Epidemiologic merit of obese-years, the combination of degree and duration of obesity

This study aims to test the effect of combining the degree and the duration of obesity into a single variable-obese-years-and to examine whether obese-years is a better predictor of the risk of diabetes than simply body mass index (BMI) or duration of obesity. Of the original cohort of the Framingham Heart Study, 5,036 participants were followed up every 2 years for up to 48 years (from 1948). The variable, obese-years, was defined by multiplying for each participant the number of BMI units above 30 kg/m(2) by the number of years lived at that BMI. Associations with diabetes were analyzed by using time-dependent Cox proportional hazards regression models adjusted for potential confounders. The incidence of type-2 diabetes increased as the number of obese-years increased, with adjusted hazard ratios of 1.07 (95% confidence interval: 1.06, 1.09) per additional 10 obese-years. The dose-response relation between diabetes incidence and obese-years varied by sex and smoking status. The Akaike Information Criterion was lowest in the model containing obese-years compared with models containing either the degree or duration of obesity alone. A construct of obese-years is strongly associated with risk of diabetes and could be a better indicator of the health risks associated with increasing body weight than BMI or duration of obesity alone.

The process of design based learning : a students' perspective

BACKGROUND : Deakin engineering has used Design Based Learning (DBL) as one of its engineering learning principles for further development in teaching and learning. Whilst the students are surveyed after every unit, this data only provides a generic overview of the process and does not help the academic staff determine if DBL is a preferable learning and teaching approach. What is required to improve the process is a holistic approach from the students’ perspective over the entire degree program.

PURPOSE : Do students see any value in DBL and should it be is further developed for teaching and learning? This study examines students’ perceptions of DBL in their curriculum, DBL in final year project, DBL in engineering career.

DESIGN/METHOD : A survey dedicated to DBL from the students’ point of view has been designed and given to 30 fulltime students in 3rd year in engineering at Deakin. A qualitative and quantitative analysis of this survey will give students’ perspective of DBL as they progress through their degree studies.

RESULTS : The full time students’ surveyed indicated that they believed that DBL was a useful tool and was of value to their career. Also that it would be helpful as part of their final project and that it helps teamwork although they would like to see it used for both team and individual work.

CONCLUSIONS : The full time students’ surveyed displayed a basic understanding of DBL and an eagerness to use it. Students’ perceived that DBL approach got an important value in their learning curriculum and it is a positive sign for the Deakin engineering to use it as one of its engineering learning principle.

Effect of the degree of crystallinity on the electrochemical behavior of Mg65Cu25Y10 and Mg70Zn25Ca5 bulk metallic glasses

The effect of varying the percent crystallinity on the electrochemical behavior of Mg65Cu25Y10 and Mg70Zn25Ca5 bulk metallic glasses was studied. The alloys were heat-treated to achieve desired microstructures ranging from fully amorphous to fully crystalline, providing a systematic basis for subsequent testing. Potentiodynamic experiments in 0.01 M sodium chloride (NaCl) were used, whereby both the amorphous and partially crystallized samples were observed to have more noble corrosion potentials and lower anodic kinetics. However, this was accompanied by more rapid cathodic kinetics relative to their fully crystalline counterparts, meaning that corrosion rates were not significantly lower in the amorphous state. To describe the electrochemical response as a function of the degree of crystallinity, differential scanning calorimetry (DSC), scanning electron microscopy, x-ray diffraction (XRD), and electrical conductivity measurements were undertaken, where it was found that crystallinity alone is not necessarily the controlling factor and microchemistry that evolves upon devitrification, plays a key role in the electrochemical response of these materials.

An algorithm for determination of rank and degree of contribution of sMRI volumetric features in depression detection

Brain volume changes at structural level appear to have utmost importance in depression biomarkers studies. However, these brain volumetric findings have very minimal utilization in depression detection studies at individual level. Thus, this paper presents an evaluation of volumetric features to identify the relevant/optimal features for the detection of depression. An algorithm is presented for determination of rank and degree of contribution (DoC) of structural magnetic resonance imaging (sMRI) volumetric features. The algorithm is based on the frequencies of each feature contribution toward the desired accuracy limit. Forty-four volumetric features from various brain regions were adopted for evaluation. From DoC analysis, the DoC of each volumetric feature for depression detection is calculated and the features that dominate the contribution are determined.

Pathway from vocational education and associate degree to higher education: Chinese international students in Australia

Understanding factors influencing international students' decision to engage in international education is essential for education providers to better cater for students' educational expectations and enhance their attractiveness to international students. Whilst there has been extensive research on the reasons why international students undertake cross-border higher education, international students' motivations for enrolling in vocational education and associate degree programmes are still under-researched. Drawing on semi-structured interviews with 30 international students from China, this research found that pathway to higher education appears to be the most important factor motivating international students to undertake vocational education and associate degree programmes. In addition, prospect of immigration, English language proficiency, previous academic performance, agent's recommendations and relatives' and friends' advice are amongst the important factors that students take into account in their decision to choose vocational education and associate degree programmes. This research also examines why Chinese international students have chosen vocational education programmes in a dual-sector university over vocational education colleges. It found that the flexibility to articulate to higher education, international reputation of the programme, practical training and favourable location are key issues that these students draw on when making their decision to study in a dual-sector university.

Use and perceptions of worked example videos for first-year students studying mathematics in a primary education degree

Worked example videos have great potential to be useful for students when learning mathematics as they can work through the questions at their own pace, pausing as needed, but still learn from the way the demonstrator thinks and solves problems. We created worked example videos each week for a mathematics subject taught in the first year of a primary education degree and investigated student perceptions and their usage patterns. An additional aspect of this undertaking was the inclusion of subtitles to make the videos accessible to hearing impaired and ESL students. This report will reflect on the process of creating these videos, as well as some initial findings on their success.

Comparing mortality outcomes of major burns and toxic epidermal necrolysis in a tertiary burns centre

 Introduction
Our aim was to provide descriptive information to burn clinicians, who have extensive experience treating major burns and determining prognosis, as to whether significant differences in mortality exist between major burns injuries and the comparatively less common toxic epidermal necrolysis for a given age and total body surface area percentage.

Methods
Retrospective data was analyzed of all deceased patients admitted to the Victorian Adult Burns Service in Melbourne, Australia over a period of 10 years with greater than 30% total body surface area burned or greater than 30% total body surface area epidermal detachment in the case of toxic epidermal necrolysis. Retrospective data was also collected on all patients, survivors and deceased, with toxic epidermal necrolysis and these patients were matched with burns patients by age and % total body surface area burned. Comparisons in outcomes were performed with mortality being the primary variable of interest.

Results
Toxic epidermal necrolysis patients that died were older (median: 68.5 vs 57 yrs; P = 0.04), had a longer length of hospital stay (36.5 vs 0.8 days; P = 0.001) and significantly longer periods of mechanical ventilation (1404 vs 14.5 h; P = 0.011) than major burns patients that died. When toxic epidermal necrolysis patients were matched to major burns patients by age and total body surface area burned, there were no significant differences between the two groups with respect to mortality.

Conclusion
Palliative care approaches are more frequently administered at the time of presentation for major burns patients in comparison to toxic epidermal necrolysis patients. This may be due to a perception that if toxic epidermal necrolysis patients can survive their initial systemic injury, they are likely to survive, as opposed to major burns patients who often undergo extensive surgery and for whom other factors should be taken into account in the context of end-of-life decision making.

A systematic review of the management and outcome of toxic epidermal necrolysis treated in burns centres

Introduction
Toxic epidermal necrolysis (TEN) is a rare condition characterised by mucocutaneous exfoliation of greater than 30% total body surface area (%TBSA), increasingly being treated in burns centres. The rate of mortality varies significantly in the literature, with recent prospective studies in non-burns centres reporting percentage mortality of approximately 45%. We undertook a systematic review of published studies that included TEN patients treated specifically in burns centres to determine a cumulative mortality rate.

Methods
Electronic searches of MEDLINE, EMBASE and The Cochrane Library (Issue 4, 2010) databases from 1966 onwards were used to identify English articles related to the treatment of TEN in burns centres.

Results
The systematic literature search identified 20 studies which specifically described patients with TEN grater than 30% %TBSA. Treatment regimens varied amongst studies, as did mortality. The overall percentage mortality of the combined populations was 30%. Risk factors commonly described as associated with mortality included age, %TBSA and delay to definitive treatment.

Conclusion
The review highlights the variation between principles of treatment and mortality amongst burns centres. It offers a standard that burns centre can use to internationally compare their mortality rates. The review supports the ongoing reporting of outcomes in TEN patients with epidermal detachment greater than 30%.

Mortality and use of the auxiliary score in extensive toxic epidermal necrolysis patients admitted to an adult burns referral centre

 Background: Toxic epidermal necrolysis (TEN) is a rare but fatal condition characterised by cutaneous exfoliation of the dermoepidermal layer and mucosal surfaces. Extensive TEN with epidermal detachment >30% of the total body surface area has been associated with a high mortality. Objective: This study aims to evaluate factors associated with mortality in extensive TEN. In the absence of data to qualify scoring systems such as SCORTEN, this study also aims to evaluate the use of the auxiliary score as a tool for calculating expected mortality. Methods: A retrospective chart review of all patients presenting to our burns service with extensive TEN was undertaken. Application and evaluation of the auxiliary score was also undertaken for this patient population. Results: In extensive TEN, age and delay in admission to a burns centre were factors associated with mortality. Applying the auxiliary score to our patient population, there were no significant differences between expected mortality and observed mortality. Conclusion: Mortality was associated with age and delay in definitive treatment in extensive TEN. Whilst SCORTEN is the gold standard prognostic tool for patients with TEN, in the absence of SCORTEN values, the auxiliary score provides an alternative scoring system to evaluate expected mortality.