A Multifaceted Strategy for Implementation of the Ottawa Ankle Rules in Two Emergency Departments

Problem Despite widespread acceptance of the Ottawa ankle rules for assessment of acute ankle injuries, their application varies considerably. Design Before and after study. Background and setting Emergency departments of a tertiary teaching hospital and a community hospital in Australia. Key measures for improvement Documentation of the Ottawa ankle rules, proportion of patients referred for radiography, proportion of radiographs showing a fracture. Strategies for change Education, a problem specific radiography request form, reminders, audit and feedback, and using radiographers as “gatekeepers.” Effects of change Documentation of the Ottawa ankle rules improved from 57.5% to 94.7% at the tertiary hospital, and 51.6% to 80.8% at the community hospital (P<0.001 for both). The proportion of patients undergoing radiography fell from 95.8% to 87.2% at the tertiary hospital, and from 91.4% to 78.9% at the community hospital (P<0.001 for both). The proportion of radiographs showing a fracture increased from 20.4% to 27.1% at the tertiary hospital (P=0.069), and 15.2% to 27.2% (P=0.002) at the community hospital. The missed fracture rate increased from 0% to 2.9% at the tertiary hospital and from 0% to 1.6% at the community hospital compared with baseline (P=0.783 and P=0.747). Lessons learnt Assessment of case note documentation has limitations. Clinician groups seem to differ in their capacity and willingness to change their practice. A multifaceted change strategy including a problem specific radiography request form can improve the selection of patients for radiography.

An approach to access control under uncertainty

In dynamic and uncertain environments such as healthcare, where the needs of security and information availability are difficult to balance, an access control approach based on a static policy will be suboptimal regardless of how comprehensive it is. The uncertainty stems from the unpredictability of users’ operational needs as well as their private incentives to misuse permissions. In Role Based Access Control (RBAC), a user’s legitimate access request may be denied because its need has not been anticipated by the security administrator. Alternatively, even when the policy is correctly specified an authorised user may accidentally or intentionally misuse the granted permission. This paper introduces a novel approach to access control under uncertainty and presents it in the context of RBAC. By taking insights from the field of economics, in particular the insurance literature, we propose a formal model where the value of resources are explicitly defined and an RBAC policy (entailing those predictable access needs) is only used as a reference point to determine the price each user has to pay for access, as opposed to representing hard and fast rules that are always rigidly applied.

Optimal budget allocation in budget-based access control

In dynamic and uncertain environments, where the needs of security and information availability are difficult to balance, an access control approach based on a static policy will be suboptimal regardless of how comprehensive it is. Risk-based approaches to access control attempt to address this problem by allocating a limited budget to users, through which they pay for the exceptions deemed necessary. So far the primary focus has been on how to incorporate the notion of budget into access control rather than what or if there is an optimal amount of budget to allocate to users. In this paper we discuss the problems that arise from a sub-optimal allocation of budget and introduce a generalised characterisation of an optimal budget allocation function that maximises organisations expected benefit in the presence of self-interested employees and costly audit.

The rules of autogeddon : sex death and law in J G Ballard’s Crash

It was reported that the manuscript of Crash was returned to the publisher with a note reading ‘The author is beyond psychiatric help’. Ballard took the lay diagnosis as proof of complete artistic success. Crash conflates the Freudian tropes of libido and thanatos, overlaying these onto the twentieth century erotic icon, the car. Beyond mere incompetent adolescent copulatory fumblings in the back seat of the parental sedan or the clichéd phallic locomotor of the mid-life Ferrari, Ballard engages the full potentialities of the automobile as the locus and sine qua non of a perverse, though functional erotic. ‘Autoeroticism’ is transformed into automotive, traumatic or surgical paraphilia, driving Helmut Newton’s insipid photo-essays of BDSM and orthopædics into an entirely new dimension, dancing precisely where (but more crucially, because) the ‘body is bruised to pleasure soul’. The serendipity of quotidian accidental collisions is supplanted, in pursuit of the fetishised object, by contrived (though not simulated) recreations of iconographic celebrity deaths. Penetration remains as a guiding trope of sexuality, but it is confounded by a perversity of focus. Such an obsessive pursuit of this autoerotic-as-reality necessitates the rejection of the law of human sexual regulation, requiring the re-interpretation of what constitutes sex itself by looking beyond or through conventional sexuality into Ballard’s paraphiliac and nightmarish consensual Other. This Other allows for (if not demands) the tangled wreckage of a sportscar to function as a transformative sexual agent, creating, of woman, a being of ‘free and perverse sexuality, releasing within its dying chromium and leaking engine-parts, all the deviant possibilities of her sex’.

Young, inexperienced and on the road: Do novice drivers comply with road rules?

Young novice drivers are at considerable risk of injury and fatality, particularly when they first drive independently. Graduated Driver Licensing (GDL) has been introduced in numerous jurisdictions to allow more driving experience in conditions of reduced risk and increasing driving privileges over a longer duration. Queensland, Australia, enhanced GDL July 2007. Learners must record 100 hours in a logbook (10 hours at night) over 1 year, no mobile handsfree/loudspeaker by driver or any passenger. Provisional 1 (P1) drivers must not carry 2 or more peer passengers 11pm - 5am, no mobile handsfree/loudspeaker by any passenger. Self-reported compliance with new GDL and general road rules has not been examined.

Practice and procedure : an application under r367 of the Uniform Civil Procedure Rules may be of use in obtaining copies of otherwise unavailable documents held by government agencies.

In Bowenbrae Pty Ltd v Flying Fighters Maintenance and Restoration [2010] QDC 347 Reid DCJ made orders requiring the plaintiffs to make application under the Freedom of Information Act 1982 (Cth) (“the FOI Act”) for documents sought by the defendant.

Do balanced skills help nascent entrepreneurs to make progress in the venture creation process?

We apply Lazear’s jack-of-all-trades theory to investigate the effect of nascent entrepreneurs´ balanced skill set across various functional areas on the performance of nascent projects. Analyzing longitudinal data on innovative nascent projects, we find that nascent entrepreneurs with a more balanced skill set are more successful in that they progress faster in the venture creation process.

New design rules for the shear strength of LiteSteel Beams

Abstract: The LiteSteel Beam (LSB) is a new cold-formed hollow flange channel section produced using dual electric resistance welding and automated continuous roll-forming technologies. The innovative LSB sections have many beneficial characteristics and are commonly used as flexural members in building construction. However, limited research has been undertaken on the shear behaviour of LSBs. Therefore a detailed investigation including both numerical and experimental studies was undertaken to investigate the shear behaviour of LSBs. Finite element models of LSBs in shear were developed to simulate the nonlinear ultimate strength behaviour of LSBs including their elastic buckling characteristics, and were validated by comparing their results with experimental test results. Validated finite element models were then used in a detailed parametric study into the shear behaviour of LSBs. The parametric study results showed that the current design rules in cold-formed steel structures design codes are very conservative for the shear design of LSBs. Significant improvements to web shear buckling occurred due to the presence of torsionally rigid rectangular hollow flanges while considerable post-buckling strength was also observed. This paper therefore proposes improved shear strength design rules for LSBs within the current cold-formed steel code guidelines. It presents the details of the parametric study and the new shear strength equations. The new equations were also developed based on the direct strength method. The proposed shear strength equations have the potential to be used with other conventional cold-formed steel sections such as lipped channel sections.

New design rules for the shear strength of LiteSteel Beams with web openings

Abstract: LiteSteel beam (LSB) is a new cold-formed steel hollow flange channel section produced using a patented manufacturing process involving simultaneous cold-forming and dual electric resistance welding. The LSBs are commonly used as floor joists and bearers with web openings in residential, industrial and commercial buildings. Their shear strengths are considerably reduced when web openings are included for the purpose of locating building services. However, no research has been undertaken on the shear behaviour and strength of LSBs with web openings. Therefore experimental and numerical studies were undertaken to investigate the shear behaviour and strength of LSBs with web openings. In this research, finite element models of LSBs with web openings in shear were developed to simulate the shear behaviour and strength of LSBs including their buckling characteristics. They were then validated by comparing their results with available experimental test results and used in a detailed parametric study. The results showed that the current design rules in cold-formed steel structures design codes are very conservative for the shear design of LSBs with web openings. Improved design equations have been proposed for the shear capacity of LSBs with web openings based on both experimental and parametric study results. An alternative shear design method based on an equivalent reduced web thickness was also proposed. It was found that the same shear strength design rules developed for LSBs without web openings can be used for LSBs with web openings provided the equivalent reduced web thickness equation developed in this paper is used. This is a significant advancement as it simplifies the shear design methods of LSBs with web openings considerably.

Young, inexperienced and on the road : do novice drivers comply with road rules?

The graduated driver licensing (GDL) program in Queensland, Australia, was considerably enhanced in July 2007. This paper explores the compliance of young Learner and Provisional (intermediate) drivers with current GDL requirements and general road rules. Unsupervised driving, Learner logbook accuracy, and experiences of punishment avoidance were explored, along with speeding as a Provisional driver. Participants (609 females; M = 17.43 years) self-reported sociodemographic characteristics, driving behaviours and licensing experiences as Learners. A subset of participants (238 females, 105 males) completed another survey six months later exploring their Provisional behaviours and experiences. While the majority of the participants reported compliance with both the GDL requirements and general road rules such as stopping at red lights on their Learner licence; a considerable proportion reported speeding. Furthermore, they reported becoming less compliant during the Provisional phase, particularly with speed limits. Self-reported speeding was predicted by younger age at licensure, being in a relationship, driving unsupervised, submitting inaccurate Learner logbooks, and speeding as a Learner. Enforcement and education countermeasures should focus upon curtailing noncompliance, targeting speeding in particular. Novice drivers should be encouraged to comply with all road rules, including speed limits, and safe driving behaviours should be developed and reinforced during the Learner and early Provisional periods. Novice drivers have been found to model their parents’ driving, and parents are pivotal in regulating novice driving. It is vital young novice drivers and parents alike are encouraged to comply with all road rules, including GDL requirements.

Balanced skills among nascent entrepreneurs

This paper examines the effects and origins of balanced skills among nascent entrepreneurs. In a first step we apply Lazear’s jack-of-all-trades theory to investigate performance effects of a balanced skill set. Second, we investigate potential sources of balanced skills, thereby testing the investment hypothesis against the endowment hypothesis. Analyzing data on high-potential nascent projects, we find support for the notion that balanced skills are important for making progress in the venture creation process. Regarding the origins of balanced skills, the data support both hypotheses. In line with the investment hypothesis an early interest in an entrepreneurial career, prior managerial and entrepreneurial experience are significantly related with a more balanced skill set. Supporting the endowment hypothesis, an entrepreneurial personality profile indicating entrepreneurial talent is correlated with a balanced skill set. Our results thus hint at the need for theories on the origins of a balanced skill set that integrate both views.

Improved design rules for hollow flange sections subject to lateral distortional buckling

The LiteSteel Beam (LSB) is a new hollow flange section with a unique geometry consisting of torsionally rigid rectangular hollow flanges and a relatively slender web. It is subjected to lateral distortional buckling when used as flexural members, which reduces its member moment capacity. An investigation into the flexural behaviour of LSBs using experiments and numerical analyses led to the development of new design rules for LSBs subject to lateral distortional buckling. However, the comparison of moment capacity results with the new design rules showed that they were conservative for some LSB sections while slightly unconservative for others due to the effects of section geometry. It is also unknown whether these design rules are applicable to other hollow flange sections such as hollow flange beams (HFB). This paper presents the details of a study into the lateral distortional buckling behaviour of hollow flange sections such as LSBs, HFBs and their variations. A geometrical parameter defined as the ratio of flange torsional rigidity to the major axis flexural rigidity of the web (GJf/EIxweb) was found to be a critical parameter in evaluating the lateral distortional buckling behaviour and moment capacities of hollow flange sections. New design rules were therefore developed by using a member slenderness parameter modified by K, where K is a function of GJf/EIxweb. The new design rules based on the modified slenderness parameter were found to be accurate in calculating the moment capacities of not only LSBs and HFBs, but also other types of hollow flange sections.

Eight simple rules for losing your doctoral virginity

Right now, there are thousands of brand new PhD candidates entering universities around the country. Many of them will be highly anxious, knowing that they have a long, difficult journey ahead of them which, statistically speaking, they have less than a 75 per cent chance of completing successfully...