The impact of heatwaves on emergency department visits in Brisbane, Australia : a time series study

Introduction The acute health effects of heatwaves in a subtropical climate and their impact on emergency departments (ED) are not well known. The purpose of this study is to examine overt heat-related presentations to EDs associated with heatwaves in Brisbane. Methods Data were obtained for the summer seasons (December to February) from 2000-2012. Heatwave events were defined as two or more successive days with daily maximum temperature >=34[degree sign]C (HWD1) or >=37[degree sign]C (HWD2). Poisson generalised additive model was used to assess the effect of heatwaves on heat-related visits (International Classification of Diseases (ICD) 10 codes T67 and X30; ICD 9 codes 992 and E900.0). Results Overall, 628 cases presented for heat-related illnesses. The presentations significantly increased on heatwave days based on HWD1 (relative risk (RR) = 4.9, 95% confidence interval (CI): 3.8, 6.3) and HWD2 (RR = 18.5, 95% CI: 12.0, 28.4). The RRs in different age groups ranged between 3-9.2 (HWD1) and 7.5-37.5 (HWD2). High acuity visits significantly increased based on HWD1 (RR = 4.7, 95% CI: 2.3, 9.6) and HWD2 (RR = 81.7, 95% CI: 21.5, 310.0). Average length of stay in ED significantly increased by >1 hour (HWD1) and >2 hours (HWD2). Conclusions Heatwaves significantly increase ED visits and workload even in a subtropical climate. The degree of impact is directly related to the extent of temperature increases and varies by socio-demographic characteristics of the patients. Heatwave action plans should be tailored according to the population needs and level of vulnerability. EDs should have plans to increase their surge capacity during heatwaves.

Living City 2013 Workshop

Living City 2013 Workshop, as part of a school term’s design-based curriculum connected to the KGSC/QUT Design Excellence Program and run from 11 February – 1 May, 2013, was essentially a three-day place-based urban design immersion workshop program for 25 Year 11 Visual Art and Design Students and 2 Teachers from Kelvin Grove State College (KGSC) held at both Queensland University of Technology (QUT) Gardens Point Campus and The Edge, State Library of Queensland. Mentored by 4 design professionals, 2 tertiary design academics, 2 public artists, and 12 QUT tertiary design students, the workshop explored youth-inspired public space design solutions for the active Brisbane City Council redevelopment site of Queens Wharf Road precinct. As well as the face-to-face workshops, for Living City 2013, an interactive web environment was introduced to enable students to connect with each other and program mentors throughout the course of the program. The workshop, framed within notions of ecological, economic, social and cultural sustainability, aimed to raise awareness of the layered complexity and perspectives involved in the design of shared city spaces and to encourage young people to voice their own concerns as future citizens about the shape and direction of their city. The program commenced with an introductory student briefing by stakeholders and mentors at KGSC on 11 February, an introduction to site appraisal and site visit held at QUT and Queens Wharf Road on 20 February, and a follow up site analysis session on 6 March. Day 1 Workshop on April 17 at the Edge, State Library of Queensland, as part of the Design Minds partnership (http://designminds.org.au/kelvin-grove-state-college-excellence-in-art-design/), focused on mentoring team development of a concept design for a range of selected sites. Two workshops on April 22 and 23 at QUT, to develop these designs and presentation schemes, followed this. The workshop program culminated in a visual presentation of concept design ideas and discussion with a public audience in the Ideas Gallery on The Deck, King George Square during the Brisbane City Council City Centre Master Plan Ideas Fiesta on 1 May, 2013, as referenced in the Ideas Fiesta Wrap-up Report (http://www.brisbane.qld.gov.au/planning-building/planning-guidelines-tools/city-centre-master-plan/city-centre-master-plan-ideas-fiesta). Students were introduced to design methodology, team thinking strategies, the scope of design practices and professions, presentation skills and post-secondary pathways, while participating teachers acquired content and design learning strategies transferable in many other contexts. The program was fully documented on the Living City website (http://www.livingcity.net.au/LC2013x/index.html) and has been recognised by the Brisbane City Council Youth Strategy 2014-2019 as a best practice model for making Brisbane a well-designed, subtropical city.

Random Gabor based templates for facial expression recognition in images with facial occlusion

Robust facial expression recognition (FER) under occluded face conditions is challenging. It requires robust algorithms of feature extraction and investigations into the effects of different types of occlusion on the recognition performance to gain insight. Previous FER studies in this area have been limited. They have spanned recovery strategies for loss of local texture information and testing limited to only a few types of occlusion and predominantly a matched train-test strategy. This paper proposes a robust approach that employs a Monte Carlo algorithm to extract a set of Gabor based part-face templates from gallery images and converts these templates into template match distance features. The resulting feature vectors are robust to occlusion because occluded parts are covered by some but not all of the random templates. The method is evaluated using facial images with occluded regions around the eyes and the mouth, randomly placed occlusion patches of different sizes, and near-realistic occlusion of eyes with clear and solid glasses. Both matched and mis-matched train and test strategies are adopted to analyze the effects of such occlusion. Overall recognition performance and the performance for each facial expression are investigated. Experimental results on the Cohn-Kanade and JAFFE databases demonstrate the high robustness and fast processing speed of our approach, and provide useful insight into the effects of occlusion on FER. The results on the parameter sensitivity demonstrate a certain level of robustness of the approach to changes in the orientation and scale of Gabor filters, the size of templates, and occlusions ratios. Performance comparisons with previous approaches show that the proposed method is more robust to occlusion with lower reductions in accuracy from occlusion of eyes or mouth.

Matching image sets via adaptive multi convex hull

Traditional nearest points methods use all the samples in an image set to construct a single convex or affine hull model for classification. However, strong artificial features and noisy data may be generated from combinations of training samples when significant intra-class variations and/or noise occur in the image set. Existing multi-model approaches extract local models by clustering each image set individually only once, with fixed clusters used for matching with various image sets. This may not be optimal for discrimination, as undesirable environmental conditions (eg. illumination and pose variations) may result in the two closest clusters representing different characteristics of an object (eg. frontal face being compared to non-frontal face). To address the above problem, we propose a novel approach to enhance nearest points based methods by integrating affine/convex hull classification with an adapted multi-model approach. We first extract multiple local convex hulls from a query image set via maximum margin clustering to diminish the artificial variations and constrain the noise in local convex hulls. We then propose adaptive reference clustering (ARC) to constrain the clustering of each gallery image set by forcing the clusters to have resemblance to the clusters in the query image set. By applying ARC, noisy clusters in the query set can be discarded. Experiments on Honda, MoBo and ETH-80 datasets show that the proposed method outperforms single model approaches and other recent techniques, such as Sparse Approximated Nearest Points, Mutual Subspace Method and Manifold Discriminant Analysis.

Improved image set classification via joint sparse approximated nearest subspaces

Existing multi-model approaches for image set classification extract local models by clustering each image set individually only once, with fixed clusters used for matching with other image sets. However, this may result in the two closest clusters to represent different characteristics of an object, due to different undesirable environmental conditions (such as variations in illumination and pose). To address this problem, we propose to constrain the clustering of each query image set by forcing the clusters to have resemblance to the clusters in the gallery image sets. We first define a Frobenius norm distance between subspaces over Grassmann manifolds based on reconstruction error. We then extract local linear subspaces from a gallery image set via sparse representation. For each local linear subspace, we adaptively construct the corresponding closest subspace from the samples of a probe image set by joint sparse representation. We show that by minimising the sparse representation reconstruction error, we approach the nearest point on a Grassmann manifold. Experiments on Honda, ETH-80 and Cambridge-Gesture datasets show that the proposed method consistently outperforms several other recent techniques, such as Affine Hull based Image Set Distance (AHISD), Sparse Approximated Nearest Points (SANP) and Manifold Discriminant Analysis (MDA).

Myogel, a novel, basement membrane-rich, extracellular matrix derived from skeletal muscle, is highly adipogenic in vivo and in vitro

Background/Aims Biological and synthetic scaffolds play important roles in tissue engineering and are being developed towards human clinical applications. Based on previous work from our laboratory, we propose that extracellular matrices from skeletal muscle could be developed for adipose tissue engineering. Methods Extracellular matrices (Myogels) extracted from skeletal muscle of various species were assessed using biochemical assays including ELISA and Western blotting. Biofunctionality was assessed using an in vitro differentiation assay and a tissue engineering construct model in the rat. Results Myogels were successfully extracted from mice, rats, pigs and humans. Myogels contained significant levels of laminin α4- and α2-subunits and collagen I compared to Matrigel™, which contains laminin 1 (α1β1γ1) and collagen IV. Levels of growth factors such as fibroblast growth factor 2 were significantly higher than Matrigel, vascular endothelial growth factor-A levels were significantly lower and all other growth factors were comparable. Myogels reproducibly stimulated adipogenic differentiation of preadipocytes in vitro and the growth of adipose tissue in the rat. Conclusions We found Myogel induces adipocyte differentiation in vitroand shows strong adipogenic potential in vivo, inducing the growth of well-vascularised adipose tissue. Myogel offers an alternative for current support scaffolds in adipose tissue engineering, allowing the scaling up of animal models towards clinical adipose tissue engineering applications.

Undulating matter : a topology of the studio

With specific reference to the writing of Dan Graham and the experiences of creative practice, this paper will elaborate an account of studio practice as a topology - a theory drawn from mathematics in which space is understood not as a static field but in terms of properties of connectedness, movement and differentiation. This paper will trace a brief sequence of topological formulations to draw together the expression of topology as form and its structural dimension as a methodology in the specific context of the author’s studio practice. In so doing, this paper seeks to expand the notion of topology in art beyond its association with Conceptual Art of the 1960s and 70s to propose that topology provides a dynamic theoretical model for apprehending the generative ‘logic’ that gives direction and continuity to the art-making process.

Validation of a framework for measuring hospital disaster resilience using factor analysis

Hospital disaster resilience can be defined as “the ability of hospitals to resist, absorb, and respond to the shock of disasters while maintaining and surging essential health services, and then to recover to its original state or adapt to a new one.” This article aims to provide a framework which can be used to comprehensively measure hospital disaster resilience. An evaluation framework for assessing hospital resilience was initially proposed through a systematic literature review and Modified-Delphi consultation. Eight key domains were identified: hospital safety, command, communication and cooperation system, disaster plan, resource stockpile, staff capability, disaster training and drills, emergency services and surge capability, and recovery and adaptation. The data for this study were collected from 41 tertiary hospitals in Shandong Province in China, using a specially designed questionnaire. Factor analysis was conducted to determine the underpinning structure of the framework. It identified a four-factor structure of hospital resilience, namely, emergency medical response capability (F1), disaster management mechanisms (F2), hospital infrastructural safety (F3), and disaster resources (F4). These factors displayed good internal consistency. The overall level of hospital disaster resilience (F) was calculated using the scoring model: F = 0.615F1 + 0.202F2 + 0.103F3 + 0.080F4. This validated framework provides a new way to operationalise the concept of hospital resilience, and it is also a foundation for the further development of the measurement instrument in future studies.

Medial temporal lobe roles in human path integration

Path integration is a process in which observers derive their location by integrating self-motion signals along their locomotion trajectory. Although the medial temporal lobe (MTL) is thought to take part in path integration, the scope of its role for path integration remains unclear. To address this issue, we administered a variety of tasks involving path integration and other related processes to a group of neurosurgical patients whose MTL was unilaterally resected as therapy for epilepsy. These patients were unimpaired relative to neurologically intact controls in many tasks that required integration of various kinds of sensory self-motion information. However, the same patients (especially those who had lesions in the right hemisphere) walked farther than the controls when attempting to walk without vision to a previewed target. Importantly, this task was unique in our test battery in that it allowed participants to form a mental representation of the target location and anticipate their upcoming walking trajectory before they began moving. Thus, these results put forth a new idea that the role of MTL structures for human path integration may stem from their participation in predicting the consequences of one's locomotor actions. The strengths of this new theoretical viewpoint are discussed.

Intercalation of dodecylamine into kaolinite and its layering structure investigated by molecular dynamics simulation

Dodecylamine was successfully intercalated into the layer space of kaolinite by utilizing the methanol treated kaolinite–dimethyl sulfoxide (DMSO) intercalation complex as an intermediate. The basal spacing of kaolinite, measured by X-ray diffraction (XRD), increased from 0.72 nm to 4.29 nm after the intercalation of dodecylamine. Also, the significant variation observed in the Fourier Transform Infrared Spectroscopy (FTIR) spectra of kaolinite when intercalated with dodecylamine verified the feasibility of intercalation of dodecylamine into kaolinite. Isothermal-isobaric (NPT) molecular dynamics simulation with the use of Dreiding force field was performed to probe into the layering behavior and structure of nanoconfined dodecylamine in the kaolinite gallery. The concentration profiles of the nitrogen atom, methyl group and methylene group of intercalated dodecylamine molecules in the direction perpendicular to the kaolinite basal surface indicated that the alkyl chains within the interlayer space of kaolinite exhibited an obvious layering structure. However, the unified bilayer, pseudo-trilayer, or paraffin-type arrangements of alkyl chains deduced based on their chain length combined with the measured basal spacing of organoclays were not found in this study. The alkyl chains aggregated to a mixture of ordered paraffin-type-like structure and disordered gauche conformation in the middle interlayer space of kaolinite, and some alkyl chains arranged in two bilayer structures, in which one was close to the silica tetrahedron surface, and the other was close to the alumina octahedron surface with their alkyl chains parallel to the kaolinite basal surface.

Personality disorders

This chapter explains the main categories of personality disorders and their diagnosis.Nursing interventions are described, and challenges working with people who have personality disorders are discussed.Limitations in our understanding of personality disorders, and problems of categorisation, diagnosis and treatment are also discussed.

Funding emergency care : Australian style

The ongoing challenge for ED leaders is to remain abreast of system-wide changes that impact on the day-to-day management of their departments. Changes to the funding model creates another layer of complexity and this introductory paper serves as the beginning of a discussion about the way in which EDs are funded and how this can and will impact on business decisions, models of care and resource allocation within Australian EDs. Furthermore it is evident that any funding model today will mature and change with time, and moves are afoot to refine and contextualise ED funding over the medium term. This perspective seeks to provide a basis of understanding for our current and future funding arrangements in Australian EDs.

Senataxin plays an essential role with DNA damage response proteins in meiotic recombination and gene silencing

Senataxin, mutated in the human genetic disorder ataxia with oculomotor apraxia type 2 (AOA2), plays an important role in maintaining genome integrity by coordination of transcription, DNA replication, and the DNA damage response. We demonstrate that senataxin is essential for spermatogenesis and that it functions at two stages in meiosis during crossing-over in homologous recombination and in meiotic sex chromosome inactivation (MSCI). Disruption of the Setx gene caused persistence of DNA double-strand breaks, a defect in disassembly of Rad51 filaments, accumulation of DNA:RNA hybrids (R-loops), and ultimately a failure of crossing-over. Senataxin localised to the XY body in a Brca1-dependent manner, and in its absence there was incomplete localisation of DNA damage response proteins to the XY chromosomes and ATR was retained on the axial elements of these chromosomes, failing to diffuse out into chromatin. Furthermore persistence of RNA polymerase II activity, altered ubH2A distribution, and abnormal XY-linked gene expression in Setx⁻/⁻ revealed an essential role for senataxin in MSCI. These data support key roles for senataxin in coordinating meiotic crossing-over with transcription and in gene silencing to protect the integrity of the genome.

Functional role for senataxin, defective in ataxia oculomotor apraxia type 2, in transcriptional regulation

Ataxia oculomotor apraxia type 2 (AOA2) is an autosomal recessive neurodegenerative disorder characterized by cerebellar ataxia and oculomotor apraxia. The gene mutated in AOA2, SETX, encodes senataxin, a putative DNA/RNA helicase which shares high homology to the yeast Sen1p protein and has been shown to play a role in the response to oxidative stress. To investigate further the function of senataxin, we identified novel senataxin-interacting proteins, the majority of which are involved in transcription and RNA processing, including RNA polymerase II. Binding of RNA polymerase II to candidate genes was significantly reduced in senataxin deficient cells and this was accompanied by decreased transcription of these genes, suggesting a role for senataxin in the regulation/modulation of transcription. RNA polymerase II-dependent transcription termination was defective in cells depleted of senataxin in keeping with the observed interaction of senataxin with poly(A) binding proteins 1 and 2. Splicing efficiency of specific mRNAs and alternate splice-site selection of both endogenous genes and artificial minigenes were altered in senataxin depleted cells. These data suggest that senataxin, similar to its yeast homolog Sen1p, plays a role in coordinating transcriptional events, in addition to its role in DNA repair.

Absent interiors

Anuradha Mathur and Dilip da Cunha theorise in their work on cities and flooding that it is not the floodwaters that threaten lives and homes, the real cause of danger in natural disaster is the fixity of modern civilisation. Their work traces the fluidity of the boundaries between 'dry' and 'wet' land challenging the deficiencies of traditional cartography in representing the extents of bodies of water. Mathur and da Cunha propose a process of unthinking to address the redevelopment of communities in the aftermath of natural disaster. By documenting the path of floodwaters in non-Euclidean space they propose a more appropriate response to flooding. This research focuses on the documentation of flooding in the interior of dwellings, which is an extreme condition of damage by external conditions in an environment designed to protect from these very elements. Because the floodwaters don't discriminate between the interior and the exterior, they move between structures with disregard for the systems of space we have in place. With the rapid clean up that follows flood damage, little material evidence is left for post mortem examination. This is especially the case for the flood damaged interior, piles of materials susceptible to the elements, furniture, joinery and personal objects line curbsides awaiting disposal. There is a missed opportunity in examining the interior in the after math of flood, in the way that Mathur and Dilip investigate floods and the design of cities, the flooded interior proffers an undersigned interior to study. In the absence of intact flood damaged interior, this research relies on two artists' documentation of the flooded interior. The first case study is the mimetic scenographic interiors of a flood-damaged office exhibited in the Bangkok art gallery by the group _Proxy in 2011. The second case study is Robert Polidori's photographic exhibition in New Orleans, described by Julianna Preston as, 'a series of interiors undetected by satellite imaging or storm radar. More telling, more dramatic, more unnerving, more alarming, they force a disturbance of what is familiar'.