Women's psychosocial well-being following a major life transition

Some women are devastated by divorce, while others learn from the experience. In-depth interviews with sole-parenting women yielded themes that were then assessed using structured questionnaires. Statistical models showed that psychological adjustment and physical well-being related more strongly to psychological factors, such as sense of coherence, than to situational variables.

Substrate specificity, regulation, and polymorphism of human cytochrome P450 2B6

CYP2B6 is mainly expressed in the liver that has been thought historically to play an insignificant role in human drug metabolism. However, increased interest in this enzyme has been stimulated by the discovery of polymorphic and ethnic differences in CYP2B6 expression, identification of additional substrates for CYP2B6, and evidence for co-regulation with CYP3A4. This paper updates our knowledge about the structure, function, regulation and polymorphism of CYP2B6. CYP2B6 can metabolise approximately 8% of clinically used drugs (n > 60), including cyclophosphamide, ifosfamide, tamoxifen, ketamine, artemisinin, nevirapine, efavirenz, bupropion, sibutramine, and propofol. CYP2B6 is one of the CYP enzymes that bioactivate several procarcinogens and toxicants. This enzyme also metabolizes arachidonic acid, lauric acid, 17beta-estradiol, estrone, ethinylestradiol, and testosterone. Typical substrates of CYP2B6 are non-planar molecules, neutral or weakly basic, highly lipophilic with one or two hydrogen-bond acceptors. The crystal structure of CYP2B6 has not been resolved, while several pharmacophore and homology models of human CYP2B6 have been reported. Human CYP2B6 is closely regulated by constitutive androstane receptor (CAR/NR1I3) which can activate CYP2B6 expression upon ligand binding. Pregnane X receptor and glucocorticoid receptor also play a role in the regulation of CYP2B6. Induction of CYP2B6 may partially explain some clinical drug interactions observed. For example, coadministered carbamazepine decreases the systemic exposure of bupropion. There is a wide interindividual variability in the expression and activity of CYP2B6. Such a large variability is probably due to effects of genetic polymorphisms and exposure to drugs that are inducers or inhibitors of CYP2B6. To date, at least 28 allelic variants and some subvariants of CYP2B6 (*1B through *29) have been described and some of them have been shown to have important functional impact on drug clearance and drug response. For example, the efavirenz plasma levels in African-American subjects with the CYP2B6 homozygous 516T/T genotype are approximately 3-fold higher than individuals carrying the homozygous G/G genotype. The CYP2B6 516T/T genotype is associated with 1.7-fold greater plasma levels of nevirapine in HIV-infected patients. Smokers with the 1459C>T (R487C) variant of CYP2B6 may be more vulnerable to abstinence symptoms and relapse following treatment with bupropion as a smoking cessation agent. Further studies in the structure, function, regulation and polymorphism of CYP2B6 are warranted.

Linking water-resource models to ecosystem-response models to guide water-resource planning -- an example from the Murray--Darling Basin, Australia

Objectively assessing ecological benefits of competing watering strategies is difficult. We present a framework of coupled models to compare scenarios, using the Coorong, the estuary for the MurrayDarling River system in South Australia, as a case study. The framework links outputs from recent modelling of the effects of climate change on water availability across the MurrayDarling Basin to a hydrodynamic model for the Coorong, and then an ecosystem-response model. The approach has significant advantages, including the following: (1) evaluating management actions is straightforward because of relatively tight coupling between impacts on hydrology and ecology; (2) scenarios of 111 years reveal the impacts of realistic climatic and flow variability on Coorong ecology; and (3) ecological impact is represented in the model by a series of ecosystem states, integrating across many organisms, not just iconic species. We applied the approach to four flow scenarios, comparing conditions without development, current water-use levels, and two predicted future climate scenarios. Simulation produced a range of hydrodynamic conditions and consequent distributions of ecosystem states, allowing managers to compare scenarios. This approach could be used with many climates and/or management actions for optimisation of flow delivery to environmental assets.

Clinical and economic burden of emergency department presentations for neutropenia following outpatient chemotherapy for cancer in Victoria, Australia

Objective. To examine the clinical characteristics and financial charges associated with treating adult cancer patients receiving chemotherapy in outpatient clinics who presented to the emergency department (ED) with neutropenia.
Design and Setting. A retrospective audit was conducted across two health services involving ED episodes and subsequent hospital admissions of patients who received chemotherapy through day oncology from January 1 to December 31, 2007 and presented to the ED with neutropenia. ED data were collected from the Victorian Emergency Minimum Dataset and charges were collected from Health Information Services. Descriptive and bivariate statistics were used to describe the patient and clinical characteristics and financial outcomes, and to explore associations between these factors.
Results. In total, 200 neutropenic episodes in 159 outpatients were seen in the ED over the survey period. The mean patient age was 56.6 years (standard deviation, 13.2 years) and 47.2% were male. Overall, 70.0% of ED episodes were triaged as Australasian Triage Scale 2 (emergency). The median ED wait time was 10 minutes and the median ED length of stay was 6.8 hours. The median charge for each ED episode was $764.08 Australian dollars. The total combined ED and inpatient charge per episode was in the range of $144.27-$174,732.68, with a median charge of $5,640.87.
Conclusions. This study provides important insights into the clinical and economic burden of neutropenia from both the ED and inpatient perspectives. Alternative treatment models, such as outpatient treatment, early discharge programs or prophylactic interventions to reduce the clinical and economic burden of neutropenia on our health system, must be explored.

"Tomorrow's car" : Deakin Universities new cross vehicle that combines the best of 2 worlds

Motorbike riders are 34-times more likely to die in a crash compared to car drivers per km travelled (1). Such safety risks together with special skill requirements for the driver and much lower comfort compared to normal cars are the main reasons why motorbikes represent only a fraction of all vehicle sales in developed countries. Deakin University is developing a revolutionary cross-over fun vehicle with ultra low fuel consumption and emissions. This new vehicle generation combines the best of two worlds: the fun to drive, low cost, and small size of a scooter together with the safety, comfort and easiness to operate of a car. The result is a vehicle that is more fuel efficient than most cars or even scooters.

Various tilting cross over vehicles have been presented over the last decade that were trying to automate the tilting control of narrow vehicles to make them safer. Examples of these concepts are the Carver, Clever and in some way also the MP3 scooter from Piaggio. The problem with fully enclosed concepts like the Carver or Clever is that they require very complex and therefore also expensive tilting control systems so that the vehicles are not price competitive compared to low cost micro cars or even normal small cars. The MP3 on the other hand comes with a tilting control system which is only semi automatic so that typical car advantages - comprehensive safety features like crush zones, roll over protection, air bags, safety belts or comfort features like full weather protection including heating and cooling – can not be provided.

Deakin’s approach is quite different to the above mentioned concepts. The requirements were derived based on two different investigations: The first step was a critical evaluation of social trends and the second step was an in-depth benchmarking study of existing concepts which identified the typical strengths and weaknesses of these concepts. In a critical next step a new concept was created that addresses most of the weaknesses of existing tilting three-wheelers in a holistic approach by setting clear priority rankings for the vehicle targets, based on current trends. The priorities were set in the following order: Safety, Affordability, Fun and Efficiency (SAFE).

The key feature that enables an enclosed tilting vehicle is a fully automatic tilting control system. With an automatic tilting control system the driver does not need to put the feet on the ground to balance the vehicle when he stops, so the vehicle can be built with a full enclosure. This allows the implementation of typical car like safety features (seat belts, roll over structure, crush zones, air bags). The SafeRide™ tilting control system is a passive system that involves the driver’s balancing sense in its feedback control system. The vehicle has typical scooter like steering characteristics, where the steering is initiated through countersteering. Another safety critical design feature is the crush zone between the two front wheels which is not possible with only one front wheel or with the powertrain positioned between the front wheels, as the powertrain can’t absorb a lot of energy due to its structural stiffness and density. The passive tilting control system is quite simple and therefore makes the vehicle very affordable, an important factor for successful commercialisation.

Another advantage of integrating the human balancing senses in the feedback control of the tilting system is that the system kicks in slightly after the human balancing reacts. In some instances that can generate the typical adrenalin thrill known from riding a bike. This fun factor is quite common with many trend sports like mountain biking, surfing, roller-skating, snowboarding, or skateboarding. Some of these sports have seen very rapid growth only a short time after they have been invented. Utilising the human balancing system during driving also makes the vehicle safer as the adrenalin is produced after reaching a semi-stable driving condition that is controlled by the vehicles tilting control system, but before the vehicle reaches an unstable driving condition that can not be controlled by the vehicle but only (eventually) by the driver – if he has got the required driving skill and if he is alert enough.

Efficiency superior to most cars and scooters is achieved by the aerodynamics of a fully enclosed body structure in combination with the small frontal area of a typical scooter and the droplet shape enabled by the relatively wide front with 2 wheels and the very narrow tail with only one rear wheel. The passive tilting system also contributes to the extreme efficiency as the system only draws some small electrical power for the electronic control unit. Another feature is a low cost exhaust energy recovery system which is discussed in another paper.

Neuropsychological changes following cognitive-behavioral treatment of obsessive-compulsive disorder (OCD)

Previous research has suggested that individuals with OCD show compromised performance on tests assessing visuospatial and executive processes. This study aimed to further examine such findings by investigating the relationship between OCD symptom improvement following cognitive-behavioral therapy and changes in neuropsychological performance in individuals with OCD (n = 26), compared to test-retest control participants (n = 10). Successful treatment of OCD led to improvements relative to the control group on neuropsychological tasks measuring spatial working memory. Neuroscientific models of OCD consider such findings to be consistent with possible cortical dysfunction in OCD. However, a significant limitation of the study is in its inability to discount alternative explanations for this finding, such as the influence of changes in beliefs. Implications are discussed.

Does implicit motor imagery ability predict reaching correction efficiency? A test of recent models of human motor control

Neurocomputational models of reaching indicate that efficient purposive correction of movement midflight (e.g., online control) depends on one's ability to generate and monitor an accurate internal (neural) movement representation. In the first study to test this empirically, the authors investigated the relationship between healthy young adults’ implicit motor imagery performance and their capacity to correct their reaching trajectory. As expected, after controlling for general reaching speed, hierarchical regression demonstrated that imagery ability was a significant predictor of hand correction speed; that is, faster and more accurate imagery performance associated with faster corrections to reaching following target displacement at movement onset. They argue that these findings provide preliminary support for the view that a link exists between an individual's ability to represent movement mentally and correct movement online efficiently.

Quality care outcomes following transitional care interventions for older people from hospital to home: a systematic review

 Background
Provision of high quality transitional care is a challenge for health care providers in many western countries. This systematic review was conducted to (1) identify and synthesise research, using randomised control trial designs, on the quality of transitional care interventions compared with standard hospital discharge for older people with chronic illnesses, and (2) make recommendations for research and practice.

Methods
Eight databases were searched; CINAHL, Psychinfo, Medline, Proquest, Academic Search Complete, Masterfile Premier, SocIndex, Humanities and Social Sciences Collection, in addition to the Cochrane Collaboration, Joanna Briggs Institute and Google Scholar. Results were screened to identify peer reviewed journal articles reporting analysis of quality indicator outcomes in relation to a transitional care intervention involving discharge care in hospital and follow-up support in the home. Studies were limited to those published between January 1990 and May 2013. Study participants included people 60 years of age or older living in their own homes who were undergoing care transitions from hospital to home. Data relating to study characteristics and research findings were extracted from the included articles. Two reviewers independently assessed studies for risk of bias.

Results
Twelve articles met the inclusion criteria. Transitional care interventions reported in most studies reduced re-hospitalizations, with the exception of general practitioner and primary care nurse models. All 12 studies included outcome measures of re-hospitalization and length of stay indicating a quality focus on effectiveness, efficiency, and safety/risk. Patient satisfaction was assessed in six of the 12 studies and was mostly found to be high. Other outcomes reflecting person and family centred care were limited including those pertaining to the patient and carer experience, carer burden and support, and emotional support for older people and their carers. Limited outcome measures were reported reflecting timeliness, equity, efficiencies for community providers, and symptom management.

Conclusions
Gaps in the evidence base were apparent in the quality domains of timeliness, equity, efficiencies for community providers, effectiveness/symptom management, and domains of person and family centred care. Further research that involves the person and their family/caregiver in transitional care interventions is needed.

Edge patterns in aquatic invertebrates explained by predictive models

Predictive frameworks for understanding and describing how animals respond to habitat fragmentation, particularly across edges, have been largely restricted to terrestrial systems. Abundances of zooplankton and meiofauna were measured across seagrasssand edges and the patterns compared with predictive models of edge effects. Artificial seagrass patches were placed on bare sand, and zooplankton and meiofauna were sampled with tube traps at five positions (from patch edges: 12, 60 and 130 cm into seagrass; and 12 and 60 cm onto sand). Position effects consisted of the following three general patterns: (1) increases in abundance around the seagrasssand edge (total abundance and cumaceans); (2) declining abundance from seagrass onto sand (calanoid copepods, harpacticoid copepods and amphipods); and (3) increasing abundance from seagrass onto sand (crustacean nauplii and bivalve larvae). The first two patterns are consistent with resource-distribution models, either as higher resources at the confluence of adjacent habitats or supplementation of resources from high-quality to low-quality habitat. The third pattern is consistent with reductions in zooplankton abundance as a consequence of predation or attenuation of currents by seagrass. The results show that predictive models of edge effects can apply to aquatic animals and that edges are important in structuring zooplankton and meiofauna assemblages in seagrass. © 2010 CSIRO.

Comfort in Australian offices: beyond the models?

 Thermal comfort models, as we know them today, have been available since the early 1970’s and have been applied to assess the conditioning of our buildings. What we have is a comfort value of an interior environment at a particular location as a result of several measured parameters. What we don’t often consider is how the building contributes to this resulting thermal environment and how occupants respond to its possible changes. The following research considers the climatic and comfort findings from 15 fully air conditioned office buildings between Brisbane and Melbourne Australia during brief seasonal periods of measurement. Initially, each office building
was considered as its own individual project; however the grouping of the results has led to some interesting observations:
Regardless of building type or whether there is a narrow controlled comfort band,
there can be a significant variation in the clothing level of occupants.
There is a greater exterior to interior air temperature correlation than might be expected among fully air-conditioned buildings. The diurnal ranges of interior temperatures (over 24 hours) may be far greater than anticipated. It is realised that fully conditioned buildings are far more variable than perhaps realised and that occupant comfort may relate more to user interaction (CLO value), building construction type (weight) and envelope air tightness. As a result, this investigation raises perhaps more questions than answers as to how we assess thermal comfort in
buildings.

Use of illicit tobacco following introduction of standardised packaging of tobacco products in Australia: results from a national cross-sectional survey

ABSTRACT
Objectives: To assess whether following standardisation of tobacco packaging in Australia, smokers were, as predicted by the tobacco industry, more likely to use illicit tobacco.
Methods: National cross-sectional telephone surveys conducted continuously from April 2012 (6 months before implementation of plain packaging (PP)) to March 2014 (15 months after) using responses from current cigarette smokers (n=8679). Changes between pre-PP, the transition to PP and PP phase were examined using logistic regression models.
Results: Among those whose factory-made cigarettes were purchased in Australia, compared with pre-PP, there were no significant increases in the PP phase in use of: ‘cheap whites’ (<0.1%; OR=0.24, 95% CI 0.04 to 1.56, p=0.134); international brands purchased for 20% or more below the recommended retail price (0.2%; OR=3.49, 95% CI 0.66 to 18.35, p=0.140); or packs purchased from informal sellers (<0.1%; OR=0.24, 95% CI 0.04 to 1.47, p=0.124). The prevalence of any use of unbranded illicit tobacco remained at about 3% (adjusted OR=0.79, 95% CI 0.58 to 1.08, p=0.141).
Conclusions: While unable to quantify the total extent of use of illicit manufactured cigarettes, in this large national survey we found no evidence in Australia of increased use of two categories of manufactured cigarettes likely to be contraband, no increase in purchase from informal sellers and no increased use of unbranded illicit ‘chop-chop’ tobacco.

Mental health following acquisition of disability in adulthood-the impact of wealth

BACKGROUND: Acquisition of a disability in adulthood has been associated with a reduction in mental health. We tested the hypothesis that low wealth prior to disability acquisition is associated with a greater deterioration in mental health than for people with high wealth. METHODS: We assess whether level of wealth prior to disability acquisition modifies this association using 12 waves of data (2001-2012) from the Household, Income and Labour Dynamics in Australia survey-a population-based cohort study of working-age Australians. Eligible participants reported at least two consecutive waves of disability preceded by at least two consecutive waves without disability (1977 participants, 13,518 observations). Fixed-effects linear regression was conducted with a product term between wealth prior to disability (in tertiles) and disability acquisition with the mental health component score of the SF-36 as the outcome. RESULTS: In models adjusted for time-varying confounders, there was evidence of negative effect measure modification by prior wealth of the association between disability acquisition and mental health (interaction term for lowest wealth tertile: -2.2 points, 95% CI -3.1 points, -1.2, p<0.001); low wealth was associated with a greater decline in mental health following disability acquisition (-3.3 points, 95% CI -4.0, -2.5) than high wealth (-1.1 points, 95% CI -1.7, -0.5). CONCLUSION: The findings suggest that low wealth prior to disability acquisition in adulthood results in a greater deterioration in mental health than among those with high wealth.

Consumption smoothing in Latin America: an empirical assessment of present value models

The study aims to assess the empirical adherence of the permanent income theory and the consumption smoothing view in Latin America. Two present value models are considered, one describing household behavior and the other open economy macroeconomics. Following the methodology developed in Campbell and Schiller (1987), Bivariate Vector Autoregressions are estimated for the saving ratio and the real growth rate of income concerning the household behavior model and for the current account and the change in national cash ‡ow regarding the open economy model. The countries in the sample are considered separately in the estimation process (individual system estimation) as well as jointly (joint system estimation). Ordinary Least Squares (OLS) and Seemingly Unrelated Regressions (SURE) estimates of the coe¢cients are generated. Wald Tests are then conducted to verify if the VAR coe¢cient estimates are in conformity with those predicted by the theory. While the empirical results are sensitive to the estimation method and discount factors used, there is only weak evidence in favor of the permanent income theory and consumption smoothing view in the group of countries analyzed.

Predictability of equity models

In this study, we verify the existence of predictability in the Brazilian equity market. Unlike other studies in the same sense, which evaluate original series for each stock, we evaluate synthetic series created on the basis of linear models of stocks. Following Burgess (1999), we use the “stepwise regression” model for the formation of models of each stock. We then use the variance ratio profile together with a Monte Carlo simulation for the selection of models with potential predictability. Unlike Burgess (1999), we carry out White’s Reality Check (2000) in order to verify the existence of positive returns for the period outside the sample. We use the strategies proposed by Sullivan, Timmermann & White (1999) and Hsu & Kuan (2005) amounting to 26,410 simulated strategies. Finally, using the bootstrap methodology, with 1,000 simulations, we find strong evidence of predictability in the models, including transaction costs.

Simulation -based smoothing and filtering in factor stochastic volatility models : two econometric applications (July-2001)

The past decade has wítenessed a series of (well accepted and defined) financial crises periods in the world economy. Most of these events aI,"e country specific and eventually spreaded out across neighbor countries, with the concept of vicinity extrapolating the geographic maps and entering the contagion maps. Unfortunately, what contagion represents and how to measure it are still unanswered questions. In this article we measure the transmission of shocks by cross-market correlation\ coefficients following Forbes and Rigobon's (2000) notion of shift-contagion,. Our main contribution relies upon the use of traditional factor model techniques combined with stochastic volatility mo deIs to study the dependence among Latin American stock price indexes and the North American indexo More specifically, we concentrate on situations where the factor variances are modeled by a multivariate stochastic volatility structure. From a theoretical perspective, we improve currently available methodology by allowing the factor loadings, in the factor model structure, to have a time-varying structure and to capture changes in the series' weights over time. By doing this, we believe that changes and interventions experienced by those five countries are well accommodated by our models which learns and adapts reasonably fast to those economic and idiosyncratic shocks. We empirically show that the time varying covariance structure can be modeled by one or two common factors and that some sort of contagion is present in most of the series' covariances during periods of economical instability, or crisis. Open issues on real time implementation and natural model comparisons are thoroughly discussed.