Feasibility of a stepped wedge cluster RCT and concurrent observational sub-study to evaluate the effects of modified ward night lighting on inpatient fall rates and sleep quality: A protocol for a pilot trial

Background: Falls among hospitalised patients impose a considerable burden on health systems globally and prevention is a priority. Some patient-level interventions have been effective in reducing falls, but others have not. An alternative and promising approach to reducing inpatient falls is through the modification of the hospital physical environment and the night lighting of hospital wards is a leading candidate for investigation. In this pilot trial, we will determine the feasibility of conducting a main trial to evaluate the effects of modified night lighting on inpatient ward level fall rates. We will test also the feasibility of collecting novel forms of patient level data through a concurrent observational sub-study. Methods/design: A stepped wedge, cluster randomised controlled trial will be conducted in six inpatient wards over 14 months in a metropolitan teaching hospital in Brisbane (Australia). The intervention will consist of supplementary night lighting installed across all patient rooms within study wards. The planned placement of luminaires, configurations and spectral characteristics are based on prior published research and pre-trial testing and modification. We will collect data on rates of falls on study wards (falls per 1000 patient days), the proportion of patients who fall once or more, and average length of stay. We will recruit two patients per ward per month to a concurrent observational sub-study aimed at understanding potential impacts on a range of patient sleep and mobility behaviour. The effect on the environment will be monitored with sensors to detect variation in light levels and night-time room activity. We will also collect data on possible patient-level confounders including demographics, pre-admission sleep quality, reported vision, hearing impairment and functional status. Discussion: This pragmatic pilot trial will assess the feasibility of conducting a main trial to investigate the effects of modified night lighting on inpatient fall rates using several new methods previously untested in the context of environmental modifications and patient safety. Pilot data collected through both parts of the trial will be utilised to inform sample size calculations, trial design and final data collection methods for a subsequent main trial.

Conclaves and concurrent expert evidence: A positive development in Australian legal practice?

Many Australian courts now prefer pre-hearing meetings of experts (conclaves) being convened to prepare joint reports to identify areas of agreement and disagreement, followed by concurrent expert evidence at trial. This contrasts to the traditional approach where experts did not meet before trial and did not give evidence together. Most judges, lawyers and expert witnesses favour this as a positive development in Australian legal practice, at least for civil disputes. This new approach impacts medical practitioners who are called upon to give expert evidence, or who are parties to disputes before the courts. Arguably, it is too soon to tell whether the relative lack of transparency at the conclave stage will give rise to difficulties in the coronial, disciplinary and criminal arenas.

The effect of post harvest handling on selected native food plants

A commercial issue currently facing native plant food producers and food processors, and identified by the industry itself, is that of delivering quality products consistently and at reasonable cost to end users based on a sound food technology and nutrition platform. A literature survey carried out in July 2001 by the DPI&F’s Centre for Food Technology, Brisbane in collaboration with the University of Queensland to collect the latest information at that time on the functional food market as it pertained to native food plants, indicated that little or no work had been published on this topic. This project addresses two key RIRDC sub program strategies: to identify and evaluate processes or products with prospects of commercial viability and to assist in the development of integrated production, harvesting, processing and marketing systems. This project proposal also reflects a key RIRDC R&D issue for 2002-2003; that of linking with prospective members of the value chain. The purpose of this project was to obtain chemical data on the post harvest stability of functional nutritional components (bio actives) in commercially available, hand harvested bush tomato and Kakadu plum. The project concentrated on evaluating bioactive stability as a measure of ingredient quality.

System integration design in MEMS - A case study of micromachined load cell

One of the critical issues in large scale commercial exploitation of MEMS technology is its system integration. In MEMS, a system design approach requires integration of varied and disparate subsystems with one of a kind interface. The physical scales as well as the magnitude of signals of various subsystems vary widely. Known and proven integration techniques often lead to considerable loss in advantages the tiny MEMS sensors have to offer. Therefore, it becomes imperative to think of the entire system at the outset, at least in terms of the concept design. Such design entails various aspects of the system ranging from selection of material, transduction mechanism, structural configuration, interface electronics, and packaging. One way of handling this problem is the system-in-package approach that uses optimized technology for each function using the concurrent hybrid engineering approach. The main strength of this design approach is the fast time to prototype development. In the present work, we pursue this approach for a MEMS load cell to complete the process of system integration for high capacity load sensing. The system includes; a micromachined sensing gauge, interface electronics and a packaging module representing a system-in-package ready for end characterization. The various subsystems are presented in a modular stacked form using hybrid technologies. The micromachined sensing subsystem works on principles of piezo-resistive sensing and is fabricated using CMOS compatible processes. The structural configuration of the sensing layer is designed to reduce the offset, temperature drift, and residual stress effects of the piezo-resistive sensor. ANSYS simulations are carried out to study the effect of substrate coupling on sensor structure and its sensitivity. The load cell system has built-in electronics for signal conditioning, processing, and communication, taking into consideration the issues associated with resolution of minimum detectable signal. The packaged system represents a compact and low cost solution for high capacity load sensing in the category of compressive type load sensor.

Handling sectional views in volume-based approach to automatically construct 3D solid from 2D views

This paper presents an algorithm for solid model reconstruction from 2D sectional views based on volume-based approach. None of the existing work in automatic reconstruction from 2D orthographic views have addressed sectional views in detail. It is believed that the volume-based approach is better suited to handle different types of sectional views. The volume-based approach constructs the 3D solid by a boolean combination of elementary solids. The elementary solids are formed by sweep operation on loops identified in the input views. The only adjustment to be made for the presence of sectional views is in the identification of loops that would form the elemental solids. In the algorithm, the conventions of engineering drawing for sectional views, are used to identify the loops correctly. The algorithm is simple and intuitive in nature. Results have been obtained for full sections, offset sections and half sections. Future work will address other types of sectional views such as removed and revolved sections and broken-out sections. (C) 2004 Elsevier Ltd. All rights reserved.

Measurement of air leakage in air-handling units and air conditioning ducts

The purpose of this article is to report the experience of design and testing of orifice plate-based flow measuring systems for evaluation of air leakages in components of air conditioning systems. Two of the flow measuring stations were designed with a beta value of 0.405 and 0.418. The third was a dual path unit with orifice plates of beta value 0.613 and 0.525. The flow rates covered with all the four were from 4-94 l/s and the range of Reynolds numbers is from 5600 to 76,000. The coefficients of discharge were evaluated and compared with the Stolz equation. Measured C-d values are generally higher than those obtained from the equation, the deviations being larger in the low Reynolds number region. Further, it is observed that a second-degree polynomial is inadequate to relate the pressure drop and flow rate. The lower Reynolds number limits set by standards appear to be somewhat conservative.

A Formalised Model of the Information and Materials Handling Activities in the Construction Process

A model of the information and material activities that comprise the overall construction process is presented, using the SADT activity modelling methodology. The basic model is further refined into a number of generic information handling activities such as creation of new information, information search and retrieval, information distribution and person-to-person communication. The viewpoint could be described as information logistics. This model is then combined with a more traditional building process model, consisting of phases such as design and construction. The resulting two-dimensional matrix can be used for positioning different types of generic IT-tools or construction specific applications. The model can thus provide a starting point for a discussion of the application of information and communication technology in construction and for measurements of the impacts of IT on the overall process and its related costs.

Personnel Managers and Crisis Situations. Emotion-handling Strategies

This study focuses on personnel managers in crisis situations. The interviewed personnel managers referred to emotions as a central element to be dealt with in a crisis. However, until recently, the exploration of emotions in organisational life has been de-emphasised or ignored. This study aims to bring to the surface aspects of personnel work that have so far been neglected or remained invisible. It specifically examines how personnel managers handle employees’ and their own emotions in a crisis. Based on the interviews, a number of emotional episodes were constructed. They describe the type and context of the crisis and the person(s) whose emotions are handled. The main findings of the study are the five emotion-handling strategies that could be constructed from the data. The negotiation-like manner in which personnel managers handled emotions in crisis situations proved especially interesting. They were actually negotiating emotional value for their organisations. Further, they handled their own emotions within the frame of two logics of appropriateness labelled mothering and guide-following. The episodes described also enabled identification of the values enacted by the personnel managers in handling emotions. The study provides descriptive information on emotion handling, a current and relevant feature in the practice of personnel management. It seeks to offer a frame for developing practical principles that can be helpful in a crisis. It also offers the opportunity to consider a variety of difficult situations that personnel managers may confront in their work.

Second order cone programming approaches for handling missing and uncertain data

We propose a novel second order cone programming formulation for designing robust classifiers which can handle uncertainty in observations. Similar formulations are also derived for designing regression functions which are robust to uncertainties in the regression setting. The proposed formulations are independent of the underlying distribution, requiring only the existence of second order moments. These formulations are then specialized to the case of missing values in observations for both classification and regression problems. Experiments show that the proposed formulations outperform imputation.

Extended colored Petri net: An efficient tool for analyzing concurrent systems

This paper proposes a novel and simple definition of general colored Petri nets. This definition is coherent with that of (uncolored) Petri nets, preserves the reflexivity of the original net and is extended to represent inhibitors. Also suggested are systematic and formal merging rules to obtain a well-formed structure of the extended colored Petri net by folding a given uncolored net. Finally, we present a technique to compute colored invariants by selecting colored RP-subnets. On the average, the proposed technique performs better than the existing ones. The analysis procedure is explained through an illustrative example of a three-level interrupt-priority-handler scheme.

Lenient Execution and Concurrent Execution of Re-entrant Routines: Efficient Implementation in Data Flow Systems

Implementation details of efficient schemes for lenient execution and concurrent execution of re-entrant routines in a data flow model have been discussed in this paper. The proposed schemes require no extra hardware support and utilise the existing hardware resources such as the Matching Unit and Memory Network Interface, effectively to achieve the above mentioned goals.

Performability of automated manufacturing systems with centralized material handling

We present a framework for performance evaluation of manufacturing systems subject to failure and repair. In particular, we determine the mean and variance of accumulated production over a specified time frame and show the usefulness of these results in system design and in evaluating operational policies for manufacturing systems. We extend this analysis for lead time as well. A detailed performability study is carried out for the generic model of a manufacturing system with centralized material handling. Several numerical results are presented, and the relevance of performability analysis in resolving system design issues is highlighted. Specific problems addressed include computing the distribution of total production over a shift period, determining the shift length necessary to deliver a given production target with a desired probability, and obtaining the distribution of Manufacturing Lead Time, all in the face of potential subsystem failures.

A Flat Concurrent Prolog compiler for PARAM

We describe a compiler for the Flat Concurrent Prolog language on a message passing multiprocessor architecture. This compiler permits symbolic and declarative programming in the syntax of Guarded Horn Rules, The implementation has been verified and tested on the 64-node PARAM parallel computer developed by C-DAC (Centre for the Development of Advanced Computing, India), Flat Concurrent Prolog (FCP) is a logic programming language designed for concurrent programming and parallel execution, It is a process oriented language, which embodies dataflow synchronization and guarded-command as its basic control mechanisms. An identical algorithm is executed on every processor in the network, We assume regular network topologies like mesh, ring, etc, Each node has a local memory, The algorithm comprises of two important parts: reduction and communication, The most difficult task is to integrate the solutions of problems that arise in the implementation in a coherent and efficient manner. We have tested the efficacy of the compiler on various benchmark problems of the ICOT project that have been reported in the recent book by Evan Tick, These problems include Quicksort, 8-queens, and Prime Number Generation, The results of the preliminary tests are favourable, We are currently examining issues like indexing and load balancing to further optimize our compiler.

Robust Formulations for Handling Uncertainty in Kernel Matrices

We study the problem of uncertainty in the entries of the Kernel matrix, arising in SVM formulation. Using Chance Constraint Programming and a novel large deviation inequality we derive a formulation which is robust to such noise. The resulting formulation applies when the noise is Gaussian, or has finite support. The formulation in general is non-convex, but in several cases of interest it reduces to a convex program. The problem of uncertainty in kernel matrix is motivated from the real world problem of classifying proteins when the structures are provided with some uncertainty. The formulation derived here naturally incorporates such uncertainty in a principled manner leading to significant improvements over the state of the art. 1.