Diarrhoea risk factors in enterally tube fed critically ill patients : a retrospective audit

Objective: Diarrhoea in the enterally tube fed (ETF) intensive care unit (ICU) patient is a multifactorial problem. Diarrhoeal aetiologies in this patient cohort remain debatable; however, the consequences of diarrhoea have been well established and include electrolyte imbalance, dehydration, bacterial translocation, peri anal wound contamination and sleep deprivation. This study examined the incidence of diarrhoea and explored factors contributing to the development of diarrhoea in the ETF, critically ill, adult patient. ---------- Method: After institutional ethical review and approval, a single centre medical chart audit was undertaken to examine the incidence of diarrhoea in ETF, critically ill patients. Retrospective, non-probability sequential sampling was used of all emergency admission adult ICU patients who met the inclusion/exclusion criteria. ---------- Results: Fifty patients were audited. Faecal frequency, consistency and quantity were considered important criteria in defining ETF diarrhoea. The incidence of diarrhoea was 78%. Total patient diarrhoea days (r = 0.422; p = 0.02) and total diarrhoea frequency (r = 0.313; p = 0.027) increased when the patient was ETF for longer periods of time. Increased severity of illness, peripheral oxygen saturation (Sp02), glucose control, albumin and white cell count were found to be statistically significant factors for the development of diarrhoea. ---------- Conclusion: Diarrhoea in ETF critically ill patients is multi-factorial. The early identification of diarrhoea risk factors and the development of a diarrhoea risk management algorithm is recommended.

The Heavy Vehicle Study : a case-control study investigating risk factors for crash in long distance heavy vehicle drivers in Australia

Background Heavy vehicle transportation continues to grow internationally; yet crash rates are high, and the risk of injury and death extends to all road users. The work environment for the heavy vehicle driver poses many challenges; conditions such as scheduling and payment are proposed risk factors for crash, yet the precise measure of these needs quantifying. Other risk factors such as sleep disorders including obstructive sleep apnoea have been shown to increase crash risk in motor vehicle drivers however the risk of heavy vehicle crash from this and related health conditions needs detailed investigation. Methods and Design The proposed case control study will recruit 1034 long distance heavy vehicle drivers: 517 who have crashed and 517 who have not. All participants will be interviewed at length, regarding their driving and crash history, typical workloads, scheduling and payment, trip history over several days, sleep patterns, health, and substance use. All participants will have administered a nasal flow monitor for the detection of obstructive sleep apnoea. Discussion Significant attention has been paid to the enforcement of legislation aiming to deter problems such as excess loading, speeding and substance use; however, there is inconclusive evidence as to the direction and strength of associations of many other postulated risk factors for heavy vehicle crashes. The influence of factors such as remuneration and scheduling on crash risk is unclear; so too the association between sleep apnoea and the risk of heavy vehicle driver crash. Contributory factors such as sleep quality and quantity, body mass and health status will be investigated. Quantifying the measure of effect of these factors on the heavy vehicle driver will inform policy development that aims toward safer driving practices and reduction in heavy vehicle crash; protecting the lives of many on the road network.

Information transfer for multi-trauma patients on discharge from the emergency department : mixed-method narrative review

Aim. This paper is a report of a review conducted to identify (a) best practice in information transfer from the emergency department for multi-trauma patients; (b) conduits and barriers to information transfer in trauma care and related settings; and (c) interventions that have an impact on information communication at handover and beyond. Background. Information transfer is integral to effective trauma care, and communication breakdown results in important challenges to this. However, evidence of adequacy of structures and processes to ensure transfer of patient information through the acute phase of trauma care is limited. Data sources. Papers were sourced from a search of 12 online databases and scanning references from relevant papers for 1990–2009. Review methods. The review was conducted according to the University of York’s Centre for Reviews and Dissemination guidelines. Studies were included if they concerned issues that influenced information transfer for patients in healthcare settings. Results. Forty-five research papers, four literature reviews and one policy statement were found to be relevant to parts of the topic, but not all of it. The main issues emerging concerned the impact of communication breakdown in some form, and included communication issues within trauma team processes, lack of structure and clarity during handovers including missing, irrelevant and inaccurate information, distractions and poorly documented care. Conclusion. Many factors influence information transfer but are poorly identified in relation to trauma care. The measurement of information transfer, which is integral to patient handover, has not been the focus of research to date. Nonetheless, documented patient information is considered evidence of care and a resource that affects continuing care.

Parliamentary committees are important in developing policy: evidence from a Queensland case study

Abstract This paper uses a case study to identify the impact of a Queensland parliamentary committee on policy. In 2003, the Travelsafe Committee undertook two inquiries investigating young driver and rider issues. In 2007, the Queensland Parliament passed legislation that provided the power to make regulations that changed the graduated driver licensing laws in Queensland. The analysis of the second reading speeches for this bill suggests that parliamentary committees can help set the agenda for government policy. The role of the Travelsafe Committee in this process was recognised by both government and non-government members of Parliament and by those that had been, or were currently, members of the committee and by those that had no membership experience of the Travelsafe Committee prior to the debate of the legislation. This paper suggests that in order for committees to successfully participate in policy work they need to have strong ideas, work to a consistently high standard and the chair needs to be dedicated to the work of the committee. This case study indicates the importance of parliamentary committees in the policy work of a parliament.

Citizen journalism and everyday life : a case study of Germany's myHeimat.de

The impact of citizen journalism on the established journalism industry, and its role in the future news media mix, remain key topics in current journalism studies research, not least in the context of the current crisis facing many news organisations around the globe. The centrality of this issue is also reflected in the substantial number of ‘citizen journalism’ monographs and collections published across the last few years (see for example Paterson & Domingo, 2008; Boler, 2008; Allan & Thorsen, 2009; Neuberger, Nuernbergk, & Rischke, 2009; Gordon, 2009; Russell & Echchaibi, 2009; Meikle & Redden, forthcoming). With relatively few notable exceptions, much of the research and wider public discussion surrounding the citizen journalism phenomenon has employed a relatively narrow definition of the term, with many researchers focussing on citizen journalism projects which provide mainly political news and commentary, and on their role in influencing the political process especially in countries like the U.S.

The Guardian reportage of the UK MP expenses scandal: a case study of computational journalism

The Guardian reportage of the United Kingdom Member of Parliament (MP) expenses scandal of 2009 used crowdsourcing and computational journalism techniques. Computational journalism can be broadly defined as the application of computer science techniques to the activities of journalism. Its foundation lies in computer assisted reporting techniques and its importance is increasing due to the: (a) increasing availability of large scale government datasets for scrutiny; (b) declining cost, increasing power and ease of use of data mining and filtering software; and Web 2.0; and (c) explosion of online public engagement and opinion.. This paper provides a case study of the Guardian MP expenses scandal reportage and reveals some key challenges and opportunities for digital journalism. It finds journalists may increasingly take an active role in understanding, interpreting, verifying and reporting clues or conclusions that arise from the interrogations of datasets (computational journalism). Secondly a distinction should be made between information reportage and computational journalism in the digital realm, just as a distinction might be made between citizen reporting and citizen journalism. Thirdly, an opportunity exists for online news providers to take a ‘curatorial’ role, selecting and making easily available the best data sources for readers to use (information reportage). These activities have always been fundamental to journalism, however the way in which they are undertaken may change. Findings from this paper may suggest opportunities and challenges for the implementation of computational journalism techniques in practice by digital Australian media providers, and further areas of research.

Reduction of environmental effects of civil aircraft through multi-objective flight plan optimisation

With rising environmental alarm, the reduction of critical aircraft emissions including carbon dioxides (CO2) and nitrogen oxides (NOx) is one of most important aeronautical problems. There can be many possible attempts to solve such problem by designing new wing/aircraft shape, new efficient engine, etc. The paper rather provides a set of acceptable flight plans as a first step besides replacing current aircrafts. The paper investigates a green aircraft design optimisation in terms of aircraft range, mission fuel weight (CO2) and NOx using advanced Evolutionary Algorithms coupled to flight optimisation system software. Two multi-objective design optimisations are conducted to find the best set of flight plans for current aircrafts considering discretised altitude and Mach numbers without designing aircraft shape and engine types. The objectives of first optimisation are to maximise range of aircraft while minimising NOx with constant mission fuel weight. The second optimisation considers minimisation of mission fuel weight and NOx with fixed aircraft range. Numerical results show that the method is able to capture a set of useful trade-offs that reduce NOx and CO2 (minimum mission fuel weight).

New affordable strata title housing solutions : a case study in Surabaya, Indonesia

Accessibility to affordable housing for low income people are one of the housing problems in Indonesia, especially in major cities like Jakarta and Surabaya. Government has provided indirect subsidised on home ownership for low income people through planning instrument such as inclusionary zoning. However, low cost housing has been located in cheaper land which is very far from city and employment centre. This paper aims to discuss recent government initiatives to support low cost strata title housing in prime location which closer to the employment centre. This paper compares the characteristics of existing affordable housing solutions and focus on a new initiative as a case study. Learning from this initiative will allow a recommendation on application of similar scheme in other sites. The land availability, high construction cost, culture barriers and higher risk with lower return have been named as main barriers on repeating this model in other sites. Moreover, the high-rise solution is still very expensive compared to landed houses.

Deterring drug drivers : a study into the initial impact of oral random roadside drug testing in Queensland

Objective: The global implementation of oral random roadside drug testing is relatively limited, and correspondingly, the literature that focuses on the effectiveness of this intervention is scant. This study aims to provide a preliminary indication of the impact of roadside drug testing in Queensland. Methods: A sample of Queensland motorists’ (N= 922) completed a self-report questionnaire to investigate their drug driving behaviour, as well as examine the perceived affect of legal sanctions (certainty, severity and swiftness) and knowledge of the countermeasure on their subsequent offending behaviour. Results: Analysis of the collected data revealed that approximately 20% of participants reported drug driving at least once in the last six months. Overall, there was considerable variability in respondent’s perceptions regarding the certainty, severity and swiftness of legal sanctions associated with the testing regime and a considerable proportion remained unaware of testing practices. In regards to predicting those who intended to drug driving again in the future, perceptions of apprehension certainty, more specifically low certainty of apprehension, were significantly associated with self-reported intentions to offend. Additionally, self-reported recent drug driving activity and frequent drug consumption were also identified as significant predictors, which indicates that in the current context, past behaviour is a prominent predictor of future behaviour. To a lesser extent, awareness of testing practices was a significant predictor of intending not to drug drive in the future. Conclusion: The results indicate that drug driving is relatively prevalent on Queensland roads, and a number of factors may influence such behaviour. Additionally, while the roadside testing initiative is beginning to have a deterrent impact, its success will likely be linked with targeted intelligence-led implementation in order to increase apprehension levels as well as the general deterrent effect.

Down the rabbit hole and through the looking glass: A conception of information seeking and searching through a diary study.

Information behaviour (IB) is an area within Library and Information Science that studies the totality of human behaviour in relation to information, both active and passive, along with the explicit and the tacit mental states related to information. This study reports on a recently completed dissertation research that integrates the different models of information behaviours using a diary study where 34 participants maintained a daily journal for two weeks through a web log or paper diary. This resulted in thick descriptions of IB, which were manually analysed using the Grounded Theory method of inquiry, and then cross-referenced through both text-analysis and statistical analysis programs. Among the many key findings of this study, one is the focus this paper: how participants express their feelings of the information seeking process and their mental and affective states related specifically to the sense-making component which co-occurs with almost every other aspect of information behaviour. The paper title – Down the Rabbit Hole and Through the Looking Glass – refers to an observation that some of the participants made in their journals when they searched for, or avoided information, and wrote that they felt like they have fallen into a rabbit hole where nothing made sense, and reported both positive feelings of surprise and amazement, and negative feelings of confusion, puzzlement, apprehensiveness, frustration, stress, ambiguity, and fatigue. The study situates this sense-making aspects of IB within an overarching model of information behaviour that includes IB concepts like monitoring information, encountering information, information seeking and searching, flow, multitasking, information grounds, information horizons, and more, and proposes an integrated model of information behaviour illuminating how these different concepts are interleaved and inter-connected with each other, along with it's implications for information services.

Cooperative multi-AUV tracking of phytoplankton blooms based on ocean model predictions

In recent years, ocean scientists have started to employ many new forms of technology as integral pieces in oceanographic data collection for the study and prediction of complex and dynamic ocean phenomena. One area of technological advancement in ocean sampling if the use of Autonomous Underwater Vehicles (AUVs) as mobile sensor plat- forms. Currently, most AUV deployments execute a lawnmower- type pattern or repeated transects for surveys and sampling missions. An advantage of these missions is that the regularity of the trajectory design generally makes it easier to extract the exact path of the vehicle via post-processing. However, if the deployment region for the pattern is poorly selected, the AUV can entirely miss collecting data during an event of specific interest. Here, we consider an innovative technology toolchain to assist in determining the deployment location and executed paths for AUVs to maximize scientific information gain about dynamically evolving ocean phenomena. In particular, we provide an assessment of computed paths based on ocean model predictions designed to put AUVs in the right place at the right time to gather data related to the understanding of algal and phytoplankton blooms.

Multi-objective four-dimensional vehicle motion planning in large dynamic environments

This paper presents Multi-Step A* (MSA*), a search algorithm based on A* for multi-objective 4D vehicle motion planning (three spatial and one time dimension). The research is principally motivated by the need for offline and online motion planning for autonomous Unmanned Aerial Vehicles (UAVs). For UAVs operating in large, dynamic and uncertain 4D environments, the motion plan consists of a sequence of connected linear tracks (or trajectory segments). The track angle and velocity are important parameters that are often restricted by assumptions and grid geometry in conventional motion planners. Many existing planners also fail to incorporate multiple decision criteria and constraints such as wind, fuel, dynamic obstacles and the rules of the air. It is shown that MSA* finds a cost optimal solution using variable length, angle and velocity trajectory segments. These segments are approximated with a grid based cell sequence that provides an inherent tolerance to uncertainty. Computational efficiency is achieved by using variable successor operators to create a multi-resolution, memory efficient lattice sampling structure. Simulation studies on the UAV flight planning problem show that MSA* meets the time constraints of online replanning and finds paths of equivalent cost but in a quarter of the time (on average) of vector neighbourhood based A*.

Project report. A subtropical urban community: Investigating medium to high density residential typologies by Design Charrette

The Centre for Subtropical Design at QUT, in partnership with the Queensland Government and Brisbane City Council, conducts research focused on 'best practice' outcomes for higher density urban living environments in the subtropics through the study of typical urban residential typologies, and urban design. The aim of the research is to inform and illustrate best practice subtropical design principles to policy makers and development industry professionals to stimulate climate-responsive outcomes. The Centre for Subtropical Design recently sought project-specific funding from the Queensland Department of Infrastructure and Planning (DIP) to investigate residential typologies for sustainable subtropical urban communities, based on transit orientated development principles and outcomes for areas around public transport nodes. A development site within the Fitzgibbon Urban Development Area, and close to a rail and bsu transport corridor, provided a case study location for this project. Four design-led multi-disciplinary creative teams participated in a Design Charrette and have produced concept drawings and propositions on a range of options, or prototypes. Analysis of selected prototypes has been undertaken to determine their environmental, economic and social performance. This Project Report discusses the scope of the project funded by DIP in terms of activities undertaken to date, and deliverables achieved. A subsequent Research Report will discuss the detailed findings of the analysis.