Improving the outcomes of foot and ankle surgery. Professional impact of the Australasian College of Podiatric Surgeons' audit tool

Background Surgery is an example of expanded practice scope that enhances podiatry and incorporates inter-professional collaboration. By 2050 demand for foot and ankle procedures is predicted to rise nationally by 61.9%. Performance management of this increase motivated the development of an online audit tool. Developed in collaboration with the Australasian College of Podiatric Surgeons (ACPS), the ACPS audit tool provides real-time data capture and reporting. It is the first audit tool designed in Australia to support and improve the outcomes of foot and ankle surgery. Methods Audit activity in general, orthopaedic, plastic and podiatric surgery was examined using a case study design. Audit participation enablers and barriers were explored. Case study results guided a Delphi survey of international experts experienced or associated with foot and ankle surgery. Delphi survey-derived consensus informed modification of a generic data set from the Royal Australasian College of Surgeons (RACS). Based on the Delphi survey findings the ACPS online audit tool was developed and piloted. Reliability and validity of data entry and usability of this new tool was then assessed with an online survey. Results The case study found surgeon attitudes and behaviours positively impacted audit participation, and also indicated that audit data should be: (1) available in real time, (2) identify practice change, (3) applicable for safety and quality management, and; (4) useful for peer review discussion. The Delphi process established consensus on audit variables to be captured, including the modified RACS generic data set. 382 cases of foot and ankle surgery were captured across 3 months using the new tool. Data entry was found to be valid and reliable. Real-time outcome reporting and practice change identification impacted positively on safety and quality management and assisted peer review discussion. An online survey showed high levels of usability. Conclusions Surgeon contribution to audit tool development resulted in 100% audit participation. The data from the ACPS audit tool supported the ACPS submission to the Medical Services Advisory Committee to list podiatric surgery under Medicare, an outcome noted by the Federal Minister of Health.

Effect of an interactive therapeutic robotic animal on engagement, mood states, agitation and psychotropic drug use in people with dementia: A cluster-randomised controlled trial protocol

Introduction: Apathy, agitated behaviours, loneliness and depression are common consequences of dementia. This trial aims to evaluate the effect of a robotic animal on behavioural and psychological symptoms of dementia in people with dementia living in long-term aged care. Methods and analysis: A cluster-randomised controlled trial with three treatment groups: PARO (robotic animal), Plush-Toy (non-robotic PARO) or Usual Care (Control). The nursing home sites are Australian Government approved and accredited facilities of 60 or more beds. The sites are located in South-East Queensland, Australia. A sample of 380 adults with a diagnosis of dementia, aged 60 years or older living in one of the participating facilities will be recruited. The intervention consists of three individual 15 min non-facilitated sessions with PARO or Plush- Toy per week, for a period of 10 weeks. The primary outcomes of interest are improvement in agitation, mood states and engagement. Secondary outcomes include sleep duration, step count, change in psychotropic medication use, change in treatment costs, and staff and family perceptions of PARO or Plush-Toy. Video data will be analysed using Noldus XT Pocket Observer; descriptive statistics will be used for participants’ demographics and outcome measures; cluster and individual level analyses to test all hypotheses and Generalised Linear Models for cluster level and Generalised Estimation Equations and/or Multi-level Modeling for individual level data. Ethics and dissemination: The study participants or their proxy will provide written informed consent. The Griffith University Human Research Ethics Committee has approved the study (NRS/03/14/HREC). The results of the study will provide evidence of the efficacy of a robotic animal as a psychosocial treatment for the behavioural and psychological symptoms of dementia. Findings will be presented at local and international conference meetings and published in peer-reviewed journals.

“We have to work within the system!”: Staff perceptions of organizational barriers to decision making for older adults with dementia in Australian aged care facilities

The current study explored the perceptions of direct care staff working in Australian residential aged care facilities (RACFs) regarding the organizational barriers that they believe prevent them from facilitating decision making for individuals with dementia. Normalization process theory (NPT) was used to interpret the findings to understand these barriers in a broader context. The qualitative study involved semi-structured interviews (N = 41) and focus groups (N = 8) with 80 direct care staff members of all levels working in Australian RACFs. Data collection and analysis were conducted in parallel and followed a systematic, inductive approach in line with grounded theory. The perceptions of participants regarding the organizational barriers to facilitating decision making for individuals with dementia can be described by the core category, Working Within the System, and three sub-themes: (a) finding time, (b) competing rights, and (c)not knowing. Examining the views of direct care staff through the lens of NPT allows possible areas for improvement to be identified at an organizational level and the perceived barriers to be understood in the context of promoting normalization of decision making for individuals with dementia.

Feeding mode of Australian infants in the first 12 months of life: An assessment against national breastfeeding indicators

Background: In 2011, Australia published a set of 6 population-level indicators assessing breastfeeding, formula use, and the introduction of soft/semisolid/solid foods. Objectives: This study aimed to report the feeding practices of Australian infants against these indicators and determine the predictors of early breastfeeding cessation and introduction of solids. Methods: Mother–infant dyads (N = 1470) were recruited postnatally in 2 Australian capital cities and regional areas of 1 state between February 2008 and March 2009. Demographic and feeding intention data were collected by self-completed questionnaire at infant birth, with feeding practices (current feeding mode, age of breastfeeding cessation, age of formula and/or solids introduction) reported when the infant was between 4 and 7 months of age, and around 13 months of age. Multiple logistic regression was used to determine the predictors of breastfeeding cessation and solids introduction. Results: Although initiation of breastfeeding was almost universal (93.3%), less than half of the infants were breastfed to 6 months (41.7%) and 33.3% were receiving solids by 4 months. Women who were socially disadvantaged, younger, less educated, unpartnered, primiparous, and/or overweight were most likely to have ceased breastfeeding before 6 months of age, and younger and/or less educated women were most likely to have introduced solid food by 4 months of age. Not producing adequate milk was the most common reason provided for cessation of breastfeeding. Conclusion: The feeding behaviors of Australian infants in the first 12 months fall well short of recommendations. Women need anticipatory guidance as to the indicators of breastfeeding success and the tendency of women to doubt the adequacy of their breast milk supply warrants further investigation.

Multi-Hypotheses Tracking using the Dempster–Shafer Theory, application to ambiguous road context

This paper presents a Multi-Hypotheses Tracking (MHT) approach that allows solving ambiguities that arise with previous methods of associating targets and tracks within a highly volatile vehicular environment. The previous approach based on the Dempster–Shafer Theory assumes that associations between tracks and targets are unique; this was shown to allow the formation of ghost tracks when there was too much ambiguity or conflict for the system to take a meaningful decision. The MHT algorithm described in this paper removes this uniqueness condition, allowing the system to include ambiguity and even to prevent making any decision if available data are poor. We provide a general introduction to the Dempster–Shafer Theory and present the previously used approach. Then, we explain our MHT mechanism and provide evidence of its increased performance in reducing the amount of ghost tracks and false positive processed by the tracking system.

Getting mad may not mean getting even: The influence of drivers' ethical ideologies on driving anger and related behaviour

The current study explored the influence of moral values (measured by ethical ideology) on self-reported driving anger and aggressive driving responses. A convenience sample of drivers aged 17-73 years (n = 280) in Queensland, Australia, completed a self-report survey. Measures included sensation seeking, trait aggression, driving anger, endorsement of aggressive driving responses and ethical ideology (Ethical Position Questionnaire, EPQ). Scores on the two underlying dimensions of the EPQ idealism (highI/lowI) and relativism (highR/lowR) were used to categorise drivers into four ideological groups: Situationists (highI/highR); Absolutists (highI/lowR); Subjectivists (lowI/highR); and Exceptionists (lowI/lowR). Mean aggressive driving scores suggested that exceptionists were significantly more likely to endorse aggressive responses. After accounting for demographic variables, sensation seeking and driving anger, ethical ideological category added significantly, though modestly to the prediction of aggressive driving responses. Patterns in results suggest that those drivers in ideological groups characterised by greater concern to avoid affecting others negatively (i.e. highI, Situationists, Absolutists) may be less likely to endorse aggressive driving responses, even when angry. In contrast, Subjectivists (lowI, HighR), reported the lowest levels of driving anger yet were significantly more likely to endorse aggressive responses. This provides further insight into why high levels of driving anger may not always translate into more aggressive driving.

Distributed Robotic Vision as a service

The vision sense of standalone robots is limited by line of sight and onboard camera capabilities, but processing video from remote cameras puts a high computational burden on robots. This paper describes the Distributed Robotic Vision Service, DRVS, which implements an on-demand distributed visual object detection service. Robots specify visual information requirements in terms of regions of interest and object detection algorithms. DRVS dynamically distributes the object detection computation to remote vision systems with processing capabilities, and the robots receive high-level object detection information. DRVS relieves robots of managing sensor discovery and reduces data transmission compared to image sharing models of distributed vision. Navigating a sensorless robot from remote vision systems is demonstrated in simulation as a proof of concept.

Air pollution and fasting blood glucose: A longitudinal study in China

Limited studies have examined the associations between air pollutants [particles with diameters of 10um or less (PM10), sulfur dioxide (SO2), and nitrogen dioxide (NO2)] and fasting blood glucose (FBG). We collected data for 27,685 participants who were followed during 2006 and 2008. Generalized Estimating Equation models were used to examine the effects of air pollutants on FBG while controlling for potential confounders. We found that increased exposure to NO2, SO2 and PM10 was significantly associated with increased FBG levels in single pollutant models (p<0.001). For exposure to 4 days’ average of concentrations, a 100 µg/m3 increase in SO2, NO2, and PM10 was associated with 0.17 mmol/L (95%CI: 0.15–0.19), 0.53 mmol/L (95%CI: 0.42–0.65), and 0.11 mmol/L (95%CI: 0.07–0.15) increase in FBG, respectively. In the multi-pollutant models, the effects of SO2 were enhanced, while the effects of NO2 and PM10 were alleviated. The effects of air pollutants on FBG were stronger in female, elderly, and overweight people than in male, young and underweight people. In conclusion, the findings suggest that air pollution increases the levels of FBG. Vulnerable people should pay more attention on highly polluted days to prevent air pollution-related health issues.

Atmospheric visibility and PM10 as indicators of new particle formation in an urban environment

It is well-known that new particle formation (NPF) in the atmosphere is inhibited by pre-existing particles in the air that act as condensation sinks to decrease the concentration and, thus, the supersaturation of precursor gases. In this study, we investigate the effects of two parameters - atmospheric visibility, expressed as the particle back-scatter coefficient (BSP), and PM10 particulate mass concentration, on the occurrences of NPF events in an urban environment where the majority of precursor gases originate from motor vehicle and industrial sources. This is the first attempt to derive direct relationships between each of these two parameters and the occurrence of NPF. NPF events were identified from data obtained with a neutral cluster and air ion spectrometer over 245 days within a calendar year. Bayesian logistic regression was used to determine the probability of observing NPF as functions of BSP and PM10. We show that the BSP at 08 h on a given day is a reliable indicator of an NPF event later that day. The posterior median probability of observing an NPF event was greater than 0.5 (95%) when the BSP at 08 h was less than 6.8 Mm-1.

Assessing police classifications of sexual assault reports: A meta-analysis of false reporting rates

The objective of the study was to determine, through meta-analysis, the rate of confirmed false reports of sexual assault to police. The meta-analysis initially involved a search for relevant articles. The search revealed seven studies where researchers or their trained helpers evaluated reported sexual assault cases to determine the rate of confirmed false reports. The meta-analysis calculated an overall rate and tested for possible moderators of effect size. The meta-analytic rate of false reports of sexual assault was .052 (95% CIs .030, .089). The rates for the individual studies were heterogeneous, suggesting the possibility of moderators of rate. However, the four possible moderators examined, year of publication, whether the data set used had information in addition to police reports, whether the study was completed in the U.S. or elsewhere, and whether inter-rater reliabilities were reported, were all not significant. The meta-analysis of seven relevant studies shows that confirmed false allegations of sexual assault made to police occur at a significant rate. The total false reporting rate, including both confirmed and equivocal cases, would be greater than the 5 percent rate found here.

Why are students choosing STEM and when do they make their choice?

BACKGROUND OR CONTEXT The higher education sector plays an important role in encouraging students into the STEM pipeline through fostering partnerships with schools, building on universities long tradition in engagement and outreach to secondary schools. Numerous activities focus on integrated STEM learning experiences aimed at developing conceptual scientific and mathematical knowledge with opportunities for students to show and develop skills in working with each other and actively engaging in discussion, decision making and collaborative problem solving. (NAS, 2013; AIG, 2015; OCS, 2014). This highlights the importance of the development and delivery of engaging integrated STEM activities connected to the curriculum to inspire the next generation of scientists and engineers and generally preparing students for post-secondary success. The broad research objective is to gain insight into which engagement activities and to what level they influence secondary school students’ selection of STEM-related career choices at universities. PURPOSE OR GOAL To evaluate and determine the effectiveness of STEM engagement activities impacting student decision making in choosing a STEM-related degree choice at university. APPROACH A survey was conducted with first-year domestic students studying STEM-related fieldswithin the Science and Engineering Faculty at Queensland University of Technology. Of the domestic students commencing in 2015, 29% responded to the survey. The survey was conducted using Survey Monkey and included a variety of questions ranging from academic performance at school to inspiration for choosing a STEM degree. Responses were analysed on a range of factors to evaluate the influence on students’ decisions to study STEM and whether STEM high school engagement activities impacted these decisions. To achieve this the timing of decision making for students choice in study area, degree, and university is compared with the timing of STEM engagement activities. DISCUSSION Statistical analysis using SPSS was carried out on survey data looking at reasons for choosing STEM degrees in terms of gender, academic performance and major influencers in their decision making. It was found that students choose their university courses based on what subjects they enjoyed and exceled at in school. These results found a high correlation between enjoyment of a school subject and their interest in pursuing this subject at university and beyond. Survey results indicated students are heavily influenced by their subject teachers and parents in their choice of STEM-related disciplines. In terms of career choice and when students make their decision, 60% have decided on a broad area of study by year 10, whilst only 15% had decided on a specific course and 10% had decided on which university. The timing of secondary STEM engagement activities is seen as a critical influence on choosing STEM disciplines or selection of senior school subjects with 80% deciding on specific degree between year 11 and 12 and 73% making a decision on which university in year 12. RECOMMENDATIONS/IMPLICATIONS/CONCLUSION Although the data does not support that STEM engagement activities increase the likelihood of STEM-related degree choice, the evidence suggests the students who have participated in STEM activities associate their experiences with their choice to pursue a STEM-related course. It is important for universities to continue to provide quality engaging and inspirational learning experiences in STEM, to identify and build on students’ early interest and engagement, increase STEM knowledge and awareness, engage them in interdisciplinary project-based STEM practices, and provide them with real-world application experiences to sustain their interest.

Shifting the Focus. Incorporating knowledge about Aboriginal engineering into main stream content

BACKGROUND OR CONTEXT The concept of 'Aboriginal engineering' has had little exposure in conventional engineering education programs, despite more than 40,000 years of active human engagement with the diverse Australian environment. The work reported in this paper began with the premise that Indigenous Student Support Through Indigenous Perspectives Embedded in Engineering Curricula (Goldfinch, et al 2013) would provide a clear and replicable means of encouraging Aboriginal teenagers to consider a career in engineering. Although that remains a key outcome of this OLT project, the direction taken by the research had led to additional insights and perspectives that have wide implications for engineering education more generally. There has only been passing reference to the achievements of Aboriginal engineering in current texts, and the very absence of such references was a prompt to explore further as our work developed. PURPOSE OR GOAL Project goals focused on curriculum-based change, including development of a model for inclusive teaching spaces, and study units employing key features of the model. As work progressed we found we needed to understand more about the principles and practices informing the development of pre-contact Aboriginal engineering strategies for sustaining life and society within the landscape of this often harsh continent. We also found ourselves being asked 'what engineering did Aboriginal cultures have?' Finding that there are no easy-to- access answers, we began researching the question, while continuing to engage with specific curriculum trials. APPROACH Stakeholders in the project had been identified as engineering educators, potential Aboriginal students and Aboriginal communities local to Universities involved in the project. We realised, early on, that at least one more group was involved - all the non-Aboriginal students in engineering classes. This realisation, coupled with recognition of the need to understand Aboriginal engineering as a set of viable, long term practices, altered the focus of our efforts. Rather than focusing primarily on finding ways to attract Aboriginal engineering students, the shift has been towards evolving ways of including knowledge about Aboriginal practices and principles in relevant engineering content. DISCUSSION This paper introduces the model resulting from the work of this project, explores its potential influence on engineering curriculum development and reports on implementation strategies. The model is a static representation of a dynamic and cyclic approach to engaging with Aboriginal engineering through contact with local communities in regard to building knowledge about the social beliefs underlying Aboriginal engineering principles and practices. Ways to engage engineering educators, students and the wider community are evolving through the continuing work of the project team and will be reported in more detail in the paper. RECOMMENDATIONS/IMPLICATIONS/CONCLUSION While engineering may be considered by some to be agnostic in regard to culture and social issues, the work of this project is drawing attention to the importance of including such issues into curriculum materials at a number of levels of complexity. The paper will introduce and explore the central concepts of the research completed to date, as well as suggesting ways in which engineering educators can extend their knowledge and understanding of Aboriginal engineering principles in the context of their own specialisations.

Laboratories transformation

BACKGROUND OR CONTEXT Laboratories provide the physical spaces for engineering students to connect with theory and have a personal hands-on learning experience. Learning space design and development is well established in many universities however laboratories are often not part of that movement. While active, collaborative and group learning pedagogies are all key words in relation to these new spaces the concepts have always been central to laboratory based learning. The opportunity to build on and strengthen good practice in laboratories is immense. In the 2001 review “Universities in Crisis” many references are made to the decline of laboratories. One such comment in the review was made by Professor Ian Chubb (AVCC), who in 2013, as Chief Scientist for Australia, identifies the national concern about STEM education and presents a strategic plan to address the challenges ahead. What has been achieved and changed in engineering teaching and research laboratories in this time? PURPOSE OR GOAL A large number of universities in Australia and New Zealand own laboratory and other infrastructure designed well for the era they were built but now showing signs of their age, unable to meet the needs of today’s students, limiting the effectiveness of learning outcomes and presenting very low utilisation rates. This paper will present a model for new learning space design that improves student experience and engagement, supporting academic aims and significantly raising the space utilisation rate. APPROACH A new approach in laboratory teaching and research including new management has been adopted by the engineering disciplines at QUT. Flexibility is an underpinning principle along with the modularisation of fixed teaching and learning equipment, high utilisation of spaces and dynamic pedagogical approaches. The revitalised laboratories and workshop facilities are used primarily for the engineering disciplines and increasingly for integrated use across many disciplines in the STEM context. The new approach was built upon a base of an integrated faculty structure from 2005 and realised in 2010 as an associated development with the new Science and Engineering Centre (SEC). Evaluation through student feedback surveys for practical activities, utilisation rate statistics and uptake by academic and technical staff indicate a very positive outcome. DISCUSSION Resulting from this implementation has been increased satisfaction by students, creation of social learning and connecting space and an environment that meets the needs and challenges of active, collaborative and group learning pedagogies. Academic staff are supported, technical operations are efficient and laboratories are effectively utilised. RECOMMENDATIONS/IMPLICATIONS/CONCLUSION Future opportunities for continuous improvement are evident in using the student feedback to rectify faults and improve equipment, environment and process. The model is easily articulated and visible to other interested parties to contribute to sector wide development of learning spaces.

Insights into the growth of newly formed particles in a subtropical urban environment

The role of different chemical compounds, particularly organics, involved in the new particle formation (NPF) and its consequent growth are not fully understood. Therefore, this study was conducted to investigate the chemical composition of aerosol particles during NPF events in an urban subtropical environment. Aerosol chemical composition was measured along with particle number size distribution (PNSD) and several other air quality parameters at five sites across an urban subtropical environment. An Aerodyne compact Time-of-Flight Aerosol Mass Spectrometer (c-TOF-AMS) and a TSI Scanning Mobility Particle Sizer (SMPS) measured aerosol chemical composition (particles above 50 nm in vacuum aerodynamic diameter) and PNSD (particles within 9-414 nm in mobility diameter), respectively. Five NPF events, with growth rates in the range 3.3-4.6 nm, were detected at two of the sites. The NPF events happened on relatively warmer days with lower condensation sink (CS). Temporal percent fractions of organics increased after the particles grew enough to have a significant contribution to particles volume, while the mass fraction of ammonium and sulphate decreased. This uncovered the important role of organics in the growth of newly formed particles. Three organic markers, factors f43, f44 and f57, were calculated and the f44 vs f43 trends were compared between nucleation and non-nucleation days. K-means cluster analysis was performed on f44 vs f43 data and it was found that they follow different patterns on nucleation days compared to non-nucleation days, whereby f43 decreased for vehicle emission generated particles, while both f44 and f43 decreased for NPF generated particles. It was found for the first time that vehicle generated and newly formed particles cluster in different locations on f44 vs f43 plot and this finding can be potentially used as a tool for source apportionment of measured particles.

Evaluation of the Red Light Camera Program and the Owner Onus Legislation

Red light cameras were introduced in Victoria in August 1983, with the intention of reducing the number of accidents that result from motorists disobeying red traffic signals at signalised intersections. Accident data from 46 treated and 46 control sites from 1981 to 1986 were analysed. The analysis indicated that red light camera use resulted in a reduction in the incidence of right angle accidents, and in the number of accident casualties. Legislation was introduced in March 1986 to place the onus for red light camera offences onto the vehicle owner. This legislation was intended to improve Police efficiency and therefore increase the number of red light cameras in operation. Data supplied by the Police indicated that these aims have beneficial road safety effects.