Management of delirium in medicine : experience of a close observation unit

Objective(s): A new model of care for the management of patients with delirium was developed and evaluated. Method: A 4-bedded Close Observation Unit (COU) was introduced. The model comprised an education strategy for assistants in nursing (AIN), environmental adaptations and AIN to patient ratio of 1:4. Outcomes in all patients with delirium before and after introduction of the new model of care were compared. Results: 105 patients were admitted to COU, of whom 100 (95%) were diagnosed with delirium. In-hospital mortality improved after introduction of the unit (15% versus 5%; p=0.002) without significant change in length of stay, discharge destination or falls frequency. Conclusion: A dedicated unit for delirium management within medicine achieved a reduction in mortality.

Towards Bayesian experimental design for nonlinear models that require a large number of sampling times

The use of Bayesian methodologies for solving optimal experimental design problems has increased. Many of these methods have been found to be computationally intensive for design problems that require a large number of design points. A simulation-based approach that can be used to solve optimal design problems in which one is interested in finding a large number of (near) optimal design points for a small number of design variables is presented. The approach involves the use of lower dimensional parameterisations that consist of a few design variables, which generate multiple design points. Using this approach, one simply has to search over a few design variables, rather than searching over a large number of optimal design points, thus providing substantial computational savings. The methodologies are demonstrated on four applications, including the selection of sampling times for pharmacokinetic and heat transfer studies, and involve nonlinear models. Several Bayesian design criteria are also compared and contrasted, as well as several different lower dimensional parameterisation schemes for generating the many design points.

Weight stigma in maternity care : women's experiences and care providers' attitudes

Background: Weight stigma is pervasive in Western society and in healthcare settings, and has a negative impact on victims’ psychological and physical health. In the context of an increasing focus on the management of overweight and obese women during and after pregnancy in research and clinical practice, the current studies aimed to examine the presence of weight stigma in maternity care. Addressing previous limitations in the weight stigma literature, this paper quantitatively explores the presence of weight stigma from both patient and care provider perspectives. Methods: Study One investigated associations between pre-pregnancy body mass index (BMI) and experiences of maternity care from a state-wide, self-reported survey of 627 Australian women who gave birth in 2009. Study Two involved administration of an online survey to 248 Australian pre-service medical and maternity care providers, to investigate their perceptions of, and attitudes towards, providing care for pregnant patients of differing body sizes. Both studies used linear regression analyses. Results: Women with a higher BMI were more likely to report negative experiences of care during pregnancy and after birth, compared to lower weight women. Pre-service maternity care providers perceived overweight and obese women as having poorer self-management behaviours, and reported less positive attitudes towards caring for overweight or obese pregnant women, than normal weight pregnant women. Even care providers who reported few weight-stigmatising attitudes responded less positively to overweight and obese pregnant women. Conclusions: Overall, these results provide preliminary evidence that weight stigma is present in maternity care settings in Australia. They suggest a need for further research into the nature and consequences of weight stigma in maternity care, and for the inclusion of strategies to recognise and combat weight stigma in maternity care professionals’ training.

A meta-analysis of genome-wide association studies to identify prostate cancer susceptibility loci associated with aggressive and non-aggressive disease

Genome-wide association studies (GWAS) have identified multiple common genetic variants associated with an increased risk of prostate cancer (PrCa), but these explain less than one-third of the heritability. To identify further susceptibility alleles, we conducted a meta-analysis of four GWAS including 5953 cases of aggressive PrCa and 11 463 controls (men without PrCa). We computed association tests for approximately 2.6 million SNPs and followed up the most significant SNPs by genotyping 49 121 samples in 29 studies through the international PRACTICAL and BPC3 consortia. We not only confirmed the association of a PrCa susceptibility locus, rs11672691 on chromosome 19, but also showed an association with aggressive PrCa [odds ratio = 1.12 (95% confidence interval 1.03-1.21), P = 1.4 × 10(-8)]. This report describes a genetic variant which is associated with aggressive PrCa, which is a type of PrCa associated with a poorer prognosis.

Identification of 23 new prostate cancer susceptibility loci using the iCOGS custom genotyping

Prostate cancer is the most frequently diagnosed cancer in males in developed countries. To identify common prostate cancer susceptibility alleles, we genotyped 211,155 SNPs on a custom Illumina array (iCOGS) in blood DNA from 25,074 prostate cancer cases and 24,272 controls from the international PRACTICAL Consortium. Twenty-three new prostate cancer susceptibility loci were identified at genome-wide significance (P < 5 × 10−8). More than 70 prostate cancer susceptibility loci, explaining ~30% of the familial risk for this disease, have now been identified. On the basis of combined risks conferred by the new and previously known risk loci, the top 1% of the risk distribution has a 4.7-fold higher risk than the average of the population being profiled. These results will facilitate population risk stratification for clinical studies.

Kaolinite - NMF intercalates

Bulk and size-fractionated kaolinites from seven localities in Australia as well as the Clay Minerals Society Source Clays Georgia KGa-1 and KGa-2 have been studied by X-ray diffraction (XRD), laser scattering, and electron microscopy in order to understand the variation of particle characteristics across a range of environments and to correlate specific particle characteristics with intercalation behavior. All kaolinites have been intercalated with N-methyl formamide (NMF) after pretreatment with hydrazine hydrate, and the relative efficiency of intercalation has been determined using XRD. Intercalate yields of kaolinite: NMF are consistently low for bulk samples that have a high proportion of small-sized particles (i.e., <0.5 µm) and for biphased kaolinites with a high percentage (>60%) of low-defect phase. In general, particle size appears to be a more significant controlling factor than defect distribution in determining the relative yield of kaolinite: NMF intercalate.

Existential place-making : the dialogical realms of design for dwelling with disability

The world of disability is often neglected or taken for granted in able-bodied society. Apart from the challenge that disability is a social construct (Linton, 1998, 2006; Longmore, 2003; Thompson, 1997) there is an impact on the people with disability that they either feel left out or they don’t belong in the larger community. The able-bodied community is also left with very little knowledge or no sensitivity towards people with disability. These internal whirlpools do not contribute to any community only to create larger gaps and higher differences between the groups of people. Peace (2010) claims that disability is something imposed on to a person on top of a physical impairment. Nord (2008) advocates that while environmental barriers and social attitudes are crucial aspects of a person’s experience, they can indeed disable a person. The study reported high-lights what is home for people with disability and their family members. The way the person with disability and family members without disability share the same home and nurture personal relationships with each other demands greater attention. This research sheds light on the intricate relationships that exists between the family members including person with disability and their built environment. These existential connections provide a holistic viewpoint and the glimpse into the lived experiences of homes for people with disability and their care-givers. Concepts of universal design or barrier free design have not been successful (Connell and Sanford, 1999) in revealing in-depth the nature of place-making for people with disability and their care-givers. Such studies fail to incorporate the holistic needs of individuals with disability and their family members in terms of their bodily, visceral, emotional, social, psycho-social, intuitive, spiritual and temporal needs, to name a few (Franz, Bitner, 2010). This paper reports on some preliminary findings on phenomena of dwelling for people with different kinds of disability and their care-givers sharing the same home from an interior design perspective.

Abstraction as noise : enhancing the poetic

Abstraction in its resistance to evident meaning has the capacity to interrupt or at least provide tools with which to question an overly compliant reception of the information to which we are subject. It does so by highlighting a latency or potentiality inherent in materiality that points to the possibility of a critical resistance to this ceaseless flow of sound/image/data. This resistance has been remarked on in differing ways by a number of commentators such as Lyotard, in his exploration of the avant-garde and the sublime for example. This joint paper will initially map the collaborative project by Daniel Mafe and Andrew Brown, Affecting Interference which conjoins painting with digital sound and animations into a single, large scale, immersive exhibition/installation. The work acts as an interstitial point between contrasting approaches to abstraction: the visual and aural, the digital and analogue. The paper will then explore the ramifications of this through the examination of abstraction as ‘noise’, that is as that raw inassimilable materiality, within which lays the creative possibility to forge and embrace the as-yet-unthought and almost-forgotten. It does so by establishing a space for a more poetic and slower paced critical engagement for the viewing and receiving information or data. This slowing of perception through the suspension of easy recognition runs counter to our current ‘high performance’ culture, and it’s requisite demand for speedy assimilation of content, representing instead the poetic encounter with a potentiality or latency inherent in the nameless particularity of that which is.

Seriously playful : the uses of networked spoof videos in China

This thesis examines online spoof videos in China. It shows the relationship between user-created content and change and how such videos are impacting on social memory. In the West, we are witnessing two outstanding trends in media. On the one hand, media are turning more "demotic" (Turner, 2006) and "participatory" (Jenkins, 2006), whereby lay audiences use popular media for identity formation, representation and association, reconfiguring the media and cultural landscape, and rendering invalid the old paradigm based on the dichotomy of audience and author, creator and consumer, expert and amateur. On the other hand, in both mainstream media and user-creation online there is a trend towards "silly citizenship", with comedy, send-ups and spoofs that used to reside in the margin propelled to the central stage in both pleasure and politics (Hartley, 2010), as is shown in the rising popularity of the Daily Show, Colbert Report, and spoof videos in elections ,e.g. the 2008 presidential election in US (Gray, Jones, & Thompson, 2009; Tryon, 2008). User generated content—and spoof subcultures—is now much a debated phenomenon in China. However, with different political (one party rule and censorship) and cultural (media regarded mainly as instrument for education and social stabilization instead of a critical fourth estate) configurations, will the social and cultural impacts of the two trends in the West be as the same in China? If not, what will be the specificities in the China context? The project starts with a historical review of popular culture and user-created content in China, before turning to spoof videos and looking at how they are produced and shared, travel and diffused on the Internet, and how the communities and sub-cultures forming and emerging around spoof videos are changing the overall cultural landscape in China. By acting as a participant observer in online video sharing sites and conducting face-to face as well as online interviews, I identify lead users and creators of spoof videos and the social networks emerging around them. I call these lead users "skill hubs" and their networks "liquid communities", foregrounding the fact that their appeal doesn’t come from their amicable personality, but rather from their creative skills; and that the networks surrounding them are in a permanent flux, with members coming and going as they see fit. I argue that the "liquidness" (Bauman, 2000) of these communities is what makes them constantly creative and appealing. Textual analysis of online videos, their comments and derivatives are conducted to tease out the uses that that can be made of spoof videos, namely as phatic communication, as alternative memory and as political engagement. Through these analyses I show that spoof videos constitute not only a space where young generations can engage with each other, communicate their anger and dissatisfaction, fun and hope, and where they participate in socio-cultural and political debates, but also create a space where they can experiment with their new skills, new ideas, and new citizenship. The rise of spoof videos heralds the beginning of a trend in popular culture in contemporary China towards the "canonization of the jester" and the dethroning of the establishment. I also argue that a historical perspective is needed to understand the current surge of use creativity and user activism in China, and that many forms of popular media we experience today have their antecedents in various stages of Chinese history. The entrenched "control-resistance" binary is inadequate in interpreting the rich, flux and multilayered Internet space in China.

National architecture conference 2012

May was a particularly busy month with lots of exciting architectural things happening in Brisbane, including the sell-out 2012 National Architecture Conference. The total number of conference attendees was 1,625, which was the largest number of attendees to any Australian National Architecture Conference to date. This was the first time that the National Architecture Conference had been held in Brisbane in over 20 years, and the enormous turnout of 947 Queenslanders to the conference was testament to the positive decision to include Brisbane as a conference venue. The theme of this year’s conference was ‘experience’. Building on ideas introduced in the recent ‘natural artifice’ conference, creative directors Shane Thompson, Michael Rayner and Peter Skinner focused closely on the real, sensed experience of architecture within its natural and constructed settings and the experience of designing and making architecture. The conference attracted a variety of high profile international speakers, including architect and professor, Wang Shu, the 2012 Pritzker Architecture Prize Laureate and co-founder of the Amateur Architecture Studio in China. Other highlights included presentations from Peter Rich [South Africa], Kathryn Findlay [United Kingdom], Rachel Neeson [Australia], Anuradha Mathur & Dilip da Cunha [United States] and Kjetil Thorsen [Norway]. QUT had a strong presence at the conference. In addition to pleasing attendance rates from QUT School of Design students and staff, our Head-of-School Professor Paul Sanders, was given the honourable task of introducing keynote speaker Peter Rich, and facilitating the Q&A session after his presentation, which received a standing ovation. There were many events organised for students and young architects by QUT’s SONA reps, including a masterclass, opening party, collaborative design and construction of the SONA Pavilion, and finally, organisation of the all important SONA Hangover Breakfast, the morning after the closing party. The 2012 National Architecture Conference was truly memorable and an experience not to have been missed. I encourage anyone with a passion for architecture and a desire to be completely inspired by current and emerging leaders in our exciting profession, to start making plans to attend next year’s conference.

To separate or not to separate? Parental decision-making regarding the separation of twins in the early years of schooling

In recent times concerns about possible adverse effects of early separation and advocacy for individual rights have resulted in a movement away from organizational level policies about the separation of twin children as they enter school. Instead, individualized approaches that focus on the twin children’s characteristics and family perspectives have been proposed. This study, conducted in Australia where all but a few families had choice about the class placement of their twin children, questioned parents (N = 156) about their placement decisions. Results indicated that most parents opted for placement together in the early years of schooling. The choice to separate twins at school entry was associated with parent identification of risk in the twin relationship, while being kept together was associated with parent identification of absence of such risk. The findings are discussed in light of the current evidence against separation, and suggest that parent choices regarding the separation of twin children in the early years are informative to educational policy and practice.

Kaolin derivatives

Amorphous derivatives of kaolin group minerals characterized by high specific surfaces and/or high cation exchange capacities and a .sup.27 AL MAS NMR spectrum having a dominant peak at about 55 ppm relative to Al(H.sub.2 O).sub.6.sup.3+. Such derivatives are prepared by reacting a kaolin group mineral with a reagent, such as, an alkali metal halide or an ammonium halide which converts the majority of the octahedrally coordinated aluminum in the kaolin group mineral to tetrahedrally coordinated aluminum. Such derivatives show high selectivity in its cation exchange towards the metals: Pb.sup.2+, Cu.sup.2+, Cd.sup.2+, Ni.sup.2+, CO.sup.2+, Cr.sup.3+, Sr.sup.2-, Zn.sup.2+, Nd.sup.3+ and UO.sub.2.sup.+.

Work integrated research higher degree studies : experiences, benefits, barriers and coping strategies

Attributed to the changing social, political and economic landscape of the ‘knowledge economy’, Australian universities are under pressure to produce researchers that have a variety of skills which meet the demands of an increasingly diverse job market. As a consequence, the Australian PhD now includes a range of doctoral degrees. This paper reports on the experiences of two PhD students engaged in an informally managed research higher degree program described in this paper as a Work Integrated Research Higher Degree (WIRHD). Their learning process shares the attributes from both the traditional PhD program and professional doctorates. However, because of the blended nature of the learning contexts, what students need to manage within the WIRHD is much more complicated than the established RHD programs. An exploratory case study approach exploring experiences, benefits, barriers and coping strategies was conducted with the view to develop a preliminary integrative framework that attempts to explain the various contexts that influence the learning experience of WIRHD candidates. The paper concludes with some recommended strategies for helping WIRHD candidates to manage the challenges associated with their learning process.