Smoothing a Discrete Hazard Function for the Number of Patients Colonized with Methicillin-Resistance Staphylococcus Aureus in an Intensive Care Unit

A new method for estimating the time to colonization of Methicillin-resistant Staphylococcus Aureus (MRSA) patients is developed in this paper. The time to colonization of MRSA is modelled using a Bayesian smoothing approach for the hazard function. There are two prior models discussed in this paper: the first difference prior and the second difference prior. The second difference prior model gives smoother estimates of the hazard functions and, when applied to data from an intensive care unit (ICU), clearly shows increasing hazard up to day 13, then a decreasing hazard. The results clearly demonstrate that the hazard is not constant and provide a useful quantification of the effect of length of stay on the risk of MRSA colonization which provides useful insight.

An investigation of nucleation events in a coastal urban environment in the southern hemisphere

The occurrence of and conditions favourable to nucleation were investigated at an industrial and commercial coastal location in Brisbane, Australia during five different campaigns covering a total period of 13 months. To identify potential nucleation events, the difference in number concentration in the size range 14-30 nm (N14-30) between consecutive observations was calculated using first-order differencing. The data showed that nucleation events were a rare occurrence, and that in the absence of nucleation the particle number was dominated by particles in the range 30-300 nm. In many instances, total particle concentration declined during nucleation. There was no clear pattern in change in NO and NO2 concentrations during the events. SO2 concentration, in the majority of cases, declined during nucleation but there were exceptions. Most events took place in summer, followed by winter and then spring, and no events were observed for the autumn campaigns. The events were associated with sea breeze and long-range transport. Roadside emissions, in contrast, did not contribute to nucleation, probably due to the predominance of particles in the range 50-100 nm associated with these emissions.

On the efficiency of impingers with fritted nozzle tip for collection of ultrafine particles

The aim of this study was to determine the collection efficiency of ultrafine particles into an impinger fitted with a fritted nozzle tip as a means to increase contact surface area between the aerosol and the liquid. The influence of liquid sampling volume, frit porosity and the nature of the sampling liquid was explored and it was shown that all impact on the collection efficiency of particles smaller than 220 nm. Obtained values for overall collection efficiency were substantially higher (~30–95%) than have been previously reported, mainly due to the high deposition of particles in the fritted nozzle tip, especially in case of finer porosity frits and smaller particles. Values for the capture efficiency of the solvent alone ranged from 20 to 45%, depending on the type and the volume of solvent. Additionally, our results show that airstream dispersion into bubbles improves particle trapping by the liquid and that there is a difference in collection efficiencies based on the nature and volume of the solvent used.

Particle and gaseous emissions from compressed natural gas and ultralow sulphur diesel-fuelled buses at four steady engine loads

Exhaust emissions from thirteen compressed natural gas (CNG) and nine ultralow sulphur diesel in-service transport buses were monitored on a chassis dynamometer. Measurements were carried out at idle and at three steady engine loads of 25%, 50% and 100% of maximum power at a fixed speed of 60 kmph. Emission factors were estimated for particle mass and number, carbon dioxide and oxides of nitrogen for two types of CNG buses (Scania and MAN, compatible with Euro 2 and 3 emission standards, respectively) and two types of diesel buses (Volvo Pre-Euro/Euro1 and Mercedez OC500 Euro3). All emission factors increased with load. The median particle mass emission factor for the CNG buses was less than 1% of that from the diesel buses at all loads. However, the particle number emission factors did not show a statistically significant difference between buses operating on the two types of fuel. In this paper, for the very first time, particle number emission factors are presented at four steady state engine loads for CNG buses. Median values ranged from the order of 1012 particles min-1 at idle to 1015 particles km-1 at full power. Most of the particles observed in the CNG emissions were in the nanoparticle size range and likely to be composed of volatile organic compounds The CO2 emission factors were about 20% to 30% greater for the diesel buses over the CNG buses, while the oxides of nitrogen emission factors did not show any difference due to the large variation between buses.

The experiences of teacher aides who support students with disabilities and learning difficulties : a phenomenological study

Schools in Queensland, Australia, are undergoing inclusive education reform, following the report of the Ministerial Taskforce on Inclusive Education (Students with Disabilities) in 2004. The State government’s responses to the taskforce report emphasise a commitment to social justice and equity so that all students can be included in ways that enable them to achieve their potential. Teacher aides are employed in schools as ancillary staff to support students with disabilities and learning difficulties. Their support roles in schools are emerging within an educational context in which assumptions about disability, difference and inclusion of students with disabilities and learning difficulties are changing. It is important to acknowledge teacher aides as support practitioners, and to understand their roles in relation to the inclusion of students with disabilities and learning difficulties as inclusive education reform continues. This study used a phenomenological approach to explore the lived experiences of teacher aides as they supported students with disabilities and learning difficulties in primary schools. Four key insights into the support roles of teacher aides in primary schools in Brisbane, Queensland emerged from the study: 1) teacher aides develop empathetic relationships with students that contribute significantly to the students’ sense of belonging within school communities; 2) lack of clear definition of roles and responsibilities for teacher aides has detrimental effects on inclusion of students; 3) collaborative planning and implementation of classroom learning and socialisation programs enhances inclusion; and 4) teacher aides learn about supporting students while on-the-job, and in consultation and collaboration with other members of the students’ support networks.

i-Cobb - An innovative technique in spinal radiographic measurement

The measurement of Cobb angles from radiographs is routine practice in spinal clinics. The technique relies on the use and availability of specialist equipment such as a goniometer, cobbometer or protractor. The aim of this study was to validate the use of i-Phone (Apple Inc) combined with Tilt Meter Pro software as compared to a protractor in the measurement of Cobb angles. Between November 2008 and December 2008 20 patients were selected at random from the Paediatric Spine Research Groups Database. A power calculation was performed which indicated if n=240 measurements the study had a 96% chance of detecting a 5 degree difference between groups. All patients had idiopathic scoliosis with a range of curve types and severities. The study found the i-Phone combined with Tilt Meter Pro software offers a faster alternative to the traditional method of Cobb angle measurement. The use of i-Phone offers a more convenient way of measuring Cobb angles in the outpatient setting. The intra-observer repeatability of the iPhone is equivalent to the protractor in the measurement of Cobb angles.

Creating a therapeutic environment : a non-randomised controlled trial of a quiet time intervention for patients in acute care

Background: Noise is a significant barrier to sleep for acute care hospital patients, and sleep has been shown to be therapeutic for health, healing and recovery. Scheduled quiet time interventions to promote inpatient rest and sleep have been successfully trialled in critical care but not in acute care settings. Objectives: The study aim was to evaluate as cheduled quiet time intervention in an acute care setting. The study measured the effect of a scheduled quiet time on noise levels, inpatients’ rest and sleep behaviour, and wellbeing. The study also examined the impact of the intervention on patients’, visitors’ and health professionals’ satisfaction, and organisational functioning. Design: The study was a multi-centred non-randomised parallel group trial. Settings: The research was conducted in the acute orthopaedic wards of two major urban public hospitals in Brisbane, Australia. Participants: All patientsadmitted to the two wards in the5-month period of the study were invited to participate, withafinalsample of 299 participants recruited. This sample produced an effect size of 0.89 for an increase in the number of patients asleep during the quiet time. Methods: Demographic data were collected to enable comparison between groups. Data for noise level, sleep status, sleepiness and well being were collected using previously validated instruments: a Castle Model 824 digital sound level indicator; a three point sleep status scale; the Epworth Sleepiness Scale; and the SF12 V2 questionnaire. The staff, patient and visitor surveys on the experimental ward were adapted from published instruments. Results: Significant differences were found between the two groups in mean decibel level and numbers of patients awake and asleep. The difference in mean measured noise levels between the two environments corresponded to a ‘perceived’ difference of 2 to 1. There were significant correlations between average decibel level and number of patients awake and asleep in the experimental group, and between average decibel level and number of patients awake in the control group. Overall, patients, visitors and health professionals were satisfied with the quiet time intervention. Conclusions: The findings show that a quiet time intervention on an acute care hospital ward can affect noise level and patient sleep/wake patterns during the intervention period. The overall strongly positive response from surveys suggests that scheduled quiet time would be a positively perceived intervention with therapeutic benefit.

Critically evaluating rural women’s participation and empowerment : An interdisciplinary feminist framework for research and analysis

Community development is increasingly using participatory processes that aim to be inclusive and empowering. However, researchers have found that such processes can have contradictory effects. Australian research has highlighted the significant leadership of rural women in sustainable community and economic development and in the adoption of new communication technologies such as the Internet. A focus on gender in participatory development may therefore lead to more effective programs and policies. This chapter outlines an interdisciplinary feminist framework for critically evaluating the participation and empowerment of rural women. This framework was found effective in evaluating an Australian project that aimed to enhance rural women’s access to communication technologies and to empower its participants. Its multiple theoretical and methodological approaches are outlined. The framework advocates an analysis of diversity and difference and the macro and micro contexts. Some principles and strategies for rural women’s inclusion, participation, empowerment, and for participatory feminist evaluation are outlined.

From the account manager’s conscience to top-of-mind : account planning in Australia

What began as the “account manager’s conscience” has grown to be top-of-mind in Australian advertising today. Account planning is a hybrid discipline which uses research to bring the consumer voice to the campaign process during strategy generation, creative development and evaluation. In Australia, account planning is subjected to the “Vegemite Factor” where planners are spread too thinly across accounts and much of the market is dominated by freelance researchers and planners. This unique environment has shaped many different perceptions of account planning in Australia. These are compared with an international definition of account planning and the current research. While many basic tenants of the definition are shared by Australian advertising professionals, the difference appears to be in the ongoing nature, team approach and level of commitment. In Australia, account planners seem to be more facilitators of the strategic direction, than directors of it. Instead of exerting a sustained influence across the campaign, most energy appears to be expended at the start of campaign development, rather than extending through to its evaluation.