A pilot study on understanding the journey of advanced prostate cancer patients

Objective: To understand the journey of advanced prostate cancer patients for supporting development of an innovative patient journey browser. Background: Prostate cancer is one of the common cancers in Australia. Due to the chronic nature of the disease, it is important to have effective disease management strategy and care model. Multi-disciplinary care is a well-proven approach for chronic disease management. The Multi-disciplinary team (MDT) can function more effectively if all the required information is available for the clinical decision support. The development of innovative technology relies on an accurate understanding of the advanced prostate cancer patient’s journey over a prolonged period. This need arises from the fact that advanced prostate cancer patients may follow various treatment paths and change their care providers. As a result of this, it is difficult to understand the actual sources of patient’s clinical records and their treatment patterns. The aim of the research is to understand variable sources of clinical records, treatment patterns, alternative therapies, over the counter (OTC) medications of advanced prostate cancer patients. This study provides better and holistic understanding of advanced prostate cancer journey. Methods: The study was conducted through an on-line survey developed to seek and analyse the responses from the participants. The on-line questionnaire was carefully developed through consultations with the clinical researchers at the Australian Prostate Cancer Research Centre-Queensland, prostate cancer support group representatives and health informaticians at the Australian e-Health Research Centre. The non-identifying questionnaire was distributed to the patients through prostate cancer support groups in Queensland, Australia. The pilot study was carried out between August 2010 and December 2010. Results: The research made important observations about the advanced prostate cancer journey. It showed that General Practitioner (GP) was the common source of patient’s clinical records (41%) followed by Urologist (14%) and other clinicians (14%). The data analysis also showed that selenium was the common complementary supplement (55%) used by the patients and about 48% patients did not use any OTC drugs. The most common OTC used by the patients was Paracetamol (about 45%). Conclusion: The results have provided a foundation to the architecture of the proposed technology solution. The outcomes of this study are incorporated in design of the proposed patient journey browser system. A basic version of the system is currently being used at the advanced prostate cancer MDT meetings.

My Kitchen Rules pair are all the rage on social media – for now

The launch of the current series of My Kitchen Rules has undoubtedly been successful, both in terms of television ratings and in capturing a social media audience, clearly winning the battle for the Twitter audience on premiere night, and maintaining a lead over both The Block and The Biggest Loser since then. But it is the controversy surrounding Perth contestants Kelly Ramsay and Chloe James that has dominated media coverage today, detailing the abuse to which they have been subjected on social media.

Can SNOMED CT as implemented in New South Wales, Australia be used for road trauma injury surveillance in emergency departments?

The introduction of Systematized Nomenclature of Medicine - Clinical Terms (Snomed CT) for diagnosis coding in emergency departments (EDs) in New South Wales (NSW) has implications for injury surveillance abilities. This study aimed to assess the consequences of its introduction, as implemented as part of the ED information system in NSW, for identifying road trauma-related injuries in EDs. It involved a retrospective analysis of road trauma-related injuries identified in linked police, ED and mortality records during March 2007 to December 2009. Between 53.7% to 78.4% of all Snomed CT classifications in the principal provisional diagnosis field referred to the type of injury or symptom experienced by the individual. Of the road users identified by police, 3.2% of vehicle occupants, 6% of motorcyclists, 10.0% of pedal cyclists and 5.2% of pedestrians were identified using Snomed CT classifications in the principal provisional diagnosis field. The introduction of Snomed CT may provide flexible terminologies for clinicians. However, unless carefully implemented in information systems, its flexibility can lead to mismatches between the intention and actual use of defined data fields. Choices available in Snomed CT to indicate either symptoms, diagnoses, or injury mechanisms need to be controlled and these three concepts need to be retained in separate data fields to ensure a clear distinction between their classification in the ED.

The girlfriend guide to life : love, friends, changes and all that awks stuff answered

A special issue of Girlfriend magazine addressing sexual health, targeted at 14-17 year old girls

'The Australian we all aspire to be' : commemorative journalism and the death of the Crocodile Hunter

This article examines the news coverage the death of Steve Irwin, widely known as the Crocodile Hunter, generated in Australia. In line with past research on commemorative journalism, the study demonstrates the dominant discourses employed in the reporting of Irwin's death. It is argued that Australia's newspapers invoked a number of national myths, such as mateship, larrikinism and anti-elitism, in order to re-assert notions of Australian identity and social values and to deal with the grief over his loss. Most importantly, the study sheds new light on how news media deal with challenges to the dominant memorialising discourse. Past studies had not been able to investigate in much detail alternative discourses, but in examining Irwin's death, we are able to see how the media deal with such an unwanted interruption. It is argued that newspapers appropriated the alternative perspective within the mythical terms of their memorialising discourse, thereby not allowing it to disrupt the memorialisation itself and in fact further strengthening the process of mythologising the Crocodile Hunter.

Crucial roles for olfactory ensheathing cells and olfactory mucosal cells in the repair of damaged neural tracts

Olfactory ensheathing cells, the glial cells of the olfactory nervous system, exhibit unique growth-promoting and migratory properties that make them interesting candidates for cell therapies targeting neuronal injuries such as spinal cord injury. Transplantation of olfactory cells is feasible and safe in humans; however, functional outcomes are highly variable with some studies showing dramatic improvements and some no improvements at all. We propose that the reason for this is that the identity and purity of the cells is different in each individual study. We have shown that olfactory ensheathing cells are not a uniform cell population and that individual subpopulations of OECs are present in different regions of the olfactory nervous system, with strikingly different behaviors. Furthermore, the presence of fibroblasts and other cell types in the transplant can dramatically alter the behavior of the transplanted glial cells. Thus, a thorough characterization of the differences between olfactory ensheathing cell subpopulations and how the behavior of these cells is affected by the presence of other cell types is highly warranted.

Aha! The return of Alan Partridge

Throughout a long and occasionally distinguished career first as a television sports correspondent, then chat show host (dramatically ended by the accidental homicide of a guest live on air), then rebirth as a radio presenter at North Norfolk Digital, Alan Partridge has navigated the stormy waters of the British media landscape, now achieving mainstream success on the big screen with a starring role in Steve Coogan’s Alpha Papa (Declan Lowney, 2013). A man who in his desperation for a television series of his own once sank so low as to pitch a show called Monkey Tennis to the BBC finally finds his inner hero in a film which, while presenting mainly as comedy, also contains a biting critique of trends in the British media with which all journalists and media practitioners in general will be familiar. Alpha Papa is a nostalgic, elegiac riff on the pleasures and values of local radio the way it used to be, exemplified by North Norfolk Digital’s stable of flawed, but endearing jocks – Wally Banter, Bruno Brooks, Dave Clifton (who in one scene recounts the depths to which he sank as an alcoholic, drug addicted wreck—“I woke up in a skip with someone else’s underpants in my mouth. I can laugh about it now …”), and Pat Farrell. 50- something Pat is sacked by the new owners of North Norfolk Digital, who in their efforts to transform the station into a “multiplatform content provider” going by the more Gen Yfriendly name of Shape (“the way you want it to be”), wish to replace him with a younger, brattish model lacking in taste and manners. Out go records by the likes of Glen Campbell and Neil Diamond (“You can keep Jesus Christ”, observes Partridge after playing Diamond’s Sweet Caroline in a demonstration of the crackling radio repartee for which he is by now renowned, “that was the king of the Jews”), in comes Roachford. Pat, grieving his dead wife Molly, finally snaps and turns the glitzy media launch of Shape into a hostage siege. Only Alan Partridge, it seems, can step in and talk Pat out of a looming catastrophe.

Where are all the female participants in sports and exercise medicine research?

The aim of this study is to estimate the ratio of male and female participants in Sports and Exercise Medicine research. Original research articles published in three major Sports and Exercise Medicine journals (Medicine and Science in Sport and Exercise, British Journal of Sports Medicine and American Journal of Sports Medicine) over a three year period were examined. Each article was screened to determine the following: total number of participants, the number of female participants and the number of male participants. The percentage of females and males per article in each of the journals was also calculated. Cross tabulations and Chi square analysis were used to compare the gender representation of participants within each of the journals. Data were extracted from 1, 382 articles involving a total of 6, 076, 705 participants. 2, 366, 998 (39%) participants were female and 3, 709, 707 (61%) male. The average percentage of female participants per article across the journals ranged from 35-37%. Females were significantly under-represented across all of the journals (X2 =23566, df=2, p<0.00001). There were no significant differences between the three journals. In conclusion, Sports and Exercise Medicine practitioners should be cognisant of sexual dimorphism and gender disparity in the current literature.

Automatic de-identification of electronic health records : an Australian perspective

We present an approach to automatically de-identify health records. In our approach, personal health information is identified using a Conditional Random Fields machine learning classifier, a large set of linguistic and lexical features, and pattern matching techniques. Identified personal information is then removed from the reports. The de-identification of personal health information is fundamental for the sharing and secondary use of electronic health records, for example for data mining and disease monitoring. The effectiveness of our approach is first evaluated on the 2007 i2b2 Shared Task dataset, a widely adopted dataset for evaluating de-identification techniques. Subsequently, we investigate the robustness of the approach to limited training data; we study its effectiveness on different type and quality of data by evaluating the approach on scanned pathology reports from an Australian institution. This data contains optical character recognition errors, as well as linguistic conventions that differ from those contained in the i2b2 dataset, for example different date formats. The findings suggest that our approach compares to the best approach from the 2007 i2b2 Shared Task; in addition, the approach is found to be robust to variations of training size, data type and quality in presence of sufficient training data.

All the worldwide web's a stage : teenage girls' self-presentation and identities formation through status updates

This study investigates grade eight girls’ use of status updates on Facebook in order to create identities online. Using sociologist Erving Goffman’s theory of self-presentation as a framework, Jones and Pittman’s subsequent strategies of self-presentation are used to discover the ways in which teenage girls use status updates in order to create identities online and manage audience impressions. Using a mixed methods design, the results showed that, while existing self-presentation strategies persist, social networking has created new means of self-presentation. This study adds to a growing pool of research regarding teens’ engagement with social networking websites to form identities.

Mid-Holocene sea-level and coral reef demise : U-Th dating of subfossil corals in Moreton Bay, Australia

It is increasingly apparent that sea-level data (e.g. microfossil transfer functions, dated coral microatolls and direct observations from satellite and tidal gauges) vary temporally and spatially at regional to local scales, thus limiting our ability to model future sea-level rise for many regions. Understanding sealevel response at ‘far-field’ locations at regional scales is fundamental for formulating more relevant sea-level rise susceptibility models within these regions under future global change projections. Fossil corals and reefs in particular are valuable tools for reconstructing past sea levels and possible environmental phase shifts beyond the temporal constraints of instrumental records. This study used abundant surface geochronological data based on in situ subfossil corals and precise elevation surveys to determine previous sea level in Moreton Bay, eastern Australia, a far-field site. A total of 64 U-Th dates show that relative sea level was at least 1.1 m above modern lowest astronomical tide (LAT) from at least ˜6600 cal. yr BP. Furthermore, a rapid synchronous demise in coral reef growth occurred in Moreton Bay ˜5800 cal. yr BP, coinciding with reported reef hiatus periods in other areas around the Indo-Pacific region. Evaluating past reef growth patterns and phases allows for a better interpretation of anthropogenic forcing versus natural environmental/climatic cycles that effect reef formation and demise at all scales and may allow better prediction of reef response to future global change.

The "Shackleton Site" (IODP Site U1385) on the Iberian Margin

Nick Shackleton’s research on piston cores from the Iberian margin highlighted the importance of this region for providing high-fidelity records of millennial-scale climate variability, and for correlating climate events from the marine environment to polar ice cores and European terrestrial sequences. During the Integrated Ocean Drilling Program (IODP) Expedition 339, we sought to extend the Iberian margin sediment record by drilling with the D/V JOIDES Resolution. Five holes were cored at Site U1385 using the advanced piston corer (APC) system to a maximum depth of ∼ 155.9 m below sea floor (m b.s.f.). Immediately after the expedition, cores from all holes were analyzed by core scanning X-ray fluorescence (XRF) at 1 cm spatial resolution. Ca/Ti data were used to accurately correlate from hole-to-hole and construct a composite spliced section, containing no gaps or disturbed intervals to 166.5 m composite depth (mcd). A low-resolution (20 cm sample spacing) oxygen isotope record confirms that Site U1385 contains a continuous record of hemipelagic sedimentation from the Holocene to 1.43 Ma (Marine Isotope Stage 46). The sediment profile at Site U1385 extends across the middle Pleistocene transition (MPT) with sedimentation rates averaging ∼ 10 cm kyr−1. Strongprecession cycles in colour and elemental XRF signals provide a powerful tool for developing an orbitally tuned reference timescale. Site U1385 is likely to become an important type section for marine–ice–terrestrial core correlations and the study of orbital- and millennial-scale climate variability.

De-Identification of health records using Anonym: Effectiveness and robustness across datasets

Objective Evaluate the effectiveness and robustness of Anonym, a tool for de-identifying free-text health records based on conditional random fields classifiers informed by linguistic and lexical features, as well as features extracted by pattern matching techniques. De-identification of personal health information in electronic health records is essential for the sharing and secondary usage of clinical data. De-identification tools that adapt to different sources of clinical data are attractive as they would require minimal intervention to guarantee high effectiveness. Methods and Materials The effectiveness and robustness of Anonym are evaluated across multiple datasets, including the widely adopted Integrating Biology and the Bedside (i2b2) dataset, used for evaluation in a de-identification challenge. The datasets used here vary in type of health records, source of data, and their quality, with one of the datasets containing optical character recognition errors. Results Anonym identifies and removes up to 96.6% of personal health identifiers (recall) with a precision of up to 98.2% on the i2b2 dataset, outperforming the best system proposed in the i2b2 challenge. The effectiveness of Anonym across datasets is found to depend on the amount of information available for training. Conclusion Findings show that Anonym compares to the best approach from the 2006 i2b2 shared task. It is easy to retrain Anonym with new datasets; if retrained, the system is robust to variations of training size, data type and quality in presence of sufficient training data.

Lying in all honesty : capturing truth in women’s confessional memoir

This paper explores the slippery nature of illness and diagnosis in Lauren Slater’s memoir, Lying: a Metaphorical Memoir (2000). Speaking from the shadowy intersection of childhood and adolescence, Slater’s narrator, Lauren, uses the metaphor of epilepsy to describe her own predilection for exaggeration. In exploiting the fallibility of the first-person narrator, Slater insists on the legitimacy of metaphor in accounts of childhood illness that are more concerned with narrative truth than historical accuracy. The result of this playfulness and general misrule is that Slater writes herself into a double bind: on one side, she is the child narrator who inadvertently misrepresents events and misdirects readers, and on the other side, she is the untrustworthy author who employs metaphor as a licence to lie.