Current management of transitional feeding issues in preterm neonates born in Queensland, Australia

Background: Many preterm neonates display difficulty establishing suck-feeding competence in the weeks following birth. Ineffective management of transitional feeding issues may cause patient complications, and can contribute to increased length of stay. Aims: Given that many neonatal nurseries appear to vary in their neonatal feeding management practices, the aim of this study was to investigate and document the routine level of support and intervention currently provided for preterm neonates with transitional feeding issues across the various level II (special care) nurseries (SCNs) in Queensland, Australia. Methods: A questionnaire was mailed to all Queensland SCNs in 2005 (n = 36). The questionnaire contained a series of closed-choice and short-answer questions designed to obtain information from each SCN regarding their current practices for managing transitional feeding issues in preterm neonates. Results were confirmed during a follow-up phone call. Results: Responses were obtained from 29 SCNs (80.6%). None of these nurseries reported having any formal, written policies regarding the management of transitional feeding issues in preterm neonates. Wide variations were reported in relation to the suck-feeding assessments and interventions used by staff within the various SCNs. Of the 29 nurseries, 4 (13.8%) reported using checklists or assessments to judge readiness for suck-feeds, and 5 (17.2%) reported using pulse oximetry to judge tolerance of suck-feeding attempts. Eighteen SCNs (62.1%) reported offering some form of active intervention to assist neonates with transitional feeding issues, with the most common intervention techniques reported being non-nutritive sucking during tube feeds, pre-feeding oral stimulation, and actively pacing suck-feeds. Twenty-two SCNs (75.4%) reported having access to a lactation consultant to assist mothers with breastfeeding issues. Conclusions: Differences were reported in the routine management of transitional feeding issues in preterm neonates across the various SCNs in Queensland. It is suggested that evidence based guidelines need to be developed, and that, in order to do this, further research studies are required to determine current best practice, as well as to answer remaining questions. © 2008 Elsevier Ireland Ltd. All rights reserved.

Understanding Early Childhood Education and Care in Australia: Practices and Perspectives

A foundational text for pre-service teachers explaining the theories, policies and pedagogies that shape the provision of early childhood education and care in Australia. In order to effectively practise as an early childhood educator it is essential to understand the theories, policies and pedagogy that shape the discipline. Understanding Early Childhood Education and Care in Australia provides core foundational knowledge that is critical for best practice. Part One looks at concepts of childhood and the development of mass education before examining influential theories including developmental psychology, sociology, feminisms and critical theory. Specific approaches are also analysed including Reggio Emilia, Montessori, Multiple Intelligences and HighScope. Part Two focuses on the guiding frameworks and policies in Australia and explores in depth issues affecting Indigenous children and provisions for recognising diversity and the practice of inclusion. The final section examines teaching and leadership and considers curriculum, pedagogy and assessment, building relationships between staff and families, the care of babies and infants, the environment in which early childhood education takes place and the responsibilities and professional development of teachers. This essential reference will ensure pre-service teachers develop a sophisticated understanding of how theory underpins effective practice in early childhood education.

Phoenix activity: Regulatory challenges and the law

Remedying the mischief of phoenix activity is of practical importance. The benefits include continued confidence in our economy, law that inspires best practice among directors, and law that is articulated in a manner such that penalties act as a sufficient deterrent and the regulatory system is able to detect offenders and bring them to account. Any further reforms must accommodate and tolerate legal phoenix activity. Phoenix activity pushes tolerance of entrepreneurial activity to its absolute limits. The wisest approach would be to front end the reforms so as to alleviate the considerable detection and enforcement burden upon regulatory bodies. There is little doubt that breach of the existing law is difficult and expensive to detect; and this is a significant burden when regulators have shrinking budgets and are rapidly losing feet on the ground. This front end approach may need to include restrictions on access to limited liability. The more limited liability is misused, the stronger the argument to limit access to limited liability. This paper proposes that such an approach is a legitimate next step for a robust and mature capitalist economy.

Questions about multidisciplinary teams

Multidisciplinary care (MDC) involves health professionals from a range of disciplines working together as a team (a multidisciplinary team – MDT) to deliver comprehensive care that addresses as many of a patient's needs as possible. Writing in 2011, Wilcoxon and others concluded: ‘Multidisciplinary care is accepted as best practice in cancer treatment planning and care.’ Yet their report (of the national audit of multidisciplinary cancer care in Australia) indicated that two-thirds of the surveyed hospitals did not have a MDT. Further, they found that where teams did exist, one-third of patients were not told that their case would be discussed by the team; the MDT-recommended treatment plan was not included in the patient’s record one-quarter of the time; and less than 1 per cent of teams reported routine attendance by the tumour-specific minimum core team. There is sparse case authority as to the potential medico-legal consequences of MDC by MDTs. This article raises five questions about legal aspects of MDC for consideration. The questions are not limited to cancer care, as MDTs are increasingly used in other areas of medicine.

Technology and the City: Systems, Applications and Implications

This book investigates and reveals the interplay between smart technologies and cities, a topic that has gained incredible currency in urban studies in recent years. Beginning with an elaboration of the historical significance of technologies in economic growth, social progress and urban development, the author then goes on to introduce the most prominent smart urban information technologies before demonstrating the use of these technologies in various smart urban systems. The book then showcases some of the most significant cases of smart city best practice from across the globe before discussing the magnitude and prospects of smart technologies and systems for our cities and societies. "The interplay between smart urban technologies and city development is a relatively uncharted territory. Technology and the City aims to fill that gap, exploring the growing importance of smart technologies and systems in contemporary cities, and providing an in-depth understanding of both theoretical and practical aspects of smart urban technology adoption, and its implications for our cities. Beginning with an elaboration of the historical significance of technologies in economic growth, social progress and urban development, Yigitcanlar introduces the most prominent smart urban information technologies. The book showcases significant smart city practices from across the globe that uses smart urban technologies and systems most effectively. It explores the role of these technologies and asks how they can be adopted into the planning, development and management processes of cities for sustainable urban futures. This pioneering volume contributes to the conceptualisation and practice of smart technology and system adoption in our cities by disseminating both conceptual and empirical research findings with real-world best practice applications. With a multidisciplinary approach to themes of technology and urban development, this book is a key reference source for scholars, practitioners, consultants, city officials, policymakers and urban technology enthusiasts."--Publisher website

Evaluation of the implementation of the prostate cancer specialist nurse role

A national prostate cancer specialist nursing pilot program, supported by Prostate Cancer Foundation of Australia, was launched in May 2012 with funding support from The Movember Foundation. The pilot program aimed to trial a best practice model for providing specialist nursing care to those affected by prostate cancer. Prostate cancer specialist nurses were allocated to 12 hospitals across all Australian states and territories to work in the context of multidisciplinary care. The Prostate Cancer Foundation provided professional development support for nurses through a structured program. This article presents key outcomes from the research commissioned by the Prostate Cancer Foundation to evaluate the prostate cancer specialist nurse role. Specifically, the paper reports evaluation data relating to the roles and functions of the prostate cancer specialist nurse to explore the influence of the role on outcomes for patients, carers and services.

A systems evaluation of high-input management using fortified molasses for beef production in Australia's dry tropics

The potential of beef producers to profitably produce 500-kg steers at 2.5 years of age in northern Australia's dry tropics to meet specifications of high-value markets, using a high-input management (HIM) system was examined. HIM included targeted high levels of fortified molasses supplementation, short seasonal mating and the use of growth promotants. Using herds of 300-400 females plus steer progeny at three sites, HIM was compared at a business level to prevailing best-practice, strategic low-input management (SLIM) in which there is a relatively low usage of energy concentrates to supplement pasture intake. The data presented for each breeding-age cohort within management system at each site includes: annual pregnancy rates (range: 14-99%), time of conception, mortalities (range: 0-10%), progeny losses between confirmed pregnancy and weaning (range: 0-29%), and weaning rates (range: 14-92%) over the 2-year observation. Annual changes in weight and relative net worth were calculated for all breeding and non-breeding cohorts. Reasons for outcomes are discussed. Compared with SLIM herds, both weaning weights and annual growth were >= 30 kg higher, enabling 86-100% of HIM steers to exceed 500 kg at 2.5 years of age. Very few contemporary SLIM steers reached this target. HIM was most profitably applied to steers. Where HIM was able to achieve high pregnancy rates in yearlings, its application was recommended in females. Well managed, appropriate HIM systems increased profits by around $15/adult equivalent at prevailing beef and supplement prices. However, a 20% supplement price rise without a commensurate increase in values for young slaughter steers would generally eliminate this advantage. This study demonstrated the complexity of pro. table application of research outcomes to commercial business, even when component research suggests that specific strategies may increase growth and reproductive efficiency and/or be more pro. table. Because of the higher level of management required, higher costs and returns, and higher susceptibility to market changes and disease, HIM systems should only be applied after SLIM systems are well developed. To increase profitability, any strategy must ultimately either increase steer growth and sale values and/or enable a shift to high pregnancy rates in yearling heifers.

Factors influencing the release and establishment of weed biological control agents

Mike Day and colleagues recently published their paper 'Factors influencing the release and establishment of weed biocontrol agents' in Proceedings of the 16th Australian Weeds Conference. The CRC for Australian Weed Management facilitated an investigation into the factors influencing the release and establishment of weed biological control agents on a wide variety of Australian weeds. The investigation improved the understanding of post-release ecology of biocontrol agents and generated recommendations for best practice. Factors affecting successful establishment on the weed include host plant characteristics, size of releases, dispersal power of the agent, predation and parasitism, and climate. A best practice guide was produced by the CRC to assist practitioners in designing robust release strategies to increase rates of establishment.

Fox management in south-eastern Australia: management strategies and cost-efficiencies

The European red fox is one of Australia´s most devastating vertebrate affecting both biodiversity and agricultural production. Fox management strategies rely heavily on poisoning using baits impregnated with sodium fluoroacetate (1080). Factors such as the ability of foxes to locate bait, palatability and toxicity of bait, pattern and density of bait distribution, and cost/benefits of specific use patterns all affect the overall efficiency of management programs. It is essential to examine and refine all such factors to manage the damaging impacts of this pest species. This book examines the problems associated with management of the fox in south-eastern Australia, highlights deficiencies in ´best-practice´ baiting techniques, and provides recommendations to improve current management strategies and guide future research.

Cocowood processing manual: from coconut wood to quality flooring.

This manual describes best practice for producing high-value flooring products from coconut ‘wood’—or cocowood. It meets international standards for flooring products and accounts for the recognised, specific, local conditions of the Pacific Islands. The information is intended for operators skilled in timber processing, who need to work with the unusual properties of cocowood, and specifies where cocowood processes differ from standard practice for timber. For other processes, refer to the relevant standards set by the importing country. These technical guidelines are based on the research outcomes of the ACIAR project, 'Improving value and marketability of coconut wood'. The manual is divided into three chapters. Each chapter adds to different aspects of primary and secondary processing. Chapter 1 provides an overview of the best practice steps for harvesting and processing cocowood. There is also a glossary of terms specifically associated with processing cocowood and a section on managing processing risks. Chapter 2 covers cocowood’s unique properties and how they relate to critical processing techniques. This is followed by sections that set out the processing methods in more detail, explaining why these practices are essential when working with cocowood. Chapter 3 provides more information, including contacts, current timber standards and some useful publications.

Cone beam computed tomography in oral radiology

In dentistry, basic imaging techniques such as intraoral and panoramic radiography are in most cases the only imaging techniques required for the detection of pathology. Conventional intraoral radiographs provide images with sufficient information for most dental radiographic needs. Panoramic radiography produces a single image of both jaws, giving an excellent overview of oral hard tissues. Regardless of the technique, plain radiography has only a limited capability in the evaluation of three-dimensional (3D) relationships. Technological advances in radiological imaging have moved from two-dimensional (2D) projection radiography towards digital, 3D and interactive imaging applications. This has been achieved first by the use of conventional computed tomography (CT) and more recently by cone beam CT (CBCT). CBCT is a radiographic imaging method that allows accurate 3D imaging of hard tissues. CBCT has been used for dental and maxillofacial imaging for more than ten years and its availability and use are increasing continuously. However, at present, only best practice guidelines are available for its use, and the need for evidence-based guidelines on the use of CBCT in dentistry is widely recognized. We evaluated (i) retrospectively the use of CBCT in a dental practice, (ii) the accuracy and reproducibility of pre-implant linear measurements in CBCT and multislice CT (MSCT) in a cadaver study, (iii) prospectively the clinical reliability of CBCT as a preoperative imaging method for complicated impacted lower third molars, and (iv) the tissue and effective radiation doses and image quality of dental CBCT scanners in comparison with MSCT scanners in a phantom study. Using CBCT, subjective identification of anatomy and pathology relevant in dental practice can be readily achieved, but dental restorations may cause disturbing artefacts. CBCT examination offered additional radiographic information when compared with intraoral and panoramic radiographs. In terms of the accuracy and reliability of linear measurements in the posterior mandible, CBCT is comparable to MSCT. CBCT is a reliable means of determining the location of the inferior alveolar canal and its relationship to the roots of the lower third molar. CBCT scanners provided adequate image quality for dental and maxillofacial imaging while delivering considerably smaller effective doses to the patient than MSCT. The observed variations in patient dose and image quality emphasize the importance of optimizing the imaging parameters in both CBCT and MSCT.

Prevention of muddy taints in farmed barramundi

Recommended best practice protocols to manage water quality within growout systems and the measurable impact on barramundi flavour.

Revenue loss minimisation in farmed prawns

Best practice protocols for on-farm management of prawn quality to meet market requirements.

Impact of control strategies on bellyache bush (Jatropha gossypiifolia L.) mortality, seedling recruitment, population dynamics, pasture yield and cost analysis

Bellyache bush (Jatropha gossypiifolia L.) is an invasive weed that has the potential to greatly reduce biodiversity and pasture productivity in northern Australia’s rangelands. This paper reports an approach to develop best practice options for controlling medium to dense infestations of bellyache bush using combinations of control methods. The efficacy of five single treatments including foliar spraying, slashing, stick raking, burning and do nothing (control) were compared against 15 combinations of these treatments over 4 successive years. Treatments were evaluated using several attributes, including plant mortality, changes in population demographics, seedling recruitment, pasture yield and cost of treatment. Foliar spraying once each year for 4 years proved the most cost-effective control strategy, with no bellyache bush plants recorded at the end of the study. Single applications of slashing, stick raking and to a lesser extent burning, when followed up with foliar spraying also led to significantly reduced densities of bellyache bush and changed the population from a growing one to a declining one. Total experimental cost estimates over 4 successive years for treatments where burning, stick raking, foliar spraying, and slashing were followed with foliar spraying were AU$408, AU$584, AU$802 and AU$789 ha–1, respectively. Maximum pasture yield of 5.4 t ha–1 occurred with repeated foliar spraying. This study recommends that treatment combinations using either foliar spraying alone or as a follow up with slashing, stick raking or burning are best practice options following consideration of the level of control, changes in pasture yield and cost effectiveness.

Northern Grazing Systems Bioeconomic analysis and regional assessment

This project is part of the Northern Grazing Systems (NGS) projects which aim to increase adoption of innovative best-practice grazing management by beef producers throughout Queensland, Northern Territory and the Kimberley and Pilbara regions of Western Australia.