Teledermatology : the case of telemedicine adoption and success in New Zealand

Using a theoretical framework extracted from thetechnological innovation theories, this research attempts to explain factors influencing the adoption and diffusion of telemedicine utilising the video conferencing technology (TMVC) for dermatology within health Waikato (HW) in New Zealand. Findings indicate weak presence of critical assessment into technological innovation factors prior to TMVC adoption. Factors such as complexity, compatibility, and trialability were not assessed extensively by HW and could have hindered its adoption. TMVC was mainly assessed according to its relative advantage and cost effectiveness. This is essential but should consider other important factors explained in this research. The successful diffusion of TMVC in the case study relied on its economical benefit and on its effectiveness as a diagnostic tool. This research highlights the importance of the product champion factor on the successful adoption and diffusion of TMVC.

Emission-based condition monitoring technique for ZnO surge arrester

In this paper, electromagnetic emission at the frequency range of 30MHz to 300MHz is used to detect physical defects on the 22kV outdoor zinc-oxide (ZnO) surge arresters. Different weather conditions combining with artificially created pollution were produced in a laboratory environment and measurements were recorded over a fixed period of time. Pollution due to fine dust particles has been created according to IEC standard under both wet and dry conditions. The aim is to detect the defects (bushing damage) when the surge arrester is subjected to various weather and surface condition. The collected electromagnetic signals were sampled and analyzed using analysis tools such as the autocorrelation coefficient and Wigner-Ville distribution. The results from the present paper indicate that electromagnetic radiation from the defects on surge arrester combining with the adequate analysis tools can be used as a valuable diagnostic tool for power system operator.

20 years on - have student evaluations made a difference?

This paper poses the question, what impact have student evaluations (SE’s) of teaching had on the improvement in teaching in Australian tertiary education. The paper proposes to assess the effectiveness of SE’s through an investigations of the ways in which have been used in Australian tertiary education over the last 20 years or so. Three approaches are discussed: a) quality assurance - student evaluations used to ensure the quality of the learning environment in which learning takes place; b) quality improvement - student evaluations used as a diagnostic tool for individual teaching staff; and c) student feedback – student evaluations used to provide prospective and current students with information to help inform their choices and expectations. The discussions reviews some of the research and known practise in Australian universities. It concludes that SE’s have had a profound impact on pedagological understandings of tertiary education by placing the student at centre stage of teaching and learning. However it suggests that we do not know how SE’s have impacted on teaching effectiveness and improvement. The paper concludes by recommending further research to define critical success factors, a better understanding of how to make the student feedback and evaluation tools and mechanisms more approachable and meaningful for students, and an assessment of the ‘survey industry’ as a sustainable enterprise.

Sexing accuracy and indicators of maturation status in captive Murray cod Maccullochella peelii peelii using non-invasive ultrasonic imagery

Macroscopic- and histological-based assessments of gonad condition were compared with ultrasound images to determine the feasibility of this technology as a non-invasive diagnostic tool for identifying sex and assessing maturation status of Murray cod. Four age-classes (1⁺, 2⁺, 3⁺ and 6⁺ years), were sub-sampled at monthly intervals throughout their annual reproductive cycle and scanned with a 5 MHz linear transducer. An interpretation of sex was made from the resulting images and maximum cross-sectional gonad diameter and area were recorded. Fish were subsequently dissected to confirm gender, and the weights and maturation status of gonads determined and then compared with their respective image profile. Ovaries of females were usually a distinctive feature in ultrasound images, being particularly obvious in older and/or more developed fish. In contrast, the identification of male testis was more problematic. Nonetheless, identifying sex from ultrasound images was consistently achieved by recording the presence/absence of a female ovary (96% total sexing accuracy). Maximum cross-sectional ovary diameter and area were highly correlated with gonad weight (r² = 0.90 and 0.89, respectively) suggesting that indices of maturation status, comparable to the gonadosomatic index (GSI), can be obtained non-destructively from ultrasound scans of females. A less distinct relationship occurred between these dimensions and weight of testes (r² = 0.41). Significant increases (P < 0.05) in mean gonad index (GI, calculated from gonad diameter) occurred for most gonad development stages. However, differences in mean GI between maturation stages were confounded by phenotypic variability, indicating that GI may be limited to population level studies. Nevertheless, ultrasound images of ovaries at each development stage were visually distinctive and enabled qualitative evaluations of maturity, thereby complementing quantitative GI assessments. Repeated serial-monitoring of the same population using ultrasound appears to have great potential for tracking maturation-induced changes in broodfish.

The use of auricular examination for screening heaptic disorders

Researches on auricular acupuncture (AA) have examined mainly its treatment effects. This study aimed to investigate the accuracy and precision of using auricular examination (AE) as a complementary diagnostic tool for screening hepatic disorders. Twenty patients suffering from liver dysfunction and 25 controls aged 18–60 years were recruited from an acute hospital. Participants were examined using three AE methods including visual inspection, electrical skin resistance measurement, and tenderness testing on the liver AA zone of both ears. Significant differences were found in visual inspection and electrical skin resistance on the AA zones between the two groups. Patients suffering from liver dysfunction tended to have at least one abnormality in skin color, appearance, presence of papules, abundance of capillary and desquamation on the ear (Relative Risk—Right ear: RR = 2.9, 95% confidence interval (CI) 1.4, 6.2; Left: RR = 1.8, 95% CI, 1.01, 3.1). The sensitivity for visual inspection was 0.7 for both ears; specificity was 0.76 for the (R) and 0.6 for the (L) ear. The mean difference in electrical skin resistance was 4.3 MΩ (95% CI, 1.7, 6.9) for the (L) ear; 4.5 MΩ (95% CI, 1.5, 7.6) for the (R) ear. Our results suggest that malfunction of the liver appeared to be reflected by the presence of morphological changes on the liver AA zone. Visual inspection and electrical skin resistance on the liver AA zone are potentially sensitive to screen hepatic disorders.

Physical, chemical and biological characterization of membrane fouling

In this chapter, advanced characterization of membrane fouling as a diagnostic tool has been summarized to prevent membrane fouling. Physical, chemical and biological analyses as membrane autopsies are mainly utilized to better understand membrane foulant. The physical characterization gives structure, roughness, charge effect, strength and hydrophobicity of membrane fouling. The chemical methods provide qualitative and quantitative measurements of different inorganic and organic matter. The biological properties present the spatial biofilm distribution, structure of dominant microorganisms and isolation and identification of microorganisms. In addition, detailed membrane foulant types are reviewed in terms of structure, roughness, hydrophobicity, charge effect, strength, calcium, magnesium, aluminum, iron, silicate, particle, functional group, biopolymer, humic acid, polysaccharide, structural composition, biofilm structure, microorganism and foulant interaction.

Effect of bronchoalveolar lavage-directed therapy on pseudomonas aeruginosa infection and structural lung injury in children with cystic fibrosis

Context Early pulmonary infection in children with cystic fibrosis leads to increased morbidity and mortality. Despite wide use of oropharyngeal cultures to identify pulmonary infection, concerns remain over their diagnostic accuracy. While bronchoalveolar lavage (BAL) is an alternative diagnostic tool, evidence for its clinical benefit is lacking.

Objective To determine if BAL-directed therapy for pulmonary exacerbations during the first 5 years of life provides better outcomes than current standard practice relying on clinical features and oropharyngeal cultures.

Design, Setting, and Participants The Australasian Cystic Fibrosis Bronchoalveolar Lavage (ACFBAL) randomized controlled trial, recruiting infants diagnosed with cystic fibrosis through newborn screening programs in 8 Australasian cystic fibrosis centers. Recruitment occurred between June 1, 1999, and April 30, 2005, with the study ending on December 31, 2009.

Interventions BAL-directed (n=84) or standard (n=86) therapy until age 5 years. The BAL-directed therapy group underwent BAL before age 6 months when well, when hospitalized for pulmonary exacerbations, if Pseudomonas aeruginosa was detected in oropharyngeal specimens, and after P aeruginosa eradication therapy. Treatment was prescribed according to BAL or oropharyngeal culture results.

Main Outcome Measures Primary outcomes at age 5 years were prevalence of P aeruginosa on BAL cultures and total cystic fibrosis computed tomography (CF-CT) score (as a percentage of the maximum score) on high-resolution chest CT scan.

Results Of 267 infants diagnosed with cystic fibrosis following newborn screening, 170 were enrolled and randomized, and 157 completed the study. At age 5 years, 8 of 79 children (10%) in the BAL-directed therapy group and 9 of 76 (12%) in the standard therapy group had P aeruginosa in final BAL cultures (risk difference, −1.7% [95% confidence interval, −11.6% to 8.1%]; P=.73). Mean total CF-CT scores for the BAL-directed therapy and standard therapy groups were 3.0% and 2.8%, respectively (mean difference, 0.19% [95% confidence interval, −0.94% to 1.33%]; P=.74).

Conclusion Among infants diagnosed with cystic fibrosis, BAL-directed therapy did not result in a lower prevalence of P aeruginosa infection or lower total CF-CT score when compared with standard therapy at age 5 years.

Trial Registration anzctr.org.au Identifier: ACTRN12605000665639

Field evaluation of a suite of biomarkers in an Australian Tropical Reef Species, Stripey Seaperch (Lutjanus carponotatus) : Assessment of Produced Formation water from the Harriet A Platform

There is paucity of data regarding hydrocarbon exposure of tropical fish species inhabiting the waters near oil and gas platforms on the Northwest Shelf of Australia. A comprehensive field study assessed the exposure and potential effects associated with the produced water (PW) plume from the Harriet A production platform on the northwest shelf in a local reef species, Stripey seaperch (Lutjanus carponotatus). This field study was a continuation of an earlier pilot study which concluded that there were “warning signs” of potential biological effects on fish populations exposed to PW. A 10-day field caging study was conducted deploying 15 individual fish into 6 separate steel cages set 1-m subsurface at 3 stations in a concentration gradient moving away from the platform. A battery of biomarkers were evaluated including hepatosomatic index (HSI), total cytochrome P450, bile metabolites, CYP1A-, CYP2K- and CYP2M-like proteins, cholinesterase (ChE) activity, and histopathology of liver and gill tissues. Water column and PW effluent samples was also collected. Results confirmed that PAH metabolites in bile, CYP1A-, CYP2K-, and CYP2M-like proteins and liver histopathology provided evidence of significant exposure and effects after 10 days at the near-field site (~200 m off the Harriet A platform). Hepatosomatic index, total cytochrome P450, and ChE did not provide site-specific differences by day 10 of exposure to PW. CYP proteins were shown by principal component analysis (PCA) to be the best diagnostic tool for determining exposure and associated biological effects of PW on L. carponotatus. Using a suite of biomarkers has been widely advocated as a vital component in environmental risk assessments worldwide. This study demonstrates the usefulness of biomarkers for assessing the Harriet A PW discharge into Australian waters with broader applications for other PW discharges. This approach has merit as a valuable addition to environmental management strategies for protecting Australia’s tropical environment and its rich biodiversity.

Peptide-fluorescent bacteria complex as luminescent reagents for cancer diagnosis

Currently in clinic, people use hematoxylin and eosin stain (H&E stain) and immunohistochemistry methods to identify the generation and genre of cancers for human pathological samples. Since these methods are inaccurate and time consuming, developing a rapid and accurate method to detect cancer is urgently demanded. In our study, binding peptides for lung cancer cell line A549 were identified using bacteria surface display method. With those binding peptides for A549 cells on the surface, the fluorescent bacteria (Escherichia coli with stably expressed green fluorescent protein) were served as specific detecting reagents for the diagnosis of cancers. The binding activity of peptide-fluorescent bacteria complex was confirmed by detached cancer cells, attached cancer cells and mice tumor xenograft samples. A unique fixation method was developed for peptide-bacteria complex in order to make this complex more feasible for the clinic use. This peptide-fluorescent bacteria complex has great potential to become a new diagnostic tool for clinical application.

Longitudinal associations between fish consumption and depression in young adults

Few studies have examined longitudinal associations between fish consumption and depression; none have defined depression using a diagnostic tool. We investigated whether fish consumption was associated with fewer new depression episodes in a national study of Australian adults. In 2004–2006, 1,386 adults aged 26–36 years (38% males) completed a 127-item (9 fish items) food frequency questionnaire. Fish intake was examined continuously (times/week) and dichotomously (reference group: <2 times/week). During 2009–2011, the lifetime version of the Composite International Diagnostic Interview was administered by telephone. New episodes of major depression/dysthymic disorder (since baseline) were defined using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. During follow-up, 160 (18.8%) women and 70 (13.1%) men experienced depression. For women, each additional weekly serving of fish consumed at baseline decreased the risk of having a new depressive episode by 6% (adjusted relative risk = 0.94, 95% confidence interval: 0.87, 1.01). Women who ate fish ≥2 times/week at baseline had a 25% lower risk of depression during follow-up than those who ate fish <2 times/week (adjusted relative risk = 0.75, 95% confidence interval: 0.57, 0.99). Reverse causation was also suggested but appeared to be restricted to persons with recent depression. Fish consumption was not associated with depression in men. These findings provide further evidence that fish consumption may be beneficial for women's mental health.

Measuring organisational capabilities in the higher education sector

Purpose – Drawing on the resource-based view (RBV), the purpose of this paper is to develop a framework and instrument to measure the organisational capabilities of university schools/ departments. In doing so, this study provides evidence of the way competitive resources are bundled to generate organisational capabilities that give university schools/departments a sustainable competitive advantage. Design/methodology/approach – A questionnaire to measure the resources that contribute to the capabilities of university schools/departments was developed. Constructs were determined, and the questionnaire was refined based on an analysis of responses from 166 Heads of schools/departments across all 39 Australian public universities. Findings – Heads conceive of the development of capabilities within their schools/departments along the core operating functions of research, teaching, and networking. Reliability and supplementary analysis confirm these constructs have strong convergent and discriminant validity as well as internal consistency. Research limitations/implications – The findings confirm that effective management and coordination of research, teaching, and networking with important stakeholders are keys to success. The framework and instrument developed in this paper also provides the opportunity to investigate university performance through the perspective of the RBV, which will enhance the understanding of the determinants of universities’ performance. Practical implications – The framework and questionnaire developed in this study can be utilised by Heads as a diagnostic tool to gain an understanding of their department’s/school’s organisational capabilities in the areas of research, teaching, and networking. Originality/value – This paper is the first study to develop a framework and questionnaire to measure organisational capabilities for university academic schools/departments.

Pseudomonas aeruginosa genotypes acquired by children with cystic fibrosis by age 5-years

BACKGROUND: We describe Pseudomonas aeruginosa acquisitions in children with cystic fibrosis (CF) aged ≤5-years, eradication treatment efficacy, and genotypic relationships between upper and lower airway isolates and strains from non-CF sources. METHODS: Of 168 CF children aged ≤5-years in a bronchoalveolar lavage (BAL)-directed therapy trial, 155 had detailed microbiological results. Overall, 201/271 (74%) P. aeruginosa isolates from BAL and oropharyngeal cultures were available for genotyping, including those collected before and after eradication therapy. RESULTS: Eighty-two (53%) subjects acquired P. aeruginosa, of which most were unique strains. Initial eradication success rate was 90%, but 36 (44%) reacquired P. aeruginosa, with genotypic substitutions more common in BAL (12/14) than oropharyngeal (3/11) cultures. Moreover, oropharyngeal cultures did not predict BAL genotypes reliably. CONCLUSIONS: CF children acquire environmental P. aeruginosa strains frequently. However, discordance between BAL and oropharyngeal strains raises questions over upper airway reservoirs and how to best determine eradication in non-expectorating children.

Multi-layer attribute selection and classification algorithm for the diagnosis of cardiac autonomic neuropathy based on HRV attributes

Cardiac autonomic neuropathy (CAN) poses an important clinical problem, which often remains undetected due difficulty of conducting the current tests and their lack of sensitivity. CAN has been associated with growth in the risk of unexpected death in cardiac patients with diabetes mellitus. Heart rate variability (HRV) attributes have been actively investigated, since they are important for diagnostics in diabetes, Parkinson's disease, cardiac and renal disease. Due to the adverse effects of CAN it is important to obtain a robust and highly accurate diagnostic tool for identification of early CAN, when treatment has the best outcome. Use of HRV attributes to enhance the effectiveness of diagnosis of CAN progression may provide such a tool. In the present paper we propose a new machine learning algorithm, the Multi-Layer Attribute Selection and Classification (MLASC), for the diagnosis of CAN progression based on HRV attributes. It incorporates our new automated attribute selection procedure, Double Wrapper Subset Evaluator with Particle Swarm Optimization (DWSE-PSO). We present the results of experiments, which compare MLASC with other simpler versions and counterpart methods. The experiments used our large and well-known diabetes complications database. The results of experiments demonstrate that MLASC has significantly outperformed other simpler techniques.

Introducing the D4 Diagnostic Quadrant as a targeting tool: developing a framework for the effectiveness of HIV/AIDS interventions in Tanzania and beyond

The current study develops and evaluates a tool to distinguish four different categories of educators for the effective delivery of HIV/AIDS health education using data from 548 randomly selected participants aged 16 years. The D4 Diagnostic Quadrant is based on HIV knowledge and sexual practice behaviours and indicates four distinct typologies of educator. The discerning educator has high HIV/AIDS knowledge and healthy sexual practices. The dissolute educator has high HIV/AIDS knowledge but employs unhealthy or risky sexual practices. The decorous educator has low HIV/AIDS knowledge but practices healthy sexual practices. The disempowered educator has low HIV/AIDS knowledge and employs unhealthy or risky sexual practices. The study found that the two categories that will result in the most effective behaviour-change interventions are those that target ‘discerning’ and ‘decorous’ individuals as the educators. Both these categories have underlying healthy practices that minimise the risk of HIV transmission. The D4 Diagnostic Quadrant tool provides information as to existing knowledge and beliefs about HIV/AIDS that can inform decisions relating to the allocation of scarce resources. The tool will be very useful in the selection process of would-be educators particularly in health-promotion interventions.

Robust-diagnostic regression : a prelude for inducing reliable knowledge from regression

Regression lies heart in statistics, it is the one of the most important branch of multivariate techniques available for extracting knowledge in almost every field of study and research. Nowadays, it has drawn a huge interest to perform the tasks with different fields like machine learning, pattern recognition and data mining. Investigating outlier (exceptional) is a century long problem to the data analyst and researchers. Blind application of data could have dangerous consequences and leading to discovery of meaningless patterns and carrying to the imperfect knowledge. As a result of digital revolution and the growth of the Internet and Intranet data continues to be accumulated at an exponential rate and thereby importance of detecting outliers and study their costs and benefits as a tool for reliable knowledge discovery claims perfect attention. Investigating outliers in regression has been paid great value for the last few decades within two frames of thoughts in the name of robust regression and regression diagnostics. Robust regression first wants to fit a regression to the majority of the data and then to discover outliers as those points that possess large residuals from the robust output whereas in regression diagnostics one first finds the outliers, delete/correct them and then fit the regular data by classical (usual) methods. At the beginning there seems to be much confusion but now the researchers reach to the consensus, robustness and diagnostics are two complementary approaches to the analysis of data and any one is not good enough. In this chapter, we discuss both of them under the unique spectrum of regression diagnostics. Chapter expresses the necessity and views of regression diagnostics as well as presents several contemporary methods through numerical examples in linear regression within each aforesaid category together with current challenges and possible future research directions. Our aim is to make the chapter self-explained maintaining its general accessibility.