Access to cardiac rehabilitation does not equate to attendance

Background/Aims Timely access to appropriate cardiac care is critical for optimizing positive outcomes after a cardiac event. Attendance at cardiac rehabilitation (CR) remains less than optimal (10%–30%). Our aim was to derive an objective, comparable, geographic measure reflecting access to cardiac services after a cardiac event in Australia. Methods An expert panel defined a single patient care pathway and a hierarchy of the minimum health services for CR and secondary prevention. Using geographic information systems a numeric/alpha index was modelled to describe access before and after a cardiac event. The aftercare phase was modelled into five alphabetical categories: from category A (access to medical service, pharmacy, CR, pathology within 1 h) to category E (no services available within 1 h). Results Approximately 96% or 19 million people lived within 1 h of the four basic services to support CR and secondary prevention, including 96% of older Australians and 75% of the indigenous population. Conversely, 14% (64,000) indigenous people resided in population locations that had poor access to health services that support CR after a cardiac event. Conclusion Results demonstrated that the majority of Australians had excellent ‘geographic’ access to services to support CR and secondary prevention. Therefore, it appears that it is not the distance to services that affects attendance. Our ‘geographic’ lens has identified that more research on socioeconomic, sociological or psychological aspects to attendance is needed.

Atmospheric deposition as a source of heavy metals in urban stormwater

Atmospheric deposition is one of the most important pathways of urban stormwater pollution. Atmospheric deposition which can be in the form of either wet or dry deposition have distinct characteristics in terms of associated particulate sizes, pollutant types and influential parameters. This paper discusses the outcomes of a comprehensive research study undertaken to identify important traffic characteristics and climate factors such as antecedent dry period and rainfall characteristics which influences the characteristics of wet and dry deposition of solids and heavy metals. The outcomes confirmed that Zinc (Zn) is correlated with traffic volume whereas Lead (Pb), Cadmium (Cd), Nickel (Ni), and Copper (Cu) are correlated with traffic congestion. Consequently, reducing traffic congestion will be more effective than reducing traffic volume for improving air quality particularly in relation to Pb, Cd, Ni, and Cu. Zn was found to have the highest atmospheric deposition rate compared to other heavy metals. Zn in dry deposition is associated with relatively larger particle size fractions (>10 µm), whereas Pb, Cd, Ni and Cu are associated with relatively smaller particle size fractions (<10 µm). The analysis further revealed that bulk (wet plus dry) deposition which is correlated with rainfall depth and contains a relatively higher percentage of smaller particles compared to dry deposition which is correlated with the antecedent dry period. As particles subjected to wet deposition are smaller, they disperse over a larger area from the source of origin compared to particles subjected to dry deposition as buoyancy forces become dominant for smaller particles compared to the influence of gravity. Furthermore, exhaust emission particles were found to be primarily associated with bulk deposition compared to dry deposition particles which mainly originate from vehicle component wear.

Getting the point : the role of gesture in managing intersubjectivity in a design activity

This paper illustrates the complexity of pointing as it is employed in a design workshop. Using the method of interaction analysis, we argue that pointing is not merely employed to index, locate, or fix reference to an object. It also constitutes a practice for reestablishing intersubjectivity and solving interactional trouble such as misunderstandings or disagreements by virtue of enlisting something as part of the participants’ shared experience. We use this analysis to discuss implications for how such practices might be supported with computer mediation, arguing for a “bricolage” approach to systems development that emphasizes the provision of resources for users to collaboratively negotiate the accomplishment of intersubjectivity ra- ther than systems that try to support pointing as a specific gestural action.

Do the skeletons in the hospital closet still exist? What do they eat?

One aim of the Australasian Nutrition Care Day Survey (ANCDS) was to explore dietary intake and nutritional status of acute care hospital patients. Dietitians from 56 hospitals in Australia and New Zealand completed a 24-hour nutritional status and dietary intake audit of 3000 adult patients. Participants were evaluated for nutritional risk using the Malnutrition Screening Tool (MST). Those ‘at risk’ underwent nutritional assessment using Subjective Global Assessment (SGA). Dietitians observed participants’ dietary intake at each main meal and recorded mid-meal intake via participant interviews. Intakes were recorded as 0%, 25%, 50%, 75%, or 100% of that offered for each meal during the 24-hour audit. Preliminary results for 1550 participants (males = 853; females = 697), age = 64 ± 17 years and BMI = 27 ± 7 kg/m2. Fifty-five percent (n = 853) of the participants had BMI > 25 kg/m2. The MST identified 41% (n = 636) ‘at risk’ for malnutrition. Of those ‘at risk’, 70% were assessed as malnourished resulting in an overall malnutrition prevalence of 30% (25% moderately malnourished, 5% severely malnourished). One-quarter of malnourished participants (n = 118) were on standard hospital diets without additional nutritional support. Fifty percent of malnourished patients (n = 235) and 40% of all patients (n = 620) had an overall 24-hour food consumption of ≤50% during the 24-hour audit. The ANCDS found that skeletons in the hospital closet continue to exist and that acute care patients continue to have suboptimal dietary intake. The ANCDS provides valuable insight into gaps in existing nutrition care practices.

Future Information Communication Technology and Applications : ICFICE 2013

Focuses on the various aspects of advances in future information communication technology and its applications Presents the latest issues and progress in the area of future information communication technology Applicable to both researchers and professionals These proceedings are based on the 2013 International Conference on Future Information & Communication Engineering (ICFICE 2013), which will be held at Shenyang in China from June 24-26, 2013. The conference is open to all over the world, and participation from Asia-Pacific region is particularly encouraged. The focus of this conference is on all technical aspects of electronics, information, and communications ICFICE-13 will provide an opportunity for academic and industry professionals to discuss the latest issues and progress in the area of FICE. In addition, the conference will publish high quality papers which are closely related to the various theories and practical applications in FICE. Furthermore, we expect that the conference and its publications will be a trigger for further related research and technology improvements in this important subject. "This work was supported by the NIPA (National IT Industry Promotion Agency) of Korea Grant funded by the Korean Government (Ministry of Science, ICT & Future Planning)."

The catalytic role of an isolated-Ti atom in the hydrogenation of Ti-doped Al(001) surface : An ab initio density functional theory calculation

Recent work [S. Chaudhuri, J.T. Muckerman, J. Phys. Chem. B 109 (2005) 6952] reported that two Ti-substituted atoms on an Al(0 0 1) surface can form a catalytically active site for the dissociation of H2, but the diffusion barrier of atomic H away from Ti site is as high as 1.57 eV. By using ab initio density functional calculations, we found that two hydrogen molecules can dissociate on isolated-Ti atom doped Al(0 0 1) surface with small activation barriers (0.21 and 0.235 eV for first and second H2, respectively). Additionally, the diffusion barrier of atomic H away from Ti site is also moderate (0.47 eV). These results contribute further towards understanding the improved kinetics observed in recycling of hydrogen with Ti-doped NaAlH4.

Business in troubled waters : does adverse attitude affect firm value?

This paper investigates the relationship between US MNCs' valuations and anti-Americanism in countries where MNCs' foreign subsidiaries are located. We find that MNCs suffer value-destruction when they enter markets where people express severe anti-Americanism. However, we uncover that geographic diversification into these high anti-Americanism countries significantly increases firm value if the MNC has high levels of intangibles such as technological know-how and marketing expertise. Our findings are consistent with the notion that the advantages from internalizing the cross-border transfer of intangibles are greater when barriers to competition are higher.

Camera trapping and invasions of privacy : an Australian legal perspective

Camera trapping is a scientific survey technique that involves the placement of heat-and motion-sensing automatic triggered cameras into the ecosystem to record images of animals for the purpose of studying wildlife. As technology continues to advance in sophistication, the use of camera trapping is becoming more widespread and is a crucial tool in the study of, and attempts to preserve, various species of animals, particularly those that are internationally endangered. However, whatever their value as an ecological device, camera traps also create a new risk of incidentally and accidentally capturing images of humans who venture into the area under surveillance. This article examines the current legal position in Australia in relation to such unintended invasions of privacy. It considers the current patchwork of statute and common laws that may provide a remedy in such circumstances. It also discusses the position that may prevail should the recommendations of either the Australian Law Reform Commission and/or New South Wales Law Reform Commission be adopted and a statutory cause of action protecting personal privacy be enacted.

Multi-gene phylogenetic analysis of south-east Asian pest members of the Bactrocera dorsalis species complex (Diptera: Tephritidae) does not support current taxonomy

Bactrocera dorsalis sensu stricto, B. papayae, B. philippinensis and B. carambolae are serious pest fruit fly species of the B. dorsalis complex that predominantly occur in south-east Asia and the Pacific. Identifying molecular diagnostics has proven problematic for these four taxa, a situation that cofounds biosecurity and quarantine efforts and which may be the result of at least some of these taxa representing the same biological species. We therefore conducted a phylogenetic study of these four species (and closely related outgroup taxa) based on the individuals collected from a wide geographic range; sequencing six loci (cox1, nad4-3′, CAD, period, ITS1, ITS2) for approximately 20 individuals from each of 16 sample sites. Data were analysed within maximum likelihood and Bayesian phylogenetic frameworks for individual loci and concatenated data sets for which we applied multiple monophyly and species delimitation tests. Species monophyly was measured by clade support, posterior probability or bootstrap resampling for Bayesian and likelihood analyses respectively, Rosenberg's reciprocal monophyly measure, P(AB), Rodrigo's (P(RD)) and the genealogical sorting index, gsi. We specifically tested whether there was phylogenetic support for the four 'ingroup' pest species using a data set of multiple individuals sampled from a number of populations. Based on our combined data set, Bactrocera carambolae emerges as a distinct monophyletic clade, whereas B. dorsalis s.s., B. papayae and B. philippinensis are unresolved. These data add to the growing body of evidence that B. dorsalis s.s., B. papayae and B. philippinensis are the same biological species, which poses consequences for quarantine, trade and pest management.

InterLACE : a new international collaboration for a Life course approach to women's reproductive health and chronic disease events.

Evidence from population-based studies of women increasingly points to the inter-related nature of reproductive health, lifestyle, and chronic disease risk. This paper describes the recently established International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease. InterLACE aims to advance the evidence base for women's health policy beyond associations from disparate studies by means of systematic and culturally sensitive synthesis of longitudinal data. Currently InterLACE draws on individual level data for reproductive health and chronic disease among 200,000 women from over thirteen studies of women's health in seven countries. The rationale for this multi-study research programme is set out in terms of a life course perspective to reproductive health. The research programme will build a comprehensive picture of reproductive health through life in relation to chronic disease risk. Although combining multiple international studies poses methodological challenges, InterLACE represents an invaluable opportunity to strength evidence to guide the development of timely and tailored preventive health strategies.

On the beach : exploring the complex egalitarianism of the Australian beach

Australia, internationally, is known as a beach loving country, particularly in popular culture. The beach did not figure significantly in academic discussion before the 1980s when Fiske, Hodge, and Turner (1987, 54) researched the beach as a space of myth, seeing it as an integral part of the modern Australian identity. One common myth in Australia is that the beach is an equaliser, a place of multiple ethnicities, shapes, sizes, and genders (Dutton, 1985). I agree that the beach remains a significant aspect of Australian identity; however, limiting its meaning to a mythic space contributing to a homogenous national identity is not adequate. This paper will explore how Australian texts comment on or challenge the myth of the beach as an egalitarian space. I argue that recent Australian texts show a more complex, layered representation of this concept; and that the beach also in this respect can no longer be understood as a myth transcending difference.

A point prevalence study of cancer nursing practices for managing intravascular devices in an Australian tertiary cancer center

Purpose The use of intravascular devices is associated with a number of potential complications. Despite a number of evidence-based clinical guidelines in this area, there continues to be nursing practice discrepancies. This study aims to examine nursing practice in a cancer care setting to identify nursing practice and areas for improvement respective to best available evidence. Methods A point prevalence survey was undertaken in a tertiary cancer care centre in Queensland, Australia. On a randomly selected day, four nurses assessed intravascular device related nursing practices and collected data using a standardized survey tool. Results 58 inpatients (100%) were assessed. Forty-eight (83%) had a device in situ, comprising 14 Peripheral Intravenous Catheters (29.2%), 14 Peripherally Inserted Central Catheters (29.2%), 14 Hickman catheters (29.2%) and six Port-a-Caths (12.4%). Suboptimal outcomes such as incidences of local site complications, incorrect/inadequate documentation, lack of flushing orders, and unclean/non intact dressings were observed. Conclusions This study has highlighted a number of intravascular device related nursing practice discrepancies compared with current hospital policy. Education and other implementation strategies can be applied to improve nursing practice. Following education strategies, it will be valuable to repeat this survey on a regular basis to provide feedback to nursing staff and implement strategies to improve practice. More research is required to provide evidence to clinical practice with regards to intravascular device related consumables, flushing technique and protocols.

Tumour necrosis is an independent prognostic marker in non-small cell lung cancer : correlation with biological variables

Background Tumour necrosis (TN) is recognized to be a consequence of chronic cellular hypoxia. TN and hypoxia correlate with poor prognosis in solid tumours. Methods In a retrospective study the prognostic implications of the extent of TN was evaluated in non-small cell lung cancer (NSCLC) and correlated with clinicopathological variables and expression of epidermal growth factor receptor, Bcl-2, p53 and matrix metalloproteinase-9 (MMP-9). Tissue specimens from 178 surgically resected cases of stage I-IIIA NSCLC with curative intent were studied. The specimens were routinely processed, formalin-fixed and paraffin-embedded. TN was graded as extensive or either limited or absent by two independent observers; disagreements were resolved using a double-headed microscope. The degree of reproducibility was estimated by re-interpreting 40 randomly selected cases after a 4 month interval. Results Reproducibility was attained in 36/40 cases, Kappa score=0.8 P<0.001. TN correlated with T-stage (P=0.001), platelet count (P=0.004) and p53 expression (P=0.031). Near significant associations of TN with N-stage (P=0.063) and MMP-9 expression (P=0.058) were seen. No association was found with angiogenesis (P=0.98). On univariate (P=0.0016) and multivariate analysis (P=0.023) TN was prognostic. Conclusion These results indicate that extensive TN reflects an aggressive tumour phenotype in NSCLC and may improve the predictive power of the TMN staging system. The lack of association between TN and angiogenesis may be important although these variables were not evaluated on serial sections. © 2002 Elsevier Science Ireland Ltd. All rights reserved.

Targeting amino acid transport in metastatic castration-resistant prostate cancer : effects on cell cycle, cell growth, and tumor development

Background L-type amino acid transporters (LATs) uptake neutral amino acids including L-leucine into cells, stimulating mammalian target of rapamycin complex 1 signaling and protein synthesis. LAT1 and LAT3 are overexpressed at different stages of prostate cancer, and they are responsible for increasing nutrients and stimulating cell growth. Methods We examined LAT3 protein expression in human prostate cancer tissue microarrays. LAT function was inhibited using a leucine analog (BCH) in androgen-dependent and -independent environments, with gene expression analyzed by microarray. A PC-3 xenograft mouse model was used to study the effects of inhibiting LAT1 and LAT3 expression. Results were analyzed with the Mann-Whitney U or Fisher exact tests. All statistical tests were two-sided. Results LAT3 protein was expressed at all stages of prostate cancer, with a statistically significant decrease in expression after 4–7 months of neoadjuvant hormone therapy (4–7 month mean = 1.571; 95% confidence interval = 1.155 to 1.987 vs 0 month = 2.098; 95% confidence interval = 1.962 to 2.235; P = .0187). Inhibition of LAT function led to activating transcription factor 4–mediated upregulation of amino acid transporters including ASCT1, ASCT2, and 4F2hc, all of which were also regulated via the androgen receptor. LAT inhibition suppressed M-phase cell cycle genes regulated by E2F family transcription factors including critical castration-resistant prostate cancer regulatory genes UBE2C, CDC20, and CDK1. In silico analysis of BCH-downregulated genes showed that 90.9% are statistically significantly upregulated in metastatic castration-resistant prostate cancer. Finally, LAT1 or LAT3 knockdown in xenografts inhibited tumor growth, cell cycle progression, and spontaneous metastasis in vivo. Conclusion Inhibition of LAT transporters may provide a novel therapeutic target in metastatic castration-resistant prostate cancer, via suppression of mammalian target of rapamycin complex 1 activity and M-phase cell cycle genes.

A needle in a haystack : the use of routinely collected emergency department injury surveillance data to help identify physical child abuse

A retrospective, descriptive analysis of a sample of children under 18 years presenting to a hospital emergency department (ED) for treatment of an injury was conducted. The aim was to explore characteristics and identify differences between children assigned abuse codes and children assigned unintentional injury codes using an injury surveillance database. Only 0.1% of children had been assigned the abuse code and 3.9% a code indicating possible abuse. Children between 2-5 years formed the largest proportion of those coded to abuse. Superficial injury and bruising were the most common types of injury seen in children in the abuse group and the possible abuse group (26.9% and 18.8% respectively), whereas those with unintentional injury were most likely to present with open wounds (18.4%). This study demonstrates that routinely collected injury surveillance data can be a useful source of information for describing injury characteristics in children assigned abuse codes compared to those assigned no abuse codes.