Evaluation of a novel photography-based home assessment protocol for identification of environmental risk factors for falls in elderly persons

PRINCIPLES To evaluate the validity and feasibility of a novel photography-based home assessment (PhoHA) protocol, as a possible substitute for on-site home assessment (OsHA). METHODS A total of 20 patients aged ≥65 years who were hospitalised in a rehabilitation centre for musculoskeletal disorders affecting mobility participated in this prospective validation study. For PhoHA, occupational therapists rated photographs and measurements of patients' homes provided by patients' confidants. For OsHA, occupational therapists conducted a conventional home visit. RESULTS Information obtained by PhoHA was 79.1% complete (1,120 environmental factors identified by PhoHA vs 1416 by OsHA). Of the 1,120 factors, 749 had dichotomous (potential hazards) and 371 continuous scores (measurements with tape measure). Validity of PhoHA to potential hazards was good (sensitivity 78.9%, specificity 84.9%), except for two subdomains (pathways, slippery surfaces). Pearson's correlation coefficient for the validity of measurements was 0.87 (95% confidence interval [CI 0.80-0.92, p <0.001). Agreement between methods was 0.52 (95%CI 0.34-0.67, p <0.001, Cohen's kappa coefficient) for dichotomous and 0.86 (95%CI 0.79-0.91, p <0.001, intraclass correlation coefficient) for continuous scores. Costs of PhoHA were 53.0% lower than those of OsHA (p <0.001). CONCLUSIONS PhoHA has good concurrent validity for environmental assessment if instructions for confidants are improved. PhoHA is potentially a cost-effective method for environmental assessment.

Time-series of seagrass and land cover maps from 1972 to 2010, in South East Queensland, Australia, with links to GeoTIFFs

Long term global archives of high-moderate spatial resolution, multi-spectral satellite imagery are now readily accessible, but are not being fully utilised by management agencies due to the lack of appropriate methods to consistently produce accurate and timely management ready information. This work developed an object-based remote sensing approach to map land cover and seagrass distribution in an Australian coastal environment for a 38 year Landsat image time-series archive (1972-2010). Landsat Multi-Spectral Scanner (MSS), Thematic Mapper (TM) and Enhanced Thematic Mapper (ETM+) imagery were used without in situ field data input (but still using field knowledge) to produce land and seagrass cover maps every year data were available, resulting in over 60 map products over the 38 year archive. Land cover was mapped annually using vegetation, bare ground, urban and agricultural classes. Seagrass distribution was also mapped annually, and in some years monthly, via horizontal projected foliage cover classes, sand and deep water. Land cover products were validated using aerial photography and seagrass maps were validated with field survey data, producing several measures of accuracy. An average overall accuracy of 65% and 80% was reported for seagrass and land cover products respectively, which is consistent with other studies in the area. This study is the first to show moderate spatial resolution, long term annual changes in land cover and seagrass in an Australian environment, created without the use of in situ data; and only one of a few similar studies globally. The land cover products identify several long term trends; such as significant increases in South East Queensland's urban density and extent, vegetation clearing in rural and rural-residential areas, and inter-annual variation in dry vegetation types in western South East Queensland. The seagrass cover products show that there has been a minimal overall change in seagrass extent, but that seagrass cover level distribution is extremely dynamic; evidenced by large scale migrations of higher seagrass cover levels and several sudden and significant changes in cover level. These mapping products will allow management agencies to build a baseline assessment of their resources, understand past changes and help inform implementation and planning of management policy to address potential future changes.

Composite of coastal seagrass meadows in Queensland, Australia - November 1984 to June 2010

Approximately 18,400 km**2 of seagrass habitat has been mapped within the coastal waters (<15 m) of Queensland (Australia) between November 1984 and June 2010. The total seagrass meadow distribution was calculated by merging maps from 115 separate mapping surveys (varying locations and dates). Due to tropical seagrass dynamism, meadow distribution can change seasonally and between years, and as a consequence, the composite represents the maximum area of seabed where seagrass has been observed/recorded. Mapping survey methodologies followed standardised global seagrass research methods (McKenzie et al. 2001) where the presence of seagrass was determined from in situ visual assessment of the seabed by either divers or drop cameras at GPS marked positions. Seagrass meadow boundaries were determined based on the positions of survey sites and the presence of seagrass, coupled with depth contours and remote sensing (e.g. aerial photography) where available. The merged meadow boundary accuracy was dependent on the original survey maps and varied from 10-100 m. The resulting composite seagrass distribution was saved as an ArcMap polygon shapefile, and projected to Geocentric Datum of Australia GDA94.

Residential and lifestyle changes for adults with an intellectual disability in Queensland 1960-2001

As we celebrate 50 years of the Schonell Special Education Research Centre it is timely to consider changes that have occurred in the provision of residential services for people with an intellectual disability. Before the 1970s adults and children were cared for in large institutions using a medical model of care. In the mid-1970s a new developmental model based on education and training was implemented in response to the principle of normalisation and issues of social justice. The most dramatic changes have occurred in the last ten years with the decision to close large institutions and relocate residents into ordinary homes in the community. This paper describes changes in lifestyle for adults with an intellectual disability as a result of the move from institutional to community residential service provision. The Challinor Centre in Ipswich, Queensland, Australia provides examples of lifestyle changes that have occurred under different models of service provision during this time. Community living is described with research evidence validating the advantages of this type of service provision for residents with an intellectual disability. Outcomes have been documented through the use of group results and a case study of one individual following deinstitutionalisation describes the benefits of this new model of residential accommodation

Paediatric telecardiology services in Queensland: a review of three years' experience

Videoconferencing at 384 kbit/s for the transmission of echocardiograms has proved useful for the assessment of children with suspected cardiac disease, in regional areas of Queensland. A retrospective review of patient and management outcomes was conducted on cardiac teleconsultations performed at two regional hospitals during the period November 2000 to February 2004, inclusive. There were 106 echo studies. A subset of 72 cardiac teleconsultations performed between May 2001 and February 2004 was reviewed in detail. The median age of patients at the time of consultation was 3 months (range 1 day-17 years). Sixteen per cent of teleconsultations were classified as urgent and were conducted on the same day as referral. Following the videoconference, 90% of patients could be managed locally and reviewed by the paediatrician or visiting paediatric cardiologist during an outreach clinic. Six children (8%) had significant cardiac lesions that were initially managed locally, with subsequent elective transfer at the appropriate time for treatment. Only one child (1%) required urgent transfer to the tertiary centre for specialist care and surgery. Telecardiology was effective in accurately identifying congenital heart disease. Paediatric telecardiology is an evolving modality of assessment and communication, and is likely to result in continued improvements in patient care, patient outcomes and parental satisfaction, in provincial centres removed from the tertiary cardiac centre.

Effects of phosphorus on the growth and nitrogen fixation rates of Lyngbya majuscula: implications for management in Moreton Bay, Queensland

Significant acetylene reduction and therefore N-2 fixation was observed for Lyngbya majuscula only during dark periods, which suggests that oxygenic photosynthesis and N-2 fixation are incompatible processes for this species. Results from a series of batch and continuous-flow-culture reactor studies showed that the specific growth rate and N-2 fixation rate of L, majuscula increased with phosphate (P-PO4) concentration up to a maximum value and thereafter remained constant. The P-PO4 concentrations corresponding to the maximum N-2 fixation and maximum growth rates were -0.27 and -0.18 muM respectively and these values are denoted as the saturation values for N-2 fixation and growth respectively. Regular monitoring studies in Moreton Bay, Queensland, show that concentrations Of P-PO4 generally exceed these saturation values over a large portion of the Bay and therefore, the growth of the bloom-forming L, majuscula is potentially maximised throughout much of the Bay by the elevated P-PO4 concentrations. Results from other studies suggest that the elevated P-PO4 concentrations in the Bay can be largely attributed to discharges from waste-water treatment plants (WWTPs), and thus it is proposed that the control of the growth of L. majuscula in Moreton Bay will require a significant reduction in the P load from the WWTP discharges. If the current strategy of N load reduction for these discharges is maintained in the absence of substantial P load reduction, it is hypothesised that the growth of L, majuscula and other diazotrophs in Moreton Bay will increase in the future.

Mapping and characterising subtropical estuarine landscapes using aerial photography and GIS for potential application in wildlife conservation and management

Coarse-resolution thematic maps derived from remotely sensed data and implemented in GIS play an important role in coastal and marine conservation, research and management. Here, we describe an approach for fine-resolution mapping of land-cover types using aerial photography and ancillary GIs and ground data in a large (100 x 35 km) subtropical estuarine system (Moreton Bay, Queensland, Australia). We have developed and implemented a classification scheme representing 24 coastal (subtidal, intertidal. mangrove, supratidal and terrestrial) cover types relevant to the ecology of estuarine animals, nekton and shorebirds. The accuracy of classifications of the intertidal and subtidal cover types, as indicated by the agreement between the mapped (predicted) and reference (ground) data, was 77-88%, depending on the zone and level of generalization required. The variability and spatial distribution of habitat mosaics (landscape types) across the mapped environment were assessed using K-means clustering and validated with Classification and Regression Tree models. Seven broad landscape types could be distinguished and ways of incorporating the information on landscape composition into site-specific conservation and field research are discussed. This research illustrates the importance and potential applications of fine-resolution mapping for conservation and management of estuarine habitats and their terrestrial and aquatic wildlife. (c) 2005 Elsevier Ltd. All rights reserved.

Review of the evidence for prehospital administration of benzyl penicillin in meningoccocal septicaemia - experience in Queensland

Meningococcal disease is a rare but potential killer in both adults and children. Community acquired meningococcal disease is caused by a variety of serogroups of Neisseria meningitides. Of the five main subgroups, A, B, C, W135 and Y, serogroups, A and Y are rarely identified in Australia. Alternatively, Serogroup B accounts for the highest number of cases followed by serogroup C strains. Meningococcal infection causes two distinct clinical profiles, though dual presentations are not uncommon. The first, meningitis presenting alone, is the more common form of infection and requires urgent but not immediate medical treatment. Conversely the second presentation, meningococcal septicaemia, is considered a medical emergency. In Queensland, careful and detailed consideration of the evidence for introduction of benzyl penicillin for the prehospital treatment of meningococcal septicaemia has been conducted. Notwithstanding the seriousness of the septicaemic presentation, these reviews have resulted in the decision not to introduce this drug in the ambulance service at the time. This paper describes the reasoning behind these decisions.

How the west was once: vegetation change in south-west Queensland from 1930 to 1995

Conflicting perceptions of past and present rangeland condition and limited historical data have led to debate regarding the management of vegetation in pastoral landscapes both internationally and in Australia. In light of this controversy we have sought to provide empirical evidence to determine the trajectory of vegetational change in a semi-arid rangeland for a significant portion of the 20th century using a suite of proxy measures. Ambathala Station, approximately 780 km west of Brisbane, in the semi-arid rangelands of south-western Queensland, Australia. We excavated stratified deposits of sheep manure which had accumulated beneath a shearing shed between the years 1930 and 1995. Multi-proxy data, including pollen and leaf cuticle analyses and analysis of historical aerial photography were coupled with a fine resolution radiocarbon chronology to generate a near annual history of vegetation on the property and local area. Aerial photography indicates that minor (< 5%) increases in the density of woody vegetation took place between 1951 and 1994 in two thirds of the study area not subjected to clearing. Areas that were selectively or entirely cleared prior to the 1950s (approximately 16% of the study area) had recovered to almost 60% of their original cover by the 1994 photo period. This slight thickening is only partially evident from pollen and leaf cuticle analyses of sheep faeces. Very little change in vegetation is revealed over the nearly 65 years based on the relative abundances of pollen taxonomic groups. Microhistological examination of sheep faeces provides evidence of dramatic changes in sheep diet. The majority of dietary changes are associated with climatic events of sustained above-average rainfall or persistent drought. Most notable in the dietary analysis is the absence of grass during the first two decades of the record. In contrast to prevailing perceptions and limited research into long-term vegetation change in the semi-arid areas of eastern Australia, the record of vegetation change at the Ambathala shearing shed indicates only a minor increase in woody vegetation cover and no decrease in grass cover on the property over the 65 years of pastoral activity covered by the study. However, there are marked changes in the abundance of grass cuticles in sheep faeces. The appearance and persistence of grass in sheep diets from the late 1940s can be attributed to the effects of periods of high rainfall and possibly some clearing and thinning of vegetation. Lower stock numbers may have allowed grass to persist through later drought years. The relative abundances of major groups of plant pollen have not changed significantly over the past 65 years.