The economic impact of progressive neurological illness on quality of life in Australia

The current study examined the impact of financial costs and self-reported economic pressure on the quality of life of patients with progressive neurological illness. Participants were 423 people from four illness groups in Australia. Participants completed measures of: 1. quality of life, 2. income, 3. expenses, 4. economic pressure, 5. social support, 6. relationship satisfaction, and 7. severity of illness. There was a strong negative association between quality of life and economic pressure (but not income or expenses) for all groups. Subjective assessment of economic pressure was strongly associated with quality of life for people with motor neurone disease and multiple sclerosis. Implications of these results for assisting people with progressive neurological illnesses to cope with the financial changes that occur due to their illness are discussed.

Recovering from an acute cardiac event – the relationship between depression and life satisfaction

Aims. This study sought to measure the rates and trajectory of depression over six months following admission for an acute cardiac event and describe the relationship between depression and life satisfaction.
Background. Co-morbid depression has an impact on cardiac mortality and is associated with the significant impairment of quality of life and well-being, impairments in psychosocial function, decreased medication adherence and increased morbidity.
Design. This was a descriptive, correlational study.
Method. The study was undertaken at a large public hospital in Melbourne. Participants were asked to complete a survey containing the cardiac depression scale (CDS) and the Personal Well-being Index.
Results. This study mapped the course of depression over six months of a cohort of patients admitted for an acute cardiac event. Significant levels of depressive symptoms were found, at a level consistent with the literature. A significant correlation between depressive symptoms as measured by the CDS and the Personal Well-being Index was found.
Conclusions. Depression remains a significant problem following admission for an acute coronary event. The Personal Wellbeing Index may be a simple, effective and non-confrontational initial screening tool for those at risk of depressive symptoms in this population. Relevance to clinical practice. Despite the known impact of depression on coronary heart disease (CHD), there is limited research describing its trajectory. This study makes a compelling case for the systematic screening for depression in patients with CHD and the importance of the nursing role in identifying at risk individuals.

Diet quality in bipolar disorder in a population-based sample of women

Background : Recent epidemiological evidence has indicated a role for diet quality in unipolar depressive illness. This study examined the association between diet quality and bipolar disorder (BD) in an epidemiological cohort of randomly selected, population-based women aged 20–93 years.

Methods : An a priori diet quality score was derived from food frequency questionnaire data, a factor analysis identified habitual dietary patterns and glycemic load was assessed. Mental health was assessed using the SCID-I/NP.

Results : BD was identified in 23 women and there were 691 participants with no history of psychopathology. Compared to those with no psychopathology, those with BD had a higher glycemic load (p = 0.06) and higher scores on a ‘western’ dietary factor (p = 0.03) and the ‘modern’ dietary factor (p = 0.02). For each standard deviation increase in a ‘western’ and ‘modern’ dietary pattern and glycemic load, the odds ratios for BD were increased (‘western’ OR = 1.88, 95% CI 1.33–2.65; ‘modern’ OR = 1.72, 95% CI 1.14–2.39; GL OR = 1.56, 95% CI 1.13–2.14). Conversely, a ‘traditional’ dietary pattern was associated with reduced odds for BD (OR = 0.53 95% CI 0.32–0.89) after adjustments for overall energy intake.

Limitations : The small sample size did not allow for multivariate analyses and the cross-sectional study design precludes any determinations regarding the direction of the relationships between diet quality and BD.

Conclusion : These data are largely concordant with results from dietary studies in unipolar depression. However, clinical recommendations cannot be made until the direction of the relationship between diet quality and BD is determined. Longitudinal studies are warranted.

Predictors of quality of life in carers for people with a progressive neurological illness: a longitudinal study

Purpose The aim of the present research was to determine the predictors of quality of life (QOL) among carers for people living with a chronic degenerative neurological illness, with comparisons of the differences in significant predictors of QOL between illness groups.
Methods Psychosocial and economic variables were examined among 192 carers for people living at home with motor neurone disease, Huntington’s disease, multiple sclerosis, and Parkinson’s, over a twelve-month period, to determine their contribution to the prediction of carer QOL.
Results Mood was the only consistent predictor of carer QOL across groups; however, marital relationship satisfaction, social support satisfaction, income, and economic pressure significantly predicted carer QOL for at least one of the illness groups, in addition to mood.
Conclusions The findings highlight the importance of recognising the varying roles that psychosocial and economic variables play on the prediction of carer QOL within each of these illness groups.

Utility-based quality of life of overweight and obese adolescents

Objective : To explore the relationship between overweight/obesity and utility in adolescents.

Methods : Data were collected from 2890 adolescents attending 13 secondary schools in the state of Victoria, Australia. The Assessment of Quality of Life 6-Dimension (AQoL-6D) questionnaire was used to measure individual utility. Adolescent's height and weight were measured and weight status categories assigned according to the World Health Organization adolescent growth standards. Multivariate linear regression analyses were undertaken for the whole population and subpopulations of boys and girls to estimate the mean differences in utility scores between 1) overweight and healthy weight and 2) obese and healthy weight adolescents, while controlling for demographic and socioeconomic status variables.

Results : The mean age of adolescents was 14.6 years, 56.2% were boys, 22.2% were overweight, and 9.4% were obese. The mean utility of healthy weight adolescents was 0.860. After adjustments, the overweight and obese groups reported significantly lower mean utility scores (differences: −0.018 and −0.059, respectively, relative to the healthy weight group). This can be interpreted as equivalent to a stated willingness to sacrifice 1.8% and 5.9% of a life in perfect health or 2.3% and 6.8% of a life at healthy weight. A significant utility difference associated with overweight was only experienced by girls (−0.039, P = 0.003). Both sexes experienced significant utility differences associated with obesity, but the magnitude was double for girls (−0.084, P < 0.001) relative to boys (−0.041, P = 0.022).

Conclusion : Utility is lower among overweight and more so among obese adolescents.

Correlation between shoulder flow zone quality and material flow quantity during friction stir welding of thick aluminum section using scroll shoulder tool

The so-called scroll shoulder tool is widely used particularly for thick section friction stir welding (FSW). However, the correlation between its shoulder flow zone weld quality and material flow quantity remains unclear. This information is important for tool design. In the present study, a scroll shoulder tool was used to FSW 20mm thick 6061 aluminum (Al) plates at a range of welding parameters. The pick-up material (PUM) by the scroll was quantified, and the effect of welding parameters and PUM on the shoulder flow zone formation and weld quality was studied. It was found that there is a positive linear relationship between the PUM and weld quality. In order to obtain a defect-free FSW weld produced by the scroll shoulder tool, scroll groove needs to be fully filled by PUM.

The relationship between emergence of the shortest path and information value using ant-like agents

Ant-like agents forage between two points. These agents' probabilistic movements are based on the use of two pheromones; one marking trails towards the goal and another marking trails back to the starting point. Path selection decisions are influenced by the relative levels of attractive and repulsive pheromone in each agent's local environment. Our work in [5] evaluates three pheromone perception strategies, investigating path formation speed, quality, directionality, robustness and adaptability under different parameter settings(degree of randomness, pheromone evaporation rate and pheromone diffusion rate). We re-evaluate two of these strategies in terms of the amount of information they provide using Shannon's formulation [3, 4, 8, 9, 12, 14, 15, 16, 17]. We determine information as the difference between uncertainty before and after path selection decisions. Our focus in this paper is on investigating relationships between the emergence of the shortest path and the amount of stigmergic information that exists in the form of pheromone. Agents are deployed centrally and emergence measures are determined using the worst, reference and best cases observed in [5]. Additionally, the amount of local and global information that is available to agents in each movement step is evaluated. Furthermore, Pearson's correlation coefficients between measures of emergence and the amount of information are calculated. The significance of these correlation coefficients is tested using a 2 tailed test at 1% level of significance. Consequently the relationship between the amount of information and emergent behaviour is established. Significant relationships between information and the emergence of the shortest path exist when strong emergent behaviour is present.

Strategic facilities management system in relation with building performance; the significance and relationship

Healthcare design frequently involves complex concepts that are difficult to measure and evaluate because the building require a modern, quality, functional and therapeutic environment. For this specific reason, facilities management has become a very important support system to ensure smoothness in healthcare business. Facilities management in healthcare building is a complicated system involving multiple layers of administrative division and sub-divisions. Building performance such as building impact, function and quality prove to have significant impact on strategic facilities management. This paper will do an extensive review of strategic healthcare business management as a holistic approach and examine how facilities management can effectively manage their division with consideration and understanding of building performance. The correlation between strategic facilities management and building performance will be identified and a framework for strategic FM system with regards to building performance will be developed.

Service quality assessment in provision of library services

Libraries are dynamic organization providing dynamic services to their patrons. However, advances in IT and networking have created a serious competition to libraries from many information service provisioning agents. The purpose of this study is to understand the issue relevant to service quality assessment in libraries and subsequently develop a conceptual model of aligning library quality of service assessment for effective reporting of library value and performance to stakeholders. In this paper, we will focus on the provision of library services and the nature of the relationship and interactions between various components of library services.

Sustainable retrofit potential in lower quality office stock in the central business district

Given the relationship between energy consumption, greenhouse gas emissions and climate change, the built environment has significant potential to lessen overall emissions. With around half of all greenhouse gas emissions attributed to the built environment; it has a significant role to play in mitigating global warming. With large percentages of office stock structurally vacant in some city centres and only 1 or 2% of new buildings added to the total stock each year; the scope for reductions lay with adaptation of existing buildings. The stock with the highest levels of vacancy and obsolescence offers the highest potential of all.

Many cities are now aiming to become carbon neutral. Successful retrofit demands that social, technological, environmental, economic and legislative criteria are addressed. Buildings have to meet user and community needs. City centres comprise a range of different type of office stock with regards to age, size, location, height, tenure and quality. All buildings present challenges and opportunities with regards to retrofit and sustainability and integrating retrofit measures that reduce energy, water and resource consumption.

Using a selection of low grade office buildings to develop retrofit profiles, this paper addresses the questions; (a) what is the nature of retrofits in relation to low quality office building stock in the Central Business District (CBD) and, (b) what is the extent and scope for sustainable retrofits to low quality office buildings. Using Melbourne CBD retrofit events of low quality office buildings were analysed between 1998 and 2008 to identify the scope and extent for integrating sustainability into retrofits projects.

A study of older Australians’ volunteering and quality of life : empirical evidence and policy implications

Older Australians are confronted by dramatic changes in their physical, social, financial, and psychological well-being. There are social costs to these changes related to their productivity and increased costs associated with caring for older Australians. Greater community engagement through voluntary work practice may minimize these costs, as well as positively influence volunteers' subjective quality of life (QOL). This study investigates the motivations for older Australians to engage in formal voluntary work. It seeks to identify whether the motivational factors to volunteer are associated with individuals' subjective QOL. The results indicate a positive relationship between older people's motivations to volunteer and their subjective QOL. This association is strengthened by respondents' community orientation, positive perception of voluntary work, positive personal attitudes toward volunteering, and their self-esteem. The role of policy makers in motivating larger participation by the older groups is discussed.

Utility-based quality of life associated with overweight and obesity : the Australian diabetes, obesity, and lifestyle study

This study aimed to estimate utility-based quality of life (UQoL) differences between healthy body weight and excess body weight categories. Cross-sectional analysis of 10,959 adults, participating in baseline data collection of the nationally representative Australian Diabetes, Obesity, and Lifestyle (AusDiab) Study was undertaken. Height and weight were measured by trained personnel. Body weight categories were assigned as healthy weight, overweight, and obesity subclasses I, II and III. UQoL was assessed using the SF-6D, which captures physical functioning, role limitation, social functioning, pain, mental health, and vitality on a score of 0.00–1.00 (worst-best). The relationship between body weight categories and UQoL was assessed using linear regression, adjusting for age, sex, education, and smoking. Relative to the healthy weight group (mean UQoL score 0.77), mean adjusted UQoL differences (95% confidence intervals) were 0.001 (−0.008, 0.010) for overweight, −0.012 (−0.022, −0.001) for class-I obese, −0.020 (−0.041, 0.001) for class-II obese, and −0.069 (−0.099, −0.039) for class-III obese groups. Adding metabolic syndrome markers to the covariates had little impact on these differences. Results confirmed an inverse dose–response relationship between body weight and UQoL in this study of Australian adults. This highlights the need to incorporate UQoL measures which are sensitive to the subclasses of obesity when evaluating obesity interventions.

The allometric relationship between mean fibre diameter of mohair and the fleece-free liveweight of Angora goats over their lifetime

As mean fibre diameter (MFD) is the primary determinant of mohair price we aimed to quantify the lifetime changes in mohair MFDas Angora goats aged and grew. Measurements were made over 12 shearing periods on a population of Angora goats representing the current range and diversity of genetic origins including South African, Texan and interbred admixtures of these and Australian sources. Records of sire, dam, birthweight, birth parity, liveweight, fleece growth and fleece quality were taken for does and castrated males (wethers) (n = 267 animals). Fleece-free liveweights (FFL_wt) were determined for each goat at shearing time by subtracting the greasy fleece weight from the liveweight recorded immediately before shearing. A restricted maximum likelihood growth curve model was developed for relating MFD to FFL_wt, age and other measurements.Asimple way of describing the results is:MFD= k (FFL_wt)b E; where k is a parameter that can vary in a systematic way with shearing(age), breed, weaning weight, sire, dam and individual; b is a parameter that is the same for nearly the whole study; and E are independent errors from a log-normal distribution. The analysis shows that ^b = 0.34, with s.e. (^b) = 0.021. Thus, mohair MFD was allometrically related to the cube root of FFLwt over the lifetime of Angora goats. However, the allometric proportionality constant differed in a systematic way with age at shearing, genetic strain, weaning weight, sire, dam and individual. For Texan-breed goats, MFD decreased as weaning weight increased (P = 0.00016). The findings indicate that management factors that affect liveweight and weaning weight have lifetime effects on mohair fibre diameter and therefore the value of mohair and the profitability of the mohair enterprise.

The health-related quality of life burden of co-morbid cardiovascular disease and major depressive disorder in Australia : findings from a population-based, cross-sectional study

Purpose Health-related quality of life (HRQOL) can be significantly impaired by the presence of chronic conditions such as cardiovascular disease (CVD) and major depressive disorder (MDD). The aim of this paper was to (1) identify differences in HRQOL between individuals with CVD, MDD, or both, compared to a healthy reference group, (2) establish whether the influence of co-morbid MDD and CVD on HRQOL is additive or synergistic and (3) determine the way in which depression severity interacts with CVD to influence overall HRQOL.

Methods Population-based data from the 2007 Australian National Survey of Mental Health and Well-being (NSMHWB) (n = 8841) were used to compare HRQOL of individuals with MDD and CVD, MDD but not CVD, CVD but not MDD, with a healthy reference group. HRQOL was measured using the Assessment of Quality of Life (AQOL). MDD was identified using the Composite International Diagnostic Interview (CIDI 3.0).

Results Of all four groups, individuals with co-morbid CVD and depression reported the greatest deficits in AQOL utility scores (Coef: −0.32, 95% CI: −0.40, −0.23), after adjusting for covariates. Those with MDD only (Coef: −0.27, 95% CI: −0.30, −0.24) and CVD only (Coef: −0.08, 95% CI: −0.11, −0.05) also reported reduced AQOL utility scores. Second, the influence of MDD and CVD on HRQOL was shown to be additive, rather than synergistic. Third, a significant dose–response relationship was observed between depression severity and HRQOL. However, CVD and depression severity appeared to act independently of each other in impacting HRQOL.

Conclusions HRQOL is greatly impaired in individuals with co-morbid MDD and CVD; these conditions appear to influence HRQOL in an additive fashion. HRQOL alters with depression severity, therefore treating depression and improving HRQOL is of clinical importance.

The allometric relationship between clean mohair growth and the fleece-free liveweight of Angora goats is affected by liveweight change

Clean fleece weight (CFWt) is affected by liveweight and change in liveweight in Merino sheep, Angora and cashmere goats. However, how these relationships progress as animals age has not been elucidated. Measurements were made over 12 shearing periods on a population of Angora goats representing the current range and diversity of genetic origins including South African, Texan and interbred admixtures of these and Australian sources. Records of breed, sire, dam, date of birth, dam age, birthweight, birth parity, weaning weight, liveweight, fleece growth and fleece quality were taken for does and castrated males (wethers) (n = 267 animals). Fleece-free liveweights (FFLwt) were determined for each goat at shearing time by subtracting the greasy fleece weight from the liveweight recorded immediately before shearing. The average of the FFLwt at the start of the period and the FFLWt at the end of the period was calculated (AvFFLwt). Liveweight change (LwtCh) was the change in FFLwt over the period between shearings. A restricted maximum likelihood model was developed for CFWt, after log10 transformation, which allowed the observations of the same animal at different ages to be correlated in an unstructured manner. A simple way of describing the results is: CFWt = κ (AvFFLwt)β, where κ is a parameter that can vary in a systematic way with shearing age, shearing treatment and LwtCh; and β is an allometric coefficient that only varies with LwtCh. CFWt was proportional to FFLwt0.67 but only when liveweight was lost at the rate of 5–10 kg during a shearing interval of 6 months. The allometric coefficient declined to 0.3 as LwtCh increased from 10 kg loss to 20 kg gain during a shearing interval. A consequence is that, within an age group of Angora goats, the largest animals will be the least efficient in converting improved nutrition to mohair.