A systematic review of axillary web syndrome (AWS)

Introduction Axillary web syndrome (AWS) can result in early post-operative and long-term difficulties following lymphadenectomy for cancer and should be recognised by clinicians. This systematic review was conducted to synthesise information on AWS clinical presentation and diagnosis, frequency, natural progression, grading, pathoaetiology, risk factors, symptoms, interventions and outcomes. Methods Electronic searches were conducted using Cochrane, Pubmed, MEDLINE, CINAHL, EMBASE, AMED, PEDro and Google Scholar until June 2013. The methodological quality of included studies was determined using the Downs and Black checklist. Narrative synthesis of results was undertaken. Results Thirty-seven studies with methodological quality scores ranging from 11 to 26 on a 28-point scale were included. AWS diagnosis relies on inspection and palpation; grading has not been validated. AWS frequency was reported in up to 85.4 % of patients. Biopsies identified venous and lymphatic pathoaetiology with five studies suggesting lymphatic involvement. Twenty-one studies reported AWS occurrence within eight post-operative weeks, but late occurrence of greater than 3 months is possible. Pain was commonly reported with shoulder abduction more restricted than flexion. AWS symptoms usually resolve within 3 months but may persist. Risk factors may include extensiveness of surgery, younger age, lower body mass index, ethnicity and healing complications. Low-quality studies suggest that conservative approaches including analgesics, non-steroidal anti-inflammatory drugs and/or physiotherapy may be safe and effective for early symptom reduction. Conclusions AWS appears common. Current evidence for the treatment of AWS is insufficient to provide clear guidance for clinical practice. Implications for Cancer Survivors Cancer survivors should be informed about AWS. Further investigation is needed into pathoaetiology, long-term outcomes and to determine effective treatment using standardised outcomes.

Australian patients using a cardiac-diabetes web-based intervention program: Contributions to person-centered clinical practice

Rationale, aims and objectives: Patients with both cardiac disease and diabetes have poorer health outcomes than patients with only one chronic condition. While evidence indicates that internet based interventions may improve health outcomes for patients with a chronic disease, there is no literature on internet programs specific to cardiac patients with comorbid diabetes. Therefore this study aimed to develop a specific web-based program, then to explore patients’ perspectives on the usefulness of a new program. Methods: The interpretive approach using semi-structured interviews on a purposive sample of eligible patients with type 2 diabetes and a cardiac condition in a metropolitan hospital in Brisbane, Australia. Thematic analysis was undertaken to describe the perceived usefulness of a newly developed Heart2heart webpage. Results: Themes identified included confidence in hospital health professionals and reliance on doctors to manage conditions. Patients found the webpage useful for managing their conditions at home. Conclusions: The new Heart2heart webpage provided a positive and useful resource. Further research on to determine the potential influence of this resource on patients’ self-management behaviours is paramount. Implications for practice include using multimedia strategies for providing information to patients’ comorbidities of cardiac disease and type 2 diabetes, and further development on enhancement of such strategies

Tracking the patient journey by combining multiple hospital database systems

With new national targets for patient flow in public hospitals designed to increase efficiencies in patient care and resource use, better knowledge of events affecting length of stay will support improved bed management and scheduling of procedures. This paper presents a case study involving the integration of material from each of three databases in operation at one tertiary hospital and demonstrates it is possible to follow patient journeys from admission to discharge. What is known about this topic? At present, patient data at one Queensland tertiary hospital are assembled in three information systems: (1) the Hospital Based Corporate Information System (HBCIS), which tracks patients from in-patient admission to discharge; (2) the Emergency Department Information System (EDIS) containing patient data from presentation to departure from the emergency department; and (3) Operation Room Management Information System (ORMIS), which records surgical operations. What does this paper add? This paper describes how a new enquiry tool may be used to link the three hospital information systems for studying the hospital journey through different wards and/or operating theatres for both individual and groups of patients. What are the implications for practitioners? An understanding of the patients’ journeys provides better insight into patient flow and provides the tool for research relating to access block, as well as optimising the use of physical and human resources.

Systematic literature review of incidence rates of low-speed vehicle run-over incidents in children

Aim: To systematically review the literature investigating the incidence of fatal and or nonfatal low-speed vehicle run-over (LSVRO) incidents in children aged 0–15 years. Methods: The following databases were searched using specific search terms, from their date of conception up to June 2011: Cochrane Library, Medline, CINAHL, Embase, AMI, Sociological Abstracts, ERIC, PsycArticles, PsycInfo, Urban Studies and Planning; Australian Criminology Database; Dissertations and Thesis; Academic Research Library; Social Services Abstracts; Family and Society; Scopus; and Web of Science. A total of 128 articles were identified in the databases (33 found by hand searching). The title and abstract of these were read, and 102 were removed because they were not primary research articles relating to LSVRO-type injuries. Twenty-six articles were assessed against the inclusion (reporting population level incidence rates) and exclusion criteria, 19 of which were excluded, leaving a total of five articles for inclusion in the review. Findings: Five studies were identified that met the inclusion criteria. The incidence rate in nonfatal LSVRO events varied in the range of 7.09 to 14.79 per 100,000 and from 0.63 to 3.2 per 100,000 in fatal events. Discussion: Using International Classification of Diseases codes for classifying fatal or nonfatal LSVRO incidents is problematic as there is no specific code for LSVRO. The current body of research is void of a comprehensive secular population data analysis. Only with an improved spectrum of incidence rates will appropriate evaluation of this problem be possible, and this will inform nursing prevention interventions. The effect of LSVRO incidents is clearly understudied. More research is required to address incidence rates in relation to culture, environment, risk factors, car design, and injury characteristics. Conclusions: Thevlack of nursing research or policy around this area of injury, most often to children, indicates a field of inquiry and policy development that needs attention.

Doing Digital Composition on the Social Web: Knowledge Processes in Literacy Learning

The power to influence others in ever-expanding social networks in the new knowledge economy is tied to capabilities with digital media production. This chapter draws on research in elementary classrooms to examine the repertoires of cross-disciplinary knowledge that literacy learners need to produce innovative digital media via the “social web”. It focuses on the knowledge processes that occurred when elementary students engaged in multimodal text production with new digital media. It draws on Kalantzis and Cope’s (2008) heuristic for theorizing “Knowledge Processes” in the Learning by Design approach to pedagogy. Learners demonstrate eight “Knowledge Processes” across different subject domains, skills areas, and sensibilities. Drawing data from media-based lessons across several classroom and schools, this chapter examines what kinds of knowledge students utilize when they produce digital, multimodal texts in the classroom. The Learning by Design framework is used as an analytic tool to theorize how students learn when they engaged in a specific domain of learning – digital media production.

Finding within-organisation spatial information on the web

Information available on company websites can help people navigate to the offices of groups and individuals within the company. Automatically retrieving this within-organisation spatial information is a challenging AI problem This paper introduces a novel unsupervised pattern-based method to extract within-organisation spatial information by taking advantage of HTML structure patterns, together with a novel Conditional Random Fields (CRF) based method to identify different categories of within-organisation spatial information. The results show that the proposed method can achieve a high performance in terms of F-Score, indicating that this purely syntactic method based on web search and an analysis of HTML structure is well-suited for retrieving within-organisation spatial information.

“I have to rest all the time because you are not allowed to play”: Exploring children’s perceptions of autonomy during sleep-time in long day care services

Daytime sleep is a significant part of the daily routine for children attending early childhood education and care (ECEC) services in Australia and many other countries. The practice of sleep-time can account for a substantial portion of the day in ECEC and often involves a mandated sleep/rest period for all children, including older preschool-aged children. Yet, there is evidence that children have a reduced need for daytime sleep as they approach school entry age and that continuation of mandated sleep-time in ECEC for preschool-aged children may have a negative impact on their health, development, learning and well-being. Mandated sleep-time practices also go against current quality expectations for services to support children’s agency and autonomy in ECEC. This study documents children’s reports of their experiences of sleep-time in ECEC. Semi-structured interviews were conducted with 54 preschool-aged children (44–63 months) across four long day ECEC services that employed a range of sleep-time practices. Findings provide a snapshot of children’s views and experiences of sleep-time and perceptions of autonomy-supportive practices. These provide a unique platform to support critical reflection on sleep-time policies and practices, with a view to continuous quality improvement in ECEC. This study forms part of a programme of work from the Sleep in Early Childhood research group. Our work examines sleep practices in ECEC, the subsequent staff, parent and child experiences and impacts on family and child learning and development outcomes.

CSSP (Consensus Secondary Structure Prediction): a web-based server for structural biologists

Sequence-structure correlation studies are important in deciphering the relationships between various structural aspects, which may shed light on the protein-folding problem. The first step of this process is the prediction of secondary structure for a protein sequence of unknown three-dimensional structure. To this end, a web server has been created to predict the consensus secondary structure using well known algorithms from the literature. Furthermore, the server allows users to see the occurrence of predicted secondary structural elements in other structure and sequence databases and to visualize predicted helices as a helical wheel plot. The web server is accessible at http://bioserver1.physics.iisc.ernet.in/cssp/.

Generalized Query-By-Rule: a heterogeneous database query language

This paper describes the design and implementation of a high-level query language called Generalized Query-By-Rule (GQBR) which supports retrieval, insertion, deletion and update operations. This language, based on the formalism of database logic, enables the users to access each database in a distributed heterogeneous environment, without having to learn all the different data manipulation languages. The compiler has been implemented on a DEC 1090 system in Pascal.

ADAMIS: a database for medical information systems

This paper describes the design and implementation of ADAMIS (‘A database for medical information systems’). ADAMIS is a relational database management system for a general hospital environment. Apart from the usual database (DB) facilities of data definition and data manipulation, ADAMIS supports a query language called the ‘simplified medical query language’ (SMQL) which is completely end-user oriented and highly non-procedural. Other features of ADAMIS include provision of facilities for statistics collection and report generation. ADAMIS also provides adequate security and integrity features and has been designed mainly for use on interactive terminals.

Access path query language for relational database systems

Database management systems offer a very reliable and attractive data organization for fast and economical information storage and processing for diverse applications. It is much more important that the information should be easily accessible to users with varied backgrounds, professional as well as casual, through a suitable data sublanguage. The language adopted here (APPLE) is one such language for relational database systems and is completely nonprocedural and well suited to users with minimum or no programming background. This is supported by an access path model which permits the user to formulate completely nonprocedural queries expressed solely in terms of attribute names. The data description language (DDL) and data manipulation language (DML) features of APPLE are also discussed. The underlying relational database has been implemented with the help of the DATATRIEVE-11 utility for record and domain definition which is available on the PDP-11/35. The package is coded in Pascal and MACRO-11. Further, most of the limitations of the DATATRIEVE-11 utility have been eliminated in the interface package.

Is there a relationship between screening for diabetes related foot complications and limb amputation?

Background From the conservative estimates of registrants with the National Diabetes Supply Scheme, we will be soon passing 1.1 Million Australians affected by all types of diabetes. The diabetes complications of foot ulceration and amputation are costly to all. These costs can be reduced with appropriate prevention strategies, starting with identifying people at risk through primary care diabetic foot screening. Yet levels of diabetic foot screening in Australia are difficult to quantify. This presentation aims to report on foot screening rates as recorded in existing academic literature, national health surveys and national database reports. Methods Literature searches included diabetic foot screening that occurred in the primary care setting for populations over 2000 people from 2002 to 2014. Searches were performed using Medline and CINAHL as well as internet searches of Organisations for Economic Co-operation and Development (OECD) countries health databases. The focus is on type 1 and type 2 diabetes in adults, and not gestational diabetes or children. The two primary outcome measures were foot -screening rates as a percentage of adult diabetic population and major lower limb amputation incidence rates from standardised OECD data. Results The most recent and accurate level for Australian population review was in the AUSDIAB (Australian Diabetes and lifestyle survey) from 2004. This survey reported screening in primary care to be as low as 50%. Countries such as the United Kingdom and United States of America have much higher reported rates of foot screening (67-86%) recorded using national databases and web based initiatives that involve patients and clinicians. By comparison major amputation rates for Australia were similar to the United Kingdom at 6.5 versus 5.1 per 100,000 population, but dis-similar to the United States of America at 17 per 100,000 population. Conclusions Australian rates of diabetic foot screening in primary care centres is ambiguous. There is no direct relationship between foot screening levels in a primary care environment and major lower limb amputation, based on national health survey's and OECD data. Uptake of national registers, incentives and web-based systems improve levels of diabetic foot assessment, which are the first steps to a healthier diabetic population.

World Wide Web korpuksena kielitieteellisen tutkimusaineiston haku verkkosivuilta

Tämä tutkielma käsittelee World Wide Webin sisältämien verkkosivujen sisältöjen käyttöä korpusmaisesti kielitieteellisenä tutkimusaineistona. World Wide Web sisältää moninkertaisesti enemmän tekstiä kuin suurimmat olemassa olevat perinteiset tekstikorpukset, joten verkkosivuilta voi todennäköisesti löytää paljon esiintymiä sellaisista sanoista ja rakenteista, jotka ovat perinteisissä korpuksissa harvinaisia. Verkkosivuja voidaan käyttää aineistona kahdella eri tavalla: voidaan kerätä satunnainen otos verkkosivuista ja luoda itsenäinen korpus niiden sisällöistä, tai käyttää koko World Wide Webiä korpuksena verkkohakukoneiden kautta. Verkkosivuja on käytetty tutkimusaineistona monilla eri kielitieteen aloilla, kuten leksikograafisessa tutkimuksessa, syntaktisten rakenteiden tutkimuksessa, pedagogisena materiaalina ja vähemmistökielten tutkimuksessa. Verkkosivuilla on perinteisiin korpuksiin verrattuna useita haitallisia ominaisuuksia, jotka pitää ottaa huomioon, kun niitä käytetään aineistona. Kaikki sivut eivät sisällä kelvollista tekstiä, ja sivut ovat usein esimerkiksi HTML-muotoisia, jolloin ne pitää muuttaa helpommin käsiteltävissä olevaan muotoon. Verkkosivut sisältävät enemmän kielellisiä virheitä kuin perinteiset korpukset, ja niiden tekstityypit ja aihepiirit ovat runsaslukuisempia kuin perinteisten korpusten. Aineiston keräämiseen verkkosivuilta tarvitaan tehokkaita ohjelmatyökaluja. Näistä yleisimpiä ovat kaupalliset verkkohakukoneet, joiden kautta on mahdollista päästä nopeasti käsiksi suureen määrään erilaisia sivuja. Näiden lisäksi voidaan käyttää erityisesti kielitieteellisiin tarpeisiin kehitettyjä työkaluja. Tässä tutkielmassa esitellään ohjelmatyökalut WebCorp, WebAsCorpus.org, BootCaT ja Web as Corpus Toolkit, joiden avulla voi hakea aineistoa verkkosivuilta nimenomaan kielitieteellisiin tarkoituksiin.

Data definition and manipulation languages for a CAD database

In this paper the main features of ARDBID (A Relational Database for Interactive Design) have been described. An overview of the organization of the database has been presented and a detailed description of the data definition and manipulation languages has been given. These have been implemented on a DEC 1090 system.