Impacts and adaptation response of infrastructure and communities to heatwaves : the southern Australian experience of 2009

From 27 January to 8 February during the summer of 2009, southern Australia experienced one of the nation‘s most severe heatwaves. Governments, councils, utilities, hospitals and emergency response organisations and the community were largely underprepared for an extreme event of this magnitude. This case study targets the experience and challenges faced by decision makers and policy makers and focuses on the major metropolitan areas affected by the heatwave — Melbourne and Adelaide. The study examines the 2009 heatwave‘s characteristics; its impacts (on human health, infrastructure and human services); the degree of adaptive capacity (vulnerability and resilience) of various sectors, communities and individuals; and the reactive responses of government and emergency and associated services and their effectiveness. Barriers and challenges to adaptation and increasing resilience are also identified and further areas for research are suggested. This study does not include details of the heatwave‘s effects beyond Victoria and South Australia, or its economic impacts, or of Victoria‘s 'Black Saturday‘ bushfires.

Impact of zooming and enhancing Region of Interests for optimizing user experience on mobile sports video

In mobile videos, small viewing size and bitrate limitation often cause unpleasant viewing experiences, which is particularly important for fast-moving sports videos. For optimizing the overall user experience of viewing sports videos on mobile phones, this paper explores the benefits of emphasizing Region of Interest (ROI) by 1) zooming in and 2) enhancing the quality. The main goal is to measure the effectiveness of these two approaches and determine which one is more effective. To obtain a more comprehensive understanding of the overall user experience, the study considers user’s interest in video content and user’s acceptance of the perceived video quality, and compares the user experience in sports videos with other content types such as talk shows. The results from a user study with 40 subjects demonstrate that zooming and ROI-enhancement are both effective in improving the overall user experience with talk show and mid-shot soccer videos. However, for the full-shot scenes in soccer videos, only zooming is effective while ROI-enhancement has a negative effect. Moreover, user’s interest in video content directly affects not only the user experience and the acceptance of video quality, but also the effect of content type on the user experience. Finally, the overall user experience is closely related to the degree of the acceptance of video quality and the degree of the interest in video content. This study is valuable in exploiting effective approaches to improve user experience, especially in mobile sports video streaming contexts, whereby the available bandwidth is usually low or limited. It also provides further understanding of the influencing factors of user experience.

A model for integrating clinical care and basic science research, and pitfalls of performing complex research projects for addressing a clinical challenge

The collaboration of clinicians with basic science researchers is crucial for addressing clinically relevant research questions. In order to initiate such mutually beneficial relationships, we propose a model where early career clinicians spend a designated time embedded in established basic science research groups, in order to pursue a postgraduate qualification. During this time, clinicians become integral members of the research team, fostering long term relationships and opening up opportunities for continuing collaboration. However, for these collaborations to be successful there are pitfalls to be avoided. Limited time and funding can lead to attempts to answer clinical challenges with highly complex research projects characterised by a large number of "clinical" factors being introduced in the hope that the research outcomes will be more clinically relevant. As a result, the complexity of such studies and variability of its outcomes may lead to difficulties in drawing scientifically justified and clinically useful conclusions. Consequently, we stress that it is the basic science researcher and the clinician's obligation to be mindful of the limitations and challenges of such multi-factorial research projects. A systematic step-by-step approach to address clinical research questions with limited, but highly targeted and well defined research projects provides the solid foundation which may lead to the development of a longer term research program for addressing more challenging clinical problems. Ultimately, we believe that it is such models, encouraging the vital collaboration between clinicians and researchers for the work on targeted, well defined research projects, which will result in answers to the important clinical challenges of today.

Clinical outcomes in residential care : setting benchmarks for quality

Aim Australian residential aged care does not have a system of quality assessment related to clinical outcomes, or comprehensive quality benchmarking. The Residential Care Quality Assessment was developed to fill this gap; and this paper discusses the process by which preliminary benchmarks representing high and low quality were developed for it. Methods Data were collected from all residents (n = 498) of nine facilities. Numerator–denominator analysis of clinical outcomes occurred at a facility-level, with rank-ordered results circulated to an expert panel. The panel identified threshold scores to indicate excellent and questionable care quality, and refined these through Delphi process. Results Clinical outcomes varied both within and between facilities; agreed thresholds for excellent and poor outcomes were finalised after three Delphi rounds. Conclusion Use of the Residential Care Quality Assessment provides a concrete means of monitoring care quality and allows benchmarking across facilities; its regular use could contribute to improved care outcomes within residential aged care in Australia.

Prospective, non-randomized phase 2 clinical trial of carboplatin plus paclitaxel with sequential radical pelvic radiotherapy for uterine papillary serous carcinoma

Objective Uterine Papillary Serous Carcinoma (UPSC) is uncommon and accounts for less than 5% of all uterine cancers. Therefore the majority of evidence about the benefits of adjuvant treatment comes from retrospective case series. We conducted a prospective multi-centre non-randomized phase 2 clinical trial using four cycles of adjuvant paclitaxel plus carboplatin chemotherapy followed by pelvic radiotherapy, in order to evaluate the tolerability and safety of this approach. Methods This trial enrolled patients with newly diagnosed, previously untreated patients with stage 1b-4 (FIGO-1988) UPSC with a papillary serous component of at least 30%. Paclitaxel (175 mg/m2) and carboplatin (AUC 6) were administered on day 1 of each 3-week cycle for 4 cycles. Chemotherapy was followed by external beam radiotherapy to the whole pelvis (50.4 Gy over 5.5 weeks). Completion and toxicity of treatment (Common Toxicity Criteria, CTC) and quality of life measures were the primary outcome indicators. Results Twenty-nine of 31 patients completed treatment as planned. Dose reduction was needed in 9 patients (29%), treatment delay in 7 (23%), and treatment cessation in 2 patients (6.5%). Hematologic toxicity, grade 3 or 4 occurred in 19% (6/31) of patients. Patients' self-reported quality of life remained stable throughout treatment. Thirteen of the 29 patients with stages 1–3 disease (44.8%) recurred (average follow up 28.1 months, range 8–60 months). Conclusion This multimodal treatment is feasible, safe and tolerated reasonably well and would be suitable for use in multi-institutional prospective randomized clinical trials incorporating novel therapies in patients with UPSC.

Rumination, post-traumatic growth, and distress : structural equation modelling with cancer survivors

Objective Theoretical models of post-traumatic growth (PTG) have been derived in the general trauma literature to describe the post-trauma experience that facilitates the perception of positive life changes. To develop a statistical model identifying factors that are associated with PTG, structural equation modelling (SEM) was used in the current study to assess the relationships between perception of diagnosis severity, rumination, social support, distress, and PTG. Method A statistical model of PTG was tested in a sample of participants diagnosed with a variety of cancers (N=313). Results An initial principal components analysis of the measure used to assess rumination revealed three components: intrusive rumination, deliberate rumination of benefits, and life purpose rumination. SEM results indicated that the model fit the data well and that 30% of the variance in PTG was explained by the variables. Trauma severity was directly related to distress, but not to PTG. Deliberately ruminating on benefits and social support were directly related to PTG. Life purpose rumination and intrusive rumination were associated with distress. Conclusions The model showed that in addition to having unique correlating factors, distress was not related to PTG, thereby providing support for the notion that these are discrete constructs in the post-diagnosis experience. The statistical model provides support that post-diagnosis experience is simultaneously shaped by positive and negative life changes and that one or the other outcome may be prevalent or may occur concurrently. As such, an implication for practice is the need for supportive care that is holistic in nature.

The QUT creative industries experience

This publication assembles essays by people who are leading voices and practitioners in the creative industries, writing from the perspectives of education, research and business development. The idea for the publication arose from a request in 2007 from key Chinese policy academics for information on what they called ‘The Queensland model’. Apart from a co-authored article published in Chinese in that year by three of the contributors to this publication, there was little assembled evidence of the model. The interest from China culminated in requests to visit and see the Queensland model first hand. Since 2007, there have been many visitors to the Creative Industries Precinct and the Kelvin Grove Urban Village. The tours have generally taken people to different organisational units within the larger complex. This publication follows this approach but also shows how the various organisational units are integrated.

Clinical investigation of asmofilcon A silicone hydrogel lenses

Purpose. To investigate the clinical and subjective performance of asmofilcon A, a new third generation silicone hydrogel contact lens during 6-night extended wear (EW) over 6 months. Methods. A prospective, randomized, single-masked study was conducted. Sixty experienced daily wear soft contact lens wearers were randomly assigned to wear either asmofilcon A or senofilcon A contact lenses bilaterally for 6 months on an EW basis. Evaluations were conducted at contact lens delivery and after 1 week, 4 weeks, 3 and 6 months of EW. Results. Fifty subjects (83%) successfully completed the study. Two subjects experienced adverse events; one unilateral red eye with asmofilcon A and one asymptomatic infiltrate with senofilcon A. There were no significant differences in high or low contrast distance visual acuity between asmofilcon A and senofilcon A; however, low contrast distance visual acuity decreased significantly over time with both contact lens types (p < 0.05). The two lens types did not vary significantly with respect to any of the objective and subjective measures assessed (p > 0.05). Superior palpebral conjunctival injection showed a statistically significant increase over time with both lens types (p < 0.05). Both lens types were rated highly with respect to overall comfort, with subjects reporting 14 or 15 h of comfortable lens wearing time per day at each of the study visits (p > 0.05). Overall satisfaction ratings were also very high at all visits, with median scores of 95 (86 to 99) for asmofilcon A and 90 (85 to 96) for senofilcon A at 6 months (p > 0.05). Conclusions. Over 6 months of EW, the asmofilcon A contact lens performed in a similar manner to senofilcon A with respect to visual acuity, ocular health, and contact lens performance measures. Longer-term EW studies are required to investigate the changes over time observed with both lens types.

Emotional experience with portable health devices

This paper reports on a six month longitudinal study exploring people’s personal and social emotional experience with health related portable interactive devices (PIDs). The focus is on emotions and how health PIDs mediate this experience in everyday contexts. The study reported here is an extension of a previous experiment conducted by the authors exploring media related PIDs [1]. The findings identified interesting aspects of health device interaction. Findings revealed people interact with health PIDs emotionally both at a personal and a social level. However, in contrast to media PIDs, participants reported significantly less social experiences than personal experiences. Nevertheless, the social level plays an important role such that negative social experiences had a significant influence on the perceived emotional experience over the course of six months. When no negative social experiences were reported the emotional experience over the course of six months became neutral. The findings are discussed in regards to their significance to the field of design, their implication for future health PID design and future research directions.

Survey of novice motorcycle riders and their riding experience before licensing

Graduated licensing schemes have been found to reduce the crash risk of young novice drivers, but there is less evidence of their success with novice motorcycle riders. This study examined the riding experience of a sample of Australian learner-riders to establish the extent and variety of their riding practice during the learner stage. Riders completed an anonymous questionnaire at a compulsory rider-training course for the licensing test. The majority of participants were male (81%) with an average age of 33 years. They worked full time (81%), held an unrestricted driver's license (81%), and owned the motorcycle that they rode (79%). These riders had held their learner's license for an average of 6 months. On average, they rode 6.4 h/week. By the time they attempted the rider-licensing test, they had ridden a total of 101 h. Their total hours of on-road practice were comparable to those of learner-drivers at the same stage of licensing, but they had less experience in adverse or challenging road conditions. A substantial proportion had little or no experience of riding in the rain (57%), at night (36%), in heavy traffic (22%), on winding rural roads (52%), or on high-speed roads (51%). These findings highlight the differences in the learning processes between unsupervised novice motorcycle riders and supervised novice drivers. Further research is necessary to clarify whether specifying the conditions under which riders should practice during the graduated licensing process would likely reduce or increase their crash risk.

Conceptualising a capstone experience for law students

Currently the final year curriculum in most, if not all, Australian law schools is delivered in a disjointed way which is not engaging final year students in a genuine capstone experience that supports the development of their professional identity and their transition out of university. The possible benefits of a capstone experience include preparing law students for the practice of law by assisting them to synthesise and extend their knowledge and skills, develop a professional identity that incorporates moral, ethical and social values, and become skilled problem solvers and life-long learners who can meet the rigours of the dynamic, competitive, and challenging world of twenty-first century legal practice. In 2009 the ALTC funded the “Curriculum renewal in legal education” project which seeks to achieve curriculum renewal for legal education through the articulation of a set of curriculum design principles for the final year and the design of a transferable model for an effective final year program. The three cornerstone capstone curriculum objectives identified by the project are closure of the tertiary experience, reflection on that experience, and transitioning from university student to legal professional. These cornerstone curriculum objectives will inform the development of the final year principles and model program. This paper will report on the progress that has been made on the project including a meeting of the project reference group held in February 2010 and the draft curriculum design principles.

Assessing the capstone experience : conceptualising a capstone experience for law students

Assessment Principle -- -- The capstone experience should include assessment that: 1: Enables students to apply their knowledge skills and capabilities in an authentic context ; 2: Tests whether or not students are able to apply knowledge skills and capabilities in unfamiliar contexts ; 3: Incorporates feedback from a multitude of sources including peers and self‐reflection to enable students to become self‐reliant and to exercise their own professional judgment ; 4: Recognises the culminating nature of the capstone experience.

Clinical indicators of quality for Australian residential aged care facilities : establishing reliability, validity, and quality thresholds

Background: In response to the need for more comprehensive quality assessment within Australian residential aged care facilities, the Clinical Care Indicator (CCI) Tool was developed to collect outcome data as a means of making inferences about quality. A national trial of its effectiveness and a Brisbane-based trial of its use within the quality improvement context determined the CCI Tool represented a potentially valuable addition to the Australian aged care system. This document describes the next phase in the CCI Tool.s development; the aims of which were to establish validity and reliability of the CCI Tool, and to develop quality indicator thresholds (benchmarks) for use in Australia. The CCI Tool is now known as the ResCareQA (Residential Care Quality Assessment). Methods: The study aims were achieved through a combination of quantitative data analysis, and expert panel consultations using modified Delphi process. The expert panel consisted of experienced aged care clinicians, managers, and academics; they were initially consulted to determine face and content validity of the ResCareQA, and later to develop thresholds of quality. To analyse its psychometric properties, ResCareQA forms were completed for all residents (N=498) of nine aged care facilities throughout Queensland. Kappa statistics were used to assess inter-rater and test-retest reliability, and Cronbach.s alpha coefficient calculated to determine internal consistency. For concurrent validity, equivalent items on the ResCareQA and the Resident Classification Scales (RCS) were compared using Spearman.s rank order correlations, while discriminative validity was assessed using known-groups technique, comparing ResCareQA results between groups with differing care needs, as well as between male and female residents. Rank-ordered facility results for each clinical care indicator (CCI) were circulated to the panel; upper and lower thresholds for each CCI were nominated by panel members and refined through a Delphi process. These thresholds indicate excellent care at one extreme and questionable care at the other. Results: Minor modifications were made to the assessment, and it was renamed the ResCareQA. Agreement on its content was reached after two Delphi rounds; the final version contains 24 questions across four domains, enabling generation of 36 CCIs. Both test-retest and inter-rater reliability were sound with median kappa values of 0.74 (test-retest) and 0.91 (inter-rater); internal consistency was not as strong, with a Chronbach.s alpha of 0.46. Because the ResCareQA does not provide a single combined score, comparisons for concurrent validity were made with the RCS on an item by item basis, with most resultant correlations being quite low. Discriminative validity analyses, however, revealed highly significant differences in total number of CCIs between high care and low care groups (t199=10.77, p=0.000), while the differences between male and female residents were not significant (t414=0.56, p=0.58). Clinical outcomes varied both within and between facilities; agreed upper and lower thresholds were finalised after three Delphi rounds. Conclusions: The ResCareQA provides a comprehensive, easily administered means of monitoring quality in residential aged care facilities that can be reliably used on multiple occasions. The relatively modest internal consistency score was likely due to the multi-factorial nature of quality, and the absence of an aggregate result for the assessment. Measurement of concurrent validity proved difficult in the absence of a gold standard, but the sound discriminative validity results suggest that the ResCareQA has acceptable validity and could be confidently used as an indication of care quality within Australian residential aged care facilities. The thresholds, while preliminary due to small sample size, enable users to make judgements about quality within and between facilities. Thus it is recommended the ResCareQA be adopted for wider use.