Development of health risk-based metrics for defining a heatwave : a time series study in Brisbane, Australia

Background: This study attempted to develop health risk-based metrics for defining a heatwave in Brisbane, Australia. Methods: Poisson generalised additive model was performed to assess the impact of heatwaves on mortality and emergency hospital admissions (EHAs) in Brisbane. Results: In general, the higher the intensity and the longer the duration of a heatwave, the greater the health impacts. There was no apparent difference in EHAs risk during different periods of a warm season. However, there was a greater risk of mortality in the second half of a warm season than that in the first half. While elderly (>75 years)were particularly vulnerable to both the EHA and mortality effects of a heatwave, the risk for EHAs also significantly increased for two other age groups (0-64 years and 65-74 years) during severe heatwaves. Different patterns between cardiorespiratory mortality and EHAs were observed. Based on these findings, we propose the use of a teiered heat warning system based on the health risk of heatwave. Conclusions: Health risk-based metrics are a useful tool for the development of local heatwave definitions. thsi tool may have significant implications for the assessment of heatwave-related health consequences and development of heatwave response plans and implementation strategies.

Latent class analysis reveals distinct subgroups of patients based on symptom occurrence and demographic and clinical characteristics

Context Cancer patients experience a broad range of physical and psychological symptoms as a result of their disease and its treatment. On average, these patients report ten unrelieved and co-occurring symptoms. Objectives To determine if subgroups of oncology outpatients receiving active treatment (n=582) could be identified based on their distinct experience with thirteen commonly occurring symptoms; to determine whether these subgroups differed on select demographic, and clinical characteristics; and to determine if these subgroups differed on quality of life (QOL) outcomes. Methods Demographic, clinical, and symptom data from one Australian and two U.S. studies were combined. Latent class analysis (LCA) was used to identify patient subgroups with distinct symptom experiences based on self-report data on symptom occurrence using the Memorial Symptom Assessment Scale (MSAS). Results Four distinct latent classes were identified (i.e., All Low (28.0%), Moderate Physical and Lower Psych (26.3%), Moderate Physical and Higher Psych (25.4%), All High (20.3%)). Age, gender, education, cancer diagnosis, and presence of metastatic disease differentiated among the latent classes. Patients in the All High class had the worst QOL scores. Conclusion Findings from this study confirm the large amount of interindividual variability in the symptom experience of oncology patients. The identification of demographic and clinical characteristics that place patients are risk for a higher symptom burden can be used to guide more aggressive and individualized symptom management interventions.

Assessment and application of clustering techniques to atmospheric particle number size distribution for the purpose of source apportionment

Long-term measurements of particle number size distribution (PNSD) produce a very large number of observations and their analysis requires an efficient approach in order to produce results in the least possible time and with maximum accuracy. Clustering techniques are a family of sophisticated methods which have been recently employed to analyse PNSD data, however, very little information is available comparing the performance of different clustering techniques on PNSD data. This study aims to apply several clustering techniques (i.e. K-means, PAM, CLARA and SOM) to PNSD data, in order to identify and apply the optimum technique to PNSD data measured at 25 sites across Brisbane, Australia. A new method, based on the Generalised Additive Model (GAM) with a basis of penalised B-splines, was proposed to parameterise the PNSD data and the temporal weight of each cluster was also estimated using the GAM. In addition, each cluster was associated with its possible source based on the results of this parameterisation, together with the characteristics of each cluster. The performances of four clustering techniques were compared using the Dunn index and Silhouette width validation values and the K-means technique was found to have the highest performance, with five clusters being the optimum. Therefore, five clusters were found within the data using the K-means technique. The diurnal occurrence of each cluster was used together with other air quality parameters, temporal trends and the physical properties of each cluster, in order to attribute each cluster to its source and origin. The five clusters were attributed to three major sources and origins, including regional background particles, photochemically induced nucleated particles and vehicle generated particles. Overall, clustering was found to be an effective technique for attributing each particle size spectra to its source and the GAM was suitable to parameterise the PNSD data. These two techniques can help researchers immensely in analysing PNSD data for characterisation and source apportionment purposes.

Balancing the books : an assessment of financial stress associated with social work and human service student placements

This report presents the findings from a study of the financial impact of work-integrated learning commonly referred to as 'placement' among social work and human services students. Based on a survey of 214 respondants, 14 in-depth interviews and two focus groups, the findings indicate that two thirds of the surveyed group felt tired and anxious about their experience of balancing paid work and placement, with 2 in 5 reporting their learning experience was compromised as a result. The significant implications and potential solutions are also discussed.

Considerations for a social and geographical framework for agent-based epidemics

Understanding the dynamics of disease spread is of crucial importance, in contexts such as estimating load on medical services to risk assessment and intervention policies against large-scale epidemic outbreaks. However, most of the information is available after the spread itself, and preemptive assessment is far from trivial. Here, we investigate the use of agent-based simulations to model such outbreaks in a stylised urban environment. For most diseases, infection of a new individual may occur from casual contact in crowds as well as from repeated interactions with social partners such as work colleagues or family members. Our model therefore accounts for these two phenomena.Presented in this paper is the initial framework for such a model, detailing implementation of geographical features and generation of social structures. Preliminary results are a promising step towards large-scale simulations and evaluation of potential intervention policies.

A parallel approach to social network generation and agent-based epidemic simulation

Understanding the dynamics of disease spread is essential in contexts such as estimating load on medical services, as well as risk assessment and interven- tion policies against large-scale epidemic outbreaks. However, most of the information is available after the outbreak itself, and preemptive assessment is far from trivial. Here, we report on an agent-based model developed to investigate such epidemic events in a stylised urban environment. For most diseases, infection of a new individual may occur from casual contact in crowds as well as from repeated interactions with social partners such as work colleagues or family members. Our model therefore accounts for these two phenomena. Given the scale of the system, efficient parallel computing is required. In this presentation, we focus on aspects related to paralllelisation for large networks generation and massively multi-agent simulations.

PM348 Heart education assessment and rehabilitation toolkit: Heart online. A web resource for clinicians

Access to the right information at the right time is a challenge facing health professionals across the globe. HEART Online (www.heartonline.org.au) is a website designed to support the delivery of evidence based care for the prevention and rehabilitation of heart disease. It was developed by the Queensland Government and the National Heart Foundation of Australia and launched May 2013.

Vibration based baseline updating method to localize crack formation and propagation in reinforced concrete members

Structural Health Monitoring (SHM) schemes are useful for proper management of the performance of structures and for preventing their catastrophic failures. Vibration based SHM schemes has gained popularity during the past two decades resulting in significant research. It is hence evitable that future SHM schemes will include robust and automated vibration based damage assessment techniques (VBDAT) to detect, localize and quantify damage. In this context, the Damage Index (DI) method which is classified as non-model or output based VBDAT, has the ability to automate the damage assessment process without using a computer or numerical model along with actual measurements. Although damage assessment using DI methods have been able to achieve reasonable success for structures made of homogeneous materials such as steel, the same success level has not been reported with respect to Reinforced Concrete (RC) structures. The complexity of flexural cracks is claimed to be the main reason to hinder the applicability of existing DI methods in RC structures. Past research also indicates that use of a constant baseline throughout the damage assessment process undermines the potential of the Modal Strain Energy based Damage Index (MSEDI). To address this situation, this paper presents a novel method that has been developed as part of a comprehensive research project carried out at Queensland University of Technology, Brisbane, Australia. This novel process, referred to as the baseline updating method, continuously updates the baseline and systematically tracks both crack formation and propagation with the ability to automate the damage assessment process using output only data. The proposed method is illustrated through examples and the results demonstrate the capability of the method to achieve the desired outcomes.

Comparison of Body Composition Assessment Methods in Breast Cancer Survivors

Purpose/Objectives: To examine and compare the reliability of four body composition methods commonly used in assessing breast cancer survivors. Design: Cross-sectional. Setting: A rehabilitation facility at a university-based comprehensive cancer center in the southeastern United States. Sample: 14 breast cancer survivors aged 40-71 years. Methods: Body fat (BF) percentage was estimated via bioelectric impedance analysis (BIA), air displacement plethysmography (ADP), and skinfold thickness (SKF) using both three- and seven-site algorithms, where reliability of the methods was evaluated by conducting two tests for each method (test 1 and test 2), one immediately after the other. An analysis of variance was used to compare the results of BF percentage among the four methods. Intraclass correlation coefficient (ICC) was used to test the reliability of each method. Main Research Variable: BF percentage. Findings: Significant differences in BF percentage were observed between BIA and all other methods (three-site SKF, p < 0.001; seven-site SKF, p < 0.001; ADP, p = 0.002). No significant differences (p > 0.05) in BF percentage between three-site SKF, seven-site SKF, and ADP were observed. ICCs between test 1 and test 2 for each method were BIA = 1, ADP = 0.98, three-site SKF = 0.99, and seven-site SKF = 0.94. Conclusions: ADP and both SKF methods produce similar estimates of BF percentage in all participants, whereas BIA overestimated BF percentage relative to the other measures. Caution is recommended when using BIA as the body composition method for breast cancer survivors who have completed treatment but are still undergoing adjuvant hormonal therapy. Implications for Nursing: Measurements of body composition can be implemented very easily as part of usual care and should serve as an objective outcome measure for interventions designed to promote healthy behaviors among breast cancer survivors. - See more at: https://onf.ons.org/onf/38/4/comparison-body-composition-assessment-methods-breast-cancer-survivors#sthash.5djfTS1Q.dpuf

Non-destructive structural integrity assessment of a decommissioned rail wagon system

This paper presents a multi-criteria based approach for nondestructive diagnostic structural integrity assessment of a decommissioned flatbed rail wagon (FBRW) used for road bridge superstructure rehabilitation and replacement applications. First, full-scale vibration and static test data sets are employed in a FE model of the FBRW to obtain the best ‘initial’ estimate of the model parameters. Second, the ‘final’ model parameters are predicted using sensitivity-based perturbation analysis without significant difficulties encountered. Consequently, the updated FBRW model is validated using the independent sets of full-scale laboratory static test data. Finally, the updated and validated FE model of the FBRW is used for structural integrity assessment of a single lane FBRW bridge subjected to the Australian bridge design traffic load.

Too much knowledge for a nurse? Use of physical assessment by final-semester nursing students

There is debate around the scope of physical assessment skills that should be taught in undergraduate nursing programs. Yet this debate is largely uninformed by evidence on what is learned and practiced by nursing students. This study examined the pattern and correlates of physical assessment skill utilization by 208 graduating nursing students at an Australian university, including measures of knowledge, frequency of use and perceived barriers to physical assessment skills during clinical practice. Of the 126 skills surveyed, on average only five were used every time students practiced. Core skills reflected inspection or general observation of the patient; none involved complex palpation, percussion or auscultation. Skill utilization was also shaped by specialty area. Most skills (70%) were, on average, never performed or learned and students perceived nursing physical assessment was marginalized in both university and workplace contexts. Lack of confidence was thus a significant barrier to use of skills. Based on these findings we argue that the current debate must shift to how we might best support students to integrate comprehensive physical assessment into nursing practice.

A laboratory assessment of the choice of vessel size under individual transferable quota regimes

This paper examines the effect of individual transferable quota regimes on technology choice, such as choice of vessel size, by using the laboratory experiment method. We find that even if vessel sizes change over time, the quota price can converge to the fundamental value conditioned on the vessels chosen. We also find that subjects choose their vessel type to maximise their profits based on the quota trading prices in the previous period. This result implies that the efficiency of quota markets in the beginning period is important because any inefficiency in quota markets may affect vessel sizes in ensuing periods. Moreover, we find that the initial allocations may significantly influence vessel sizes through two channels: first, a higher initial allocation to a subject increases the likelihood that the subject invests in a large-sized vessel; second, the quota price may be higher and more unstable under unequal allocation than under equal allocation; thus, whether the allocation is equal influences subjects' choice of vessel type. © 2014 Australian Agricultural and Resource Economics Society Inc.

Design and evaluation of decision and control strategies for autonomous vision-based see and avoid systems

This paper details the design and performance assessment of a unique collision avoidance decision and control strategy for autonomous vision-based See and Avoid systems. The general approach revolves around re-positioning a collision object in the image using image-based visual servoing, without estimating range or time to collision. The decision strategy thus involves determining where to move the collision object, to induce a safe avoidance manuever, and when to cease the avoidance behaviour. These tasks are accomplished by exploiting human navigation models, spiral motion properties, expected image feature uncertainty and the rules of the air. The result is a simple threshold based system that can be tuned and statistically evaluated by extending performance assessment techniques derived for alerting systems. Our results demonstrate how autonomous vision-only See and Avoid systems may be designed under realistic problem constraints, and then evaluated in a manner consistent to aviation expectations.

Mobile Romberg test assessment (mRomberg)

Background The diagnosis of frailty is based on physical impairments and clinicians have indicated that early detection is one of the most effective methods for reducing the severity of physical frailty. Maybe, an alternative to the classical diagnosis could be the instrumentalization of classical functional testing, as Romberg test or Timed Get Up and Go Test. The aim of this study was (I) to measure and describe the magnitude of accelerometry values in the Romberg test in two groups of frail and non-frail elderly people through instrumentation with the iPhone 4®, (II) to analyse the performances and differences between the study groups, and (III) to analyse the performances and differences within study groups to characterise accelerometer responses to increasingly difficult challenges to balance. Methods This is a cross-sectional study of 18 subjects over 70 years old, 9 frail subjects and 9 non-frail subjects. The non-parametric Mann–Whitney U test was used for between-group comparisons in means values derived from different tasks. The Wilcoxon Signed-Rank test was used to analyse differences between different variants of the test in both independent study groups. Results The highest difference between groups was found in the accelerometer values with eyes closed and feet parallel: maximum peak acceleration in the lateral axis (p < 0.01), minimum peak acceleration in the lateral axis (p < 0.01) and minimum peak acceleration from the resultant vector (p < 0.01). Subjects with eyes open and feet parallel, greatest differences found between the groups were in the maximum peak acceleration in the lateral axis (p < 0.01), minimum peak acceleration in the lateral axis (p < 0.01) and minimum peak acceleration from the resultant vector (p < 0.001). With eyes closed and feet in tandem, the greatest differences found between the groups were in the minimum peak acceleration in the lateral axis (p < 0.01). Conclusions The accelerometer fitted in the iPhone 4® is able to study and analyse the kinematics of the Romberg test between frail and non-frail elderly people. In addition, the results indicate that the accelerometry values also were significantly different between the frail and non-frail groups, and that values from the accelerometer accelerometer increased as the test was made more complicated.

Catholic teachers’ postgraduate qualifications and students’ end of schooling outcomes: A large scale Queensland based comparative study

A key feature of the current era of Australian schooling is the dominance of publically available student, school and teacher performance data. Our paper examines the intersection of data on teachers’ postgraduate qualifications and students’ end of schooling outcomes in 26 Catholic Systemic Secondary Schools and 18 Catholic Independent Secondary Schools throughout the State of Queensland. We introduce and justify taking up a new socially-just measurement model of students’ end of schooling outcomes, called the ‘Tracking and Academic Management Index’, otherwise known as ‘TAMI’. Additional analysis is focused on the outcomes of top-end students vis-à-vis all students who are encouraged to remain in institutionalised education of one form or another for the two final years of senior secondary schooling. These findings of the correlations between Catholic teachers’ postgraduate qualifications and students’ end of schooling outcomes are also compared with teachers’ postgraduate qualifications and students’ end of schooling outcomes across 174 Queensland Government Secondary Schools and 58 Queensland Independent Secondary Schools from the same data collection period. The findings raise important questions about the transference of teachers’ postgraduate qualifications for progressing students’ end of schooling outcomes as well as the performance of Queensland Catholic Systemic Secondary Schools and Queensland Catholic Independent Secondary Schools during a particular era of education.