Building Healthy Communities : GP Network, Medicare Local and Primary Health Care in the Wheatbelt Region of Western Australia

• Government reports consistently recognise the importance of Primary Health Care to an efficient health system. Barriers identified in Australia’s Primary Health Care include workforce pressures, increase rate of chronic disease, and equitable access to Primary Health Care services. • General Practitioners (GPs) are the key to the successful delivery of Primary Health Care especially in rural and remote regions such as the Wheatbelt region in Western Australia (WA). • The Wheatbelt region of WA is vast: some 72,500 residents spread across 150,000km2 in 43 Local Government Authorities catchments. Majority of the Wheatbelt residents live in small towns. There is a higher reported rates of chronic disease, more at risk of chronic diseases and less utilisation of Primary Health Care services in this region. • General practice patients in the Wheatbelt are among those most in need of Primary Health Care services. • Wheatbelt GP Network (the “Network”) was established in 1998. It is a key health service delivery stakeholder in the Wheatbelt. • The Network has responded to the health needs of the community by creating a mobile Allied Health Team that works closely with GPs and is adaptive to ensure priority needs are met. • The Medicare Local model introduced by the Australian Government in 2011 aimed to improve the delivery of Primary Health Care services by improved health planning and coordinating service delivery. • Little if any recognition has been given to the outstanding work that many Divisions of General Practice have done in improving the delivery of Primary Health Care services such as the Network. • The Network has continued to support GPs and general practices and created a complementary system that integrated general practice with the work of an Allied Health Team. Its program mix is extensive. • The Network has consistently delivered on-required contract outputs and has a fifteen (15) years history of operating successfully in a large geographical area comprising in the main smaller communities that cannot support the traditional health services model. • The complexity of supporting International Medical Graduates in the region requires special attention. • The introduction of the Medicare Local in the South West of WA and their intention to take over the delivery of health services, thus effectively shutting the Network will have catastrophic consequences and cannot be supported economically. • The Network proposes to create a new model, built on its past work that increases the delivery of Primary Health Care services through its current Allied Health Team. • The proposal uses the Wheatbelt GP Super Clinic currently under construction in Northam, part of the Network and funded by the Australian Government is a key to the proposed new model. • Wheatbelt GP Super Clinic is different from existing models of GP Super Clinics around Australia which focus predominately on co-location of services. Wheatbelt GP Super Clinic utilises a hub and spoke model of service outreach to small rural towns to ensure equitable Primary Health Care coverage and continuum of care in a financially responsible and viable manner. In particular, the Wheatbelt GP Super Clinic recognises the importance of Allied Health Professionals and will involve them in a collaborative model with rural general practice. • The proposed model advocated by the Network aims to substitute the South West WA Medicare Local direct service delivery proposed for the Wheatbelt. The Network’s proposed model is to expand on the current hub and spoke model of Primary Health Care delivery to otherwise small unviable Wheatbelt towns. A flexible and adaptive skill mix of Allied Health Professionals, Nurse Practitioners and GPs ensure equitable access to service. Expanded scope of practices are utilised to reduce duplication of service and concentration of services in major towns. This involves a partnership approach. • If the proposed model not funded, the Network and the Wheatbelt region will stand to lose 16 Allied Health Professionals and defeats the purpose of Australian Government current funding for the construction of the Wheatbelt GP Super Clinic. • The Network has considered how its model can best be funded. It proposes a re-allocation of funds made available to the South West WA Medicare Local. • This submission argues that the proposal for the South West WA Medicare Local to take over the service delivery of Primary Health Care services in the Wheatbelt makes no economic sense when an existing agency (the Network) has the infrastructure in place, is experienced in working in this geographical area that has special needs and is capable to expand its programs to meet demand.

Odometry-driven inference to link multiple exemplars of a location

A major challenge for robot localization and mapping systems is maintaining reliable operation in a changing environment. Vision-based systems in particular are susceptible to changes in illumination and weather, and the same location at another time of day may appear radically different to a system using a feature-based visual localization system. One approach for mapping changing environments is to create and maintain maps that contain multiple representations of each physical location in a topological framework or manifold. However, this requires the system to be able to correctly link two or more appearance representations to the same spatial location, even though the representations may appear quite dissimilar. This paper proposes a method of linking visual representations from the same location without requiring a visual match, thereby allowing vision-based localization systems to create multiple appearance representations of physical locations. The most likely position on the robot path is determined using particle filter methods based on dead reckoning data and recent visual loop closures. In order to avoid erroneous loop closures, the odometry-based inferences are only accepted when the inferred path's end point is confirmed as correct by the visual matching system. Algorithm performance is demonstrated using an indoor robot dataset and a large outdoor camera dataset.

Constructing a frame of cube : connecting 3D shapes with direction, location and movement

With the advancement of new technologies, this author has in 2010 started to engineer an online learning environment for investigating the nature and development of spatial abilities, and the teaching and learning of geometry. This paper documents how this new digital learning environment can afford the opportunity to integrate the learning about 3D shapes with direction, location and movement, and how young children can mentally and visually construct virtual 3D shapes using movements in both egocentric and fixed frames of reference (FOR). Findings suggest that year 4 (aged 9) children can develop the capacity to construct a cube using egocentric FOR only, fixed FOR only or a combination of both FOR. However, these young participants were unable to articulate the effect of individual or combined FOR movements. Directions for future research are proposed.

Conceptions of ‘community’ among older adults living in high-density urban areas : an Australian case study

Aim The aim of this study was to explore the social networks of community and its connection to location for older people living in inner city high density (ICHD). Method Using a case study approach employing qualitative (diaries, in-depth interviews) and quantitative (global positioning systems and geographical information systems mapping) methods, this paper explores the everyday interaction and social networks and where they manifest spatially for a group of older ICHD Australians. Results Social networks in two community territories were found to be of particular importance to participants in terms of influencing feelings of well-being, support, social inclusion and cohesion. These two territories include the building where older people reside and the area immediately surrounding the building. Conclusion This study highlights the importance of recognising the spatial aspect to better understand the social networks of community and their effects on well-being and social cohesion for ICHD older people.

Comparing female victims of separation/divorce assault across geographical regions

Recent analyses of National Crime Victimization Survey (NCVS) data show that male-to-female separation/divorce assault varies across geographic regions in the United States, with rural rates of such woman abuse being higher than those for suburban and urban areas. Using the same data set, the main objective of this paper is to present the results of an investigation into whether characteristics of female victims of separation/divorce assault also differ across urban, suburban, and rural communities.

Current trends and issues in geographical education

In this introductory chapter to Schmeinck, D. and Lidstone, J. (2014) “Current trends and issues in geographical education” in Schmeinck, D. and Lidstone, J. (2014) Eds) Standards and Research in Geographical Education: Current Trends and International Issues. Berlin. Mensch und Buch Verlag. Pp. 5 - 16. , the authors review and analyse eleven papers originally presented to the Congress of the International Geographical Union held in Cologne in 2012. Taking the collection of papers as a single corpus representing the “state of the art” of geography education, they applied lexical and bibliometric analyses in an innovative attempt to identify the nature of geographical education as represented by this anthology of peer reviewed chapters presented at the start of the second decade of the Twenty-first century?

Standards and Research in Geographical Education: Current Trends and International Issues

What is the state of geographical education in the second decade of the 21st century? This volume presents a selection of peer reviewed papers presented at the 2012 Cologne Congress of the International Geographical Union (IGU) sessions on Geographical Education as representative of current thinking in the area. It then presents (perhaps for the first time) a cross-case analysis of the common factors of all these papers as a current summary of the “state of the art” of geographical education today. The primary aim of the individual authors as well as the editors is not only to record the current state of the art of geographical education but also to promote ongoing discussions of the longer term health and future prospects of international geographical education. We wish to encourage ongoing debate and discussion amongst local, national, regional and international education journals, conferences and discussion groups as part of the international mission of the Commission on Geographical Eduction. While the currency of these chapters in terms of their foci, breadth and recency of the theoretical literature on which they are based and the new research findings they present justifies considerable confidence in the current health of geographical education as an educational and research endeavour, each new publication should only be the start of new scholarly inquiry. Where should we, as a scholarly community, place our energies for the future? If readers are left with a new sense of direction, then the aims of the authors and editors will have been amply met.

Geo-locked photo sharing on mobile devices

We introduce the idea of geo-locking through a mobile phone based photo sharing application called Picalilly (figure 1). Using its geo-locking feature, Picalilly allows its users to manually define geographical boundaries for sharing photos -- limiting sharing within user-defined boundaries as well as facilitating open sharing between strangers within such boundaries. To explore the potential of geo-locking, we carried out a small scale field trial of Picalilly involving two groups of students, who were part of a two-week long introduction program at a university. Our preliminary results show that Picalilly facilitated 1) sharing of 'places' and 2) localized explorations.

Occupy Oakland and #oo : uses of Twitter within the Occupy movement

Social media have become crucial tools for political activists and protest movements, providing another channel for promoting messages and garnering support. Twitter, in particular, has been identified as a noteworthy medium for protests in countries including Iran and Egypt to receive global attention. The Occupy movement, originating with protests in, and the physical occupation of, Wall Street, and inspiring similar demonstrations in other U.S. cities and around the world, has been intrinsically linked with social media through location-specific hashtags: #ows for Occupy Wall Street, #occupysf for San Francisco, and so on. While the individual protests have a specific geographical focus-highlighted by the physical occupation of parks, buildings, and other urban areas-Twitter provides a means for these different movements to be linked and promoted through tweets containing multiple hashtags. It also serves as a channel for tactical communications during actions and as a space in which movement debates take place. This paper examines Twitter's use within the Occupy Oakland movement. We use a mixture of ethnographic research through interviews with activists and participant observation of the movements' activities, and a dataset of public tweets containing the #oo hashtag from early 2012. This research methodology allows us to develop a more accurate and nuanced understanding of how movement activists use Twitter by cross-checking trends in the online data with observations and activists' own reported use of Twitter. We also study the connections between a geographically focused movement such as Occupy Oakland and related, but physically distant, protests taking place concurrently in other cities. This study forms part of a wider research project, Mapping Movements, exploring the politics of place, investigating how social movements are composed and sustained, and the uses of online communication within these movements.

Identifying steganographic payload location in binary image

In this paper, we propose a steganalysis method that is able to identify the locations of stego bearing pixels in the binary image. In order to do that, our proposed method will calculate the residual between a given stego image and its estimated cover image. After that, we will compute the local entropy difference between these two versions of images as well. Finally, we will compute the mean of residual and mean of local entropy difference across multiple stego images. From these two means, the locations of stego bearing pixels can be identified. The presented empirical results demonstrate that our proposed method can identify the stego bearing locations of near perfect accuracy when sufficient stego images are supplied. Hence, our proposed method can be used to reveal which pixels in the binary image have been used to carry the secret message.

Location of hydrogen atoms in hydronium jarosite

Various models for the crystal structure of hydronium jarosite were determined from Rietveld refinements against neutron powder diffraction patterns collected at ambient temperature and also single-crystal X-ray diffraction data. The possibility of a lower symmetry space group for hydronium jarosite that has been suggested by the literature was investigated. It was found the space group is best described as R3¯m, the same for other jarosite minerals. The hydronium oxygen atom was found to occupy the 3¯m site (3a Wyckoff site). Inadequately refined hydronium bond angles and bond distances without the use of restraints are due to thermal motion and disorder of the hydronium hydrogen atoms across numerous orientations. However, the acquired data do not permit a precise determination of these orientations; the main feature up/down disorder of hydronium is clear. Thus, the highest symmetry model with the least disorder necessary to explain all data was chosen: The hydronium hydrogen atoms were modeled to occupy an m (18 h Wyckoff site) with 50 % fractional occupancy, leading to disorder across two orientations. A rigid body description of the hydronium ion rotated by 60° with H–O–H bond angles of 112° and O–H distances of 0.96 Å was optimal. This rigid body refinement suggests that hydrogen bonds between hydronium hydrogen atoms and basal sulfate oxygen atoms are not predominant. Instead, hydrogen bonds are formed between hydronium hydrogen atoms and hydroxyl oxygen atoms. The structure of hydronium alunite is expected to be similar given that alunite supergroup minerals are isostructural.

An assessment of the geographical scale of recurrent gene flow in wild populations of two species of Mekong River carps (Henicorhynchus spp.)

The Mekong is the most productive river fishery in the world, and such as, the Mekong River Basin (MRB) is very important to very large human populations across the region as a source of revenue (through fishing and marketing of aquatic resources products) and as the major source for local animal protein. Threats to biodiversity in the MRB, either to the fishery sector itself or to other sectors are a major concern, even though currently, fisheries across this region are still very productive. If not managed properly however, fish population declines will cause significant economic impact and affect livelihoods of local people and will have a major impact on food security and nutrition. Biodiversity declines will undoubtedly affect food security, income and socio-economic status of people in the MRB that depend on aquatic resources. This is an indicator of unsustainable development and hence should be avoided. Genetic diversity (biodiversity) that can be measured using techniques based on DNA markers; refers to variation within and among populations within the same species or reproductive units. In a population, new genetic variation is generated by sexual recombination contributed by individuals with mutations in genes and chromosomes. Over time, populations of a species that are not reproducing together will diverge as differential impacts of selection and genetic drift change their genetic attributes. For mud carp (Henicorhynchus spp.), understanding the status of breeding units in the MRB will be important for their long term persistence, sustainability and for implementing effective management strategies. Earlier analysis of stock structure in two economically important mud carp species (Henicorhynchus siamensis and H. lobatus) in the MRB completed with mtDNA markers identified a number of populations of both species where gene flow had apparently been interrupted or reduced but applying these data directly to management unit identification is potentially compromised because information was only available about female dispersal patterns. The current study aimed to address this problem and to fully assess the extent of current gene flow (nDNA) and reproductive exchange among selected wild populations of two species of carp (Henicorhynchus spp.) of high economic importance in the MRB using combined mtDNA and nDNA markers. In combination, the data can be used to define effective management units for each species. In general, nDNA diversity for H. lobatus (with average allelic richness (A) 7.56 and average heterozygosity (Ho) 0.61) was very similar to that identified for H. siamensis (A = 6.81 and Ho = 0.75). Both mud carp species show significant but low FST estimates among populations as a result of lower genetic diversity among sampled populations compared with genetic diversity within populations that may potentially mask any 'real' population structure. Overall, population genetic structure patterns from mtDNA and nDNA in both Henicorhynchus species were largely congruent. Different population structures however, were identified for the two Henicorhynchus species across the same geographical area. Apparent co-similarity in morphology and co-distribution of these two relatively closely related species does not apparently imply parallel evolutionary histories. Differences in each species population structure likely reflect historical drainage rearrangement of the Mekong River. The data indicate that H. siamensis is likely to have occupied the Mekong system for much longer than has H. lobatus in the past. Two divergent stocks were identified for H. lobatus in the MRB below the Khone Falls while a single stock had been evident in the earlier mtDNA study. This suggests that the two Henicorhynchus species may possess different life history traits and that different patterns of gene flow has likely influenced modern genetic structure in these close congeners. In combination, results of the earlier mtDNA and the current study have implications for effective management of both Henicorhynchus species across the MRB. Currently, both species are essentially treated as a single management unit in this region. This strategy may be appropriate for H. lobatus as a single stock was evident in the main stream of the MRB, but may not be appropriate for H. siamensis as more than a single stock was identified across the same range for this species. Management strategies should consider this difference to conserve overall biodiversity (local discrete populations) and this will include maintaining natural habitat and migration pathways, provision of fish sanctuaries (refuges) and may also require close monitoring of any stock declines, a signal that may require effective recovery strategies.

Top-k retrieval using facility location analysis

The top-k retrieval problem aims to find the optimal set of k documents from a number of relevant documents given the user’s query. The key issue is to balance the relevance and diversity of the top-k search results. In this paper, we address this problem using Facility Location Analysis taken from Operations Research, where the locations of facilities are optimally chosen according to some criteria. We show how this analysis technique is a generalization of state-of-the-art retrieval models for diversification (such as the Modern Portfolio Theory for Information Retrieval), which treat the top-k search results like “obnoxious facilities” that should be dispersed as far as possible from each other. However, Facility Location Analysis suggests that the top-k search results could be treated like “desirable facilities” to be placed as close as possible to their customers. This leads to a new top-k retrieval model where the best representatives of the relevant documents are selected. In a series of experiments conducted on two TREC diversity collections, we show that significant improvements can be made over the current state-of-the-art through this alternative treatment of the top-k retrieval problem.

Serial explant culture provides novel insights into the potential location and phenotype of corneal endothelial progenitor cells

The routine cultivation of human corneal endothelial cells, with the view to treating patients with endothelial dysfunction, remains a challenging task. While progress in this field has been buoyed by the proposed existence of progenitor cells for the corneal endothelium at the corneal limbus, strategies for exploiting this concept remain unclear. In the course of evaluating methods for growing corneal endothelial cells, we have noted a case where remarkable growth was achieved using a serial explant culture technique. Over the course of 7 months, a single explant of corneal endothelium, acquired from cadaveric human tissue, was sequentially seeded into 7 culture plates and on each occasion produced a confluent cell monolayer. Sample cultures were confirmed as endothelial in origin by positive staining for glypican-4. On each occasion, small cells, closest to the tissue explant, developed into a highly compact layer with an almost homogenous structure. This layer was resistant to removal with trypsin and produced continuous cell outgrowth during multiple culture periods. The small cells gave rise to larger cells with phase-bright cell boundaries and prominent immunostaining for both nestin and telomerase. Nestin and telomerase were also strongly expressed in small cells immediately adjacent to the wound site, following transfer of the explant to another culture plate. These findings are consistent with the theory that progenitor cells for the corneal endothelium reside within the limbus and provide new insights into expected expression patterns for nestin and telomerase within the differentiation pathway.