Hospital discharge information after elective total hip or knee joint replacement surgery: A clinical audit of preferences among general practitioners

The demand for elective joint replacement (EJR) surgery for degenerative joint disease continues to rise in Australia, and relative to earlier practices, patients are discharged back to the care of their general practitioner (GP) and other community-based providers after a shorter hospital stay and potentially greater post-operative acuity. In order to coordinate safe and effective post-operative care, GPs rely on accurate, timely and clinically-informative information from hospitals when their patients are discharged. The aim of this project was to undertake an audit with GPs regarding their preferences about the components of information provided in discharge summaries for patients undergoing EJR surgery for the hip or knee. GPs in a defined catchment area were invited to respond to an online audit instrument, developed by an interdisciplinary group of clinicians with knowledge of orthopaedic surgery practices. The 15-item instrument required respondents to rank the importance of components of discharge information developed by the clinician working group, using a three-point rating scale.Fifty-three GPs and nine GP registrars responded to the audit invitation (11.0% response rate). All discharge information options were ranked as ‘essential’ by a proportion of respondents, ranging from 14.8–88.5%. Essential information requested by the respondents included early post-operative actions required by the GP, medications prescribed, post-operative complications encountered and noting of any allergies. Non-essential information related to the prosthesis used. The provision of clinical guidelines was largely rated as ‘useful’ information (47.5–56.7%). GPs require a range of clinical information to safely and effectively care for their patients after discharge from hospital for EJR surgery. Implementation of changes to processes used to create discharge summaries will require engagement and collaboration between clinical staff, hospital administrators and information technology staff, supported in parallel by education provided to junior medical staff

Plasma-laser assisted synthesis of nanoparticles for antibacterial coatings

The “green synthesis” of colloidal nanoparticles and their application for the antibacterial coatings is based on the plasma-laser assisted ablation in liquids. Nanoparticles are synthesized through the process of laser ablation of target in water, which enables additional advantages in comparison with the other standard wet chemical synthesis, such as simplicity and complete utilization of materials. Furthermore, these nanoparticles are used and tested for antibacterial coatings on polymers, where they are grafted or imbedded through atmospheric pressure plasma assisted processes. The advantages of different coatings made from those nanoparticles are presented as well.Plasmatexinfo:eu-repo/semantics/publishedVersio

How Advanced Change Patterns Impact the Process of Process Modeling

Process model quality has been an area of considerable research efforts. In this context, correctness-by-construction as enabled by change patterns provides promising perspectives. While the process of process modeling (PPM) based on change primitives has been thoroughly investigated, only little is known about the PPM based on change patterns. In particular, it is unclear what set of change patterns should be provided and how the available change pattern set impacts the PPM. To obtain a better understanding of the latter as well as the (subjective) perceptions of process modelers, the arising challenges, and the pros and cons of different change pattern sets we conduct a controlled experiment. Our results indicate that process modelers face similar challenges irrespective of the used change pattern set (core pattern set versus extended pattern set, which adds two advanced change patterns to the core patterns set). An extended change pattern set, however, is perceived as more difficult to use, yielding a higher mental effort. Moreover, our results indicate that more advanced patterns were only used to a limited extent and frequently applied incorrectly, thus, lowering the potential benefits of an extended pattern set

Developing the future of gamma-ray astrophysics with monolithic silicon pixels

This paper explores the potential of AstroPix, a project to develop Complementary Metal Oxide Semiconductor (CMOS) pixels for the next generation of space-based high-energy astrophysics experiments. Multimessenger astrophysics is a rapidly developing field whose upcoming missions need support from new detector technology such as AstroPix. ATLASPix, a monolithic silicon detector optimized for the ATLAS particle detector at CERN, is the beginning of the larger AstroPix project. Energy resolution is a driving parameter in the reconstruction of gamma-ray events, and therefore the characterization of ATLASPix energy resolution is the focus of this paper. The intrinsic energy resolution of the detector exceeded our baseline requirements of <10% at 60 keV. The digital output of ATLASPix results in energy resolutions insufficient to advance gamma-ray astronomy. However, the results from the intrinsic energy resolution indicate the digital capability of the detector can be redesigned, and the next generation of pixels for the larger AstroPix project have already been constructed. Iterations of AstroPix-type pixels are an exciting new technology candidate to support new space-based missions

Transceiver ASIC in HVCMOS Technology for 3D Ultrasound Computer Tomography

Abstract3D Ultrasound Computer Tomography (3D USCT) is an imaging method for the early de-tection of breast cancer. It provides three-dimensional multimodal images of the breast. Thenew 3D USCT device developed currently at Karlsruhe Institute of Technology containsmore than two thousand ultrasound transducers placed in a water-filled aperture where thepatient submerges one breast. The ultrasound transducers are grouped as transducer arraysystems (TAS) of 18 receiver (RX) and transmitter (TX) elements. The transducer front-end electronics contain high-voltage (HV) and low-voltage (LV) amplifiers and switcheswhich are implemented as an application-specific integrated circuit (ASIC). This contribu-tion presents a patented mixed signal, multichannel, transceiver ASIC developed in a com-mercial 350 nm high-voltage CMOS (HV-CMOS) process. The HV-CMOS process provideslow-voltage and high-voltage transistors that can be combined on the same substrate. TheHV transistors can sustain voltages up to 120 V

Porphyromonas gingivalis: a clonal pathogen?: Diversities in housekeeping genes and the major fimbriae gene

The introduction of multilocus sequence typing (MLST) in infectious disease research has allowed standardized typing of bacterial clones. Through multiple markers around the genome, it is possible to determine the sequence type (ST) of bacterial isolates to establish the population structure of a species. For the periodontal pathogen, Porphyromonas gingivalis, the MLST scheme has been established at www.pubmlst.org/pgingivalis, and data from the database indicate a high degree of genetic diversity and a weakly clonal population structure comparable with Neisseria menigitidis. The major fimbriae (FimA) have been held responsible for the adhesive properties of P. gingivalis and represent an important virulence factor. The fimA genotyping method (PCR based) indicate that fimA genotype II, IV and Ib are associated with diseased sites in periodontitis and tissue specimens from cardiovascular disease. fimA genotyping of the isolates in the MLST database supports the association of genotypes II and IV with periodontitis. As a result of multiple positive PCR reactions in the fimA genotyping, sequencing of the fimA gene revealed only minor nucleotide variation between isolates of the same and different genotypes, suggesting that the method should be redesigned or re-evaluated. Results from several investigations indicate a higher intraindividual heterogeneity of P. gingivalis than found earlier. Detection of multiple STs from one site in several patients with “refractory” periodontitis, showed allelic variation in two housekeeping genes indicating recombination between different clones within the periodontal pocket

Double Dielectric Barrier (DBD) plasma-assisted deposition of chemical stabilized nanoparticles on polyamide 6,6 and polyester fabrics

The development of new multifunctional textiles containing nanoparticles (NPs) has had a special interest in several applications for pharmaceutical, medical, engineering, agricultural, and food products.[1-2] Cu, Zn and especially Ag NPs exhibit strong antibacterial activities on a broad spectrum of bacteria.[3-5] Most of the antimicrobial textiles coated with NPs are not able to perform a controlled release of the antibiotic species. Thus, the immobilization of NPs in the substrate or its inclusion in polymeric matrix is essential to control the NPs antibiotic effect with time. Dielectric barrier discharge (DBD) plasma technology is one of the most effective non-thermal plasma sources.[6] However, an even dispersion and coating of NPs onto fabrics remain a challenge due to the high degree of aggregation of metal NPs.[7] Some capping agents were described to increase the suspension stability such as citrate and SDS.[8] In this work, Ag, Zn, and Cu NPs deposition on DBD plasma pre-treated polyamide 6,6 (PA66) and polyester (PES) were tested for the production of durable antibacterial textiles. SEM-EDX analysis and the effect of some NPs stabilizers (e.g. sodium citrate, sodium alginate and Polyvinyl alcohol (PVA)) was analysed by dynamic light scattering (DLS) in term of size, polydispersity index and zeta potential. XPS analyses prove the DBD efficacy in providing oxygen species onto the fabric’s surfaces. The SEM analyses prove the deposition of the Ag and Cu NPs onto the PES and PA66 fabrics. No zinc was detected. However, antimicrobial tests in PES shows that all the NPs have an antimicrobial effect but Cu and Zn show activity only in S. aureus and Ag only in E.coli. Cu shows a reasonable dispersion onto the fibres but PVP coated AgNPs display a high level of aggregation even after 1 hour of ultrasonic treatment. To solve instability and aggregation problems, NPs suspensions were prepared in different concentrations (1, 2.5 and 5 wt%) of citrate, alginate and PVA using water and ethanol as control by ultrasonic bath. In table 1 are resumed the best results obtained for each NP compared to water as control. Ethanol and PVA were disregarded due to the highest instability and lowest ζ potential, respectively. XPS, SEM and antimicrobial data shows lack in coating uniformity. It is clear that doesn't exist a univocal dispersant and concentration for all NPs. Despite the improving in ζ potentials and stability of the colloids, the obtained sizes still show a high degree of aggregation.info:eu-repo/semantics/publishedVersio

Sand in the wheels, or oiling the wheels, of international finance? : New Labour's appeal to a 'new Bretton Woods'

Tony Blair’s political instinct typically is to associate himself only with the future. As such, his explicit appeal to ‘the past’ in his references to New Labour’s desire to establish a “new Bretton Woods” is sufficient in itself to arouse some degree of analytical curiosity (see Blair 1998a). The fact that this appeal was made specifically in relation to Bretton Woods is even more interesting. The resonant image of the international economic context established by the original Bretton Woods agreements invokes a style and content of policy-making which Tony Blair typically dismisses as neither economically nor politically consistent with his preferred vision of the future (see Blair 2000c, 2001b)

Psychopolitics: Peter Sedgwick’s legacy for mental health movements

This paper re-considers the relevance of Peter Sedgwick's Psychopolitics (1982) for a politics of mental health. Psychopolitics offered an indictment of ‘anti-psychiatry’ the failure of which, Sedgwick argued, lay in its deconstruction of the category of ‘mental illness’, a gesture that resulted in a politics of nihilism. ‘The radical who is only a radical nihilist’, Sedgwick observed, ‘is for all practical purposes the most adamant of conservatives’. Sedgwick argued, rather, that the concept of ‘mental illness’ could be a truly critical concept if it was deployed ‘to make demands upon the health service facilities of the society in which we live’. The paper contextualizes Psychopolitics within the ‘crisis tendencies’ of its time, surveying the shifting welfare landscape of the subsequent 25 years alongside Sedgwick's continuing relevance. It considers the dilemma that the discourse of ‘mental illness’ – Sedgwick's critical concept – has fallen out of favour with radical mental health movements yet remains paradigmatic within psychiatry itself. Finally, the paper endorses a contemporary perspective that, while necessarily updating Psychopolitics, remains nonetheless ‘Sedgwickian’

Discourse or dialogue? Habermas, the Bakhtin Circle, and the question of concrete utterances

This is the author's accepted manuscript. The final publication is available at Springer via the link below.This article argues that the Bakhtin Circle presents a more realistic theory of concrete dialogue than the theory of discourse elaborated by Habermas. The Bakhtin Circle places speech within the “concrete whole utterance” and by this phrase they mean that the study of everyday language should be analyzed through the mediations of historical social systems such as capitalism. These mediations are also characterized by a determinate set of contradictions—the capital-labor contradiction in capitalism, for example—that are reproduced in unique ways in more concrete forms of life (the state, education, religion, culture, and so on). Utterances always dialectically refract these processes and as such are internal concrete moments, or concrete social forms, of them. Moreover, new and unrepeatable dialogic events arise in these concrete social forms in order to overcome and understand the constant dialectical flux of social life. But this theory of dialogue is different from that expounded by Habermas, who tends to explore speech acts by reproducing a dualism between repeatable and universal “abstract” discursive processes (commonly known as the ideal speech situation) and empirical uses of discourse. These critical points against Habermas are developed by focusing on six main areas: sentences and utterances; the lifeworld and background language; active versus passive understandings of language; validity claims; obligation and relevance in language; and dialectical universalism