Adjustment of apnea-hypopnea index with severity of obstruction events enhances detection of sleep apnea patients with the highest risk of severe health consequences

Introduction Presently, the severity of obstructive sleep apnea (OSA) is estimated based on the apnea-hypopnea index (AHI). Unfortunately, AHI does not provide information on the severity of individual obstruction events. Previously, the severity of individual obstruction events has been suggested to be related to the outcome of the disease. In this study, we incorporate this information into AHI and test whether this novel approach would aid in discriminating patients with the highest risk. We hypothesize that the introduced adjusted AHI parameter provides a valuable supplement to AHI in the diagnosis of the severity of OSA. Methods This hypothesis was tested by means of retrospective follow-up (mean ± sd follow-up time 198.2 ± 24.7 months) of 1,068 men originally referred to night polygraphy due to suspected OSA. After exclusion of the 264 patients using CPAP, the remaining 804 patients were divided into normal (AHI < 5) and OSA (AHI ≥ 5) categories based on conventional AHI and adjusted AHI. For a more detailed analysis, the patients were divided into normal, mild, moderate, and severe OSA categories based on conventional AHI and adjusted AHI. Subsequently, the mortality and cardiovascular morbidity in these groups were determined. Results Use of the severity of individual obstruction events for adjustment of AHI led to a significant rearrangement of patients between severity categories. Due to this rearrangement, the number of deceased patients diagnosed to have OSA was increased when adjusted AHI was used as the diagnostic index. Importantly, risk ratios of all-cause mortality and cardiovascular morbidity were higher in moderate and severe OSA groups formed based on the adjusted AHI parameter than in those formed based on conventional AHI. Conclusions The adjusted AHI parameter was found to give valuable supplementary information to AHI and to potentially improve the recognition of OSA patients with the highest risk of mortality or cardiovascular morbidity.

An investigation of nucleation events in a coastal urban environment in the southern hemisphere

The occurrence of and conditions favourable to nucleation were investigated at an industrial and commercial coastal location in Brisbane, Australia during five different campaigns covering a total period of 13 months. To identify potential nucleation events, the difference in number concentration in the size range 14-30 nm (N14-30) between consecutive observations was calculated using first-order differencing. The data showed that nucleation events were a rare occurrence, and that in the absence of nucleation the particle number was dominated by particles in the range 30-300 nm. In many instances, total particle concentration declined during nucleation. There was no clear pattern in change in NO and NO2 concentrations during the events. SO2 concentration, in the majority of cases, declined during nucleation but there were exceptions. Most events took place in summer, followed by winter and then spring, and no events were observed for the autumn campaigns. The events were associated with sea breeze and long-range transport. Roadside emissions, in contrast, did not contribute to nucleation, probably due to the predominance of particles in the range 50-100 nm associated with these emissions.

Improving road safety through deterrence-based initiatives : a review of research

The efficacy of road safety countermeasures to deter motorists from engaging in illegal behaviours is extremely important when considering the personal and economic impact of road accidents on the community. Within many countries, deterrence theory has remained a cornerstone to criminology and criminal justice policy, particularly within the field of road safety, as policy makers and enforcement agencies attempt to increase perceptions regarding the certainty, severity and swiftness of sanctions for those who engage in illegal motoring behaviours. Using the Australian experience (particularly the tremendous amount of research into drink driving), the current paper reviews the principles underpinning deterrence theory, the utilisation of the approach within some contemporary road safety initiatives (e.g., Random Breath Testing) as well as highlights some methods to enhance a deterrent effect. The paper also provides direction for future deterrence-based research, in particular, considering the powerful impact of non-legal sanctions, punishment avoidance as well as creating culturally embedded behavioural change.

Faculty and students’ awareness and challenges of e-learning in a college of education

This study explored the use of e-learning by student teachers and faculty members at the Paro College of Education, Royal University of Bhutan. It provides an overview of the current status of e-learning at the College including the challenges faced by both faculty members and students teachers, and the influence of ICT resources on the use of e-learning by the lecturers and student teachers. The results indicated that there exist challenges in exercising e-learning at the College for teaching and learning. The data indicated that the Internet connection is slow and revealed that most of the lecturers have average computer competency. This study strongly recommends that the College develops a strategic plan for ICT infrastructure and resources that includes policy and guidelines for use. This study also suggests that lecturers and student teachers use freely available e-learning management software.

Queensland College of Teachers annual lecture 2010 : child protection

Teachers have a crucial role as “sentinels” for children who have been abused or neglected. This professional development session will provide a framework for understanding the types, incidence and causes of child abuse and neglect, and teachers’ role in reporting suspected cases. The session will provide participants with knowledge and skills to enable them to identify warning signs and indicators of child abuse and neglect, know the basis of their duties to report suspected cases of abuse and neglect, and respond to the needs of abused and neglected children at school. The presentation will focus on: • the reasons why child abuse and neglect can occur; • the different types of child abuse and neglect and their effects on children; • the warning signs and indicators of physical abuse, emotional abuse, sexual abuse and neglect; • applying knowledge of indicators to make judgements about risk of harm; • responding to indications of risk of harm, including complying with legislative and policy-based duties to report suspected child abuse and neglect.

Multi-modal summarization of key events and top players in sports tournament videos

To detect and annotate the key events of live sports videos, we need to tackle the semantic gaps of audio-visual information. Previous work has successfully extracted semantic from the time-stamped web match reports, which are synchronized with the video contents. However, web and social media articles with no time-stamps have not been fully leveraged, despite they are increasingly used to complement the coverage of major sporting tournaments. This paper aims to address this limitation using a novel multimodal summarization framework that is based on sentiment analysis and players' popularity. It uses audiovisual contents, web articles, blogs, and commentators' speech to automatically annotate and visualize the key events and key players in a sports tournament coverage. The experimental results demonstrate that the automatically generated video summaries are aligned with the events identified from the official website match reports.

Nursing research : the Australian College of Nursing position statement

Background Nursing perspectives play an important role in addressing the health priorities of today’s society. The Australian College of Nursing (ACN) acknowledges the significant contribution that nursing research has made since the first nurse researcher, Florence Nightingale, documented the factors that affected the morbidity and mortality of soldiers wounded in the Crimean war in the 1800s. The nursing profession continues to celebrate the significant contribution nursing research made to improving nursing practice and health outcomes. These significant contributions over recent years include, but are not limited to: 1. Health services research that has demonstrated the importance of nursing services and how such services are designed/organised to ensure safety and quality of care (Duffield, et al., 2011; Fernandez, et al., 2012; Middleton, et al., 2011); 2. Clinical research that has demonstrated the value of specific nursing interventions to improved health outcomes, including enhanced survival, reduced morbidity, and improved quality of life and consumer engagement (Cancer Australia and Cancer Voices Australia, 2011; Kitson, et al., 2013; Middleton, et al., 2012; Rickard, et al., 2012; Zeitz, et al., 2011); 3. Basic science research that has advanced discoveries in terms of understanding the biological mechanisms underpinning nursing interventions (Illi, et al., 2012; Kim, et al., 2012; Miaskowski, et al., 2010; Simonova, et al., 2012); 4. Epidemiological research that has advanced understanding about how individuals and populations respond to health problems (Carrington, et al., 2012); 5. Qualitative research that has advanced understanding about experiences of and responses to health and illness and the processes of care that are important to optimal outcomes (Schulman-Green, et al., 2012; Scott, et al., 2011).

A novel representation of bioacoustic events for content-based search in field audio data

Bioacoustic data can provide an important base for environmental monitoring. To explore a large amount of field recordings collected, an automated similarity search algorithm is presented in this paper. A region of an audio defined by frequency and time bounds is provided by a user; the content of the region is used to construct a query. In the retrieving process, our algorithm will automatically scan through recordings to search for similar regions. In detail, we present a feature extraction approach based on the visual content of vocalisations – in this case ridges, and develop a generic regional representation of vocalisations for indexing. Our feature extraction method works best for bird vocalisations showing ridge characteristics. The regional representation method allows the content of an arbitrary region of a continuous recording to be described in a compressed format.

Rapid scanning of spectrograms for efficient identification of bioacoustic events in big data

Acoustic sensing is a promising approach to scaling faunal biodiversity monitoring. Scaling the analysis of audio collected by acoustic sensors is a big data problem. Standard approaches for dealing with big acoustic data include automated recognition and crowd based analysis. Automatic methods are fast at processing but hard to rigorously design, whilst manual methods are accurate but slow at processing. In particular, manual methods of acoustic data analysis are constrained by a 1:1 time relationship between the data and its analysts. This constraint is the inherent need to listen to the audio data. This paper demonstrates how the efficiency of crowd sourced sound analysis can be increased by an order of magnitude through the visual inspection of audio visualized as spectrograms. Experimental data suggests that an analysis speedup of 12× is obtainable for suitable types of acoustic analysis, given that only spectrograms are shown.

Plasma-enabled graded nanotube biosensing arrays on a Si nanodevice platform : catalyst-free integration and in situ detection of nucleation events

Low-temperature plasmas in direct contact with arbitrary, written linear features on a Si wafer enable catalyst-free integration of carbon nanotubes into a Si-based nanodevice platform and in situ resolution of individual nucleation events. The graded nanotube arrays show reliable, reproducible, and competitive performance in electron field emission and biosensing nanodevices.

Plasmas meet nanoparticles—where synergies can advance the frontier of medicine

Nanoparticles and low-temperature plasmas have been developed, independently and often along different routes, to tackle the same set of challenges in biomedicine. There are intriguing similarities and contrasts in their interactions with cells and living tissues, and these are reflected directly in the characteristics and scope of their intended therapeutic solutions, in particular their chemical reactivity, selectivity against pathogens and cancer cells, safety to healthy cells and tissues and targeted delivery to diseased tissues. Time has come to ask the inevitable question of possible plasma–nanoparticle synergy and the related benefits to the development of effective, selective and safe therapies for modern medicine. This perspective paper offers a detailed review of the strengths and weakenesses of nanomedicine and plasma medicine as a stand-alone technology, and then provides a critical analysis of some of the major opportunities enabled by synergizing nanotechnology and plasma technology. It is shown that the plasma–nanoparticle synergy is best captured through plasma nanotechnology and its benefits for medicine are highly promising.

Interpreting and comparing risks in the presence of competing events

Competing events are common in medical research. Ignoring them in the statistical analysis can easily lead to flawed results and conclusions. This article uses a real dataset and a simple simulation to show how standard analysis fails and how such data should be analysed

Community pharmacy dispensing of prescription medicine sample packs: Changing the business of medicine initiation?

Prescription medicine samples (or starter packs) are provided by pharmaceutical manufacturers to prescribing doctors as one component in the suite of marketing products used to convince them to prescribe a particular medicine [1,2]. Samples are generally newer, more expensive treatment options still covered by patent [3,4]. Safe, effective, judicious and appropriate medicine use (quality use of medicines) [5] could be enhanced by involving community pharmacists in the dispensing of starter packs. Doctors who use samples show a trend towards prescribing more expensive medicines overall [6] and also prescribe more medicines [7]. Cardiovascular health and mental health are Australian National Health Priority Areas [8] and account for approximately 30% and 17%, respectively, of annual government Pharmaceutical Benefits System (PBS) in 2006 [9]. The PBS is Australia's universal prescription subsidy scheme [9]. Antihypertensives were a major contributor to the estimated 80 000 medicine-related hospital admissions in Australia in 1999 [10] and also internationally [11,12]. The aim of this study was to pilot an alternative model for supply of free sample or starter packs of prescription medicines and ascertain if it is a viable model in daily practice.