79 resultados para Medically Undeserved Areas


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An effective control of the ion current distribution over large-area (up to 103 cm2) substrates with the magnetic fields of a complex structure by using two additional magnetic coils installed under the substrate exposed to vacuum arc plasmas is demonstrated. When the magnetic field generated by the additional coils is aligned with the direction of the magnetic field generated by the guiding and focusing coils of the vacuum arc source, a narrow ion density distribution with the maximum current density 117 A m-2 is achieved. When one of the additional coils is set to generate the magnetic field of the opposite direction, an area almost uniform over the substrate of 103 cm2 ion current distribution with the mean value of 45 A m-2 is achieved. Our findings suggest that the system with the vacuum arc source and two additional magnetic coils can be effectively used for the effective, high throughput, and highly controllable plasma processing.

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Manipulation of a single nanoparticle in the near-substrate areas of high-density plasmas of low-temperature glow discharges is studied. It is shown that the nanoparticles can be efficiently manipulated by the thermophoretic force controlled by external heating of the substrate stage. Particle deposition onto or repulsion from nanostructured carbon surfaces critically depends on the values of the neutral gas temperature gradient in the near-substrate areas, which is directly measured in situ in different heating regimes by originally developed temperature gradient probe. The measured values of the near-surface temperature gradient are used in the numerical model of nanoparticle dynamics in a variable-length presheath. Specific conditions enabling the nanoparticle to overcome the repulsive potential and deposit on the substrate during the discharge operation are investigated. The results are relevant to fabrication of various nanostructured films employing structural incorporation of the plasma-grown nanoparticles, in particular, to nanoparticle deposition in the plasma-enhanced chemical-vapor deposition of carbon nanostructures in hydrocarbon-based plasmas.

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Using a case study approach, this paper presents a robust methodology for assessing the compatibility of stormwater treatment performance data between two geographical regions in relation to a treatment system. The desktop analysis compared data derived from a field study undertaken in Florida, USA, with South East Queensland (SEQ) rainfall and pollutant characteristics. The analysis was based on the hypothesis that when transposing treatment performance information from one geographical region to another, detailed assessment of specific rainfall and stormwater quality parameters is required. Accordingly, characteristics of measured rainfall events and stormwater quality in the Florida study were compared with typical characteristics for SEQ. Rainfall events monitored in the Florida study were found to be similar to events that occur in SEQ in terms of their primary characteristics of depth, duration and intensity. Similarities in total suspended solids (TSS) and total nitrogen (TN) concentration ranges for Florida and SEQ suggest that TSS and TN removal performances would not be very different if the treatment system is installed in SEQ. However, further investigations are needed to evaluate the treatment performance of total phosphorus (TP). The methodology presented also allows comparison of other water quality parameters.

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Land use and agricultural practices can result in important contributions to the global source strength of atmospheric nitrous oxide (N2O) and methane (CH4). However, knowledge of gas flux from irrigated agriculture is very limited. From April 2005 to October 2006, a study was conducted in the Aral Sea Basin, Uzbekistan, to quantify and compare emissions of N2O and CH4 in various annual and perennial land-use systems: irrigated cotton, winter wheat and rice crops, a poplar plantation and a natural Tugai (floodplain) forest. In the annual systems, average N2O emissions ranged from 10 to 150 μg N2O-N m−2 h−1 with highest N2O emissions in the cotton fields, covering a similar range of previous studies from irrigated cropping systems. Emission factors (uncorrected for background emission), used to determine the fertilizer-induced N2O emission as a percentage of N fertilizer applied, ranged from 0.2% to 2.6%. Seasonal variations in N2O emissions were principally controlled by fertilization and irrigation management. Pulses of N2O emissions occurred after concomitant N-fertilizer application and irrigation. The unfertilized poplar plantation showed high N2O emissions over the entire study period (30 μg N2O-N m−2 h−1), whereas only negligible fluxes of N2O (<2 μg N2O-N m−2 h−1) occurred in the Tugai. Significant CH4 fluxes only were determined from the flooded rice field: Fluxes were low with mean flux rates of 32 mg CH4 m−2 day−1 and a low seasonal total of 35.2 kg CH4 ha−1. The global warming potential (GWP) of the N2O and CH4 fluxes was highest under rice and cotton, with seasonal changes between 500 and 3000 kg CO2 eq. ha−1. The biennial cotton–wheat–rice crop rotation commonly practiced in the region would average a GWP of 2500 kg CO2 eq. ha−1 yr−1. The analyses point out opportunities for reducing the GWP of these irrigated agricultural systems by (i) optimization of fertilization and irrigation practices and (ii) conversion of annual cropping systems into perennial forest plantations, especially on less profitable, marginal lands.

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Since 2000, the Government of Viet Nam has committed to provide rural communities with increased access to safe water through a variety of household water supply schemes (wells, ferrocement tanks and jars) and piped water schemes. One possible, unintended consequence of these schemes is the concomitant increase in water containers that may serve as habitats for dengue mosquito immatures, principally Aedes aegypti. To assess these possible impacts we undertook detailed household surveys of Ae. aegypti immatures, water storage containers and various socioeconomic factors in three rural communes in southern Viet Nam. Positive relationships between the numbers of household water storage containers and the prevalence and abundance of Ae. aegypti immatures were found. Overall, water storage containers accounted for 92–97% and 93–96% of the standing crops of III/IV instars and pupae, respectively. Interestingly, households with higher socioeconomic levels had significantly higher numbers of water storage containers and therefore greater risk of Ae. aegypti infestation. Even after provision of piped water to houses, householders continued to store water in containers and there was no observed decrease in water storage container abundance in these houses, compared to those that relied entirely on stored water. These findings highlight the householders’ concerns about the limited availability of water and their strong behavoural patterns associated with storage of water. We conclude that household water storage container availability is a major risk factor for infestation with Ae. aegypti immatures, and that recent investment in rural water supply infrastructure are unlikely to mitigate this risk, at least in the short term.

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This paper presents a numerical model for understanding particle transport and deposition in metal foam heat exchangers. Two-dimensional steady and unsteady numerical simulations of a standard single row metal foam-wrapped tube bundle are performed for different particle size distributions, i.e. uniform and normal distributions. Effects of different particle sizes and fluid inlet velocities on the overall particle transport inside and outside the foam layer are also investigated. It was noted that the simplification made in the previously-published numerical works in the literature, e.g. uniform particle deposition in the foam, is not necessarily accurate at least for the cases considered here. The results highlight the preferential particle deposition areas both along the tube walls and inside the foam using a developed particle deposition likelihood matrix. This likelihood matrix is developed based on three criteria being particle local velocity, time spent in the foam, and volume fraction. It was noted that the particles tend to deposit near both front and rear stagnation points. The former is explained by the higher momentum and direct exposure of the particles to the foam while the latter only accommodate small particles which can be entrained in the recirculation region formed behind the foam-wrapped tubes.

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Objective: In 2011, the Australian Commission on Safety and Quality in Health Care (ACSQHC) recommended that all hospitals in Australia must have an Antimicrobial Stewardship (AMS) program by 2013. Nevertheless, little is known about current AMS activities. This study aimed to determine the AMS activities currently undertaken, and to identify gaps, barriers to implementation and opportunities for improvement in Queensland hospitals. Methods: The AMS activities of 26 facilities from 15 hospital and health services in Queensland were surveyed during June 2012 to address strategies for effective AMS: implementing clinical guidelines, formulary restriction, reviewing antimicrobial prescribing, auditing antimicrobial use and selective reporting of susceptibility results. Results: The response rate was 62%. Nineteen percent had an AMS team (a dedicated multidisciplinary team consisting of a medically trained staff member and a pharmacist). All facilities had access to an electronic version of Therapeutic Guidelines: Antibiotic, with a further 50% developing local guidelines for antimicrobials. One-third of facilities had additional restrictions. Eighty-eight percent had advice for restricted antimicrobials from in-house infectious disease physicians or clinical microbiologists. Antimicrobials were monitored with feedback given to prescribers at point of care by 76% of facilities. Deficiencies reported as barriers to establishing AMS programs included: pharmacy resources, financial support by hospital management, and training and education in antimicrobial use. Conclusions: Several areas for improvement were identified: reviewing antimicrobial prescribing with feedback to the prescriber, auditing, and training and education in antimicrobial use. There also appears to be a lack of resources to support AMS programs in some facilities. What is known about the topic? The ACSQHC has recommended that all hospitals implement an AMS program by 2013 as a requirement of Standard 3 (Preventing and Controlling Healthcare-Associated Infections) of the National Safety and Quality Health Service Standards. The intent of AMS is to ensure appropriate prescribing of antimicrobials as part of the broader systems within a health service organisation to prevent and manage healthcare-associated infections, and improve patient safety and quality of care. This criterion also aligns closely with Standard 4: Medication Safety. Despite this recommendation, little is known about what AMS activities are undertaken in these facilities and what additional resources would be required in order to meet these national standards. What does the paper add? This is the first survey that has been conducted of public hospital and health services in Queensland, a large decentralised state in Australia. This paper describes what AMS activities are currently being undertaken, identifies practice gaps, barriers to implementation and opportunities for improvement in Queensland hospitals. What are the implications for practitioners? Several areas for improvement such as reviewing antimicrobial prescribing with feedback to the prescriber, auditing, and training and education in antimicrobial use have been identified. In addition, there appears to be a lack of resources to support AMS programs in some facilities.

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Deliberate firesetting costs our community in destruction to property and lives. Public concern heightens when similar fires occur in a series, raising the specter of copycat firesetting. Difficulties associated with researching copycat crimes in general mean that not a lot is known about copycat firesetting. As an initial step toward filling this research gap, we explore connections between research on copycat crime and research into deliberate firesetting. The intention is to extract salient features from what is known about the phenomena of deliberate firesetting and copycat crime, map them together, and point out shared and unique characteristics. It is argued that a “copycat firesetter” is likely to exist as a distinct subgroup and potentially requiring targeted interventions.

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The focus of this paper is on two World Heritage Areas: the Great Barrier Reef in Queensland, Australia and the Everglades in Florida. While both are World Heritage listed by the UNESCO, the Everglades is on the "World Heritage in Danger" list and the Great Barrier Reef could be on this list within the next year if present pressures continue. This paper examines the planning approaches and governance structures used in these two areas (Queensland and Florida) to manage the growth and development pressures. To make the analysis manageable, given the scale of these World Heritage areas, case studies at the local government level will be used: the Cairns Regional Council in Queensland and Monroe County in Florida. The case study analysis will involve three steps: (1) examination of the various plans at the federal, state, local levels that impact upon environmental quality in the Great Barrier Reef and Everglades; (2) assessing the degree to which these plans have been implemented; and (3) determine if (and how) the plans have improved environmental quality. In addition to the planning analysis we will also examine the governance structures (Lebel et al. 2006) within which planning operates. In any comparative analysis context is important (Hantrais 2009). Contextual differences between Queensland and Florida have previously been examined by Sipe, et al. (2007) and will be used as the starting point for this analysis. Our operating hypothesis and preliminary analysis suggests that the planning approaches and governance structures used in Florida and Queensland are considerably different, but the environmental outcomes may be similar. This is based, in part, on Vella (2004) who did a comparative analysis of environmental practices in the sugar industry in Florida and Queensland. This research re-examines this hypothesis and broadens the focus beyond the sugar industry to growth and development more broadly.

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Background Injury is the leading cause of adolescent death and injury around the road is a common source of adolescent injuries. Skills for Preventing Injury in Youth (SPIY) is a comprehensive program developed in Australia for early adolescents (term-long curriculum, including looking out for friends, first-aid training coupled with teacher school-connectedness professional development). Jessors’ Protection-Risk Framework guided the program approach focusing on building protective relationships. Method A randomized controlled trial with 35 schools was undertaken. Students completed surveys at baseline, six-months post-intervention and twelve-months post intervention. There were 1686 students (56% female) who completed the twelve-month survey, including the Extended-Adolescent Injury Checklist whereby students self-report on medically-treated injuries over the previous three-months (only road-related items are reported in this study; cycling, motorcycle riding, pedestrian, and riding as a passenger). Randomly selected SPIY classes also participated in focus groups and reported on perceptions of SPIY and injury risk behavior. Results As a check of randomization baseline differences of the variables were examined, with no significant differences between intervention and control groups. At the 12-month follow-up, there were fewer medically-treated injuries among the intervention students compared with the control group, particularly associated with being a passenger. The process evaluation revealed students perceived change in injury risk and risk behaviors. Conclusions While data analyses are continuing, the results indicate that the program seeking to encourage adolescents to look out for their friends, build connections to school and provide first aid skills training goes some way to reducing self-reported medically-treated injuries around the road.

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There are limited community-based data on the burden of influenza and influenza-like illnesses during pregnancy to inform disease surveillance and control. We aimed to determine the incidence of medically-attended respiratory illnesses (MARI) in pregnant women and the proportion of women who are tested for respiratory pathogens at these visits. We conducted a nested retrospective cohort study of a non-random sample of women aged ≥18 years who had a live birth in maternity units in Brisbane, Queensland, from March 2012 to October 2014. The primary outcomes were self-reported doctor visits for MARI and laboratory investigations for respiratory pathogens. Descriptive analyses were performed. Among 1202 participants, 222 (18.5%, 95%CI 16.3%-20.7%) self-reported MARI during their pregnancy. Of those with an MARI, 20.3% (45/222) self-reported a laboratory test was performed. We were able to confirm with health service providers that 46.7% (21/45) of tests were undertaken, responses from providers were not received for the remainder. Whilst one in five women in this population reported a MARI in pregnancy, only 3.7% (45/1202) reported a clinical specimen had been arranged at the consultation and the ability to validate that self-report was problematic. As the focus on maternal immunisation increases, ascertainment of the aetiological agent causing MARI in this population will be required and efficient and reliable methods for obtaining those data at the community level need to be established.

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he composition and relative abundance of airborne pollen in urban areas of Australia and New Zealand are strongly influenced by geographical location, climate and land use. There is mounting evidence that the diversity and quality of airborne pollen is substantially modified by climate change and land-use yet there are insufficient data to project the future nature of these changes. Our study highlights the need for long-term aerobiological monitoring in Australian and New Zealand urban areas in a systematic, standardised, and sustained way, and provides a framework for targeting the most clinically significant taxa in terms of abundance, allergenic effects and public health burden.

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Background Understanding the relationship between extreme weather events and childhood hand, foot and mouth disease (HFMD) is important in the context of climate change. This study aimed to quantify the relationship between extreme precipitation and childhood HFMD in Hefei, China, and further, to explore whether the association varied across urban and rural areas. Methods Daily data on HFMD counts among children aged 0–14 years from 2010 January 1st to 2012 December 31st were retrieved from Hefei Center for Disease Control and Prevention. Daily data on mean temperature, relative humidity and precipitation during the same period were supplied by Hefei Bureau of Meteorology. We used a Poisson linear regression model combined with a distributed lag non-linear model to assess the association between extreme precipitation (≥ 90th precipitation) and childhood HFMD, controlling for mean temperature, humidity, day of week, and long-term trend. Results There was a statistically significant association between extreme precipitation and childhood HFMD. The effect of extreme precipitation on childhood HFMD was the greatest at six days lag, with a 5.12% (95% confident interval: 2.7–7.57%) increase of childhood HFMD for an extreme precipitation event versus no precipitation. Notably, urban children and children aged 0–4 years were particularly vulnerable to the effects of extreme precipitation. Conclusions Our findings indicate that extreme precipitation may increase the incidence of childhood HFMD in Hefei, highlighting the importance of protecting children from forthcoming extreme precipitation, particularly for those who are young and from urban areas.