Development and feasibility of a smartphone, ECG and GPS based system for remotely monitoring exercise in cardiac rehabilitation

Background Despite its efficacy and cost-effectiveness, exercise-based cardiac rehabilitation is undertaken by less than one-third of clinically eligible cardiac patients in every country for which data is available. Reasons for non-participation include the unavailability of hospital-based rehabilitation programs, or excessive travel time and distance. For this reason, there have been calls for the development of more flexible alternatives. Methodology and Principal Findings We developed a system to enable walking-based cardiac rehabilitation in which the patient's single-lead ECG, heart rate, GPS-based speed and location are transmitted by a programmed smartphone to a secure server for real-time monitoring by a qualified exercise scientist. The feasibility of this approach was evaluated in 134 remotely-monitored exercise assessment and exercise sessions in cardiac patients unable to undertake hospital-based rehabilitation. Completion rates, rates of technical problems, detection of ECG changes, pre- and post-intervention six minute walk test (6 MWT), cardiac depression and Quality of Life (QOL) were key measures. The system was rated as easy and quick to use. It allowed participants to complete six weeks of exercise-based rehabilitation near their homes, worksites, or when travelling. The majority of sessions were completed without any technical problems, although periodic signal loss in areas of poor coverage was an occasional limitation. Several exercise and post-exercise ECG changes were detected. Participants showed improvements comparable to those reported for hospital-based programs, walking significantly further on the post-intervention 6 MWT, 637 m (95% CI: 565–726), than on the pre-test, 524 m (95% CI: 420–655), and reporting significantly reduced levels of cardiac depression and significantly improved physical health-related QOL. Conclusions and Significance The system provided a feasible and very flexible alternative form of supervised cardiac rehabilitation for those unable to access hospital-based programs, with the potential to address a well-recognised deficiency in health care provision in many countries. Future research should assess its longer-term efficacy, cost-effectiveness and safety in larger samples representing the spectrum of cardiac morbidity and severity.

Spatio-temporal patterns of Barmah Forest virus disease in Queensland, Australia

Background Barmah Forest virus (BFV) disease is a common and wide-spread mosquito-borne disease in Australia. This study investigated the spatio-temporal patterns of BFV disease in Queensland, Australia using geographical information system (GIS) tools and geostatistical analysis. Methods/Principal Findings We calculated the incidence rates and standardised incidence rates of BFV disease. Moran's I statistic was used to assess the spatial autocorrelation of BFV incidences. Spatial dynamics of BFV disease was examined using semi-variogram analysis. Interpolation techniques were applied to visualise and display the spatial distribution of BFV disease in statistical local areas (SLAs) throughout Queensland. Mapping of BFV disease by SLAs reveals the presence of substantial spatio-temporal variation over time. Statistically significant differences in BFV incidence rates were identified among age groups (χ2 = 7587, df = 7327,p<0.01). There was a significant positive spatial autocorrelation of BFV incidence for all four periods, with the Moran's I statistic ranging from 0.1506 to 0.2901 (p<0.01). Semi-variogram analysis and smoothed maps created from interpolation techniques indicate that the pattern of spatial autocorrelation was not homogeneous across the state. Conclusions/Significance This is the first study to examine spatial and temporal variation in the incidence rates of BFV disease across Queensland using GIS and geostatistics. The BFV transmission varied with age and gender, which may be due to exposure rates or behavioural risk factors. There are differences in the spatio-temporal patterns of BFV disease which may be related to local socio-ecological and environmental factors. These research findings may have implications in the BFV disease control and prevention programs in Queensland.

Taxonomy for rainfall events based on pollutant wash-off potential in urban areas

Conventional rainfall classification for modelling and prediction is quantity based. This approach can lead to inaccuracies in stormwater quality modelling due to the assignment of stochastic pollutant parameters to a rainfall event. A taxonomy for natural rainfall events in the context of stormwater quality is presented based on an in-depth investigation of the influence of rainfall characteristics on stormwater quality. In the research study, the natural rainfall events were classified into three types based on average rainfall intensity and rainfall duration and the classification was found to be independent of the catchment characteristics. The proposed taxonomy provides an innovative concept in stormwater quality modelling and prediction and will contribute to enhancing treatment design for stormwater quality mitigation.

Green Business Process Management

In managing their operations, organizations have traditionally focused on economic imperatives in terms of time, cost, efficiency, and quality. In doing so, they have been a major contributor to environmental degradation caused by re-source consumption, greenhouse emissions, and wastage. As a consequence, or-ganizations are increasingly encouraged to improve their operations also from an ecological perspective, and thus to consider environmental sustainability as an additional management imperative. In order to lessen their impact on the natural environment, organizations must design and implement environmentally sustainable processes, which we call the challenge of Green Business Process Management (Green BPM). This chapter elaborates on the challenge and perspec-tive of Green BPM, and explores the contributions that business process management can provide to creating environmentally sustainable organizations. Our key premise is that business as well as information technology managers need to engage in a process-focused discussion to enable a common, comprehensive understanding of organizational processes, and the process-centered opportunities for making these processes, and ultimately the organization as a process-centric entity, “green.” Through our review of the key BPM capability areas and how they can be framed in terms of environmental sustainability considerations, we provide an overview and introduction to the subsequent chapters in this book.

Effective discrimination of acoustic emission source signals for structural health monitoring

Acoustic emission (AE) is the phenomenon where stress waves are generated due to rapid release of energy within a material caused by sources such as crack initiation or growth. AE technique involves recording the stress waves by means of sensors and subsequent analysis of the recorded signals to gather information about the nature of the source. Though AE technique is one of the popular non destructive evaluation (NDE) techniques for structural health monitoring of mechanical, aerospace and civil structures; several challenges still exist in successful application of this technique. Presence of spurious noise signals can mask genuine damage‐related AE signals; hence a major challenge identified is finding ways to discriminate signals from different sources. Analysis of parameters of recorded AE signals, comparison of amplitudes of AE wave modes and investigation of uniqueness of recorded AE signals have been mentioned as possible criteria for source differentiation. This paper reviews common approaches currently in use for source discrimination, particularly focusing on structural health monitoring of civil engineering structural components such as beams; and further investigates the applications of some of these methods by analyzing AE data from laboratory tests.

The development of ground impact models for the analysis of the risks associated with Unmanned Aircraft Operations over inhabited areas

With the emergence of Unmanned Aircraft Systems (UAS) there is a growing need for safety standards and regulatory frameworks to manage the risks associated with their operations. The primary driver for airworthiness regulations (i.e., those governing the design, manufacture, maintenance and operation of UAS) are the risks presented to people in the regions overflown by the aircraft. Models characterising the nature of these risks are needed to inform the development of airworthiness regulations. The output from these models should include measures of the collective, individual and societal risk. A brief review of these measures is provided. Based on the review, it was determined that the model of the operation of an UAS over inhabited areas must be capable of describing the distribution of possible impact locations, given a failure at a particular point in the flight plan. Existing models either do not take the impact distribution into consideration, or propose complex and computationally expensive methods for its calculation. A computationally efficient approach for estimating the boundary (and in turn area) of the impact distribution for fixed wing unmanned aircraft is proposed. A series of geometric templates that approximate the impact distributions are derived using an empirical analysis of the results obtained from a 6-Degree of Freedom (6DoF) simulation. The impact distributions can be aggregated to provide impact footprint distributions for a range of generic phases of flight and missions. The maximum impact footprint areas obtained from the geometric template are shown to have a relative error of typically less than 1% compared to the areas calculated using the computationally more expensive 6DoF simulation. Computation times for the geometric models are on the order of one second or less, using a standard desktop computer. Future work includes characterising the distribution of impact locations within the footprint boundaries.

Relating vehicle generated pollutants to urban stormwater quality

Rapid urbanisation and resulting continuous increase in traffic has been recognised as key factors in the contribution of increased pollutant loads to urban stormwater and in turn to receiving waters. Urbanisation primarily increases anthropogenic activities and the percentage of impervious surfaces in urban areas. These processes are collectively responsible for urban stormwater pollution. In this regard, urban traffic and land use related activities have been recognised as the primary pollutant sources. This is primarily due to the generation of a range of key pollutants such as solids, heavy metals and PAHs. Appropriate treatment system design is the most viable approach to mitigate stormwater pollution. However, limited understanding of the pollutant process and transport pathways constrains effective treatment design. This highlights necessity for the detailed understanding of traffic and other land use related pollutants processes and pathways in relation to urban stormwater pollution. This study has created new knowledge in relation to pollutant processes and transport pathways encompassing atmospheric pollutants, atmospheric deposition and build-up on ground surfaces of traffic generated key pollutants. The research study was primarily based on in-depth experimental investigations. This thesis describes the extensive knowledge created relating to the processes of atmospheric pollutant build-up, atmospheric deposition and road surface build-up and establishing their relationships as a chain of processes. The analysis of atmospheric deposition revealed that both traffic and land use related sources contribute total suspended particulate matter (TSP) to the atmosphere. Traffic sources become dominant during weekdays whereas land use related sources become dominant during weekends due to the reduction in traffic sources. The analysis further concluded that atmospheric TSP, polycyclic aromatic hydrocarbons (PAHs) and heavy metals (HMs) concentrations are highly influenced by total average daily heavy duty traffic, traffic congestion and the fraction of commercial and industrial land uses. A set of mathematical equation were developed to predict TSP, PAHs and HMs concentrations in the atmosphere based on the influential traffic and land use related parameters. Dry deposition samples were collected for different antecedent dry days and wet deposition samples were collected immediately after rainfall events. The dry deposition was found to increase with the antecedent dry days and consisted of relatively coarser particles (greater than 1.4 ìm) when compared to wet deposition. The wet deposition showed a strong affinity to rainfall depth, but was not related to the antecedent dry period. It was also found that smaller size particles (less than 1.4 ìm) travel much longer distances from the source and deposit mainly with the wet deposition. Pollutants in wet deposition are less sensitive to the source characteristics compared to dry deposition. Atmospheric deposition of HMs is not directly influenced by land use but rather by proximity to high emission sources such as highways. Therefore, it is important to consider atmospheric deposition as a key pollutant source to urban stormwater in the vicinity of these types of sources. Build-up was analysed for five different particle size fractions, namely, <1 ìm, 1-75 ìm, 75-150 ìm, 150-300 ìm and >300 ìm for solids, PAHs and HMs. The outcomes of the study indicated that PAHs and HMs in the <75 ìm size fraction are generated mainly by traffic related activities whereas the > 150 ìm size fraction is generated by both traffic and land use related sources. Atmospheric deposition is an important source for HMs build-up on roads, whereas the contribution of PAHs from atmospheric sources is limited. A comprehensive approach was developed to predict traffic and other land use related pollutants in urban stormwater based on traffic and other land use characteristics. This approach primarily included the development of a set of mathematical equations to predict traffic generated pollutants by linking traffic and land use characteristics to stormwater quality through mathematical modelling. The outcomes of this research will contribute to the design of appropriate treatment systems to safeguard urban receiving water quality for future traffic growth scenarios. The „real world. application of knowledge generated was demonstrated through mathematical modelling of solids in urban stormwater, accounting for the variability in traffic and land use characteristics.

Determination of coastal ground and surface water processes and character by use of hydrochemistry and stable isotopes, Fraser Coast, Queensland

This study was part of an integrated project developed in response to concerns regarding current and future land practices affecting water quality within coastal catchments and adjacent marine environments. Two forested coastal catchments on the Fraser Coast, Australia, were chosen as examples of low-modification areas with similar geomorphological and land-use characteristics to many other coastal zones in southeast Queensland. For this component of the overall project, organic , physico-chemical (Eh, pH and DO), ionic (Fe2+, Fe3+), and isotopic (ä13CDIC, ä15NDIN ä34SSO4) data were used to characterise waters and identify sources and processes contributing to concentrations and form of dissolved Fe, C, N and S within the ground and surface waters of these coastal catchments. Three sites with elevated Fe concentrations are discussed in detail. These included a shallow pool with intermittent interaction with the surface water drainage system, a monitoring well within a semi-confined alluvial aquifer, and a monitoring well within the fresh/saline water mixing zone adjacent to an estuary. Conceptual models of processes occurring in these environments are presented. The primary factors influencing Fe transport were; microbial reduction of Fe3+ oxyhydroxides in groundwaters and in the hyporheic zone of surface drainage systems, organic input available for microbial reduction and Fe3+ complexation, bacterial activity for reduction and oxidation, iron curtain effects where saline/fresh water mixing occurs, and variation in redox conditions with depth in ground and surface water columns. Data indicated that groundwater seepage appears a more likely source of Fe to coastal waters (during periods of low rainfall) via tidal flux. The drainage system is ephemeral and contributes little discharge to marine waters. However, data collected during a high rainfall event indicated considerable Fe loads can be transported to the estuary mouth from the catchment.

Nanoparticles in European cities and associated health impacts

Atmospheric nanoparticles are one of those pollutants currently unregulated through ambient air quality standards. The aim of this chapter is to assess the environmental and health impacts of atmospheric nanoparticles in European environments. The chapter begins with the conventional information on the origin of atmospheric nanoparticles, followed by their physical and chemical characteristics. A brief overview of recently published review articles on this topic is then presented to guide those readers interested in exploring any specific aspect of nanoparticles in greater detail. A further section reports a summary of recently published studies on atmospheric nanoparticles in European cities. This covers a total of about 45 sampling locations in 30 different cities within 15 European countries for quantifying levels of roadside and urban background particle number concentrations (PNCs). Average PNCs at roadside and urban background sites were found to be 3.82±3.25 ×104 cm–3 and 1.63±0.82 ×104 cm–3, respectively, giving a roadside to background PNC ratio of ~2.4. Engineered nanoparticles are one of the key emerging categories of airborne nanoparticles, especially for the indoor environments. Their ambient concentrations may increase in future due to widespread use of nanotechnology integrated products. Evaluation of their sources and probable impacts on air quality and human health are briefly discussed in the following section. Respiratory deposition doses received by the public exposed to roadside PNCs in numerous European locations are then estimated. These were found to be in the 1.17–7.56 1010 h–1 range over the studied roadside European locations. The following section discusses the potential framework for airborne nanoparticle regulations in Europe and, in addition, the existing control measures to limit nanoparticle emissions at source. The chapter finally concludes with a synthesis of the topic areas covered and highlights important areas for further work.

Joined-up practice : five areas of exemplary practice for social workers and educators to re-engage homeless youth

Young people seen as ‘at risk’ are a substantial focus across a wide range of policy and practice fields in national and international contexts. This article addresses two of those fields, youth homelessness and youth failing to obtain a basic education that will give them access to employment and full community participation as active citizens. By comparing solutions to the problems of youth homelessness and youth educationally at risk, the article distils key meta-characteristics useful for both social workers and educators in mutually supporting some of the most at risk young people in our communities today. This is what the authors term ‘a joined-up practice’.

Neuronal nicotinic acetylcholine receptors : neuroplastic changes underlying alcohol and nicotine addictions

Addictive drugs can activate systems involved in normal reward-related learning, creating long-lasting memories of the drug's reinforcing effects and the environmental cues surrounding the experience. These memories significantly contribute to the maintenance of compulsive drug use as well as cue-induced relapse which can occur even after long periods of abstinence. Synaptic plasticity is thought to be a prominent molecular mechanism underlying drug-induced learning and memories. Ethanol and nicotine are both widely abused drugs that share a common molecular target in the brain, the neuronal nicotinic acetylcholine receptors (nAChRs). The nAChRs are ligand-gated ion channels that are vastly distributed throughout the brain and play a key role in synaptic neurotransmission. In this review, we will delineate the role of nAChRs in the development of ethanol and nicotine addiction. We will characterize both ethanol and nicotine's effects on nAChR-mediated synaptic transmission and plasticity in several key brain areas that are important for addiction. Finally, we will discuss some of the behavioral outcomes of drug-induced synaptic plasticity in animal models. An understanding of the molecular and cellular changes that occur following administration of ethanol and nicotine will lead to better therapeutic strategies.

Experiences of neighbourhood walkability among older Australians living in high density inner-city areas

Walking as an out-of-home mobility activity is recognised for its contribution to healthy and active ageing. The environment can have a powerful effect on the amount of walking activity undertaken by older people, thereby influencing their capacity to maintain their wellbeing and independence. This paper reports the findings from research examining the experiences of neighbourhood walking for 12 older people from six different inner-city high density suburbs, through analysis of data derived from travel diaries, individual time/space activity maps (created via GPS tracking over a seven-day period and GIS technology), and in-depth interviews. Reliance on motor vehicles, the competing interests of pedestrians and cyclists on shared pathways and problems associated with transit systems, public transport, and pedestrian infrastructure emerged as key barriers to older people venturing out of home on foot. GPS and GIS technology provide new opportunities for furthering understanding of the out-of-home mobility of older populations.

Risk-based approach to the management of on-site wastewater treatment facilities

Background On-site wastewater treatment system (OWTS) siting, design and management has traditionally been based on site specific conditions with little regard to the surrounding environment or the cumulative effect of other systems in the environment. The general approach has been to apply the same framework of standards and regulations to all sites equally, regardless of the sensitivity, or lack thereof, to the receiving environment. Consequently, this has led to the continuing poor performance and failure of on-site systems, resulting in environmental and public health consequences. As a result, there is increasing realisation that more scientifically robust evaluations in regard to site assessment and the underlying ground conditions are needed. Risk-based approaches to on-site system siting, design and management are considered the most appropriate means of improvement to the current standards and codes for on-site wastewater treatment systems. The Project Research in relation to this project was undertaken within the Gold Coast City Council region, the major focus being the semi-urban, rural residential and hinterland areas of the city that are not serviced by centralised treatment systems. The Gold Coast has over 15,000 on-site systems in use, with approximately 66% being common septic tank-subsurface dispersal systems. A recent study evaluating the performance of these systems within the Gold Coast area showed approximately 90% were not meeting the specified guidelines for effluent treatment and dispersal. The main focus of this research was to incorporate strong scientific knowledge into an integrated risk assessment process to allow suitable management practices to be set in place to mitigate the inherent risks. To achieve this, research was undertaken focusing on three main aspects involved with the performance and management of OWTS. Firstly, an investigation into the suitability of soil for providing appropriate effluent renovation was conducted. This involved detailed soil investigations, laboratory analysis and the use of multivariate statistical methods for analysing soil information. The outcomes of these investigations were developed into a framework for assessing soil suitability for effluent renovation. This formed the basis for the assessment of OWTS siting and design risks employed in the developed risk framework. Secondly, an assessment of the environmental and public health risks was performed specifically related the release of contaminants from OWTS. This involved detailed groundwater and surface water sampling and analysis to assess the current and potential risks of contamination throughout the Gold Coast region. Additionally, the assessment of public health risk incorporated the use of bacterial source tracking methods to identify the different sources of fecal contamination within monitored regions. Antibiotic resistance pattern analysis was utilised to determine the extent of human faecal contamination, with the outcomes utilised for providing a more indicative public health assessment. Finally, the outcomes of both the soil suitability assessment and ground and surface water monitoring was utilised for the development of the integrated risk framework. The research outcomes achieved through this project enabled the primary research aims and objects to be accomplished. This in turn would enable Gold Coast City Council to provide more appropriate assessment and management guidelines based on robust scientific knowledge which will ultimately ensure that the potential environmental and public health impacts resulting from on-site wastewater treatment is minimised. As part of the implementation of suitable management strategies, a critical point monitoring program (CPM) was formulated. This entailed the identification of the key critical parameters that contribute to the characterised risks at monitored locations within the study area. The CPM will allow more direct procedures to be implemented, targeting the specific hazards at sensitive areas throughout Gold Coast region.