Designing the future in wound care : the role of the nurse practitioner

The nurse practitioner is emerging as a new level and type of health care. Increasing specialisation and advanced educational opportunities in nursing and the inequality in access to health care for sectors of the community have established the conditions under which the nurse practitioner movement has strengthened both nationally and internationally. The boundaries of responsibility for nurses are changing, not only because of increased demands but also because nurses have demonstrated their competence in varied extended and expanded practice roles. The nurse practitioner role reflects the continuing development of the nursing profession and substantially extends the career path for clinical nurses. This paper describes an aspect of a large-scale investigation into the feasibility of the role of the nurse practitioner in the Australian Capital Territory (ACT) health care system. The paper reports on the trial of practice for a wound care nurse practitioner model in a tertiary institution. In the trial the wound care nurse practitioner worked in an extended practice role for 10 months. The nurse practitioner practice was supported, monitored and mentored by a clinical support team. Data were collected relating to a range of outcomes including definition of the scope of practice for the model, description of patient demographics and outcomes and the efficacy of the nurse practitioner service. The findings informed the development of clinical protocols that define the scope of practice and the parameters of the wound care nurse practitioner model and provided information on the efficacy of this model of health care for the tertiary care environment. The findings further suggest that this model brings expert wound care and case management to an at-risk patient population. Recommendations are made relating to ongoing research into the role of the wound care nurse practitioner model in the ACT health care system.

What makes inner city high density living attractive? Insight from residents in Brisbane, Australia

Australia’s urban form and planning has shifted from traditional individual dwellings on spacious suburban blocks towards higher density urban consolidation. Despite relatively strong market demand for inner city high density (ICHD) living, there is ongoing need to explore and understand the aspects that make this urban form liveable and sustainable. The purpose of this research is to explore the viewpoints of current ICHD residents to better understand the liveability and sustainability matters that affect their everyday experiences and perceptions of this urban form. Qualitative interviews with 24 ICHD Brisbane (Australia) residents illustrates their perceptions and experiences of liveability and the ways in which it is broadly understood within three main domains and nine key sub-concepts, including: individual dwelling (thermal comfort, natural light and balconies, noise mitigation), building complex (shared space, good neighbour protocols, environmental sustainability) and the community (transport, amenities, sense of community). Focussing on the experience of ICHD residents, this research highlights the ways in which multiple aspects of the immediate living environment, the dwelling, building complex and the community intertwine to provide residents with a liveable space. The results show that urban features that reflect current societal pressure for greater sustainability such as lower energy use are the exact same features sought by ICHD residents in determining their liveability. By highlighting the aspects current ICHD residents value most about their dwellings, buildings and communities, these findings will help inform policy-makers, planners, developers and designers as they create urban spaces and dwellings that are more liveable and sustainable.

The emerging framework of cross-border insolvency in and around Australia : Saad Investments, Japan Airlines and Lehman Brothers – part one

Recent decades have witnessed a global acceleration of legislative and private sector initiatives to deal with Cross-Border insolvency. Legislative institutions include the various national implementations of the Model Law on Cross-Border Insolvency (Model Law) published by the United Nations Commission on International Trade (UNCITRAL).3 Private mechanisms include Cross-Border protocols developed and utilised by insolvency professionals and their advisers (often with the imprimatur of the judiciary), on both general and ad hoc bases. The Asia Pacific region has not escaped the effect of those developments, and the economic turmoil of the past few years has provided an early test for some of the emerging initiatives in that region. This two-part article explores the operation of those institutions through the medium of three recent cases.

The emerging framework of cross-border insolvency in and around Australia : Saad Investments, Japan Airlines and Lehman Brothers – Part Two

Recent decades have witnessed a global acceleration of legislative and private sector initiatives to deal with Cross-Border insolvency. Legislative institutions include the various national implementations of the Model Law on Cross-Border Insolvency (Model Law) published by the United Nations Commission on International Trade (UNCITRAL).3 Private mechanisms include Cross-Border protocols developed and utilised by insolvency professionals and their advisers (often with the imprimatur of the judiciary), on both general and ad hoc bases. The Asia Pacific region has not escaped the effect of those developments, and the economic turmoil of the past few years has provided an early test for some of the emerging initiatives in that region. This two-part article explores the operation of those institutions through the medium of three recent cases.

A reliable real-time transport protocol for control systems over wireless networks

Deploying networked control systems (NCSs) over wireless networks is becoming more and more popular. However, the widely-used transport layer protocols, Transmission Control Protocol (TCP) and User Datagram Protocol (UDP), are not designed for real-time applications. Therefore, they may not be suitable for many NCS application scenarios because of their limitations on reliability and/or delay performance, which real-control systems concern. Considering a typical type of NCSs with periodic and sporadic real-time traffic, this paper proposes a highly reliable transport layer protocol featuring a packet loss-sensitive retransmission mechanism and a prioritized transmission mechanism. The packet loss-sensitive retransmission mechanism is designed to improve the reliability of all traffic flows. And the prioritized transmission mechanism offers differentiated services for periodic and sporadic flows. Simulation results show that the proposed protocol has better reliability than UDP and improved delay performance than TCP over wireless networks, particularly when channel errors and congestions occur.

Efficient route update and maintenance processes for multipath routing in large-scale industrial wireless sensor networks

Reliable communications is one of the major concerns in wireless sensor networks (WSNs). Multipath routing is an effective way to improve communication reliability in WSNs. However, most of existing multipath routing protocols for sensor networks are reactive and require dynamic route discovery. If there are many sensor nodes from a source to a destination, the route discovery process will create a long end-to-end transmission delay, which causes difficulties in some time-critical applications. To overcome this difficulty, the efficient route update and maintenance processes are proposed in this paper. It aims to limit the amount of routing overhead with two-tier routing architecture and introduce the combination of piggyback and trigger update to replace the periodic update process, which is the main source of unnecessary routing overhead. Simulations are carried out to demonstrate the effectiveness of the proposed processes in improvement of total amount of routing overhead over existing popular routing protocols.

Social cars : sensing, gathering, sharing and conveying social cues to road users

Intelligent Transport Systems (ITS) resembles the infrastructure for ubiquitous computing in the car. It encompasses a) all kinds of sensing technologies within vehicles as well as road infrastructure, b) wireless communication protocols for the sensed information to be exchanged between vehicles (V2V) and between vehicles and infrastructure (V2I), and c) appropriate intelligent algorithms and computational technologies that process these real-time streams of information. As such, ITS can be considered a game changer. It provides the fundamental basis of new, innovative concepts and applications, similar to the Internet itself. The information sensed or gathered within or around the vehicle has led to a variety of context-aware in-vehicular technologies within the car. A simple example is the Anti-lock Breaking System (ABS), which releases the breaks when sensors detect that the wheels are locked. We refer to this type of context awareness as vehicle/technology awareness. V2V and V2I communication, often summarized as V2X, enables the exchange and sharing of sensed information amongst cars. As a result, the vehicle/technology awareness horizon of each individual car is expanded beyond its observable surrounding, paving the way to technologically enhance such already advanced systems. In this chapter, we draw attention to those application areas of sensing and V2X technologies, where the human (driver), the human’s behavior and hence the psychological perspective plays a more pivotal role. The focal points of our project are illustrated in Figure 1: In all areas, the vehicle first (1) gathers or senses information about the driver. Rather than to limit the use of such information towards vehicle/technology awareness, we see great potential for applications in which this sensed information is then (2) fed back to the driver for an increased self-awareness. In addition, by using V2V technologies, it can also be (3) passed to surrounding drivers for an increased social awareness, or (4), pushed even further, into the cloud, where it is collected and visualized for an increased, collective urban awareness within the urban community at large, which includes all city dwellers.

Improving the efficiency of RFID authentication with pre-computation

Security of RFID authentication protocols has received considerable interest recently. However, an important aspect of such protocols that has not received as much attention is the efficiency of their communication. In this paper we investigate the efficiency benefits of pre-computation for time-constrained applications in small to medium RFID networks. We also outline a protocol utilizing this mechanism in order to demonstrate the benefits and drawbacks of using thisapproach. The proposed protocol shows promising results as it is able to offer the security of untraceableprotocols whilst only requiring the time comparable to that of more efficient but traceable protocols.

Feasibility of agent-based modelling of articular cartilage including a conceptual representation of its structure

Articular cartilage is a complex structure with an architecture in which fluid-swollen proteoglycans constrained within a 3D network of collagen fibrils. Because of the complexity of the cartilage structure, the relationship between its mechanical behaviours at the macroscale level and its components at the micro-scale level are not completely understood. The research objective in this thesis is to create a new model of articular cartilage that can be used to simulate and obtain insight into the micro-macro-interaction and mechanisms underlying its mechanical responses during physiological function. The new model of articular cartilage has two characteristics, namely: i) not use fibre-reinforced composite material idealization ii) Provide a framework for that it does probing the micro mechanism of the fluid-solid interaction underlying the deformation of articular cartilage using simple rules of repartition instead of constitutive / physical laws and intuitive curve-fitting. Even though there are various microstructural and mechanical behaviours that can be studied, the scope of this thesis is limited to osmotic pressure formation and distribution and their influence on cartilage fluid diffusion and percolation, which in turn governs the deformation of the compression-loaded tissue. The study can be divided into two stages. In the first stage, the distributions and concentrations of proteoglycans, collagen and water were investigated using histological protocols. Based on this, the structure of cartilage was conceptualised as microscopic osmotic units that consist of these constituents that were distributed according to histological results. These units were repeated three-dimensionally to form the structural model of articular cartilage. In the second stage, cellular automata were incorporated into the resulting matrix (lattice) to simulate the osmotic pressure of the fluid and the movement of water within and out of the matrix; following the osmotic pressure gradient in accordance with the chosen rule of repartition of the pressure. The outcome of this study is the new model of articular cartilage that can be used to simulate and study the micromechanical behaviours of cartilage under different conditions of health and loading. These behaviours are illuminated at the microscale level using the socalled neighbourhood rules developed in the thesis in accordance with the typical requirements of cellular automata modelling. Using these rules and relevant Boundary Conditions to simulate pressure distribution and related fluid motion produced significant results that provided the following insight into the relationships between osmotic pressure gradient and associated fluid micromovement, and the deformation of the matrix. For example, it could be concluded that: 1. It is possible to model articular cartilage with the agent-based model of cellular automata and the Margolus neighbourhood rule. 2. The concept of 3D inter connected osmotic units is a viable structural model for the extracellular matrix of articular cartilage. 3. Different rules of osmotic pressure advection lead to different patterns of deformation in the cartilage matrix, enabling an insight into how this micromechanism influences macromechanical deformation. 4. When features such as transition coefficient were changed, permeability (representing change) is altered due to the change in concentrations of collagen, proteoglycans (i.e. degenerative conditions), the deformation process is impacted. 5. The boundary conditions also influence the relationship between osmotic pressure gradient and fluid movement at the micro-scale level. The outcomes are important to cartilage research since we can use these to study the microscale damage in the cartilage matrix. From this, we are able to monitor related diseases and their progression leading to potential insight into drug-cartilage interaction for treatment. This innovative model is an incremental progress on attempts at creating further computational modelling approaches to cartilage research and other fluid-saturated tissues and material systems.

Paramedics' perceptions of their role in palliative care : analysis of focus group transcripts

Paramedics play an important role in out-of-hospital health care. They provide unscheduled care, assisting both patients with minor injuries and those experiencing life-threatening emergencies. Increasingly, paramedics are called on to manage chronic and complex health needs, including symptom relief for patients at the end of life. However, paramedics may not be well prepared to offer palliative care, as practice guidelines and education tend to focus on the management of acute medical emergencies and major trauma. Emergency medical services that employ paramedics rarely have practice guidelines or protocols that deal specifically with palliative care.

Methodological challenges in conducting a systematic review of community wide interventions to increase physical activity

Introduction: Evaluating the effectiveness of interventions designed to increase the physical activity in communities is often a difficult and complex task, requiring considerable expertise and investment, and often constrained by methodological limitations. These limitations, in turn, create additional challenges when these studies are used in systematic reviews as they hinder the confidence, precision and interpretation of results. The objective of this paper is to summarise the methodological challenges posed in conducting a systematic review of community-wide physical activity interventions to help inform those conducting future primary research and systematic reviews. Methods: We conducted a Cochrane systematic review of community-wide interventions to increase physical activity. We assessed the methodological quality of the included studies. We will investigate these in greater detail, particularly in relation to the potential impact on measures of effect, confidence in results, generalizability of results and general interpretation. Results: The systematic review was conducted and has been published in the Cochrane Library. A logic model was helpful in defining and interpreting the studies. Many studies of unsuitable study design were excluded; however several important methodological limitations of the primary studies evaluating community-wide physical activity interventions emerged. These included: - the failure to use validated tools to measure physical activity; - issues associated with pre and post test designs; - inadequate sampling of populations; - poor control groups; and - intervention and measurement protocols of inadequate duration. Although it is challenging to undertake rigorous evaluations of complex interventions, these issues result in significant uncertainty over the effectiveness of these interventions, and the possible factors required for a community-wide intervention to be successful. In particular, the combination of several of these limitations (e.g. un-validated tools, inadequate sampling, and short duration) is that studies may lack the sensitivity to detect any meaningful change. Multiple publications of findings for the same study also made interpretation difficult; however, interventions with parallel qualitative publications were helpful. Discussion: Evaluating community wide interventions to increase physical activity in a rigorous way is incredibly challenging. These findings reflect these challenges but have important ramifications for researchers conducting primary studies to determine the efficacy of such interventions, as well as for researchers conducting systematic reviews. This new review shows that the inadequacies of design and evaluation are continuing. It is hoped that the adoption of such suggestions may aid in the development of systematic reviews, but more importantly, in enabling translation of such findings into policy and practice.

A state-aware RFID privacy model with reader corruption

A number of security models have been proposed for RFID systems. Recent studies show that current models tend to be limited in the number of properties they capture. Consequently, models are commonly unable to distinguish between protocols with regard to finer privacy properties. This paper proposes a privacy model that introduces previously unavailable expressions of privacy. Based on the well-studied notion of indistinguishability, the model also strives to be simpler, easier to use, and more intuitive compared to previous models.

A state-aware RFID privacy model with reader corruption

A number of security models have been proposed for RFID systems. Recent studies show that current models tend to be limited in the number of properties they capture. Consequently, models are commonly unable to distinguish between protocols with regard to finer privacy properties. This paper proposes a privacy model that introduces previously unavailable expressions of privacy. Based on the well-studied notion of indistinguishability, the model also strives to be simpler, easier to use, and more intuitive compared to previous models.

A simulation framework for smart meter security evaluation

The evolution of classic power grids to smart grids creates chances for most participants in the energy sector. Customers can save money by reducing energy consumption, energy providers can better predict energy demand and environment benefits since lower energy consumption implies lower energy production including a decrease of emissions from plants. But information and communication systems supporting smart grids can also be subject to classical or new network attacks. Attacks can result in serious damage such as harming privacy of customers, creating economical loss and even disturb the power supply/demand balance of large regions and countries. In this paper, we give an overview about the German smart measuring architecture, protocols and security. Afterwards, we present a simulation framework which enables researchers to analyze security aspects of smart measuring scenarios.

Mutually unbiased bases as submodules and subspaces

Mutually unbiased bases (MUBs) have been used in several cryptographic and communications applications. There has been much speculation regarding connections between MUBs and finite geometries. Most of which has focused on a connection with projective and affine planes. We propose a connection with higher dimensional projective geometries and projective Hjelmslev geometries. We show that this proposed geometric structure is present in several constructions of MUBs.