Outdoor fungi and child asthma health service attendances

Asthma is a significant global public health issue. Severe asthma exacerbations can be triggered by environmental factors and require medical care from health services. Although it is known that fungal exposure may lead to allergic sensitization, little is understood about its impact on asthma exacerbations. This review aims to examine whether outdoor fungi play a significant role in child asthma exacerbations. Systematic search of seven electronic databases and hand searching for peer-reviewed studies published in English, up to 31 August 2013. Inclusion criteria were study population aged <18 yr, diagnosis of asthma, attended a health service; outdoor fungi exposure was reported. Quality and risk of bias assessments were conducted. Due to significant heterogeneity, meta-analysis was not conducted. Of the 1896 articles found, 15 were eligible. Findings were not consistent, possibly due to methodological variations in exposure classifications, statistical methods and inclusion of confounders. Cross-sectional studies found no or weak associations. All but one time series studies indicated an association that varied between fungal species. Increasing evidence indicates that asthmatic children are susceptible to asthma exacerbations when exposed to outdoor fungal spores. There is limited understanding of the contributions of different fungal species. Research is needed to investigate interactions of outdoor fungi with pollen, air pollutants and respiratory viruses.

‘I felt like I was watching porn’: the reality of preparing pre-service teachers to teach about sexual pleasure

Overwhelmingly, school-based sexuality education programmes focus on the prevention of infection, pregnancy and abuse, with little if any attention given to positive views of sexuality and rarely the inclusion of sex positive issues such as pleasure, intimacy and desire. This paper explores the experience of teaching about pleasure to pre-service health and physical education teachers as part of compulsory studies in a unit on sexuality education designed to prepare them to teach sexuality education in secondary schools. Drawing on the aims, theoretical framework, content and pedagogical structure of the unit, and data collected from 42, third-year pre-service teachers (PST) in Australia via surveys and student assessment, the paper provides some practical examples of what teaching about pleasure might look like in practice. It argues that with adequate preparation, a framework to celebrate sex and sexuality, a gender lens to examine normative discourses, and the opportunity for reflection, PST can develop the confidence, skill and willingness to include pedagogies of pleasure in their school-based work.

Clinical review criteria and medical emergency teams: evaluating a two-tier rapid response system

OBJECTIVES: To assess the prevalence of patients fulfilling clinical review criteria (CRC), to determine activation rates for CRC assessments, to compare baseline characteristics and outcomes of patients who fulfilled CRC with patients who did not, and to identify the documented nursing actions in response to CRC values. DESIGN, SETTING AND PARTICIPANTS: A cross-sectional study using a retrospective medical record audit, in a universityaffiliated, tertiary referral hospital with a two-tier rapid response system in Melbourne, Australia. We used a convenience sample of hospital inpatients on general medical, surgical and specialist service wards admitted during a 24-hour period in 2013. MAIN OUTCOME MEASURES: Medical emergency team (MET) or code blue activation, unplanned intensive care unit admissions, hospital length of stay and inhospital mortality. For patients who fulfilled CRC or MET criteria during the 24- hour period, the specific criteria fulfilled, escalation treatments and outcomes were collected. RESULTS: Of the sample (N = 422), 81 patients (19%) fulfilled CRC on 109 occasions. From 109 CRC events, 66 patients (81%) had at least one observation fulfilling CRC, and 15 patients (18%) met CRC on multiple occasions. The documented escalation rate was 58 of 109 events (53%). The number of patients who fulfilled CRC and subsequent MET call activation criteria within 24 hours was significantly greater than the number who did not meet CRC (P < 0.001). CONCLUSIONS: About one in five patients reached CRC during the study period; these patients were about four times more likely to also fulfil MET call criteria. Contrary to hospital policy, escalation was not documented for about half the patients meeting CRC values. Despite the clarity of escalation procedures on the graphic observation chart, escalation remains an ongoing problem. Further research is needed on the impact on patient outcomes over time and to understand factors influencing staff response.

Oncology service initiatives and research in regional Australia

OBJECTIVE: This paper reflects on the recent growth of cancer research being conducted through some of Australia's rural centres. It encompasses work being done across the fields of clinical, translational and health services research. DESIGN: This is a collaborative piece with contributions from rural health researchers, clinical and cancer services staff from several different regions. CONCLUSION: The past decade has seen an expansion in cancer research in rural and regional Australia driven in part by the recognition that cancer patients in remote areas experience poorer outcomes than their metropolitan counterparts. This work has led to the development of more effective cancer networks and new models of care designed to meet the particular needs of the rural cancer patient. It is hoped that the growth of cancer research in regional centres will, in time, reduce the disparity between rural and urban communities and improve outcomes for cancer patients across both populations.

Energy efficient sleep schedule with service coverage guarantee in wireless sensor networks

Service oriented architecture has been proposed to support collaborations among distributed wireless sensor network (WSN) applications in an open dynamic environment. However, WSNs are resource constraint, and have limited computation abilities, limited communication bandwidth and especially limited energy. Fortunately, sensor nodes in WSNs are usually deployed redundantly, which brings the opportunity to adopt a sleep schedule for balanced energy consumption to extend the network lifetime. Due to miniaturization and energy efficiency, one sensor node can integrate several sense units and support a variety of services. Traditional sleep schedule considers only the constraints from the sensor nodes, can be categorized to a one-layer (i.e., node layer) issue. The service oriented WSNs should resolve the energy optimization issue considering the two-layer constraints, i.e., the sensor nodes layer and service layer. Then, the one-layer energy optimization scheme in previous work is not applicable for service oriented WSNs. Hence, in this paper we propose a sleep schedule with a service coverage guarantee in WSNs. Firstly, by considering the redundancy degree on both the service level and the node level, we can get an accurate redundancy degree of one sensor node. Then, we can adopt fuzzy logic to integrate the redundancy degree, reliability and energy to get a sleep factor. Based on the sleep factor, we furthermore propose the sleep mechanism. The case study and simulation evaluations illustrate the capability of our proposed approach.

Big data sensing and service: a tutorial

As the advance of the Internet of Things (IoT), more M2M sensors and devices are connected to the Internet. These sensors and devices generate sensor-based big data and bring new business opportunities and demands for creating and developing sensor-oriented big data infrastructures, platforms and analytics service applications. Big data sensing is becoming a new concept and next technology trend based on a connected sensor world because of IoT. It brings a strong impact on many sensor-oriented applications, including smart city, disaster control and monitor, healthcare services, and environment protection and climate change study. This paper is written as a tutorial paper by providing the informative concepts and taxonomy on big data sensing and services. The paper not only discusses the motivation, research scope, and features of big data sensing and services, but also exams the required services in big data sensing based on the state-of-the-art research work. Moreover, the paper discusses big data sensing challenges, issues, and needs.