Is there a relationship between screening for diabetes related foot complications and limb amputation?

Background From the conservative estimates of registrants with the National Diabetes Supply Scheme, we will be soon passing 1.1 Million Australians affected by all types of diabetes. The diabetes complications of foot ulceration and amputation are costly to all. These costs can be reduced with appropriate prevention strategies, starting with identifying people at risk through primary care diabetic foot screening. Yet levels of diabetic foot screening in Australia are difficult to quantify. This presentation aims to report on foot screening rates as recorded in existing academic literature, national health surveys and national database reports. Methods Literature searches included diabetic foot screening that occurred in the primary care setting for populations over 2000 people from 2002 to 2014. Searches were performed using Medline and CINAHL as well as internet searches of Organisations for Economic Co-operation and Development (OECD) countries health databases. The focus is on type 1 and type 2 diabetes in adults, and not gestational diabetes or children. The two primary outcome measures were foot -screening rates as a percentage of adult diabetic population and major lower limb amputation incidence rates from standardised OECD data. Results The most recent and accurate level for Australian population review was in the AUSDIAB (Australian Diabetes and lifestyle survey) from 2004. This survey reported screening in primary care to be as low as 50%. Countries such as the United Kingdom and United States of America have much higher reported rates of foot screening (67-86%) recorded using national databases and web based initiatives that involve patients and clinicians. By comparison major amputation rates for Australia were similar to the United Kingdom at 6.5 versus 5.1 per 100,000 population, but dis-similar to the United States of America at 17 per 100,000 population. Conclusions Australian rates of diabetic foot screening in primary care centres is ambiguous. There is no direct relationship between foot screening levels in a primary care environment and major lower limb amputation, based on national health survey's and OECD data. Uptake of national registers, incentives and web-based systems improve levels of diabetic foot assessment, which are the first steps to a healthier diabetic population.

Transcriptional regulation of a pineapple polyphenol oxidase gene and its relationship to blackheart.

Two genes encoding polyphenol oxidase (PPO) were isolated from pineapple (Ananas comosus[L.] Merr. cv. Smooth Cayenne). Sequence analyses showed that both contained a single intron and encoded typical chloroplast-localized PPO proteins, the sequences of which corresponded to two pineapple PPO cDNAs, PINPPO1 and PINPPO2, recently described by Stewart et al. (2001). Southern blot analyses suggested that pineapple contained only two PPO genes. Analysis of expression of PINPPO1 promoter GUS fusion constructs showed this promoter had a low basal activity and was cold- and wound-inducible, consistent with known mRNA expression profiles. Striking homologies to gibberellin response complexes (GARC) were observed in sequences of both the PINPPO1 and PINPPO2 promoters. Transient assays in mature pineapple fruit and stable expression in transgenic tobacco showed that PINPPO1 promoter-GUS fusions were indeed gibberellin (GA) responsive. A role for the element within the putative GARCs in mediating GA-responsiveness of the PINPPO1 promoter was confirmed by mutational analysis. PINPPO2 was also shown to be GA-responsive by RT-PCR analysis. Mutant PINPPO1 promoter-GUS fusion constructs, which were no longer GA-inducible, showed a delayed response to cold induction in pineapple fruit in transient assays, suggesting a role for GA in blackheart development. This was supported by observations that exogenous GA3 treatment induced blackheart in the absence of chilling. Sequences showing homology to GARCs are also present in some PPO promoters in tomato, suggesting that GA regulates PPO expression in diverse species.

Scrotal Circumference at Puberty and its Relationship to Testes Mass in Three Genotypes of Beef Cattle

Scrotal circumference (SC) is a simple, non-invasive measurement commonly used to evaluate bull breeding potential although its validity as a predictor of fertility is questionable (Holroyd, 1998). SC is highly heritable but varies with breed and animal factors such as condition, live weight and age. As an indicator of fertility, recommended SC values range broadly from 30cm to 38cm (Miller, 1992). It is assumed that SC accurately reflects testes mass (TM) which may be related to direct measures of fertility such as spermatogenesis (Entwistle, 1992). The SC measurements made here test the assumption that SC, used to estimate testes volume (TV), is directly related to TM. Miller (1992) reported a value of 261mm as the SC threshold for puberty. We have studied serial SC measurements so as to devise a more accurate means of using SC to determine puberty.

Relationship between malnutrition and selected risk factors in two hospitals in Vietnam

Aim: The purpose of this study was to determine the percentage of patients assessed as malnourished using the Subjective Global Assessment in two hospitals in Ho Chi Minh City and Can Tho across multiple wards; and to investigate the association with factors including gender, age, days since admission, medical diagnosis and number of medications used. Methods: This cross-sectional study involved 205 inpatients from a hospital in Ho Chi Minh City and 78 inpatients and 89 outpatients from a hospital in Can Tho. Malnutrition status was assessed using Subjective Global Assessment. Ward, gender, age, medical diagnosis, time since admission and medication number were extracted from medical records. Results: 35.6% of inpatients and 9.0% of outpatients were malnourished. Multivariate analysis revealed factors predicting malnutrition status within inpatients (OR (95%CI)) were: age (OR = 1.03 (1.01-1.06)); cancer diagnosis (OR = 34.25 (3.16-370.89)); respiratory ward (11.49 (1.05-125.92)); or general medicine ward (20.34 (2.10-196.88)). Conclusions: Results indicate that malnutrition is a common problem in hospitals in Vietnam. Further research is needed to confirm this finding across a wider range of hospitals and to investigate the feasibility and efficacy of implementation of nutrition interventions in hospital settings.

Locus Bonus : The Relationship of the Roman Villa to its Environment in the Vicinity of Rome

The aim of this study is to examine the relationship of the Roman villa to its environment. The villa was an important feature of the countryside intended both for agricultural production and for leisure. Manuals of Roman agriculture give instructions on how to select a location for an estate. The ideal location was a moderate slope facing east or south in a healthy area and good neighborhood, near good water resources and fertile soils. A road or a navigable river or the sea was needed for transportation of produce. A market for selling the produce, a town or a village, should have been nearby. The research area is the surroundings of the city of Rome, a key area for the development of the villa. The materials used consist of archaeological settlement sites, literary and epigraphical evidence as well as environmental data. The sites include all settlement sites from the 7th century BC to 5th century AD to examine changes in the tradition of site selection. Geographical Information Systems were used to analyze the data. Six aspects of location were examined: geology, soils, water resources, terrain, visibility/viewability and relationship to roads and habitation centers. Geology was important for finding building materials and the large villas from the 2nd century BC onwards are close to sources of building stones. Fertile soils were sought even in the period of the densest settlement. The area is rich in water, both rainfall and groundwater, and finding a water supply was fairly easy. A certain kind of terrain was sought over very long periods: a small spur or ridge shoulder facing preferably south with an open area in front of the site. The most popular villa resorts are located on the slopes visible from almost the entire Roman region. A visible villa served the social and political aspirations of the owner, whereas being in the villa created a sense of privacy. The area has a very dense road network ensuring good connectivity from almost anywhere in the region. The best visibility/viewability, dense settlement and most burials by roads coincide, creating a good neighborhood. The locations featuring the most qualities cover nearly a quarter of the area and more than half of the settlement sites are located in them. The ideal location was based on centuries of practical experience and rationalized by the literary tradition.

The Relationship Between University Culture and Climate and Research Scientists’ Spin-off Intentions

Over the past decades, universities have increasingly become involved in entrepreneurial activities. Despite efforts to embrace their 'third mission', universities still demonstrate great heterogeneity in terms of their involvement in academic entrepreneurship. This chapter adopts an institutional perspective to understand how organizational characteristics affect research scientists' entrepreneurial intentions. We study the impact of university culture and climate on entrepreneurial intentions, thereby specifically focusing on intentions to spin off a company. Using a sample of 437 research scientists from Swedish and German universities, our results reveal that the extent to which universities articulate entrepreneurship as a fundamental element of their mission fosters research scientists' spin-off intentions. Furthermore, the presence of university role models positively affects research scientists' propensity to engage in entrepreneurial activities, both directly and indirectly through entrepreneurial self-efficacy. Finally, research scientists working at universities which explicitly reward people for 'third mission' related output show higher levels of spin-off intentions. This study has implications for both academics and practitioners, including university managers and policy makers.

Assessing the relationship between shire winter crop yield and seasonal variability of the MODIS NDVI and EVI images

Australian researchers have been developing robust yield estimation models, based mainly on the crop growth response to water availability during the crop season. However, knowledge of spatial distribution of yields within and across the production regions can be improved by the use of remote sensing techniques. Images of Moderate Resolution Imaging Spectroradiometer (MODIS) vegetation indices, available since 1999, have the potential to contribute to crop yield estimation. The objective of this study was to analyse the relationship between winter crop yields and the spectral information available in MODIS vegetation index images at the shire level. The study was carried out in the Jondaryan and Pittsworth shires, Queensland , Australia . Five years (2000 to 2004) of 250m resolution, 16-day composite of MODIS Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) images were used during the winter crop season (April to November). Seasonal variability of the profiles of the vegetation index images for each crop season using different regions of interest (cropping mask) were displayed and analysed. Correlation analysis between wheat and barley yield data and MODIS image values were also conducted. The results showed high seasonal variability in the NDVI and EVI profiles, and the EVI values were consistently lower than those of the NDVI. The highest image values were observed in 2003 (in contrast to 2004), and were associated with rainfall amount and distribution. The seasonal variability of the profiles was similar in both shires, with minimum values in June and maximum values at the end of August. NDVI and EVI images showed sensitivity to seasonal variability of the vegetation and exhibited good association (e.g. r = 0.84, r = 0.77) with winter crop yields.

Standardising bull breeding soundness evaluations and reporting in Australia

There is substantial variation in bull breeding soundness evaluation procedures and reports in Australia; the situation is compounded by difficulties in interpretation and the validity of many reports. In an effort to overcome this, the scientific literature was reviewed [Fordyce G. In: Fordyce G, editor. Bull fertility: selection and management in Australia. Eight Mile Plains, Australia: Australian Cattle Vets; 2002] and the needs of stakeholders were considered in preparing a manual, Evaluating and Reporting Bull Fertility [Entwistle KW, Fordyce G. Evaluating and reporting bull fertility. Eight Mile Plains, Australia: Australian Cattle Vets; 2003.] that outlined standards for assessing and reporting bull breeding soundness. A new recording and reporting system, called Bull Reporter, is based on standards from this manual and groups bull fertility traits into five summary categories: Scrotum, Physical, Crush-side Semen, Sperm Morphology, and Serving. The client will generally select which categories they wish to have included in the evaluation to suit their specific purposes. While there is adequate room for comments, the veterinarian is not required to make an overall judgment of whether the bull has normal capacity to sire calves under natural mating management, but ensures the standards for each selected category are met. Professional, standardised, easy-to-read reports are produced either electronically [Entwistle KW, Fordyce G. Evaluating and reporting bull fertility. Eight Mile Plains, Australia: Australian Cattle Vets; 2003.] or manually. A bull owner or their agent signs the certificate to affirm that bulls have not undergone procedures to rectify faults which may have otherwise caused them to fail the standards. An accreditation system for assessing sperm morphology was established because of its demonstrated relationship with pregnancy rates and because of the difficulties in achieving consistent and accurate assessments among laboratories. It is considered that Bull Reporter is applicable to beef and dairy bulls across all levels of management, genotypes and environments throughout Australia, with substantial potential for application elsewhere in the world.

Relationship Between Hardness Genes and Quality in Barley (Hordeum vulgare)

Barley (Hordeum vulgare) genotypes were sequenced for polymorphism in the hardness genes, these being the three hordoindoline (hin a, hin b1 and hin b2) genes. The variation in haplotype was determined by sequencing for single nucleotide polymorphisms (SNPs). Polymorphism between each gene was then compared to grain hardness (three methods), malt quality characteristics (hot water extract and friability) and cattle feed quality. Two haplotypes were found in a set of forty barley genotypes. For hin a, two alleles were present, namely hin a1 and hin a2. However, there was no specific hin a allele that was associated with grain hardness, malt and feed quality. Barley has two hin b genes, namely hin b1 and hin b2, and the genotypes tested here had one of two alleles for each gene. However, there were no obvious effects on hardness or quality from either of these hin b alleles. Unlike wheat, where a clear relationship has been demonstrated between a number of SNPs in the wheat hardness genes and quality (soft or hard wheat), there was no such relationship for barley. Despite the wide range in hardness, malt and feed quality, there were only two haplotypes for each of the hin a, hin b1 and hin b2 genes and there was no clear relationship between grain hardness, malt or feed quality. The genotypes used in this study demonstrated that there was a low level of polymorphism in hardness genes in current commercial varieties as well as breeding lines and these polymorphisms had no impact on quality.

No Wrong Door: The Salvation Army Doorways Case Management Service

The primary aim of the evaluation project was to determine the impact of The Salvation Army Doorways case management model in relation to client satisfaction and meeting client needs. Specifically, the project sought to: • Provide an overview of structural barriers confronting individuals who are entrenched in enduring poverty; • Provide an overview of the specific issues encountered by individuals, including insight into personal challenges, hopes and dreams; • Analyse the effectiveness of Doorways interventions, specifically: o How important is the relationship with staff at the Doorways centre? o What skills and knowledge do staff need? o What Doorways activities are the most successful in breaking the cycle of poverty? o How important are community connections? • Provide information to The Salvation Army on what works well in Doorways and how Doorways might be improved or enhanced.

Assessing the relationship between patch type and soil mites: A molecular approach

An urgent need exists for indicators of soil health and patch functionality in extensive rangelands that can be measured efficiently and at low cost. Soil mites are candidate indicators, but their identification and handling is so specialised and time-consuming that their inclusion in routine monitoring is unlikely. The aim of this study was to measure the relationship between patch type and mite assemblages using a conventional approach. An additional aim was to determine if a molecular approach traditionally used for soil microbes could be adapted for soil mites to overcome some of the bottlenecks associated with soil fauna diversity assessment. Soil mite species abundance and diversity were measured using conventional ecological methods in soil from patches with perennial grass and litter cover (PGL), and compared to soil from bare patches with annual grasses and/or litter cover (BAL). Soil mite assemblages were also assessed using a molecular method called terminal-restriction fragment length polymorphism (T-RFLP) analysis. The conventional data showed a relationship between patch type and mite assemblage. The Prostigmata and Oribatida were well represented in the PGL sites, particularly the Aphelacaridae (Oribatida). For T-RFLP analysis, the mite community was represented by a series of DNA fragment lengths that reflected mite sequence diversity. The T-RFLP data showed a distinct difference in the mite assemblage between the patch types. Where possible, T-RFLP peaks were matched to mite families using a reference 18S rDNA database, and the Aphelacaridae prevalent in the conventional samples at PGL sites were identified, as were prostigmatids and oribatids. We identified limits to the T-RFLP approach and this included an inability to distinguish some species whose DNA sequences were similar. Despite these limitations, the data still showed a clear difference between sites, and the molecular taxonomic inferences also compared well with the conventional ecological data. The results from this study indicated that the T-RFLP approach was effective in measuring mite assemblages in this system. The power of this technique lies in the fact that species diversity and abundance data can be obtained quickly because of the time taken to process hundreds of samples, from soil DNA extraction to data output on the gene analyser, can be as little as 4 days.

An assessment of the genetic relationship between sweet and grain sorghums, within Sorghum bicolor ssp. bicolor (L.) Moench, using AFLP markers

Compared to grain sorghums, sweet sorghums typically have lower grain yield and thick, tall stalks which accumulate high levels of sugar (sucrose, fructose and glucose). Unlike commercial grain sorghum (S. bicolor ssp. bicolor) cultivars, which are usually F1 hybrids, commercial sweet sorghums were selected as wild accessions or have undergone limited plant breeding. Although all sweet sorghums are classified within S. bicolor ssp. bicolor, their genetic relationship with grain sorghums is yet to be investigated. Ninety-five genotypes, including 31 sweet sorghums and 64 grain sorghums, representing all five races within the subspecies bicolor, were screened with 277 polymorphic amplified fragment length polymorphism (AFLP) markers. Cluster analysis separated older sweet sorghum accessions (collected in mid 1800s) from those developed and released during the early to mid 1900s. These groups were emphasised in a principle component analysis of the results such that sweet sorghum lines were largely distinguished from the others, particularly by a group of markers located on sorghum chromosomes SBI-08 and SBI-10. Other studies have shown that QTL and ESTs for sugar-related traits, as well as for height and anthesis, map to SBI-10. Although the clusters obtained did not group clearly on the basis of racial classification, the sweet sorghum lines often cluster with grain sorghums of similar racial origin thus suggesting that sweet sorghum is of polyphyletic origin within S. bicolor ssp. bicolor.

The development and inter-relationship of metacognitive components among primary school children

Much interest has been expressed in the construct metacognition, the individual's knowledge and control of his own cognitive processes. Recent educational proposals have suggested the training of general metacognitive principles in schools. The exact nature of the construct has, however, remained vague. The aim of the present study was to provide some clarity. In a study of the metacognitive responses of 144 primary school children (aged 7‐11 years) four measures commonly used to assess metacognitive function were examined. First, the content of each measure was examined. Secondly, in an attempt to identify a metacognitive factor, commonality among the measures, both of developmental patterns and statistical relationship, was sought. Whilst a common pattern of development in the children's responses to the four measures was identified, factor analysis failed to provide evidence for a common metacognitive factor and unified construct.

Asiakkaan ja asiantuntijan pedagoginen suhde : Fenomenologinen tutkimus fysioterapiatilanteista asiakkaiden ja fysioterapeuttien kokemana

Väitöskirja on fenomenologinen tutkimus koetusta asiakas-asiantuntijasuhteesta. Tutkimuksen tarkoituksena on selvittää ihmisten välisiä asiakas-asiantuntijatilanteiden suhteita ja siten mahdollistaa asiakkaan hyvinvointia. Tutkimuskohteena on fysioterapiasuhde, jota aiemmin on selvitetty fysioterapeutin parantamisena, asiakkaan terveyden edistämisenä tai vuorovaikutussuhteena. Tässä tutkimuksessa mielenkiinto kohdistuu fysioterapiatilanteissa koettuihin asiakkaiden ja asiantuntijoiden välisiin suhteisiin. Tutkimukseen osallistuivat 16 fysioterapiatilanteen kokenutta asiakasta ja 16 saman tilanteen kokenutta fysioterapeuttia, jotka toimivat tutkimusajankohtana erikoissairaanhoidossa, kunnan terveyskeskuksessa tai yksityisessä fysioterapialaitoksessa. Avoimen yksilöhaastattelun tehtävänä oli kuvata mitä osanottaja koki juuri päättyneessä tilanteessa. Tutkimusaineiston analyysi etenee ensimmäisessä vaiheessa fenomenologisen tutkimuksen mukaan, yksilöllisten ihmisten välisten suhteiden koettujen merkitysten ja merkityskokonaisuuksien analyysiin ja merkitysperspektiivin synteesiin. Tutkimuksen ensimmäisen vaiheen yksilöllisten merkitysperspektiivien perusteella fysioterapiasuhde osoittautui muutossuhteeksi, mikä ei ollut erilainen eri organisaatioissa, vaan siinä ilmeni pedagogisen suhteen oppimisen ja ohjauksen piirteitä. Tutkimuksen toisessa vaiheessa vietiin pedagogisen suhteen mukaisesti yhteen ja vertailtiin yksilöllisten merkitysperspektiivien merkityksiä ja merkityskokonaisuuksia asiakkaiden ja fysioterapian asiantuntijoiden näkökulmina sekä saman tilanteen yhteisenä koettuna näkökulmana. Asiakkaiden näkökulmasta suhteen voimavarana oli hänen kokema kehollinen vieraus, mikä ohjasi asiakas-asiantuntijasuhdetta neljänlaiseen asiakkaan muutossuhteeseen. Fysioterapian asiantuntijoiden näkökulmasta asiaosaamisena oli asiakkaan parantaminen liikkeen tai toiminnan avulla, mikä ohjasi asiakas-asiantuntijasuhdetta asiantuntijan näkökulmasta erilaisiin ohjaussuhteisiin. Samassa tilanteessa asiakkaiden ja asiantuntijan yhteisenä kokemat aukeamat etenivät spontaaneista turvallisuuden ja luottavaisuuden aukeamista aktiivisiin yhteisymmärryksen ja yhteissanoituksen aukeamiin. Pedagoginen suhde avautui merkityskokonaisuuksina joko vain asiakkaalle tai asiantuntijalle tai yhteisenä koettuina pedagogisina aukeamina. Edellä mainituista kolmesta (asiakkaan, asiantuntijan, yhteisenä koettu) näkökulmasta asiakas-asiantuntijasuhde osoittautui tässä tutkimuksessa neljäksi erilaiseksi asiakkaan, asiantuntijan ja yhteytenä koetun näkökulmia yhdistäväksi pedagogiseksi prosessiksi. Tutkimuksen tulosten synteesi osoitti, että pedagogisen prosessin suuntaa muuttavat yhteytenä koettujen aukeamien väliset dialogit, joissa spontaani, yhdessä näkyvä ja yhdessä koettua sanoittava dialogihetket osoittautuivat pedagogista prosessia kääntäviksi mahdollisuuksiksi. Tämän tutkimuksen mukaan vasta aktiivinen yhteistä kieltä tuottava pedagoginen suhde mahdollistaa asiakkaan kokeman kehollisen vierauden ymmärtämisen ja yhteissanoittamisen. Sanoittamalla kokemaansa asiakas voi jakaa kokemaansa toimimattomuutta tutulla kielellä myös muiden kun tilanteessa olleiden kanssa ja siten oppia itsenäisesti ohjaamaan omaa hyvinvointiaan. Tämän tutkimusten tulosten mukaan vain yhdessä (Pentin ja Sarin) tilanteessa pedagoginen prosessi eteni yhteiseksi kieleksi. Tutkimustulokset haastavat kehittämään asiakas-asiantuntijasuhdetta siten, että pedagoginen prosessi voisi toteutua kokonaisuudessaan. Avainsanat: asiakas-asiantuntijasuhde, pedagoginen suhde, fenomenologia, kokemus, merkitysanalyysi, dialogi, fysioterapia