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The article discusses the case study of using bitumen paper pipes in the sluicing industry in Victoria in the early 1860s. Topics include the use of pipes for water collection and distribution in the Victorian goldfields, the unreliability of the new bitumen pipes in water supply networks and how sluicing companies abandoned the experiment after their unsatisfactory performance, and the invention of bitumen paper pipes as water infrastructure development was growing in the area.

Activity reporting of Pastoral Care Coordinators (PCCs) is often inadequate within care settings because of suboptimal analog data collection methods. This study aims to render pastoral care activity reporting more efficient through digitizing data collection in pastoral care settings. A one-year feasibility (pilot) study of a digital tool, the "Pastoral Care Activity Tracker" (PCAT) was conducted between June 1, 2020 and May 31, 2021 at HammondCare, an Australian nonprofit healthcare organization. Feasibility was measured using electronic activity logs collected by the tool and user feedback surveys by PCCs. Of the 43 PCCs working in the organization, 42 (97.7%) used the PCAT tool to complete the logging of 66,298 pastoral care activities (M [SD] = 1,578.5 [827.8] activities per PCC). Most activities were logged successfully (98.3%) and took less than one minute (89.5%). Survey responses (n = 20, 46.6%) indicated many PCCs found the PCAT more convenient (n = 15, 75.0%) and easier to use (n = 10, 50.0%) than paper-based method. PCCs found the PCAT to be feasible, favorable, and easier to use for report generation compared to paper-based methods. The feasibility of the PCAT improved pastoral care activity data capture, as perceived by PCCs. [ABSTRACT FROM AUTHOR]

Millions of Australians use the private health system every year. They should receive safe, high-quality, value-based care. However, poor policy and inadequate regulation of medical technology is driving low-value care at great expense to consumers and the broader health system. Key drivers include the Prescribed List of Medical Devices and Human Tissue, gaps in quality and safety controls for devices being used, and marketing and conflicts of interest. All of these should be addressed to reduce low-value care in Australia's private health system, so consumers are protected from harm and limited health budgets are used effectively. What is known about the topic? With health expenditure rising unsustainably, there is a growing focus on ways to reduce low-value care to improve health outcomes and eliminate unnecessary costs. What does this paper add? This paper details drivers of low-value care in Australia's private health system and recommendations to overcome them. Drivers include the Prescribed List of Medical Devices, gaps in safety and quality controls, and conflicts of interest and marketing. What are the implications for practitioners? These insights are relevant to clinicians, researchers, policymakers, consumers and health business leaders with an interest in low-value care. This article belongs to the Special Issue: Value-based Healthcare. [ABSTRACT FROM AUTHOR]

As we review health governance during the COVID-19 pandemic, we have an opportunity to reflect on these processes and ensure that future challenges might be managed in a more collaborative and whole of system response. This 'Perspective' reviews COVID-19 responses in Australia, reflects on a number of potential solutions that have been developed by organisations over the past two decades and proffers a governance framework for a Communicable Disease and Pandemic Management Authority that might assist health responses to future challenges. What is known about the topic? Responses to the COVID-19 pandemic were at best disorganised with multiple failures at almost every level. Reflecting on these responses is essential if we are to perform better in future health and societal crises, which will inevitably occur. What does this paper add? This paper summarises a number of organisational 'structures' and discussion documents that have been developed over the past decades which might be useful starting points for development of a structure(s) that would leave Australia in a better position when the next 'wave' hits. What are the implications for practitioners? Good governance is fundamental to how we do business and the complexities of the health and welfare system(s) only compound these challenges. [ABSTRACT FROM AUTHOR]

Digital fabrication and '3D Making' are prominent recent additions to school curricula, hastened by the increased affordability of Computer Assisted Design software and devices such as 3D printers. It is increasingly argued that classroom use of these technologies can re-orientate schools towards forms of skills and knowledge appropriate for contemporary industry, STEM education and 'Maker culture'. Amidst such rhetoric, questions are raised about how these technologies are being used in schools, and the extent to which this represents 'new' and/or 'innovative' forms of education. This paper presents an ethnographic investigation of a 3D printing course enacted in an Australian high school. These curricular activities are considered from three different perspectives: (i) the artefacts and devices involved in the project; (ii) the surrounding social and educational contexts; and (iii) the activities and practices implicit in the implementation of the project. These different levels of analysis highlight the complexities of technology-based schooling -- not least the ways in which possible technical and/or pedagogical 'innovations' associated with 3D printing are shaped by the situational constraints of school contexts. The paper concludes by considering the likely future(s) of 3D printing and other forms of digital fabrication within the institutional confines of school. [ABSTRACT FROM AUTHOR]

Scenario Art (visual representations of a future scenario, used to enhance decision-making processes) is offered as a new tool to facilitate a transition to sustainable futures. The paper acknowledges recent evaluations of current futures methods (methods for long-term decision making and strategy development that involve consideration of multiple future circumstances), which have found that the futures field is not having the transformative influence expected. It is argued that to have a transformative influence, world views need to be drawn out and examined. An analysis of the results of a workshop (Vision 2040) that tested the application of Scenario Art, alongside art and neurological theory, is used to explore the relationship between Scenario Art, neurological processes, and the implications of these neurological processes in the context of decision-making processes. Vision 2040 utilized a deliberative process and aimed to establish a shared vision and strategy for the future of the mining and minerals industry in Australia. The workshop involved a range of futures methods which provided an opportunity for mining stakeholders to explore how the mining and minerals industry in Australia can deliver long-term national benefit. This paper focuses on the results of applying Scenario Art at this workshop which support that Scenario Art increases a person's level of empathy, creativity, responsiveness to risk, imagination and willingness to consider alternative perspectives. In the context of developing a shared vision, it was found that this increased a person's ability to recognise strategies and actions that would benefit multiple stakeholders and to recognise shared and conflicting ideas, values and perspectives for a preferred future. [ABSTRACT FROM AUTHOR]

The projects presented in this paper address two issues. The first issue is about the act of interactivism of liberating the projector, and the subsequent design considerations of taking a certain technology out of its intended context, and the issue of breaking out of the 'frame'. The second issue is about how video material through personal projection becomes a human output modality, potentially enabling a new and exciting form of audiovisual expression. This restores the balance of the enormous amount of images (still and moving) we take from out environment, but rarely give back. To address this asymmetry, the Videowalker project has been developed, as an instrument and an idea. It aims to address the urban space and the natural environment with audiovisual material, responding and reflecting on the context. Through the project the trend of portable projectors is anticipated, with the explicit aim to investigate how this technology can be used as an expressive human output modality. This means that a strong emphasis in the development and design processes is put on the interface as well as the audience experience. The paper describes the background of the project and its approaches, and experiences and reflections on a range of instantiations/performances with the instrument in Spain, The Netherlands and Australia since 2003. The technology of the set-up is described in enough detail to enable others to replicate the system. Related projects are described and compared, and the notion of Videowalk is placed in an artistic historic context. From the experiments and events a number of issues have come up, and identified as the most important design parameters to research were the shape of the projection and the nature of the audiovisual content. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to describe an innovative information and decision support tool (ToolSHeD™) developed to help construction designers to integrate the management of OHS risk into the design process. The underlying structure of the prototype web-based system and the process of knowledge acquisition and modelling are described. Design/methodology/approach - The ToolSHeD™ research and development project involved the capture of expert reasoning regarding design impacts upon occupational health and safety (OHS) risk. This knowledge was structured using an innovative method well-suited to modelling knowledge in the context of uncertainty and discretionary decision-making. Example "argument trees" are presented, representing the reasoning used by a panel of experts to assess the risk of falling from height during roof maintenance work, The advantage of using this method for modelling OHS knowledge, compared to the use of simplistic rules, is discussed Findings - The ToolSHeD™ prototype'development and testing reveals that argument trees can represent design safety risk knowledge effectively. Practical implications - The translation of argument trees into a web-based decision support tool is described and the potential impact of this tool in providing construction designers (architects and engineers) with easy and inexpensive access to expert OHS knowledge is discussed. Originality/value - The paper describes a new computer application, currently undergoing testing in the Australian building and construction industry. Its originality lies in the fact that ToolSHeD™ deploys argument trees to represent expert OHS reasoning, overcoming inherent limitations in rule-based expert systems. [ABSTRACT FROM AUTHOR]

This paper describes selected results from over a dozen collaborative projects led by Commonwealth Scientific and Industrial Research Organisation (CSIRO) in Australia spanning a 30-year history of developments in satellite, airborne, field and drill core sensing technologies and how these can assist explorers to measure and map valuable mineral information. The exploration case histories are largely from Australian test sites and describe how spectral sensing technologies have progressed from early "niche creation" systems, such as the field PIMA-II (Portable Field Mineral Analyzer) and airborne Geoscan, HyMap™ and OARS-TIPS (Operational Airborne Remote Sensing - Thermal Infrared Profiling Spectrometer) systems and drill-core HyLogger™ systems, to the current expanding array of pubic and commercial mineral mapping sensors, including the ASTER (Advanced Spaceborne Thermal Emission and Reflectance Radiometer) satellite system which has acquired imagery spanning the entire Earth's land surface (<83°latitude). These sensors are delivering voluminous spectral data from different parts of the visible to the thermal infrared (400 to 14,000 nm) spectrum at different spectral, radiometric and spatial resolutions. Two critical exploration challenges are central to the case histories, namely: (i) can surface cover, such as vegetation, regolith or transported materials, be characterized and accounted for so that the target geology is accurately revealed; and (ii) does this revealed geology show evidence of alteration footprints to potential economic mineralization. Spectrally measurable minerals important to solving these challenges include white micas, kaolinite and garnets, with measurement of their respective physicochemistries being key. For example, kaolin disorder is useful for mapping transported versus weathered in situ materials, while the chemical substitution in white micas and garnets provide vectors to potential economic mineralization. Importantly, appropriate selection of the optimum sensor/data type for a given geological application depends primarily on the level of detail/accuracy of the mineral information required by the user. A major opportunity is to now harness the many sensor/data types and deliver to users consistent, accurate mineral information products, that is, creation of a number of valuable global mineral product standards. As part of this vision, CSIRO has been developing improved sensor/data calibration processes and information extraction methods that for example, unmix the target mineralogy from green and dry vegetation cover in remote sensing data sets. Emphasis to date has been on generating public spectral-mineral product standards, especially at ASTER's limited but geologically-valuable spectral resolution. The results are showing that scalable, global, three-dimensional (3D) mineral maps are achievable which will only improve our ability to more accurately characterize regolith and geological architecture, increase our understanding of formative processes and assist the discovery of new economic mineral systems. [ABSTRACT FROM AUTHOR]

The cardiac defibrillator is the most commonly used instrument in hospital, ambulance and industry for resuscitation after electrocution or cardiac arrest. Defibrillation involves the application of a short pulse of electric current (4-10ms) through the chest of the patient; it has been demonstrated that the required energy is a function of the patient's weight. A knowledge of the performance of a defibrillator is essential; front panel meters, although calibrated in joules, read capacitor voltage only, and a loss of capacitance is not easily detected in use. We have had personal experience of this loss on several occasions. Commercial defibrillator testers employ analogue circuitry and are no more reliable in calibration than defibrillators themselves. This paper discusses the design of a microprocessor-based defibrillator analyser which has a performance far superior to existing testers. It gives an absolute digital readout of the energy delivered into a standard 50 Ω load, the peak defibrillating voltage, and the rise time of the defibrillator output wave. Facilities are also provided for storage of the defibrillator output waveform, so that the profile can be examined on an oscilloscope. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to present a preliminary psychometric evaluation of the electronic mobile shower commode assessment tool (eMAST) 1.0.Design/methodology/approach A cross-sectional validation study was undertaken with 32 adults with spinal cord injury (SCI), aged 18 years or older, who use mobile shower commodes for toileting and/or showering. The eMAST 1.0, Quebec user evaluation of satisfaction with assistive technology, Version 2.0 (QUEST 2.0), and modified system usability scale (SUS) were administered online via SurveyMonkey. The eMAST 1.0 was re-administered approximately seven days later. Psychometric properties of internal consistency, test-retest reliability, and convergent validity were assessed.Findings As hypothesised, the eMAST 1.0 demonstrated strong internal consistency (Cronbach’s α=0.73, N=32); acceptable test-retest reliability (intra-class coefficient (3, 1)=0.75 (0.53-0.88, 95 per cent confidence interval) (n=27)); and strong, positive correlations with the QUEST 2.0’s devices subscale and modified SUS (Pearson’s correlation coefficients 0.70 and 0.63, respectively).Research limitations/implications The sample was not fully representative of Australian data in terms of gender, or state of residence, but was representative in terms of SCI level. Age data were not assessed. The sample size was small but adequate for a preliminary psychometric evaluation.Originality/value The preliminary psychometric evaluation indicates the eMAST 1.0 is a valid and reliable instrument that measures usability of MSCs for adults with SCI. It may be useful for exploring relationships between usability and satisfaction of MSCs. [ABSTRACT FROM AUTHOR]

Aim To discuss the methods of a study which will aim to determine the usability of a medical device not yet approved for use in a clinical trial. Background The Blood Loss Estimation and Evaluation of Drape (BLEED) pilot aims to determine the usability of a drape which measures blood loss during third stage labour. Third stage blood loss is usually estimated visually. This method has been found to be inaccurate. The drape has been tested in developing countries overseas and has been found to more accurately measure third stage blood loss when compared with visual methods. The usability of the drape has not yet been evaluated. Review methods Before starting the BLEED pilot study, the risks to the participants were evaluated and the drape was determined to pose minimal risk of harm for participants. The pilot study will involve recruitment of women and health professionals who will use the drape to measure third stage blood loss and then complete a survey about their opinion of the drape's usability. The data will be used to determine the suitability of using the drape in a clinical trial. Discussion The benefits of pursing this programme of research outweigh the challenges. The drape has been validated as more accurate than visual estimation for evaluating blood loss during third stage labour, yet the usability has not been established and a clinical trial is needed. This programme of research will determine if routine use of this drape in research and practice is justified. Conclusion This work will assist health professionals who are considering ways to improve clinical outcomes and will particularly inform researchers who are interested in piloting new devices in maternity care. While adherence to monitoring requirements and governance of clinical trials is essential, the system has become complicated for investigator-initiated research using devices. Despite these challenges, the authors of this paper believe that this research programme is justified. Implications for practice The complexity of navigating documentation and governance required for clinical trials may deter some healthcare professionals who plan to initiate research that involves the use of a medical device. While adherence to monitoring requirements and governance of clinical research is essential, research involving the evaluation of emerging medical technologies can be complicated, particularly for an investigator-initiated (clinician) researcher who does not have the support of a biotech company. These issues may deter clinician researchers from initiating trials and impede their ability to implement clinical research. Despite the challenges, the effectiveness and safety of technologies must be evaluated for their effectiveness in improving clinical outcomes for patients. [ABSTRACT FROM AUTHOR]

Objective. This study aimed to estimate costs of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) to patients, government and Australian society. Methods. Australian ME/ CFS patients and their carers were recruited using convenience sampling. Patients completed an online retrospective cost diary, providing ME/CFS-related direct medical, non-medical and indirect costs. Informal care costs were collected directly from carers. Data from the Pharmaceutical Benefits Scheme and Medicare Benefits Schedule were linked to participant survey data. Annual per patient and total societal costs were estimated, broken down by category and presented in 2021 AUD. Factors associated with higher costs were investigated using generalised linear models. Results. One hundred and seventy five patients (mean age 49 years s.d. 14, 79.4% female) completed the cost diary. Estimated total annual societal costs of ME/CFS in Australia ranged between $1.38 and $10.09 billion, with average annual total costs of $63 400/patient. Three-quarters of these costs were due to indirect costs ($46 731). Disability severity was the key factor associated with higher costs, particularly for indirect costs (being 2.27-fold higher for severe disability than no/mild disability). Conclusions. ME/CFS poses a significant economic burden in Australia, owing mainly to high indirect and informal care costs. [ABSTRACT FROM AUTHOR]

It is well recognized around the world that plasterboard clad walls can provide significant bracing to light framed residential structures. In Australia, local codes of practice allow up to 50% of lateral bracing to be provided by such walls. While plasterboard contributes to the structural performance, associated quality control tests do not explicitly cover the bracing quality of plasterboard. The majority of existing quality control tests are related to other performance criteria such as damage during handling and punching of nail or screw heads through the plasterboard in ceiling applications. This paper reports the findings of a study into the adequacy of existing plasterboard quality tests as a measure of its bracing capacity. The paper also reports the development of a new test method, described herein as fastener bearing test, as an alternate quality control method for bracing capacity of plasterboard. This fastener bearing test is subsequently validated through an extensive experimental program. The paper concludes that the proposed test is a simple and reliable method to assess the bracing capacity of plasterboard. [ABSTRACT FROM AUTHOR]

1. The existence of perceived ecological impacts and development of adaptive management solutions to mitigate these problems are important issues in sustainable aquaculture. This paper examines the general impacts of two newly established trial longline installations on the infauna in Twofold Bay, a large, coastal embayment in south-east Australia. 2. We hypothesized that the physical presence of these longline installations and the biological activities of the mussels they supported would result in temporal changes in densities of infaunal taxa below installations differing from those at undisturbed control sites. We also predicted different patterns of variability in infauna between longline and control sites from before to after the longlines were stocked. These hypotheses were tested by using a beyond-BACI sampling design and asymmetrical analyses of variance to compare changes in densities of taxa at several different spatial scales below the proposed longline sites with those at two adjacent control sites, before and after the longlines were stocked. 3. After 18 months of longline operations, there was no evidence of any impact on total number of taxa, nor densities of individual taxa. Short-term temporal trends in densities in plots at control sites from April to May 2001 were often as different from each other as from those at the longline site. This indicates that densities of taxa at the farm site were within the range typically found at undisturbed sites, so there were no ecological impacts from the farm. 4. These results do not concur with previous studies on impact of mussel farming in semi-enclosed coastal waters. Differences in location, scale of production, duration of operation and assimilative capacity of the environment probably contributed to this discrepancy. The infauna in Twofold Bay either do not respond to this form of disturbance or have not yet been exposed to disturbance of a sufficient magnitude, or for a sufficient period of time, to elicit a detectable response. Better definition of the potential ecological impacts associated with aquaculture, plus their scale and magnitude in different environments is needed to design experiments and monitoring programmes to detect specific impacts. This activity can only be considered sustainable once we know that these impacts are localized, reversible and short-term. [ABSTRACT FROM AUTHOR]

It seems that calculators continue to be misunderstood as devices solely for calculation, although the likely contributions to learning mathematics with modern calculators arise from other characteristics. A four-part model to understand the educational significance of calculators underpins this paper. Each of the four components (representation, calculation, exploration and affirmation) is highlighted and illustrated, mostly with relatively unsophisticated modern calculators such as those widely accessible to students in years 6-10, but also recognising some calculator features not available to younger Australian students. Intelligent use of calculators at these levels of schooling offers many opportunities for students to develop a solid understanding of key aspects of mathematics through their own actions, provided our apparentobsession with calculators as merely 'answering devices' is overcome. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapists are key members of the multidisciplinary team and regularly work with people of higher weight across age groups and practice settings. There is limited existing research regarding the occupational therapy role with this client group. The aim of this study was to explore occupational therapy practice and barriers to service provision for Australian occupational therapists working with clients of higher weight. Methods: A cross‐sectional study design using a self‐administered online survey was distributed to members of the national occupational therapy professional association. The survey was designed to identify common assessments and interventions used with clients of higher weight and explore occupational therapists' perspectives on their knowledge and confidence and the barriers to service delivery. Descriptive statistics were used to summarise rating scales, and open‐ended responses were analysed using thematic analysis. Results: Eighty Australian occupational therapists working in a range of settings and with varied experience levels participated in the study. Participants described the most common areas of occupational therapy assessment and intervention when working with clients of higher weight to be self‐care, equipment prescription, home modifications and pressure care. Respondents were least confident in interventions related to psychosocial, leisure and employment interventions. Barriers to service delivery included accessibility and cost of equipment, lack of training and weight stigma. Conclusion: Occupational therapy practice promotes and enables participation in everyday occupations with people of higher weight. This study highlights not only the occupational therapy skills and unique approach to the person, their environment and occupations but also the challenges faced by occupational therapists when working with people of higher weight. Occupational therapists could consider utilising the weight‐inclusive paradigm to broaden their contribution from self‐care to other important aspects of participation and well‐being. [ABSTRACT FROM AUTHOR]

The Electro-Neuro-Adaptive-Regulator (ENAR) device is a hand-held electrotherapy which is applied using energetic medicine principles and aspects of acupuncture theory. The aim of this paper is to report the findings of a postmarket survey of persons who have used the ENAR device. The conditions for which the therapy was used and its perceived effectiveness are discussed. A web-based survey of Australian recipients of ENAR therapy was completed by 481 respondents. Most (76%) used ENAR exclusively for pain relief for musculoskeletal disorders, especially back, shoulder, and neck pain; 8% used ENAR exclusively for nonmusculoskeletal disorders; while 16% used ENAR for both. Respondents reported a mean reduction in pain of 70% (t(423) = 38.73, P < .001) and functional improvement of 62% (t(423) = 10.45, P < .001) using 11-point numerical rating scales. Following ENAR treatment, medication reduction was reported by 91% of respondents. Most respondents reported high satisfaction following ENAR therapy, with between 15 and 20% achieving complete pain relief. The self-delivery of ENAR may, in part, account for the high level of satisfaction. [ABSTRACT FROM AUTHOR]

This paper outlines and evaluates the improvements made to CSIRO's meteorological and air pollution model TAPM between V3 released in May 2005 and the latest version (V4) that was released in October 2008. Various improvements to the model science are described, including changes to the modelled vegetation, soil, momentum fluxes and turbulence calculations. The performance of the model is summarised for several meteorological and air pollution verification datasets. The results show that it performs well for a variety of locations for predictions of meteorology and annual extreme (high) concentrations, and the consistently good performance of TAPM across a range of studies gives greater confidence in the use of the model for air pollution modelling applications. [ABSTRACT FROM AUTHOR]

Amongst Australian anaesthetists there have been many whose ingenuity and mechanical knowledge produced ingenious devices. Lidwill and Geoffrey Kaye come immediately to mind, and their contributions are well-described elsewhere. In this paper, two inventions with contrasting fates are described: the Grant Humidifier and the Komesaroff single-use analgesia device. Graham Grant's invention addressed the problem of rain-out in a most ingenious manner The device was compact, efficient and deserved greater commercial success, but a similar apparatus developed in New Zealand was better supported and captured most of the market. Grant has a degree in engineering, acquired before his medical degree, but David Komesaroff spent only a year in the Engineering Faculty before transferring to Medicine. Nevertheless, he has remained interested and in touch with technical matters, and has a number of other devices to his credit. Mention is briefly made of others: Stokes (of the suction bullet), Bill Cole (an early volatile specific vaporiser), Fisk (the paediatric ventilator) and Noel Cass (the Cass needle) These achievements are by no means the end of the road. Already an Australian-designed single-use laryngoscope is being manufactured and launched on both the national and international markets. [ABSTRACT FROM AUTHOR]

Study Objective: Continuous Positive Airway Pressure (CPAP) is considered to be the gold standard treatment for obstructive sleep apnoea (OSA). CPAP monitoring systems allow tracking of patient CPAP adherence and treatment efficacy, by measuring residual sleep-disordered breathing, hours of CPAP use, and mask leak etc. The American Thoracic Society (ATS) published a position paper in 2013 highlighting issues of interpreting CPAP data such as a lack of consistency between CPAP manufacturers data algorithms, legal implications of CPAP data and implications for CPAP adherence. This paper extends on this work by investigating these issues in an Australasian context.Method: A review of current literature on CPAP monitoring systems, privacy and security of CPAP data for major Australasian CPAP providers, and CPAP adherence was undertaken. A legal review was also commissioned for issues related to privacy and security of CPAP data.Results: CPAP manufacturers' utilize different algorithms for respiratory event detection and clinicians need to be aware the implications for interpreting CPAP data. Australasian CPAP manufacturers have created security/privacy policies with the intent to follow relevant legislation to protect patients' CPAP data, however they do need to be constantly reviewed and updated to avoid data breaches and changes to agreements. No guarantees can be provided by the Australasian Sleep Association on CPAP manufacturers' compliance with these policies and there is the potential for some degree of liability for physicians and CPAP providers associated with CPAP data. Lastly, providing patients with feedback on their CPAP usage and OSA management appears to have positive influence CPAP adherence.Conclusions: CPAP data provides many opportunities to increase OSA patient care and to help patients self-manage this chronic condition. However, issues relating to lack of standardization of CPAP parameters, privacy, security, and legal implications will need to be managed in this changing technologic and clinical environment. [ABSTRACT FROM AUTHOR]

Introduction: A common method of learning about adverse events (AEs) is by reviewing medical records using the global trigger tool (GTT). However, these studies generally report rates of harm. The aim of this study is to characterise paediatric AEs detected by the GTT using descriptive and qualitative approaches. Methods: Medical records of children aged 0–15 were reviewed for presence of harm using the GTT. Records from 2012–2013 were sampled from hospital inpatients, emergency departments, general practice and specialist paediatric practices in three Australian states. Nurses undertook a review of each record and if an AE was suspected a doctor performed a verification review of a summary created by the nurse. A qualitative content analysis was undertaken on the summary of verified AEs. Results: A total of 232 AEs were detected from 6,689 records reviewed. Over four-fifths of the AEs (193/232, 83%) resulted in minor harm to the patient. Nearly half (112/232, 48%) related to medication/intravenous (IV) fluids. Of these, 83% (93/112) were adverse drug reactions. Problems with medical devices/equipment were the next most frequent with nearly two-thirds (32/51, 63%) of these related to intravenous devices. Problems associated with clinical processes/procedures comprise one in six AEs (38/232, 16%), of which diagnostic problems (12/38, 32%) and procedural complications (11/38, 29%) were the most frequent. Conclusion: Adverse drug reactions and issues with IVs are frequently identified AEs reflecting their common use in paediatrics. The qualitative approach taken in this study allowed AE types to be characterised, which is a prerequisite for developing and prioritising improvements in practice. [ABSTRACT FROM AUTHOR]

During a pandemic when hospitals are stretched and patients need isolation, the role of hospital‐in‐the‐home (HITH) providing acute medical care at home has never been more relevant. We aimed to define and address the challenges to acute home care services posed by the COVID‐19 pandemic. Planning for service operation involves staffing, equipment availability and cleaning, upskilling in telehealth and communication. Planning for clinical care involves maximising cohorts of patients without COVID‐19 and new clinical pathways for patients with COVID‐19. The risk of SARS‐CoV‐2 transmission, specific COVID‐19 clinical pathways and the well‐being of patients and staff should be addressed in advance. [ABSTRACT FROM AUTHOR]

Primary aeromedical retrievals are a direct scene response to patients with a critical injury or illness using a medically equipped aircraft. They are often high‐acuity taskings. In Australia, information on primary retrieval taskings is housed by service providers, of which there are many across the country. This exploratory literature review aims to explore the contemporary peer‐reviewed literature on primary aeromedical retrievals in Australia. The focus is on adult primary aeromedical retrievals undertaken in Australia and clinical tools used in this pre‐hospital setting. Included articles were reviewed for research theme (clinical and equipment, systems and/or outcomes), data coverage and appraisal of the evidence. Of the 37 articles included, majority explored helicopter retrievals (n = 32), retrieval systems (n = 21), compared outcomes within a service (n = 10) and explored retrievals in the state of New South Wales (n = 19). Major topics of focus included retrieval of trauma patients and airway management. Overall, the publications had a lower strength of evidence because of the preponderance of cross‐sectional and case‐study methodology. This review provides some preliminary but piecemeal insight into primary retrievals in Australia through a localised systems lens. However, there are several areas for research action and service outcome improvements suggested, all of which would be facilitated through the creation of a national pre‐hospital and retrieval registry. The creation of a registry would enable consideration of the frequency and context of retrievals, comparison across services, more sophisticated data interrogation. Most importantly, it can lead to service and pre‐hospital and retrieval system strengthening. [ABSTRACT FROM AUTHOR]

Background: Lack of time and access to equipment are recognised barriers to simulation training. Aim: To investigate the effect of a take‐home laparoscopic simulator training program on the laparoscopic skills of gynaecology trainees. Method: Participants (n = 17 in 2015, n = 16 in 2016) were supplied with a box trainer, associated equipment and instructions on self‐directed training. A program was designed and implemented in 2015 comprising of ten weekly laparoscopic skills tasks and modified in 2016 to eight monthly tasks. Half of the participants were randomly allocated a supervisor. Participants performed baseline and post‐training assessments of laparoscopic skills in a box trainer task (thread transfer) and virtual reality simulator tasks (laparoscopic tubal ligation and bilateral oophorectomy). Results: Trainees in 2015 demonstrated an improvement in the median time to complete the laparoscopic tubal ligation task (baseline 124 s vs post‐training 91 s, P = 0.041). There was no difference in the number of tubal ligation bleeding incidents, or in the time taken to complete the box trainer thread transfer task. In 2016 trainees demonstrated improvement in tubal ligation time (baseline 251 vs 71 post‐training, P = 0.021) and bilateral oophorectomy time (baseline 891 s vs 504 post‐training, P = 0.025). There was no significant difference in other outcome measures. There was no difference found in performance when groups were compared by supervisor allocation. Conclusion: A take‐home box trainer simulation‐training program was associated with improvement in laparoscopic skills. This type of program may improve trainee access to simulation training. [ABSTRACT FROM AUTHOR]

Background: Point‐of‐care lactate devices are used worldwide for intrapartum decision making. Current practice is often based on Lactate Pro (Arkray) but its imminent product discontinuation necessitates determination of an optimal replacement device. Aims: To evaluate the performance of Lactate Pro and two other point‐of‐care devices, Lactate Pro 2 (Arkray) and StatStrip (Nova Biomedical), and to derive scalp lactate cut‐offs equivalent to the current intervention trigger of >4.8 mmol/L. Materials and methods: Paired umbilical cord arterial and venous blood samples from 109 births were tested on the three point‐of‐care products (two devices each), cross‐compared with the reference method blood gas analyser. Results: All brands deviate from the blood gas analyser, with Lactate Pro and StatStrip results consistently lower and Lactate Pro 2 consistently higher. Standard deviation from the blood gas analyser was smallest for StatStrip (0.78 mmol/L, cord artery), and largest for Lactate Pro 2 (1.03 mmol/L, cord artery). Within‐brand variation exists and is similar for all brands (mean absolute difference on cord artery 0.23–0.30 mmol/L). Equivalent values to the 4.8 mmol/L intervention threshold based on Lactate Pro are 4.9–5.0 mmol/L for StatStrip and 5.3–5.9 mmol/L for Lactate Pro 2, calculated by receiver‐operating characteristic analysis. Conclusions: StatStrip appears superior to Lactate Pro 2 to replace the original Lactate Pro. Using StatStrip, the 4.8 mmol/L intervention threshold equivalent was 4.9–5.0 mmol/L. The variation in accuracy of point‐of‐care lactate devices may exceed the small increments (eg <4.2 mmol/L vs >4.8 mmol/L) that guide obstetric decisions. [ABSTRACT FROM AUTHOR]

Introduction: Tobacco use during pregnancy is substantially higher among Aboriginal women compared to non-Aboriginal women in Australia. However, no studies have investigated the amount or type of smoking cessation care that staff from Aboriginal antenatal and postnatal services provide to clients who smoke or staff confidence to do so. This study examined Aboriginal antenatal and postnatal staff confidence, perceived role and delivery of smoking cessation care to Aboriginal women and characteristics associated with provision of such care.Methods: Staff from 11 Aboriginal Maternal and Infant Health Services and eight Aboriginal Child and Family Health services in the Hunter New England Local Health District in Australia completed a cross-sectional self-reported survey (n = 67, response rate = 97.1%).Results: Most staff reported they assessed clients' smoking status most or all of the time (92.2%). However, only a minority reported they offered a quitline referral (42.2%), provided follow-up support (28.6%) or provided nicotine replacement therapy (4.7%) to most or all clients who smoked. Few staff felt confident in motivating clients to quit smoking (19.7%) and advising clients about using nicotine replacement therapy (15.6%). Staff confident with talking to clients about how smoking affected their health had significantly higher odds of offering a quitline referral [OR = 4.9 (1.7-14.5)] and quitting assistance [OR = 3.9 (1.3-11.6)] to clients who smoke.Conclusions: Antenatal and postnatal staff delivery of smoking cessation care to pregnant Aboriginal women or mothers with young Aboriginal children could be improved. Programs that support Aboriginal antenatal and postnatal providers to deliver smoking cessation care to clients are needed.Implications: Aboriginal antenatal and postnatal service staff have multiple opportunities to assist Aboriginal women to quit smoking during pregnancy and postpartum. However, staff confidence and practices of offering various forms of smoking cessation support to pregnant Aboriginal women is unexplored. This is the first study to examine the amount and type of smoking cessation support Aboriginal antenatal and postnatal service staff provide to Aboriginal women, staff confidence and their perceived role in delivering smoking cessation care. This information is valuable for developing strategies that assist antenatal and postnatal staff to improve their delivery of smoking cessation care to Aboriginal women. [ABSTRACT FROM AUTHOR]

Introduction: The principal aim of this study was to assess the accessibility of subsidized cessation medications to socioeconomically disadvantaged smokers, including smokers living in regional and remote communities.Methods: Analyses used baseline questionnaire and linked Pharmaceutical Benefits Scheme data for 18 686 regular smokers participating in the 45 and Up Study, a large-scale Australian cohort study of people aged 45 years and older. Participants who were dispensed nicotine replacement therapy, varenicline, or bupropion were identified from the Pharmaceutical Benefits Scheme data, which provide an essentially complete record of participants' access to subsidized pharmaceuticals. Associations between the supply of each pharmacotherapy and a range of sociodemographic and health-related variables were evaluated using multiple logistic regression.Results: The odds that participants were supplied with a cessation medication declined markedly with increasing age for participants older than 60 years and were substantially higher for participants who smoked 20 or more cigarettes/day than for participants who smoked fewer than 10 cigarettes/day. Participants with no formal qualification and those residing in socioeconomically disadvantaged areas had higher odds of receiving nicotine replacement therapy or varenicline than university-educated participants and participants living in the least disadvantaged areas. There was no evidence that participants residing in regional and remote communities had lower odds of receiving a cessation medication than participants residing in major cities.Conclusions: Older Australian smokers' access to cessation pharmacotherapies is determined predominantly by age and daily cigarette consumption and does not appear to be limited by educational achievement, socioeconomic disadvantage, or remoteness.Implications: Promoting the use of cessation medications is a principal measure proposed to achieve Australia's National Tobacco Strategy 2012-2018 goal of reducing cigarette consumption among socioeconomically disadvantaged smokers. The results of this large-scale cohort study indicate that access to cessation pharmacotherapies is determined primarily by age and daily cigarette consumption, and is not limited by socioeconomic circumstances, providing some reassurance that existing government subsidies are sufficient to ensure that pharmaceutical aids are accessible to all Australian smokers. [ABSTRACT FROM AUTHOR]

Introduction: People with severe acquired brain injury often require lifetime support, sometimes received from paid workers if living in shared supported accommodation. Electronic assistive technology may offer a less intrusive method of support that can enable autonomous participation and deliver cost savings. However, research on rates, barriers, and facilitators of electronic assistive technology uptake is lacking. This study aimed to identify electronic assistive technology types used by people with acquired brain injury living in shared supported accommodation, assess user satisfaction and psychosocial impact of electronic assistive technology, detail the impact of technology use on respondents' participation and support needs, and describe barriers and/or facilitators to electronic assistive technology uptake and ongoing use. Method: Participants were identified electronic assistive technology users with acquired brain injury living in shared supported accommodation in Australia (N=22). Mixed methods data were collected using semi-structured interviews and published measures of support need, electronic assistive technology satisfaction, and psychosocial impact. Results: Participants reported satisfaction with the devices they used, and positive psychosocial outcomes. Areas impacted by electronic assistive technology, key facilitators and barriers to electronic assistive technology use, and implications for occupational therapists working to deliver electronic assistive technology solutions were identified. Conclusion: Electronic assistive technology use by this group can positively influence both everyday functioning and participation. Skilled prescription and ongoing support services are necessary to maximise uptake and use. [ABSTRACT FROM AUTHOR]

Background: Low back pain is a common and costly condition internationally. There is high need to identify effective and economically efficient means for managing this problem. This study aimed to explore the cost-effectiveness of a novel motion-sensor biofeedback treatment approach in addition to guidelines-based care compared to guidelines-based care alone, from a societal perspective over a 12 month time horizon.Method: This was an incremental cost-effectiveness analysis conducted concurrently with a pilot, cluster randomized controlled trial. Health care resource use was collected using daily diaries and patient-self report at 3, 6 and 12 month follow-up assessments. Productivity was measured using industry classifications and participant self-reporting of ability to do their normal work with their present pain. Clinical effect was measured using the Patient Global Impression of Change measured at the 12 month follow-up assessment. Data were compared between groups using linear regression clustered by recruitment site. Bootstrap resampling was used to generate a visual representation of the 95% confidence interval for the incremental cost-effectiveness estimate. Two, one-way sensitivity analyses were undertaken to examine the robustness of findings to key assumptions.Result: There were n = 38 participants in the intervention group who completed the 12 month assessment and n = 45 in the control. The intervention group had greater use of trial-related medical and therapy resources [$477 per participant (95% CI: $447, $508)], but lower use of non-trial medical and therapy resources [$-53 per participant (95% CI: $-105, $-0)], and a greater improvement in productivity [$-5123 per participant (95% CI: $-10,174, $-72)]. Overall, the intervention dominated with a saving of $478,100 and an additional 41 participants self-rating as being very or much improved compared to the control. There was >99% confidence in this finding of dominance in both the primary and sensitivity analyses.Conclusions: The motion-sensor biofeedback treatment approach in addition to guidelines- based care appears to be both more clinically effective and economically efficient than guidelines- based care alone. This approach appears to be a viable means to manage low back pain and further research in this area should be a priority.Trial Registration: The randomised trial this research was based upon was prospectively registered on March 25th 2009 with the Australian New Zealand Clinical Trials Registry: ACTRN12609000157279 . [ABSTRACT FROM AUTHOR]

The article discusses issues concerning medication safety issues and strategies to prevent medication errors. Topics covered include misuse of insulin strengths, long-term adverse effects of fluoroquinolone antibiotics, safety concerns about the use of neuromuscular blockers and burn injuries during magnetic resonance imaging in patients wearing a fentaNYL transdermal system patch with metal in the backing.

Aim To determine whether applying forced air warming attenuates the impact of sedation-induced impairment of thermoregulation on body temperature of patients who are sedated during interventional procedures in the cardiac catheterization laboratory. Background A moderate proportion of sedated patients who undergo procedures in the cardiac catheterization laboratory with only passive warming become hypothermic. Hypothermia in the surgical population is associated with increased risk of adverse cardiac events, infections, thrombotic and haemorrhagic complications and prolonged hospital stay. For this reason, investigation of the clinical benefits of preventing hypothermia in sedated patients using active warming is required. Design Randomized controlled trial. Methods A total of 140 participants undergoing elective interventional procedures with sedation in a cardiac catheterization laboratory will be recruited from two hospitals in Australia. Participants will be randomized to receive forced air warming (active warming) or usual care (passive warming with heated cotton blankets) throughout procedures. The primary outcome is hypothermia (defined as temperature less than 36°C) at the conclusion of the procedure. Secondary outcomes are postprocedure temperature, postprocedural shivering, thermal discomfort, major complications, disability-free survival to 30 days postprocedure, cost-effectiveness and feasibility of conducting a larger clinical trial. Discussion The results from this study will provide high-level evidence for practice in an area where there is currently no guidance. Findings will be easily translatable into clinical practice because most hospitals already have forced air warming equipment available for use during general anaesthesia. Registration number: ACTRN12616000013460. [ABSTRACT FROM AUTHOR]

The article describes the use of evidence-based smoking cessation aids and offered to a population of psychiatric inpatients upon discharge as well as explores factors associated with their uptake. Topics discussed include psychiatric inpatient settings representing an opportunity to initiative the provision of tobacco cessation care to smokers with a mental illness. Also mentioned are most smokers with mental illness taking up a proactive offer of aids to support their stopping smoking.

The article offers the author's insight regarding software technology that gets no respect. The author cites several cases wherein software was not given any importance that is why problems occurred. He mentions that an automated teller machine (ATM) system of a bank in Australia was not able to access money through the ATM due to coding error in software. He states that a retail store in New Zealand with a software control system used to unlock the door when a customer enters had a problem when the control system opened during the Good Friday holiday causing people to enter the store in the absence of employees and then purchase anything for free.

The article provides information on legislative reforms related to Goods and services tax (GST) in Australia including digital economics. Topics discussed include involvement of non residential candidates in taxation dealing with intangibility, Netflix Tax dealing with digital products, and recommendations from Organisation for Economic Co-operation and Development (OECD).

Background: To provide a detailed description of young adults' sedentary time and physical activity. Methods: 384 young women and 389 young men aged 22.1 ± 0.6 years, all participants in the 22 year old follow-up of the Raine Study pregnancy cohort, wore Actigraph GT3X+ monitors on the hip for 24 h/day over a one-week period for at least one 'valid' day (≥10 h of waking wear time). Each minute epoch was classified as sedentary, light, moderate or vigorous intensity using 100 count and Freedson cut-points. Mixed models assessed hourly and daily variation; t-tests assessed gender differences. Results: The average (mean ± SD) waking wear time was 15.0 ± 1.6 h/day, of which 61.4 ± 10.1 % was spent sedentary, 34.6 ± 9.1 % in light-, 3.7 ± 5.3 % in moderate- and, 0.3 ± 0.6 % in vigorous-intensity activity. Average time spent in moderate to vigorous activity (MVPA) was 36.2 ± 27.5 min/day. Relative to men, women had higher sedentary time, but also higher vigorous activity time. The 'usual' bout duration of sedentary time was 11.8 ± 4.5 min in women and 11.7 ± 5.2 min in men. By contrast, other activities were accumulated in shorter bout durations. There was large variation by hour of the day and by day of the week in both sedentary time and MVPA. Evenings and Sundays through Wednesdays tended to be particularly sedentary and/or inactive. Conclusion: For these young adults, much of the waking day was spent sedentary and many participants were physically inactive (low levels of MVPA). We provide novel evidence on the time for which activities were performed and on the time periods when young adults were more sedentary and/or less active. With high sedentary time and low MVPA, young adults may be at risk for the life-course sequelae of these behaviours. [ABSTRACT FROM AUTHOR]

In the Gallipoli Campaign of 1915, doctor-soldiers, stretcher-bearers and medical corpsmen of both the Allied and the Turkish armies scrupulously followed both the letter and the spirit of the Geneva Conventions. In spite of their non-combatant roles within the imposts of the Red Cross and Red Crescent Societies, under whose emblems they serviced, medical members of both the Allied and Turkish medical services suffered great losses. Of the 66 medical officers and 536 other members of the Australian Army Medical Corps on Gallipoli, 293 were killed or wounded or evacuated sick, a casualty rate of 47 percent. This figure was the highest such casualty rate for Allied medical personnel in all the military campaigns of the twentieth century. The Turkish figures were even higher. During armistice-truces, some of which lasted for several hours for the evacuation of the wounded and the retrieval of the dead, medical officers of both sides occasionally collaborated in their work of humanity. This account describes one such encounter, and the gift of a surgical medical kit by a wounded Australian Regimental Medical Officer to his Turkish counterpart -- a tiny event in the sweep of great events, but one symbolic of an ethos of medicine and humanity higher than the tragedy of war. Military medicine has contributed much to the practice of medicine in the civilian context. Rescue and resuscitation, triage, casualty evacuation, emergency surgery, nutrition and public health are some themes where the exigencies of military medicine have engendered great advances in civilian health. One of the greatest advances of all has not been in the technical aspects of surgical or medical treatment, nor in the legacy of preventive medicine and public health, great as such advances have been. We refer here to another theme -- to the concept of "Sono Fratelli" or "They are Brothers".1 This underlying theme is the foundation of the ethical stance, binding on doctors of both civilian and military calling, to treat casualties without cognisance of politics, class, creed, race or ethnic group, or of friendly or enemy status.2,3 Such has its influence also on all of those who treat prisoners and criminals; and indeed on all those who, in the terms of contemporary bioethics, treat victims who might be classed as "captive patients". This ethos also binds those who are called upon to make ranking judgements in the order of treatment of casualties presenting concurrently, but who are of differing societal status or class. This ethic binds all members of both the civilian world of medicine and of the defence health services of civilised nations. It specifies that in emergency situations, it is an individual's wounds, injuries or illness which are the sole determinants of their treatment. We believe that this concept of humanity, enshrined from 1864 in the Geneva Conventions,4 represents an advance in medicine commensurate with any in the technical or scientific field. Its ethos, today engrafted upon the Hippocratic traditions and dictates of medical practice, determines the underlying flavour by which best-practice is conducted. In this, the Centenary Year of the Gallipoli Campaign, we describe the details of one pragmatic example of the sanctity of the Red Cross and the Red Crescent;5 and of the spirit of the Geneva Conventions which govern the conduct of doctors, both civilian and military. [ABSTRACT FROM AUTHOR]

Background Costs to families raising a child with cerebral palsy and complex needs are direct and indirect. This study investigated the self-reported real-life costs, equipment needs, and associated characteristics of children who had the highest equipment and care needs. Method The purposive sample ( n = 29) were families with a child with cerebral palsy: gross motor function levels 5 ( n = 20), level 4 ( n = 5), level 3 ( n = 4); complex communication needs ( n = 21); medical needs ( n = 14); hearing impairment ( n = 5) and visual impairment ( n = 9). Participants completed a specifically designed survey that included the Assistance to Participate Scale. Equipment and technology purchases were recorded in the areas of positioning, mobility, transport, home modifications, communication, splinting and orthoses, self-care, technology, communication devices, medical, adapted toys/leisure items and privately hired babysitters/carers. Descriptive and inferential statistics were used to analyse the data. Results Families had purchased up to 25 items within the areas described. The highest median number of items were recorded for positioning (15 items), mobility devices (9 items) and adapted toys/leisure items (9 items). Median costs were highest for home modifications ( AUD$23 000), transport ( AUD$15 000), splints and orthoses ( AUD$3145), paid carers ( AUD$3080), equipment for toileting/dressing/bathing ( AUD$2900) and technical/medical items ($2380). Children who needed more parental assistance to participate in play and recreation also required significantly more equipment overall for positioning, communication, self-care and toys/leisure. Conclusions The equipment needs of young children with complex disability are extensive and out-of-pocket expenses and parental time to support participation in play/recreation excessive. Substantial financial support to offset costs are crucial to better support families in this life situation. [ABSTRACT FROM AUTHOR]

Objective The present study aims to study whether using a videolaryngoscope ( A.P. Advance™) facilitates or hinders intubation by non-anaesthetists inexperienced in its use. Methods Thirty doctors from Emergency and Intensive Care Medicine backgrounds performed laryngoscopy and tracheal intubation using the Macintosh laryngoscope ( MAC), A.P. Advance™ Normal Blade ( AP N) and A.P. Advance™ Difficult Airway Blade ( AP DAB) in simulated normal and difficult airway manikins. The primary outcomes measured were time to successful tracheal intubation and failure to intubate within 3 min or three attempts. Secondary outcomes were number of intubation attempts, adjuncts used, glottic view and ease of intubation. Results There was a higher rate of failed intubation in the simulated difficult airway in participants using the AP N blade than either the MAC or AP DAB (23% vs 3% and 7%, P = 0.031). This was associated with a longer median time to intubate with the AP N and the AP DAB versus MAC (56.6, 50.2 vs 39.9 s, P = 0.007 and P = 0.041). In the normal airway median time to intubate was longest with the AP N (27.8 s), and this was significantly slower than the MAC (18.1 s, P = 0.003) and the AP DAB (17.3 s, P < 0.001). No one failed to intubate the normal manikin. Conclusions The use of the A.P. Advance™ videolaryngoscope should not be considered, without adequate prior training and experience, in the management of a difficult airway. The level of adequate training has yet to be established. [ABSTRACT FROM AUTHOR]

This article, based on my PhD empirical study, was conducted in a qualitative and holistic approach. It had examined how students had used formal and informal strategies, styles and situations while improvising and composing for the research task. Eighteen research groups made up of a total of 40 males and nine females had participated in improvising in their choice of popular styles of music. An average of four participants to each group, ranged in ages from 12–13 years, 13–14 years, 14–15 years, and 15–16 years, participated in the task. Certain participants requested to work with their friends partaking in more than one research group affecting the numbers in some of the groups. These participants were chosen from three different Australian school settings; a Public Sports High School, a private Anglican School, and a Catholic Systemic School, so as to avoid bias in the data. The task was an unstructured one. The participants chose to use any of the following; audio-technology such as iPods, instruments, singing, or the compositional software ‘Garage-Band.’ The data were collected from the pre-questionnaires and midi-files, as well as semi-structured interviewing which was then sorted, coded, and collated through triangulation processes. The results indicated the importance of the participants’ auditory memory that influenced their integrated improvisational skills particularly with the use of technology. [ABSTRACT FROM PUBLISHER]

Gambling using electronic gaming machines (EGMs) has emerged as a significant public health issue. While social impact assessments are required prior to the granting of new gaming machine licenses in Australia, there are a few established techniques for estimating the spatial distribution of a venue’s clientele. To this end, we calibrated a Huff model of gambling venue catchments based on a geocoded postal survey (n = 7040). We investigated the impact of different venue attractiveness measures, distance measures, distance decay functions, levels of spatial aggregation and venue types on model fit and results. We then compared model estimates for different behavioural subgroups. Our calibrated spatial model is a significant improvement on previously published models, increasingR2from 0.23 to 0.64. Venue catchments differ radically in size and intensity. As different population subgroups are attracted to different venues, there is no single best index of venue attractiveness applicable to all subpopulations. The calibrated Huff model represents a useful regulatory tool for predicting the extent and composition of gambling venue catchments. It may assist in decision-making with regard to new license applications and evaluating the impact of health interventions such as mandated reductions in EGM numbers. Our calibrated parameters may be used to improve model accuracy in other jurisdictions. [ABSTRACT FROM PUBLISHER]

Objective: The present study aims to quantify the sensitivity and specificity of three-point compression ultrasonography for diagnosing proximal lower extremity deep venous thrombosis when performed by Australian consultant emergency physicians with limited specific training. Secondary aims included quantifying rapidity, technical adequacy, predictability of equivocal results and relationships between emergency physician experience and proficiency. Methods: This prospective diagnostic study enrolled a convenience sample of adult patients presenting to a major ED with suspected lower extremity deep venous thrombosis. The index test was abbreviated compression ultrasonography examining three points: common femoral, proximal great saphenous and popliteal veins. Emergency physicians received specific training. The reference test was full-leg duplex ultrasonography in the Radiology Department. Results: A total of 15 emergency physicians participated, enrolling 178 subjects. Sensitivity of the index test was 77.8% (95% confidence interval: 54.8-91.0%), specificity was 91.4% (95% confidence interval: 84.9%-95.3%) and accuracy was 89.6% (95% confidence interval: 83.1-94.2%). Median duration of the index test was 10 min 34 s (interquartile range: 6 min 31 s) and ED diagnosis occurred significantly before Radiology Department diagnosis. The only statistically significant relationship between emergency physician experience and proficiency related to rapidity, which increased from the 36th scan. Equivocal index tests occurred in 9.2% of examinations and emergency physicians predicted equivocal assessments with specificity of 86.1% (95% confidence interval: 78.8-91.1%). Conclusions: Abbreviated ultrasonography performed by emergency physicians for proximal lower extremity deep venous thrombosis could be valuable. However, more precise estimates for sensitivity and greater understanding of relationships between emergency physician experience and proficiency are required. [ABSTRACT FROM AUTHOR]

What is already known about this subject? Compared with their healthy-weight peers, children with obesity have;, impaired physical health-related quality of life, reduced physical activity levels, reduced capacity to perform certain weight-bearing tasks in field-based fitness tests, What this study adds? First investigation of obesity-related disability in children using the International Classification for Functioning, Disability and Health framework for Children and Youth., Obesity in children appears to be associated with disability impacting basic locomotor skills and physical health-related quality of life., Children's participation in key life areas related to physical functioning appears to be minimally impacted by obesity., Objective The aim of this study was to investigate whether obesity is related to impaired day-to-day physical functioning and disability in children. Methods An observational case-control study was conducted in three Australian states. Obese ( n = 107) and healthy-weight ( n = 132) 10- to 13-year-olds (132 male, 107 female) were recruited via media advertisements. Assessment of body composition (dual energy X-ray absorptiometry), locomotor capacity (six-minute walk test [ 6MWT], timed up and down stairs test [ TUDS] and timed up and go [ TUG]) and child-reported physical health-related quality of life ( HRQoL) were undertaken. Participants wore an accelerometer for 8 days and completed two use-of-time telephone interviews to assess participation in key life areas. Results Compared with their healthy-weight counterparts, obese children had lower physical HRQoL scores ( P < 0.01) and reduced locomotor capacity ( TUDS z-score, TUG and 6MWT; P < 0.01). Higher percent body fat was significantly related to lower physical HRQoL scores ( r = −0.48, P < 0.01), slower performance times for the TUDS and TUG ( r = 0.59 and 0.26 respectively, P < 0.01), shorter 6MWT distances ( r = −0.51, P < 0.01) and reduced time spent in community participation activities ( r = −0.23, P < 0.01). Conclusions As anticipated, obesity appears to undermine physical functioning in children, including the capacity to perform basic locomotor skills yet, unexpectedly, participation in key life areas related to physical functioning appeared largely unaffected. [ABSTRACT FROM AUTHOR]

While research investigating direct-to-consumer advertising of therapeutic goods in Australia has historically focused on prescription medicines, recent action taken by regulators against companies promoting medical devices has placed the industry into the spotlight. Despite the need to effectively regulate direct-to-consumer advertising of medical devices due to its potential harms, inadequacies in the current regulatory system have been noted. Under the present system, devices with a questionable evidence base may enter the Australian marketplace without an evaluation of their effectiveness, and regulators are reliant on industry self-regulation and consumer complaints to draw attention to cases of advertising misconduct. Although some successes in the present system have been observed, we argue that the outlined inadequacies continue to enable the promotion of medical devices to consumers without thorough or sufficient examination of evidence. [ABSTRACT FROM AUTHOR]

Young males have a key role in shaping contraceptive use in a sexual relationship, yet often remain the invisible partner in safe sex promotion. This article describes a conceptual model of STI risk and condom use based on the perceptions and experiences of condom use in a group of young Australian males. An explorative descriptive design was used to conceptualize participants' condom use histories into an organized description of behavior. Forty-two semi-structured interviews were conducted with a purposive sample of males aged 15 to 25 years over an 18 month period. A sequential analytical process of data immersion, coding, and category generation was used to identify personal meanings, motivations, and contextual factors associated with condom use and non-use. Three primary discourses associated with young males' perceptions of STI risk and responding approach to condom use constructed personal commitment to sexual safety as dynamic, context-dependent, and outcome-driven (pregnancy versus STIs as the primary motivator of condom use). A regretful discourse associated with experiences of, or suspected unwanted outcomes, also emerged through changes in risk appraisals and safe sex intentions and behavior. Interventions to increase condom use should go beyond the traditional focus on risky behavior and disease prevention frameworks by addressing the contextual influences on personal risk appraisals and deliver innovative messages to reduce negative social meanings associated with condom use. [ABSTRACT FROM AUTHOR]

Conclusion: Whilst objective testing on music perception showed no individual differences between cochlear implant (CI) devices, subjective music perception was found to be superior with the MED-EL device in the majority of cases evaluated. Objective: To compare speech and music perception through two different CI systems in the same individuals. Methods: Six post-lingually deaf patients, who had been implanted with a Cochlear™ Nucleus® device in one ear and a MED-EL SONATATI100 on the contralateral side were evaluated. One subject was excluded from group analysis because of significant differences in performance between ears. Subjects completed a questionnaire designed to assess implant users' listening habits. Subjective assessments of each subject were made for comparison of speech and music perception with each system and preferences of system. The subjects consecutively used each system with the contralateral device turned off, and were objectively assessed for specific musical skills. Speech perception in quiet and in noise was tested. Results: For all objective tests of music discrimination and speech perception in noise, there were no statistically significant differences between MED-EL and Cochlear CI systems. Subjectively, four subjects thought their MED-EL device was better than their Cochlear device for music appreciation. Four thought that music sounded more natural, less tinny and more reverberant with their MED-EL CI than with their Cochlear CI. One subject rated all these to be equal. [ABSTRACT FROM AUTHOR]

The article provides information on a study which examined the use of high frequency oscillation ventilation (HFOV) in Australia and New Zealand (ANZ) during the 2009 H1N1 pandemic. The research compared clinical utilization to the same period in the previous year. Its end-points were clinical demographics, care delivery and survival. All intensive care units (ICU) using HFOV were invited to participate in the study.

Remote access laboratories (RALs) were first developed in 1994 in Australia and Switzerland. The main purposes of developing them are to enable students to do their experiments at their own pace, time and locations and to enable students and teaching staff to get access to facilities beyond their institutions. Currently, most of the experiments carried out through RALs in Australia are heavily biased towards electrical, electronic and computer engineering disciplines. However, the experiments carried out through RALs in Europe had more variety, in addition to the traditional electrical, electronic and computer engineering disciplines, there were experiments in mechanical and mechatronic disciplines. It was found that RALs are now being developed aggressively in Australia and Europe and it can be argued that RALs will develop further and faster in the future with improving Internet technology. The rising costs of real experimental equipment will also speed up their development because by making the equipment remotely accessible, the cost can be shared by more universities or institutions and this will improve their cost-effectiveness. Their development would be particularly rapid in large countries with small populations such as Australia, Canada and Russia, because of the scale of economy. Reusability of software, interoperability in software implementation, computer supported collaborative learning and convergence with learning management systems are the required development of future RALs. [ABSTRACT FROM AUTHOR]