Smell and taste dysfunction following minor stroke: A case report

Smell (olfactory) and taste (gustatory) are key senses in the regulation of nourishment and individual safety. Olfactory and gustatory dysfunctions have been infrequently reported together in patients following stroke (Landis et al., 2006; Leopold et al., 2006). This case report details two patients who experienced smell and taste dysfunction following minor stroke events. Symptoms reported included hyposmia (diminished sense of smell) and anosmia (complete loss of smell), and dysgeusia (distorted taste). Patients' sense of smell and taste were assessed in an ambulatory care stroke prevention clinic eight months following their strokes. Patient A presented with minor stroke due to a lesion in the anterior circulation, patient B with a lesion in the posterior circulation. Both patients reported intense olfactory and gustatory dysfunction immediately following their strokes. Examination revealed a general inability to detect subtle odours and the ability to identify only 'sweet' tastes for both patients. In addition, both patients reported heavily salting or sweetening their food to mask the distorted and unpleasant taste, which also impacted comorbid conditions such as hypertension and diabetes. Patients and their spouses reported a decrease in their appreciation of family-related activities due to the patients' olfactory and gustatory dysfunction. Patients reported weight loss, lack of energy and strength, likely due to poor nutrition. Olfactory and gustatory dysfunctions are potentially deleterious outcomes following minor stroke and should be assessed by health care professionals prior to patient discharge. Assistance may be required to promote the health and well-being of patients and their carers if smell and taste are impacted by the stroke event.

Ethical leadership in a time of increasing accountability

Australia, like many other countries, has embraced national testing as part of wider reforms and increased accountability in schooling. Results for standardised testing programs, such as NAPLAN, are widely published yet form only one part of accountability for educators. We argue that accountability also has moral, ethical and professional dimensions. In this paper we offer a discussion of background to our study of ethical leadership in a time of data driven or contractual accountability. Based on Starratt’s (1996) model, we define ethical leadership as a social, relational practice concerned with the moral purpose of education (Angus, 2006). Our central thesis is that given increasing accountabilities, school leaders need to consider approaches to ethical leadership to improve quality and equity in education and achieve equitable outcomes for all students. The paper concludes with key implications for school leaders.

The purpose and place of mentoring for women managers in organisations: An Australian perspective

Mentoring has been identified as an important career development activity for women managers. Over the last four decades, organisations world-wide have implemented formal mentoring programs for women and for members of minority groups in recognition of the personal and professional benefits mentoring provides, not only for persons who are mentored but also, for those who undertake the mentoring. This chapter reviews the literature on mentoring and the contribution it can make to the career development of women managers. It reviews several inter-related bodies of literature: women’s representation in management positions worldwide; theories and frameworks of mentoring; empirical research exploring the impact of mentoring relationships on women managers’ career development; current illustrations of formal programs offered to women managers in the public and private sectors; and some critical issues that continue to impact women managers in relation to mentoring relationships. The chapter concludes by making an argument for further research on gender and mentoring.

Innovatus interregnum: Waiting for a paradigm shift

The purpose of this paper is to establish the case that innovation in the theory and practice of educational administration/leadership is very unlikely to occur within the existing doxa of our times. By innovation is meant a novel conceptual or practical change in the field of practice. By doxa is meant the unquestioned rules of the game and the linkage between the agencies and organs of government and foundations supporting research in the field. An approach towards thinking outside of the prevailing doxa is presented and explained as one possible antidote to the current dominant model.

PTHR1 polymorphisms influence BMD variation through effects on the growing skeleton

We investigated whether polymorphisms in PTHR1 are associated with bone mineral density (BMD), to determine whether the association of this gene with BMD was due to effects on attainment of peak bone mass or effects on subsequent bone loss. The PTHR1 gene, including its 14 exons, their exon-intron boundaries, and 1,500 bp of its promoter region, was screened for polymorphisms by denaturing high-performance liquid chromatography (dHPLC) and sequencing in 36 osteoporotic cases. Eleven single-nucleotide polymorphisms (SNPs), one tetranucleotide repeat, and one tetranucleotide deletion were identified. A cohort of 634 families, including 1,236 men (39%) and 1,926 women (61%) ascertained with probands with low BMD (Z< -2.0) and the Children in Focus subset of the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort (785 unrelated individuals, mean age 118 months), were genotyped for the five most informative SNPs (minor allele frequency >5%) and the tetranucleotide repeat. In our osteoporosis families, association was noted between lumbar spine BMD and alleles of a known functional tetranucleotide repeat (U4) in the PTHR1 promoter region (P = 0.042) and between two and three marker haplotypes of PTHR1 polymorphisms with lumbar spine, femoral neck, and total hip BMD (P = 0.021-0.047). This association was restricted to the youngest tertile of the population (age 16-39 years, P = 0.013-0.048). A similar association was found for the ALSPAC cohort: two marker haplotypes of SNPs A48609T and C52813T were associated with height (P = 0.006) and total body less head BMD (P = 0.02), corrected for age and gender, confirming the family findings. These findings suggest a role for PTHR1 variation in determining peak BMD.

Understanding consumer loyalty to technology-based self-services with credence qualities

Purpose This paper aims to use the Model of Goal-Directed Behavior (MGB) to examine the factors affecting consumers’ continued use of emerging technology-based self-services (TBSSs) with credence qualities. Professional services, which traditionally require specialized knowledge and high levels of interpersonal interaction to produce owing to their credence qualities, are increasingly delivered via self-service technologies. Health services delivered via mobile devices, for example, facilitate self-care without direct involvement from health professionals. Design/methodology/approach A mental health service delivered via the Internet and mobile phone, myCompass, was selected as the research context. Twenty interviews were conducted with users of myCompass and the data were thematically analyzed. Findings The findings of the study showcase the unique determinants of consumers’ continued use of TBSSs with credence qualities relative to the more routine services which have been the focus of extant research. The findings further provide support for the utility of the MGB in explaining service continuance, although the importance of distinguishing between extrinsic and intrinsic motivational components of behavioral desire and capturing the impact of social influence beyond subjective norms is also highlighted. Originality/value This study contributes to recent research examining differences in consumer responses across TBSSs and behavioral loyalty to these services. It also provides empirical evidence for broadening and deepening the MGB within this behavioral domain.

Differences in identifying healthcare associated infections using clinical vignettes and the influence of respondent characteristics: A cross-sectional survey of Australian infection prevention staff

Background Australia has commenced public reporting and benchmarking of healthcare associated infections (HAIs), despite not having a standardised national HAI surveillance program. Annual hospital Staphylococcus aureus bloodstream (SAB) infection rates are released online, with other HAIs likely to be reported in the future. Although there are known differences between hospitals in Australian HAI surveillance programs, the effect of these differences on reported HAI rates is not known. Objective To measure the agreement in HAI identification, classification, and calculation of HAI rates, and investigate the influence of differences amongst those undertaking surveillance on these outcomes. Methods A cross-sectional online survey exploring HAI surveillance practices was administered to infection prevention nurses who undertake HAI surveillance. Seven clinical vignettes describing HAI scenarios were included to measure agreement in HAI identification, classification, and calculation of HAI rates. Data on characteristics of respondents was also collected. Three of the vignettes were related to surgical site infection and four to bloodstream infection. Agreement levels for each of the vignettes were calculated. Using the Australian SAB definition, and the National Health and Safety Network definitions for other HAIs, we looked for an association between the proportion of correct answers and the respondents’ characteristics. Results Ninety-two infection prevention nurses responded to the vignettes. One vignette demonstrated 100 % agreement from responders, whilst agreement for the other vignettes varied from 53 to 75 %. Working in a hospital with more than 400 beds, working in a team, and State or Territory was associated with a correct response for two of the vignettes. Those trained in surveillance were more commonly associated with a correct response, whilst those working part-time were less likely to respond correctly. Conclusion These findings reveal the need for further HAI surveillance support for those working part-time and in smaller facilities. It also confirms the need to improve uniformity of HAI surveillance across Australian hospitals, and raises questions on the validity of the current comparing of national HAI SAB rates.

Donor research in Australia: Challenges and promise

Donors are the key to the core business of Blood Collection Agencies (BCAs). However, historically, they have not been a focus of research undertaken by these organizations. This model is now changing, with significant donor research groups established in a number of countries, including Australia. Donor research in the Australian Red Cross Blood Service (Blood Service) is concentrated in the Donor and Community Research (DCR) team. Cognizant of the complex and ever-changing landscape with regard to optimal donor management, the DCR team collaborates with academics located at universities around Australia to coordinate a broad program of research that addresses both short- and-long term challenges to the blood supply. This type of collaboration is not, however, without challenges. Two major collaborative programs of the Blood Service's research, focusing on i) the recruitment and retention of plasmapheresis donors and ii) the role of the emotion pride in donor motivation and return, are showcased to elucidate how the challenges of conducting collaborative BCA research can be met. In so doing, these and the other research programs described herein demonstrate how the Blood Service supports and contributes to research that not only revises operational procedures but also contributes to advances in basic science.

A phase 1b study of placenta-derived mesenchymal stromal cells in patients with idiopathic pulmonary fibrosis

BACKGROUND AND OBJECTIVE: Idiopathic pulmonary fibrosis (IPF) is a degenerative disease characterized by fibrosis following failed epithelial repair. Mesenchymal stromal cells (MSC), a key component of the stem cell niche in bone marrow and possibly other organs including lung, have been shown to enhance epithelial repair and are effective in preclinical models of inflammation-induced pulmonary fibrosis, but may be profibrotic in some circumstances. METHODS: In this single centre, non-randomized, dose escalation phase 1b trial, patients with moderately severe IPF (diffusing capacity for carbon monoxide (DLCO ) ≥ 25% and forced vital capacity (FVC) ≥ 50%) received either 1 × 10(6) (n = 4) or 2 × 10(6) (n = 4) unrelated-donor, placenta-derived MSC/kg via a peripheral vein and were followed for 6 months with lung function (FVC and DLCO ), 6-min walk distance (6MWD) and computed tomography (CT) chest. RESULTS: Eight patients (4 female, aged 63.5 (57-75) years) with median (interquartile range) FVC 60 (52.5-74.5)% and DLCO 34.5 (29.5-40)% predicted were treated. Both dose schedules were well tolerated with only minor and transient acute adverse effects. MSC infusion was associated with a transient (1% (0-2%)) fall in SaO2 after 15 min, but no changes in haemodynamics. At 6 months FVC, DLCO , 6MWD and CT fibrosis score were unchanged compared with baseline. There was no evidence of worsening fibrosis. CONCLUSIONS: Intravenous MSC administration is feasible and has a good short-term safety profile in patients with moderately severe IPF.

Evaluating the potential use of direct evaporative cooling in Australia

Greenhouse gas emissions and associated global climate change are a significant and growing concern for the world community. In order to improve building energy efficiency, the use of evaporative cooling systems is attracting growing attention. Using a climate assessment tool, the potential use of direct evaporative coolers over different Australian climates is evaluated. It is found that overall, the potential use of direct evaporative cooling is very significant in Australian climates. Among all the eight capital cities across Australia, except for Darwin, the need of hybrid cooling for other cities is found to be insignificant,and is less than 5% if appropriate air circulation is provided on hot/warm days. It is also found that the potential use of evaporative cooling can be significantly influenced by a change in the applications or design parameters. In Brisbane, it is estimated that with an increase of sensible cooling load from 30 W/m2 to 40 W/m2 in the conditioned space, the requirement in hours of hybrid cooling can increase significantly, from 4.06% to 14.89%.

Performance analysis of solar desiccant-evaporative cooling for a commercial building under different Australian climates

This paper evaluates and compares the system performance of a solar desiccant-evaporative cooling (SDEC) system with a referenced conventional variable air volume (VAV) system for a typical office building in all 8 Australian capital cities. A simulation model of the building is developed using the whole building simulation software EnergyPlus. The performance indicators for the comparison are system coefficient of performance (COP), annual primary energy consumption, annual energy savings, and annual CO2 emissions reduction. The simulation results show that Darwin has the most apparent advantages for SDEC system applications with an annual energy savings of 557 GJ and CO2 emission reduction of 121 tonnes. The maximum system COP is 7. For other climate zones such as Canberra, Hobart and Melbourne, the SDEC system is not as energy efficient as the conventional VAV system.

Life cycle energy analysis of eight residential houses in Brisbane, Australia

Life cycle energy analysis (LCEA) of eight residential buildings in and around Brisbane, Queensland, Australia, is undertaken in this study. Energy used in all three phases of construction, operation and demolition are considered. It is found that the main contribution to the operational energy in residential buildings is from use of general appliance. The choice of building materials is shown to have significant effects on the embodied energy for the production, construction, maintenance and demolition phases. From this study, it is shown that the embodied energy may vary from 10% to 30%, while the operational energy may vary from 65% to 90%. The demolition energy generally accounts for less than 4% of life cycle energy.

Design a zero energy house in Brisbane, Australia

Due to the increasing energy demand and global warming effects, energy efficient buildings have become increasingly important in the modern construction industry. This research is conducted to evaluate the energy performance, financial feasibility and potential energy savings of zero energy houses. Through the use of building computer simulation technique, a 5 stars energy rated house was modelled and validated by comparing the energy performance of a base case scenario to a typical house in Brisbane. By integrating energy reduction strategies and utilizing onsite renewable energy such as solar energy, zero energy performance is achieved. It is found that approximately 66 % energy savings can be achieved in the household annual energy usage by focusing on maximizing the thermal performance of building envelope, minimizing the energy requirements and incorporating solar energy technologies.