Swept frequency biompedance analysis for the determination of body water compartments

Bioelectrical impedance analysis, (BIA), is a method of body composition analysis first investigated in 1962 which has recently received much attention by a number of research groups. The reasons for this recent interest are its advantages, (viz: inexpensive, non-invasive and portable) and also the increasing interest in the diagnostic value of body composition analysis. The concept utilised by BIA to predict body water volumes is the proportional relationship for a simple cylindrical conductor, (volume oc length2/resistance), which allows the volume to be predicted from the measured resistance and length. Most of the research to date has measured the body's resistance to the passage of a 50· kHz AC current to predict total body water, (TBW). Several research groups have investigated the application of AC currents at lower frequencies, (eg 5 kHz), to predict extracellular water, (ECW). However all research to date using BIA to predict body water volumes has used the impedance measured at a discrete frequency or frequencies. This thesis investigates the variation of impedance and phase of biological systems over a range of frequencies and describes the development of a swept frequency bioimpedance meter which measures impedance and phase at 496 frequencies ranging from 4 kHz to 1 MHz. The impedance of any biological system varies with the frequency of the applied current. The graph of reactance vs resistance yields a circular arc with the resistance decreasing with increasing frequency and reactance increasing from zero to a maximum then decreasing to zero. Computer programs were written to analyse the measured impedance spectrum and determine the impedance, Zc, at the characteristic frequency, (the frequency at which the reactance is a maximum). The fitted locus of the measured data was extrapolated to determine the resistance, Ro, at zero frequency; a value that cannot be measured directly using surface electrodes. The explanation of the theoretical basis for selecting these impedance values (Zc and Ro), to predict TBW and ECW is presented. Studies were conducted on a group of normal healthy animals, (n=42), in which TBW and ECW were determined by the gold standard of isotope dilution. The prediction quotients L2/Zc and L2/Ro, (L=length), yielded standard errors of 4.2% and 3.2% respectively, and were found to be significantly better than previously reported, empirically determined prediction quotients derived from measurements at a single frequency. The prediction equations established in this group of normal healthy animals were applied to a group of animals with abnormally low fluid levels, (n=20), and also to a group with an abnormal balance of extra-cellular to intracellular fluids, (n=20). In both cases the equations using L2/Zc and L2/Ro accurately and precisely predicted TBW and ECW. This demonstrated that the technique developed using multiple frequency bioelectrical impedance analysis, (MFBIA), can accurately predict both TBW and ECW in both normal and abnormal animals, (with standard errors of the estimate of 6% and 3% for TBW and ECW respectively). Isotope dilution techniques were used to determine TBW and ECW in a group of 60 healthy human subjects, (male. and female, aged between 18 and 45). Whole body impedance measurements were recorded on each subject using the MFBIA technique and the correlations between body water volumes, (TBW and ECW), and heighe/impedance, (for all measured frequencies), were compared. The prediction quotients H2/Zc and H2/Ro, (H=height), again yielded the highest correlation with TBW and ECW respectively with corresponding standard errors of 5.2% and 10%. The values of the correlation coefficients obtained in this study were very similar to those recently reported by others. It was also observed that in healthy human subjects the impedance measured at virtually any frequency yielded correlations not significantly different from those obtained from the MFBIA quotients. This phenomenon has been reported by other research groups and emphasises the need to validate the technique by investigating its application in one or more groups with abnormalities in fluid levels. The clinical application of MFBIA was trialled and its capability of detecting lymphoedema, (an excess of extracellular fluid), was investigated. The MFBIA technique was demonstrated to be significantly more sensitive, (P<.05), in detecting lymphoedema than the current technique of circumferential measurements. MFBIA was also shown to provide valuable information describing the changes in the quantity of muscle mass of the patient during the course of the treatment. The determination of body composition, (viz TBW and ECW), by MFBIA has been shown to be a significant improvement on previous bioelectrical impedance techniques. The merit of the MFBIA technique is evidenced in its accurate, precise and valid application in animal groups with a wide variation in body fluid volumes and balances. The multiple frequency bioelectrical impedance analysis technique developed in this study provides accurate and precise estimates of body composition, (viz TBW and ECW), regardless of the individual's state of health.

Development and validation of a novel approach to work sampling : a study of nurse practitioner work patterns

Objectives: This methodological paper reports on the development and validation of a work sampling instrument and data collection processes to conduct a national study of nurse practitioners’ work patterns. ---------- Design: Published work sampling instruments provided the basis for development and validation of a tool for use in a national study of nurse practitioner work activities across diverse contextual and clinical service models. Steps taken in the approach included design of a nurse practitioner-specific data collection tool and development of an innovative web-based program to train and establish inter rater reliability of a team of data collectors who were geographically dispersed across metropolitan, rural and remote health care settings. ---------- Setting: The study is part of a large funded study into nurse practitioner service. The Australian Nurse Practitioner Study is a national study phased over three years and was designed to provide essential information for Australian health service planners, regulators and consumer groups on the profile, process and outcome of nurse practitioner service. ---------- Results: The outcome if this phase of the study is empirically tested instruments, process and training materials for use in an international context by investigators interested in conducting a national study of nurse practitioner work practices. ---------- Conclusion: Development and preparation of a new approach to describing nurse practitioner practices using work sampling methods provides the groundwork for international collaboration in evaluation of nurse practitioner service.

A secure framework and related protocols for ubiquitous access to electronic health records using Java sim cards

Ubiquitous access to patient medical records is an important aspect of caring for patient safety. Unavailability of sufficient medical information at the point-ofcare could possibly lead to a fatality. The U.S. Institute of Medicine has reported that between 44,000 and 98,000 people die each year due to medical errors, such as incorrect medication dosages, due to poor legibility in manual records, or delays in consolidating needed information to discern the proper intervention. In this research we propose employing emergent technologies such as Java SIM Cards (JSC), Smart Phones (SP), Next Generation Networks (NGN), Near Field Communications (NFC), Public Key Infrastructure (PKI), and Biometric Identification to develop a secure framework and related protocols for ubiquitous access to Electronic Health Records (EHR). A partial EHR contained within a JSC can be used at the point-of-care in order to help quick diagnosis of a patient’s problems. The full EHR can be accessed from an Electronic Health Records Centre (EHRC) when time and network availability permit. Moreover, this framework and related protocols enable patients to give their explicit consent to a doctor to access their personal medical data, by using their Smart Phone, when the doctor needs to see or update the patient’s medical information during an examination. Also our proposed solution would give the power to patients to modify the Access Control List (ACL) related to their EHRs and view their EHRs through their Smart Phone. Currently, very limited research has been done on using JSCs and similar technologies as a portable repository of EHRs or on the specific security issues that are likely to arise when JSCs are used with ubiquitous access to EHRs. Previous research is concerned with using Medicare cards, a kind of Smart Card, as a repository of medical information at the patient point-of-care. However, this imposes some limitations on the patient’s emergency medical care, including the inability to detect the patient’s location, to call and send information to an emergency room automatically, and to interact with the patient in order to get consent. The aim of our framework and related protocols is to overcome these limitations by taking advantage of the SIM card and the technologies mentioned above. Briefly, our framework and related protocols will offer the full benefits of accessing an up-to-date, precise, and comprehensive medical history of a patient, whilst its mobility will provide ubiquitous access to medical and patient information everywhere it is needed. The objective of our framework and related protocols is to automate interactions between patients, healthcare providers and insurance organisations, increase patient safety, improve quality of care, and reduce the costs.

Safety culture research, lead indicators, and the development of safety effectiveness indicators in the construction sector

Construction sector application of Lead Indicators generally and Positive Performance Indicators (PPIs) particularly, are largely seen by the sector as not providing generalizable indicators of safety effectiveness. Similarly, safety culture is often cited as an essential factor in improving safety performance, yet there is no known reliable way of measuring safety culture. This paper proposes that the accurate measurement of safety effectiveness and safety culture is a requirement for assessing safe behaviours, safety knowledge, effective communication and safety performance. Currently there are no standard national or international safety effectiveness indicators (SEIs) that are accepted by the construction industry. The challenge is that quantitative survey instruments developed for measuring safety culture and/ or safety climate are inherently flawed methodologically and do not produce reliable and representative data concerning attitudes to safety. Measures that combine quantitative and qualitative components are needed to provide a clear utility for safety effectiveness indicators.

National health and hospital network for Australia's future : Implications for emergency medicine

The proposals arising from the agreement reached between the Rudd government and the States and Territories (except Western Australia) in April 2010 represent the most fundamental realignment of health responsibilities since the creation of Medicare in 1984. They will change the health system, and the structures that will craft its future direction and design. These proposals will have a significant impact on Emergency Medicine; an impact from not only the system-wide effects of the proposals but also those that derive from the specific recommendations to create an activity-based funding mechanism for EDs, to implement the four hour rule and to develop a performance indicator framework for EDs. The present paper will examine the potential impact of the proposals on Emergency Medicine to inform those who work within the system and to help guide further developments. More work is required to better evaluate the proposals and to guide the design and development of specific reform instruments. Any such efforts should be based upon a proper analysis of the available evidence, and a structured approach to research and development so as to deliver on improved services to the community, and on improved quality and safety of emergency medical care.

Towards a method of constructing self-efficacy narratives.

This paper outlines a method of constructing narratives about an individual’s self-efficacy. Self-efficacy is defined as “people’s judgments of their capabilities to organise and execute courses of action required to attain designated types of performances” (Bandura, 1986, p. 391), and as such represents a useful construct for thinking about personal agency. Social cognitive theory provides the theoretical framework for understanding the sources of self-efficacy, that is, the elements that contribute to a sense of self-efficacy. The narrative approach adopted offers an alternative to traditional, positivist psychology, characterised by a preoccupation with measuring psychological constructs (like self-efficacy) by means of questionnaires and scales. It is argued that these instruments yield scores which are somewhat removed from the lived experience of the person—respondent or subject—associated with the score. The method involves a cyclical and iterative process using qualitative interviews to collect data from participants – four mature aged university students. The method builds on a three-interview procedure designed for life history research (Dolbeare & Schuman, cited in Seidman, 1998). This is achieved by introducing reflective homework tasks, as well as written data generated by research participants, as they are guided in reflecting on those experiences (including behaviours, cognitions and emotions) that constitute a sense of self-efficacy, in narrative and by narrative. The method illustrates how narrative analysis is used “to produce stories as the outcome of the research” (Polkinghorne, 1995, p.15), with detail and depth contributing to an appreciation of the ‘lived experience’ of the participants. The method is highly collaborative, with narratives co-constructed by researcher and research participants. The research outcomes suggest an enhanced understanding of self-efficacy contributes to motivation, application of effort and persistence in overcoming difficulties. The paper concludes with an evaluation of the research process by the students who participated in the author’s doctoral study.

Contact Lens Practice, 2nd Edition

Thoroughly revised and updated, this popular book provides a comprehensive yet easy to read guide to modern contact lens practice. Beautifully re-designed in a clean, contemporary layout, this second edition presents relevant and up-to-date information in a systematic manner, with a logical flow of subject matter from front to back. This book wonderfully captures the ‘middle ground’ in the contact lens field … somewhere between a dense research-based tome and a basic fitting guide. As such, it is ideally suited for both students and general eye care practitioners who require a practical, accessible and uncluttered account of the contact lens field. Contents Part 1 Introduction Historical perspective. The anterior eye Visual optics Clinical instruments Part 2 Soft contact lenses Soft lens materials Soft lens manufacture Soft lens optics Soft lens measurement Soft lens design and fitting Soft toric lens design and fitting Soft lens care systems Part 3 Rigid contact lenses Rigid lens materials Rigid lens manufacture Rigid lens optics Rigid lens measurement Rigid lens design and fitting Rigid toric lens design and fitting Rigid lens care systems Part 4 Lens replacement modalities Unplanned lens replacement Daily soft lens replacement Planned soft lens replacement Planned rigid lens replacement Part 5 Special lenses and fitting considerations Scleral lenses Tinted lenses Presbyopia Continuous wear Sport Keratoconus High ametropia Paediatric fitting Therapeutic applications Post-refractive Surgery Post-keratoplasty Orthokeratology Diabetes Part 6 Patient examination and management History taking Preliminary examination Patient education Aftercare Complications Digital imaging Compliance Practice management Appendices Index

Workflows, processes and technical solutions for seeding the research data commons

Queensland University of Technology (QUT) completed an Australian National Data Service (ANDS) funded “Seeding the Commons Project” to contribute metadata to Research Data Australia. The project employed two Research Data Librarians from October 2009 through to July 2010. Technical support for the project was provided by QUT’s High Performance Computing and Research Support Specialists. ---------- The project identified and described QUT’s category 1 (ARC / NHMRC) research datasets. Metadata for the research datasets was stored in QUT’s Research Data Repository (Architecta Mediaflux). Metadata which was suitable for inclusion in Research Data Australia was made available to the Australian Research Data Commons (ARDC) in RIF-CS format. ---------- Several workflows and processes were developed during the project. 195 data interviews took place in connection with 424 separate research activities which resulted in the identification of 492 datasets. ---------- The project had a high level of technical support from QUT High Performance Computing and Research Support Specialists who developed the Research Data Librarian interface to the data repository that enabled manual entry of interview data and dataset metadata, creation of relationships between repository objects. The Research Data Librarians mapped the QUT metadata repository fields to RIF-CS and an application was created by the HPC and Research Support Specialists to generate RIF-CS files for harvest by the Australian Research Data Commons (ARDC). ---------- This poster will focus on the workflows and processes established for the project including: ---------- • Interview processes and instruments • Data Ingest from existing systems (including mapping to RIF-CS) • Data entry and the Data Librarian interface to Mediaflux • Verification processes • Mapping and creation of RIF-CS for the ARDC

Navigating technological contexts and experience design in music education

For some time we have jokingly referred to our network jamming research with jam2jam as ‘Switched on Orff’ (Brown, Sorensen and Dillon 2002; Dillon 2003; Dillon 2006; Dillon 2006; Brown and Dillon 2007). The connection with electronic music and Wendy Carlos’ classic work ‘Switched on Bach’ was obvious; we were using electronic music in schools and with children. The deeper connection with Orff however was about recognising that electronic music and instruments could have cultural values and knowledge embedded in their design and practice in same way as what has come to be known as the Orff method (Orff and Keetman 1958-66). However whilst the Orff method focuses upon Western art music perceptual framework electronic instruments have the potential to have more fluid musical environments and even to move to interdisciplinary study by including visual media. Whilst the Orff method focused on making sense of Western art music through experience electronic environments potentially can make sense of the world of multi media that pervades our lives.

Developing spatial infrastructures for the Q.U.T. Samford Ecological Research Facility.

Staff and students of the Surveying and Spatial Sciences discipline at QUT have worked collaboratively with the Institute of Sustainable Resources in the creation and development of spatial information layers and infrastructure to support multi-disciplinary research efforts at the Samford Ecological Research Facility (SERF). The SERF property is unique in that it provides staff and students with a semi-rural controlled research base for multiple users. This paper aims to describe the development of a number of spatial information layers and network of survey monuments that assist and support research infrastructure at SERF. A brief historical background about the facility is presented along with descriptions of the surveying and mapping activities undertaken. These broad ranging activities include introducing monument infrastructure and a geodetic control network; surveying activities for aerial photography ground-control targets including precise levelling with barcode instruments; development of an ortho-rectified image spatial information layer; Real-Time-Kinematic Global Positioning Systems (RTK-GPS) surveying for constructing 100metre confluence points/monuments to support science-based disciplines to undertake environmental research transects and long-term ecological sampling; and real-world learning initiative to assist with water engineering projects and student experiential learning. The spatial information layers and physical infrastructure have been adopted by two specific yet diverse user groups with an interest in the long-term research focus of SERF.

Making space and place for the knowledge economy : knowledge-based development of Australian cities

The impact of what has been broadly labelled the knowledge economy has been such that, even in the absence of precise measurement, it is the undoubted dynamo of today’s global market, and an essential part of any global city. The socio-economic importance of knowledge production in a knowledge economy is clear, and it is an emerging social phenomenon and research agenda in geographical studies. Knowledge production, and where, how and by whom it is produced, is an urban phenomenon that is poorly understood in an era of strong urbanisation. This paper focuses on knowledge community precincts as the catalytic magnet infrastructures impacting on knowledge production in cities. The paper discusses the increasing importance of knowledge-based urban development within the paradigm of the knowledge economy, and the role of knowledge community precincts as instruments to seed the foundation of knowledge production in cities. This paper explores the knowledge based urban development, and particularly knowledge community precinct development, potentials of Sydney, Melbourne and Brisbane, and benchmarks this against that of Boston, Massachusetts.

Widening the gap between measurement and modelling of secondary organic aerosol properties?

The link between measured sub-saturated hygroscopicity and cloud activation potential of secondary organic aerosol particles produced by the chamber photo-oxidation of α-pinene in the presence or absence of ammonium sulphate seed aerosol was investigated using two models of varying complexity. A simple single hygroscopicity parameter model and a more complex model (incorporating surface effects) were used to assess the detail required to predict the cloud condensation nucleus (CCN) activity from the subsaturated water uptake. Sub-saturated water uptake measured by three hygroscopicity tandem differential mobility analyser (HTDMA) instruments was used to determine the water activity for use in the models. The predicted CCN activity was compared to the measured CCN activation potential using a continuous flow CCN counter. Reconciliation using the more complex model formulation with measured cloud activation could be achieved widely different assumed surface tension behavior of the growing droplet; this was entirely determined by the instrument used as the source of water activity data. This unreliable derivation of the water activity as a function of solute concentration from sub-saturated hygroscopicity data indicates a limitation in the use of such data in predicting cloud condensation nucleus behavior of particles with a significant organic fraction. Similarly, the ability of the simpler single parameter model to predict cloud activation behaviour was dependent on the instrument used to measure sub-saturated hygroscopicity and the relative humidity used to provide the model input. However, agreement was observed for inorganic salt solution particles, which were measured by all instruments in agreement with theory. The difference in HTDMA data from validated and extensively used instruments means that it cannot be stated with certainty the detail required to predict the CCN activity from sub-saturated hygroscopicity. In order to narrow the gap between measurements of hygroscopic growth and CCN activity the processes involved must be understood and the instrumentation extensively quality assured. It is impossible to say from the results presented here due to the differences in HTDMA data whether: i) Surface tension suppression occurs ii) Bulk to surface partitioning is important iii) The water activity coefficient changes significantly as a function of the solute concentration.

User characteristics of transit oriented developments : the case of Kelvin Grove Urban Village

Transit oriented developments are high density mixed use developments located within short and easily walkable distance of a major transit centre. These developments are often hypothesised as a means of enticing a mode shift from the private car to sustainable transport modes such as, walking, cycling and public transport. However, it is important to gather evidence to test this hypothesis by determining the travel characteristics of transit oriented developments users. For this purpose, travel surveys were conducted for an urban transit oriented development currently under development. This chapter presents the findings from the preliminary data analysis of the travel surveys. Kelvin Grove Urban Village, a mixed use development located in Brisbane, Australia, has been selected as the case for the transit oriented developments study. Travel data for all groups of transit oriented development users ranging from students to shoppers, and residents to employees were collected. Different survey instruments were used for different transit oriented development users to optimise their response rates, and the performance of these survey instruments are stated herein. The travel characteristics of transit oriented development users are reported in this chapter by explaining mode share, trip length distribution, and time of day of trip. The results of the travel survey reveal that Kelvin Grove Urban Village users use more sustainable modes of transport as compared to other Brisbane residents.

The impact of users’ cognitive style on their navigational behaviors in web searching

User-Web interactions have emerged as an important area of research in the field of information science. In this study, we investigate the effects of users’ cognitive styles on their Web navigational styles and information processing strategies. We report results from the analyses of 594 minutes recorded Web search sessions of 18 participants engaged in 54 scenario-based search tasks. We use questionnaires, cognitive style test, Web session logs and think-aloud as the data collection instruments. We classify users’ cognitive styles as verbalisers and imagers based on Riding’s (1991) Cognitive Style Analysis test. Two classifications of navigational styles and three categories of information processing strategies are identified. Our study findings show that there exist relationships between users’ cognitive style, and their navigational styles and information processing strategies. Verbal users seem to display sporadic navigational styles, and adopt a scanning strategy to understand the content of the search result page, while imagery users follow a structured navigational style and reading approach. We develop a matrix and a model that depicts the relationships between users’ cognitive styles, and their navigational style and information processing strategies. We discuss how the findings from this study could help search engine designers to provide an adaptive navigation support to users.