Epidemiology of Clostridium difficile infection (CDI) in Queensland, Australia

Background: International epidemic clones (ribotypes 027 and 078) of Clostridium difficile have been associated with death, toxic megacolon and other adverse outcomes in North America and Europe. In 2010, the first local transmission of an epidemic strain (027) of C. difficile was reported in the state of Victoria, Australia, but no cases of infection with this strain were reported in the state of Queensland. In 2012, a prevalence study was undertaken in all public and selected private hospitals to examine the epidemiology of CDI and determine the prevalence of epidemic C. difficile strains in Queensland. Methods: Enhanced surveillance was undertaken on all hospital identified CDI cases aged over 2 years between 10 April and 15 June 2012. Where available, patient samples were cultured and isolates of C. difficile ribotyped. The toxin profile of each isolate was determined by PCR. Results: In total, 168 cases of CDI were identified during the study period. A majority (58.3%) of cases had onset of symptoms in hospital. Of the 62 patients with community onset of symptoms, most (74%) had a hospital admission in the previous 3 months. Only 4 of 168 patients had onset of symptoms within a residential care facility. Thirteen out of the 168 (7.7%) patients included in the study had severe disease (ICU admission and/or death within 30 days of onset). Overall 136/168 (81%) of cases had been prescribed antibiotics in the last month. Of concern was the emergence of a novel ribotype (244) which has recently been described in other parts of Australia and is genetically related to ribotype 027. Seven patients were infected with C. difficile ribotype 244 (8% of 83 samples ribotyped), including one patient requiring ICU admission and one patient who died. Ribotype 244 was tcdA, tcdB and CDT positive and contained a tcdC mutation at position 117. Conclusion: Ongoing surveillance is required to determine the origin and epidemiology of C. difficile ribotype 244 infections in Australia.

Developing learning cohorts for postgraduate research degrees

Development of researchers through higher degree research studies is a high priority in most universities. Yet, research about supervision as pedagogy and models of supervision is only recently gained increasing attention. Charged with producing good researchers within very limited resources, academics are constantly looking for more efficient models of supervision for higher degree research students. A cohort model of supervision promises several efficiencies, but we argue that its success lies importantly on how well the cohort is developed specifically for higher degree research studies. We drew on a growing body of literature on higher degree research supervision to design, implement and evaluate our approach to developing a cohort of seven students enrolled in the Master of Education (Research) degree. Our approach included four provisions: initial residential workshop, development of a learning community, nourishing scholarship, and ongoing learning opportunities. The four provisions resulted in gradually developing an environment and culture that students found very supportive and nurturing. This paper is based on the findings from data collected from student evaluations in the first year of studies, feedback from the cohort’s sponsor, and our reflective notes. The evaluation substantiated the value in investing time and resources for purposely developing a cohort for higher degree research studies. Whether the cohorts are sponsored or not, universities will still need to invest time and resources for cohort development if a cohort model is intended to gain wider efficiencies in supervision of higher degree research students.

Analysis of damage to buildings following the 2010–11 Eastern Australia floods

This research analyses the extent of damage to buildings in Brisbane, Ipswich and Grantham during the recent Eastern Australia flooding and explore the role planning and design/construction regulations played in these failures. It highlights weaknesses in the current systems and propose effective solutions to mitigate future damage and financial loss under current or future climates. 2010 and early 2011 saw major flooding throughout much of Eastern Australia. Queensland and Victoria were particularly hard hit, with insured losses in these states reaching $2.5 billion and many thousands of homes inundated. The Queensland cities of Brisbane and Ipswich were the worst affected; around two-thirds of all inundated property/buildings were in these two areas. Other local government areas to record high levels of inundation were Central Highlands and Rockhampton Regional Councils in Queensland, and Buloke, Campaspe, Central Gold Fields and Loddon in Victoria. Flash flooding was a problem in a number of Victorian councils, but the Lockyer Valley west of Ipswich suffered the most extensive damage with 19 lives lost and more than 100 homes completely destroyed. In all more than 28,000 properties were inundated in Queensland and around 2,500 buildings affected in Victoria. Of the residential properties affected in Brisbane, around 90% were in areas developed prior to the introduction of floodplain development controls, with many also suffering inundation during the 1974 floods. The project developed a predictive model for estimating flood loss and occupant displacement. This model can now be used for flood risk assessments or rapid assessment of impacts following a flood event.

Acacia Light Wall

The Acacia Light Wall is a permanent public artwork within the 3 stage Eden on the Yarra – a residential / commercial development on Victoria Street Abbotsford, Melbourne. The work was commissioned by the Hampton Group for Acacia Place, the first building in the development. The stylised screen was inspired by tangled wattle trees (Australia’s most common Acacia). The work consists of two walls, made from laser cut aluminium screen, acrylic ‘windows” Philips Colour Kinetic controllable LED (1250 nodes), Philips Colour Kinetics control ‘iPlayers”. One wall is 10 m long x 3 to 5 metres and the second is 12m by 3m. The windows are lit by an array of 600+ LED’s in each wall. These lights change colour from week to week marking the progress of the seasons. We worked with the project horticulturalist to develop a palate of colours for each week’s ‘light show’ that was drawn from local flowers and foliage likely to be in bloom that week. The lighting display is not static but rather a very slow moving (morphing) light show. It isn’t fast and flashy. Instead it’s restful and profound.

Web crippling tests of hollow flange channel beams – end one flange and interior one flange load cases

LiteSteel beam (LSB) is a new cold-formed steel hollow flange channel section produced using a patented manufacturing process involving simultaneous cold-forming and dual electric resistance welding. The LSBs were commonly used as floor joists and bearers with web openings in residential, industrial and commercial buildings. Due to the unique geometry of LSBs, as well as its unique residual stress characteristics and initial geometric imperfections resultant of manufacturing processes, much of the existing research for common cold-formed steel sections is not directly applicable to LSBs. Many research studies have been carried out to evaluate the behaviour and design of LSBs subject to pure bending actions, predominant shear and combined actions. However, to date, no investigation has been conducted into the web crippling behaviour and strength of LSB sections. Hence detailed experimental studies were conducted to investigate the web crippling behaviour and strengths of LSBs under EOF (End One Flange) and IOF (Interior One Flange) load cases. A total of 26 web crippling tests was conducted and the results were compared with current AS/NZS 4600 design rules. This comparison showed that AS/NZS 4600 (SA, 2005) design rules are very conservative for LSB sections under EOF and IOF load cases. Suitable design equations have been proposed to determine the web crippling capacity of LSBs based on experimental results. This paper presents the details of this experimental study on the web crippling behaviour and strengths of LiteSteel beams under EOF and IOF load cases.

Numerical studies and design of hollow flange channel beams subject to combined bending and shear actions

LiteSteel beam (LSB) is a cold-formed steel hollow flange channel section produced using a patented manufacturing process involving simultaneous cold-forming and dual electric resistance welding. It is commonly used as floor joists and bearers in residential, industrial and commercial buildings. Design of the LSB is governed by the Australian cold-formed steel structures code, AS/NZS 4600. Due to the geometry of the LSB, as well as its unique residual stress characteristics and initial geometric imperfections resultant of manufacturing processes, currently available design equations for common cold-formed sections are not directly applicable to the LSB. Many research studies have been carried out to evaluate the behaviour and design of LSBs subject to pure bending actions and predominant shear actions. To date, however, no investigation has been conducted into the strength of LSB sections under combined bending and shear actions. Hence experimental and numerical studies were conducted to assess the combined bending and shear behaviour of LSBs. Finite element models of LSBs were developed to simulate their combined bending and shear behaviour and strength of LSBs. They were then validated by comparing the results with available experimental test results and used in a detailed parametric study. The results from experimental and finite element analyses were compared with current AS/NZS 4600 and AS 4100 design rules. Both experimental and numerical studies show that the AS/NZS 4600 design rule based on circular interaction equation is conservative in predicting the combined bending and shear capacities of LSBs. This paper presents the details of the numerical studies of LSBs and the results. In response to the inadequacies of current approaches to designing LSBs for combined bending and shear, two lower bound design equations are proposed in this paper.

Improving construction management : an investigation into the influences of effective stakeholder involvement on project quality outcomes

This research has developed a framework to improve the effectiveness and efficiency of stakeholder involvement during the early planning stages of residential construction projects, in order to improve many of the quality issues that occur during the construction phases of such projects. A mixed methods approach (survey, interviews and case studies) was employed to collect the required data. It is expected that with development, this framework can bring some significant benefits to future construction projects in terms of reducing rework and wastage, improving timely delivery and avoiding disputes. The research is also anticipated to produce three high impact journal articles.

Design of light gauge steel roofing systems subject to high wind forces

Light gauge steel roofing systems made of thin profiled roof sheeting and battens are used commonly in residential, industrial and commercial buildings. Their critical design load combination is that due to wind uplift forces that occur during high wind events such as tropical cyclones and thunderstorms. However, premature local failures at their screw connections have been a concern for many decades since cyclone Tracy that devastated Darwin in 1974. Extensive research that followed cyclone Tracy on the pull-through and pull-out failures of roof sheeting to batten connections has significantly improved the safety of roof sheeting. However, this has made the batten to rafter/truss connection the weakest, and recent wind damage investigations have shown the failures of these connections and the resulting loss of entire roof structures. Therefore an experimental research program using both small scale and full scale air-box tests is currently under way to investigate the pull-through failures of thin-walled steel battens under high wind uplift forces. Tests have demonstrated that occurrence of pull-through failures in the bottom flanges of steel batttens and the need to develop simple test and design methods as a function of many critical parameters such as steel batten geometry, thickness and grade, screw fastener sizes and other fastening details. This paper presents the details of local failures that occur in light fauge roofing systems, a review of the current design and test methods for steel battens and associated short comings, and the test results obtained to date on pull-through failures of battens from small scale and full scale tests. Finally, it proposes the use of suitable small scale test methods that can be used by both researchers and manufacturers of such screw-fastened light gauge steel batten systems.

The cost of changing your mind!

A recent decision of the Queensland Civil and Administrative Tribunal dealt with the liability of a purchaser to pay a termination penalty where a contract for the purchase of a residential property was terminated during the ‘cooling-off’ period. The decision is Lucy Cole Prestige Properties Broadbeach Pty Ltd ATF Gaindri FT Trust t/as Lucy Cole Prestige Properties Broadbeach Pty Ltd v Kastrissios [2013] QCAT 653.

Psychometric properties of the modified RESIDE physical activity questionnaire among low-income overweight women

Objectives This study explored the criterion-related validity and test-retest reliability of the modified RESIDential Environment physical activity questionnaire and whether the instrument's validity varied by body mass index, education, race/ethnicity, or employment status. Design Validation study using baseline data collected for randomized trial of a weight loss intervention. Methods Participants recruited from health departments wore an ActiGraph accelerometer and self-reported non-occupational walking, moderate and vigorous physical activity on the modified RESIDential Environment questionnaire. We assessed validity (n = 152) using Spearman correlation coefficients, and reliability (n = 57) using intraclass correlation coefficients. Results When compared to steps, moderate physical activity, and bouts of moderate/vigorous physical activity measured by accelerometer, these questionnaire measures showed fair evidence for validity: recreational walking (Spearman correlation coefficients 0.23–0.36), total walking (Spearman correlation coefficients 0.24–0.37), and total moderate physical activity (Spearman correlation coefficients 0.18–0.36). Correlations for self-reported walking and moderate physical activity were higher among unemployed participants and women with lower body mass indices. Generally no other variability in the validity of the instrument was found. Evidence for reliability of RESIDential Environment measures of recreational walking, total walking, and total moderate physical activity was substantial (intraclass correlation coefficients 0.56–0.68). Conclusions Evidence for questionnaire validity and reliability varied by activity domain and was strongest for walking measures. The questionnaire may capture physical activity less accurately among women with higher body mass indices and employed participants. Capturing occupational activity, specifically walking at work, may improve questionnaire validity.

Functional independence following subacute inpatient rehabilitation was not affected by age among older patients recovering from cardiac-related hospital admissions

Introduction Older people recovering from cardiac events requiring an acute hospital admission may experience a decline in physical function limiting their ability to return home to their previous accommodation. Subacute inpatient rehabilitation therapies have potential to assist recovery of physical functioning. However, it is unknown whether age influences the length of stay or physical functioning at discharge from subacute inpatient rehabilitation for this population. Objectives This study examined the outcomes of a cohort of older patients recovering from a cardiac event requiring hospitalisation to investigate the association between age and physical function at discharge, as well as age and length of rehabilitation stay. Methods Participants included 145 consecutive inpatient admissions to a subacute geriatric assessment and rehabilitation unit with a cardiac condition as their primary reason for hospital admission. Participants were required to complete a multi-disciplinary physical functioning assessment within 72 hours of admission to the unit, and again within 72 hours prior to discharge from the unit. The primary outcome measure was the Functional Independence Measure motor score. Demographic and clinical information, including length of stay and discharge destination, were also recorded. Results A total n=126 (87%) participants, with a mean (standard deviation) age of 79 (10) years, had both assessments completed and were included in analyses. Participants who had passed away (n=4, 3%), or did not have both assessments completed per protocol were excluded from analyses. Discharge destinations included home (n=101, 80%), residential aged care (n=17, 13%) and another hospital (n=8, 6%). The (median, interquartile range) Functional Independence Measure motor score was higher at discharge (79, 71 to 84) than admission (61, 48 to 71); z=7.75 p<0.001. Age was not associated with Functional Independence Measure motor score at discharge (t= -0.18, p=0.86), or length of stay in the rehabilitation unit (t= -0.52, 0.60). Conclusion Any perception that age may be associated with longer lengths of stay and reduced physical function outcomes among patients with cardiac conditions admitted for subacute inpatient rehabilitation for older adults is not supported data from this investigation. Older age should not be considered a disincentive when considering the suitability of patients with cardiac diagnoses for this type of inpatient rehabilitation or their potential physical functioning outcome.

Assessment of driving-related performance in chronic whiplash using an advanced driving simulator

Driving is often nominated as problematic by individuals with chronic whiplash associated disorders (WAD), yet driving-related performance has not been evaluated objectively. The purpose of this study was to test driving-related performance in persons with chronic WAD against healthy controls of similar age, gender and driving experience to determine if driving-related performance in the WAD group was sufficiently impaired to recommend fitness to drive assessment. Driving-related performance was assessed using an advanced driving simulator during three driving scenarios; freeway, residential and a central business district (CBD). Total driving duration was approximately 15 min. Five driving tasks which could cause a collision (critical events) were included in the scenarios. In addition, the effect of divided attention (identify red dots projected onto side or rear view mirrors) was assessed three times in each scenario. Driving performance was measured using the simulator performance index (SPI) which is calculated from 12 measures. z-Scores for all SPI measures were calculated for each WAD subject based on mean values of the control subjects. The z-scores were then averaged for the WAD group. A z-score of ≤−2 indicated a driving failing grade in the simulator. The number of collisions over the five critical events was compared between the WAD and control groups as was reaction time and missed response ratio in identifying the red dots. Seventeen WAD and 26 control subjects commenced the driving assessment. Demographic data were comparable between the groups. All subjects completed the freeway scenario but four withdrew during the residential and eight during the CBD scenario because of motion sickness. All scenarios were completed by 14 WAD and 17 control subjects. Mean z-scores for the SPI over the three scenarios was statistically lower in the WAD group (−0.3 ± 0.3; P < 0.05) but the score was not below the cut-off point for safe driving. There were no differences in the reaction time and missed response ratio in divided attention tasks between the groups (All P > 0.05). Assessment of driving in an advanced driving simulator for approximately 15 min revealed that driving-related performance in chronic WAD was not sufficiently impaired to recommend the need for fitness to drive assessment.

An investigation of Staphylococcus aureus and related species from flood affected and other environmental sources

This research investigated the microbial air quality of flooded houses in Brisbane suburbs following the January 2011 flood event. Flood waters can carry and spread human pathogenic bacteria, and these organisms can be dispersed into residential air by aerosolisation. This study found that the bacterial load was significantly different for indoor and outdoor areas of flood affected houses, but no significant differences were observed between flooded and non-flooded houses. This could be due to the rapid clean-up of flooded houses following the event. Molecular methods were used to identify and characterise staphylococcal species in residential air of flooded and non-flooded houses. A major finding was the diverse population of airborne staphylococci as well as the high rate of methicillin-resistance in these strains. By determining the genetic relatedness of residential air sourced staphylococci, a potential source for pathogenic strains can be identified.

The 4th Knowledge Cities World Summit Proceedings

FROM KCWS 2011 CHAIRS AND SUMMIT PROCEEDING EDITORS In recent years, with the impact of global knowledge economy, a more comprehensive development approach has gained significant popularity. This new development approach, so called ‘knowledgebased development’, is different from its traditional predecessor. With a much more balanced focus on all of the four key development domains – economic, enviro-urban, institutional, and sociocultural – this contemporary approach, aims to bring economic prosperity, environmental sustainability and local institutional competence with a just socio-spatial order to our cities and regions. The ultimate goal of knowledge-based development is to produce a city purposefully designed to encourage the continuous production, circulation and commercialisation of social and scientific knowledge – this will in turn establish a ‘knowledge city’. A city following the ‘knowledge city’ concept embarks on a strategic mission to firmly encourage and nurture locally focussed innovation, science and creativity within the context of an expanding knowledge economy and society. In this regard a ‘knowledge city’ can be seen as an integrated city, which physically and institutionally combines the functions of a science and technology park with civic and residential functions and urban amenities. It also offers one of the effective paradigms for the sustainable cities of our time. This fourth edition of KCWS – The 4th Knowledge Cities World Summit 2011 – makes an important reminder that the 'knowledge city' concept is a key notion in the 21st Century development. Considering this notion, the Summit sheds light on the multi-faceted dimensions and various scales of building a ‘knowledge city’ via 'knowledge-based development' paradigm by particularly focusing on the overall Summit theme of ‘Knowledge Cities for Future Generations’. At this summit, the theoretical and practical maturing of knowledge-based development paradigms are advanced through the interplay between the world’s leading academics’ theories and the practical models and strategies of practitioners’ and policy makers’ drawn from around the world. This summit proceeding is compiled in order to disseminate the knowledge generated and shared in KCWS 2011 with the wider research, governance, and practice communities the knowledge cocreated in this summit. All papers of this proceeding have gone through a double-blind peer review process and been reviewed by our summit editorial review and advisory board members. We, organisers of the summit, cordially thank the members of the Summit Proceeding Editorial Review and Advisory Board for their diligent work in the review of the papers. We hope the papers in this proceeding will inspire and make a significant contribution to the research, governance, and practice circles.

Measuring the preference for dwelling characteristics of Melbourne : railway stations and house prices

The relationship between public transportation and home values has proven to be complex, with studies providing divergent findings. Using Victorian Valuer General Data for 2009, this paper applies a hedonic pricing approach to the Melbourne metropolitan housing market in order to estimate the impacts of proximity to a train station on residential property prices. The findings reveal a negative impact on dwelling price for those properties within 125 metres from a train station and a positive relationship between dwelling price and proximity for properties more than 125 metres away.