Radiographer commenting of trauma radiographs : a survey of the benefits, barriers and enablers to participation in an Australian healthcare setting

Introduction Radiographer abnormality detection systems that highlight abnormalities on trauma radiographs (‘red dot’ system) have been operating for more than 30 years. Recently, a number of pitfalls have been identified. These limitations initiated the evolution of a radiographer commenting system, whereby a radiographer provides a brief description of abnormalities identified in emergency healthcare settings. This study investigated radiographers' participation in abnormality detection systems, their perceptions of benefits, barriers and enablers to radiographer commenting, and perceptions of potential radiographer image interpretation services for emergency settings. Methods A cross-sectional survey was implemented. Participants included radiographers from four metropolitan hospitals in Queensland, Australia. Conventional descriptive statistics, histograms and thematic analysis were undertaken. Results Seventy-three surveys were completed and included in the analysis (68% response rate); 30 (41%) of respondents reported participating in abnormality detection in 20% or less of examinations, and 26(36%) reported participating in 80% or more of examinations. Five overarching perceived benefits of radiographer commenting were identified: assisting multidisciplinary teams, patient care, radiographer ability, professional benefits and quality of imaging. Frequently reported perceived barriers included ‘difficulty accessing image interpretation education’, ‘lack of time’ and ‘low confidence in interpreting radiographs’. Perceived enablers included ‘access to image interpretation education’ and ‘support from radiologist colleagues’. Conclusions A range of factors are likely to contribute to the successful implementation of radiographer commenting in addition to abnormality detection in emergency settings. Effective image interpretation education amenable to completion by radiographers would likely prove valuable in preparing radiographers for participation in abnormality detection and commenting systems in emergency settings.

Obesity and comorbid risk factors for cardiovascular disease among physically inactive patients with musculoskeletal disorders : a targeted intervention for this priority patient group is warranted

Introduction The benefits of physical activity are established and numerous; not the least of which is reduced risk of negative cardiovascular events. While sedentary lifestyles are having negative impacts across populations, people with musculoskeletal disorders may face additional challenges to becoming physically active. Unfortunately, interventions in ambulatory hospital clinics for people with musculoskeletal disorders primarily focus on their presenting musculoskeletal complaint with cursory attention given to lifestyle risk factors; including physical inactivity. This missed opportunity is likely to have both personal costs for patients and economic costs for downstream healthcare funders. Objectives The objective of this study was to investigate the presence of obesity, diabetes, diagnosed cardiac conditions, and previous stroke (CVA) among insufficiently physically active patients accessing (non-surgical) ambulatory hospital clinics for musculoskeletal disorders to indicate whether a targeted risk-reducing intervention is warranted. Methods A sub-group analysis of patients (n=110) who self-reported undertaking insufficient physical activity level to meet national (Australian) minimum recommended guidelines was conducted. Responses to the Active Australia Survey were used to identify insufficiently active patients from a larger cohort study being undertaken across three (non-surgical) ambulatory hospital clinics for musculoskeletal disorders. Outcomes of interest included body mass index, Type-II diabetes, diagnosed cardiac conditions, previous CVA and patients’ current health-related quality of life (Euroqol-5D). Results The mean (standard deviation) age of inactive patients was 56 (14) years. Body mass index values indicated that n=80 (73%) were overweight n=26 (24%), or obese n=45 (49%). In addition to their presenting condition, a substantial number of patients reported comorbid diabetes n=23 (21%), hypertension n=25 (23%) or an existing heart condition n=14 (13%); 4 (3%) had previously experienced a CVA as well as other comorbid conditions. Health-related quality of life was also substantially impacted, with a mean (standard deviation) multi-attribute utility score of 0.51 (0.32). Conclusion A range of health conditions and risk factors for further negative health events, including cardiovascular complications, consistent with physically inactive lifestyles were evident. A targeted risk-reducing intervention is warranted for this high risk clinical group.

Objective measurement of physical activity in youth : current issues, future directions

Second-generation activity monitors have revolutionized the way in which we measure youth physical activity. Use of the monitors avoids the problems associated with self-report methods and allows for the estimation of physical activity patterns over time. This article examines important methodological issues related to the use of activity monitors in children and adolescents.

Five-level current-source inverters with buck-boost and inductive-current balancing capabilities

This paper presents new five-level current-source inverters (CSIs) with voltage/current buck-boost capability, unlike existing five-level CSIs where only voltage-boost operation is supported. The proposed inverters attain self-inductive-current-balancing per switching cycle at their dc front ends without having to include additional balancing hardware or complex control manipulation. The inverters can conveniently be controlled by using the well-established phase-shifted carrier modulation scheme with only two additional linear references and a mapping logic table needed. Existing modulators can therefore be conveniently retrofitted for controlling the presented inverters. By appropriately coordinating the inverter gating signals, their implementations can be realized by using the least number of components without degrading performance. These enhanced features of the inverters have already been verified in simulation and experimentally using a scaled-down laboratory platform.

Are mothers of young children really inactive?

Australian surveys have found that only 43% of women meet the current recommendation for regular moderate physical activity, and that women who are mothers of young children are even less likely to be adequately active for health benefit. These women spend a significant proportion of their day in occupational, household and care-giving activities, which may not be ‘captured’ in conventional physical activity surveys. The purpose of this study was to compare physical activity in young mothers and age-matched controls using three different measures of physical activity. 35 women (16 mothers of young children, M) and 19 age-matched comparison women (NM) completed a survey which asked about walking to and from places, and about moderate and vigorous activity in leisure time and at work (paid and unpaid). They also kept a detailed diary of all their activities for two week-days and two week-end days, and wore a pedometer (Yamax digiwalker) on these days. Each activity in the diary was assigned an energy expenditure (EE) score based on it's intensity (Compendium of Physical Activity) and time spent in that activity. There were no differences between M and NM for pedometer steps (M: 9270 sd 2947; NM: 9768 sd 3051) or for daily energy expenditure (EE) calculated from the diaries (M: 2029 sd 189; NM: 2015 sd 169 METS.mins) or survey (M: 2079 sd 448; NM: 1495 sd 325). There was a significant correlation between pedometer steps and daily METs.mins estimated from the diaries (r = 0.35, p = 0.04); however no relationship was observed between pedometer steps and EE from the survey (r = .09, p = .56). Further analysis of the individual survey items found pedometer steps to be related to EE from walking to and from places (r = .34) and leisure time (r = .31), but not work related activity (r = -.08). There were no significant relationships between EE computed from the diaries and any of the survey questions. The three activity measures indicate that the physical activity levels of the young mothers in our sample were comparable to age-matched non-mothers. The results of the correlation analyses highlight the difficulty of assessing low-intensity work-related physical activity via self-report. Supported by Australian Commonwealth Department of Health and Aged Care.

Entrepreneurship education in non-business schools : best practice for Australian contexts of knowledge and innovation communities (Final Report)

In the current era of global economic instability, business and industry have already identified a widening gap between graduate skills and employability. An important element of this is the lack of entrepreneurial skills in graduates. This Teaching Fellowship investigated two sides of a story about entrepreneurial skills and their teaching. Senior players in the innovation commercialisation industry, a high profile entrepreneurial sector, were surveyed to gauge their needs and experiences of graduates they employ. International contexts of entrepreneurship education were investigated to explore how their teaching programs impart the skills of entrepreneurship. Such knowledge is an essential for the design of education programs that can deliver the entrepreneurial skills deemed important by industry for future sustainability. Two programs of entrepreneurship education are being implemented at QUT that draw on the best practice exemplars investigated during this Fellowship. The QUT Innovation Space (QIS) focuses on capturing the innovation and creativity of students, staff and others. The QIS is a physical and virtual meeting and networking space; a connected community enhancing the engagement of participants. The Q_Hatchery is still embryonic; but it is intended to be an innovation community that brings together nascent entrepreneurial businesses to collaborate, train and support each other. There is a niche between concept product and business incubator where an experiential learning environment for otherwise isolated ‘garage-at-home’ businesses could improve success rates. The QIS and the Q_Hatchery serve as living research laboratories to trial the concepts emerging from the skills survey. The survey of skills requirements of the innovation commercialisation industry has produced a large and high quality data set still being explored. Work experience as an employability factor has already emerged as an industry requirement that provides employee maturity. Exploratory factor analysis of the skills topics surveyed has led to a process-based conceptual model for teaching and learning higher-order entrepreneurial skills. Two foundational skills domains (Knowledge, Awareness) are proposed as prerequisites which allow individuals with a suite of early stage entrepreneurial and behavioural skills (Pre-leadership) to further leverage their careers into a leadership role in industry with development of skills around higher order elements of entrepreneurship, management in new business ventures and progressing winning technologies to market. The next stage of the analysis is to test the proposed model through structured equation modelling. Another factor that emerged quickly from the survey analysis broadens the generic concept of team skills currently voiced in Australian policy documents discussing the employability agenda. While there was recognition of the role of sharing, creating and using knowledge in a team-based interdisciplinary context, the adoption and adaptation of behaviours and attitudes of other team members of different disciplinary backgrounds (interprofessionalism) featured as an issue. Most undergraduates are taught and undertake teamwork in silos and, thus, seldom experience a true real-world interdisciplinary environment. Enhancing the entrepreneurial capacity of Australian industry is essential for the economic health of the country and can only be achieved by addressing the lack of entrepreneurial skills in graduates from the higher education system. This Fellowship has attempted to address this deficiency by identifying the skills requirements and providing frameworks for their teaching.

Disaster resilience in tertiary hospitals : a cross-sectional survey in Shandong Province, China

Background: Hospital disaster resilience can be defined as a hospital’s ability to resist, absorb, and respond to the shock of disasters while maintaining critical functions, and then to recover to its original state or adapt to a new one. This study aims to explore the status of resilience among tertiary hospitals in Shandong Province, China. Methods: A stratified random sample (n = 50) was derived from tertiary A, tertiary B, and tertiary C hospitals in Shandong Province, and was surveyed by questionnaire. Data on hospital characteristics and 8 key domains of hospital resilience were collected and analysed. Variables were binary, and analysed using descriptive statistics such as frequencies. Results: A response rate of 82% (n = 41) was attained. Factor analysis identified four key factors from eight domains which appear to reflect the overall level of disaster resilience. These were hospital safety, disaster management mechanisms, disaster resources and disaster medical care capability. The survey demonstrated that in regard to hospital safety, 93% had syndromic surveillance systems for infectious diseases and 68% had evaluated their safety standards. In regard to disaster management mechanisms, all had general plans, while only 20% had specific plans for individual hazards. 49% had a public communication protocol and 43.9% attended the local coordination meetings. In regard to disaster resources, 75.6% and 87.5% stockpiled emergency drugs and materials respectively, while less than a third (30%) had a signed Memorandum of Understanding with other hospitals to share these resources. Finally in regard to medical care, 66% could dispatch an on-site medical rescue team, but only 5% had a ‘portable hospital’ function and 36.6% and 12% of the hospitals could surge their beds and staff capacity respectively. The average beds surge capacity within 1 day was 13%. Conclusions: This study validated the broad utility of a framework for understanding and measuring the level of hospital resilience. The survey demonstrated considerable variability in disaster resilience arrangements of tertiary hospitals in Shandong province, and the difference between tertiary A hospitals and tertiary B hospitals was also identified in essential areas.

Alternating current electrohydrodynamics induced nanoshearing and fluid micromixing for specific capture of cancer cells

We report a new tuneable alternating current (ac) electrohydrodynamics (ac-EHD) force referred to as “nanoshearing” which involves fluid flow generated within a few nanometers of an electrode surface. This force can be externally tuned via manipulating the applied ac-EHD field strength. The ability to manipulate ac-EHD induced forces and concomitant fluid micromixing can enhance fluid transport within the capture domain of the channel (e.g., transport of analytes and hence increase target–sensor interactions). This also provides a new capability to preferentially select strongly bound analytes over onspecifically bound cells and molecules. To demonstrate the utility and versatility of nanoshearing phenomenon to specifically capture cancer cells, we present proof-of-concept data in lysed blood using two microfluidic devices containing a long array of asymmetric planar electrode pairs. Under the optimal experimental conditions, we achieved high capture efficiency (e.g., approximately 90%; %RSD=2, n=3) with a 10-fold reduction in nonspecific dsorption of non-target cells for the detection of whole cells expressing Human Epidermal Growth Factor Receptor 2 (HER2). We believe that our ac-EHD devices and the use of tuneable nanoshearing phenomenon may find relevance in a wide variety of biological and medical applications.

Bike share's impact on car use : evidence from the United States, Great Britain, and Australia

There are currently more than 700 cities operating bike share programs. Purported benefits of bike share include flexible mobility, physical activity, reduced congestion, emissions and fuel use. Implicit or explicit in the calculation of program benefits are assumptions regarding the modes of travel replaced by bike share journeys. This paper examines the degree to which car trips are replaced by bike share, through an examination of survey and trip data from bike share programs in Melbourne, Brisbane, Washington, D.C., London, and Minneapolis/St. Paul. A secondary and unique component of this analysis examines motor vehicle support services required for bike share fleet rebalancing and maintenance. These two components are then combined to estimate bike share’s overall contribution to changes in vehicle kilometers traveled. The results indicate an estimated reduction in motor vehicle use due to bike share of approx. 90,000 km per annum in Melbourne and Minneapolis/St. Paul and 243,291 km for Washington, D.C. London’s bike share program however recorded an additional 766,341 km in motor vehicle use. This was largely due to a low car mode substitution rate and substantial truck use for rebalancing of bicycles. As bike share programs mature, evaluation of their effectiveness in reducing car use may become increasingly important. Researchers can adapt the analytical approach proposed in this paper to assist in the evaluation of current and future bike share programs.

A survey in mathematics for industry: Two-timing and matched asymptotic expansions for singular perturbation problems

Following the derivation of amplitude equations through a new two-time-scale method [O'Malley, R. E., Jr. & Kirkinis, E (2010) A combined renormalization group-multiple scale method for singularly perturbed problems. Stud. Appl. Math. 124, 383-410], we show that a multi-scale method may often be preferable for solving singularly perturbed problems than the method of matched asymptotic expansions. We illustrate this approach with 10 singularly perturbed ordinary and partial differential equations. © 2011 Cambridge University Press.

Defining and Accounting for Fundraising Income and Expenses : Executive Summary : ACPNS Current issues Information Sheet 2014/2

Executive summary of Report examining definitions of fundraising and formal Australian accounting standards to ascertain their impact on reporting fundraising transactions by not-for-profit entities.

Current control in the magnetron systems for nanofabrication : a comparison

A cylindrical magnetron system and a hybrid inductively coupled plasma-assisted magnetron deposition system were examined experimentally in light of their discharge characteristics with a view to stress the enhanced controllability of the hybrid system. The comparative study has shown that the hybrid magnetron + the inductively coupled plasma system is a flexible, powerful, and convenient tool that has certain advantages as compared with the cylindrical dc magnetrons. In particular, the hybrid system features more linear current-voltage characteristics and the possibility of a bias-independent control of the discharge current.

Open-air direct current plasma jet : scaling up, uniformity, and cellular control

Atmospheric-pressure plasma jets are commonly used in many fields from medicine to nanotechnology, yet the issue of scaling the discharges up to larger areas without compromising the plasma uniformity remains a major challenge. In this paper, we demonstrate a homogenous cold air plasmaglow with a large cross-section generated by a direct current power supply. There is no risk of glow-to-arc transitions, and the plasmaglow appears uniform regardless of the gap between the nozzle and the surface being processed. Detailed studies show that both the position of the quartz tube and the gas flow rate can be used to control the plasma properties. Further investigation indicates that the residual charges trapped on the inner surface of the quartz tube may be responsible for the generation of the air plasma plume with a large cross-section. The spatially resolved optical emission spectroscopy reveals that the air plasma plume is uniform as it propagates out of the nozzle. The remarkable improvement of the plasma uniformity is used to improve the bio-compatibility of a glass coverslip over a reasonably large area. This improvement is demonstrated by a much more uniform and effective attachment and proliferation of human embryonic kidney 293 (HEK 293) cells on the plasma-treated surface.