Terminally-ill people living alone without a caregiver: an Australian national scoping study of palliative care needs

Home-based palliative care services are facing increasing challenges in servicing the needs of clients who live alone and without a primary caregiver. The findings from the analysis of 721 services’ records from three Australian states, and feedback from health professionals in interviews and postal surveys, demonstrated that there were aspects of being on one’s own with a terminal illness and living at home that require a specialised approach and support. This study explored the issues of palliative care patients living alone, from a service provider perspective, and provided evidence-based information to assist with service planning. The study made recommendations to the Australian Department of Health and Ageing about services considered important in developing support structures for this growing population.

An analysis of the RC4 family of stream ciphers against algebraic attacks

To date, most applications of algebraic analysis and attacks on stream ciphers are on those based on lin- ear feedback shift registers (LFSRs). In this paper, we extend algebraic analysis to non-LFSR based stream ciphers. Specifically, we perform an algebraic analysis on the RC4 family of stream ciphers, an example of stream ciphers based on dynamic tables, and inves- tigate its implications to potential algebraic attacks on the cipher. This is, to our knowledge, the first pa- per that evaluates the security of RC4 against alge- braic attacks through providing a full set of equations that describe the complex word manipulations in the system. For an arbitrary word size, we derive alge- braic representations for the three main operations used in RC4, namely state extraction, word addition and state permutation. Equations relating the inter- nal states and keystream of RC4 are then obtained from each component of the cipher based on these al- gebraic representations, and analysed in terms of their contributions to the security of RC4 against algebraic attacks. Interestingly, it is shown that each of the three main operations contained in the components has its own unique algebraic properties, and when their respective equations are combined, the resulting system becomes infeasible to solve. This results in a high level of security being achieved by RC4 against algebraic attacks. On the other hand, the removal of an operation from the cipher could compromise this security. Experiments on reduced versions of RC4 have been performed, which confirms the validity of our algebraic analysis and the conclusion that the full RC4 stream cipher seems to be immune to algebraic attacks at present.

Cherbourg time : young black and deadly art 2003-2007

Art is most often at the margins of community life, seen as a distraction or entertainment only; an individual’s whim. It is generally seen as without a useful role to play in that community. This is a perception of grown-ups; children seem readily to accept an engagement with art making. Our research has shown that when an individual is drawn into a crafted art project where they have an actual involvement with the direction and production of the art work, then they become deeply engaged on multiple levels. This is true of all age groups. Artists skilled in community collaboration are able to produce art of value that transcends the usual judgements of worth. It gives people a licence to unfetter their imagination and then cooperatively be drawn back to a reachable visual solution. If you engage with children in a community, you engage the extended family at some point. The primary methodology was to produce a series of educationally valid projects at the Cherbourg State School that had a resonance into that community, then revisit and refine them where necessary and develop a new series that extended all of the positive aspects of them. This was done over a period of five years. The art made during this time is excellent. The children know it, as do their families, staff at the school, members of the local community and the others who have viewed it in exhibitions in far places like Brisbane and Melbourne. This art and the way it has been made has been acknowledged as useful by the children, teachers and the community, in educational and social terms. The school is a better place to be. This has been acknowledged by the children, teachers and the community The art making of the last five years has become an integral part of the way the school now operates and the influence of that has begun to seep into other parts of the community. Art needs to be taken from the margins and put to work at the centre.

An initial technology roadmap for home automation : home and personal life management

Home Automation (HA) has emerged as a prominent ¯eld for researchers and in- vestors confronting the challenge of penetrating the average home user market with products and services emerging from technology based vision. In spite of many technology contri- butions, there is a latent demand for a®ordable and pragmatic assistive technologies for pro-active handling of complex lifestyle related problems faced by home users. This study has pioneered to develop an Initial Technology Roadmap for HA (ITRHA) that formulates a need based vision of 10-15 years, identifying market, product and technology investment opportunities, focusing on those aspects of HA contributing to e±cient management of home and personal life. The concept of Family Life Cycle is developed to understand the temporal needs of family. In order to formally describe a coherent set of family processes, their relationships, and interaction with external elements, a reference model named Fam- ily System is established that identi¯es External Entities, 7 major Family Processes, and 7 subsystems-Finance, Meals, Health, Education, Career, Housing, and Socialisation. Anal- ysis of these subsystems reveals Soft, Hard and Hybrid processes. Rectifying the lack of formal methods for eliciting future user requirements and reassessing evolving market needs, this study has developed a novel method called Requirement Elicitation of Future Users by Systems Scenario (REFUSS), integrating process modelling, and scenario technique within the framework of roadmapping. The REFUSS is used to systematically derive process au- tomation needs relating the process knowledge to future user characteristics identi¯ed from scenarios created to visualise di®erent futures with richly detailed information on lifestyle trends thus enabling learning about the future requirements. Revealing an addressable market size estimate of billions of dollars per annum this research has developed innovative ideas on software based products including Document Management Systems facilitating automated collection, easy retrieval of all documents, In- formation Management System automating information services and Ubiquitous Intelligent System empowering the highly mobile home users with ambient intelligence. Other product ideas include robotic devices of versatile Kitchen Hand and Cleaner Arm that can be time saving. Materialisation of these products require technology investment initiating further research in areas of data extraction, and information integration as well as manipulation and perception, sensor actuator system, tactile sensing, odour detection, and robotic controller. This study recommends new policies on electronic data delivery from service providers as well as new standards on XML based document structure and format.

Birthing practices of traditional birth attendants in south Asia in the context of training programmes

Traditional Birth Attendants (TBA) training has been an important component of public health policy interventions to improve maternal and child health in developing countries since the 1970s. More recently, since the 1990s, the TBA training strategy has been increasingly seen as irrelevant, ineffective or, on the whole, a failure due to evidence that the maternal mortality rate (MMR) in developing countries had not reduced. Although, worldwide data show that, by choice or out of necessity, 47 percent of births in the developing world are assisted by TBAs and/or family members, funding for TBA training has been reduced and moved to providing skilled birth attendants for all births. Any shift in policy needs to be supported by appropriate evidence on TBA roles in providing maternal and infant health care service and effectiveness of the training programmes. This article reviews literature on the characteristics and role of TBAs in South Asia with an emphasis on India. The aim was to assess the contribution of TBAs in providing maternal and infant health care service at different stages of pregnancy and after-delivery and birthing practices adopted in home births. The review of role revealed that apart from TBAs, there are various other people in the community also involved in making decisions about the welfare and health of the birthing mother and new born baby. However, TBAs have changing, localised but nonetheless significant roles in delivery, postnatal and infant care in India. Certain traditional birthing practices such as bathing babies immediately after birth, not weighing babies after birth and not feeding with colostrum are adopted in home births as well as health institutions in India. There is therefore a thin precarious balance between the application of biomedical and traditional knowledge. Customary rituals and perceptions essentially affect practices in home and institutional births and hence training of TBAs need to be implemented in conjunction with community awareness programmes.

Twelve-month effectiveness of a parent-led, family-focused weight-management program for prepubertal children : a randomized, controlled trial

BACKGROUND Parenting-skills training may be an effective age-appropriate child behavior-modification strategy to assist parents in addressing childhood overweight. OBJECTIVE Our goal was to evaluate the relative effectiveness of parenting-skills training as a key strategy for the treatment of overweight children. DESIGN The design consisted of an assessor-blinded, randomized, controlled trial involving 111 (64% female) overweight, prepubertal children 6 to 9 years of age randomly assigned to parenting-skills training plus intensive lifestyle education, parenting-skills training alone, or a 12-month wait-listed control. Height, BMI, and waist-circumference z score and metabolic profile were assessed at baseline, 6 months, and 12 months (intention to treat). RESULTS After 12 months, the BMI z score was reduced by ∼10% with parenting-skills training plus intensive lifestyle education versus ∼5% with parenting-skills training alone or wait-listing for intervention. Waist-circumference z score fell over 12 months in both intervention groups but not in the control group. There was a significant gender effect, with greater reduction in BMI and waist-circumference z scores in boys compared with girls. CONCLUSION Parenting-skills training combined with promoting a healthy family lifestyle may be an effective approach to weight management in prepubertal children, particularly boys. Future studies should be powered to allow gender subanalysis.

Family-focused weight management program for five- to nine-year-olds incorporating parenting skills training with healthy lifestyle information to support behaviour modification

his case study aims to describe how general parenting principles can be used as part of parent-led, family-focused child weight management that is in line with current Australian Clinical Practice Guidelines. A parent-led, family-focused child weight management program was designed for use by dietitians with parents of young children (five- to nine-year-olds). The program utilises the cornerstones of overweight treatment: diet, activity, behaviour modification and family support delivered in an age-appropriate, family-focused manner. Parents participate in 16 sessions (4 parenting-focused, 8 lifestyle-focused and 4 individual telephone support calls) conducted weekly, fortnightly then monthly over six months. This case study illustrates how a family used the program, resulting in reduced degree of overweight and stabilised waist circumference in the child over 12 months. In conclusion, linking parenting skills to healthy family lifestyle education provides an innovative approach to family-focused child weight management. It addresses key Australian Clinical Practice Guidelines, works at the family level, and provides a means for dietitians to easily adopt age-appropriate behaviour modification as part of their practice.