conducted with 72 outpatients receiving anti-cancer therapy via an administration site distal to at least one previous uncomplicated venous puncture on the same arm in a tertiary cancer centre in Australia. Participants were interviewed and assessed at baseline data before treatment and on day 7 for incidence of extravasation/phlebitis. Results: Of 72 participants with 99 occasions of treatment, there was one incident of infiltration (possible extravasation) at the venous puncture site proximal to the administration site and two incidents of phlebitis at the administration site. Conclusions: A 24 hour delay is unnecessary if an alternative vein can be accessed for anti-cancer therapy after a proximal venous puncture. Implications for practice: Extravasation can occur at a venous puncture site proximal to an administration site in the same vein. However, the nurse can administer anti-cancer therapy at a distal site if the nurse can confidently determine the vein of choice is not in any way connected to the previous puncture site through visual inspection and palpation.

A multi-resolution image alignment technique based on direct methods for pose estimation of aerial vehicles

In this paper, we seek to expand the use of direct methods in real-time applications by proposing a vision-based strategy for pose estimation of aerial vehicles. The vast majority of approaches make use of features to estimate motion. Conversely, the strategy we propose is based on a MR (Multi- Resolution) implementation of an image registration technique (Inverse Compositional Image Alignment ICIA) using direct methods. An on-board camera in a downwards-looking configuration, and the assumption of planar scenes, are the bases of the algorithm. The motion between frames (rotation and translation) is recovered by decomposing the frame-to-frame homography obtained by the ICIA algorithm applied to a patch that covers around the 80% of the image. When the visual estimation is required (e.g. GPS drop-out), this motion is integrated with the previous known estimation of the vehicles’ state, obtained from the on-board sensors (GPS/IMU), and the subsequent estimations are based only on the vision-based motion estimations. The proposed strategy is tested with real flight data in representative stages of a flight: cruise, landing, and take-off, being two of those stages considered critical: take-off and landing. The performance of the pose estimation strategy is analyzed by comparing it with the GPS/IMU estimations. Results show correlation between the visual estimation obtained with the MR-ICIA and the GPS/IMU data, that demonstrate that the visual estimation can be used to provide a good approximation of the vehicle’s state when it is required (e.g. GPS drop-outs). In terms of performance, the proposed strategy is able to maintain an estimation of the vehicle’s state for more than one minute, at real-time frame rates based, only on visual information.

Drivers of satisfaction and dissatisfaction for overseas service consumers : a critical incident technique approach

This is one of the few studies in the academic literature that directly addresses inward exporting of customer services, which is a topic that has gained less attention from an international services marketing point of view. The objective of this study is to explore the drivers of satisfaction and dissatisfaction for overseas service customers of higher education in Australia. Critical incident technique (CIT) method was used to collect and analyse the data and a total of 107 critical incidents were collected. Findings from this study show that service satisfaction and dissatisfaction for international students derive from: elements of the core service (educational service performance), personal sources (international student performance), and the external environment (socialization and host environment performance). Additionally, results show that the drivers of satisfaction and dissatisfaction for international students are not necessarily the same. Limitations relating to the specific sector of higher education and the cross sectional natures of the data are addressed.

A technique for living: Some thoughts on beginning reading pedagogy in sixteenth century England

This paper extends Hunter’s notion of ‘personal comportment’ in relation to literature and literacy education. It connects literacy teaching practices as described by a group of influential schoolmasters during the early modern period in England to the development of particular ways of conducting the self that invited a separation of personal religious beliefs, piety and secular reading competencies.

Evaluation cortical bone elasticity in response to pulse power excitation using ultrasonic technique

This paper presents the ultrasonic velocity measurement method which investigates the possible effects of high voltage high frequency pulsed power on cortical bone material elasticity. Before applying a pulsed power signal on a live bone, it is essential to determine the safe parameters of pulsed power applied on bone non-destructively. Therefore, the possible changes in cortical bone material elasticity due to a specified pulsed power excitation have been investigated. A controllable positive buck-boost converter with adjustable output voltage and frequency has been used to generate high voltage pulses (500V magnitude at 10 KHz frequency). To determine bone elasticity, an ultrasonic velocity measurement has been conducted on two groups of control (unexposed to pulse power but in the same environmental condition) and cortical bone samples exposed to pulsed power. Young’s modulus of cortical bone samples have been determined and compared before and after applying the pulsed power signal. After applying the high voltage pulses, no significant variation in elastic property of cortical bone specimens was found compared to the control. The result shows that pulsed power with nominated parameters can be applied on cortical bone tissue without any considerable negative effect on elasticity of bone material.

Foresight practice in Australia: a meta-scan of practitioners and organisations

This critical review of foresight professionals seeks to analyse their social interests, methodology, epistemological focal domains, capacitating focus, geography and organisational type. The call for a deeper understanding of the practice in the Australian context is made in order for the foundations for a National Foresight Strategy to be laid.

A study on the use of acoustic emission technique as a structural health monitoring tool

As civil infrastructures such as bridges age, there is a concern for safety and a need for cost-effective and reliable monitoring tool. Different diagnostic techniques are available nowadays for structural health monitoring (SHM) of bridges. Acoustic emission is one such technique with potential of predicting failure. The phenomenon of rapid release of energy within a material by crack initiation or growth in form of stress waves is known as acoustic emission (AE). AEtechnique involves recording the stress waves bymeans of sensors and subsequent analysis of the recorded signals,which then convey information about the nature of the source. AE can be used as a local SHM technique to monitor specific regions with visible presence of cracks or crack prone areas such as welded regions and joints with bolted connection or as a global technique to monitor the whole structure. Strength of AE technique lies in its ability to detect active crack activity, thus helping in prioritising maintenance work by helping focus on active cracks rather than dormant cracks. In spite of being a promising tool, some challenges do still exist behind the successful application of AE technique. One is the generation of large amount of data during the testing; hence an effective data analysis and management is necessary, especially for long term monitoring uses. Complications also arise as a number of spurious sources can giveAEsignals, therefore, different source discrimination strategies are necessary to identify genuine signals from spurious ones. Another major challenge is the quantification of damage level by appropriate analysis of data. Intensity analysis using severity and historic indices as well as b-value analysis are some important methods and will be discussed and applied for analysis of laboratory experimental data in this paper.

Reliability of clinical measurement for assessing spinal fusion: An experimental sheep study

Study Design. A sheep study designed to compare the accuracy of static radiographs, dynamic radiographs, and computed tomographic (CT) scans for the assessment of thoracolumbar facet joint fusion as determined by micro-CT scanning. Objective. To determine the accuracy and reliability of conventional imaging techniques in identifying the status of thoracolumbar (T13-L1) facet joint fusion in a sheep model. Summary of Background Data. Plain radiographs are commonly used to determine the integrity of surgical arthrodesis of the thoracolumbar spine. Many previous studies of fusion success have relied solely on postoperative assessment of plain radiographs, a technique lacking sensitivity for pseudarthrosis. CT may be a more reliable technique, but is less well characterized. Methods. Eleven adult sheep were randomized to either attempted arthrodesis using autogenous bone graft and internal fixation (n = 3) or intentional pseudarthrosis (IP) using oxidized cellulose and internal fixation (n = 8). After 6 months, facet joint fusion was assessed by independent observers, using (1) plain static radiography alone, (2) additional dynamic radiographs, and (3) additional reconstructed spiral CT imaging. These assessments were correlated with high-resolution micro-CT imaging to predict the utility of the conventional imaging techniques in the estimation of fusion success. Results. The capacity of plain radiography alone to correctly predict fusion or pseudarthrosis was 43% and was not improved using plain radiography and dynamic radiography with also a 43% accuracy. Adding assessment by reformatted CT imaging to the plain radiography techniques increased the capacity to predict fusion outcome to 86% correctly. The sensitivity, specificity, and accuracy of static radiography were 0.33, 0.55, and 0.43, respectively, those of dynamic radiography were 0.46, 0.40, and 0.43, respectively, and those of radiography plus CT were 0.88, 0.85, and 0.86, respectively. Conclusion. CT-based evaluation correlated most closely with high-resolution micro-CT imaging. Neither plain static nor dynamic radiographs were able to predict fusion outcome accurately. © 2012 Lippincott Williams & Wilkins.

An estimation of crash risks using a log-linear model and the induced exposure technique

Prevention and safety promotion programmes. Traditionally, in-depth investigations of crash risks are conducted using exposure controlled study or case-control methodology. However, these studies need either observational data for control cases or exogenous exposure data like vehicle-kilometres travel, entry flow or product of conflicting flow for a particular traffic location, or a traffic site. These data are not readily available and often require extensive data collection effort on a system-wide basis. Aim: The objective of this research is to propose an alternative methodology to investigate crash risks of a road user group in different circumstances using readily available traffic police crash data. Methods: This study employs a combination of a log-linear model and the quasi-induced exposure technique to estimate crash risks of a road user group. While the log-linear model reveals the significant interactions and thus the prevalence of crashes of a road user group under various sets of traffic, environmental and roadway factors, the quasi-induced exposure technique estimates relative exposure of that road user in the same set of explanatory variables. Therefore, the combination of these two techniques provides relative measures of crash risks under various influences of roadway, environmental and traffic conditions. The proposed methodology has been illustrated using Brisbane motorcycle crash data of five years. Results: Interpretations of results on different combination of interactive factors show that the poor conspicuity of motorcycles is a predominant cause of motorcycle crashes. Inability of other drivers to correctly judge the speed and distance of an oncoming motorcyclist is also evident in right-of-way violation motorcycle crashes at intersections. Discussion and Conclusions: The combination of a log-linear model and the induced exposure technique is a promising methodology and can be applied to better estimate crash risks of other road users. This study also highlights the importance of considering interaction effects to better understand hazardous situations. A further study on the comparison between the proposed methodology and case-control method would be useful.