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Lighting industry professionals work in an international marketplace and encounter a range of social, geographical and cultural challenges associated with this. Education in lighting should introduce students to aspects of these challenges. To achieve this, an international field trip was recently undertaken that sought to provide an authentic learning experience for students. Twelve Masters of Lighting students from two Australian universities took part in a field trip to Shanghai, China and surrounding areas. The goal was to offer students insight into practical issues in the lighting industry at an international level and to do so in a unique and authentic context. To evaluate the outcomes of the trip, each participant was surveyed afterwards. Benefits were identified in terms of: increased knowledge and insight into manufacturing issues in lighting, experiential learning in lighting design practice not available locally (e.g, master planning), increased understanding of cultural influences in design and enhancing professional contacts within the lighting industry. Field trips may also act as an inverted curriculum experience for new students to engage them and promote learning within a professional context.

We sought to determine the impact of the presence of a pharmacist on medication and patient related outcomes during the emergency management of critically ill patients requiring resuscitation or medical emergency response team care in a hospital setting. We conducted a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search of databases from January 1995 to April 2023 was conducted to identify studies of contemporary pharmacist practice. Results were extracted and analysed for included studies, those evaluating the impact of the presence of a pharmacist on medication and patient related outcomes during the emergency management of critically ill hospitalised patients requiring resuscitation or medical emergency response team care. To determine risk of bias, the Newcastle-Ottowa Quality Assessment scale was used for non-randomised studies and the Revised Cochrane risk-of-bias tool for randomised trials. Of 1345 studies identified, 54 were selected for full text review, and 30 were included in the final analysis. There were 29 cohort studies and one randomised controlled trial. The studies reported the impact of a pharmacist for a variety of patient presentations. The study team assigned each study to one of eight patient cohorts: acute stroke, cardiac arrest, rapid response calls, S-T segment elevation myocardial infarction, acute haemorrhage, major trauma resuscitation, sepsis and status epilepticus. The most frequently reported outcome, associated with a statistically significant benefit in 23 studies, was time to medication administration. Few studies reported a significant difference in patient outcome measures such as mortality. Only 8 of the 30 studies were assessed to have a low risk of bias. The results of this systematic review provide support for a beneficial impact of a pharmacist presence and intervention during resuscitation or medical emergency response team care, with significant improvements in outcomes such as time to initiation of time-critical medications, medication appropriateness and guideline compliance. However, studies were predominantly small and retrospective and were not powered to detect differences in patient related measures such as length of stay and mortality. Future research should investigate the clinical impacts of the pharmacist in ED resuscitation settings in controlled, prospective studies with robust sampling methods. [ABSTRACT FROM AUTHOR]

Objective: To assess the accuracy and marginal value of quantitative D‐dimer testing for diagnosing venom‐induced consumption coagulopathy (VICC) in people bitten by Australian snakes. Design, setting: Analysis of data for suspected and confirmed cases of snakebite collected prospectively by the Australian Snakebite Project, 2005–2019, from 200 hospitals across Australia. Participants: 1363 patients for whom D‐dimer was quantitatively assessed within 24 hours of suspected or confirmed snakebite. Main outcome measures: Diagnostic performance of quantitative D‐dimer testing for detecting systemic envenoming with VICC (area under the receiver operating characteristic curve, AUC); optimal D‐dimer cut‐off value (maximum sum of sensitivity and specificity). Results: D‐dimer values exceeded 2.5 mg/L within three hours of the bite for 95% of patients who developed VICC, and were lower than 2.5 mg/L for 95% of non‐envenomed patients up to six hours after snakebite. The AUC for diagnosing envenoming with VICC on the basis of quantitative D‐dimer testing within six hours of snakebite was 0.97 (95% CI, 0.96–0.98; 944 patients). Diagnostic performance increased during the first three hours after snakebite; for quantitative D‐dimer testing at 2–6 hours, the AUC was 0.99 (95% CI, 0.99–1.0); with a cut‐off of 2.5 mg/L, sensitivity was 97.1% (95% CI, 95.0–98.3%) and specificity 99.0% (95% CI, 97.6–99.6%) for VICC. For 36 patients with normal international normalised ratio (INR) and activated partial thromboplastin time (aPTT) values 2–6 hours after snakebite, the AUC was 0.97 (95% CI, 0.93–1.0); with a cut‐off of 1.4 mg/L, sensitivity was 94% (95% CI, 82–99%) and specificity 96% (95% CI, 94–97%). In all but one of 84 patients who developed VICC‐related acute kidney injury, D‐dimer values exceeded 4 mg/L within 24 hours of the bite. Conclusion: D‐dimer concentrations assessed 2–6 hours after snakebite, with a cut‐off value of 2.5 mg/L, could be useful for diagnosing envenoming with VICC. [ABSTRACT FROM AUTHOR]

Exposure to environmental changes in windows are essential to sustain healthy conditions indoors; however, there are no procedures for capturing these variations dynamically. In this study, we provide the foundations for building a framework aimed at understanding the effects of luminous variability in window views. First, we labelled a sample of views (n = 40) using a surface layout approach, resulting in four view type categories. Next, we captured time-lapse imagery from selected views (n = 8) to produce panorama sequences. We calculated the absolute lightness variation in Matlab, resulting in three luminous change categories (i.e. Global, Local, and Minimal variation). Concurrently, we collected environmental measures to define variability thresholds. The integrated analysis showed a higher occurrence of luminous changes in two categories in controlled conditions, suggesting that viewing configuration might prevail over window orientation for conveying light changes over time. [ABSTRACT FROM AUTHOR]

Introduction: Paracetamol is a common agent taken in deliberate self‐poisoning and in accidental overdose in adults and children. Paracetamol poisoning is the commonest cause of severe acute liver injury. Since the publication of the previous guidelines in 2015, several studies have changed practice. A working group of experts in the area, with representation from all Poisons Information Centres of Australia and New Zealand, were brought together to produce an updated evidence‐based guidance. Main recommendations (unchanged from previous guidelines): The optimal management of most patients with paracetamol overdose is usually straightforward. Patients who present early should be given activated charcoal. Patients at risk of hepatotoxicity should receive intravenous acetylcysteine.The paracetamol nomogram is used to assess the need for treatment in acute immediate release paracetamol ingestions with a known time of ingestion.Cases that require different management include modified release paracetamol overdoses, large or massive overdoses, accidental liquid ingestion in children, and repeated supratherapeutic ingestions. Major changes in management in the guidelines: The new guidelines recommend a two‐bag acetylcysteine infusion regimen (200 mg/kg over 4 h, then 100 mg/kg over 16 h). This has similar efficacy but significantly reduced adverse reactions compared with the previous three‐bag regimen.Massive paracetamol overdoses that result in high paracetamol concentrations more than double the nomogram line should be managed with an increased dose of acetylcysteine.All potentially toxic modified release paracetamol ingestions (≥ 10 g or ≥ 200 mg/kg, whichever is less) should receive a full course of acetylcysteine. Patients ingesting ≥ 30 g or ≥ 500 mg/kg should receive increased doses of acetylcysteine. [ABSTRACT FROM AUTHOR]

• Attempt to obtained reference levels useful to optimize work modality. • Our reference levels are comparable with ISTISAN DRL (17/33) and literature data. • Optimization is required for some centres. The Council Directive 2013/59/EURATOM considers interventional radiology to be a special practice involving high doses of radiation and requiring strict monitoring to ensure the best quality assurance programs. This work reports the early experience of managing dose data from patients undergoing angiography in a multicentre study. The study was based on a survey of about 15,200 sample procedures performed in 21 Italian hospitals centres involved on a voluntary basis. The survey concerned the collection of data related to different interventional radiology procedures: interventional cardiology, radiology, neuroradiology, vascular surgery, urology, endoscopy and pain therapy from a C-Arm and fixed units. The analysis included 11 types of procedures and for each procedure, air-kerma, kerma-area product and fluoroscopy time were collected. The duration and dose values of fluoroscopic exposure for each procedure is strongly dependent on individual clinical circumstances including the complexity of the procedure; the observed distribution of patient doses was very wide, even for a specified protocol. The median values of the parameters were compared with the diagnostic reference levels (DRL) proposed for some procedures in Italy (ISTISAN) or internationally. This work proposes local DRL values for three procedures. This first data collection serves to take stock of the situation on patient's dosimetry in several sectors and is the starting point for obtaining and updating DRL recalling that these levels are dependent on experience and technology available. [ABSTRACT FROM AUTHOR]

Discomfort glare is common problem in modern buildings that employ highly-glazed façades. Glare not only has negative impacts on occupant comfort but can also increase energy use in buildings. Yet a robust discomfort glare metric, particularly with regards to daylight, has proven elusive. The Unified Glare Probability (UGP), developed using 493 surveys under clear skies in Brisbane, Australia, shows promise as useful tool for estimating glare from windows. This investigation attempts to validate the UGP using a similarly large number of surveys under different sky conditions, different building types and demographics in the tropical climate of Kuala Lumpur, Malaysia. The study uses a similar methodology to the initial investigation of the UGP, using a combination of luminance mapping with a post-occupancy evaluation (POE) questionnaire on discomfort glare. A total of 341 surveys were collected from six buildings; three green-rated and three regular office buildings. Hypothesis testing of the luminance data collected in these buildings indicate that the ratio of window to background luminances are a more sensitive measure of occupant discomfort than ratios of window to task luminances. The results for the UGP show agreement in predicting discomfort from windows between both data sets using regression analysis. A simple hypothesis test showed discomfort was accurately predicted by the old UGP model for 69% of new surveys. The agreement between the two data sets for window glare enabled them to be combined into one massive data set of 813 surveys to update the UGP. The updated metric uses a logistic curve in place of the original linear transformation of the Unified Glare Rating (UGR) to prevent illogical values of probability being obtained from the metric. [ABSTRACT FROM AUTHOR]

Abstract: Glare indices have yet to be extensively tested in daylit open plan offices, as such there is no effective method to predict discomfort glare within these spaces. This study into discomfort glare in open plan green buildings targeted full-time employees, working under their everyday lighting conditions. Three green buildings in Brisbane were used for data collection, two were Green Star accredited and the other contained innovative daylighting strategies. Data were collected on full-time employees, mostly aged between 30 and 50 years, who broadly reflect the demographics of the wider working population in Australia. It was discovered 36 of the 64 respondents experienced discomfort from both electric and daylight sources at their workspace. The study used a specially tailored post-occupancy evaluation (POE) survey to help assess discomfort glare. Luminance maps extracted from High Dynamic Range (HDR) images were used to capture the luminous environment of the occupants. These were analysed using participant data and the program Evalglare. The physical results indicated no correlation with other developed glare metrics for daylight within these open plan green buildings, including the recently developed Daylight Glare Probability (DGP) Index. The strong influence of vertical illuminance, E v in the DGP precludes the mostly contrast-based glare from windows observed in this investigation from forming a significant part of this index. Furthermore, critical assessment of the survey techniques used are considered. These will provide insight for further research into discomfort glare in the endeavour to fully develop a suitable glare metric. [Copyright &y& Elsevier]