Referral patterns and proximity to palliative care inpatient services by level of socio-economic disadvantage : a national study using spatial analysis

Background: A range of health outcomes at a population level are related to differences in levels of social disadvantage. Understanding the impact of any such differences in palliative care is important. The aim of this study was to assess, by level of socio-economic disadvantage, referral patterns to specialist palliative care and proximity to inpatient services. Methods: All inpatient and community palliative care services nationally were geocoded (using postcode) to one nationally standardised measure of socio-economic deprivation – Socio-Economic Index for Areas (SEIFA; 2006 census data). Referral to palliative care services and characteristics of referrals were described through data collected routinely at clinical encounters. Inpatient location was measured from each person’s home postcode, and stratified by socio-economic disadvantage. Results: This study covered July – December 2009 with data from 10,064 patients. People from the highest SEIFA group (least disadvantaged) were significantly less likely to be referred to a specialist palliative care service, likely to be referred closer to death and to have more episodes of inpatient care for longer time. Physical proximity of a person’s home to inpatient care showed a gradient with increasing distance by decreasing levels of socio-economic advantage. Conclusion: These data suggest that a simple relationship of low socioeconomic status and poor access to a referral-based specialty such as palliative care does not exist. Different patterns of referral and hence different patterns of care emerge.

Bilingual asynchronous online discussion groups : design and delivery of an e-Learning distance study module for nurse academics in a developing country

The advent of eLearning has seen online discussion forums widely used in both undergraduate and postgraduate nursing education. This paper reports an Australian university experience of design, delivery and redevelopment of a distance education module developed for Vietnamese nurse academics. The teaching experience of Vietnamese nurse academics is mixed and frequently limited. It was decided that the distance module should attempt to utilise the experience of senior Vietnamese nurse academics - asynchronous online discussion groups were used to facilitate this. Online discussion occurred in both Vietnamese and English and was moderated by an Australian academic working alongside a Vietnamese translator. This paper will discuss the design of an online learning environment for foreign correspondents, the resources and translation required to maximise the success of asynchronous online discussion groups, as well as the rationale of delivering complex content in a foreign language. While specifically addressing the first iteration of the first distance module designed, this paper will also address subsequent changes made for the second iteration of the module and comment on their success. While a translator is clearly a key component of success, the elements of simplicity and clarity combined with supportive online moderation must not be overlooked.

Design and delivery of a distance education programme : educating Vietnamese nurse academics from Australia

In 2008 a move away from medical staff providing nursing education in Vietnam saw the employment of many new nurse academics. To assist in the instruction of these novice academics and provide them with sound teaching and learning practice as well as curriculum design and implementation skills, Queensland University of Technology (QUT) successfully tendered an international grant. One of QUT’s initiatives in educating the Vietnamese academics was a distance learning programme. Developed specifically for Vietnamese nurse academics, the programme was designed for Australian based delivery to academics in Vietnam. This paper will present an overview of why four separate modules were utilised for the delivery of content (modules were delivered at a rate of one per semester). It will address bilingual online discussion boards which were used in each of the modules and the process of moderating these given comments were posted in both Vietnamese and English. It will describe how content was scaffolded across four modules and how the modules themselves modelled new teaching delivery strategies. Lastly, it will discuss the considerations of programme delivery given the logistics of an Australian based delivery. Feedback from the Vietnamese nurse academics across their involvement in the programme (and at the conclusion of their fourth and final module) has been overwhelmingly positive. Feedback suggests the programme has altered teaching and assessment approaches used by some Vietnamese nurse academics. Additionally, Vietnamese nurse academics are reporting that they are engaging more with the application of their content indicating a cultural shift in the approach taken in Vietnamese nurse education.

Mechanism of dehydroxylation temperature decrease and high temperature phase transition of coal-bearing strata kaolinite intercalated by potassium acetate

The thermal decomposition and dehydroxylation process of coal-bearing strata kaolinite–potassium acetate intercalation complex (CSKK) has been studied using X-ray diffraction (XRD), infrared spectroscopy (IR), thermal analysis, mass spectrometric analysis and infrared emission spectroscopy. The XRD results showed that the potassium acetate (KAc) have been successfully intercalated into coal-bearing strata kaolinite with an obvious basal distance increase of the first basal peak, and the positive correlation was found between the concentration of intercalation regent KAc and the degree of intercalation. As the temperature of the system is raised, the formation of KHCO3, KCO3 and KAlSiO4, which is derived from the thermal decomposition or phase transition of CSKK, is observed in sequence. The IR results showed that new bands appeared, the position and intensities shift can also be found when the concentration of intercalation agent is raised. The thermal analysis and mass spectrometric analysis results revealed that CSKK is stable below 300 °C, and the thermal decomposition products (H2O and CO2) were further proved by the mass spectrometric analysis. A comparison of thermal analysis results of original coal-bearing strata kaolinite and its intercalation complex gives new discovery that not only a new mass loss peak is observed at 285 °C, but also the temperature of dehydroxylation and dehydration of coal bearing strata kaolinite is decreased about 100 °C. This is explained on the basis of the interlayer space of the kaolinite increased obviously after being intercalated by KAc, which led to the interlayer hydrogen bonds weakened, enables the dehydroxylation from kaolinite surface more easily. Furthermore, the possible structural model for CSKK has been proposed, with further analysis required in order to prove the most possible structures.

Nature and genesis of clay minerals of the Rustler Formation in the vicinity of the Waste Isolation Pilot Plant in Souteastern New Mexico

Detailed mineralogical studies of the matrix and fracture-fill materials of a large number of samples from the Rustler Formation have been carried out using x-ray diffraction, high-resolution transmission electron microscopy, electron microprobe analysis, x-ray fluorescence, and atomic absorption spectrophotometry. These analyses indicate the presence of four clay minerals: interstratified chlorite/saponite, illite, chlorite, and serpentine. Corrensite (regularly stratified chlorite/saponite) is the dominant clay mineral in samples from the Culebra dolomite and two shale layers of the lower unnamed member of the Rustler Formation. Within other layers of the Rustler Formation, disordered mixed chlorite/saponite is usually the most abundant clay mineral. Studies of the morphology and composition of clay crystallites suggest that the corrensite was formed by the alteration of detrital dioctahedral smectite in magnesium-rich pore fluids during early diagenesis of the Rustler Formation. This study provides initial estimates of the abundance and nature of the clay minerals in the Culebra dolomite in the vicinity of the Waste Isolation Pilot Plant.

Distances travelled by feral horses in ‘outback’ Australia

Reasons for performing study: The distance travelled by Australian feral horses in an unrestricted environment has not previously been determined. It is important to investigate horse movement in wilderness environments to establish baseline data against which the movement of domestically managed horses and wild equids can be compared. Objectives: To determine the travel dynamics of 2 groups of feral horses in unrestricted but different wilderness environments. Methods: Twelve feral horses living in 2 wilderness environments (2000 vs. 20,000 km2) in outback Australia were tracked for 6.5 consecutive days using custom designed, collar mounted global positioning systems (GPS). Collars were attached after darting and immobilising the horses. The collars were recovered after a minimum of 6.5 days by re-darting the horses. Average daily distance travelled was calculated. Range use and watering patterns of horses were analysed by viewing GPS tracks overlaid on satellite photographs of the study area. Results: Average distance travelled was 15.9 ± 1.9 km/day (range 8.1–28.3 km/day). Horses were recorded up to 55 km from their watering points and some horses walked for 12 h to water from feeding grounds. Mean watering frequency was 2.67 days (range 1–4 days). Central Australian horses watered less frequently and showed a different range use compared to horses from central Queensland. Central Australian horses walked for long distances in direct lines to patchy food sources whereas central Queensland horses were able to graze close to water sources and moved in a more or less circular pattern around the central water source. Conclusions: The distances travelled by feral horses were far greater than those previously observed for managed domestic horses and other species of equid. Feral horses are able to travel long distances and withstand long periods without water, allowing them to survive in semi-arid conditions.

Enlarged stopping distance to improve vehicle discharge at urban signalised intersections

Normally, vehicles queued at an intersection reach maximum flow rate after the fourth vehicle and results in a start-up lost time. This research demonstrated that the Enlarged Stopping Distance (ESD) concept could assist in reducing the start-up time and therefore increase traffic flow capacity at signalised intersections. In essence ESD gives sufficient space for a queuing vehicle to accelerate simultaneously without having to wait for the front vehicle to depart, hence reducing start-up lost time. In practice, the ESD concept would be most effective when enlarged stopping distance between the first and second vehicle allowing faster clearance of the intersection.

A distance too far away : a novel and exegesis

This practice-led research examines the generative function of loss in fiction that explores themes of grief and longing. This research considers how loss may be understood as a structuring mechanism through which characters evaluate time, resolve loss and affect future change. The creative work is a work of literary fiction titled A Distance Too Far Away. Aubrey, the story’s protagonist, is a woman in her twenties living in Brisbane in the early 1980s, carving out an independent life for herself away from her family. Through a flashback narrative sequence, told from the perspective of the twelve year narrator, Aubrey retraces a significant point of rupture in her life following a series of family tragedies. A Distance Too Far Away explores the tension between belonging and freedom, and considers how the past provides a malleable space for illuminating desire in order to traverse the gap between the world as it is and the world as we want it to be. The exegetical component of this research considers an alternative critical frame for interpreting the work of American author Anne Tyler, a writer who has had a significant influence on my own practice. Frequently criticised for creating sentimental and inert characters, many critics observe that nothing happens in Tyler’s circular plots. This research challenges these assertions, and through a contextual analysis of Tyler’s Ladder of Years (1995) investigates how Tyler engages with memory and nostalgia in order to move across time and resolve loss.

Verification of patient position and delivery of IMRT by electronic portal imaging

Background and purpose: The purpose of the work presented in this paper was to determine whether patient positioning and delivery errors could be detected using electronic portal images of intensity modulated radiotherapy (IMRT). Patients and methods: We carried out a series of controlled experiments delivering an IMRT beam to a humanoid phantom using both the dynamic and multiple static field method of delivery. The beams were imaged, the images calibrated to remove the IMRT fluence variation and then compared with calibrated images of the reference beams without any delivery or position errors. The first set of experiments involved translating the position of the phantom both laterally and in a superior/inferior direction a distance of 1, 2, 5 and 10 mm. The phantom was also rotated 1 and 28. For the second set of measurements the phantom position was kept fixed and delivery errors were introduced to the beam. The delivery errors took the form of leaf position and segment intensity errors. Results: The method was able to detect shifts in the phantom position of 1 mm, leaf position errors of 2 mm, and dosimetry errors of 10% on a single segment of a 15 segment IMRT step and shoot delivery (significantly less than 1% of the total dose). Conclusions: The results of this work have shown that the method of imaging the IMRT beam and calibrating the images to remove the intensity modulations could be a useful tool in verifying both the patient position and the delivery of the beam.

Count-min sketches for estimating password frequency within Hamming distance two

The count-min sketch is a useful data structure for recording and estimating the frequency of string occurrences, such as passwords, in sub-linear space with high accuracy. However, it cannot be used to draw conclusions on groups of strings that are similar, for example close in Hamming distance. This paper introduces a variant of the count-min sketch which allows for estimating counts within a specified Hamming distance of the queried string. This variant can be used to prevent users from choosing popular passwords, like the original sketch, but it also allows for a more efficient method of analysing password statistics.

Human identification at a distance using iris and face

This research has successfully applied super-resolution and multiple modality fusion techniques to address the major challenges of human identification at a distance using face and iris. The outcome of the research is useful for security applications.

Isolation and use of chromosome 1 probes for linkage studies on Charcot-Marie-Tooth disease

Nine probes were isolated from a human chromosome 1 enriched library and mapped to regions of chromosome 1 using somatic cell hybrid lines. One clone, LR67, which mapped 1q12→q23 detected a BglI RFLP. This probe, as well as 4 other known chromosome 1 markers, α-spectrin, Factor XIIIB, DR10 and DR78, were used for linkage studies in 15 Charcot-Marie-Tooth disease (CMT1) families. Close linking of CMT1 to any of the 5 markers was not indicated. Total lod scores excluded linkage of CMT1 to LR67 and to DR10 at 5 cM or less, to DR78 and 10 cM or less, α-spectrin at 15 cM or less and Factor XIIIB at 20 cM or less. Possible linkage, however, was shown between LR67 and CMT1 at a distance of 30 cM. Also linkage at a distance of 5 cM was detected between this probe and α-spectrin.

Precedent-free fault isolation in a diesel engine EGR valve system

In this paper, a framework for isolating unprecedented faults for an EGR valve system is presented. Using normal behavior data generated by a high fidelity engine simulation, the recently introduced Growing Structure Multiple Model System (GSMMS) is used to construct models of normal behavior for an EGR valve system and its various subsystems. Using the GSMMS models as a foundation, anomalous behavior of the entire system is then detected as statistically significant departures of the most recent modeling residuals from the modeling residuals during normal behavior. By reconnecting anomaly detectors to the constituent subsystems, the anomaly can be isolated without the need for prior training using faulty data. Furthermore, faults that were previously encountered (and modeled) are recognized using the same approach as the anomaly detectors.

Precedent-free fault isolation in a diesel engine exhaust gas recirculation system

In this paper, a recently introduced model-based method for precedent-free fault detection and isolation (FDI) is modified to deal with multiple input, multiple output (MIMO) systems and is applied to an automotive engine with exhaust gas recirculation (EGR) system. Using normal behavior data generated by a high fidelity engine simulation, the growing structure multiple model system (GSMMS) approach is used to construct dynamic models of normal behavior for the EGR system and its constituent subsystems. Using the GSMMS models as a foundation, anomalous behavior is detected whenever statistically significant departures of the most recent modeling residuals away from the modeling residuals displayed during normal behavior are observed. By reconnecting the anomaly detectors (ADs) to the constituent subsystems, EGR valve, cooler, and valve controller faults are isolated without the need for prior training using data corresponding to particular faulty system behaviors.

YBa2Cu3O7/NdGaO3/YBa 2Cu3O7 trilayers by modified off-axis sputtering

High-quality epitaxial YBa2Cu3O7-δ (YBCO) thin films were achieved by a modified off-axis sputtering technique with high deposition rates (3.3 nm/min). The film quality and the deposition rate depended crucially on the target-to-substrate separation. Epitaxial YBCO/NdGaO3(NGO)/YBCO trilayers were successfully grown onto SrTiO3, Y-ZrO2, and LaAlO3 substrates by dc and rf sputtering. The epitaxial relations were found to be [001] YBCO//[001]NGO, [100]YBCO, or [010] YBCO//[110]NGO and [001]YBCO//[110] NGO, [100]YBCO, or [010]YBCO//[001] NGO, where the latter orientation relationship was dominating. Subsequent top YBCO layers grew c axis oriented independently of the two epitaxial orientations of the NGO. The orientation relationships between YBCO and NGO were the same. Auger electron depth profiles and transmission electron microscopy indicated that the interdiffusion at the interface between the YBCO and NGO layers was not strong even at 740°C. The superconducting transition temperatures of the top and bottom YBCO layers were about the same as that of YBCO single layers, i.e., 87-90 K. Scanning electron microscopy of the surface morphologies of the YBCO and the NGO showed that a smaller substrate-target distance resulted in smoother films.