Clinically indicated replacement versus routine replacement of peripheral venous catheters (Review)

Background Centers for Disease Control Guidelines recommend replacement of peripheral intravenous (IV) catheters every 72 to 96 hours. Routine replacement is thought to reduce the risk of phlebitis and bacteraemia. Catheter insertion is an unpleasant experience for patients and replacement may be unnecessary if the catheter remains functional and there are no signs of inflammation. Costs associated with routine replacement may be considerable. Objectives To assess the effects of removing peripheral IV catheters when clinically indicated compared with removing and re-siting the catheter routinely.

Value-oriented process modeling : integrating financial perspectives into business process re-design

Purpose – Financial information about costs and return on investments are of key importance to strategic decision-making but also in the context of process improvement or business engineering. In this paper we propose a value-oriented approach to business process modeling based on key concepts and metrics from operations and financial management, to aid decision making in process re-design projects on the basis of process models. Design/methodology/approach – We suggest a theoretically founded extension to current process modeling approaches, and delineate a framework as well as methodical support to incorporate financial information into process re-design. We use two case studies to evaluate the suggested approach. Findings – Based on two case studies, we show that the value-oriented process modeling approach facilitates and improves managerial decision-making in the context of process re-design. Research limitations / implications – We present design work and two case studies. More research is needed to more thoroughly evaluate the presented approach in a variety of real-life process modeling settings. Practical implications – We show how our approach enables decision makers to make investment decisions in process re-design projects, and also how other decisions, for instance in the context of enterprise architecture design, can be facilitated. Originality/value – This study reports on an attempt to integrate financial considerations into the act of process modeling, in order to provide more comprehensive decision making support in process re-design projects.

Ex vivo investigation of novel wound healing therapies and development of a 3-D human skin equivalent wound model

It has previously been found that complexes comprised of vitronectin and growth factors (VN:GF) enhance keratinocyte protein synthesis and migration. More specifically, these complexes have been shown to significantly enhance the migration of dermal keratinocytes derived from human skin. In view of this, it was thought that these complexes may hold potential as a novel therapy for healing chronic wounds. However, there was no evidence indicating that the VN:GF complexes would retain their effect on keratinocytes in the presence of chronic wound fluid. The studies in this thesis demonstrate for the first time that the VN:GF complexes not only stimulate proliferation and migration of keratinocytes, but also these effects are maintained in the presence of chronic wound fluid in a 2-dimensional (2-D) cell culture model. Whilst the 2-D culture system provided insights into how the cells might respond to the VN:GF complexes, this investigative approach is not ideal as skin is a 3-dimensional (3-D) tissue. In view of this, a 3-D human skin equivalent (HSE) model, which reflects more closely the in vivo environment, was used to test the VN:GF complexes on epidermopoiesis. These studies revealed that the VN:GF complexes enable keratinocytes to migrate, proliferate and differentiate on a de-epidermalised dermis (DED), ultimately forming a fully stratified epidermis. In addition, fibroblasts were seeded on DED and shown to migrate into the DED in the presence of the VN:GF complexes and hyaluronic acid, another important biological factor in the wound healing cascade. This HSE model was then further developed to enable studies examining the potential of the VN:GF complexes in epidermal wound healing. Specifically, a reproducible partial-thickness HSE wound model was created in fully-defined media and monitored as it healed. In this situation, the VN:GF complexes were shown to significantly enhance keratinocyte migration and proliferation, as well as differentiation. This model was also subsequently utilized to assess the wound healing potential of a synthetic fibrin-like gel that had previously been demonstrated to bind growth factors. Of note, keratinocyte re-epitheliasation was shown to be markedly improved in the presence of this 3-D matrix, highlighting its future potential for use as a delivery vehicle for the VN:GF complexes. Furthermore, this synthetic fibrin-like gel was injected into a 4 mm diameter full-thickness wound created in the HSE, both keratinocytes and fibroblasts were shown to migrate into this gel, as revealed by immunofluorescence. Interestingly, keratinocyte migration into this matrix was found to be dependent upon the presence of the fibroblasts. Taken together, these data indicate that reproducible wounds, as created in the HSEs, provide a relevant ex vivo tool to assess potential wound healing therapies. Moreover, the models will decrease our reliance on animals for scientific experimentation. Additionally, it is clear that these models will significantly assist in the development of novel treatments, such as the VN:GF complexes and the synthetic fibrin-like gel described herein, ultimately facilitating their clinical trial in the treatment of chronic wounds.

Re-invent yourself: from London intensive care nursing and the Nigerian oil fields to an an academic library in Brisbane; a career change worth making.

A complete change of career forces a seismic shift in every aspect of your life. From day one, you have to face the loss of long held beliefs, behaviours, the known world of self, and security. We came from professions that themselves are poles apart, and many of the challenges we faced entering the profession were the same: juggling full-time work, part time study, and family commitmemts, taking a pay cut, and loss of social life. But over a short period of time we both transitioned to our new profession successfully. so what make our successful transition possible?

Re-Lifing commercial buildings : design and construction solutions for existing buildings

The resources listed in this document describe the design and construction opportunities available to building owners who wish to re-Life their properties. They do not yet examine management opportunities, which may also help owners improve the efficiency of their existing stock.

Re-life of buildings - decision support tools for maximising project efficiency

This paper describes the process adopted in developing an integrated decision support framework for planning of office building refurbishment projects, with specific emphasize on optimising rentable floor space, structural strengthening, residual life and sustainability. Expert opinion on the issues to be considered in a tool is being captured through the DELPHI process, which is currently ongoing. The methodology for development of the integrated tool will be validated through decisions taken during a case study project: refurbishment of CH1 building of Melbourne City Council, which will be followed through to completion by the research team. Current status of the CH1 planning will be presented in the context of the research project.

Re-valuing construction through project delivery

In moving from lowest cost adversarial based traditional procurement towards value driven methodologies the challenges range from re-engineering the process, to metrics and team alignment. This paper describes research into methodologies which encourage alignment of project partners towards achieving mutually beneficial goals. The research identifies nine variables which influence the achievement of successful projects delivering value. Results from case studies illustrate that not all parties can achieve value for themselves which directs attention to the balance between deliverables and the interests of team members. Re- valuing construction demands refocusing towards the delivery of operational assets and their place in the value system whilst recognising the need to manage the delivery process and the team to align the value to the parties. The objective of the project was to develop tools and recommendations for reform of project delivery in the building and construction industry to transform business-as-usual performance into exceptional performance. Benefits flow not only to the construction industry, but to the community as a whole because a more sophisticated industry can deliver more effective use of assets, financing, operating and maintenance of facilities to suit the community’s needs. This research was funded by the Australian Cooperative Research Centre for Construction Innovation.

The user-led disruption : self-(re)broadcasting at Justin.tv and elsewhere

The rise of videosharing and self-(re)broadcasting Web services is posing new threats to a television industry already struggling with the impact of filesharing networks. This paper outlines these threats, focussing especially on the DIY re-broadcasting of live sports using Websites such as Justin.tv and a range of streaming media networks built on peer-to-peer filesharing technology.

Re-imagining and re-imaging the nation through the history curriculum.

Nationalism is not a naturally occurring sentiment, but rather needs to be carefully nurtured and sustained in the social imaginary through the production and circulation of unifying narratives that invoke the nation’s imagined community. The school curriculum is crucial in this process, legitimating and disseminating selected narratives while de-legitimating and marginalising other accounts and their voices. Certain watershed events in nations’ histories have always posed political problems in history curricula (Cajani & Ross, 2007) –however the pressures and concerns of current times now suggest political solutions in history curricula. This paper briefly examines recent political debates in Australia to argue that the school history curriculum has become a site of increasing interest for the exercise of official forms of nationalism and the production of a nostalgic, celebratory national biography. The public debates around school history curriculum are theorised as nostalgic re-nationalising efforts in response to the march of cultural globalisation and its attendant uncertainties.

Organic and acquisitive employment growth : re-examining,testing and extending Penrose's Growth Theory.

Edith Penrose’s theory of firm growth postulates that a firm’s current growth rate will be influenced by the adjustment costs of, and changes to a firm’s productive opportunity set arising from, previous growth. Although she explicitly considered the impact of previous organic growth on current organic growth, she was largely silent about the impact of previous acquisitive growth. In this paper we extend Penrose’s work to examine that the relative impact of organic and acquisitive growth on the adjustment costs and productive opportunity set of the firm. Employing a panel of commercially active enterprises in Sweden over a 10 year period our results suggest the following. First, previous organic growth acts as a constraint on current organic growth. Second, previous acquisitive growth has a positive effect on current organic growth. We conclude that organic growth and acquisitive growth constitute two distinct strategic options facing the firm, which have a differential impact on the future organic growth of the firm.

Re-imagining school through young people’s drawings

Children’s drawings provide rich qualitative data (Walker, 2008) and “valuable information for the assessment of children's environmental perceptions” (Barraza, 1999, p. 49). They are the primary data source being used to re-imagine school from a student perspective (Schratz & Steiner-Löffler, 1998) in a research project being carried out with primary school students in Queensland, Australia. This paper will report on the progress of this project which addresses a mostly unmet need for students’ perspectives to be included in school design (Rudduck & Flutter, 2004). Grade 5/6 students in a number of primary schools have been invited to submit annotated drawings with up to 200 words of text illustrating their ideal educational spaces. Using purpose-designed analytical tools, the submissions will be compared across student backgrounds and school types to obtain a better understanding of the needs and educational desires of young people in relation to changing learning environments. The findings will inform consideration of the design and use of educational spaces with all work exhibited through a dedicated website. The term ‘educational spaces’ avoids restrictive notions of what the concept of ‘school’ means, referring to any real or virtual space in which teaching and learning may occur or, as Ferguson and Seddon (2007) have referred to it, “the shifting imagery of education” that includes red brick schools and dispersed learning networks. The theoretical framework for this study is grounded in the work of Greene (1995) and Wright-Mills (2001) who cited the deployment of critical and empathic imagination in addressing education reform.

Automating human thought processes for a UAV forced landing

This paper describes the current status of a program to develop an automated forced landing system for a fixed-wing Unmanned Aerial Vehicle (UAV). This automated system seeks to emulate human pilot thought processes when planning for and conducting an engine-off emergency landing. Firstly, a path planning algorithm that extends Dubins curves to 3D space is presented. This planning element is then combined with a nonlinear guidance and control logic, and simulated test results demonstrate the robustness of this approach to strong winds during a glided descent. The average path deviation errors incurred are comparable to or even better than that of manned, powered aircraft. Secondly, a study into suitable multi-criteria decision making approaches and the problems that confront the decision-maker is presented. From this study, it is believed that decision processes that utilize human expert knowledge and fuzzy logic reasoning are most suited to the problem at hand, and further investigations will be conducted to identify the particular technique/s to be implemented in simulations and field tests. The automated UAV forced landing approach presented in this paper is promising, and will allow the progression of this technology from the development and simulation stages through to a prototype system

Young people, imagination and re-engagement in the middle years

This article reports on the first stage of a study that uses Young People as Researchers methodology to investigate the phenomenon of middle-year student disengagement. The study obtains student perspectives on the meanings of engagement and disengagement using a variety of innovative research methods. The first stage of the study focused on a two-day workshop giving students and teachers an overview of the project and providing training and experience in conducting research in their schools. The process employed by the study provides spaces and resources for critical thinking and encourages imaginative responses to the real life problems confronting the students and their peers and affecting their educational engagement. This article describes ways in which engagement is viewed both theoretically and through the empirical work of the student researchers, and how various applications of ‘disciplined imagination’ connect with methods of investigating and understanding engagement.

Critical Systems Theory: A Political Economy of Language, Thought, and Technology

An emergent form of political economy, facilitated by information and communication technologies (ICTs), is widely propagated as the apotheosis of unmitigated social, economic, and technological progress. Meanwhile, throughout the world, social degradation and economic inequality are increasing logarithmically. Valued categories of thought are, axiomatically, the basic commodities of the “knowledge economy”. Language is its means of exchange. This paper proposes a sociolinguistic method with which to critically engage the hyperbole of the “Information Age”. The method is grounded in a systemic social theory that synthesises aspects of autopoiesis and Marxist political economy. A trade policy statement is analysed to exemplify the sociolinguistically created aberrations that are today most often construed as social and political determinants.