Estimating the intensity of ward admission and its effect on emergency department access block

Emergency department access block is an urgent problem faced by many public hospitals today. When access block occurs, patients in need of acute care cannot access inpatient wards within an optimal time frame. A widely held belief is that access block is the end product of a long causal chain, which involves poor discharge planning, insufficient bed capacity, and inadequate admission intensity to the wards. This paper studies the last link of the causal chain-the effect of admission intensity on access block, using data from a metropolitan hospital in Australia. We applied several modern statistical methods to analyze the data. First, we modeled the admission events as a nonhomogeneous Poisson process and estimated time-varying admission intensity with penalized regression splines. Next, we established a functional linear model to investigate the effect of the time-varying admission intensity on emergency department access block. Finally, we used functional principal component analysis to explore the variation in the daily time-varying admission intensities. The analyses suggest that improving admission practice during off-peak hours may have most impact on reducing the number of ED access blocks.

Toughening epoxy thermosets with block ionomers : the role of phase domain size

Herein we report a novel approach to toughen epoxy thermosets using a block ionomer, i.e., sulfonated polystyrene-block-poly(ethylene-co-butylene)-block- polystyrene (SSEBS). SSEBS was synthesized by sulfonation of SEBS with 67 wt % polystyrene (PS). Phase morphology of the epoxy/SSEBS blends can be controlled at either nanometer or micrometer scale by simply adjusting the sulfonation degree of SSEBS. It has been found that there exists a critical degree of sulfonation (10.8 mol %) forming nanostructures in these epoxy/SSEBS blends. Above this critical value, macrophase separation can be avoided and only microphase separation occurs, yielding transparent nanostructured blends. All epoxy/SSEBS blends display increased fracture toughness compared to neat epoxy. But the toughening efficiency varies with the phase domain size, and their correlation has been established over a broad range of length scales from nanometers to a few micrometers. In the nanostructured blends with SSEBS of high sulfonation degrees, the fracture toughness decreases with decreasing size of the phase domains. In the macrophase-separated blends, only a slight improvement in toughness can be obtained with SSEBS of low sulfonation degrees. The epoxy blend with submicrometer phase domains in the range 0.05-1.0 μm containing SSEBS of a moderate degree of sulfonation (5.8 mol %) displays the maximum toughness. This study has clearly clarified the role of phase domain size on toughening efficiency in epoxy thermosets.

Nanostructure toughening of epoxy thermosets with block Ionomer complexes

This thesis addresses an important issue in polymer materials science, the toughening of thermosetting polymers. A novel approach has been developed, i.e., the use of block ionomers/complexes to promote compatibilization with thermosetting epoxies. The morphology and mechanical properties of the resulting nanostructured epoxies were intensively studied to establish structure-property correlation.

Synthesis and self-assembly of hybrid amphiphilic block copolymers

This thesis focused on the synthesis and self-assembly of novel block copolymers for the purpose of drug delivery. The block copolymers achieved comprise of a synthetic block and a peptide block and self-assemble into nano sized particles which can act as drug containers.

Made in New Zealand: place and enchantment in Margaret Mahy's picture books

Margaret Mahy published over a hundred picture books from A Lion in the Meadow in 1969 to a cluster of posthumous texts. This article considers the extent to which Mahy’s picture books can be said to have been “made in New Zealand,” given that most have been illustrated by artists from other countries, particularly Britain. Mahy’s picture book narratives are, I argue, informed by values, assumptions and orientations toward the natural world which subtly but unmistakably locate protagonists in New Zealand, even when the books’ illustrations reflect British, American or Canadian geographic and cultural settings. In this sense Mahy’s picture books are transnational products, traversing national and cultural boundaries.

Two trees: Australian artists' books to Afghanistan and back

Two Trees documents an artists' books collaboration between 14 Australian women artists and women in Afghanistan who were learning literacy. The collaboration resulted in 36 concertina books of images, withDari and Pashto hand written texts.The books are held in the State Library of Queensland's artists' books collection. Two Trees includes includes an introduction by Barbara Kameniar, and texts by Malalai Joya, Gali Weiss, Matthias Thomczak and Latifa Ahmady.

Distinct disulfide isomers of μ-Conotoxins KIIIA and KIIIB block voltage-gated sodium channels

In the preparation of synthetic conotoxins containing multiple disulfide bonds, oxidative folding can produce numerous permutations of disulfide bond connectivities. Establishing the native disulfide connectivities thus presents a significant challenge when the venom-derived peptide is not available, as is increasingly the case when conotoxins are identified from cDNA sequences. Here, we investigate the disulfide connectivity of μ-conotoxin KIIIA, which was predicted originally to have a [C1–C9,C2–C15,C4–C16] disulfide pattern based on homology with closely related μ-conotoxins. The two major isomers of synthetic μ-KIIIA formed during oxidative folding were purified and their disulfide connectivities mapped by direct mass spectrometric collision-induced dissociation fragmentation of the disulfide-bonded polypeptides. Our results show that the major oxidative folding product adopts a [C1–C15,C2–C9,C4–C16] disulfide connectivity, while the minor product adopts a [C1–C16,C2–C9,C4–C15] connectivity. Both of these peptides were potent blockers of NaV1.2 (Kd values of 5 and 230 nM, respectively). The solution structure for μ-KIIIA based on nuclear magnetic resonance data was recalculated with the [C1–C15,C2–C9,C4–C16] disulfide pattern; its structure was very similar to the μ-KIIIA structure calculated with the incorrect [C1–C9,C2–C15,C4–C16] disulfide pattern, with an α-helix spanning residues 7–12. In addition, the major folding isomers of μ-KIIIB, an N-terminally extended isoform of μ-KIIIA identified from its cDNA sequence, were isolated. These folding products had the same disulfide connectivities as μ-KIIIA, and both blocked NaV1.2 (Kd values of 470 and 26 nM, respectively). Our results establish that the preferred disulfide pattern of synthetic μ-KIIIA and μ-KIIIB folded in vitro is 1–5/2–4/3–6 but that other disulfide isomers are also potent sodium channel blockers. These findings raise questions about the disulfide pattern(s) of μ-KIIIA in the venom of Conus kinoshitai; indeed, the presence of multiple disulfide isomers in the venom could provide a means of further expanding the snail’s repertoire of active peptides.

Permian fusuline fauna from the lower part of the lugu formation in the central qiangtang block and its geological implications

A Kubergandian (Kungurian) fusuline fauna from the lower part of the Lugu Formation in the Cuozheqiangma area, central Qiangtang Block is described. This fusuline fauna belongs to the Southern Transitional Zone in palaeobiogeography, and is characterised by the presence of the distinctive bi-temperate genus Monodiexodina and many genera common in lower latitude Tethyan areas such as Parafusulina and Pseudodoliolina. The occurrence of Monodiexodina in the fauna confirms that the seamount-type carbonates of the Lugu Formation did not originate from the Palaeotethys Ocean, but rather from a branch of the Neotethys Ocean after the rifting of the Qiangtang Block from the Tethys Himalaya area in the Artinskian. © 2014 Geological Society of China.

Unfolding projects: Afghan and Australian artist’s books collaborations

In August 2009 an email was circulated to a number of Australian women artists with an offer to participate in a project of dialogue with women in Afghanistan. The project grew as a response to the dire situation of many women in Afghanistan, particularly in relation to education; many women are illiterate because they were and often still are, forbidden, restricted, or discouraged from attending school. By April 2010, 53 artists’ books by 14 women artists from various parts of Australia were delivered to Afghanistan, thereby beginning a process of creative collaboration between women situated in different places, cultures, and languages, attempting a productive connection through image and text. Each artist had created a small series of concertinas of imagery consistent with her current studio practice, which were then delivered to Afghanistan and distributed amongst women participating in literacy education. The women were asked to relate to the images by writing their own words directly within. The general intent was for the concertinas to be sent back to Australia, then bound and exhibited to raise public awareness, and possibly sold to raise funds. The artistic intent, however, was not the fundraising aspect as much as to take part in a process of support and dialogue with women in Afghanistan. It was a manoeuvre that said 'you are not alone'. The aim was to mobilise a conversation of sorts through the visuality and materiality of the artist’s book, despite the limitations of cultural, experiential, and physical distance. Just over six months from their delivery to Afghanistan, 36 of the 53 books returned to Australia, each marked with handwritten stories and poems in Dari and Pashto. This paper discusses the processes and considerations involved in the project, and the partnership formed with SAWA-Australia (Support Association for the Women of Afghanistan).