Identifying risk factors and protective factors for venous leg ulcer recurrence using a theoretical approach : a longitudinal study

Background The high recurrence rate of chronic venous leg ulcers has a significant impact on an individual’s quality of life and healthcare costs. Objectives This study aimed to identify risk and protective factors for recurrence of venous leg ulcers using a theoretical approach by applying a framework of self and family management of chronic conditions to underpin the study. Design Secondary analysis of combined data collected from three previous prospective longitudinal studies. Setting The contributing studies’ participants were recruited from two metropolitan hospital outpatient wound clinics and three community-based wound clinics. Participants Data were available on a sample of 250 adults, with a leg ulcer of primarily venous aetiology, who were followed after ulcer healing for a median follow-up time of 17 months after healing (range: 3 to 36 months). Methods Data from the three studies were combined. The original participant data were collected through medical records and self-reported questionnaires upon healing and every 3 months thereafter. A Cox proportion-hazards regression analysis was undertaken to determine the influential factors on leg ulcer recurrence based on the proposed conceptual framework. Results The median time to recurrence was 42 weeks (95% CI 31.9–52.0), with an incidence of 22% (54 of 250 participants) recurrence within three months of healing, 39% (91 of 235 participants) for those who were followed for six months, 57% (111 of 193) by 12 months, 73% (53 of 72) by two years and 78% (41 of 52) of those who were followed up for three years. A Cox proportional-hazards regression model revealed that the risk factors for recurrence included a history of deep vein thrombosis (HR 1.7, 95% CI 1.07–2.67, p=0.024), history of multiple previous leg ulcers (HR 4.4, 95% CI 1.84–10.5, p=0.001), and longer duration (in weeks) of previous ulcer (HR 1.01, 95% CI 1.003–1.01, p<0.001); while the protective factors were elevating legs for at least 30 minutes per day (HR 0.33, 95% CI 0.19–0.56, p<0.001), higher levels of self-efficacy (HR 0.95, 95% CI 0.92–0.99, p=0.016), and walking around for at least three hours/day (HR 0.66, 95% CI 0.44–0.98, p=0.040). Conclusions Results from this study provide a comprehensive examination of risk and protective factors associated with leg ulcer recurrence based on the chronic disease self and family management framework. These results in turn provide essential steps towards developing and testing interventions to promote optimal prevention strategies for venous leg ulcer recurrence.

Evolution of the docklands food hub : a design-led innovation approach to food sovereignty through local food systems

Access to nutritious, safe and culturally appropriate food is a basic human right (Mechlem, 2004). Food sovereignty defines this right through the empowerment of the people to redefine food and agricultural systems, and through ecologically sustainable production methods. At the heart of the food sovereignty movement are the interests of producers, distributors and consumers, rather than the interests of markets and corporations, which dominate the current globalized food system (Hinrichs, 2003). Food sovereignty challenges designers to enable people to innovate the food system. We are yet to develop economically viable solutions for scaling projects and providing citizens, governments and business with tools to develop and promote projects to innovate food systems and promote food sovereignty (Meroni, 2011; Murray, Caulier-Grice and Mulgan, 2010). This article examines how a design-led approach to innovation can assist in the development of new business models and ventures for local food systems: this is presented through an emerging field of research ‘Design-Led Food Communities’. Design-Led Food Communities enables citizens, governments and business to innovate local food projects through the application of design. This article reports on the case study of the Docklands Food Hub Project in Melbourne, Australia. Preliminary findings demonstrate valued outcomes, but also a deficiency in the design process to generate food solutions collaboratively between government, business and citizens.

An agent-based approach to immune modelling

This study focuses on trying to understand why the range of experience with respect to HIV infection is so diverse, especially as regards to the latency period. The challenge is to determine what assumptions can be made about the nature of the experience of antigenic invasion and diversity that can be modelled, tested and argued plausibly. To investigate this, an agent-based approach is used to extract high-level behaviour which cannot be described analytically from the set of interaction rules at the cellular level. A prototype model encompasses local variation in baseline properties contributing to the individual disease experience and is included in a network which mimics the chain of lymphatic nodes. Dealing with massively multi-agent systems requires major computational efforts. However, parallelisation methods are a natural consequence and advantage of the multi-agent approach. These are implemented using the MPI library.

A parallel approach to social network generation and agent-based epidemic simulation

Understanding the dynamics of disease spread is essential in contexts such as estimating load on medical services, as well as risk assessment and interven- tion policies against large-scale epidemic outbreaks. However, most of the information is available after the outbreak itself, and preemptive assessment is far from trivial. Here, we report on an agent-based model developed to investigate such epidemic events in a stylised urban environment. For most diseases, infection of a new individual may occur from casual contact in crowds as well as from repeated interactions with social partners such as work colleagues or family members. Our model therefore accounts for these two phenomena. Given the scale of the system, efficient parallel computing is required. In this presentation, we focus on aspects related to paralllelisation for large networks generation and massively multi-agent simulations.

The potential for utilising the collaborative learning spaces approach in the delivery of résumé development education

This study investigated the potential for using collaborative learning spaces for the development of résumé writing knowledge and skills in higher education students. Utilising a collaborative learning environment, 227 students from a mix of programmes and year levels participated in one of 24 workshops centering on a technology supported, shared review and reflection approach to résumé construction. It was concluded that use of technology supported collaborative learning spaces has the potential to be a valuable, innovative approach for the delivery of career management related skills in higher education.

A ‘Big Data’ Approach to Mapping the Australian Twittersphere

This chapter discusses the methodological aspects and empirical findings of a large-scale, funded project investigating public communication through social media in Australia. The project concentrates on Twitter, but we approach it as representative of broader current trends toward the integration of large datasets and computational methods into media and communication studies in general, and social media scholarship in particular. The research discussed in this chapter aims to empirically describe networks of affiliation and interest in the Australian Twittersphere, while reflecting on the methodological implications and imperatives of ‘big data’ in the humanities. Using custom network crawling technology, we have conducted a snowball crawl of Twitter accounts operated by Australian users to identify more than one million users and their follower/followee relationships, and have mapped their interconnections. In itself, the map provides an overview of the major clusters of densely interlinked users, largely centred on shared topics of interest (from politics through arts to sport) and/or sociodemographic factors (geographic origins, age groups). Our map of the Twittersphere is the first of its kind for the Australian part of the global Twitter network, and also provides a first independent and scholarly estimation of the size of the total Australian Twitter population. In combination with our investigation of participation patterns in specific thematic hashtags, the map also enables us to examine which areas of the underlying follower/followee network are activated in the discussion of specific current topics – allowing new insights into the extent to which particular topics and issues are of interest to specialised niches or to the Australian public more broadly. Specifically, we examine the Twittersphere footprint of dedicated political discussion, under the #auspol hashtag, and compare it with the heightened, broader interest in Australian politics during election campaigns, using #ausvotes; we explore the different patterns of Twitter activity across the map for major television events (the popular competitive cooking show #masterchef, the British #royalwedding, and the annual #stateoforigin Rugby League sporting contest); and we investigate the circulation of links to the articles published by a number of major Australian news organisations across the network. Such analysis, which combines the ‘big data’-informed map and a close reading of individual communicative phenomena, makes it possible to trace the dynamic formation and dissolution of issue publics against the backdrop of longer-term network connections, and the circulation of information across these follower/followee links. Such research sheds light on the communicative dynamics of Twitter as a space for mediated social interaction. Our work demonstrates the possibilities inherent in the current ‘computational turn’ (Berry, 2010) in the digital humanities, as well as adding to the development and critical examination of methodologies for dealing with ‘big data’ (boyd and Crawford, 2011). Out tools and methods for doing Twitter research, released under Creative Commons licences through our project Website, provide the basis for replicable and verifiable digital humanities research on the processes of public communication which take place through this important new social network.

Renewable energy distribution in public spaces: Analyzing the case of Ballast Point Park in Sydney, using a triple bottom line approach

As cities are rapidly developing new interventions against climate change, embedding renewable energy in public spaces is an important strategy. However, most interventions primarily include environmental sustainability while neglecting the social and economic interrelationships of electricity production. Although there is a growing interest in sustainability within environmental design and landscape architecture, public spaces are still awaiting viable energy-conscious design and assessment interventions. The purpose of this paper is to investigate this issue in a renowned public space—Ballast Point Park in Sydney—using a triple bottom line (TBL) case study approach. The emerging factors and relationships of each component of TBL, within the context of public open space, are identified and discussed. With specific focus on renewable energy distribution in and around Ballast Point Park, the paper concludes with a general design framework, which conceptualizes an optimal distribution of onsite electricity produced from renewable sources embedded in public open spaces.

Meta-regulation approach to raise social accountability In global supply firms

This Article proposes a meta-regulation approach to address the gap between the objectives, commitment, practice and outcome in the accountability practice of the global supply chain in the developing countries. The literatures on the accountability practice in the global supply chains typically focuses on the strategies for raising corporate social accountability standards in multinational buying firms and seldom focuses on this strategies in the outsourced firms in the developing countries. This article tries to fill this void by examining the situation in Bangladesh, the third largest RMG supply country in the world. It conceptualizes a meta-regulation approach with the aim of raising social accountability practice in this industry. It shows that this regulation approach is suitable to effectively raise this practice standard in a perspective where the non-legal drivers are meagrely low, global buying firms are highly profit driven and the governmental agencies are either inadequate or highly corrupt.

Is the sun too bright in Queensland? An approach to robust outdoor colour beacon detection

Using cameras onboard a robot for detecting a coloured stationary target outdoors is a difficult task. Apart from the complexity of separating the target from the background scenery over different ranges, there are also the inconsistencies with direct and reflected illumination from the sun,clouds, moving and stationary objects. They can vary both the illumination on the target and its colour as perceived by the camera. In this paper, we analyse the effect of environment conditions, range to target, camera settings and image processing on the reported colours of various targets. The analysis indicates the colour space and camera configuration that provide the most consistent colour values over varying environment conditions and ranges. This information is used to develop a detection system that provides range and bearing to detected targets. The system is evaluated over various lighting conditions from bright sunlight, shadows and overcast days and demonstrates robust performance. The accuracy of the system is compared against a laser beacon detector with preliminary results indicating it to be a valuable asset for long-range coloured target detection.

A neurofuzzy approach to future intelligent driver support systems

This paper reviews a variety of advanced signal processing algorithms that have been developed at the University of Southampton as part of the Prometheus (PROgraMme for European Traffic flow with Highest Efficiency and Unprecedented Safety) research programme to achieve an intelligent driver warning system (IDWS). The IDWS includes: visual detection of both generic obstacles and other vehicles, together with their tracking and identification, estimates of time to collision and behavioural modelling of drivers for a variety of scenarios. These application areas are used to show the applicability of neurofuzzy techniques to the wide range of problems required to support an IDWS, and for future fully autonomous vehicles.

Specificity and context in post-exercise recovery: It is not a one-size-fits-all approach

The concept of specificity of exercise prescription and training is a longstanding and widely accepted foundation of the exercise sciences. Simply, the principle holds that training adaptations are achieved relative to the stimulus applied. That is, the manipulation of training variables (e.g. intensity or loading, mode, volume and frequency) directly influences the acute training stimulus, and so the long-term adaptive response (Young et al., 2001; Bird et al., 2005). Translating this concept to practice then recommends that exercise be prescribed specific to the desired outcomes, and the more closely this is achieved, the greater the performance gain is likely to be. However, the cardiovascular and metabolic adaptations traditionally associated with long, slow distance training types, similarly achieved using high-intensity training methods (for a review see Gibala et al., 2012), highlights understanding of underlying physiology as paramount for effective training program design. Various other factors including illness, sleep and psychology also impact on the training stimulus (Halson, 2014) and must be managed collectively with appropriate post-exercise recovery to continue performance improvements and reduce overtraining and injury risks (Kenttä and Hassmén, 1998).