Chronic condition management and self-management in Aboriginal communities in South Australia : outcomes of a longitudinal study

OBJECTIVES: This paper describes the longitudinal component of a larger mixed methods study into the processes and outcomes of chronic condition management and self-management strategies implemented in three Aboriginal communities in South Australia. The study was designed to document the connection between the application of structured systems of care for Aboriginal people and their longer-term health status. METHODS: The study concentrated on three diverse Aboriginal communities in South Australia; the Port Lincoln Aboriginal Health Service, the Riverland community, and Nunkuwarrin Yunti Aboriginal Health Service in the Adelaide metropolitan area. Repeated-measure clinical data were collected for individual participants using a range of clinical indicators for diabetes (type 1 and 2) and related chronic conditions. Clinical data were analysed using random effects modelling techniques with changes in key clinical indicators being modelled at both the individual and group levels. RESULTS: Where care planning has been in place longer than in other sites overall improvements were noted in BMI, cholesterol (high density and low density lipids) and HbA1c. These results indicate that for Aboriginal patients with complex chronic conditions, participation in and adherence to structured care planning and self-management strategies can contribute to improved overall health status and health outcomes. CONCLUSIONS: The outcomes reported here represent an initial and important step in quantifying the health benefits that can accrue for Aboriginal people living with complex chronic conditions such as diabetes, heart disease and respiratory disease. The study highlights the benefits of developing long-term working relationships with Aboriginal communities as a basis for conducting effective collaborative health research programs.

Low frequency ultrasound debridement (Sonoca-185) in acute wound management: a case study

There are numerous evidence-based wound debridement techniques that promote wound healing. However, some of these techniques may cause discomfort and pain for the patient and can be costly for the health care provider. A new, non-invasive wound debridement technique known as low-frequency ultrasonic debridement (LFUD) has been used for the removal of unhealthy tissue and bacterial load in wound management in the clinical setting. This paper reports the use of LFUD by a skin integrity clinical nurse consultant (CNC) as an adjuvant wound debridement and healing technique in a patient with a parastomal abscess. LFUD was found to benefit this patient in terms of expedited wound healing and increased comfort, enabling the patient to have a successful skin graft that led to complete wound closure and discharge from hospital in a timely manner.

Data summarization techniques for big data - a survey

In current digital era according to (as far) massive progress and development of internet and online world technologies such as big and powerful data servers we face huge volume of information and data day by day from many different resources and services which was not available to human kind just a few decades ago. This data comes from available different online resources and services that are established to serve customers. Services and resources like Sensor Networks, Cloud Storages, Social Networks and etc., produce big volume of data and also need to manage and reuse that data or some analytical aspects of the data. Although this massive volume of data can be really useful for people and corporates it could be problematic as well. Therefore big volume of data or big data has its own deficiencies as well. They need big storage/s and this volume makes operations such as analytical operations, process operations, retrieval operations real difficult and hugely time consuming. One resolution to overcome these difficult problems is to have big data summarized so they would need less storage and extremely shorter time to get processed and retrieved. The summarized data will be then in "compact format" and still informative version of the entire data. Data summarization techniques aim then to produce a "good" quality of summaries. Therefore, they would hugely benefit everyone from ordinary users to researches and corporate world, as it can provide an efficient tool to deal with large data such as news (for new summarization).

Evaporation, seepage and water quality management in storage dams: a review of research methods

One of the most significant sources of water wastage in Australia is loss from small storage dams, either by seepage or evaporation. Over much of Australia, evaporative demand routinely exceeds precipitation. This paper outlines first, methodologies and measurement techniques to quantify the rate of evaporative loss from fresh water storages. These encompass high-accuracy water balance monitoring; determination of the validity of alternative estimation equations, in particular the FAO56 Penman- Monteith ETo methodology; and the commencement of CFD modeling to determine a 'dam factor' in relation to practical atmospheric measurement techniques. Second, because the application of chemical monolayers is the only feasible alternative to the high cost of physically covering the storages to retard evaporation, the use of cetyl alcohol-based monolayers is reviewed, and preliminary research on their degradation by photolytic action, by wind break-up and by microbial degradation reported. Similarly, preliminary research on monolayer visualisation techniques for field application is reported; and potential enhancement of monolayers by other chemicals and attendant water quality issues are considered.

An exploration of how clinician attitudes and beliefs influence the implementation of lifestyle risk factor management in primary healthcare: a grounded theory study

Background

Despite the effectiveness of brief lifestyle intervention delivered in primary healthcare (PHC), implementation in routine practice remains suboptimal. Beliefs and attitudes have been shown to be associated with risk factor management practices, but little is known about the process by which clinicians' perceptions shape implementation. This study aims to describe a theoretical model to understand how clinicians' perceptions shape the implementation of lifestyle risk factor management in routine practice. The implications of the model for enhancing practices will also be discussed.

Methods

The study analysed data collected as part of a larger feasibility project of risk factor management in three community health teams in New South Wales (NSW), Australia. This included journal notes kept through the implementation of the project, and interviews with 48 participants comprising 23 clinicians (including community nurses, allied health practitioners and an Aboriginal health worker), five managers, and two project officers. Data were analysed using grounded theory principles of open, focused, and theoretical coding and constant comparative techniques to construct a model grounded in the data.

Results

The model suggests that implementation reflects both clinician beliefs about whether they should (commitment) and can (capacity) address lifestyle issues. Commitment represents the priority placed on risk factor management and reflects beliefs about role responsibility congruence, client receptiveness, and the likely impact of intervening. Clinician beliefs about their capacity for risk factor management reflect their views about self-efficacy, role support, and the fit between risk factor management ways of working. The model suggests that clinicians formulate different expectations and intentions about how they will intervene based on these beliefs about commitment and capacity and their philosophical views about appropriate ways to intervene. These expectations then provide a cognitive framework guiding their risk factor management practices. Finally, clinicians' appraisal of the overall benefits versus costs of addressing lifestyle issues acts to positively or negatively reinforce their commitment to implementing these practices.

Conclusion

The model extends previous research by outlining a process by which clinicians' perceptions shape implementation of lifestyle risk factor management in routine practice. This provides new insights to inform the development of effective strategies to improve such practices.

Power management and control strategies for efficient operation of a solar power dominated hybrid DC microgrid for remote power applications

In this paper, a hybrid DC microgrid consisting of a diesel generator with a rectifier, a solar photovoltaic (PV) system, and a battery energy storage system is presented in relation to an effective power management strategy and different control techniques are adopted to power electronic interfaces. The solar PV and battery energy storage systems are considered as the main sources of energy sources that supply the load demand on a daily basis whereas the diesel generator is used as a backup for the emergency operation of the microgrid. All system components are connected to a common DC bus through an appropriate power electronics devices (e.g., rectifier systems, DC/DC converter). Also a detailed sizing philosophy of all components along with the energy management strategy is proposed. Energy distribution pattern of each individual component has been conducted based on the monthly basis along with a power management algorithm. The power delivered by the solar PV system and diesel generator is controlled via DC-DC converterand excitation controllers which are designed based on a linearquadratic regulator (LQR) technique as as proportional integral (PI)controllers. The component level power distribution is investigatedusing these controllers under fluctuating load and solar irradiationconditions and comparative results are presented.

Impacts and management of feral cats Felis catus in Australia

Feral cats are among the most damaging invasive species worldwide, and are implicated in many extinctions, especially in Australia, New Zealand and other islands. Understanding and reducing their impacts is a global conservation priority. We review knowledge about the impacts and management of feral cats in Australia, and identify priorities for research and management. In Australia, the most well understood and significant impact of feral cats is predation on threatened mammals. Other impacts include predation on other vertebrates, resource competition, and disease transmission, but knowledge of these impacts remains limited. Lethal control is the most common form of management, particularly via specifically designed poison baits. Non-lethal techniques include the management of fire, grazing, food, and trophic cascades. Managing interactions between these processes is key to success. Given limitations on the efficacy of feral cat management, conservation of threatened mammals has required the establishment of insurance populations on predator-free islands and in fenced mainland enclosures. Research and management priorities are to: prevent feral cats from driving threatened species to extinction; assess the efficacy of new management tools; trial options for control via ecosystem management; and increase the potential for native fauna to coexist with feral cats.