Key priorities for Australian infection control : summary of findings from the launch of the Centre for Research Excellence in Reducing Healthcare Associated Infections

The launch of the Centre of Research Excellence in Reducing Healthcare Associated Infection (CRE-RHAI) took place in Sydney on Friday 12 October 2012. The mission of the CRE-RHAI is to generate new knowledge about strategies to reduce healthcare associated infections and to provide data on the cost-effectiveness of infection control programs. As well as launching the CRE-RHAI, an important part of this event was a stakeholder Consultation Workshop, which brought together several experts in the Australian infection control community. The aims of this workshop were to establish the research and clinical priorities in Australian infection control, assess the importance of various multi-resistant organisms, and to gather information about decision making in infection control. We present here a summary and discussion of the responses we received.

Effects of type 2 diabetes behavioural telehealth interventions on glycaemic control and adherence : a systematic review

We reviewed the effect of behavioural telehealth interventions on glycaemic control and diabetes self-management in patients with type 2 diabetes. The databases CINAHL, Medline and psychINFO were searched in August 2012. Journal articles were selected that had been published in English with a randomized controlled trial design using a usual care comparison group, and in which the primary intervention component was delivered by telehealth. Relevant outcome measures were glycaemic control and one or more of the following diabetes self-care areas: diet, physical activity, blood glucose self-monitoring (BGSM) or medication adherence. Interventions were excluded if they were primarily based on telemonitoring. The search retrieved 1027 articles, from which 49 were selected based on their title and abstract. Fourteen articles (reporting 13 studies) met the eligibility criteria for inclusion. Four studies reported significant improvements in glycaemic control. Five of eight studies on dietary adherence reported significant treatment effects, as did five of eight on physical activity, four of nine on blood glucose self-monitoring, and three of eight on medication adherence. Overall, behavioural telehealth interventions show promise in improving the diabetes self-care and glycaemic control of people with type 2 diabetes.

When does change begin following screening and brief intervention among depressed problem drinkers?

Brief interventions are effective for problem drinking and reductions are known to occur in association with screening and assessment. The present study sought to assess, among participants (N=202) in a clinical trial, how much change occurred between baseline assessment and a one-session brief intervention (S1), and the predictors of early change. The primary focus was on changes in the Beck Depression Inventory Fast Screen scores and alcohol consumption (standard drinks per week) prior to random allocation to nine further sessions addressing either depression, alcohol, or both problems. There were large and clinically significant reductions between baseline and S1, with the strongest predictors being baseline scores in the relevant domain and change in the other domain. Client engagement was also predictive of early depression changes. Monitoring progress in both domains from first contact, and provision of empathic care, followed by brief intervention appear to be useful for this high prevalence comorbidity.

Utility of the Mild Brain Injury Atypical Symptoms Scale to detect symptom exaggeration : an analogue simulation study

Brief self-report symptom checklists are often used to screen for postconcussional disorder (PCD) and posttraumatic stress disorder (PTSD) and are highly susceptible to symptom exaggeration. This study examined the utility of the five-item Mild Brain Injury Atypical Symptoms Scale (mBIAS) designed for use with the Neurobehavioral Symptom Inventory (NSI) and the PTSD Checklist–Civilian (PCL–C). Participants were 85 Australian undergraduate students who completed a battery of self-report measures under one of three experimental conditions: control (i.e., honest responding, n = 24), feign PCD (n = 29), and feign PTSD (n = 32). Measures were the mBIAS, NSI, PCL–C, Minnesota Multiphasic Personality Inventory–2, Restructured Form (MMPI–2–RF), and the Structured Inventory of Malingered Symptomatology (SIMS). Participants instructed to feign PTSD and PCD had significantly higher scores on the mBIAS, NSI, PCL–C, and MMPI–2–RF than did controls. Few differences were found between the feign PCD and feign PTSD groups, with the exception of scores on the NSI (feign PCD > feign PTSD) and PCL–C (feign PTSD > feign PCD). Optimal cutoff scores on the mBIAS of ≥8 and ≥6 were found to reflect “probable exaggeration” (sensitivity = .34; specificity = 1.0; positive predictive power, PPP = 1.0; negative predictive power, NPP = .74) and “possible exaggeration” (sensitivity = .72; specificity = .88; PPP = .76; NPP = .85), respectively. Findings provide preliminary support for the use of the mBIAS as a tool to detect symptom exaggeration when administering the NSI and PCL–C.

Identification of evidence-based biospecimen quality-control tools

Control of biospecimen quality that is linked to processing is one of the goals of biospecimen science. Consensus is lacking, however, regarding optimal sample quality-control (QC) tools (ie, markers and assays). The aim of this review was to identify QC tools, both for fluid and solid-tissue samples, based on a comprehensive and critical literature review. The most readily applicable tools are those with a known threshold for the preanalytical variation and a known reference range for the QC analyte. Only a few meaningful markers were identified that meet these criteria, such as CD40L for assessing serum exposure at high temperatures and VEGF for assessing serum freeze-thawing. To fully assess biospecimen quality, multiple QC markers are needed. Here we present the most promising biospecimen QC tools that were identified.

A New DER coordination in LV network based on the concept of distributed control

Given the paradigm of smart grid as the promising backbone for future network, this paper uses this paradigm to propose a new coordination approach for LV network based on distributed control algorithm. This approach divides the LV network into hierarchical communities where each community is controlled by a control agent. Different level of communication has been proposed for this structure to control the network in different operation modes.

Rule-based transit signal priority control method using a real-time transit travel time prediction model

An advanced rule-based Transit Signal Priority (TSP) control method is presented in this paper. An on-line transit travel time prediction model is the key component of the proposed method, which enables the selection of the most appropriate TSP plans for the prevailing traffic and transit condition. The new method also adopts a priority plan re-development feature that enables modifying or even switching the already implemented priority plan to accommodate changes in the traffic conditions. The proposed method utilizes conventional green extension and red truncation strategies and also two new strategies including green truncation and queue clearance. The new method is evaluated against a typical active TSP strategy and also the base case scenario assuming no TSP control in microsimulation. The evaluation results indicate that the proposed method can produce significant benefits in reducing the bus delay time and improving the service regularity with negligible adverse impacts on the non-transit street traffic.

Effect of attitudes, subjective norms and perceived control on nurses' intention to assess patients' pain

This study examines the underlying determinants of nurses' behaviour regarding the conduct of pain assessments. One hundred nurses in a variety of health care facilities were invited to complete an Attitude Intention Questionnaire based upon the theory of planned action which is an extension of the theory of reasoned action. Results provide some support for the theory of planned action, as nurses' intention to conduct pain assessment was shown to be predicted by attitude, subjective norms and perceived control, although the latter was the only variable to make an independent contribution to intention. Additional support for the importance of perceived control was provided by the analysis of 'intenders' and 'non-intenders' (to conduct pain assessments), as perceived control was the only variable which differed significantly between the groups. The findings are consistent with earlier studies which showed that the variables in the theory of planned behaviour provided reasonably accurate predictions of behavioural intention.

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.

Advanced battery storage control for an autonomous microgrid

A new control method for battery storage to maintain acceptable voltage profile in autonomous microgrids is proposed in this article. The proposed battery control ensures that the bus voltages in the microgrid are maintained during disturbances such as load change, loss of micro-sources, or distributed generations hitting power limit. Unlike the conventional storage control based on local measurements, the proposed method is based on an advanced control technique, where the reference power is determined based on the voltage drop profile at the battery bus. An artificial neural network based controller is used to determine the reference power needed for the battery to hold the microgrid voltage within regulation limits. The pattern of drop in the local bus voltage during power imbalance is used to train the controller off-line. During normal operation, the battery floats with the local bus voltage without any power injection. The battery is charged or discharged during the transients with a high gain feedback loop. Depending on the rate of voltage fall, it is switched to power control mode to inject the reference power determined by the proposed controller. After a defined time period, the battery power injection is reduced to zero using slow reverse-droop characteristics, ensuring a slow rate of increase in power demand from the other distributed generations. The proposed control method is simulated for various operating conditions in a microgrid with both inertial and converter interfaced sources. The proposed battery control provides a quick load pick up and smooth load sharing with the other micro-sources in a disturbance. With various disturbances, maximum voltage drop over 8% with conventional energy storage is reduced within 2.5% with the proposed control method.

Active and reactive power control of synchronous generator for the realization of a virtual power plant

This paper presents a novel power control strategy that decouples the active and reactive power for a synchronous generator connected to a power network. The proposed control paradigm considers the capacitance of the transmission line along with its resistance and reactance as-well. Moreover the proposed controller takes into account all cases of R-X relationships, thus allowing it to function in Virtual Power Plant (VPP) structures which operate at both medium voltage (MV) and low voltage (LV) levels. The independent control of active and reactive power is achieved through rotational transformations of the terminal voltages and currents at the synchronous generator's output. This paper details the control technique by first presenting the mathematical and electrical network analysis of the methodology and then successfully implementing the control using MATLAB-SIMULINK simulation.

Vertical infrastructure inspection using a quadcopter and shared autonomy control

This paper presents a shared autonomy control scheme for a quadcopter that is suited for inspection of vertical infrastructure — tall man-made structures such as streetlights, electricity poles or the exterior surfaces of buildings. Current approaches to inspection of such structures is slow, expensive, and potentially hazardous. Low-cost aerial platforms with an ability to hover now have sufficient payload and endurance for this kind of task, but require significant human skill to fly. We develop a control architecture that enables synergy between the ground-based operator and the aerial inspection robot. An unskilled operator is assisted by onboard sensing and partial autonomy to safely fly the robot in close proximity to the structure. The operator uses their domain knowledge and problem solving skills to guide the robot in difficult to reach locations to inspect and assess the condition of the infrastructure. The operator commands the robot in a local task coordinate frame with limited degrees of freedom (DOF). For instance: up/down, left/right, toward/away with respect to the infrastructure. We therefore avoid problems of global mapping and navigation while providing an intuitive interface to the operator. We describe algorithms for pole detection, robot velocity estimation with respect to the pole, and position estimation in 3D space as well as the control algorithms and overall system architecture. We present initial results of shared autonomy of a quadrotor with respect to a vertical pole and robot performance is evaluated by comparing with motion capture data.

Sensing and control for a small-size helicopter

This paper details the progress to date, toward developing a small autonomous helicopter. We describe system architecture, avionics, visual state estimation, custom IMU design, aircraft modelling, as well as various linear and neuro/fuzzy control algorithms. Experimental results are presented for state estimation using fused stereo vision and IMU data, heading control, and attitude control. FAM attitude and velocity controllers have been shown to be effective in simulation.

Airborne collision scenario flight tests : impact of angle measurement errors on reactive vision-based avoidance control

The future emergence of many types of airborne vehicles and unpiloted aircraft in the national airspace means collision avoidance is of primary concern in an uncooperative airspace environment. The ability to replicate a pilot’s see and avoid capability using cameras coupled with vision based avoidance control is an important part of an overall collision avoidance strategy. But unfortunately without range collision avoidance has no direct way to guarantee a level of safety. Collision scenario flight tests with two aircraft and a monocular camera threat detection and tracking system were used to study the accuracy of image-derived angle measurements. The effect of image-derived angle errors on reactive vision-based avoidance performance was then studied by simulation. The results show that whilst large angle measurement errors can significantly affect minimum ranging characteristics across a variety of initial conditions and closing speeds, the minimum range is always bounded and a collision never occurs.