Health Assessment and Physical Examination

"This first Australia and New Zealand edition of the comprehensive Estes’ Health Assessment and Physical Examination is designed to teach students to assess a patient’s physical, psychological, cultural and emotional dimensions of health as a foundation of nursing care. The skills of interviewing, inspection, percussion, palpation, auscultation, and documentation are defined to help students to make clinical assessments and promote healthy patient outcomes. A strong emphasis on science encompasses all the technical aspects of anatomy, physiology and assessment, while highlighting clinically relevant information. Emphasis on caring is displayed through themes of assessment of the whole person, which also encourages nurses to think about care for themselves as well as patients."--publisher website

Deriving a preference-based measure for cancer using the EORTC QLQ-C30 : a confirmatory versus exploratory approach

Background: To derive preference-based measures from various condition-specific descriptive health-related quality of life (HRQOL) measures. A general 2-stage method is evolved: 1) an item from each domain of the HRQOL measure is selected to form a health state classification system (HSCS); 2) a sample of health states is valued and an algorithm derived for estimating the utility of all possible health states. The aim of this analysis was to determine whether confirmatory or exploratory factor analysis (CFA, EFA) should be used to derive a cancer-specific utility measure from the EORTC QLQ-C30. Methods: Data were collected with the QLQ-C30v3 from 356 patients receiving palliative radiotherapy for recurrent or metastatic cancer (various primary sites). The dimensional structure of the QLQ-C30 was tested with EFA and CFA, the latter based on a conceptual model (the established domain structure of the QLQ-C30: physical, role, emotional, social and cognitive functioning, plus several symptoms) and clinical considerations (views of both patients and clinicians about issues relevant to HRQOL in cancer). The dimensions determined by each method were then subjected to item response theory, including Rasch analysis. Results: CFA results generally supported the proposed conceptual model, with residual correlations requiring only minor adjustments (namely, introduction of two cross-loadings) to improve model fit (increment χ2(2) = 77.78, p < .001). Although EFA revealed a structure similar to the CFA, some items had loadings that were difficult to interpret. Further assessment of dimensionality with Rasch analysis aligned the EFA dimensions more closely with the CFA dimensions. Three items exhibited floor effects (>75% observation at lowest score), 6 exhibited misfit to the Rasch model (fit residual > 2.5), none exhibited disordered item response thresholds, 4 exhibited DIF by gender or cancer site. Upon inspection of the remaining items, three were considered relatively less clinically important than the remaining nine. Conclusions: CFA appears more appropriate than EFA, given the well-established structure of the QLQ-C30 and its clinical relevance. Further, the confirmatory approach produced more interpretable results than the exploratory approach. Other aspects of the general method remain largely the same. The revised method will be applied to a large number of data sets as part of the international and interdisciplinary project to develop a multi-attribute utility instrument for cancer (MAUCa).

Accident risk identification and its impact analyses for strategic construction safety management

The study presented in this paper reviewed 9,358 accidents which occurred in the U.S. construction industry between 2002 and 2011, in order to understand the relationships between the risk factors and injury severity (e.g. fatalities, hospitalized injuries, or non-hospitalized injuries) and to develop a strategic prevention plan to reduce the likelihood of fatalities where an accident is unavoidable. The study specifically aims to: (1) verify the relationships among risk factors, accident types, and injury severity, (2) determine significant risk factors associated with each accident type that are highly correlated to injury severity, and (3) analyze the impact of the identified key factors on accident and fatality occurrence. The analysis results explained that safety managers’ roles are critical to reducing human-related risks—particularly misjudgement of hazardous situations—through safety training and education, appropriate use of safety devices and proper safety inspection. However, for environment-related factors, the dominant risk factors were different depending on the different accident types. The outcomes of this study will assist safety managers to understand the nature of construction accidents and plan for strategic risk mitigation by prioritizing high frequency risk factors to effectively control accident occurrence and manage the likelihood of fatal injuries on construction sites.

Intratherapist reliability in the rating of scapula posture in multiple planes of reference

Background: Evaluation of scapular posture is a fundamental component in the clinical evaluation of the upper quadrant. This study examined the intrarater reliability of scapular posture ratings. Methods: A test-retest reliability investigation was undertaken with one week between assessment sessions. At each session physical therapists conducted visual assessments of scapula posture (relative to the thorax) in five different scapula postural planes (plane of scapula, sagittal plane, transverse plane, horizontal plane, and vertical plane). These five plane ratings were performed for four different scapular posture perturbating conditions (rest, isometric shoulder; flexion, abduction, and external rotation). Results. A total of 100 complete scapular posture ratings (50 left, 50 right) were undertaken at each assessment. The observed agreement between the test and retest postural plane ratings ranged from 59% to 87%; 16 of the 20 plane-condition combinations exceeded 75% observed agreement. Kappa (and prevalence adjusted bias adjusted kappa) values were inconsistent across the postural planes and perturbating conditions. Conclusions: This investigation generally revealed fair to moderate intrarater reliability in the rating of scapular posture by visual inspection. However, enough disagreement between assessments was present to warrant caution when interpreting perceived changes in scapula position between longitudinal assessments using visual inspection alone.

The high price of hesitation where time of the essence

The decision of Lai v Soineva [2011] QSC 247 in relation to the operation of standard conditions in the Queensland REIQ contract highlights a very practical issue often overlooked in the heat of a transaction .The point is relatively simple. In this instance ,the case concerned the interpretation of the printed "Building and Pest Inspection Clause" but is of relevance to the printed "Finance Clause" in the same contract as the wording and principles are identical. It highlights the issue of knowing well what is in the standard contract and not making assumptions. The case also highlights the cost to a party of dithering in making an election in a time of the essence environment

Hybrid game evolutionary algorithm for mission path planning of aerial survey tasks

The aim of this paper is to implement a Game-Theory based offline mission path planner for aerial inspection tasks of large linear infrastructures. Like most real-world optimisation problems, mission path planning involves a number of objectives which ideally should be minimised simultaneously. The goal of this work is then to develop a Multi-Objective (MO) optimisation tool able to provide a set of optimal solutions for the inspection task, given the environment data, the mission requirements and the definition of the objectives to minimise. Results indicate the robustness and capability of the method to find the trade-off between the Pareto-optimal solutions.

Service condition of railroad corridors around the insulated rail joints

Railroad corridors contain large number of Insulated Rail Joints (IRJs) that act as safety critical elements in the circuitries of the signaling and broken rail identification systems. IRJs are regarded as sources of excitation for the passage of loaded wheels leading to high impact forces; these forces in turn cause dips, cross levels and twists to the railroad geometry in close proximity to the sections containing the IRJs in addition to the local damages to the railhead of the IRJs. Therefore, a systematic monitoring of the IRJs in railroad is prudent to mitigate potential risk of their sudden failure (e.g., broken tie plates) under the traffic. This paper presents a simple method of periodic recording of images using time-lapse photography and total station surveying measurements to understand the ongoing deterioration of the IRJs and their surroundings. Over a 500 day period, data were collected to examine the trends in narrowing of the joint gap due to plastic deformation the railhead edges and the dips, cross levels and twists caused to the railroad geometry due to the settlement of ties (sleepers) around the IRJs. The results reflect that the average progressive settlement beneath the IRJs is larger than that under the continuously welded rail, which leads to excessive deviation of railroad profile, cross levels and twists.

Image based visual servo control for fixed wing UAVs tracking linear infrastructure in wind

This paper presents an Image Based Visual Servo control design for Fixed Wing Unmanned Aerial Vehicles tracking locally linear infrastructure in the presence of wind using a body fixed imaging sensor. Visual servoing offers improved data collection by posing the tracking task as one of controlling a feature as viewed by the inspection sensor, although is complicated by the introduction of wind as aircraft heading and course angle no longer align. In this work it is shown that the effects of wind alter the desired line angle required for continuous tracking to equal the wind correction angle as would be calculated to set a desired course. A control solution is then sort by linearizing the interaction matrix about the new feature pose such that kinematics of the feature can be augmented with the lateral dynamics of the aircraft, from which a state feedback control design is developed. Simulation results are presented comparing no compensation, integral control and the proposed controller using the wind correction angle, followed by an assessment of response to atmospheric disturbances in the form of turbulence and wind gusts

Sensors for missions

An onboard payload may be seen in most instances as the “Raison d’Etre” for a UAV. It will define its capabilities, usability and hence market value. Large and medium UAV payloads exhibit significant differences in size and computing capability when compared with small UAVs. The latter have stringent size, weight, and power requirements, typically referred as SWaP, while the former still exhibit endless appetite for compute capability. The tendency for this type of UAVs (Global Hawk, Hunter, Fire Scout, etc.) is to increase payload density and hence processing capability. An example of this approach is the Northrop Grumman MQ-8 Fire Scout helicopter, which has a modular payload architecture that incorporates off-the-shelf components. Regardless of the UAV size and capabilities, advances in miniaturization of electronics are enabling the replacement of multiprocessing, power-hungry general-purpose processors for more integrated and compact electronics (e.g., FPGAs). Payloads play a significant role in the quality of ISR (intelligent, surveillance, and reconnaissance) data, and also in how quick that information can be delivered to the end user. At a high level, payloads are important enablers of greater mission autonomy, which is the ultimate aim in every UAV. This section describes common payload sensors and introduces two examples cases in which onboard payloads were used to solve real-world problems. A collision avoidance payload based on electro optical (EO) sensors is first introduced, followed by a remote sensing application for power line inspection and vegetation management.

A practical comparison of manual and autonomous methods for acoustic monitoring

1. Autonomous acoustic recorders are widely available and can provide a highly efficient method of species monitoring, especially when coupled with software to automate data processing. However, the adoption of these techniques is restricted by a lack of direct comparisons with existing manual field surveys. 2. We assessed the performance of autonomous methods by comparing manual and automated examination of acoustic recordings with a field-listening survey, using commercially available autonomous recorders and custom call detection and classification software. We compared the detection capability, time requirements, areal coverage and weather condition bias of these three methods using an established call monitoring programme for a nocturnal bird, the little spotted kiwi(Apteryx owenii). 3. The autonomous recorder methods had very high precision (>98%) and required <3% of the time needed for the field survey. They were less sensitive, with visual spectrogram inspection recovering 80% of the total calls detected and automated call detection 40%, although this recall increased with signal strength. The areal coverage of the spectrogram inspection and automatic detection methods were 85% and 42% of the field survey. The methods using autonomous recorders were more adversely affected by wind and did not show a positive association between ground moisture and call rates that was apparent from the field counts. However, all methods produced the same results for the most important conservation information from the survey: the annual change in calling activity. 4. Autonomous monitoring techniques incur different biases to manual surveys and so can yield different ecological conclusions if sampling is not adjusted accordingly. Nevertheless, the sensitivity, robustness and high accuracy of automated acoustic methods demonstrate that they offer a suitable and extremely efficient alternative to field observer point counts for species monitoring.

Influence of oxidation and reduction conditions upon the morphology of silica-supported polycrystalline silver catalysts

The effect of oxidation and reduction conditions upon the morphology of polycrystalline silver catalysts has been investigated by means of in situ Fourier-transform infrared (FTIR) spectroscopy. Characterization of the sample was achieved by inspection of the νas(COO) band profile of adsorbed formate, recorded after dosing with formic acid at ambient temperature. Evidence was obtained for the existence of a silver surface reconstructed by the presence of subsurface oxygen in addition to the conventional family of Ag(111) and Ag(110) crystal faces. Oxidation at 773 K facilitated the reconstruction of silver planes due to the formation of subsurface oxygen species. Prolonged oxygen treatment at 773 K also caused particle fragmentation as a consequence of excessive oxygen penetration of the silver catalyst at defect sites. It was also deduced that the presence of oxygen in the gas phase stabilized the growth of silver planes which could form stronger bonds with oxygen. In contrast, high-temperature thermal treatment in vacuum induced significant sintering of the silver catalyst. Reduction at 773 K resulted in substantial quantities of dissolved hydrogen (and probably hydroxy species) in the bulk silver structure. Furthermore, enhanced defect formation in the catalyst was also noted, as evidenced by the increased concentration of formate species associated with oxygen-reconstructed silver faces.

Genomic evidence for the parallel evolution of coastal forms in the Senecio lautus complex

Instances of parallel ecotypic divergence where adaptation to similar conditions repeatedly cause similar phenotypic changes in closely related organisms are useful for studying the role of ecological selection in speciation. Here we used a combination of traditional and next generation genotyping techniques to test for the parallel divergence of plants from the Senecio lautus complex, a phenotypically variable groundsel that has adapted to disparate environments in the South Pacific. Phylogenetic analysis of a broad selection of Senecio species showed that members of the S. lautus complex form a distinct lineage that has diversified recently in Australasia. An inspection of thousands of polymorphisms in the genome of 27 natural populations from the S. lautus complex in Australia revealed a signal of strong genetic structure independent of habitat and phenotype. Additionally, genetic differentiation between populations was correlated with the geographical distance separating them, and the genetic diversity of populations strongly depended on geographical location. Importantly, coastal forms appeared in several independent phylogenetic clades, a pattern that is consistent with the parallel evolution of these forms. Analyses of the patterns of genomic differentiation between populations further revealed that adjacent populations displayed greater genomic heterogeneity than allopatric populations and are differentiated according to variation in soil composition. These results are consistent with a process of parallel ecotypic divergence in face of gene flow.

Bending properties of Ag nanowires with pre-existing surface defects

Materials used in the engineering always contain imperfections or defects which significantly affect their performances. Based on the large-scale molecular dynamics simulation and the Euler–Bernoulli beam theory, the influence from different pre-existing surface defects on the bending properties of Ag nanowires (NWs) is studied in this paper. It is found that the nonlinear-elastic deformation, as well as the flexural rigidity of the NW is insensitive to different surface defects for the studied defects in this paper. On the contrary, an evident decrease of the yield strength is observed due to the existence of defects. In-depth inspection of the deformation process reveals that, at the onset of plastic deformation, dislocation embryos initiate from the locations of surface defects, and the plastic deformation is dominated by the nucleation and propagation of partial dislocations under the considered temperature. Particularly, the generation of stair-rod partial dislocations and Lomer–Cottrell lock are normally observed for both perfect and defected NWs. The generation of these structures has thwarted attempts of the NW to an early yielding, which leads to the phenomenon that more defects does not necessarily mean a lower critical force.

Robust vision-based underwater homing using self-similar landmarks

Next-generation autonomous underwater vehicles (AUVs) will be required to robustly identify underwater targets for tasks such as inspection, localization, and docking. Given their often unstructured operating environments, vision offers enormous potential in underwater navigation over more traditional methods; however, reliable target segmentation often plagues these systems. This paper addresses robust vision-based target recognition by presenting a novel scale and rotationally invariant target design and recognition routine based on self-similar landmarks that enables robust target pose estimation with respect to a single camera. These algorithms are applied to an AUV with controllers developed for vision-based docking with the target. Experimental results show that the system performs exceptionally on limited processing power and demonstrates how the combined vision and controller system enables robust target identification and docking in a variety of operating conditions.

Investigation of a food poisoning outbreak due to nitrite contained in cooked peanut [一起因食用煮花生米引起亚硝酸盐中毒的调查报告]

Two workers were hospitalised with similar symptoms. Information was gathered from patients, doctors, colleagues and food seller. Laboratory tests were undertaken on remaining food and vomits. We identified the source food and toxin responsible for this outbreak, and subsequently helped doctors to treat these patients. The intake was estimated to be over the fatal limit but both were fully recovered after treatment. Abstract in Chinese 2001年11月20日，寿光市植物油厂的2名装卸工人因食用花生米引起亚硝酸盐急性中毒，现报告如下。 1 中毒经过 11月20日下午，市植物油厂装卸工人秦×下班后，到本厂职工食堂买了馒头、大米稀饭和少许咸菜，然后到厂外买了1瓶白酒，又到个体菜摊李×处买了2元钱的煮花生米，约400g。17：40与同事江×一同在宿舍内饮酒吃饭，其中花生米大部分被秦×吃掉，江×吃得少。18：30左右秦×在装卸过程中出现双腿发软、恶心、呕吐、呼吸困难、视物模糊，江×随后也出现类似症状，2人被迅速送往寿光市人民医院进行抢救。到医院时已进入昏迷状态，查体可见全身皮肤粘膜青紫、手指脚趾发黑，经吸氧并心电监护、应用美兰静推后，江×症状减轻，于次日出院；秦×因中毒严重，于次日脱离危险，11月23日痊愈出院。……