Accurate placement of a pelvic binder improves reduction of unstable fractures of the pelvic ring

The aim of this study was to assess the accuracy of placement of pelvic binders and to determine whether circumferential compression at the level of the greater trochanters is the best method of reducing a symphyseal diastasis. Patients were identified by a retrospective review of all pelvic radiographs performed at a military hospital over a period of 30 months. We analysed any pelvic radiograph on which the buckle of the pelvic binder was clearly visible. The patients were divided into groups according to the position of the buckle in relation to the greater trochanters: high, trochanteric or low. Reduction of the symphyseal diastasis was measured in a subgroup of patients with an open-book fracture, which consisted of an injury to the symphysis and disruption of the posterior pelvic arch (AO/OTA 61-B/C). We identified 172 radiographs with a visible pelvic binder. Five cases were excluded due to inadequate radiographs. In 83 (50%) the binder was positioned at the level of the greater trochanters. A high position was the most common site of inaccurate placement, occurring in 65 (39%). Seventeen patients were identified as a subgroup to assess the effect of the position of the binder on reduction of the diastasis. The mean gap was 2.8 times greater (mean difference 22 mm) in the high group compared with the trochanteric group (p < 0.01). Application of a pelvic binder above the level of the greater trochanters is common and is an inadequate method of reducing pelvic fractures and is likely to delay cardiovascular recovery in these seriously injured patients.

A more efficient and effective heuristic algorithm for the MapReduce placement problem in cloud computing

The placement of the mappers and reducers on the machines directly affects the performance and cost of the MapReduce computation in cloud computing. From the computational point of view, the mappers/reducers placement problem is a generalization of the classical bin packing problem, which is NP-complete. Thus, in this paper we propose a new heuristic algorithm for the mappers/reducers placement problem in cloud computing and evaluate it by comparing with other several heuristics on solution quality and computation time by solving a set of test problems with various characteristics. The computational results show that our heuristic algorithm is much more efficient than the other heuristics. Also, we verify the effectiveness of our heuristic algorithm by comparing the mapper/reducer placement for a benchmark problem generated by our heuristic algorithm with a conventional mapper/reducer placement. The comparison results show that the computation using our mapper/reducer placement is much cheaper while still satisfying the computation deadline.

A new grouping genetic algorithm for the MapReduce placement problem in cloud computing

MapReduce is a computation model for processing large data sets in parallel on large clusters of machines, in a reliable, fault-tolerant manner. A MapReduce computation is broken down into a number of map tasks and reduce tasks, which are performed by so called mappers and reducers, respectively. The placement of the mappers and reducers on the machines directly affects the performance and cost of the MapReduce computation. From the computational point of view, the mappers/reducers placement problem is a generation of the classical bin packing problem, which is NPcomplete. Thus, in this paper we propose a new grouping genetic algorithm for the mappers/reducers placement problem in cloud computing. Compared with the original one, our grouping genetic algorithm uses an innovative coding scheme and also eliminates the inversion operator which is an essential operator in the original grouping genetic algorithm. The new grouping genetic algorithm is evaluated by experiments and the experimental results show that it is much more efficient than four popular algorithms for the problem, including the original grouping genetic algorithm.

Accelerometer validity and placement for detection of changes in physical activity in dogs under controlled conditions on a treadmill

The objective of the research was to determine the optimal location and method of attachment for accelerometer-based motion sensors, and to validate their ability to differentiate rest and increases in speed in healthy dogs moving on a treadmill. Two accelerometers were placed on a harness between the scapulae of dogs with one in a pouch and one directly attached to the harness. Two additional accelerometers were placed (pouched and not pouched) ventrally on the dog's collar. Data were recorded in 1. s epochs with dogs moving in stages lasting 3. min each on a treadmill: (1) at rest, lateral recumbency, (2) treadmill at 0% slope, 3. km/h, (3) treadmill at 0% slope, 5. km/h, (4) treadmill at 0% slope, 7. km/h, (5) treadmill at 5% slope, 5. km/h, and; (6) treadmill at 5% slope, 7. km/h. Only the harness with the accelerometer in a pouch along the dorsal midline yielded statistically significant increases (P< 0.05) in vector magnitude as walking speed of the dogs increased (5-7. km/h) while on the treadmill. Statistically significant increases in vector magnitude were detected in the dogs as the walking speed increased from 5 to 7. km/h, however, changes in vector magnitude were not detected when activity intensity was increased as a result of walking up a 5% grade. Accelerometers are a valid and objective tool able to discriminate between and monitor different levels of activity in dogs in terms of speed of movement but not in energy expenditure that occurs with movement up hill.

The special branch : governing mentalities through alternative-site placement

"…one should try to locate power at the extreme points of its exercise, where it is always less legal in character." (Foucault, 1980, p.97) Studies of schooling practices as techniques deriving from a particular art of governing that Foucault (2003b) called ‘governmentality’ have shown how psychopathologising discourses work to construct particular student-subjects and legitimise various practices of exclusion (Gram, 2007b). Here I extend this work to consider the use of alternative-site placement as an intensification in response to governmentality being put ‘at risk’. Governing ‘at a distance’ conjures an illusion of individual freedom which relies on the production of subjects who ‘choose’ to make choices that are consistent with the aspirations of government. In this chapter, it is argued that the designation of a child as ‘disorderly’ legitimises the intrusion of state into the private domain of the family via the Trojan horse of early intervention. This is enabled by the psy-sciences, whose technologies and aims amount to the moral retraining of ‘improper’ future-citizens who, in choosing to choose otherwise, threaten to make visible invisible relations of power. Alternative-site placement in special schools running intensive behaviour modification programs allows for a ‘redoubled insistence’ (Ewald, 1992) of these norms and limits that a ‘disorderly’ child threatens to transgress.

A Memetic Algorithm for the location-based continuously operating reference stations placement problem in Network Real-Time Kinematic

Network Real-Time Kinematic (NRTK) is a technology that can provide centimeter-level accuracy positioning services in real time, and it is enabled by a network of Continuously Operating Reference Stations (CORS). The location-oriented CORS placement problem is an important problem in the design of a NRTK as it will directly affect not only the installation and operational cost of the NRTK, but also the quality of positioning services provided by the NRTK. This paper presents a Memetic Algorithm (MA) for the location-oriented CORS placement problem, which hybridizes the powerful explorative search capacity of a genetic algorithm and the efficient and effective exploitative search capacity of a local optimization. Experimental results have shown that the MA has better performance than existing approaches. In this paper we also conduct an empirical study about the scalability of the MA, effectiveness of the hybridization technique and selection of crossover operator in the MA.

A new approach to the cloud-based heterogeneous MapReduce placement problem

Guaranteeing Quality of Service (QoS) with minimum computation cost is the most important objective of cloud-based MapReduce computations. Minimizing the total computation cost of cloud-based MapReduce computations is done through MapReduce placement optimization. MapReduce placement optimization approaches can be classified into two categories: homogeneous MapReduce placement optimization and heterogeneous MapReduce placement optimization. It is generally believed that heterogeneous MapReduce placement optimization is more effective than homogeneous MapReduce placement optimization in reducing the total running cost of cloud-based MapReduce computations. This paper proposes a new approach to the heterogeneous MapReduce placement optimization problem. In this new approach, the heterogeneous MapReduce placement optimization problem is transformed into a constrained combinatorial optimization problem and is solved by an innovative constructive algorithm. Experimental results show that the running cost of the cloud-based MapReduce computation platform using this new approach is 24:3%-44:0% lower than that using the most popular homogeneous MapReduce placement approach, and 2:0%-36:2% lower than that using the heterogeneous MapReduce placement approach not considering the spare resources from the existing MapReduce computations. The experimental results have also demonstrated the good scalability of this new approach.

Effectiveness of electrocardiographic guidance in CVAD tip placement

Background International standard practice for the correct confirmation of the central venous access device is the chest X-ray. The intracavitary electrocardiogram-based insertion method is radiation-free, and allows real-time placement verification, providing immediate treatment and reduced requirement for post-procedural repositioning. Methods Relevant databases were searched for prospective randomised controlled trials (RCTs) or quasi RCTs that compared the effectiveness of electrocardiogram-guided catheter tip positioning with placement using surface-anatomy-guided insertion plus chest X-ray confirmation. The primary outcome was accurate catheter tip placement. Secondary outcomes included complications, patient satisfaction and costs. Results Five studies involving 729 participants were included. Electrocardiogram-guided insertion was more accurate than surface anatomy guided insertion (odds ratio: 8.3; 95% confidence interval (CI) 1.38; 50.07; p=0.02). There was a lack of reporting on complications, patient satisfaction and costs. Conclusion The evidence suggests that intracavitary electrocardiogram-based positioning is superior to surface-anatomy-guided positioning of central venous access devices, leading to significantly more successful placements. This technique could potentially remove the requirement for post-procedural chest X-ray, especially during peripherally inserted central catheter (PICC) line insertion.

Are dietetics educators' attitudes to assessment a barrier to expanding placement opportunities? Results of a Delphi study

Aim Assessment of entry-level health professionals is complex, especially in the work-based setting, placing additional pressures on these learning environments. The present study aims to gain understanding and ideally consensus regarding the setting for assessment of all elements of competence for entry-level dietitians across Australia. Methods Seventy-five experienced academic and practitioner assessors were invited to participate in an online Delphi survey. The 166 entry-level performance criteria of the competency standards for dietitians formed the basis of the questions in the survey, with rating on which ones could be assessed in the practice setting, those which could be assessed in a classroom/university setting and which could be assessed in either setting. Forty-three of 75 invited assessors responded to the first round of the Delphi. A second modified survey was sent to the 43 participants with 34 responding. Results Consensus was achieved for the assessment setting for 86 (52%) of the performance criteria after two rounds of surveying. The majority of these performance criteria achieved consensus at round one (n = 44) and were deemed to be best assessed in the practice setting (n = 55). This study highlighted the perspectives of assessors and their preference for the work-based setting for assessment. Conclusions To reduce the focus on work-based settings as the only place for competence-based assessment of health professionals, there is a need to support individual and organisational change through challenging existing norms around assessment.

Factors influencing radiation therapy student clinical placement satisfaction

Introduction Radiation therapy students at Queensland University of Technology (QUT) attend clinical placements at five different clinical departments with varying resources and support strategies. This study aimed to determine the relative availability and perceived importance of different factors affecting student support while on clinical placement. The purpose of the research was to inform development of future support mechanisms to enhance radiation therapy students’ experience on clinical placement. Methods This study used anonymous Likert-style surveys to gather data from years 1 and 2 radiation therapy students from QUT and clinical educators from Queensland relating to availability and importance of support mechanisms during clinical placements in a semester. Results The study findings demonstrated student satisfaction with clinical support and suggested that level of support on placement influenced student employment choices. Staff support was perceived as more important than physical resources; particularly access to a named mentor, a clinical educator and weekly formative feedback. Both students and educators highlighted the impact of time pressures. Conclusions The support offered to radiation therapy students by clinical staff is more highly valued than physical resources or models of placement support. Protected time and acknowledgement of the importance of clinical education roles are both invaluable. Joint investment in mentor support by both universities and clinical departments is crucial for facilitation of effective clinical learning.

Benefits of blended learning for the first year medical imaging students in preparation for clinical placement

Although there is a plethora of definitions of blended learning, the underlying distinguishing feature is the combination of traditional content delivery and the utilisation of technology. Within Medical Imaging undergraduate education there is evidence of advantages and increased student engagement when utilising a blended learning approach. Although the embedding of technology has been proven to be a useful teaching tool, “Educators should tailor their teaching media to learner’s needs rather than assume that web based learning is intrinsically superior”. This study aims to determine which clinical learning tools are perceived to be the most useful to the student in preparing them for placements.

“What are they really doing?” An exploration of student learning activities in field placement

Social work students consistently identify their field placement as having the most impact on their learning. Despite this, research on learning activities used during placement and the impact on practice competency and social work identity is limited. This is the second paper from a research study exploring student experiences of learning on placement. Data were gathered from 263 social work students about 14 key learning activities they experienced during placement. The more regularly students engaged in learning activities with their social work supervisor, the more likely they were to report a sense of social work identity and feelings of practice competence. However, the regular use of learning activities varied widely between placements. Surprisingly, approximately half the students did not regularly have the opportunity to observe social work practice, have their practice observed, or to link social work theory and the Code of Ethics to their practice with their social work supervisor.

A study of placement algorithms through trial interchange of logic modules

Based on trial interchanges, this paper develops three algorithms for the solution of the placement problem of logic modules in a circuit. A significant decrease in the computation time of such placement algorithms can be achieved by restricting the trial interchanges to only a subset of all the modules in a circuit. The three algorithms are simulated on a DEC 1090 system in Pascal and the performance of these algorithms in terms of total wirelength and computation time is compared with the results obtained by Steinberg, for the 34-module backboard wiring problem. Performance analysis of the first two algorithms reveals that algorithms based on pairwise trial interchanges (2 interchanges) achieve a desired placement faster than the algorithms based on trial N interchanges. The first two algorithms do not perform better than Steinberg's algorithm1, whereas the third algorithm based on trial pairwise interchange among unconnected pairs of modules (UPM) and connected pairs of modules (CPM) performs better than Steinberg's algorithm, both in terms of total wirelength (TWL) and computation time.

Pole placement in multi-input systems via elementary transformations

This paper is concerned with the development of an algorithm for pole placement in multi-input dynamic systems. The algorithm which uses a series of elementary transformations is believed to be simpler, computationally more efficient and numerically stable when compared with earlier methods. In this paper two methods have been presented.