Key beliefs of hospital nurses’ hand-hygiene behaviour: Protecting your peers and needing effective reminders

Issues addressed: Hand hygiene in hospitals is vital to limit the spread of infections. This study aimed to identify key beliefs underlying hospital nurses’ hand-hygiene decisions to consolidate strategies that encourage compliance. Methods: Informed by a theory of planned behaviour belief framework, nurses from 50 Australian hospitals (n = 797) responded to how likely behavioural beliefs (advantages and disadvantages), normative beliefs (important referents) and control beliefs (barriers) impacted on their hand-hygiene decisions following the introduction of a national ‘5 moments for hand hygiene’ initiative. Two weeks after completing the survey, they reported their hand-hygiene adherence. Stepwise regression analyses identified key beliefs that determined nurses’ hand-hygiene behaviour. Results: Reducing the chance of infection for co-workers influenced nurses’ hygiene behaviour, with lack of time and forgetfulness identified as barriers. Conclusions: Future efforts to improve hand hygiene should highlight the potential impact on colleagues and consider strategies to combat time constraints, as well as implementing workplace reminders to prompt greater hand-hygiene compliance. So what? Rather than emphasising the health of self and patients in efforts to encourage hand-hygiene practices, a focus on peer protection should be adopted and more effective workplace reminders should be implemented to combat forgetting.

Unfamiliar destinations

A score investigating issues of mobility, accessing mobility, and alternative mobility I have been working on. This score is continuing a series, called The Excentric Fixations Project, I have been working on since 20019. It is also the middle score of in a series of three processual performance scores I have been asked to develop as part of QUT’s contribution to a federally funded Higher Education Participation Program, where universities in the region partner to develop, deliver and evaluate activities that build aspiration amongst disadvantaged students. The program encourages participants to use investigations of small moments of anxiety about meeting new people, taking new paths, or trying new things, in order to imagine new ways of dealing with these issues at a larger level, in study, career, or life choices.

Thermal behavior of kaolinite–urea intercalation complex and molecular dynamics simulation for urea molecule orientation

The thermal behavior of kaolinite–urea intercalation complex was investigated by thermogravimetry–differential scanning calorimetry (TG–DSC), X-ray diffraction (XRD), and fourier transform infrared spectroscopy (FTIR). In addition, the interaction mode of urea molecules intercalated into the kaolinite gallery was studied by means of molecular dynamics simulation. Three main mass losses were observed at 136 °C, in the range of 210–270 °C, and at 500 °C in the TG–DSC curves, which were, respectively, attributed to (1) melting of the surface-adsorbed urea, (2) removal of the intercalated urea, and (3) dehydroxylation of the deintercalated kaolinite. The three DSC endothermic peaks at 218, 250, and 261 °C were related to the successive removals of intercalated urea with three different distribution structures. Based on the angle between the dipole moment vector of urea and the basal surface of kaolinite, the three urea models could be described as follows: (1) Type A, the dipole moment vector is nearly parallel to the basal surface of kaolinite; (2) Type B, the dipole moment vector points to the silica tetrahedron with the angle between it and the basal surface of kaolinite ranging from 20°to 40°; and (3) Type C, the dipole moment vector is nearly perpendicular to the basal surface of kaolinite. The three distribution structures of urea molecules were validated by the results of the molecular dynamics simulation. Furthermore, the thermal behavior of the kaolinite–urea intercalation complex investigated by TG–DSC was also supported by FTIR and XRD analyses.

Experimentally reduced hip-abductor muscle strength and frontal-plane biomechanics during walking

Researchers have postulated that reduced hip-abductor muscle strength may have a role in the progression of knee osteoarthritis by increasing the external knee-adduction moment. However, the relationship between hip-abductor strength and frontal-plane biomechanics remains unclear. To experimentally reduce hip-abduction strength and observe the subsequent changes in frontal-plane biomechanics. Descriptive laboratory study. Research laboratory. Eight healthy, recreationally active men (age = 27 ± 6 years, height = 1.75 ± 0.11 m, mass = 76.1 ± 10.0 kg). All participants underwent a superior gluteal nerve block injection to reduce the force output of the hip-abductor muscle group. Maximal isometric hip-abduction strength and gait biomechanical data were collected before and after the injections. Gait biomechanical variables collected during walking consisted of knee- and hip-adduction moments and impulses and the peak angles of contralateral pelvic drop, hip adduction, and ipsilateral trunk lean. Hip-abduction strength was reduced after the injection (P = .001) and remained lower than baseline values at the completion of the postinjection gait data collection (P = .02). No alterations in hip- or knee-adduction moments (hip: P = .11; knee: P = .52) or impulses (hip: P = .16; knee: P = .41) were found after the nerve block. Similarly, no changes in angular kinematics were observed for contralateral pelvic drop (P = .53), ipsilateral trunk lean (P = .78), or hip adduction (P = .48). A short-term reduction in hip-abductor strength was not associated with alterations in the frontal-plane gait biomechanics of young, healthy men. Further research is needed to determine whether a similar relationship is true in older adults with knee osteoarthritis.

Data driven and practice-based evidence : design and development of efficient and effective clinical decision support system

Decision-making is such an integral aspect in health care routine that the ability to make the right decisions at crucial moments can lead to patient health improvements. Evidence-based practice, the paradigm used to make those informed decisions, relies on the use of current best evidence from systematic research such as randomized controlled trials. Limitations of the outcomes from randomized controlled trials (RCT), such as “quantity” and “quality” of evidence generated, has lowered healthcare professionals’ confidence in using EBP. An alternate paradigm of Practice-Based Evidence has evolved with the key being evidence drawn from practice settings. Through the use of health information technology, electronic health records (EHR) capture relevant clinical practice “evidence”. A data-driven approach is proposed to capitalize on the benefits of EHR. The issues of data privacy, security and integrity are diminished by an information accountability concept. Data warehouse architecture completes the data-driven approach by integrating health data from multi-source systems, unique within the healthcare environment.

Disorganising principles: Corporeal fragmentation and the possibilities for repair

Dancers investigate ever-expanding relationships to embodiment through the variety of unique choreographic signatures that are continually erupting in professional practice. They live fragmented lineages that are interrupted and redirected as they traverse between various projects led by different choreographers or the same choreographer pursuing different creative goals. As contemporary dance continues to reconceive ways of moving, the dominant lineages of dance training are less useful as reference points through which dancers can recalibrate bodily activity and thus rebalance. In this chapter, I examine the impulse towards fragmentation in contemporary dance and explore how moments of agency for dancers might arise and be seized within the complexities of this environment. These issues are discussed in relation to my encounter with a bodywork therapy of Japanese origin, Amatsu, which I studied throughout 2012, and through the teaching principles of Gill Clarke as illuminated through the Minding Motion project, which explored Clarke’s pedagogy for Tanzplan, Germany 2010 (Diehl and Lampert, 2011). Moments from performance and bodywork practice are offered as examples throughout the chapter.

The peer leader capacity building model: A student learning journey

The benefits of peer leader experiences in building graduate skills and capabilities, is well documented and recognised in the higher education sector (Ender & Kay, 2001; Lindsey, Weiler, Zarich, Haddock, Krafchick, & Zimmerman, 2014; Shook & Keup, J., 2012). While benefits are acknowledged, responsibility for identifying, structuring and recording the learning experiences and learning outcomes is charged to the student. This poster describes a framework ‘The Peer Leader Capacity Building Model’ that purposefully structures the peer-leader’s learning journey providing: timely training, moments of critical reflection and goal setting. The model articulates the fundamental interplay of learning and peer leader service which forms the peer ‘learnership’. The journey begins with the ‘aspiration’ phase where students come to understand their leadership opportunities, progressing through ‘enabling’ and ‘mastering’ phases where students shape their learner-leader experience, and finally, to the ‘contributing graduate’ phase where students emerge as competent graduates able to confidently participate in their communities and workplaces. In shifting from a program centric approach that priorities the needs of the mentees, the Peer Leader Capacity Building Model focuses on the individual as a peer leader encouraging the student to shape their individual ‘learnscape’ through consciously navigating both their curricula and co-curricular learning experiences.

Habitus realisation: Negotiating identities through Chinese looks and Chinese language

The increasing linguistic and cultural diversity of our contemporary world points to the salience of maintaining and developing Heritage Language of ethnic minority groups. The mutually constitutive effect between Heritage Language learning and ethnic identity construction has been well documented in the literature. Classical social psychological work often quantitatively structures this phenomenon in a predictable linear relationship. In contrast, poststructural scholarship draws on qualitative approaches to claim the malleable and multiple dynamics behind the phenomenon. The two schools oppose but complement each other. Nevertheless, both schools struggle to capture the detailed and nuanced construction of ethnic identity through Heritage Language learning. Different from the extant research, we make an attempt to ethno-methodologically unearth the nuisances and predicaments embedded in the reflexive, subtle, and multi-layered identity constructions through nuanced, inter-nested language practices. Drawing on data from the qualitative phase of a large project, we highlight some small but powerful moments abstracted from the interview accounts of five Chinese Australian young people. Firstly, we zoom in on the life politics behind the ‘seen but unnoticed’ stereotype that looking Chinese means being able to speak Chinese. Secondly, we speculate the power relations between the speaker and the listener through the momentary and inadvertent breaches of the taken-for-granted stereotype. Next, we unveil how learning Chinese has become an accountably rational priority for these young Chinese Australians. Finally, we argue that the normalised stereotype becomes visible and hence stable when it is breached – a practical accomplishment that we term ‘habitus realisation’.

Yellow Peril

This catalogue essay was written to accompany Eugenia Lim's 2015 exhibition at Metro Arts, Brisbane, 'Yellow Peril'. It discusses Lim's exploration of her identity as a Chinese-Australian, providing contextual information of Chinese immigration during Australia's gold rush years and the work of Hong Kong born American artist, Tseng Kwong Chi. It presents Yellow Peril as an exhibition that speaks critically about art and our cultural history amidst a fine layering of imagery, object and context, with a vitality that is derived from its rich and compelling base in real life moments and connections.

Warmwaters

This project originated from both investigation of the musicalisation of theatre and impact of gender upon contemporary physical comedy. Developed as a ‘music first’ proposition, the initial experiment was to blend music and theatre so they were indistinguishable. Musicalising theatre, and theatricalising music. This established a covert intermediality with the potential to work in theatre or music venues. An iterative cycle of writing, performance, and videography over two years in venues ranging from small cafes to Woodford Folk Festival resulted in a full-length performance premiering at Brisbane Powerhouse’s Queensland Cabaret Festival 2015. The soundtrack to the show was recorded as a full-length album at QUT’s Gasworks Studio and released in 2014. It’s become clear that male/female musical comedy acts are an extremely rare pairing. Certain preconceptions about gender and comedy complicate the field; indeed the comic tropes of the double act which the Warmwaters flow around and through. Brian Logan (2011) even poses that “the male-female dynamic militate[s] against comedy”. This performance-led research draws on Comedy Studies to examine three classic formulations of the comic duo as they are manifested at critical incidents in the Warmwaters’ show. These moments are examined in terms of comic functionality and gender, evaluating and potentially reformulating them, whilst working towards a better understanding of the relative scarcity of the male/female musical comedy duo. Prototypes have been performed in various venues, utilising performance as research: cycles in which discoveries made during unpredictable gigs in music venues are captured on video, transcribed, rewritten, then fed back into live performance.

Uncanny Intimacy

Summary: Uncanny Intimacy charts an artists’ journeys towards ecological understanding. Use the mysterious inorganic ‘telescope’, to peer deep within a contemporary 'cabinet of {research} curiosities’, witnessing diverse moments of insight and inspiration animated by the darkly compelling worlds of Australia’s iconic flying foxes. Exhibition Statement: Uncanny Intimacy charts an artists’ journeys towards ecological understanding. Use the mysterious inorganic ‘telescope’ to peer deep within a contemporary 'cabinet of {research} curiosities’, witnessing diverse moments of insight and inspiration, animated by the darkly compelling worlds of Australia’s iconic flying foxes. Uncanny Intimacy calls us to imagine a radical rethinking of ecological ethics. By understanding existence as innately coexistence, we are asked to contemplate how ecologies might be better understood, better conserved and made flourish.

The role of time pressure and different psychological safety climate referents in the prediction of nurses’ hand hygiene compliance

In this study of 638 Australian nurses, compliance to hand hygiene (HH), as defined by the “five moments” recommended by the World Health Organisation (2009), was examined. Hypotheses focused on the extent to which time pressure reduces compliance and safety climate (operationalised in relation to HH using colleagues, manager, and hospital as referents) increases compliance. It also was proposed that HH climate would interact with time pressure, such that the negative effects of time pressure would be less marked when HH climate is high. The extent to which the three HH climate variables would interact among each other, either in the form of boosting or compensatory effects, was tested in an exploratory manner. A prospective research design was used in which time pressure and the HH climate variables were assessed at Time 1 and compliance was assessed by self-report two weeks later. Compliance was high but varied significantly across the 5 HH Moments, suggesting that nurses make distinctions between inherent and elective HH and also seemed to engage in some implicit rationing of HH. Time pressure dominated the utility of HH climate to have its positive impact on compliance. The most conducive workplace for compliance was one low in time pressure and high in HH climate. Colleagues were very influential in determining compliance, more so than the manager and hospital. Manager and hospital support for HH enhanced the positive effects of colleagues on compliance. Providing training and enhancing knowledge was important, not just for compliance, but for safety climate.

Using axially loaded MRI to investigate the biomechanics of adolescent idiopathic scoliosis

Introduction. Spinal flexibility measurement is an important aspect of pre-operative clinical assessment in the treatment of Adolescent Idiopathic Scoliosis (AIS). Clinically, curve flexibility is a combined measure for all vertebral levels. We propose that in vivo flexibility for individual spinal joints could provide valuable additional information in planning treatment for scoliosis. Methods. Individual spinal joint flexibility in the coronal plane was measured for a series of AIS patients using axially loaded magnetic resonance imaging. Each patient underwent magnetic resonance imaging in the supine position, with no axial load, and then following application of an axial compressive load equal to half the patient’s bodyweight. Coronal plane disc wedge angles in the unloaded and loaded configurations were measured. Joint moments exerted by the axial compressive load were used to derive estimates of individual joint compliance. Results. Fifteen AIS patients were included in the study (mean clinical Cobb angle 46 degrees, mean age 15.3 years). Mean intra-observer measurement error for endplate inclination was 1.6˚. The mean increase in measured major Cobb angle between unloaded and loaded scans was 7.6˚. For certain spinal levels (+2,+1,-2 relative to the apex) there was a statistically significant relationship between change in wedge angle under load and initial wedge angle, such that initially highly wedged discs demonstrated a smaller change in wedge angle than less wedged discs. Highly wedged discs were observed near the apex of the curve, which corresponded to lower joint compliance in the apical region. Conclusion. Approaches such as this can provide valuable biomechanical data on in vivo spinal biomechanics in AIS. Knowledge of individual joint flexibility may assist surgeons to determine which spinal procedure is most appropriate for a patient, which levels should be included in a spinal fusion and the relative mobility of individual joints in the deformed region of the spine.

Efficient simulation of stochastic chemical kinetics with the Stochastic Bulirsch-Stoer extrapolation method

Background Biochemical systems with relatively low numbers of components must be simulated stochastically in order to capture their inherent noise. Although there has recently been considerable work on discrete stochastic solvers, there is still a need for numerical methods that are both fast and accurate. The Bulirsch-Stoer method is an established method for solving ordinary differential equations that possesses both of these qualities. Results In this paper, we present the Stochastic Bulirsch-Stoer method, a new numerical method for simulating discrete chemical reaction systems, inspired by its deterministic counterpart. It is able to achieve an excellent efficiency due to the fact that it is based on an approach with high deterministic order, allowing for larger stepsizes and leading to fast simulations. We compare it to the Euler τ-leap, as well as two more recent τ-leap methods, on a number of example problems, and find that as well as being very accurate, our method is the most robust, in terms of efficiency, of all the methods considered in this paper. The problems it is most suited for are those with increased populations that would be too slow to simulate using Gillespie’s stochastic simulation algorithm. For such problems, it is likely to achieve higher weak order in the moments. Conclusions The Stochastic Bulirsch-Stoer method is a novel stochastic solver that can be used for fast and accurate simulations. Crucially, compared to other similar methods, it better retains its high accuracy when the timesteps are increased. Thus the Stochastic Bulirsch-Stoer method is both computationally efficient and robust. These are key properties for any stochastic numerical method, as they must typically run many thousands of simulations.

Optimizing the quantum dot: Plasmon interaction in a nano gap waveguide

Spontaneous emission (SE) of a Quantum emitter depends mainly on the transmission strength between the upper and lower energy levels as well as the Local Density of States (LDOS)[1]. When a QD is placed in near a plasmon waveguide, LDOS of the QD is increased due to addition of the non-radiative decay and a plasmonic decay channel to free space emission[2-4]. The slow velocity and dramatic concentration of the electric field of the plasmon can capture majority of the SE into guided plasmon mode (Гpl ). This paper focused on studying the effect of waveguide height on the efficiency of coupling QD decay into plasmon mode using a numerical model based on finite elemental method (FEM). Symmetric gap waveguide considered in this paper support single mode and QD as a dipole emitter. 2D simulation models are done to find normalized Гpl and 3D models are used to find probability of SE decaying into plasmon mode ( β) including all three decay channels. It is found out that changing gap height can increase QD-plasmon coupling, by up to a factor of 5 and optimally placed QD up to a factor of 8. To make the paper more realistic we briefly studied the effect of sharpness of the waveguide edge on SE emission into guided plasmon mode. Preliminary nano gap waveguide fabrication and testing are already underway. Authors expect to compare the theoretical results with experimental outcomes in the future