Implementation and evaluation of a new model of nursing practice in radiation oncology

Patients undergoing radiation therapy for cancer face a series of challenges that require support from a multidisciplinary team which includes radiation oncology nurses. However, the specific contribution of nursing, and the models of care that best support the delivery of nursing interventions in the radiotherapy setting, is not well described. In this case study, the Interaction Model of Client Health Behaviour and the associated principles of person-centred care were incorporated into a new model of care that was implemented in one radiation oncology setting in Brisbane, Australia. The new model of care was operationalised through a Primary Nursing/Collaborative Practice framework. To evaluate the impact of the new model for patients and health professionals, multiple sources of data were collected from patients and clinical staff prior to, during, and 18 months following introduction of the practice redesign. One cohort of patients and clinical staff completed surveys incorporating measures of key outcomes immediately prior to implementation of the model, while a second cohort of patients and clinical staff completed these same surveys 18 months following introduction of the model. In-depth interviews were also conducted with nursing, medical and allied health staff throughout the implementation phase to obtain a more comprehensive account of the processes and outcomes associated with implementing such a model. From the patients’ perspectives, this study demonstrated that, although adverse effects of radiotherapy continue to affect patient well-being, patients continue to be satisfied with nursing care in this specialty, and that they generally reported high levels of functioning despite undergoing a curative course of radiotherapy. From the health professionals’ perspective, there was evidence of attitudinal change by nursing staff within the radiotherapy department which reflected a greater understanding and appreciation of a more person-centred approach to care. Importantly, this case study has also confirmed that a range of factors need to be considered when redesigning nursing practice in the radiotherapy setting, as the challenges associated with changing traditional practices, ensuring multidisciplinary approaches to care, and resourcing a new model were experienced. The findings from this study suggest that the move from a relatively functional approach to a person-centred approach in the radiotherapy setting has contributed to some improvements in the provision of individualised and coordinated patient care. However, this study has also highlighted that primary nursing may be limited in its approach as a framework for patient care unless it is supported by a whole team approach, an appropriate supportive governance model, and sufficient resourcing. Introducing such a model thus requires effective education, preparation and ongoing support for the whole team. The challenges of providing care in the context of complex interdisciplinary relationships have been highlighted by this study. Aspects of this study may assist in planning further nursing interventions for patients undergoing radiotherapy for cancer, and continue to enhance the contribution of the radiation oncology nurse to improved patient outcomes.

Living the nation

Belonging to and identifying with a nation has, since the latter half of the 18th century, been a distinctly human quality. To be human is to be part of a nation. Yet, contemporary theorists such as Appadurai and Fukuyama argue this universal human trait is undergoing vast change, threatened, it seems, by irrelevance and obsolescence, a return to tribalism and widened conceptual horizons represented by the likes of transnationalism and cosmopolitanism. These same threats are often attributed to the changing ideas and experience of spatiality and temporality enabled by information and communication technologies such as the Internet, spurred on by the rising intensity of flow amongst and within the human population. This paper argues that in the analysis of changes to the nation—which I suggest is best considered as the nexus of the body politic, the social body and human bodies—it is the notion of lived time and lived space that is most appropriate. The notion of the lived is borrowed and extended from Henri Lefebvre, who theorises that between mentally conceived and physically perceived space, lies its socially lived counterpart, which he defines as “the materialisation of social being”. As such, lived space (and time) draws on both its material and mental aspects. It is the thesis of this paper that against such a background as lived time and lived space the nation becomes much more than a political concept and/or project and is revealed as lived phenomenon, experienced in and through the dynamics of everyday praxis. Inherent to this argument is the understanding that it is the interplay between the possibilities imagined of the nation and; its eventual realisation through social acts and practices that marks it as a profoundly human institution.

Improving detection probabilities for pests in stored grains

BACKGROUND: The presence of insects in stored grains is a significant problem for grain farmers, bulk grain handlers and distributors worldwide. Inspections of bulk grain commodities is essential to detect pests and therefore to reduce the risk of their presence in exported goods. It has been well documented that insect pests cluster in response to factors such as microclimatic conditions within bulk grain. Statistical sampling methodologies for grains, however, have typically considered pests and pathogens to be homogeneously distributed throughout grain commodities. In this paper we demonstrate a sampling methodology that accounts for the heterogeneous distribution of insects in bulk grains. RESULTS: We show that failure to account for the heterogeneous distribution of pests may lead to overestimates of the capacity for a sampling program to detect insects in bulk grains. Our results indicate the importance of the proportion of grain that is infested in addition to the density of pests within the infested grain. We also demonstrate that the probability of detecting pests in bulk grains increases as the number of sub-samples increases, even when the total volume or mass of grain sampled remains constant. CONCLUSION: This study demonstrates the importance of considering an appropriate biological model when developing sampling methodologies for insect pests. Accounting for a heterogeneous distribution of pests leads to a considerable improvement in the detection of pests over traditional sampling models.

Parents as coteachers of science and technology in a middle-school classroom

This study explores coteaching/cogenerative dialoguing with parents to investigate how it may be employed to engage parents more meaningfully in schools. The cogens provided a space where participants became aware of resources available for coteaching, made decisions about planning and enacting coteaching, as well as interstitial culture that facilitated positive parent-teacher relationships.

Life-cycle management of construction projects based on virtual prototyping technology

Life-cycle management (LCM) has been employed in the management of construction projects for many years in order to reduce whole life cost, time, risk and improve the service to owners. However, owing to lack of an effective information sharing platform, the current LCM of construction projects is not effectively used in the construction industry. Based upon the analysis of the information flow of LCM, a virutal prototyping (VP)-based communication and collaboration information platform is proposed. Following this, the platform is customized using DASSAULT sofware. The whole process of implementing the VP-based LCM are also discussed and, from a simple case study, it is demonstrated that the VP-based communication and collaboration information platform is an effective tool to support the LCM of construction projects.

The role of the rule of law in virtual communities

There is a severe tendency in cyberlaw theory to delegitimize state intervention in the governance of virtual communities. Much of the existing theory makes one of two fundamental flawed assumptions: that communities will always be best governed without the intervention of the state; or that the territorial state can best encourage the development of communities by creating enforceable property rights and allowing the market to resolve any disputes. These assumptions do not ascribe sufficient weight to the value-laden support that the territorial state always provides to private governance regimes, the inefficiencies that will tend to limit the development utopian communities, and the continued role of the territorial state in limiting autonomy in accordance with communal values. In order to overcome these deterministic assumptions, this article provides a framework based upon the values of the rule of law through which to conceptualise the legitimacy of the private exercise of power in virtual communities. The rule of law provides a constitutional discourse that assists in considering appropriate limits on the exercise of private power. I argue that the private contractual framework that is used to govern relations in virtual communities ought to be informed by the values of the rule of law in order to more appropriately address the governance tensions that permeate these spaces. These values suggest three main limits to the exercise of private power: that governance is limited by community rules and that the scope of autonomy is limited by the substantive values of the territorial state; that private contractual rules should be general, equal, and certain; and that, most importantly, internal norms be predicated upon the consent of participants.

A new approach for finding an appropriate combination of texture parameters for classification

This paper suggests an approach for finding an appropriate combination of various parameters for extracting texture features (e.g. choice of spectral band for extracting texture feature, size of the moving window, quantization level of the image, and choice of texture feature etc.) to be used in the classification process. Gray level co-occurrence matrix (GLCM) method has been used for extracting texture from remotely sensed satellite image. Results of the classification of an Indian urban environment using spatial property (texture), derived from spectral and multi-resolution wavelet decomposed images have also been reported. A multivariate data analysis technique called ‘conjoint analysis’ has been used in the study to analyze the relative importance of these parameters. Results indicate that the choice of texture feature and window size have higher relative importance in the classification process than quantization level or the choice of image band for extracting texture feature. In case of texture features derived using wavelet decomposed image, the parameter ‘decomposition level’ has almost equal relative importance as the size of moving window and the decomposition of images up to level one is sufficient and there is no need to go for further decomposition. It was also observed that the classification incorporating texture features improves the overall classification accuracy in a statistically significant manner in comparison to pure spectral classification.

Dwell-time and run-time control for DC mass rapid transit railways

Dwell times at stations and inter-station run times are the two major operational parameters to maintain train schedule in railway service. Current practices on dwell-time and run-time control are that they are only optimal with respect to certain nominal traffic conditions, but not necessarily the current service demand. The advantages of dwell-time and run-time control on trains are therefore not fully considered. The application of a dynamic programming approach, with the aid of an event-based model, to devise an optimal set of dwell times and run times for trains under given operational constraints over a regional level is presented. Since train operation is interactive and of multi-attributes, dwell-time and run-time coordination among trains is a multi-dimensional problem. The computational demand on devising trains' instructions, a prime concern in real-time applications, is excessively high. To properly reduce the computational demand in the provision of appropriate dwell times and run times for trains, a DC railway line is divided into a number of regions and each region is controlled by a dwell- time and run-time controller. The performance and feasibility of the controller in formulating the dwell-time and run-time solutions for real-time applications are demonstrated through simulations.

Lift@Weimar : sustainable interaction with food, technology, and the city (Workshop)

This workshop explores innovative approaches to understanding and cultivating sustainable food culture in urban environments via human-computer-interaction (HCI) design and ubiquitous technologies. We perceive the city as an intersecting network of people, place, and technology in constant transformation. Our 2009 OZCHI workshop, Hungry 24/7? HCI Design for Sustainable Food Culture, opened a new space for discussion on this intersection amongst researchers and practitioners from diverse backgrounds including academia, government, industry, and non-for-profit organisations. Building on the past success, this new instalment of the workshop series takes a more refined view on mobile human-food interaction and the role of interactive media in engaging citizens to cultivate more sustainable everyday human-food interactions on the go. Interactive media in this sense is distributed, pervasive, and embedded in the city as a network. The workshop addresses environmental, health, and social domains of sustainability by bringing together insights across disciplines to discuss conceptual and design approaches in orchestrating mobility and interaction of people and food in the city as a network of people, place, technology, and food.

Determination of a set of surrogate parameters to assess urban stormwater quality

This paper presents the outcomes of a research project, which focused on developing a set of surrogate parameters to evaluate urban stormwater quality using simulated rainfall. Use of surrogate parameters has the potential to enhance the rapid generation of urban stormwater quality data based on on-site measurements and thereby reduce resource intensive laboratory analysis. The samples collected from rainfall simulations were tested for a range of physico-chemical parameters which are key indicators of nutrients, solids and organic matter. The analysis revealed that [total dissolved solids (TDS) and dissolved organic carbon (DOC)]; [total solids (TS) and total organic carbon (TOC)]; [turbidity (TTU)]; [electrical conductivity (EC)]; [TTU and EC] as appropriate surrogate parameters for dissolved total nitrogen (DTN), total phosphorus (TP), total suspended solids (TSS), TDS and TS respectively. Relationships obtained for DTN-TDS, DTN-DOC, and TP-TS demonstrated good portability potential. The portability of the relationship developed for TP and TOC was found to be unsatisfactory. The relationship developed for TDS-EC and TS-EC also demonstrated poor portability.

Metal Contaminants in Leachate from Sanitary Landfills

The uncontrolled disposal of solid wastes poses an immediate threat to public health and a long term threat to the environmental well being of future generations. Solid waste is waste resulting from human activities that is solid and unwanted (Peavy et al., 1985). If unmanaged, dumped solid wastes generate liquid and gaseous emissions that are detrimental to the environment. This can lead to a serious form of contamination known as metal contamination, which poses a risk to human health and ecosystems. For example, some heavy metals (cadmium, chromium compounds, and nickel tetracarbonyl) are known to be highly toxic, and are aggressive at elevated concentrations. Iron, copper, and manganese can cause staining, and aluminium causes depositions and discolorations. In addition, calcium and magnesium cause hardness in water causing scale deposition and scum formation. Though not a metal but a metalloid, arsenic is poisonous at relatively high concentrations and when diluted at low concentrations causes skin cancer. Normally, metal contaminants are found in a dissolved form in the liquid percolating through landfills. Because average metal concentrations from full-scale landfills, test cells, and laboratory studies have tended to be generally low, metal contamination originating from landfills is not generally considered a major concern (Kjeldsen et al., 2002; Christensen et al., 1999). However, a number of factors make it necessary to take a closer look at metal contaminants from landfills. One of these factors relates to variability. Landfill leachate can have different qualities depending on the weather and operating conditions. Therefore, at one moment in time, metal contaminant concentrations may be quite low, but at a later time these concentrations could be quite high. Also, these conditions relate to the amount of leachate that is being generated. Another factor is biodiversity. It cannot be assumed that a particular metal contaminant is harmless to flora and fauna (including micro organisms) just because it is harmless to human health. This has significant implications for ecosystems and the environment. Finally, there is the moral factor. Because uncertainty surrounds the potential effects of metal contamination, it is appropriate to take precautions to prevent it from taking place. Consequently, it is necessary to have good scientific knowledge (empirically supported) to adequately understand the extent of the problem and improve the way waste is being disposed of

Pet food from bovine origin drying by green heat pump technology and fluidization

Bovine intestine was dried in a heat pump fluid bed combination. Minimum fluidisation velocity was calculated by Ergun Equation and some relations were established.

Adherence to medicines in the older-aged with chronic conditions : does an intervention concerning adherence by an allied health professional help?

Adherence to medicines is a major determinant of the effectiveness of medicines. However, estimates of non-adherence in the older-aged with chronic conditions vary from 40 to 75%. The problems caused by non-adherence in the older-aged include residential care and hospital admissions, progression of the disease, and increased costs to society. The reasons for non-adherence in the older-aged include items related to the medicine (e.g. cost, number of medicines, adverse effects) and those related to person (e.g. cognition, vision, depression). It is also known that there are many ways adherence can be increased (e.g. use of blister packs, cues). It is assumed that interventions by allied health professions, including a discussion of adherence, will improve adherence to medicines in the older aged but the evidence for this has not been reviewed. There is some evidence that telephone counselling about adherence by a nurse or pharmacist does improve adherence, short- and long-term. However, face-to-face intervention counselling at the pharmacy, or during a home visit by a pharmacist, has shown variable results with some studies showing improved adherence and some not. Education programs during hospital stays have not been shown to improve adherence on discharge, but education programs for subjects with hypertension have been shown to improve adherence. In combination with an education program, both counselling and a medicine review program have been shown to improve adherence short-term in the older-aged. Thus, there are many unanswered questions about the most effective interventions to promote adherence. More studies are needed to determine the most appropriate interventions by allied health professions, and these need to consider the disease state, demographics, and socio-economic status of the older-aged subject, and the intensity and duration of intervention needed.

Assessing wet crashes for the skid resistance management of road assets

Australia, road crash trauma costs the nation A$15 billion annually whilst the US estimates an economic impact of around US$ 230 billion on its network. Worldwide economic cost of road crashes is estimated to be around US$ 518 billion each year. Road accidents occur due to a number of factors including driver behaviour, geometric alignment, vehicle characteristics, environmental impacts, and the type and condition of the road surfacing. Skid resistance is considered one of the most important road surface characteristics because it has a direct effect on traffic safety. In 2005, Austroads (the Association of Australian and New Zealand Road Transport and Traffic Authorities) published a guideline for the management of skid resistance and Queensland Department of Main Roads (QDMR) developed a skid resistance management plan (SRMP). The current QDMR strategy is based on rationale analytical methodology supported by field inspection with related asset management decision tools. The Austroads’s guideline and QDMR's skid resistance management plan have prompted QDMR to review its skid resistance management practice. As a result, a joint research project involving QDMR, Queensland University of Technology (QUT) and the Corporative Research Centre for Integrated Engineering Asset Management (CRC CIEAM) was formed. The research project aims at investigating whether there is significant relationship between road crashes and skid resistance on Queensland’s road networks. If there is, the current skid resistance management practice of QDMR will be reviewed and appropriate skid resistance investigatory levels will be recommended. This paper presents analysis results in assessing the relationship between wet crashes and skid resistance on Queensland roads. Attributes considered in the analysis include surface types, annual average daily traffic (AADT), speed and seal age.

Application of reliability-centred maintenance technology on electric trains

This paper demonstrates the application of the reliability-centred maintenance (RCM) process to analyse and develop preventive maintenance tasks for electric multiple units (EMU) in the East Rail of the Kowloon-Canton Railway Corporation (KCRC). Two systems, the 25 kV electrical power supply and the air-conditioning system of the EMU, have been chosen for the study. RCM approach on the two systems is delineated step by step in the paper. This study confirms the feasibility and effectiveness of RCM applications on the maintenance of electric trains.