Telephone-delivered health coaching improves anxiety outcomes after myocardial infarction: The 'ProActive Heart' trial

Background: Recently, we found a telephone-delivered secondary prevention programme using health coaching (‘ProActive Heart’) to be effective in improving a range of key behavioural outcomes for myocardial infarction (MI) patients. What remains unclear, however, is the extent to which these treatment effects translate to important psychological outcomes such as depression and anxiety outcomes, an issue of clinical significance due to the substantial proportion of MI patients who experience depression and anxiety. The objective of the study was to investigate, as a secondary hypothesis of a larger trial, the effects of a telephone-delivered health coaching programme on depression and anxiety outcomes of MI patients. Design: Two-arm, parallel-group, randomized, controlled design with six-months outcomes. Methods: Patients admitted to one of two tertiary hospitals in Brisbane, Australia following MI were assessed for eligibility. Four hundred and thirty patients were recruited and randomly assigned to usual care or an intervention group comprising up to 10 telephone-delivered ‘health coaching’ sessions (ProActive Heart). Regression analysis compared Hospital Anxiety and Depression Scale scores of completing participants at six months (intervention: n = 141 versus usual care: n = 156). Results: The intervention yielded reductions in anxiety at follow-up (mean difference = −0.7, 95% confidence interval=−1.4,−0.02) compared with usual care. A similar pattern was observed in mean depression scores but was not statistically significant. Conclusions: The ProActive Heart programme effectively improves anxiety outcomes of patients following myocardial infarction. If combined with psychological-specific treatment, this programme could impact anxiety of greater intensity in a clinically meaningful way.

The Australian prehospital pandemic risk perception study and an examination of new public health roles in pandemic response for ambulance services

This report is one of a series of products resulting from a National Health and Medical Research Council (NHMRC) Urgent Research Grant – Pandemic Influenza [No 409973]. The research targeted two key aspects of planning and preparedness for a human influenza pandemic, namely:

Functional MRI BOLD response to Tower of London performance of first-episode schizophrenia patients using cortical pattern matching

Due to its three-dimensional folding pattern, the human neocortex; poses a challenge for accurate co-registration of grouped functional; brain imaging data. The present study addressed this problem by; employing three-dimensional continuum-mechanical image-warping; techniques to derive average anatomical representations for coregistration; of functional magnetic resonance brain imaging data; obtained from 10 male first-episode schizophrenia patients and 10 age-matched; male healthy volunteers while they performed a version of the; Tower of London task. This novel technique produced an equivalent; representation of blood oxygenation level dependent (BOLD) response; across hemispheres, cortical regions, and groups, respectively, when; compared to intensity average co-registration, using a deformable; Brodmann area atlas as anatomical reference. Somewhat closer; association of Brodmann area boundaries with primary visual and; auditory areas was evident using the gyral pattern average model.; Statistically-thresholded BOLD cluster data confirmed predominantly; bilateral prefrontal and parietal, right frontal and dorsolateral; prefrontal, and left occipital activation in healthy subjects, while; patients’ hemispheric dominance pattern was diminished or reversed,; particularly decreasing cortical BOLD response with increasing task; difficulty in the right superior temporal gyrus. Reduced regional gray; matter thickness correlated with reduced left-hemispheric prefrontal/; frontal and bilateral parietal BOLD activation in patients. This is the; first study demonstrating that reduction of regional gray matter in; first-episode schizophrenia patients is associated with impaired brain; function when performing the Tower of London task, and supports; previous findings of impaired executive attention and working memory; in schizophrenia.

Victoria's Child FIRST and IFS differential response system : progress and issues

Differential response has long been utilized by statutory child protection systems in Australia. This article describes the advent and history of Victoria's differential response system, with a particular focus on the Child FIRST and IFS programme. This program entails a partnership arrangement between the Department of Human Services child protection services and community-based, not-for-profit agencies to provide a diverse range of early intervention and prevention services. The findings of a recent external service system evaluation, a judicial inquiry, and the large-scale Child and Family Services Outcomes Survey of parents/carers perspectives of their service experiences are used to critically examine the effectiveness of this differential response approach. Service-user perspectives of the health and wellbeing of children and families are identified, as well as the recognized implementation issues posing significant challenges for the goal of an integrated partnership system. The need for ongoing reform agendas is highlighted along with the policy, program and structural tensions that exist in differential response systems, which are reliant upon partnerships and shared responsibilities for protecting children and assisting vulnerable families. Suggestions are made for utilizing robust research and evaluation that gives voice to service users and promotes their rights and interests.

Wide-band spectral power fluctuations characterize the response of simulated cortical networks to increasing stimulus intensity

The hippocampus is an anatomically distinct region of the medial temporal lobe that plays a critical role in the formation of declarative memories. Here we show that a computer simulation of simple compartmental cells organized with basic hippocampal connectivity is capable of producing stimulus intensity sensitive wide-band fluctuations of spectral power similar to that seen in real EEG. While previous computational models have been designed to assess the viability of the putative mechanisms of memory storage and retrieval, they have generally been too abstract to allow comparison with empirical data. Furthermore, while the anatomical connectivity and organization of the hippocampus is well defined, many questions regarding the mechanisms that mediate large-scale synaptic integration remain unanswered. For this reason we focus less on the specifics of changing synaptic weights and more on the population dynamics. Spectral power in four distinct frequency bands were derived from simulated field potentials of the computational model and found to depend on the intensity of a random input. The majority of power occurred in the lowest frequency band (3-6 Hz) and was greatest to the lowest intensity stimulus condition (1% maximal stimulus). In contrast, higher frequency bands ranging from 7-45 Hz show an increase in power directly related with an increase in stimulus intensity. This trend continues up to a stimulus level of 15% to 20% of the maximal input, above which power falls dramatically. These results suggest that the relative power of intrinsic network oscillations are dependent upon the level of activation and that above threshold levels all frequencies are damped, perhaps due to over activation of inhibitory interneurons.

Rapid-response vaccines - does DNA offer a solution?

In responding to future influenza pandemics and other infectious agents, plasmid DNA overcomes many of the limitations of conventional vaccine production approaches.

Side Channel Analysis of Some Hash Based MACs: A Response to SHA-3 Requirements

The forthcoming NIST’s Advanced Hash Standard (AHS) competition to select SHA-3 hash function requires that each candidate hash function submission must have at least one construction to support FIPS 198 HMAC application. As part of its evaluation, NIST is aiming to select either a candidate hash function which is more resistant to known side channel attacks (SCA) when plugged into HMAC, or that has an alternative MAC mode which is more resistant to known SCA than the other submitted alternatives. In response to this, we perform differential power analysis (DPA) on the possible smart card implementations of some of the recently proposed MAC alternatives to NMAC (a fully analyzed variant of HMAC) and HMAC algorithms and NMAC/HMAC versions of some recently proposed hash and compression function modes. We show that the recently proposed BNMAC and KMDP MAC schemes are even weaker than NMAC/HMAC against the DPA attacks, whereas multi-lane NMAC, EMD MAC and the keyed wide-pipe hash have similar security to NMAC against the DPA attacks. Our DPA attacks do not work on the NMAC setting of MDC-2, Grindahl and MAME compression functions.

Proactive training system for safe and efficient precast installation

The construction industry is a crucial component of the Hong Kong economy, and the safety and efficiency of workers are two of its main concerns. The current approach to training workers relies primarily on instilling practice and experience in conventional teacher-apprentice settings on and off site. Both have their limitations however, on-site training is very inefficient and interferes with progress on site, while off-site training provides little opportunity to develop the practical skills and awareness needed through hands-on experience. A more effective way is to train workers in safety awareness and efficient working by current novel information technologies. This paper describes a new and innovative prototype system – the Proactive Construction Management System (PCMS) – to train precast installation workers to be highly productive while being fully aware of the hazards involved. PCMS uses Chirp-Spread-Spectrum-based (CSS) real-time location technology and Unity3D-based data visualisation technology to track construction resources (people, equipment, materials, etc.) and provide real-time feedback and post-event visualisation analysis in a training environment. A trial of a precast facade installation on a real site demonstrates the benefits gained by PCMS in comparison with equivalent training using conventional methods. It is concluded that, although the study is based on specific industrial conditions found in Hong Kong construction projects, PCMS may well attract wider interest and use in future.

A biphasic response to adenosine in the coronary vasculature of the K+-arrested perfused rat heart

Biphasic vasodilatory responses to adenosine and 5'-N-ethylcarboxamidoadenosine (NECA) were observed in the coronary vasculature of K(+)-arrested perfused rat hearts. Dose-response data for both agonists were best represented by two-site models. For adenosine, two sites with negative log ED50 (pED50) values of 8.1 +/- 0.1 (mean +/- S.E.M) and 5.2 +/- 0.1 were obtained, mediating 31 +/- 2% and 69 +/- 2% of the total response. In the presence of 8-phenyltheophylline, the vasodilatory response to adenosine remained best fitted to a two-site model with pED50 values of 7.0 +/- 0.2 and 5.4 +/- 0.2. The relative contribution of each site to the total response remained unchanged. For NECA, pED50 values of 9.6 +/- 0.1 and 6.8 +/- 0.2 were obtained, representing 48 +/- 3% and 52 +/- 3% of the sites, respectively. In contrast, ATP produced a monophasic response with a pED50 value of 8.8 +/- 0.1. These results provide evidence of adenosine receptor and response heterogeneity in the in situ coronary vasculature.

A method to evaluate the response of the coronary circulation of perfused rat heart to adenosine

Exogenous adenosine causes a monophasic dilation of the coronary vessels in paced, perfused rat heart preparations. Because levels of endogenous adenosine in paced hearts may mask the presence of high potency adenosine receptors, we have developed a method to measure coronary vascular responses in a potassium-arrested heart. Hearts from adult male, Wistar rats were perfused at a constant flow rate of 10 mL/min in the nonrecirculating, Langendorff mode, using Krebs-Henseleit buffer. After 30 min, coronary perfusion pressure was 44 +/- 1 mmHg (mean +/- SEM). Hearts were then perfused with a modified Krebs-Henseleit buffer containing 35 mM potassium. Coronary perfusion pressure increased by 84 +/- 3 mmHg. Adenosine-induced reductions in coronary perfusion pressure were expressed as a percentage of the maximal increase in pressure produced by modified Krebs-Henseleit buffer from the equilibration level. A concentration-response curve for adenosine (n = 6) was biphasic and best described by the presence of two adenosine receptors, with negative log EC50 values of 8.8 +/- 0.3 and 4.3 +/- 0.1, representing 29 +/- 3 and 71 +/- 3%, respectively, of the observed response. Interstitial adenosine sampled by microdialysis during potassium arrest was 25% of the concentration found in paced hearts. Endogenous adenosine in nonarrested hearts may obscure the biphasic response of the coronary vessels to adenosine.

Enhancements to dielectric response measurements of oil-paper insulation for online and offline applications

The research introduces a promising technique for monitoring the degradation status of oil-paper insulation systems of large power transformers in an online mode and innovative enhancements are also made on the existing offline measurements, which afford more direct understanding of the insulation degradation process. Further, these techniques benefit from a quick measurement owing to the chirp waveform signal application. The techniques are improved and developed on the basis of measuring the impedance response of insulation systems. The feasibility and validity of the techniques was supported by the extensive simulation works as well as experimental investigations.

Visualization of complex biological systems: An immune response model using OpenGL

In this paper we present an update on our novel visualization technologies based on cellular immune interaction from both large-scale spatial and temporal perspectives. We do so with a primary motive: to present a visually and behaviourally realistic environment to the community of experimental biologists and physicians such that their knowledge and expertise may be more readily integrated into the model creation and calibration process. Visualization aids understanding as we rely on visual perception to make crucial decisions. For example, with our initial model, we can visualize the dynamics of an idealized lymphatic compartment, with antigen presenting cells (APC) and cytotoxic T lymphocyte (CTL) cells. The visualization technology presented here offers the researcher the ability to start, pause, zoom-in, zoom-out and navigate in 3-dimensions through an idealised lymphatic compartment.

Road operation phase sustainability indicator as a response to the climate change phenomena

Road infrastructure is a major contributor of greenhouse gas (GHG) around the world. Once constructed, a road becomes a part of a road network and is subjected to recurrent maintenance/rehabilitation activities. Studies to date are mostly aimed at the development of sustainability indicators that deal with the material and construction phases of a road when it is constructed. The operation phase is infrequently studied and there is a need for sustainability indicators to be developed relating to this phase to better understand the GHG emissions as a proper response to the climate change phenomena. During the operation phase, maintenance/rehabilitation activities are undertaken based on certain agreed intervention criteria that do not include environmental implications relating to the climate change aspect properly. Availability of appropriate indicators may, therefore, assist in sustainable road asset maintenance management. This paper presents the findings of a literature based study and has proposed a way forward to develop a key “road operation phase” environmental indicator, which can contribute to road operation phase carbon footprint management based on a comprehensive road life cycle system boundary model. The proposed indicator can address multiple aspects of high impact road operation life environmental components such as: pavement rolling resistance, albedo, material, traffic congestion and lighting, based on availability of relevant scientific knowledge. Development of the indicator to appropriate level would offset the impacts of these components significantly and contribute to sustainable road operation management.

Response of segmented bored transit tunnels to surface blast

Increasing threat of terrorism highlights the importance of enhancing the resilience of underground tunnels to all hazards. This paper develops, applies and compares the Arbitrary Lagrangian Eulerian (ALE) and Smooth Particle Hydrodynamics (SPH) techniques to treat the response of buried tunnels to surface explosions. The results and outcomes of the two techniques were compared, along with results from existing test data. The comparison shows that the ALE technique is a better method for describing the tunnel response for above ground explosion with regards to modeling accuracy and computational efficiency. The ALE technique was then applied to treat the blast response of different types of segmented bored tunnels buried in dry sand. Results indicate that the most used modern ring type segmented tunnels were more flexible for in-plane response, however, they suffered permanent drifts between the rings. Hexagonal segmented tunnels responded with negligible drifts in the longitudinal direction, but the magnitudes of in-plane drifts were large and hence hazardous for the tunnel. Interlocking segmented tunnels suffered from permanent drifts in both the longitudinal and transverse directions. Multi-surface radial joints in both the hexagonal and interlocking segments affected the flexibility of the tunnel in the transverse direction. The findings offer significant new information in the behavior of segmented bored tunnels to guide their future implementation in civil engineering applications.