Seasonal variation in cardiovascular disease risk factors in a subarctic population : the Tromso Study 1979-2008

Background Seasonal changes in cardiovascular disease (CVD) risk factors may be due to exposure to seasonal environmental variables like temperature and acute infections or seasonal behavioural patterns in physical activity and diet. Investigating the seasonal pattern of risk factors should help determine the causes of the seasonal pattern in CVD. Few studies have investigated the seasonal variation in risk factors using repeated measurements from the same individual, which is important as individual and population seasonal patterns may differ. Methods The authors investigated the seasonal pattern in systolic and diastolic blood pressure, heart rate, body weight, total cholesterol, triglycerides, high-density lipoprotein cholesterol, C reactive protein and fibrinogen. Measurements came from 38 037 participants in the population-based cohort, the Tromsø Study, examined up to eight times from 1979 to 2008. Individual and population seasonal patterns were estimated using a cosinor in a mixed model. Results All risk factors had a highly statistically significant seasonal pattern with a peak time in winter, except for triglycerides (peak in autumn), C reactive protein and fibrinogen (peak in spring). The sizes of the seasonal variations were clinically modest. Conclusions Although the authors found highly statistically significant individual seasonal patterns for all risk factors, the sizes of the changes were modest, probably because this subarctic population is well adapted to a harsh climate. Better protection against seasonal risk factors like cold weather could help reduce the winter excess in CVD observed in milder climates.

The effect of implementing a modified early warning scoring (MEWS) system on the adequacy of vital sign documentation

Introduction and objectives Early recognition of deteriorating patients results in better patient outcomes. Modified early warning scores (MEWS) attempt to identify deteriorating patients early so timely interventions can occur thus reducing serious adverse events. We compared frequencies of vital sign recording 24 h post-ICU discharge and 24 h preceding unplanned ICU admission before and after a new observation chart using MEWS and an associated educational programme was implemented into an Australian Tertiary referral hospital in Brisbane. Design Prospective before-and-after intervention study, using a convenience sample of ICU patients who have been discharged to the hospital wards, and in patients with an unplanned ICU admission, during November 2009 (before implementation; n = 69) and February 2010 (after implementation; n = 70). Main outcome measures Any change in a full set or individual vital sign frequency before-and-after the new MEWS observation chart and associated education programme was implemented. A full set of vital signs included Blood pressure (BP), heart rate (HR), temperature (T°), oxygen saturation (SaO2) respiratory rate (RR) and urine output (UO). Results After the MEWS observation chart implementation, we identified a statistically significant increase (210%) in overall frequency of full vital sign set documentation during the first 24 h post-ICU discharge (95% CI 148, 288%, p value <0.001). Frequency of all individual vital sign recordings increased after the MEWS observation chart was implemented. In particular, T° recordings increased by 26% (95% CI 8, 46%, p value = 0.003). An increased frequency of full vital sign set recordings for unplanned ICU admissions were found (44%, 95% CI 2, 102%, p value = 0.035). The only statistically significant improvement in individual vital sign recordings was urine output, demonstrating a 27% increase (95% CI 3, 57%, p value = 0.029). Conclusions The implementation of a new MEWS observation chart plus a supporting educational programme was associated with statistically significant increases in frequency of combined and individual vital sign set recordings during the first 24 h post-ICU discharge. There were no significant changes to frequency of individual vital sign recordings in unplanned admissions to ICU after the MEWS observation chart was implemented, except for urine output. Overall increases in the frequency of full vital sign sets were seen.

Design and construction of fixed bed pyrolysis system and plum seed pyrolysis for bio-oil production

This work investigated the production of bio oil from plum seed (Zyziphus jujuba) by fixed bed pyrolysis technology. A fixed bed pyrolysis system has been designed and fabricated for production of bio oil. The major components of the system are: fixed bed reactor, liquid condenser and liquid collector. Nitrogen gas was used to maintain the inert atmosphere in the reactor where the pyrolysis reaction takes place. The feedstock considered in this study is plum seed as it is available waste material in Bangladesh. The reactor is heated by means of a cylindrical biomass external heater. Rice husk was used as the energy source. The products are oil, char and gas. The parameters varied are reactor bed temperature, running time and feed particle size. The parameters are found to influence the product yields significantly. The maximum liquid yield of 39 wt% at 5200C for a feed particle size of 2.36-4.75 mm and a gas flow rate of 8 liter/min with a running time of 120 minute. The pyrolysis oil obtained at these optimum process conditions are analyzed for some of their properties as an alternative fuel. The density of the liquid was closer with diesel. The viscosity of the plum seed liquid was lower than that of the conventional fuels. The calorific value of the pyrolysis oil is one half of the diesel fuel.

How to work the crowd : a snapshot of barriers and motivations to crowdfunding

Introduction This study is a snapshot of Australian donor motivations and donor barriers to crowdfunding, and provides some indicative recommendations on ways the uptake of crowdfunding in the creative industries might increase. It is based upon a literature review and semi-structured interviews with 17 stakeholders who have used crowdfunding in Australia, including: creative producers seeking funds; financial crowdfunding donors; Artsupport Australia mentors of artists who are using crowdfunding; and crowdfunding site stakeholders. About the report Artsupport Australia commissioned the Queensland University of Technology Creative Industries team to produce a report on trends related to crowdfunding, particularly identifying barriers and motivations that might be associated with it. Artsupport Australia suggested a list of interview candidates, based on those individuals’ knowledge or experience with crowdfunding, to provide a better understanding of perceptions of this emerging practice, and to inform discussions on whether it is a useful revenue generating mechanism for the cultural sector.

Gender differences in recreational and transport cycling : a cross-sectional mixed-methods comparison of cycling patterns, motivators, and constraints

Background: Gender differences in cycling are well-documented. However, most analyses of gender differences make broad comparisons, with few studies modeling male and female cycling patterns separately for recreational and transport cycling. This modeling is important, in order to improve our efforts to promote cycling to women and men in countries like Australia with low rates of transport cycling. The main aim of this study was to examine gender differences in cycling patterns and in motivators and constraints to cycling, separately for recreational and transport cycling. Methods: Adult members of a Queensland, Australia, community bicycling organization completed an online survey about their cycling patterns; cycling purposes; and personal, social and perceived environmental motivators and constraints (47% response rate). Closed and open-end questions were completed. Using the quantitative data, multivariable linear, logistic and ordinal regression models were used to examine associations between gender and cycling patterns, motivators and constraints. The qualitative data were thematically analysed to expand upon the quantitative findings. Results: In this sample of 1862 bicyclists, men were more likely than women to cycle for recreation and for transport, and they cycled for longer. Most transport cycling was for commuting, with men more likely than women to commute by bicycle. Men were more likely to cycle on-road, and women off-road. However, most men and women did not prefer to cycle on-road without designed bicycle lanes, and qualitative data indicated a strong preference by men and women for bicycle-only off-road paths. Both genders reported personal factors (health and enjoyment related) as motivators for cycling, although women were more likely to agree that other personal, social and environmental factors were also motivating. The main constraints for both genders and both cycling purposes were perceived environmental factors related to traffic conditions, motorist aggression and safety. Women, however, reported more constraints, and were more likely to report as constraints other environmental factors and personal factors. Conclusion: Differences found in men’s and women’s cycling patterns, motivators and constraints should be considered in efforts to promote cycling, particularly in efforts to increase cycling for transport.

Teamwork in first year law units : can it work?

Since the 1980s, higher education in Australia has undergone significant change which has led to the belief that universities should cultivate students’ generic skills and attributes. For example, Achieving Quality states that generic skills ‘should represent the central achievements of higher education as a process’ (Higher Education Council, 1992, p 20). The CALD Standards for Australian Law Schools also recognise that tertiary curricula should ‘seek to develop knowledge, understanding, skills, and values’ (Council of Australian Law Deans, 2009, [2.3]. See also AQF Council, 2010, pp 32-5, 40-2; AQF Council, 2011, p 45-50). This more instrumentalist view of education is similarly exhibited by students (Saulwick and Muller, 2006, pp 7, 34). No longer does the modern graduate expect their university degree to equip them solely with the content knowledge of their discipline, but also with the skills and attributes relevant to their career and prospective employment.

Monitoring charged particle and ion emissions from a laser printer

While the emission rate of ultrafine particles has been measured and quantified, there is very little information on the emission rates of ions and charged particles from laser printers. This paper describes a methodology that can be adopted for measuring the surface charge density on printed paper and the ion and charged particle emissions during operation of a high-emitting laser printer and shows how emission rates of ultrafine particles, ions and charged particles may be quantified using a controlled experiment within a closed chamber.

Perceptions of clinical safety climate of the multicultural nursing workforce in Saudi Arabia : a cross-sectional survey

Purpose The purpose of this study is to explore the safety climate perceptions of the multicultural nursing workforce, and to investigate the influence of diversity of the multicultural nursing workforce on clinical safety in a large tertiary hospital in Saudi Arabia. Background Working in a multicultural environment is challenging. Each culture has its own unique characteristics and dimensions that shape the language, lifestyle, beliefs, values, customs, traditions, and patterns of behaviour, which expatriate nurses must come to terms with. However, cultural diversity in the health care environment can potentially affect the quality of care and patient safety. Method A mixed-method case study (survey, interview and document analysis) was employed. A primary study phase entailed the administration of the Safety Climate Survey (SCS). A population sampling strategy was used and 319 nurses participated, yielding a 76.8% response rate. Descriptive and inferential statistics (Kruskal–Wallis test) were used to analyse survey data. Results The data revealed the nurses’ perceptions of the clinical safety climate in this multicultural environment was unsafe, with a mean score of 3.9 out of 5. No significant difference was found between the age groups, years of nursing experience and their perceptions of the safety climate in this context. A significant difference was observed between the national background categories of nurses and perceptions of safety climate. Conclusion Cultural diversity within the nursing workforce could have a significant influence on perceptions of clinical safety. These findings have the potential to inform policy and practice related to cultural diversity in Saudi Arabia.

Quantitative studies of lower motor neuron degeneration in amyotrophic lateral sclerosis : Evidence for exponential decay of motor unit numbers and greatest rate of loss at the site of onset

Objective: To use our Bayesian method of motor unit number estimation (MUNE) to evaluate lower motor neuron degeneration in ALS. Methods: In subjects with ALS we performed serial MUNE studies. We examined the repeatability of the test and then determined whether the loss of MUs was fitted by an exponential or Weibull distribution. Results: The decline in motor unit (MU) numbers was well-fitted by an exponential decay curve. We calculated the half life of MUs in the abductor digiti minimi (ADM), abductor pollicis brevis (APB) and/or extensor digitorum brevis (EDB) muscles. The mean half life of the MUs of ADM muscle was greater than those of the APB or EDB muscles. The half-life of MUs was less in the ADM muscle of subjects with upper limb than in those with lower limb onset. Conclusions: The rate of loss of lower motor neurons in ALS is exponential, the motor units of the APB decay more quickly than those of the ADM muscle and the rate of loss of motor units is greater at the site of onset of disease. Significance: This shows that the Bayesian MUNE method is useful in following the course and exploring the clinical features of ALS. 2012 International Federation of Clinical Neurophysiology.

The health and cost implications of high body mass index in Australian Defence Force personnel.

BACKGROUND: Frequent illness and injury among workers with high body mass index (BMI) can raise the costs of employee healthcare and reduce workforce maintenance and productivity. These issues are particularly important in vocational settings such as the military, which require good physical health, regular attendance and teamwork to operate efficiently. The purpose of this study was to compare the incidence of injury and illness, absenteeism, productivity, healthcare usage and administrative outcomes among Australian Defence Force personnel with varying BMI. METHODS: Personnel were grouped into cohorts according to the following ranges for (BMI): normal (18.5-24.9 kg/m²; n = 197), overweight (25-29.9 kg/m²; n = 154) and obese (≥30 kg/m²) with restricted body fat (≤28 % for females, ≤24 % for males) (n = 148) and with no restriction on body fat (n = 180). Medical records for each individual were audited retrospectively to record the incidence of injury and illness, absenteeism, productivity, healthcare usage (i.e., consultation with medical specialists, hospital stays, medical investigations, prescriptions) and administrative outcomes (e.g., discharge from service) over one year. These data were then grouped and compared between the cohorts. RESULTS: The prevalence of injury and illness, cost of medical specialist consultations and cost of medical scans were all higher (p <0.05) in both obese cohorts compared with the normal cohort. The estimated productivity losses from restricted work days were also higher (p <0.05) in the obese cohort with no restriction on body fat compared with the normal cohort. Within the obese cohort, the prevalence of injury and illness, healthcare usage and productivity were not significantly greater in the obese cohort with no restriction on body fat compared with the cohort with restricted body fat. The number of restricted work days, the rate of re-classification of Medical Employment Classification and the rate of discharge from service were similar between all four cohorts. CONCLUSIONS: High BMI in the military increases healthcare usage, but does not disrupt workforce maintenance. The greater prevalence of injury and illness, greater healthcare usage and lower productivity in obese Australian Defence Force personnel is not related to higher levels of body fat.

Nerves of steel? Stress, work performance and elite athletes

There is a notable shortage of empirical research directed at measuring the magnitude and direction of stress effects on performance in a controlled environment. One reason for this is the inherent difficulties in identifying and isolating direct performance measures for individuals. Additionally, most traditional work environments contain a multitude of exogenous factors impacting individual performance, but controlling for all such factors is generally unfeasible (omitted variable bias). Moreover, instead of asking individuals about their self-reported stress levels, we observe workers’ behaviour in situations that can be classified as stressful. For this reason, we have stepped outside the traditional workplace in an attempt to gain greater controllability of these factors using the sports environment as our experimental space. We empirically investigate the relationship between stress and performance, in an extreme pressure situation (football penalty kicks) in a winner take all sporting environment (FIFA World Cup and UEFA European Cup competitions). Specifically, we examine all the penalty shootouts between 1976 and 2008 covering in total 16 events. The results indicate that extreme stressors can have a positive or negative impact on individuals’ performance. On the other hand, more commonly experienced stressors do not affect professionals’ performances.

Exeter short stems compared with standard length Exeter stems : experience from the Australian Orthopaedic Association National Joint Replacement Registry

The standard Exeter stem has a length of 150mm with offsets 37.5mm to 56mm. Shorter stems of lengths 95mm, 115mm and 125mm with offsets 35.5mm or less are available for patients with smaller femurs. Concern has been raised regarding the behaviour of the smaller implants. This paper analysed data from the Australian Orthopaedic Association National Joint Replacement Registry comparing survivorship of stems of offset 35.5mm or less with the standard stems of 37.5mm offset or greater. At seven years there was no significant difference in the Cumulative Percent Revision Rate in the short stems (3.4%, 95% CI 2.4-4.8%) compared with the standard length stems (3.5%, 95% CI 3.3-3.8%) despite its use in a greater proportion of potentially more difficult developmental dysplasia of the hip cases.

The use of virtual prototyping to rehearse the sequence of construction work involving mobile cranes

Purpose – Rehearsing practical site operations is without doubt one of the most effective methods for minimising planning mistakes, because of the learning that takes place during the rehearsal activity. However, real rehearsal is not a practical solution for on-site construction activities, as it not only involves a considerable amount of cost but can also have adverse environmental implications. One approach to overcoming this is by the use of virtual rehearsals. The purpose of this paper is to investigate an approach to simulation of the motion of cranes in order to test the feasibility of associated construction sequencing and generate construction schedules for review and visualisation. Design/methodology/approach – The paper describes a system involving two technologies, virtual prototyping (VP) and four-dimensional (4D) simulation, to assist construction planners in testing the sequence of construction activities when mobile cranes are involved. The system consists of five modules, comprising input, database, equipment, process and output, and is capable of detecting potential collisions. A real-world trial is described in which the system was tested and validated. Findings – Feedback from the planners involved in the trial indicated that they found the system to be useful in its present form and that they would welcome its further development into a fully automated platform for validating construction sequencing decisions. Research limitations/implications – The tool has the potential to provide a cost-effective means of improving construction planning. However, it is limited at present to the specific case of crane movement under special consideration. Originality/value – This paper presents a large-scale, real life case of applying VP technology in planning construction processes and activities.

Mandated literacy assessment and the reorganisation of teachers’ work : federal policy, local effects

This paper explores how mandated literacy assessment is reorganising teachers’ work in the context of Australia’s National Assessment Program – Literacy and Numeracy (NAPLAN), which was implemented in 2008. Students in Years 3, 5, 7 and 9 are tested annually, with school results publicly available. The wider policy context and the emergence of different forms of interconnected educational work associated with the testing phenomenon are described. Taking an Institutional Ethnography approach, the local effects of the federal policy regime are examined through a case study of one school. What mandated literacy assessment does to educators’ work in a culturally diverse low socioeconomic school community is discussed. Key themes include strategic exclusions of students from the testing process, appropriations and adaptations of literacy theory, work intensification, and ethical mediation of results. Questions concerning equity are raised about the differential effects of policy in different school contexts.

One size fits one : customizing work through manager-employee exchange

While prior research has addressed how collective workplace outcomes are negotiated between employers and trade unions, less attention has been afforded to the ‘everyday’, micro-level exchanges between managers and employees in adjusting work, alongside the ‘standard’ terms and conditions set out in employment contracts. Building on previous work on idiosyncratic deals and requests for flexible scheduling, this article presents the findings from a survey of Australian parents which addressed manager-employee exchanges which led to customized work arrangements. The survey examined the frequency with which various employment terms and conditions were negotiated, who initiated the interactions, where they occurred, and the extent of perceived compromise. The study revealed that manager-employee exchanges occur frequently in the context of roles in nuclear and extended families, and are influenced by the parameters around which formal childcare and educational settings function. Women rated the exchanges as more important than men, but men and women were similarly comfortable with the interactions and satisfied with outcomes. The findings have important implications for managers and organizations in terms of balancing the goals of efficiency with employees’ preferences for workplace flexibility and other terms beyond those which are standardized.