Life impact of ankle fractures : qualitative analysis of patient and clinician experiences

Background: Ankle fractures are one of the more commonly occurring forms of trauma managed by orthopaedic teams worldwide. The impacts of these injuries are not restricted to pain and disability caused at the time of the incident, but may also result in long term physical, psychological, and social consequences. There are currently no ankle fracture specific patient-reported outcome measures with a robust content foundation. This investigation aimed to develop a thematic conceptual framework of life impacts following ankle fracture from the experiences of people who have suffered ankle fractures as well as the health professionals who treat them. Methods: A qualitative investigation was undertaken using in-depth semi-structured interviews with people (n=12) who had previously sustained an ankle fracture (patients) and health professionals (n=6) that treat people with ankle fractures. Interviews were audio-recorded and transcribed. Each phrase was individually coded and grouped in categories and aligned under emerging themes by two independent researchers. Results: Saturation occurred after 10 in-depth patient interviews. Time since injury for patients ranged from 6 weeks to more than 2 years. Experience of health professionals ranged from 1 year to 16 years working with people with ankle fractures. Health professionals included an Orthopaedic surgeon (1), physiotherapists (3), a podiatrist (1) and an occupational therapist (1). The emerging framework derived from patient data included eight themes (Physical, Psychological, Daily Living, Social, Occupational and Domestic, Financial, Aesthetic and Medication Taking). Health professional responses did not reveal any additional themes, but tended to focus on physical and occupational themes. Conclusions: The nature of life impact following ankle fractures can extend beyond short term pain and discomfort into many areas of life. The findings from this research have provided an empirically derived framework from which a condition-specific patient-reported outcome measure can be developed.

Parking, parties and pets : disputes - the dark side of community living

In the last decade community living, in master planned communities or strata titled complexes, has increased. As land becomes scarcer, the popularity of these schemes is predicted to grow. Offsetting this popularity is the peculiarities of community living, in particular the often unthought-of difficulties arising from living in very close proximity to your neighbour. Such difficulties affect both amenity of life and property value. This paper seeks to inform practitioners of the issues arising from community living. It does this by identifying the more common forms of disputes and considering recent tribunal and court decisions. The paper concludes by identifying the dispute warning signs to assist to practitioners with the valuation process.

Mobile valuations : the Internet's impact on traditional valuation services

Preparing valuations is a time consuming process involving site inspections, research and report formulation. The ease of access to the internet has changed how and where valuations may be undertaken. No longer is it necessary to return to the office to finalise reports, or leave your desk in order to undertake research. This enables more streamlined service delivery and is viewed as a positive. However, it is not without negative impacts. This paper seeks to inform practitioners of the work environment changes flowing from increased access to the internet. It identifies how increased accessibility to, and use of, technology and the internet has, and will continue to, impact upon valuation service provision into the future.

Numerical study of impact forces on railway sleepers under wheel flat

Wheel-rail interaction is one of the most important research topics in railway engineering. It includes track vibration, track impact response and safety of the track. Track structure failures caused by impact forces can lead to significant economic loss for track owners through damage to rails and to the sleepers beneath. The wheel-rail impact forces occur because of imperfections on the wheels or rails such as wheel flats, irregular wheel profile, rail corrugation and differences in the height of rails connected at a welded joint. The vehicle speed and static wheel load are important factors of the track design, because they are related to the impact forces under wheel-rail defects. In this paper, a 3-Dimensional finite element model for the study of wheel flat impact is developed by use of the FEA software package ANSYS. The effects of the wheel flat to impact force on sleepers with various speeds and static wheel loads under a critical wheel flat size are investigated. It has found that both wheel-rail impact force and impact force on sleeper induced by wheel flat are varying nonlinearly by increasing the vehicle speed; both impact forces are nonlinearly and monotonically increasing by increasing the static wheel load. The relationships between both of impact forces induced by wheel flat and vehicles speed or static load are important to the track engineers to improve the design and maintenance methods in railway industry.

A dynamic wheel-rail impact analysis of railway track under wheel flat by Finite Element Analysis

Wheel–rail interaction is one of the most important research topics in railway engineering. It involves track impact response, track vibration and track safety. Track structure failures caused by wheel–rail impact forces can lead to significant economic loss for track owners through damage to rails and to the sleepers beneath. Wheel–rail impact forces occur because of imperfections in the wheels or rails such as wheel flats, irregular wheel profiles, rail corrugations and differences in the heights of rails connected at a welded joint. A wheel flat can cause a large dynamic impact force as well as a forced vibration with a high frequency, which can cause damage to the track structure. In the present work, a three-dimensional (3-D) finite element (FE) model for the impact analysis induced by the wheel flat is developed by use of the finite element analysis (FEA) software package ANSYS and validated by another validated simulation. The effect of wheel flats on impact forces is thoroughly investigated. It is found that the presence of a wheel flat will significantly increase the dynamic impact force on both rail and sleeper. The impact force will monotonically increase with the size of wheel flats. The relationships between the impact force and the wheel flat size are explored from this finite element analysis and they are important for track engineers to improve their understanding of the design and maintenance of the track system.

Toddlers’ food preferences : the impact of novel food exposure, maternal preferences and food neophobia

Food preferences have been identified as a key determinant of children’s food acceptance and consumption. The aim of this study was to identify factors that influence children’s liking for fruits, vegetables and non-core foods. Participants were Australian mothers (median age at delivery=31 years, 18-46 years) and their two-year-old children (M=25 months, SD=1 month; 52% female) allocated to the control group (N=230) of the NOURISH RCT. The effects of repeated exposure to new foods, maternal food preferences and child food neophobia on toddlers’ liking of vegetables, fruits and non-core foods and the proportion never tried were examined via hierarchical regression models; adjusting for key maternal (age, BMI, education) and child covariates (birth weight Z-score, gender), duration of breastfeeding and age of introduction to solids. Maternal preferences corresponded with child preferences. Food neophobia among toddlers was associated with liking fewer vegetables and fruits, and trying fewer vegetables. Number of repeated exposures to new food was not significantly associated with food liking at this age. Results highlight the need to: (i) encourage parents to offer a wide range of foods, regardless of their own food preferences, and (ii) provide parents with guidance on managing food neophobia.

The other side of the threshold : Strindberg's experiments in creative dissection

A 1500-word review of Strindberg: A Life by Sue Prideaux (Yale UP, 2012). One way of classifying biographies is to divide them into those that apply their own interpretative framework – be it psychoanalytic, gender-based, socio-historical, and so on – to a given subject and those that aim to meet the subject, on their own terms, or at least in terms that the subject would recognise...

Does residential dissonance impact residential mobility?

This research identifies residential mobility behaviour impacts of residential dissonance in Transit Oriented Developments (TODs) vs. non-TODs in Brisbane, Australia. Based on the characteristics of living environments (density, diversity, connectivity, and accessibility) and the travel preferences of 4545 individuals, respondents in 2009 were classified into one of four categories including: TOD consonants, TOD dissonants, non-TOD dissonants, and non-TOD consonants. Binary logistic regression analyses were employed to identify residential mobility behaviour of groups between 2009 and 2011; controlling for time varying covariates. The findings show that both TOD dissonants and TOD consonants move residences at an equal rate. However, TOD dissonants are more likely to move residences to their preferred non-TOD areas. In contrast, non-TOD dissonants not only moved residences at a lower rate, but their rate of mobility to their preferred TOD neighbourhood is also significantly lower due to costs and other associated factors. The findings suggest that discrete land use policy development is required to integrate non-TOD dissonant and TOD dissonant behaviours to support TOD development in Brisbane.

Uncovering the impact of organisational culture types on the willingness to share knowledge between projects

Current literature has established that organisational culture influences knowledge management efforts; however, it is only recently that research on project management has focused its interest on organisational culture in the context of knowledge sharing and some preliminary studies have been conducted. In response, this paper adds a significant contribution by providing rich empirical evidence of the relationships between culture and the willingness to share knowledge, demonstrating which cultural values are more and which are less likely to improve inter-project knowledge sharing behaviours. The use of interviews and the Organisational Culture Assessment Instrument (OCAI) (Cameron & Quinn, 2005) in the cross-case examination of culture in four participating cases has resulted in rich empirical contributions. Furthermore, this paper adds to the project management literature by introducing the Competing Values Framework (CVF) of Cameron and Quinn (2005) to evaluate knowledge sharing in the inter-project context.

Shut up & write!

This case-study exemplifies a ‘writing movement’, which is currently occurring in various parts of Australia through the support of social media. A concept emerging from the café scene in San Francisco, ‘Shut Up and Write!’ is a meetup group that brings writers together at a specific time and place to write side by side, thus making writing practice, social. This concept has been applied to the academic environment and our case-study explores the positive outcomes in two locations: RMIT University and QUT. We believe that this informal learning practice can be implemented to assist research students in developing academic skills. DESCRIPTION: Please describe your practice as a case study, including its context; challenge addressed; its aims; what it is; and how it supports creative practice PhD students or supervisors. Additional information may include: the outcomes; key factors or principles that contribute to its effectiveness; anticipated impact/evidence of impact. Research students spend the majority of their time outside of formal learning environments. Doctoral candidates enter their degree with a range of experience, knowledge and needs, making it difficult to provide writing assistance in a structured manner. Using a less structured approach to provide writing assistance has been trialled with promising results (Boud, Cohen, & Sampson, 2001; Stracke, 2010; Devenish et al, 2009). Although, semi structured approaches have been developed and examined, informal learning opportunities have received minimal attention. The primary difference of Shut Up and Write! to other writing practices, is that individuals do not engage in any structured activity and they do not share the outcomes of the writing. The purpose of Shut Up and Write! is to transform writing practice from a solitary experience, to a social one. Shut Up and Write! typically takes place outside of formal learning environments, in public spaces such as a café. The structure of Shut Up and Write! sessions is simple: participants meet at a specific time and place, chat for a few minutes, then they Shut Up and Write for a predetermined amount of time. Critical to the success of the sessions, is that there is no critiquing of the writing, and there is no competition or formal exercises. Our case-study examines the experience of two meetup groups at RMIT University and QUT through narrative accounts from participants. These accounts reveal that participants have learned: • Writing/productivity techniques; • Social/cloud software; • Aspects of the PhD; and • ‘Mundane’ dimensions of academic practice. In addition to this, activities such as Shut Up and Write! promote peer to peer bonding, knowledge exchange, and informal learning within the higher degree research experience. This case-study extends the initial work presented by the authors in collaboration with Dr. Inger Mewburn at QPR2012 – Quality in Postgraduate Research Conference, 2012.

Factors influencing caregiver : care receiver communication and its impact on the well-being of older care receivers

Examined communication between frail older people and their caregiving spouses (CGSs), and its relation to well-being in older care receivers. 53 community residing spousal dyads completed questionnaires about their well-being, relational satisfaction, and communication patterns. Conversations between the dyads were also videotaped and analyzed. The type of communication used by the CGSs was influenced by their sex, their earlier relationship with their spouse, and their level of well-being. CGSs who used an overly directive communication tone with their spouse were likely to be wives and CGSs who had a high degree of autonomy in their earlier relationship with their spouse. Low levels of life satisfaction and high affect balance in CGSs were associated with CGSs using a more patronizing tone. The well-being of care receivers was also related to their perceptions of their CGSs' communication. Care receivers who perceived their CGSs' communication as patronizing reported low levels of affect balance and high levels of conflict in the relationship. Findings suggest that certain characteristics of CGSs are related to the type of communication they use when conversing with their partner, although the relations are not always as expected.

The impact of malnutrition and decreased food intake on length of stay, readmission, and mortality in acute care patients

Rationale: The Australasian Nutrition Care Day Survey (ANCDS) evaluated if malnutrition and decreased food intake are independent risk factors for negative outcomes in hospitalised patients. Methods: A multicentre (56 hospitals) cross-sectional survey was conducted in two phases. Phase 1 evaluated nutritional status (defined by Subjective Global Assessment) and 24-hour food intake recorded as 0, 25, 50, 75, and 100% intake. Phase 2 data, which included length of stay (LOS), readmissions and mortality, were collected 90 days post-Phase 1. Logistic regression was used to control for confounders: age, gender, disease type and severity (using Patient Clinical Complexity Level scores). Results: Of 3122 participants (53% males, mean age: 65±18 years) 32% were malnourished and 23% consumed�25% of the offered food. Median LOS for malnourished (MN) patients was higher than well-nourished (WN) patients (15 vs. 10 days, p<0.0001). Median LOS for patients consuming �25% of the food was higher than those consuming �50% (13 vs. 11 days, p<0.0001). MN patients had higher readmission rates (36% vs. 30%, p = 0.001). The odds ratios of 90-day in-hospital mortality were 1.8 times greater for MN patients (CI: 1.03 3.22, p = 0.04) and 2.7 times greater for those consuming �25% of the offered food (CI: 1.54 4.68, p = 0.001). Conclusion: The ANCDS demonstrates that malnutrition and/or decreased food intake are associated with longer LOS and readmissions. The survey also establishes that malnutrition and decreased food intake are independent risk factors for in-hospital mortality in acute care patients; and highlights the need for appropriate nutritional screening and support during hospitalisation. Disclosure of Interest: None Declared.

ICT driven pedagogies and its impact on learning outcomes in high school mathematics

ICT (Information and Communication Technology) creates numerous opportunities for teachers to re-think their pedagogies. In subjects like mathematics which draws upon abstract concepts, ICT creates such an opportunity. Instead of a mimetic pedagogical approach, suitably designed activities with ICT can enable learners to engage more proactively with their learning. In this quasi-experimental designed study, ICT was used in teaching mathematics to a group of first year high school students (N=25) in Australia. The control group was taught predominantly through traditional pedagogies (N=22). Most of the variables that had previously impacted on the design of such studies were suitably controlled in this yearlong investigation. Quantitative and qualitative results showed that students who were taught by ICT driven pedagogies benefitted from the experience. Pre and post-test means showed that there was a difference between the treatment and control groups. Of greater significance was that the students (in the treatment group) believed that the technology enabled them to engage more with their learning.