Measuring episodic memory: A novel approach with an indefinite number of alternative forms

Both clinical practice and clinical research settings can require successive administrations of a memory test, particularly when following the trajectory of suspected memory decline in older adults. However, relatively few verbal episodic memory tests have alternative forms. We set out to create a broad based memory test to allow for the use of an essentially unlimited number of alternative forms. Four tasks for inclusion in such a test were developed. These tasks varied the requirement for recall as opposed to recognition, the need to form an association between unrelated words, and the need to discriminate the most recent list from earlier lists, all of which proved useful. A total of 115 participants completed the battery of tests and were used to show that the test could differentiate between older and younger adults; a sub-sample of 73 participants completed alternative forms of the tests to determine test-retest reliability and the amount of learning to learn.

Uncertainty budget in the measurement of typical airborne number, surface area and mass particle distributions

The effects of particulate matter on environment and public health have been widely studied in recent years. A number of studies in the medical field have tried to identify the specific effect on human health of particulate exposure, but agreement amongst these studies on the relative importance of the particles’ size and its origin with respect to health effects is still lacking. Nevertheless, air quality standards are moving, as the epidemiological attention, towards greater focus on the smaller particles. Current air quality standards only regulate the mass of particulate matter less than 10 μm in aerodynamic diameter (PM10) and less than 2.5 μm (PM2.5). The most reliable method used in measuring Total Suspended Particles (TSP), PM10, PM2.5 and PM1 is the gravimetric method since it directly measures PM concentration, guaranteeing an effective traceability to international standards. This technique however, neglects the possibility to correlate short term intra-day variations of atmospheric parameters that can influence ambient particle concentration and size distribution (emission strengths of particle sources, temperature, relative humidity, wind direction and speed and mixing height) as well as human activity patterns that may also vary over time periods considerably shorter than 24 hours. A continuous method to measure the number size distribution and total number concentration in the range 0.014 – 20 μm is the tandem system constituted by a Scanning Mobility Particle Sizer (SMPS) and an Aerodynamic Particle Sizer (APS). In this paper, an uncertainty budget model of the measurement of airborne particle number, surface area and mass size distributions is proposed and applied for several typical aerosol size distributions. The estimation of such an uncertainty budget presents several difficulties due to i) the complexity of the measurement chain, ii) the fact that SMPS and APS can properly guarantee the traceability to the International System of Measurements only in terms of number concentration. In fact, the surface area and mass concentration must be estimated on the basis of separately determined average density and particle morphology. Keywords: SMPS-APS tandem system, gravimetric reference method, uncertainty budget, ultrafine particles.

Development of a particle number and particle mass emissions inventory for an urban fleet : a study in South-East Queensland

Motor vehicles are a major source of gaseous and particulate matter pollution in urban areas, particularly of ultrafine sized particles (diameters < 0.1 µm). Exposure to particulate matter has been found to be associated with serious health effects, including respiratory and cardiovascular disease, and mortality. Particle emissions generated by motor vehicles span a very broad size range (from around 0.003-10 µm) and are measured as different subsets of particle mass concentrations or particle number count. However, there exist scientific challenges in analysing and interpreting the large data sets on motor vehicle emission factors, and no understanding is available of the application of different particle metrics as a basis for air quality regulation. To date a comprehensive inventory covering the broad size range of particles emitted by motor vehicles, and which includes particle number, does not exist anywhere in the world. This thesis covers research related to four important and interrelated aspects pertaining to particulate matter generated by motor vehicle fleets. These include the derivation of suitable particle emission factors for use in transport modelling and health impact assessments; quantification of motor vehicle particle emission inventories; investigation of the particle characteristic modality within particle size distributions as a potential for developing air quality regulation; and review and synthesis of current knowledge on ultrafine particles as it relates to motor vehicles; and the application of these aspects to the quantification, control and management of motor vehicle particle emissions. In order to quantify emissions in terms of a comprehensive inventory, which covers the full size range of particles emitted by motor vehicle fleets, it was necessary to derive a suitable set of particle emission factors for different vehicle and road type combinations for particle number, particle volume, PM1, PM2.5 and PM1 (mass concentration of particles with aerodynamic diameters < 1 µm, < 2.5 µm and < 10 µm respectively). The very large data set of emission factors analysed in this study were sourced from measurement studies conducted in developed countries, and hence the derived set of emission factors are suitable for preparing inventories in other urban regions of the developed world. These emission factors are particularly useful for regions with a lack of measurement data to derive emission factors, or where experimental data are available but are of insufficient scope. The comprehensive particle emissions inventory presented in this thesis is the first published inventory of tailpipe particle emissions prepared for a motor vehicle fleet, and included the quantification of particle emissions covering the full size range of particles emitted by vehicles, based on measurement data. The inventory quantified particle emissions measured in terms of particle number and different particle mass size fractions. It was developed for the urban South-East Queensland fleet in Australia, and included testing the particle emission implications of future scenarios for different passenger and freight travel demand. The thesis also presents evidence of the usefulness of examining modality within particle size distributions as a basis for developing air quality regulations; and finds evidence to support the relevance of introducing a new PM1 mass ambient air quality standard for the majority of environments worldwide. The study found that a combination of PM1 and PM10 standards are likely to be a more discerning and suitable set of ambient air quality standards for controlling particles emitted from combustion and mechanically-generated sources, such as motor vehicles, than the current mass standards of PM2.5 and PM10. The study also reviewed and synthesized existing knowledge on ultrafine particles, with a specific focus on those originating from motor vehicles. It found that motor vehicles are significant contributors to both air pollution and ultrafine particles in urban areas, and that a standardized measurement procedure is not currently available for ultrafine particles. The review found discrepancies exist between outcomes of instrumentation used to measure ultrafine particles; that few data is available on ultrafine particle chemistry and composition, long term monitoring; characterization of their spatial and temporal distribution in urban areas; and that no inventories for particle number are available for motor vehicle fleets. This knowledge is critical for epidemiological studies and exposure-response assessment. Conclusions from this review included the recommendation that ultrafine particles in populated urban areas be considered a likely target for future air quality regulation based on particle number, due to their potential impacts on the environment. The research in this PhD thesis successfully integrated the elements needed to quantify and manage motor vehicle fleet emissions, and its novelty relates to the combining of expertise from two distinctly separate disciplines - from aerosol science and transport modelling. The new knowledge and concepts developed in this PhD research provide never before available data and methods which can be used to develop comprehensive, size-resolved inventories of motor vehicle particle emissions, and air quality regulations to control particle emissions to protect the health and well-being of current and future generations.

Peripheral ocular monochromatic aberrations

Aberrations affect image quality of the eye away from the line of sight as well as along it. High amounts of lower order aberrations are found in the peripheral visual field and higher order aberrations change away from the centre of the visual field. Peripheral resolution is poorer than that in central vision, but peripheral vision is important for movement and detection tasks (for example driving) which are adversely affected by poor peripheral image quality. Any physiological process or intervention that affects axial image quality will affect peripheral image quality as well. The aim of this study was to investigate the effects of accommodation, myopia, age, and refractive interventions of orthokeratology, laser in situ keratomileusis and intraocular lens implantation on the peripheral aberrations of the eye. This is the first systematic investigation of peripheral aberrations in a variety of subject groups. Peripheral aberrations can be measured either by rotating a measuring instrument relative to the eye or rotating the eye relative to the instrument. I used the latter as it is much easier to do. To rule out effects of eye rotation on peripheral aberrations, I investigated the effects of eye rotation on axial and peripheral cycloplegic refraction using an open field autorefractor. For axial refraction, the subjects fixated at a target straight ahead, while their heads were rotated by ±30º with a compensatory eye rotation to view the target. For peripheral refraction, the subjects rotated their eyes to fixate on targets out to ±34° along the horizontal visual field, followed by measurements in which they rotated their heads such that the eyes stayed in the primary position relative to the head while fixating at the peripheral targets. Oblique viewing did not affect axial or peripheral refraction. Therefore it is not critical, within the range of viewing angles studied, if axial and peripheral refractions are measured with rotation of the eye relative to the instrument or rotation of the instrument relative to the eye. Peripheral aberrations were measured using a commercial Hartmann-Shack aberrometer. A number of hardware and software changes were made. The 1.4 mm range limiting aperture was replaced by a larger aperture (2.5 mm) to ensure all the light from peripheral parts of the pupil reached the instrument detector even when aberrations were high such as those occur in peripheral vision. The power of the super luminescent diode source was increased to improve detection of spots passing through the peripheral pupil. A beam splitter was placed between the subjects and the aberrometer, through which they viewed an array of targets on a wall or projected on a screen in a 6 row x 7 column matrix of points covering a visual field of 42 x 32. In peripheral vision, the pupil of the eye appears elliptical rather than circular; data were analysed off-line using custom software to determine peripheral aberrations. All analyses in the study were conducted for 5.0 mm pupils. Influence of accommodation on peripheral aberrations was investigated in young emmetropic subjects by presenting fixation targets at 25 cm and 3 m (4.0 D and 0.3 D accommodative demands, respectively). Increase in accommodation did not affect the patterns of any aberrations across the field, but there was overall negative shift in spherical aberration across the visual field of 0.10 ± 0.01m. Subsequent studies were conducted with the targets at a 1.2 m distance. Young emmetropes, young myopes and older emmetropes exhibited similar patterns of astigmatism and coma across the visual field. However, the rate of change of coma across the field was higher in young myopes than young emmetropes and was highest in older emmetropes amongst the three groups. Spherical aberration showed an overall decrease in myopes and increase in older emmetropes across the field, as compared to young emmetropes. Orthokeratology, spherical IOL implantation and LASIK altered peripheral higher order aberrations considerably, especially spherical aberration. Spherical IOL implantation resulted in an overall increase in spherical aberration across the field. Orthokeratology and LASIK reversed the direction of change in coma across the field. Orthokeratology corrected peripheral relative hypermetropia through correcting myopia in the central visual field. Theoretical ray tracing demonstrated that changes in aberrations due to orthokeratology and LASIK can be explained by the induced changes in radius of curvature and asphericity of the cornea. This investigation has shown that peripheral aberrations can be measured with reasonable accuracy with eye rotation relative to the instrument. Peripheral aberrations are affected by accommodation, myopia, age, orthokeratology, spherical intraocular lens implantation and laser in situ keratomileusis. These factors affect the magnitudes and patterns of most aberrations considerably (especially coma and spherical aberration) across the studied visual field. The changes in aberrations across the field may influence peripheral detection and motion perception. However, further research is required to investigate how the changes in aberrations influence peripheral detection and motion perception and consequently peripheral vision task performance.

Strategies for comparing decimal numbers with the same whole-number part

The strategies employed by 130 Grade 5 Brisbane students in comparing decimal numbers which have the same whole-number part were compared with those identified in similar studies conducted in the USA, France and Israel. Three new strategies were identified. Similar to USA results, the most common comparison errors stemmed from the incorrect whole-number strategy in which length is confused with size. The findings of this present study tend to support Resnick et al.’s (1989) hypothesis that the introduction of decimal-fraction recording before common-fraction recording seems to promote better comparison of decimal numbers.

Construction of multiplicative abstract schema for decimal-number numeration

This paper reports on an intervention study planned to help Year 6 students construct the multiplicative structure underlying decimal-number numeration. Three types of intervention were designed from a numeration model developed from a large study of 173 Year 6 students’ decimal-number knowledge. The study found that students could acquire multiplicative structure as an abstract schema if instruction took account of prior knowledge as informed by the model.

Fractions, reunitisation and the number-line representation

Centre for Mathematics and Science Education, QUT, Brisbane, Australia This paper reports on a study in which Years 6 and 10 students were individually interviewed to determine their ability to unitise and reunitise number lines used to represent mixed numbers and improper fractions. Only 16.7% of the students (all Year 6) were successful on all three tasks and, in general, Year 6 students outperformed Year 8 students. The interviews revealed that the remaining students had incomplete, fragmented or non-existent structural knowledge of mixed numbers and improper fractions, and were unable to unitise or reunitise number lines. The implication for teaching is that instruction should focus on providing students with a variety of fraction representations in order to develop rich and flexible schema for all fraction types (mixed numbers, and proper and improper fractions).

Air evacuation in war : the role of RAAF nurses undertaking air evacuation of casualties between 1943-1953

Air transportation of Australian casualties in World War II was initially carried out in air ambulances with an accompanying male medical orderly. By late 1943 with the war effort concentrated in the Pacific, Allied military authorities realised that air transport was needed to move the increasing numbers of casualties over longer distances. The Royal Australian Air Force (RAAF) became responsible for air evacuation of Australian casualties and established a formal medical air evacuation system with trained flight teams early in 1944. Specialised Medical Air Evacuation Transport Units (MAETUs) were established whose sole responsibility was undertaking air evacuations of Australian casualties from the forward operational areas back to definitive medical care. Flight teams consisting of a RAAF nursing sister (registered nurse) and a medical orderly carried out the escort duties. These personnel had been specially trained in Australia for their role. Post-WWII, the RAAF Nursing Service was demobilised with a limited number of nurses being retained for the Interim Air Force. Subsequently, those nurses were offered commissions in the Permanent Air Force. Some of the nurses who remained were air evacuation trained and carried out air evacuations both in Australia and as part of the British Commonwealth Occupation Force in Japan. With the outbreak of the Korean War in June 1950, Australia became responsible for the air evacuation of British Commonwealth casualties from Korea to Japan. With a re-organisation of the Australian forces as part of the British Commonwealth forces, RAAF nurses were posted to undertake air evacuation from Korea and back to Australia from Iwakuni, Japan. By 1952, a specialised casualty staging section was established in Seoul and staffed by RAAF nurses from Iwakuni on a rotation basis. The development of the Australian air evacuation system and the role of the flight nurses are not well documented for the period 1943-1953. The aims of this research are three fold and include documenting the origins and development of the air evacuation system from 1943-1953; analysing and documenting the RAAF nurse’s role and exploring whether any influences or lessons remain valid today. A traditional historical methodology of narrative and then analysis was used to inform the flight nurse’s role within the totality of the social system. Evidence was based on primary data sources mainly held in Defence files, the Australian War Memorial or the National Archives of Australia. Interviews with 12 ex-RAAF nurses from both WWII and the Korean War were conducted to provide information where there were gaps in the primary data and to enable exploration of the flight nurses’ role and their contributions in war of the air evacuation of casualties. Finally, this thesis highlights two lessons that remain valid today. The first is that interoperability of air evacuation systems with other nations is a force multiplier when resources are scarce or limited. Second, the pre-flight assessment of patients was essential and ensured that there were no deaths in-flight.

Alternative analytical methods for the identification of cancer-related symptom clusters

Advances in symptom management strategies through a better understanding of cancer symptom clusters depend on the identification of symptom clusters that are valid and reliable. The purpose of this exploratory research was to investigate alternative analytical approaches to identify symptom clusters for patients with cancer, using readily accessible statistical methods, and to justify which methods of identification may be appropriate for this context. Three studies were undertaken: (1) a systematic review of the literature, to identify analytical methods commonly used for symptom cluster identification for cancer patients; (2) a secondary data analysis to identify symptom clusters and compare alternative methods, as a guide to best practice approaches in cross-sectional studies; and (3) a secondary data analysis to investigate the stability of symptom clusters over time. The systematic literature review identified, in 10 years prior to March 2007, 13 cross-sectional studies implementing multivariate methods to identify cancer related symptom clusters. The methods commonly used to group symptoms were exploratory factor analysis, hierarchical cluster analysis and principal components analysis. Common factor analysis methods were recommended as the best practice cross-sectional methods for cancer symptom cluster identification. A comparison of alternative common factor analysis methods was conducted, in a secondary analysis of a sample of 219 ambulatory cancer patients with mixed diagnoses, assessed within one month of commencing chemotherapy treatment. Principal axis factoring, unweighted least squares and image factor analysis identified five consistent symptom clusters, based on patient self-reported distress ratings of 42 physical symptoms. Extraction of an additional cluster was necessary when using alpha factor analysis to determine clinically relevant symptom clusters. The recommended approaches for symptom cluster identification using nonmultivariate normal data were: principal axis factoring or unweighted least squares for factor extraction, followed by oblique rotation; and use of the scree plot and Minimum Average Partial procedure to determine the number of factors. In contrast to other studies which typically interpret pattern coefficients alone, in these studies symptom clusters were determined on the basis of structure coefficients. This approach was adopted for the stability of the results as structure coefficients are correlations between factors and symptoms unaffected by the correlations between factors. Symptoms could be associated with multiple clusters as a foundation for investigating potential interventions. The stability of these five symptom clusters was investigated in separate common factor analyses, 6 and 12 months after chemotherapy commenced. Five qualitatively consistent symptom clusters were identified over time (Musculoskeletal-discomforts/lethargy, Oral-discomforts, Gastrointestinaldiscomforts, Vasomotor-symptoms, Gastrointestinal-toxicities), but at 12 months two additional clusters were determined (Lethargy and Gastrointestinal/digestive symptoms). Future studies should include physical, psychological, and cognitive symptoms. Further investigation of the identified symptom clusters is required for validation, to examine causality, and potentially to suggest interventions for symptom management. Future studies should use longitudinal analyses to investigate change in symptom clusters, the influence of patient related factors, and the impact on outcomes (e.g., daily functioning) over time.

A comparative study of splint effectiveness in limiting forearm rotation

Study Design: Case Study Series.---------- Introduction: Restriction of forearm rotation may be required for effective management and rehabilitation of the upper limb after trauma.---------- Purpose of the Study: To compare the effectiveness of four splints in restricting forearm rotation.---------- Methods: Muenster, Sugartong, antipronation distal radioulnar joint (DRUJ), and standard wrist splints were fabricated for five healthy participants. Active range of motion (AROM) in forearm pronation and supination was measured with a goniometer for each splint, at the initial point of sensory feedback and during exertion of maximal force.---------- Results: Repeated-measures analysis of variance indicated significant differences between splints for all four AROM measures. Post hoc paired t-tests showed that the Sugartong splint was significantly more restrictive in pronation than the Muenster splint. The antipronation DRUJ splint provided significantly greater restriction in pronation than the standard wrist splint. No splints immobilized the forearm completely.---------- Conclusions: The Sugartong splint is recommended for maximal restriction in pronation, but individual patient characteristics require consideration in splint choice.

Critical analysis of high particle number emissions from accelerating compressed natural gas buses

Compressed natural gas (CNG) engines are thought to be less harmful to the environment than conventional diesel engines, especially in terms of particle emissions. Although, this is true with respect to particulate matter (PM) emissions, results of particle number (PN) emission comparisons have been inconclusive. In this study, results of on-road and dynamometer studies of buses were used to derive several important conclusions. We show that, although PN emissions from CNG buses are significantly lower than from diesel buses at low engine power, they become comparable at high power. For diesel buses, PN emissions are not significantly different between acceleration and operation at steady maximum power. However, the corresponding PN emissions from CNG buses when accelerating are an order of magnitude greater than when operating at steady maximum power. During acceleration under heavy load, PN emissions from CNG buses are an order of magnitude higher than from diesel buses. The particles emitted from CNG buses are too small to contribute to PM10 emissions or contribute to a reduction of visibility, and may consist of semivolatile nanoparticles.