A comparative study of roadblend and GB cement stabilizers

GB Cement additive is extensively used in the stabilisation of reconstruction projects throughout Queensland roads. Due to the nature/location of some projects the Department of Transport and Main Roads are currently investigating alternative binders which provide an extended working time. This project was undertaken on behalf of DTMR to research and compare GB Cement additive against a Sunstate Cement product ‘Roadblend’. The principal objective of this study is to provide the best data possible for determining the allowable working time of each binder from testing the effect of varying curing period at 0.75, 2, 3, 4, 6 and 24 hours on Maximum Dry Density (MDD). To maintain consistency in the results a UCS design was performed and only Nerimbra Quarry type 2.1 material (mixed thoroughly) was used for the project testing. The analysis of experimental results indicate that the amount of Roadblend additive required to obtain the desired unconfined compressive strength is nearly 50% less than the required amount of GB Cement. In the other hand, the allowable working time testing results were inconclusive and further testing is required to examine the possible extended working time of the Roadblend additive

Chronic condition self-management is a social practice

Self-management is widely promoted in Western health care policies as a way to address the impact of increasing rates of chronic conditions on health care systems. Mostly informed by psychological theories, self-management frameworks and interventions tend to target individual behaviours as demarcated from the many aspects of social life shaping these behaviours. Using Bourdieu’s theory of practice, we develop four propositions for a relational and socially situated (re)conceptualisation of self-management. First, self-management is a field with its own distinctive logics of practice; second, self-management goals are social practices, emerging through co-constituted patient–professional interactions; third, self-management is energised by legitimised capital; and fourth, what goals feel possible are shaped through embodied knowledge and lived experience (habitus), linked to capital. Collectively these propositions enable focus on both the meanings and resources patients and professionals bring to self-management, along with the dynamic and relational ways goals are produced through patient–professional interactions within the broader field of health care

Assessment of an ultrasound bladder scanner in prostate radiotherapy: A validation study and analysis of bladder filling variability

IntroductionDuring prostate radiotherapy treatment, it is important to ensure the position of the bladder and prostate is consistent between treatments. The aim of this study was to provide a quantitative basis for incorporating ultrasound bladder volume estimates into local practice for prostate radiotherapy.MethodsAgreement between bladder volume estimates obtained using computed tomography (CT) and ultrasound was assessed. Analysis of bladder volumes between planning and treatment scans was used to quantify expected variations in bladder volume over the course of radiotherapy. Dose–volume statistics were estimated and compared to planned dose constraints to propose a target bladder volume and tolerance.ResultsBladder volume measurements were obtained from 19 radiotherapy patients using ultrasound and CT. Ultrasound underestimated bladder volume compared to CT with a mean bias of –28 ± 30 ml. Pre-treatment (planning) bladder volumes varied from 71 to 383 ml with a mean of 200 ml. Treatment bladder volumes reduced by more than half in 9% of patients during the course of their treatment, potentially leading to a 30% increase in mean bladder dose. Patients with pre-treatment bladder volumes ConclusionsA pragmatic individualised drinking protocol, aimed at achieving a minimum ultrasound bladder volume of 200 ml at planning CT, may be beneficial to reproducibility in radiotherapy treatment. Ultrasound measurements prior to treatment should ideally confirm that bladder volume is at least half the volume measured at planning.</div

Challenging times: disconnects between patient and professional temporalities in chronic condition management

Chronic health conditions represent a key challenge for contemporary public healthcare. Current policy promotes self-management support to reduce demands on health services and improve patients’ health and wellbeing. Though there is emerging recognition that self-management is achieved in collaboration between health professionals and patients, how chronicity is managed in interaction remains relatively underexplored in research. In this paper we report on research examining how people are supported to self-manage their conditions through their healthcare encounters. We draw on observational data from consultations between people with multiple chronic health conditions and their healthcare professionals, and semi-structured interviews with both patients and professionals about these consultations. We illuminate points of disconnect between patients and health professionals and demonstrate how these disconnects unfold in self-management support interactions. We argue that self-management is temporally and socially situated, incorporating past, present and (anticipated) future experiences. However, there is a disjuncture between the temporal logics of self-management enacted by health professionals and the subjective temporalities of people’s lived experience of chronicity. Health professionals focus on patients progressing toward optimistic futures but give less attention to the complexities of patient life histories that render self-management more difficult. For self-management support to be effective, we argue that health professionals need to consider the complexities of people’s life histories and how these shape imagined futures. Policy guidelines, we argue, should attend to how relations between patients and professionals shape self-management support, and the historical and social factors that shape experiences of living with chronic conditions

The effect of grazing management on livestock exposure to parasites via the faecal–oral route

In grazing systems, heterogeneous distributions of forage resources and faeces result in localised accumulations of nutrients and parasites (both macroparasites and microparasites), creating trade-offs between the costs of exposure to infestation or infection and the benefits of nutrient intake. Each contact between livestock and faeces in the environment is a potential parasite/pathogen transmission event. Thus, herbivores must make foraging decisions in complex environments which will affect their intake of both nutrients and parasites. However, the pattern of forage and faecal resources in agricultural environments will also be affected by the grazing management system in place. The aim of this study was to investigate the effect of grazing management on the risk of infection/infestation to livestock. We used a spatially explicit individual based stochastic foraging model to simulate livestock contact (both grazing and investigative) with faeces in the environment. The model was parameterised to simulate cattle grazing under three types of grazing management: set stock (i.e. where sward growth and cattle intake are in equilibrium in a single field); a two pasture rotation grazing system with increasing number of rotations; and a rotational grazing system with two rotations and increasing subdivisions of the pasture. Overall the amount of cattle contact with faecal-contaminated patches was similar in both set stocking and rotational grazing scenarios, suggesting no difference in the risk of infection or infestation between the different systems. However, the timing and absolute amounts of peak contact varied greatly indicating that different grazing management systems expose livestock to risks of different types of parasites at different times of the grazing season. Intensive rotational systems with small pasture blocks (especially the first grazing period) maximised livestock contact with fresh faeces, and thus exposure to microparasites (e.g. bacterial pathogens). Livestock reentering pasture blocks in rotational systems and set stocked livestock had the highest contact with old faeces and thus have a greater risk of macroparasite transmission (gastrointestinal nematodes). This study highlights how livestock management affects the highly dynamic interaction between livestock and distributions of parasites in the environment and thus the levels of livestock exposure to parasites and pathogens viathe faecal–oral route

Effects of group composition on the grazing behaviour of herbivores

Animal behaviour is often a function of the animal’s physiological state. Groups of animals will often contain individuals with a range of physiological states and the grazing behaviour of herbivores is affected by their physiological state. This study compared the grazing decisions of animals in groups of single and mixed physiological states. Using a grazing model that simulated individual herbivore behaviour in relation to environmental distributions of forage resource (grass) and parasites (faeces), we tested the hypothesis that an animal’s level of parasite exposure via the faecaleoral route is affected by the composition of physiological states in the group. Four physiological states were considered: parasite naïve, parasitized, lactating and parasite-immune animals. Baseline parasite exposure levels for each state were generated by simulating single-state groups and were compared to simulations of each of the six two-state combinations. In single-state groups parasitized animals had the least and lactating animals had the greatest levels of parasite exposure. When co-grazing with lactating animals, parasitized, immune and naïve animals increased their parasite exposure, relative to single-state groups. When cograzing with parasitized animals, lactating, immune and naïve animals reduced their parasite exposure, relative to single-state groups. There was no difference in parasite exposure of the immune or naïve animals co-grazing together when compared to the single-state groups. These results highlight the need to recognize the impact of the individual when studying group-living animals

Inter- and intra-specific exposure to parasites and pathogens via the faecal-oral route : a consequence of behaviour in a patchy environment

Livestock herbivores are at risk of inter- and intra-specific exposure to parasites/pathogens via the faecal-oral route during grazing. Each contact between livestock and faeces in the environment is a potential parasite/pathogen transmission event. Cattle grazing contact with faeces varies in relation to the species depositing the faeces and the distribution of the faeces. We used a foraging model to simulate the grazing behaviour of beef cattle in two grazing systems to compare the relative inter-specific and intra-specific exposure risks to parasites/pathogens. Overall, there is a greater level of intra- vs. inter-specific risk via the faecal-oral route. However, under certain conditions, particularly for microparasite infections, e.g. paratuberculosis in rabbits and bovine tuberculosis in badgers, wildlife may pose a significant exposure risk to parasites/pathogens. These risks can be enhanced when cattle are first turned out onto pasture and in situations where intra-specific variations in wildlife behaviour result in more dispersed defecation patterns

Agent-based modelling of foraging behaviour : the impact of spatial heterogeneity on disease risks from faeces in grazing systems

Many of the most pervasive disease challenges to livestock are transmitted via oral contact with faeces (or by faecal–aerosol) and the current paper focuses on how disease risk may depend on: spatial heterogeneity, animal searching behaviour, different grazing systems and faecal deposition patterns including those representative of livestock and a range of wildlife. A spatially explicit agent-based model was developed to describe the impact of empirically observed foraging and avoidance behaviours on the risk of disease presented by investigative and grazing contact with both livestock and wildlife faeces. To highlight the role of spatial heterogeneity on disease risks an analogous deterministic model, which ignores spatial heterogeneity and searching behaviour, was compared with the spatially explicit agent-based model. The models were applied to assess disease risks in temperate grazing systems. The results suggest that spatial heterogeneity is crucial in defining the disease risks to which individuals are exposed even at relatively small scales. Interestingly, however, although sensitive to other aspects of behaviour such as faecal avoidance, it was observed that disease risk is insensitive to search distance for typical domestic livestock restricted to small field plots. In contrast disease risk is highly sensitive to distributions of faecal contamination, in that contacts with highly clumped distributions of wildlife contamination are rare in comparison to those with more dispersed contamination. Finally it is argued that the model is a suitable framework to study the relative inter- and intra-specific disease risks posed to livestock under different realistic management regime

“Kiss myAsthma”: Using a participatory design approach to develop a self-management app with young people with asthma

<p><i>Objective</i>: Young people with asthma often lack engagement in self-management. Smartphone apps offer an attractive, immediate method for obtaining asthma information and self-management support. In this research we developed an evidence-based asthma app tailored to young peoples needs, created using a participatory design approach to optimize user engagement. This paper describes the participatory design process. <i>Methods</i>: This multi-phased research included concept generation and ideation of app design by young people with asthma, and development of asthma information by the research team. Clinical review was sought regarding safety and accuracy of app content. Participants suggestions for improvement and any problems with the app were logged throughout. Our young co-designers were invited back to test a high fidelity prototype app using a “think aloud” process and completed a usability questionnaire. <i>Results</i>: Twenty asthma patients aged 15-24 years contributed to the initial app design. Three respiratory specialists and two pharmacists suggested minor corrections to clinical terminology in the app which were all incorporated. Nine co-designers acted as expert reviewers of the prototype app, of whom eight completed a usability questionnaire. Median usability scores (maximum score 6) indicated high satisfaction with app content, usefulness and ease of use [median item score 5.3 (range 4.7-6.0)]. All feedback was incorporated to create an updated prototype app. <i>Conclusions</i>: A clinically sound asthma app has been developed which is considered highly acceptable to the young co-designers. A six-week test of the engagement, acceptability, and usefulness of the app in young people not involved in the participatory design will follow.</p

Trends in the incidence and survival of births at 22 to 26 weeks in England: A population based study

Objective: To assess recent trends in incidence and survival of births at 22-26 weeks gestation in EnglandDesign: Population based cohort studyParticipants: All births in 2006 and 2014Main outcome measure: Incidence and survival of births at 22+0-26+6 weeks gestationResults: The birth rate at 22 to 26 weeks gestation reduced by 10% over time from 49.0 per 10000 births in 2006 to 44.3 per 10000 births in 2014. The largest difference was seen at 22 weeks gestation, decreasing from 7.5 to 6.1 per 10000 births. The difference lessened with increasing gestation, with similar rates at 26 weeks (11.5 and 11.7 per 10000 births in 2006 and 2014). Extended perinatal mortality and neonatal mortality improved significantly over time. The largest improvements were seen for babies at 23 weeks with live births surviving the neonatal period increasing from 26.0% to 38.8%, and at 24 weeks increased from 51.1% to 71.3%. The reduced incidence and improved survival led to a reduction over time of 7 deaths per 10000 births, a reduction of around 8% of the extended perinatal mortality rate for all births. Regional variation across England will also be explored.Conclusions: There has been a decrease in the incidence of births at 22 to 26 weeks gestation and also improvements in neonatal mortality since 2006. This reduction in mortality will impact on service costs for both neonatal and longer term care. Up-to-date survival rates are also vital in counselling parents regarding outcomes for extremely preterm babies.</p