Health-related quality of life of Australians with Parkinson disease : a comparison with international studies

Purpose: This study describes the health-related quality of life (HRQOL) of Australians living with Parkinson disease (PD) and compares the findings to international reports.
Methods: The Parkinson’s Disease Questionnaire-39 (PDQ-39) was used to measure HRQOL in 210 individuals with PD living in Australia. In parallel, a tailored literature search identified previous studies on HROQL in people with PD. A quantitative meta-analysis with a random-effects model was used to compare the HRQOL of individuals with PD living in Australia and other countries.
Results : The mean PDQ-39 summary index (SI) score for this sample of Australians with PD was 20.9 (SD 12.7). Ratings for the dimension of social support and stigma were significantly lower than ratings for bodily discomfort, mobility, activities of daily living, cognition, and emotional well-being. Comparing the Australian and international PD samples revealed a significant heterogeneity in overall HRQOL (I² = 97%). The mean PDQ-39 SI scores for Australians were lower, indicating better HRQOL relative
to samples from other countries.
Conclusions: This Australian sample with PD perceived their HRQOL as poor, although it was less severely compromised than that of international samples. While further research is required, these findings can inform the clinical decision-making processes of physiotherapists

Uplink power control via adaptive Hidden-Markov-Model-Based pathloss estimation

Dynamic variations in channel behavior is considered in transmission power control design for cellular radio systems. It is well known that power control increases system capacity, improves Quality of Service (QoS), and reduces multiuser interference. In this paper, an adaptive power control design based on the identification of the underlying pathloss dynamics of the fading channel is presented. Formulating power control decisions based on the measured received power levels allows modeling the fading channel pathloss dynamics in terms of a Hidden Markov Model (HMM). Applying the online HMM identification algorithm enables accurate estimation of the real pathloss ensuring efficient performance of the suggested power control scheme.

Technology transfer, quality standards, and North–South trade

This paper examines the economic consequences of technology transfer through licensing in a North–South model of vertical product differentiation, based on a product-line pricing framework. With its limited technological expertise, the southern firm cannot export to the northern market without purchasing the northern firm's “clean” and low-cost technology. With North–South cost-asymmetry, we conclude that the transfer of technology through licensing promotes trade, product variety and improves global welfare. However, without government intervention, the private levels of product quality chosen by firms tend to be lower than the socially optimal levels. This finding helps to explain why developed countries often set quality standards for imported foreign products.

The cost-effectiveness of the Dose Adjustment for Normal Eating (DAFNE) structured education programme: an update using the Sheffield Type 1 Diabetes policy model

AIMS: 
To estimate the cost-effectiveness of training in flexible intensive insulin therapy [as provided in the Dose Adjustment for Normal Eating (DAFNE) structured education programme] compared with no training for adults with Type 1 diabetes mellitus in the UK using the Sheffield Type 1 Diabetes Policy Model.

METHODS: 
The Sheffield Type 1 Diabetes Policy Model was used to simulate the development of long-term microvascular and macrovascular diabetes-related complications and the occurrence of diabetes-related adverse events in 5000 adults with Type 1 diabetes. Total costs and quality-adjusted life years were estimated from a National Health Service perspective over a lifetime horizon, discounted at a rate of 3.5%. The treatment effectiveness of DAFNE was modelled as a reduction in HbA1c that affected the risk of developing long-term diabetes-related complications. Probabilistic and structural sensitivity analyses were conducted.

RESULTS:
DAFNE resulted in greater life expectancy and reduced incidence of some diabetes-related complications compared with no DAFNE. DAFNE was found to generate an average of 0.0294 additional quality-adjusted life years for an additional cost of £426 per patient, leading to an incremental cost-effectiveness ratio of £14 400 compared with no DAFNE. There was a 54% probability that DAFNE would be cost-effective at a willingness-to-pay threshold of £20 000 per quality-adjusted life year.

CONCLUSIONS: 
The results of this study suggest that DAFNE is a cost-effective structured education programme for people with Type 1 diabetes and support its provision by the National Health Service in the UK.

Integrated depression management: a proposed trial of a new model of care in a low vision rehabilitation setting

Purpose:
Depression is a common problem among people with visual impairment and contributes to functional decline. This article presents a study protocol to evaluate a new model of care for those patients with depressive symptoms in which psychological treatment is integrated into low vision rehabilitation services. Low vision staff will be trained to deliver "problem solving therapy for primary care" (PST-PC), an effective psychological treatment developed specifically for delivery by non-mental health care staff. PST-PC is delivered in 8 weekly telephone sessions of 30-45 minutes duration and 4 monthly maintenance sessions. We predict this new integrated model of care will significantly reduce depressive symptoms and improve the quality of life for people with visual impairment.

Methods and Design:
A randomized controlled trial of PST-PC will be implemented nationally across low vision rehabilitation services provided by Vision Australia. Clients who screen positive for depressive symptoms and meet study criteria will be randomized to receive PST-PC or usual care, consisting of a referral to their general practitioner for more detailed assessment and treatment. Outcome measures include depressive symptoms and behaviors, quality of life, coping and psychological adjustment to visual impairment. Masked assessments will take place pre- and post-intervention as well as at 6- and 12-month follow-up.

Conclusion:
We anticipate that this innovative service delivery model will lead to sustained improvements in clients' quality of life in a cost effective manner and provide an innovative service delivery model suitable for other health care areas in which depression is co-morbid.

A manifold approach to face recognition from low quality video across illumination and pose using implicit super-resolution

We consider the problem of matching a face in a low resolution query video sequence against a set of higher quality gallery sequences. This problem is of interest in many applications, such as law enforcement. Our main contribution is an extension of the recently proposed Generic Shape-Illumination Manifold (gSIM) framework. Specifically, (i) we show how super-resolution across pose and scale can be achieved implicitly, by off-line learning of subsampling artefacts; (ii) we use this result to propose an extension to the statistical model of the gSIM by compounding it with a hierarchy of subsampling models at multiple scales; and (iii) we describe an extensive empirical evaluation of the method on over 1300 video sequences – we first measure the degradation in performance of the original gSIM algorithm as query sequence resolution is decreased and then show that the proposed extension produces an error reduction in the mean recognition rate of over 50%.

Exploring distributed leadership for the quality management of online learning environments

Online learning environments (OLEs) are complex information technology (IT) systems that intersect with many areas of university organisation. Distributed models of leadership have been proposed as appropriate for the good governance of OLEs. Based on theoretical and empirical research, a group of Australian universities proposed a framework for the quality management of OLEs, and sought to validate the model via a survey of Australasian university representatives with OLE leadership responsibility. For the framework elements: Planning and Resourcing were rated most important; Organisational structure was rated least important; Technologies were rated low in importance and high in satisfaction; Resourcing and Evaluation were rated low in satisfaction; and Resourcing had the highest rating of importance coupled with low satisfaction. Considering distributed leadership in their institution, respondents reported that the organisational alignments represented by 'official' reporting and peer relationships were significantly more important and more effective than the organisational alignments linking the formal and informal leaders. From a range of desirable characteristics of distributed leadership, 'continuity and sustainability' received the highest rating of importance and a low rating of 'in evidence' - there are concerns about the sustainability of distributed leadership for the governance of OLEs in universities.

Performance of the assessment of quality of life measure in people with hip and knee joint disease and implications for research and clinical use

Objective
To comprehensively evaluate the performance of the Assessment of Quality of Life (AQoL) instrument for measuring health-related quality of life (HRQOL) in people with hip and knee joint disease (arthritis or osteoarthritis).

Methods
Data from 237 individuals were available for analysis from a national cross-sectional, population-based study of hip and knee joint disease in Australia. AQoL-4D data were evaluated using Rasch analysis. A range of measurement properties was explored, including model and item fit, threshold ordering, differential item functioning, and targeting.

Results
Good overall fit of the AQoL with the Rasch model was demonstrated across a range of tests, supporting internal validity. Only 1 item (relating to hearing) showed evidence of misfit. Most AQoL items showed logical sequencing of response option categories, with threshold disordering evident for only 2 of the 12 items (items 4 and 9). Minor issues with potential clinical and research implications include limited options for reporting pain and some evidence of measurement bias between demographic subgroups (including age and sex). Participants' HRQOL was generally better than that represented by the AQoL items (mean ± SD for person abilities −2.15 ± 1.39, mean ± SD for item difficulties 0.00 ± 0.67), indicating ceiling effects that could impact the instrument's ability to detect HRQOL improvement in population-based studies.

Conclusion
The AQoL is a competent tool for assessing HRQOL in people with hip and knee joint disease, although researchers and clinicians should consider the caveats identified when selecting appropriate HRQOL measures for future outcome assessment involving this patient group.

Genome sequence of Ensifer meliloti strain WSM1022, a highly effective microsymbiont of the model legume Medicago truncatula A17

Ensifer meliloti WSM1022 is an aerobic, motile, Gram-negative, non-spore-forming rod that can exist as a soil saprophyte or as a legume microsymbiont of Medicago. WSM1022 was isolated in 1987 from a nodule recovered from the roots of the annual Medicago orbicularis growing on the Cyclades Island of Naxos in Greece. WSM1022 is highly effective at fixing nitrogen with M. truncatula and other annual species such as M. tornata and M. littoralis and is also highly effective with the perennial M. sativa (alfalfa or lucerne). In common with other characterized E. meliloti strains, WSM1022 will nodulate but fixes poorly with M. polymorpha and M. sphaerocarpos and does not nodulate M. murex. Here we describe the features of E. meliloti WSM1022, together with genome sequence information and its annotation. The 6,649,661 bp high-quality-draft genome is arranged into 121 scaffolds of 125 contigs containing 6,323 protein-coding genes and 75 RNA-only encoding genes, and is one of 100 rhizobial genomes sequenced as part of the DOE Joint Genome Institute 2010 Genomic Encyclopedia for Bacteria and Archaea-Root Nodule Bacteria (GEBA-RNB) project.

Optimal sensor placement and measurement of wind for water quality studies in urban reservoirs

We collaborate with environmental scientists to study the hydrodynamics and water quality in an urban district, where the surface wind distribution is an essential input but undergoes high spatial and temporal variations due to the complex urban landform created by surrounding buildings. In this work, we study an optimal sensor placement scheme to measure the wind distribution over a large urban reservoir with a limited number of wind sensors. Unlike existing sensor placement solutions that assume Gaussian process of target phenomena, this study measures the wind which inherently exhibits strong non-Gaussian yearly distribution. By leveraging the local monsoon characteristics of wind, we segment a year into different monsoon seasons which follow a unique distribution respectively. We also use computational fluid dynamics to learn the spatial correlation of wind in the presence of surrounding buildings. The output of sensor placement is a set of the most informative locations to deploy the wind sensors, based on the readings of which we can accurately predict the wind over the entire reservoir surface in real time. 10 wind sensors are finally deployed around or on the water surface of an urban reservoir. The in-field measurement results of more than 3 months suggest that the proposed sensor placement and spatial prediction approach provides accurate wind measurement which outperforms the state-of-the-art Gaussian model based or interpolation based approaches.

Quality of service-based service level agreement management framework for hydrocarbon exploration and discovery operation

 The major contributions presented in this thesis are twofold. Firstly, it presents the research towards a unique services-based Hydrocarbon Exploration and Discovery Model that demonstrates the feasibility of using advanced ICT technologies in the reproduction of stages involved in an oil and gas discovery, processing and analysis process. Secondly, the research demonstrated a solution of the problems in providing agreed level of quality of service (QoS) and formalizing of appropriate Service Level Agreements (SLA) within such complex environment where different services within the model can be delivered by a variety of service providers

Developing and using an S3R model to analyze reasoning in web-based cross-national exchanges on sustainability

Within the increasing body of research that examines students' reasoning on socioscientific issues, we consider in particular student reasoning concerning acute, open-ended questions that bring out the complexities and uncertainties embedded in ill-structured problems. In this paper, we propose a socioscientific sustainability reasoning (S3R) model to analyze students' reasoning exchanges on environmental socially acute questions (ESAQs). The paper describes the development of an epistemological analysis of how sustainability perspectives can be integrated into socioscientific reasoning, which emphasizes the need for S3R to be both grounded in context and collective. We argue the complexity of ESAQs requires a consideration of multiple dimensions that form the basis of our S3R analysis model: problematization, interactions, knowledge, uncertainties, values, and governance. For each dimension, in the model we have identified indicators of four levels of complexity. We investigated the usefulness of the model in identifying improvements in reasoning that flow from cross-national web-based exchanges between groups of French and Australian students, concerning a local and a global ESAQ. The S3R model successfully captured the nature of reasoning about socioscientific sustainability issues, with the collective negotiation of multiple forms of knowledge as a key characteristic in improving reasoning levels. The paper provides examples of collaborative argumentation in collective texts (wikis) to illustrate the various levels of reasoning in each dimension, and diagrammatic representation of the evolution of collective reflections. We observe that a staged process of construction and confrontation, involving groups representing to some extent different cultural and contextual stances, is powerful in eliciting reasoned argument of enhanced quality. © 2014 Wiley Periodicals, Inc.

Determining the sensitivity of the Antarctic amphipod Orchomenella pinguides to metals using a joint model of survival response to exposure concentration and duration

Developing water quality guidelines for Antarctic marine environments requires understanding the sensitivity of local biota to contaminant exposure. Antarctic invertebrates have shown slower contaminant responses in previous experiments compared to temperate and tropical species in standard toxicity tests. Consequently, test methods which take into account environmental conditions and biological characteristics of cold climate species need to be developed. This study investigated the effects of five metals on the survival of a common Antarctic amphipod, Orchomenella pinguides. Multiple observations assessing mortality to metal exposure were made over the 30 days exposure period. Traditional toxicity tests with quantal data sets are analysed using methods such as maximum likelihood regression (probit analysis) and Spearman–Kärber which treat individual time period endpoints independently. A new statistical model was developed to integrate the time-series concentration–response data obtained in this study. Grouped survival data were modelled using a generalized additive mixed model (GAMM) which incorporates all the data obtained from multiple observation times to derive time integrated point estimates. The sensitivity of the amphipod, O. pinguides, to metals increased with increasing exposure time. Response times varied for different metals with amphipods responding faster to copper than to cadmium, lead or zinc. As indicated by 30 days lethal concentration (LC50) estimates, copper was the most toxic metal (31 µg/L), followed by cadmium (168 µg/L), lead (256 µg/L) and zinc (822 µg/L). Nickel exposure (up to 1.12 mg/L) did not affect amphipod survival. Using longer exposure durations and utilising the GAMM model provides an improved methodology for assessing sensitivities of slow responding Antarctic marine invertebrates to contaminants.