Oxygen delivery through high-flow nasal cannulae increase end-expiratory lung volume and reduce respiratory rate in post-cardiac surgical patients

Background: High-flow nasal cannulae (HFNC) create positive oropharyngeal airway pressure but it is unclear how their use affects lung volume. Electrical impedance tomography (EIT) allows assessment of changes in lung volume by measuring changes in lung impedance. Primary objectives were to investigate the effects of HFNC on airway pressure (Paw) and end-expiratory lung volume (EELV), and to identify any correlation between the two. Secondary objectives were to investigate the effects of HFNC on respiratory rate (RR), dyspnoea, tidal volume and oxygenation; and the interaction between body mass index (BMI) and EELV. Methods: Twenty patients prescribed HFNC post-cardiac surgery were investigated. Impedance measures, Paw, PaO2/FiO2 ratio, RR and modified Borg scores were recorded first on low flow oxygen (nasal cannula or Hudson face mask) and then on HFNC. Results: A strong and significant correlation existed between Paw and end-expiratory lung impedance (EELI) (r=0.7, p<0.001). Compared with low flow oxygen, HFNC significantly increased EELI by 25.6% (95% CI 24.3, 26.9) and Paw by 3.0 cmH2O (95% CI 2.4, 3.7). RR reduced by 3.4 breaths per minute (95% CI 1.7, 5.2) with HFNC use, tidal impedance variation increased by 10.5% (95% CI 6.1, 18.3) and PaO2/FiO2 ratio improved by 30.6 mmHg (95% CI 17.9, 43.3). HFNC improved subjective dyspnoea scoring (p=0.023). Increases in EELI were significantly influenced by BMI, with larger increases associated with higher BMIs (p<0.001). Conclusions: This study suggests that HFNC improve dyspnoea and oxygenation by increasing both EELV and tidal volume, and are most beneficial in patients with higher BMIs.

An assessment of development funding for new housing post GFC in Queensland, Australia

Purpose: The purpose of this paper is to identify changes in bank lending criteria due to the GFC and to explore the associated impacts on new housing supply in Queensland, Australia. Design/methodology/approach: This research involves a survey of each of Australia’s big four banks, as well as two prominent arrangers of development finance. Data on key lending criteria was collected: Pre GFC, during the GFC, and GFC recovery stage. Findings: The GFC has resulted in a retraction of funds available for residential development. The few institutions lending are filtering out only the best credit risks by way of constrictive loan covenants including: low loan to value ratios, high cash equity requirements, regional “no go” zones, and demonstrated borrower track record. The ability of developers to proceed with new housing developments is being constrained by their inability to obtain sufficient finance. Research limitations/implications: This research uses survey data, together with an understanding of the project finance process to extrapolate impacts on the residential development industry across Queensland. No regional or sub-market analysis is included. Future research will include subsequent surveys to track any loosening of credit policies over time and sub-market sector analysis. Practical implications: The inability to obtain project finance is identified as a key constraint to new housing supply. This research will inform policy makers and provide important quantitative evidence of the importance of availability of development finance in the housing supply chain. Social implications: Queensland is facing a supply shortfall, which if not corrected, may lead to upward pressure on house prices and falling housing affordability. Originality/value: There is very little academic research on development funding. This research is unique in linking bank lending criteria to new housing supply and demonstrating the impact on the development industry.

Post-operative CT assessment of interbody fusion two years after thoracoscopic scoliosis surgery

The relationship between radiologic union and clinical outcome in thoracoscopic scoliosis surgery is not clear, as apparent non-union of a spinal fusion does not always correspond to a poor clinical result. The aim of this study was to evaluate CT fusion rates 24 months after thoracoscopic anterior scoliosis surgery, and to explore the relationship between fusion scores and; (i) rod diameter, (ii) graft type, (iii) fusion level, (iv) occurrence of post-operative implant failure, and (v) lateral position of the fusion mass in the intervertebral disc space. We propose that moderate fusion scores on the Sucato scale secure successful clinical outcomes in thoracoscopic scoliosis surgery.

Post-operative CT assessment of interbody fusion two years after thoracoscopic scoliosis surgery

The relationship between radiologic union and clinical outcome in thoracoscopic scoliosis surgery is not clear, as apparent non-union of a spinal fusion does not always correspond to a poor clinical result. The aim of this study was to evaluate CT fusion rates 2yrs after thoracoscopic surgery, and to explore the relationship between fusion scores and rod diameter, graft type, fusion level, implant failure, and lateral position in the disc space. This study suggests that moderate fusion scores secure successful clinical outcomes in thoracoscopic scoliosis surgery.

Identification of early-stage colorectal cancer patients at risk of relapse post-resection by immunobead reverse transcription-PCR analysis of peritoneal lavage fluid for malignant cells

Purpose: Colorectal cancer patients diagnosed with stage I or II disease are not routinely offered adjuvant chemotherapy following resection of the primary tumor. However, up to 10% of stage I and 30% of stage II patients relapse within 5 years of surgery from recurrent or metastatic disease. The aim of this study was to determine if tumor-associated markers could detect disseminated malignant cells and so identify a subgroup of patients with early-stage colorectal cancer that were at risk of relapse. Experimental Design: We recruited consecutive patients undergoing curative resection for early-stage colorectal cancer. Immunobead reverse transcription-PCR of five tumor-associated markers (carcinoembryonic antigen, laminin γ2, ephrin B4, matrilysin, and cytokeratin 20) was used to detect the presence of colon tumor cells in peripheral blood and within the peritoneal cavity of colon cancer patients perioperatively. Clinicopathologic variables were tested for their effect on survival outcomes in univariate analyses using the Kaplan-Meier method. A multivariate Cox proportional hazards regression analysis was done to determine whether detection of tumor cells was an independent prognostic marker for disease relapse. Results: Overall, 41 of 125 (32.8%) early-stage patients were positive for disseminated tumor cells. Patients who were marker positive for disseminated cells in post-resection lavage samples showed a significantly poorer prognosis (hazard ratio, 6.2; 95% confidence interval, 1.9-19.6; P = 0.002), and this was independent of other risk factors. Conclusion: The markers used in this study identified a subgroup of early-stage patients at increased risk of relapse post-resection for primary colorectal cancer. This method may be considered as a new diagnostic tool to improve the staging and management of colorectal cancer. © 2006 American Association for Cancer Research.

Governing a copyright culture in post-WTO China : copyright in the film and music industries, 2001 - 2005

In 2001 China amended its copyright law in accordance with the requirements of the Agreement on Trade Related Aspects of Intellectual Property (TRIPS). This thesis explores the impact of copyright reform on China’s domestic film and music industries. Through extensive interviews with film and music industry workers – directors, producers, executives, judges, lawyers and musicians – it investigates the role of copyright in film and music’s shift from state driven to commercially focussed. The construction and negotiation of a new ‘copyright culture’ in China is examined through the lens of Yurchak’s (1999) concept of ‘entrepreneurial governmentality.’ Administrative structures put in place prior to China’s economic reform are no longer capable of controlling film and music production and consumption and new approaches to managing it are becoming more important. High levels of unauthorised distribution are forcing these industries to adapt their business models so that they can function in a system with weak copyright protection. Legal, economic and political changes have resulted in the emergence of an ‘entrepreneurial governmentality’ among film and music industry professionals. This commercially focussed group is, in turn, increasing pressure on the state to expand the space in which it can function and support efforts to strengthen the copyright system that allows it to exist. It is suggested that the construction and negotiation of a new ‘copyright culture’ is now taking place. This thesis describes the current situation in the film and music industries. It examines the tension between the theoretical possibilities created by copyright law, and the practical challenges of operating in China. It observes innovative business models being applied by film and music businesses in China. It discusses the impact of traditional attitudes to copying and also examines the role that open licensing models might play in helping limit the negative effects of copyright protection on public access to content and in raising levels of education about copyright among key groups within the community.

Social defence and international reconstructon : illustrating the governance of post-war criminological discourse

This article examines the technocratic priorities of criminological discourse following the Second World War. In doing so, it charts the role and influence of the United Nations and the doctrine of social defence, and traces those shifts and events that have forged a nexus between criminological endeavour and processes of governance. This article aims to illustrate that social defence and international reconstruction provide a useful framework for understanding the links between power/knowledge and the pragmatic orientations of criminological scholarship.

e. Menura Supurba: Post human dreams of ersatz animals.

This paper discusses human and post-human relationships with nature and animals, using the work e. Menura Superba1 as a focal point. This interactive artwork takes the form of a Lyre bird in a cage, that mimics it’s audience in evocative ways. It is inspired by the historical practice of displaying taxidermy specimens and live species as trophies of travels to distant lands, and as symbols of wealth and status. In both form and intent the work hybridises elements from Enlightenment culture, with materials that conjure associations with dystopic post human futures (wire, post consumer electronic & other waste, as well working parts such as mobile phone screens, LED’s, camera, and cabling etc). Speculative science fiction, such as Phillip K Dick in Do Androids Dream of Electric Sheep? (Blade Runner), provides prescient stories about future (post) human worlds. This novel remains thought provoking as it describes a world that is all to rapidly approaching: where human activity has caused the destruction of most large animal species. In this fictional world, care for animals is not only a civic duty, it is one of the ways humans distinguish themselves from androids. As in Enlightenment times, ownership of animals (real, taxidermies, ersatz) is a form of commodity fetishism indicative of social status. Though whilst well heeled Victorians may have owned an elephant or have been proud of a trophy specimen, the wealthy in Dick’s future must be content with once common, even ersatz, animals such as sheep and owls, and would be repulsed to the core by the notion of killing an animal, even an ersatz animal, for sport. In becoming post human, humans have sought to separate themselves from the natural world, destroying much of it in the process. No technical prothesis will bring back to life the species we have rendered extinct. This (evolving) relationship between humanity and other species, therefore forms a central question in this work, providing a way of approaching the post human, and problematising anthropocentric perspectives. The world promised by post-human technology is indeed rich with possibility, but without corresponding steps to ensure the sustainability of technology (human society), this paper asks whether the richness of that experience will continue to be mirrored by the richness of the environments within which we exist?

“That you would post such a thing implies that you are a despicable human being”: spectatorship, social media, & the struggle for meaning in disability performance

Artists with disabilities working in Live Art paradigms often present performances which replay the social attitudes they are subject to in daily life as guerilla theatre in public spaces – including online spaces. In doing so, these artists draw spectators’ attention to the way their responses to disabled people contribute to the social construction of disability. They provide different theatrical, architectural or technological devices to encourage spectators to articulate their response to themselves and others. But – the use of exaggeration, comedy and confrontation in these practices notwithstanding – their blurry boundaries mean some spectators experience confusion as to whether they are responding to real life or a representation of it. This results in conflicted responses which reveal as much about the politics of disability as the performances themselves. In this paper, I examine how these conflicted responses play out in online forums. I discuss diverse examples, from blog comments on Liz Crow’s Resistance on the Plinth on YouTube, to Aaron Williamson and Katherine Araneillo’s Disabled Avant-Garde clips on YouTube, to Ju Gosling’s Letter Writing Project on her website, to segments of UK Channel 4’s mock reality show Cast Offs on YouTube. I demonstrate how online forums become a place not just for recording memories of an original performance (which posters may not have seen), but for a new performance, which goes well beyond re-membering/remediating the original. I identify trends in the way experience, memory and meaningmaking play out in these performative forums – moving from clarification of the original act’s parameters, to claims of disgust, insult or offense, to counter-claims confirming the comic or political efficacy of the act, often linked disclosure of personal memory or experience of disability. I examine the way these encounters at the interstices of live and/or online performance, memory, technology and public/private history negotiate ideas about disability, and what they tell us about the ethics and efficacy of the specific modes of performance and spectatorship these artists with disabilities are invoking.

Post-graduate health promotion students assess their information literacy

Purpose - The purpose of this paper is to examine post-graduate health promotion students’ self-perceptions of information literacy skills prior to, and after completing PILOT, an online information literacy tutorial. Design/methodology/approach – Post graduate students at Queensland University of Technology enrolled in PUP038 New Developments in Health Promotion completed a pre- and post- self-assessment questionnaire. From 2008-2011 students were required to rate their academic writing and research skills before and after completing the PILOT online information literacy tutorial. Quantitative trends and qualitative themes were analysed to establish students’ self-assessment and the effectiveness of the PILOT tutorial. Findings – The results from four years of post-graduate students’ self-assessment questionnaires provide evidence of perceived improvements in information literacy skills after completing PILOT. Some students continued to have trouble with locating quality information and analysis as well as issues surrounding referencing and plagiarism. Feedback was generally positive and students’ responses indicated they found the tutorial highly beneficial in improving their research skills. Originality/value - This paper is original because it describes post-graduate health promotion students’ self-assessment of information literacy skills over a period of four years. The literature is limited in the health promotion domain and self-assessment of post-graduate students’ information literacy skills. Keywords – Self-assessment, Post-graduate, Information literacy, Library instruction, Higher education, Health promotion, Evidence-based practice Paper Type - Research paper

‘Argue with us!’: audience co-creation through post-performance discussions.

In this article Caroline Heim explores an avenue for the audience's contribution to the theatrical event that has emerged as increasingly important over the past decade: postperformance discussions. With the exception of theatres that actively encourage argument such as the Staatstheater Stuttgart, most extant audience discussions in Western mainstream theatres privilege the voice of the theatre expert. Caroline Heim presents case studies of post-performance discussions held after performances of Anne of the Thousand Days and Who's Afraid of Virginia Woolf? which trialled a new model of audience co-creation. An audience text which informs the theatrical event was created, and a new role, that of audience critic, established in the process.

Is –110°C cold air cryotherapy effective in improving post-exercise recovery in sports people?

Whole body cryotherapy (WBC) involves repeatedly exposing an individual, dressed in minimal clothing, to extremely cold air (–100 to –130°C) for a short period. One specific claim that is often made is that WBC is effective in treating exercise-induced muscle soreness and damage. However, our results suggest that two bouts of WBC were ineffective in improving recovery from eccentric exercise when administered 24 hours after eccentric exercise.

Strolling through the (post)modern city: Modes of being a flaneur in picture books

The city and the urban condition, popular subjects of art, literature, and film, have been commonly represented as fragmented, isolating, violent, with silent crowds moving through the hustle and bustle of a noisy, polluted cityspace. Included in this diverse artistic field is children’s literature—an area of creative and critical inquiry that continues to play a central role in illuminating and shaping perceptions of the city, of city lifestyles, and of the people who traverse the urban landscape. Fiction’s textual representations of cities, its sites and sights, lifestyles and characters have drawn on traditions of realist, satirical, and fantastic writing to produce the protean urban story—utopian, dystopian, visionary, satirical—with the goal of offering an account or critique of the contemporary city and the urban condition. In writing about cities and urban life, children’s literature variously locates the child in relation to the social (urban) space. This dialogic relation between subject and social space has been at the heart of writings about/of the flâneur: a figure who experiences modes of being in the city as it transforms under the influences of modernism and postmodernism. Within this context of a changing urban ontology brought about by (post)modern styles and practices, this article examines five contemporary picture books: The Cows Are Going to Paris by David Kirby and Allen Woodman; Ooh-la-la (Max in love) by Maira Kalman; Mr Chicken Goes to Paris and Old Tom’s Holiday by Leigh Hobbs; and The Empty City by David Megarrity. I investigate the possibility of these texts reviving the act of flânerie, but in a way that enables different modes of being a flâneur, a neo-flâneur. I suggest that the neo-flâneur retains some of the characteristics of the original flâneur, but incorporates others that take account of the changes wrought by postmodernity and globalization, particularly tourism and consumption. The dual issue at the heart of the discussion is that tourism and consumption as agents of cultural globalization offer a different way of thinking about the phenomenon of flânerie. While the flâneur can be regarded as the precursor to the tourist, the discussion considers how different modes of flânerie, such as the tourist-flâneur, are an inevitable outcome of commodification of the activities that accompany strolling through the (post)modern urban space.

The lived experience of post-traumatic stress disorder as described by motor vehicle accident victims in Jordan

Aim: To explore the lived experience of post-traumatic stress disorder (PTSD) as described by individuals who have been involved in a motor vehicle accident (MVA) in Jordan. Background: Motor vehicle accident (MVA) survivors who develop post-traumatic stress disorder (PTSD) have become an important health issue. The World Health Organisation (WHO) states that trauma resulting from MVAs is a phenomenon of increasing concern, with death from injuries projected to rise from 5.1 million in 1990 to 8.4 million in 2020 particularly in developing countries such as Jordan (WHO, 2002). The impact of trauma from MVAs inevitably compromises the victim’s quality of life (WHO, 2002; Blanchard & Hickling, 2007) resulting in psychological and emotional distress, occupational disability, family disintegration, and socio-economic difficulty (Jordan Ministry of Health, 2005). The development of PTSD as a result of an MVA is not limited to the individual, but also extends to the family, friends, and the health care team involved in the person's care and rehabilitation. Design: A descriptive phenomenological approach was used for this study. Method: This study was conducted in an orthopaedic unit in Amera Basma Hospital in Irbid Jordan. Fifteen (15) participants were voluntary recruited through the process of purposeful sampling. Data was collected by face-to-face in depth-interviews. Interviews were digitally recorded and transcribed verbatim. The process of analysis was undertaken using Colaizzi’s (1978) eight step approach with the addition of two extra steps. Findings: The process of analysis identified seven themes explicated from the participants’ transcripts of interview. The seven themes were: 1. Feeling frustrated at a diminishing health status 2. Struggling to maintain a sense of independence 3. Harbouring feelings of not being able to recover 4. Feeling discriminated against and marginalised by society 5. Feeling ignored and neglected by health care professionals 6. Feeling abandoned by family, and 7. Moving toward acceptance through having faith in Allah. Conclusion: The findings of this study have the potential to make a significant contribution to extant knowledge on the topic which can inform future nursing practice, education, policy development, and research initiatives in Jordan and internationally.