The effect of exercise training on sleep quality in heart failure

Background: Heart failure is a serious condition estimated to affect 1.5-2.0% of the Australian population with a point prevalence of approximately 1% in people aged 50-59 years, 10% in people aged 65 years or more and over 50% in people aged 85 years or over (National Heart Foundation of Australian and the Cardiac Society of Australia and New Zealand, 2006). Sleep disturbances are a common complaint of persons with heart failure. Disturbances of sleep can worsen heart failure symptoms, impair independence, reduce quality of life and lead to increased health care utilisation in patients with heart failure. Previous studies have identified exercise as a possible treatment for poor sleep in patients without cardiac disease however there is limited evidence of the effect of this form of treatment in heart failure. Aim: The primary objective of this study was to examine the effect of a supervised, hospital-based exercise training programme on subjective sleep quality in heart failure patients. Secondary objectives were to examine the association between changes in sleep quality and changes in depression, exercise performance and body mass index. Methods: The sample for the study was recruited from metropolitan and regional heart failure services across Brisbane, Queensland. Patients with a recent heart failure related hospital admission who met study inclusion criteria were recruited. Participants were screened by specialist heart failure exercise staff at each site to ensure exercise safety prior to study enrolment. Demographic data, medical history, medications, Pittsburgh Sleep Quality Index score, Geriatric Depression Score, exercise performance (six minute walk test), weight and height were collected at Baseline. Pittsburgh Sleep Quality Index score, Geriatric Depression Score, exercise performance and weight were repeated at 3 months. One hundred and six patients admitted to hospital with heart failure were randomly allocated to a 3-month disease-based management programme of education and self-management support including standard exercise advice (Control) or to the same disease management programme as the Control group with the addition of a tailored physical activity program (Intervention). The intervention consisted of 1 hour of aerobic and resistance exercise twice a week. Programs were designed and supervised by an exercise specialist. The main outcome measure was achievement of a clinically significant change (.3 points) in global Pittsburgh Sleep Quality score. Results: Intervention group participants reported significantly greater clinical improvement in global sleep quality than Control (p=0.016). These patients also exhibited significant improvements in component sleep disturbance (p=0.004), component sleep quality (p=0.015) and global sleep quality (p=0.032) after 3 months of supervised exercise intervention. Improvements in sleep quality correlated with improvements in depression (p<0.001) and six minute walk distance (p=0.04). When study results were examined categorically, with subjects classified as either "poor" or "good" sleepers, subjects in the Control group were significantly more likely to report "poor" sleep at 3 months (p=0.039) while Intervention participants were likely to report "good" sleep at this time (p=0.08). Conclusion: Three months of supervised, hospital based, aerobic and resistance exercise training improved subjective sleep quality in patients with heart failure. This is the first randomised controlled trial to examine the role of aerobic and resistance exercise training in the improvement of sleep quality for patients with this disease. While this study establishes exercise as a therapy for poor sleep quality, further research is needed to investigate the effect of exercise training on objective parameters of sleep in this population.

Impact of recent coastal development and human activities on Nha Trang Bay, Vietnam : evidence from a Porites lutea geochemical record

Nha Trang Bay (NTB) is located on the Central Vietnam coast, western South China Sea. Recent coastal development of Nha Trang City has raised public concern over an increasing level of pollution within the bay and degradation of nearby coral reefs. In this study, multiple proxies (e.g., trace metals, rare earth elements (REEs), and Y/Ho) recorded in a massive Porites lutea coral colony were used to reconstruct changes in seawater conditions in the NTB from 1995 to 2009. A 14-year record of REEs and other trace metals revealed that the concentrations of terrestrial trace metals have increased dramatically in response to an increase in coastal development projects such as road, port, and resort constructions, port and river dredging, and dumping activities since 2000. The effects of such developmental processes are also evident in changes in REE patterns and Y/Ho ratios through time, suggesting that both parameters are critical proxies for marine pollution.

Newstead House : the social history, culture and architecture of a bygone era

Historic house museums form a significant component of the built heritage and social history of a country. They vary from the elaborate mansions of the wealthy to modest dwellings of the working class. Regardless of the original owner's status in society these house museums are vital to an understanding of architecture, culture and society from a bygone era. The Newstead House, the oldest surviving residence, in Brisbane, is the first house to be designated a 'Historic House Museum' in Queensland. It is a representative example of a house that demonstrates the British colonial heritage of 19th century Australia. Originally a modest cottage, on 34 acres of land, the Newstead house was built by a Scottish migrant. The ownership of the house and land changed many times, during the period from 1847 to 1939. During this period a series of prominent residents of Brisbane either owned or rented this residence. They included, an officer of the Royal Navy, politicians, magistrates, merchant ship owners, and a Consul General of the United States of America. As a result, the house went through a series of renovations and extensions to accommodate the needs of its owners and their position in society. This paper aims to investigate the significance of historic museum houses in educating the community on aspects of social history, culture and architecture of 19th century Australia. It will focus on the heritage listed Newstead House as a case study to demonstrate the significance of the house as an artefact and an educational tool.

The CGT small business concessions : recent evidence from the perspective of the tax practitioner

On 21 September 1999 Division 152 was inserted into the Income Tax Assessment Act (1997) (ITAA 1997). It was subsequently subject to amendments in 2006. Division 152 contains the small business CGT concessions, which enables eligible small business taxpayers to reduce the amount of tax payable on capital gains arising from certain CGT events (including the sale of the small business itself) that occur after 11:45 am on 21 September 1999. One of the stated principal objectives of the legislation was to provide a concessionary regime for small business owners who did not have the same ability to access the concessionary superannuation regime (particularly the superannuation guarantee charge) generally available to employees. The then Federal Treasurer, Mr Peter Costello, when announcing the introduction of the concessions, specifically stated that the object of Div 152 was to provide “small business people with access to funds for retirement or expansion”. The purpose of this project is to: one, assess the extent to which small business taxpayers understand the CGT small business concessions, particularly when considering sale of their business; two, determine which of the four small business CGT concessions are being adopted and/or recommended by tax advisors to clients; and three, determine whether the recent superannuation changes announced by the Federal Government in relation to the capping of the concessional superannuation thresholds have had an impact on the use of the small business retirement concession. It is anticipated that the results of this study will reveal that that small business owners are reliant on their tax advisors to explain the operation of Division 152. It is plausible that give the complexity of the CGT concessions, most small business owners are completely unaware of the four small business CGT concessions contained in Division 152 and do not understand how these concessions apply. Our study will also reveal the extent to which each CGT small business concession has been adopted (and reasons why). In particular, emphasis will be placed on the adoption of the small business retirement concession contained in Subdivision 152-D (and specific reasons for its adoption). This study also seeks to understand whether the recent (and impending) changes to the concessional superannuation cap has resulted in the retirement concession being more widely adopted (or recommended) by tax advisors. We would expect that the results of our study to confirm this to be the case, particularly coupled with the recent economic downturn, which has led to lower superannuation fund balances. By providing accounting firms with this information, small business owners will benefit from the information, becoming better placed to be long-term self funded retirees, providing not only financial benefits to the individuals and the country, but a significant increase in social self-assurance by these members of the community.

“We eat more than kangaroo tail or dugong you know…” : recent indigenous Australian cookbooks

This paper focuses on a series of cookbooks published by Indigenous Australian groups. These cookbooks are typically produced with government funding, and are developed by nutritionists, dieticians, and health workers in consultation with local communities. They are designed to teach Indigenous Australians to cook healthy, nutritious, low-cost meals. In this paper, Fredericks and Anderson identify the value of these cookbooks as low-cost, public health interventions. However, they note that their value as health interventions has not been tested. Fredericks and Anderson question the value of these cookbooks within the broader context of the health disadvantage faced by Indigenous Australians. They argue that the cookbooks are developed from a Western perspective of health and nutrition that fails to recognise the value of traditional Indigenous foodways. They suggest that incorporating more Indigenous food knowledge and food-related traditions into cookbooks may be one way of improving health among Indigenous peoples and revitalising Indigenous knowledge.

Review : "Networking : commercial television in Australia : a history" -- Nick Herd

Nick Herd begins his institutional history of Australian commercial television in the early 1890s, when an amateur inventor named Henry Sutton designed the ‘telephane’ with the intent of watching the Melbourne Cup in his home town of Ballarat. The ‘race that stops a nation’ was not broadcast live on television until 1960, but Sutton’s initiative indicates how closely sport and television were aligned in Australia even before the medium existed. The first licensed commercial stations to begin regular broadcasting went on air in Sydney and Melbourne shortly before the 1956 Melbourne Olympic Games, although Herd claims that this was ‘almost accidental’ rather than planned. (49) Only Melbourne viewers were able to see some events live, many via television sets in Ampol service stations following the company’s last minute sponsorship of coverage on Melbourne station GTV-9...

Life-history constraints in grassland plant species : a growth-defence trade-off is the norm

Plant growth can be limited by resource acquisition and defence against consumers, leading to contrasting trade-off possibilities. The competition-defence hypothesis posits a trade-off between competitive ability and defence against enemies (e.g. herbivores and pathogens). The growth-defence hypothesis suggests that strong competitors for nutrients are also defended against enemies, at a cost to growth rate. We tested these hypotheses using observations of 706 plant populations of over 500 species before and following identical fertilisation and fencing treatments at 39 grassland sites worldwide. Strong positive covariance in species responses to both treatments provided support for a growth-defence trade-off: populations that increased with the removal of nutrient limitation (poor competitors) also increased following removal of consumers. This result held globally across 4 years within plant life-history groups and within the majority of individual sites. Thus, a growth-defence trade-off appears to be the norm, and mechanisms maintaining grassland biodiversity may operate within this constraint.

The difficulty of establishing causation in medical negligence cases : two recent Australian decisions

This editorial on health and guardianship law provides an overview of the causation issues that precluded the recovery of two medical negligence claims in the cases of Wallace v Kam [2013] HCA 19 and Waller v James [2013] NSWSC 497.

Late Quaternary vegetation history of North Stradbroke Island, Queensland, eastern Australia

Currently there is a paucity of records of late Quaternary palaeoenvironmental variability available from the subtropics of Australia. The three continuous palaeoecological records presented here, from North Stradbroke Island, subtropical Queensland, assist in bridging this large spatial gap in the current state of knowledge. The dominance of arboreal taxa in the pollen records throughout the past >40,000 years is in contrast with the majority of records from temperate Australia, and indicates a positive moisture balance for North Stradbroke Island. The charcoal records show considerable inter-site variability indicating the importance of local-scale events on individual records, and highlighting the caution that needs to be applied when interpreting a single site as a regional record. The variability in the burning regimes is interpreted as being influenced by both climatic and human factors. Despite this inter-site variability, broad environmental trends are identifiable, with changes in the three records comparable with the OZ-INTIMATE climate synthesis for the last 35,000 years.

Timing, origin and emplacement dynamics of mass flows offshore of SE Montserrat in the last 110 ka : implications for landslide and tsunami hazards, eruption history, and volcanic island evolution

Mass flows on volcanic islands generated by volcanic lava dome collapse and by larger-volume flank collapse can be highly dangerous locally and may generate tsunamis that threaten a wider area. It is therefore important to understand their frequency, emplacement dynamics, and relationship to volcanic eruption cycles. The best record of mass flow on volcanic islands may be found offshore, where most material is deposited and where intervening hemipelagic sediment aids dating. Here we analyze what is arguably the most comprehensive sediment core data set collected offshore from a volcanic island. The cores are located southeast of Montserrat, on which the Soufriere Hills volcano has been erupting since 1995. The cores provide a record of mass flow events during the last 110 thousand years. Older mass flow deposits differ significantly from those generated by the repeated lava dome collapses observed since 1995. The oldest mass flow deposit originated through collapse of the basaltic South Soufriere Hills at 103-110 ka, some 20-30 ka after eruptions formed this volcanic center. A ∼1.8 km3 blocky debris avalanche deposit that extends from a chute in the island shelf records a particularly deep-seated failure. It likely formed from a collapse of almost equal amounts of volcanic edifice and coeval carbonate shelf, emplacing a mixed bioclastic-andesitic turbidite in a complex series of stages. This study illustrates how volcanic island growth and collapse involved extensive, large-volume submarine mass flows with highly variable composition. Runout turbidites indicate that mass flows are emplaced either in multiple stages or as single events.

Revisiting the trajectories of special teacher education in China through policy and practice

The preparation, recruitment, work, and career of teachers are important in education. This is no exemption for special education. However, the shortage of qualified teachers serving students with disabilities has long been an international problem. In China, both the quantity and the quality of special education teachers are of concern. This places unrelenting pressure on special teacher education. Given its growing size and challenges, special teacher education has received increasing attention from research, policy, and practice. However, there is a dearth of scholarship published in English to address these issues. To the best of our belief and knowledge, there is no systematic, comprehensive, and contextualised examination of special teacher education in China to date. This paper aims to make a contribution in this regard. First, we present the complexities of the Chinese context in which special teacher education is situated. Second, we synthesise recent literature on special teacher education in China through an extensive review of the relevant studies scattered in English publications. Third, we provide insights into special teacher education in China, regarding its trajectory of policy making, its history of development, and its strategies and challenges. Finally, we conclude our paper with some practical recommendations to aid the future development of special teacher education.

Lateral impact response and parametric studies of axially loaded square concrete filled steel tube columns

This paper presents a numerical study on the response of axially loaded slender square concrete filled steel tube (CFST) columns under low velocity lateral impact loading. A finite element analysis (FEA) model was developed using the explicit dynamic nonlinear finite element code LS -DYNA in which the strain rate effects of both steel and concrete, contact between steel tube and concrete and confinement effect provided by the steel tube for the concrete were considered. The model also benefited from a relatively recent feature of LS-DYNA for applying a pre-loading in the explicit solver. The developed numerical model was verified for its accuracy and adequacy by comparing the results with experimental results available in the literature. The verified model was then employed to conduct a parametric study to investigate the influence of axial load level, impact location, support conditions, and slenderness ratio on the response of the CFST columns. A good agreement between the numerical and experimental results was achieved. The model could reasonably predict the impact load-deflection history and deformed shape of the column at the end of the impact event. The results of the parametric study showed that whilst impact location, axial load level and slenderness ratio can have a significant effect on the peak impact force, residual lateral deflection and maximum lateral deflection, the influence of support fixity is minimal. With an increase of axial load to up to a certain level, the peak force increases; however, a further increase in the axial load causes a decrease in the peak force. Both residual lateral deflection and maximum lateral deflection increase as axial load level increases. Shifting the impact location towards the supports increases the peak force and reduces both residual and maximum lateral deflections. A rise in slenderness ratio decreases the peak force and increases the residual and maximum lateral deflections.

Young women's recent experience of labour and birth care in Queensland

Background Young parenthood continues to be an issue of concern in terms of clinical and psychosocial outcomes for mothers and their babies, with higher rates of medical complications such as preterm labour and hypertensive disease and a higher risk of depression. The aim of this study was to investigate how young age impacts on women's experience of intrapartum care. Methods Secondary analysis of data collected in a population based survey of women who had recently given birth in Queensland, comparing clinical and interpersonal aspects of the intrapartum maternity care experience for 237 eligible women aged 15–20 years and 6534 aged more than 20 years. Descriptive and multivariate analyses were undertaken. Results In the univariate analysis a number of variables were significantly associated with clinical aspects of labour and birth and perceptions of care: young women were more likely to birth in a public facility, to travel for birth and to live in less economically advantaged areas, to have a normal vaginal birth and to have one carer through labour. They were also less likely to report being treated with respect and kindness and talked to in a way they could understand. In logistic regression models, after adjustment for parity, other socio-demographic factors and mode of birth, younger mothers were still more likely to birth in a public facility, to travel for birth, to be more critical about interpersonal and aspects of care and the hospital or birth centre environment. Conclusion This study shows how experience of care during labour and birth is different for young women. Young women reported poorer quality interpersonal care which may well reflect an inferior care experience and stereotyping by health professionals, indicating a need for more effective staff engagement with young women at this time.

The consistency of crash involvement recall across time

Introduction Road safety researchers rely heavily on self-report data to explore the aetiology of crash risk. However, researchers consistently acknowledge a range of limitations associated with this methodological approach (e.g., self-report bias), which has been hypothesised to reduce the predictive efficacy of scales. Although well researched in other areas, one important factor often neglected in road safety studies is the fallibility of human memory. Given accurate recall is a key assumption in many studies, the validity and consistency of self-report data warrants investigation. The aim of the current study was to examine the consistency of self-report data of crash history and details of the most recent reported crash on two separate occasions. Materials & Method A repeated measures design was utilised to examine the self-reported crash involvement history of 214 general motorists over a two month period. Results A number of interesting discrepancies were noted in relation to number of lifetime crashes reported by the participants and the descriptions of their most recent crash across the two occasions. Of the 214 participants who reported having been involved in a crash, 35 (22.3%) reported a lower number of lifetime crashes as Time 2, than at Time 1. Of the 88 drivers who reported no change in number of lifetime crashes, 10 (11.4%) described a different most recent crash. Additionally, of the 34 reporting an increase in the number of lifetime crashes, 29 (85.3%) of these described the same crash on both occasions. Assessed as a whole, at least 47.1% of participants made a confirmed mistake at Time 1 or Time 2. Conclusions These results raise some doubt in regard to the accuracy of memory recall across time. Given that self-reported crash involvement is the predominant dependent variable used in the majority of road safety research, this issue warrants further investigation. Replication of the study with a larger sample size that includes multiple recall periods would enhance understanding into the significance of this issue for road safety methodology.