Impact of a government triple zero awareness campaign on emergency department patient characteristics

Objective: To evaluate the impact of a government triple zero community awareness campaign on the characteristics of patients attending an ED. Methods: A study using Emergency Department Information System data was conducted in an adult metropolitan tertiary-referral teaching hospital in Brisbane. The three outcomes measured in the 3 month post-campaign period were arrival mode, Australasian Triage Scale and departure status. These measures reflect ambulance usage, clinical urgency and illness severity, respectively. They were compared with those in the 3 month pre-campaign period. Multivariate logistic regression models were used to investigate the impacts of the campaign on each of the three outcome measures after controlling for age, sex, day and time of arrival, and daily minimum temperature. Results: There were 17 920 visits in the pre- and 17 793 visits in the post-campaign period. After the campaign, fewer patients arrived at the ED by road ambulance (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.80–1.00), although the impact of the campaign on the arrival mode was only close to statistical significance (Wald χ2-test, P= 0.055); and patients were significantly less likely to have higher clinical urgency (OR 0.86, 95% CI 0.79–0.94), while more likely to be admitted (OR 1.68, 95% CI 1.38–2.05) or complete treatment in the ED (OR 1.46, 95% CI 1.23–1.73) instead of leaving without waiting to be seen. Conclusions: The campaign had no significant impact on the arrival mode of the patients. After the campaign, the illness acuity of the patients decreased, whereas the illness severity of the patients increased.

Agronomic and economic evaluation of irrigation strategies on cotton lint yield in Australia

Cotton is one of the most important irrigated crops in subtropical Australia. In recent years, cotton production has been severely affected by the worst drought in recorded history, with the 2007–08 growing season recording the lowest average cotton yield in 30 years. The use of a crop simulation model to simulate the long-term temporal distribution of cotton yields under different levels of irrigation and the marginal value for each unit of water applied is important in determining the economic feasibility of current irrigation practices. The objectives of this study were to: (i) evaluate the CROPGRO-Cotton simulation model for studying crop growth under deficit irrigation scenarios across ten locations in New South Wales (NSW) and Queensland (Qld); (ii) evaluate agronomic and economic responses to water inputs across the ten locations; and (iii) determine the economically optimal irrigation level. The CROPGRO-Cotton simulation model was evaluated using 2 years of experimental data collected at Kingsthorpe, Qld. The model was further evaluated using data from nine locations between northern NSW and southern Qld. Long-term simulations were based on the prevalent furrowirrigation practice of refilling the soil profile when the plant -available soil water content is<50%. The model closely estimated lint yield for all locations evaluated. Our results showed that the amounts of water needed to maximise profit and maximise yield are different, which has economic and environmental implications. Irrigation needed to maximise profits varied with both agronomic and economic factors, which can be quite variable with season and location. Therefore, better tools and information that consider the agronomic and economic implications of irrigation decisions need to be developed and made available to growers.

Adapting wheat sowing dates to projected climate change in the Australian subtropics: analysis of crop water use and yield

Projected increases in atmospheric carbon dioxide concentration ([CO2]) and air temperature associated with future climate change are expected to affect crop development, crop yield, and, consequently, global food supplies. They are also likely to change agricultural production practices, especially those related to agricultural water management and sowing date. The magnitude of these changes and their implications to local production systems are mostly unknown. The objectives of this study were to: (i) simulate the effect of projected climate change on spring wheat (Triticum aestivum L. cv. Lang) yield and water use for the subtropical environment of the Darling Downs, Queensland, Australia; and (ii) investigate the impact of changing sowing date, as an adaptation strategy to future climate change scenarios, on wheat yield and water use. The multimodel climate projections from the IPCC Coupled Model Intercomparison Project (CMIP3) for the period 2030–2070 were used in this study. Climate scenarios included combinations of four changes in air temperature (08C, 18C, 28C, and 38C), three [CO2] levels (380 ppm, 500 ppm, and 600 ppm), and three changes in rainfall (–30%, 0%, and +20%), which were superimposed on observed station data. Crop management scenarios included a combination of six sowing dates (1 May, 10 May, 20 May, 1 June, 10 June, and 20 June) and three irrigation regimes (no irrigation (NI), deficit irrigation (DI), and full irrigation (FI)). Simulations were performed with the model DSSAT4.5, using 50 years of daily weather data.Wefound that: (1) grain yield and water-use efficiency (yield/evapotranspiration) increased linearly with [CO2]; (2) increases in [CO2] had minimal impact on evapotranspiration; (3) yield increased with increasing temperature for the irrigated scenarios (DI and FI), but decreased for the NI scenario; (4) yield increased with earlier sowing dates; and (5) changes in rainfall had a small impact on yield for DI and FI, but a high impact for the NI scenario.

Sediment-transport (wind) experiments in zero gravity

The carousel wind tunnel (CWT) can be a significant tool for the determination of the nature and magnitude of interparticlar forces at threshold of motion. By altering particle and drum surface electrical properties and/or by applying electric potential difference across the inner and outer drums, it should be possible to separate electrostatic effects from other forces of cohesion. Besides particle trajectory and bedform analyses, suggestions for research include particle aggregation in zero and sub-gravity environments, effect of suspension-saltation ratio on soil abrasion, and the effects of shear and shear free turbulence on particle aggregation as applied to evolution of solar nebula.

Improving the yield of the exhaustive grignard alkylation of N-benzylphthalimide

The tetraalkylation of N-benzylphthalimide is the major yield limiting step in the common synthetic route to isoindoline nitroxides. The progress of this reaction was found to be limited by the formation of previously unobserved mono- and dialkyl side products that do not lead to the desired product. The yield for the tetraalkylation of N-benzylphthalimide with ethylmagnesium iodide could be increased (60% over 2 steps) when a step-wise addition sequence was employed. The new two step synthesis offers a practical preparative scale alternative to the current approach.

Bubble extinction in Hele-Shaw flow with surface tension and kinetic undercooling regularisation

We perform an analytic and numerical study of an inviscid contracting bubble in a two-dimensional Hele-Shaw cell, where the effects of both surface tension and kinetic undercooling on the moving bubble boundary are not neglected. In contrast to expanding bubbles, in which both boundary effects regularise the ill-posedness arising from the viscous (Saffman-Taylor) instability, we show that in contracting bubbles the two boundary effects are in competition, with surface tension stabilising the boundary, and kinetic undercooling destabilising it. This competition leads to interesting bifurcation behaviour in the asymptotic shape of the bubble in the limit it approaches extinction. In this limit, the boundary may tend to become either circular, or approach a line or "slit" of zero thickness, depending on the initial condition and the value of a nondimensional surface tension parameter. We show that over a critical range of surface tension values, both these asymptotic shapes are stable. In this regime there exists a third, unstable branch of limiting self-similar bubble shapes, with an asymptotic aspect ratio (dependent on the surface tension) between zero and one. We support our asymptotic analysis with a numerical scheme that utilises the applicability of complex variable theory to Hele-Shaw flow.

Reconstructing 3D x-ray CT images of polymer gel dosimeters using the zero-scan method

In this study x-ray CT has been used to produce a 3D image of an irradiated PAGAT gel sample, with noise-reduction achieved using the ‘zero-scan’ method. The gel was repeatedly CT scanned and a linear fit to the varying Hounsfield unit of each pixel in the 3D volume was evaluated across the repeated scans, allowing a zero-scan extrapolation of the image to be obtained. To minimise heating of the CT scanner’s x-ray tube, this study used a large slice thickness (1 cm), to provide image slices across the irradiated region of the gel, and a relatively small number of CT scans (63), to extrapolate the zero-scan image. The resulting set of transverse images shows reduced noise compared to images from the initial CT scan of the gel, without being degraded by the additional radiation dose delivered to the gel during the repeated scanning. The full, 3D image of the gel has a low spatial resolution in the longitudinal direction, due to the selected scan parameters. Nonetheless, important features of the dose distribution are apparent in the 3D x-ray CT scan of the gel. The results of this study demonstrate that the zero-scan extrapolation method can be applied to the reconstruction of multiple x-ray CT slices, to provide useful 2D and 3D images of irradiated dosimetry gels.

Platinum-based chemotherapy in metastatic breast cancer : current status

Cisplatin and carboplatin are active in previously untreated patients with metastatic breast cancer (MBC) with mean response rates (RRs) of 50 and 32%, respectively. In pretreated patients the RR to cisplatin/carboplatin monotherapy declines markedly to <10%. Cisplatin and carboplatin have been combined with many other cytotoxics. In first-line setting high activity has been observed in combination with taxanes or vinorelbine (RRs consistently ∼60%). It appears that these newer combinations are superior to older regimens with etoposide (RRs 30 to 50%) or 5-fluorouracil (RRs 40 to 60%). Cisplatin-/carboplatin-based regimens with infusional 5-FU and epirubicin/paclitaxel/vinorelbine achieve high RRs of around 60 to 80%. However these regimens are difficult to administer in all patients because they require central venous access for continuous 5-FU infusion. In pretreated MBC the combinations of cisplatin-taxane/vinorelbine/gemcitabine or carboplatin-docetaxel/vinorelbine yield RRs of 40 to 50%, which are higher than those achieved with platinum-etoposide/5-FU. In locally advanced disease cisplatin-based regimens achieve very high RRs (>80%). This would suggest that in chemotherapy-naïve patients platinum-based therapy might have an important role to play. Additionally the synergy demonstrated between platinum compounds, taxanes and herceptin, in preclinical and clinical studies is of immense importance and the results of the two ongoing Breast Cancer International Research Group randomized phase III studies are eagerly awaited. These studies may help clarify the role of platinum compounds in the treatment of metastatic and possibly early breast cancer. © 2003 Elsevier Ltd. All rights reserved.

Degradation of simazine from aqueous solutions by diatomite-supported nanosized zero-valent iron composite materials

A novel composite material based on deposition of nanosized zero-valent iron (nZVI) particles on acid-leached diatomite was synthesised for the removal of a chlorinated contaminant in water. The nZVI /diatomite composites were characterized by X-ray diffraction, scanning electron microscopy, elemental analysis, transmission electron microscopy and X-ray photoelectron spectroscopy. Compared with the pure nZVI particles, better dispersion of nZVI particles on the surface or inside the pores of diatom shells was observed. The herbicide simazine was selected as the model chlorinated contaminant and the removal efficiency by nZVI /diatomite composite was compared with that of the pristine nZVI and commercial iron powder. It was found that the diatomite supported nZVI composite material prepared by centrifugation exhibits relatively better efficient activity in decomposition of simazine than commercial Fe, lab synthesized nZVI and composite material prepared via rotary evaporation, and the optimum experimental conditions were obtained based on a series of batch experiments. This study on immobilizing nZVI particles onto diatomite opens a new avenue for the practical application of nZVI and the diatomite-supported nanosized zero-valent iron composite materials have potential applications in environmental remediation.

Keep ahead of the workforce development curve through the establishment of standardised training for rail incident investigators

The Australasian rail industry lacks a consistently accepted standard of minimal training necessary to perform rail incident investigations. Current Australasian courses do not offer the breadth of development required for a comprehensive career pathway in incident investigation (Biggs, Banks & Dovan, 2012; Short, Kains & Harris, 2010).

A feasibility study of multislice x-ray CT imaging of gel dosimeters using the “zero scan” method

This study extends the ‘zero scan’ method for CT imaging of polymer gel dosimeters to include multi-slice acquisitions. Multi slice CT images consisting of 24 slices of 1.2 mm thickness were acquired of an irradiated polymer gel dosimeter, and processed with the zero scan technique. The results demonstrate that zero scan based gel readout can be successfully applied to generate a three dimensional image of the irradiated gel field. Compared to the raw CT images the processed figures and cross gel profiles demonstrated reduced noise and clear visibility of the penumbral region. Moreover these improved results further highlight the suitability of this method in volumetric reconstruction with reduced CT data acquisition per slice. This work shows that 3D volumes of irradiated polymer gel dosimeters can be acquired and processed with x-ray CT.

Comparing skin biopsy with confocal microscopy : diagnostic yield of nerve fiber density

Background and aims: The assessment of intra-epidermal nerve fiber density (IENFD) in skin biopsies and corneal nerve fiber density (CNFD) using corneal confocal microscopy (CCM) provides promising techniques to detect small nerve fiber damage in patients with peripheral neuropathy. To help define the clinical utility of each of these techniques in patients with diabetic neuropathy we have assessed sensitivity and specificity of IENFD and CNFD in predicting the following: 1) diabetic polyneuropathy (DPN); 2) risk of foot ulceration (RFU); 3) initial small fiber neuropathy (iSFN); 4) severe small fiber neuropathy (sSFN)...