P136 Domiciliary Bilevel Ventilation at Sunshine Coast University Hospital

Introduction Positive airway pressure therapy, including bilevel (BPAP) and continuous positive airway pressure (CPAP), is the mainstay of management of a group of chronic conditions that culminate in chronic hypercapnic respiratory failure such as chronic obstructive pulmonary disease (COPD), obesity hypoventilation syndrome (OHS) and respiratory muscle weakness. Heterogeneously across these conditions, BPAP can decrease hospital admission and prolong quality and duration of life. In COPD (when with comorbid obstructive sleep apnoea) and OHS, there has been some evidence to suggest that the far more economical CPAP is as effective. Here we compare local practice to guideline suggested management and previous Australasian audit data. Methods Adult patients currently managed with domiciliary BPAP by the SCUH Sleep Department were identified from local a database. Demographics, medical diagnoses, premorbid functional status, indications for BPAP, funding of BPAP, outcomes of therapy and attempts to de-escalate to CPAP were collected. Results 64 patient were identified. Data collection and analysis is ongoing and will be presented at full at the conference. Intended Outcome and Impact: We aim to review local practice managing chronic hypercapnic respiratory failure with BPAP with hope it could inform future local practice.

Improving wheat grain yield via promotion of water and nitrogen utilization in arid areas

Crop yield is limited by water and nitrogen (N) availability. However, in Hexi Corridor of northwestern China, water scarcity and excessive fertilizer N in wheat (Triticum aestivum L.) production causes serious conflicts between water and N supply and crop demand. A field experiment was conducted from 2016 to 2018 to evaluate whether reducing of irrigation and fertilizer N will reduce grain yield of wheat. There were two irrigation quotas (192 and 240 mm) and three fertilizer N rates (135, 180, and 225 kg N ha−1). The results showed that reducing irrigation to 192 mm and N rate to 180 kg N ha−1 reduced water uptake, water uptake efficiency, and N uptake of spring wheat as compared to local practice (i.e., 240 mm irrigation and 225 kg N ha−1 fertilizer). Whereas, it improved water and N utilization efficiency, and water and N productivity. Consequently, the irrigation and N rate reduced treatment achieved the same quantity of grain yield as local practice. The path analysis showed that interaction effect between irrigation and N fertilization may attributable to the improvement of grain yield with lower irrigation and N rate. The enhanced water and N utilization allows us to conclude that irrigation quota at 192 mm coupled with fertilizer N rate at 180 kg N ha−1 can be used as an efficient practice for wheat production in arid irrigation areas.

408 Hand Trauma Consent

Background Consenting patients for procedures is a regular process for a trainee surgeon. The process of consent has come under scrutiny in recent years due to inadequacies highlighted by legal cases. With over 1.36 million patients attending A&E per year with hand trauma, this is the most common acute referral to Plastic surgeons. Aim To review current local practice by auditing risks and complications from hand trauma consent forms. To develop and implement a standardised pre-printed label including relevant risks and complications for hand trauma. Method Sample of hand trauma related consent forms audited assessing and comparing the risks and complications sections to a standardised set agreed locally by Consultant Plastic surgeons, cross referenced with literature. Standardised label including relevant risks and complications put into practice then re-audit their use. Results Use of the new standardised label demonstrated an elimination of omissions and increased adherence to 100% for all the relevant risks and complications. Conclusions Significant improvements in the process of consent were achieved through the development and implementation of a standardised risk and complications label. This ensures standards from the GMC and RCS guidelines are satisfied; positively impacting on service provision by improving the quality of the consent process.

Evaluation of Improved Faba Bean Technology in The Wider-Scale: Lesson from Stakeholders’ Participation in Wag-Lasta, Ethiopia

This scale-wide participatory evaluation was designed to assess farmers’ technology preference and stakeholders’ linkage on top of estimating the advantage and efficiency of improved faba bean technology over the local practice. On-farm experiment and assessment were conducted using 100 farmers who allocate 0.25-0.5ha of land in Wag-lasta dryland. Planting and other agronomic standards were applied as per the technological recommendation. Required quantitative and qualitative data collected at farm and farmer level using quadrants and checklist, respectively. Cost-benefit analysis, descriptive and inferential statistics were employed to analyse the quantitative data. Qualitative data such as farmers’ technology preference and stakeholders’ linkage were assessed in simple ranking matrix and SWOT analysis. The improved faba bean technology provided mean grain yields of 1340 and 590 kg ha-1 in Lasta and Sekota districts, respectively. It has thus a 31.4% and 38.9% yield advantage and penalty over the local practice, in that order (p

With, Within, and Beyond the State: The Promise and Limits of Transnational Legal Ordering

Our theoretical framework provides a way to assess empirically how legal norms interact at the transnational, national, and local levels in terms of their construction, conveyance, and practice. For us, the term “transnational” thus does not suggest the disappearance of the state, the withdrawal of the state as a major actor, or processes autonomous of state law, as contended by others. Rather, the term “transnational” has three core attributes. First, it highlights that states (through state officials) are just one among many actors engaged in transnational legal ordering. Second, it points to the ways transnational legal ordering transcends and often transforms states through their participation in transnational legal processes. Third, it underscores that one needs to assess the interaction of state and nonstate actors at different levels of social organization, including international organizations and transnational networks, national institutions, and local practice, to understand transnational legal ordering.

Linguistic hybridity and learner identity: translingual practice among plurilinguals in the educational setting

Capitalizing on the ecological approach to language learning (van Lier, 2004; Kramsch, 2008) and the conceptualization of language as a local practice (Pennycook, 2010) as well as languaging (Jørgensen, 2008), accounting for the continuity of linguistic phenomena rather than a discriminatory perception of linguistic properties, we intend to delve into the problem of linguistic hybridity as a sign of L2 learner identity. A direct inspiration for the study, as exemplified in the title, is the concept of metrolingualism (Otsuji, Pennycook, 2010), which offers a potential to be very informative for the study of identity issues inscribed in language. Metrolingualism connotes linguistic hybridity, which refers to something unnatural, untypical, not conforming to the norm. Positing the continuity of language use and symbolic competence (Kramsch, Whiteside, 2008), we assume after van Lier (2004) that language is not a fixed code but socially constructed entity which mingles with personal experiences shaped by social context and activates power-related issues in language use. The aim of the paper is to delve into discursive practices of students learning/using more than one L2 in the educational setting. An examination of their narratives and their languaging about language (Swain, 2006) discloses how they position themselves as L2 language users.