Genetic diversity and regional identity in the Australian remnant Nothofagus moorei

Nothofagus moorei (F. Muell.) Krasser has a disjunct and narrow distribution in south-eastern Australian cool temperate rainforest. To assess the conservation-genetic priorities for this species, the genetic diversity of 20 populations sampled from the largest remnant patches at northern and southern distributional extremes, the McPherson and Barrington ranges (a total of 146 individuals), was investigated by using inter simple sequence repeats (ISSR). Regeneration in northern regions of N. moorei has been documented to be predominantly by vegetative means, but our results indicate little evidence of clonality outside the multi-stemmed rings of trees. In addition, genetic diversity was considerably higher in the northern (McPherson, h = 0.1613) than in the southern range (Barrington, h = 0.1159), and genetic differentiation was significantly positively correlated with geographic distance in the former region, but not the latter. Total intraspecific variation was moderate, as measured by Shannon's diversity index, I = 0.2719, and Nei's gene diversity, h = 0.1672, and is considered at the high end of spectrum for estimates of narrow endemic species. An analysis of molecular variation indicated that the majority of genetic variation is partitioned among individuals within population (60%; P < 0.001), rather than among populations within regions (10%; P < 0.001). However, a large and significant component of the measured diversity was partitioned between northern and southern regions (29%; P < 0.001). Several hypotheses are outlined to explain these differences and management implications are discussed. However, given the narrow range, poor dispersal mechanism and restriction to cool temperate rainforest, the continued existence of N. moorei is most threatened by environmental instability and habitat loss resulting from global climate change. In this context the northern regions of the species are most at risk and extinction of such populations would lead to a significant loss of genetic variation for the species as a whole.

Effects of care pathways on stroke care practices at regional hospitals

Background: Our previous work identified deficiencies in stroke care practices at regional hospitals in comparison to standards suggested by published stroke care guidelines. These deficiencies might be improved by the implementation of clinical pathways. The aim of this study was to assess changes in acute stroke care practices following the implementation of stroke care pathways at four regional Queensland hospitals. Methods: The medical records of two cohorts of 120 patients with a discharge diagnosis of stroke or transient ischaemic attack were retrospectively audited before and after implementation of stroke care pathways to identify differences in the use of acute interventions, investigations and secondary prevention strategies. Results: Following pathway implementation there were clinically important, but not statistically significant, increases in the rates of swallow assessment, allied health assessment (significant for occupational therapy, P = 0.04) and use of deep vein thrombosis prevention strategies (also significant, P = 0.006). Fewer patients were discharged on no anti-thrombotic therapy (statistically significant in the subgroup of patients with atrial fibrillation, P = 0.02). Only 37% of the patients audited were actually enrolled on the pathway. Among this subgroup there were significant increases in the rates of swallow assessment (first 24 h, P = 0.01; any time during admission, P = 0.0001), allied health assessments (all P < 0.05), estimation of blood glucose level (P = 0.0015) and the use of deep vein thrombosis prevention strategies (P = 0.0003). Conclusion: Stroke care pathways appear to improve the process of care. Whether this influences outcomes such as mortality, functional and neurological recovery, the incidence of complications, length of stay or the cost of care was beyond the scope of this study and will require further examination.

Reduction in scar thickness post myocardial infarction is secondary to increase in regional left ventricular volumes

We sought to determine the relative impact of myocardial scar and viability on post-infarct left ventricular (LV) remodeling in medically-treated patients with LV dysfunction. Forty patients with chronic ischemic heart disease (age 64±9, EF 40±11%) underwent rest-redistribution Tl201 SPECT (scar = 50% transmural extent), A global index of scarring for each patient (CMR scar score) was calculated as the sum of transmural extent scores in all segts. LV end diastolic volumes (LVEDV) and LV end systolic volumes (LVESV) were measured by real-time threedimensional echo at baseline and median of 12 months follow-up. There was a significant positive correlation between change in LVEDV with number of scar segts by all three imaging techniques (LVEDV: SPECT scar, r = 0.62, p < 0.001; DbE scar, r = 0.57, p < 0.001; CMR scar, r = 0.52, p < 0.001) but change in LV volumes did not the correlate with number of viable segments. ROC curve analysis showed that remodeling (LVEDV> 15%) was predicted bySPECTscars(AUC= 0.79),DbEscars(AUC= 0.76),CMR scars (AUC= 0.70), and CMR scar score (AUC 0.72). There were no significant differences between any of the ROC curves (Z score

The network structure of a regional tourism organization: Application of he social network theory in one region of Queensland

Regional tourism organizations (RTOs) plays a central role in planning, coordinating and marketing tourism in many areas, including Queensland, Australia. RTOs rely on interaction with a network of other organizations for their efficient functioning. This paper describes an exploratory case study that develops a method for use of social network analysis techniques to analyse the inter-organizational network in one RTO region in Queensland. Results indicate that differences exist in the structure of inter-organizational links between commercial tourism organizations and planning organizations, between tourism organizations and other sectoral clusters, and between organizations at local, regional and state levels. The results highlight areas or improvement in the role and responsibilities of RTOs in Queensland.

A comparison of telepaediatric activity at two regional hospitals in Queensland

We conducted a 15-month feasibility study of telepaediatrics. A novel service was offered to two hospitals in Queensland (Mackay and Hervey Bay). We used data from all other hospitals throughout the state as the control group. Although both intervention hospitals were provided with the same service, the telepaediatric activity generated and the effect on admissions and outpatient activity were markedly different. There was a significant decrease in the number of patient admissions to Brisbane from the Mackay region. In addition, there was an increase in the number of Mackay patients treated locally (as outpatients). In contrast, little change was observed in Hervey Bay. We assessed whether the observed differences between the two hospitals were due to various factors which influenced the use of the telepaediatric service. These factors included the method of screening patients before transfer to the tertiary centre and the physical distance between each facility and the tertiary centre. We believe that the screening method used for patient referrals was the most important determinant of the use of the telepaediatric service.