Comparison of not for resuscitation (NFR) forms across five Victorian health services

Background: 

Sensitivity of Antarctic marine invertebrates and microalgae to metal exposure

Negative impacts from contaminants have occurred in Antarctic marine ecosystems resulting from human activities. To improve risk assessment procedures and develop site-specific environmental quality guidelines and remediation targets, this study successfully developed novel toxicity testing methods to determine the sensitivity of Antarctic marine invertebrate and microalgal species to metals.

Camera trapping: a contemporary approach to monitoring invasive rodents in high conservation priority ecosystems

Invasive rodent species have established on 80% of the world's islands causing significant damage to island environments. Insular ecosystems support proportionally more biodiversity than comparative mainland areas, highlighting them as critical for global biodiversity conservation. Few techniques currently exist to adequately detect, with high confidence, species that are trap-adverse such as the black rat, Rattus rattus, in high conservation priority areas where multiple non-target species persist. This study investigates the effectiveness of camera trapping for monitoring invasive rodents in high conservation areas, and the influence of habitat features and density of colonial-nesting seabirds on rodent relative activity levels to provide insights into their potential impacts. A total of 276 camera sites were established and left in situ for 8 days. Identified species were recorded in discrete 15 min intervals, referred to as 'events'. In total, 19 804 events were recorded. From these, 31 species were identified comprising 25 native species and six introduced. Two introduced rodent species were detected: the black rat (90% of sites), and house mouse Mus musculus (56% of sites). Rodent activity of both black rats and house mice were positively associated with the structural density of habitats. Density of seabird burrows was not strongly associated with relative activity levels of rodents, yet rodents were still present in these areas. Camera trapping enabled a large number of rodents to be detected with confidence in site-specific absences and high resolution to quantify relative activity levels. This method enables detection of multiple species simultaneously with low impact (for both target and non-target individuals); an ideal strategy for monitoring trap-adverse invasive rodents in high conservation areas.

Evidence for an interaction between exercise and nutrition for improving bone and muscle health.

Regular exercise and adequate nutrition, particularly dietary calcium, vitamin D, and protein, are prescribed as strategies to optimize peak bone mass and maintain bone and muscle health throughout life. Although the mechanism of action of exercise and nutrition on bone and muscle health are different-exercise has a site-specific modifying effect, whereas nutrition has a permissive generalized effect-there is evidence that combining calcium (or calcium rich dairy foods) or dietary protein with exercise can have a synergetic effect on bone mass and muscle health, respectively. However, many questions still remain as to whether there is a threshold level for these nutrients to optimize the exercise-induced gains. Further studies are also needed to investigate whether other dietary factors, such as vitamin D, soy isoflavones or omega-3 fatty acids, or a multinutrient supplement, can enhance the effects of exercise on bone and muscle health.

Anthology

This research is a practice led investigation of large-scale site specific performance installation works that respond to local and historical trauma, place making, and belonging for communities and audiences. The research is part of an ongoing PhD which is primarily questioning how layers of history and lived experience manifest or ‘imprint’ upon natural landscapes and urban sites using the driving concepts of landscape, archaeology, and community immersion to inform the practice. The site of the primary research investigation was Anthology www.anthology.net.au- a major site-specific theatrical journey through Westlake, now known as Stirling Park – Ngunawal land, a traditional pathway and the site of one of the camps created to house the workers building the new city of Canberra. Tents and a hall were erected followed by 61 cottages built in 1923, for married tradesmen building the infrastructure for the new Federal Capital of Australia. These families lived at Westlake for 50 years until the 1960’s when the families were relocated, the houses sold and removed. A community demolished. Westlake is now parkland (and prime real estate), nestled between the lake and the Embassies of Yarralumla. The event took place between 26th November and the 6th December 2014. The performance installation was created and produced over a 3-year period with $45,000.00 in funding provided by ArtsACT and the Centenary of Canberra. Anthology alluded to the power of immersive, site-sympathetic performance as a regenerative force for communities right now. What lies in wait for artists in sites, in places…to be uncovered…with its final form revealed through careful excavation? Anthology centralised rituals of remembrance and the importance of place as vital to the restoration and regeneration of community through processing and transcending what has been lost, hidden, suppressed or in the case of Westlake or Stirling Park ‘vanished’.

Aptamer-mediated cancer gene therapy

Cancer as a genetic disorder is one of the leading causes of death worldwide. Conventional anticancer options such as chemo- and/or radio-therapy have their own drawbacks and could not provide a cure in most cases at present. More effective therapeutic strategies with less side effects are urgently needed. Aptamers, also known as chemical antibodies, are single strand DNA or RNA molecules that can bind to their target molecules with high affinity and specificity. Such site-specific binding ability of aptamers facilitates the delivery and interaction of exogenous nucleic acids with diseased genes. Thus, aptamer-guided gene therapy has emerged as a promising anticancer strategy in addition to the classic treatment regimen. Aptamers can directly deliver anti-cancer nucleic acids, e.g. small interfering RNA, micro RNA, antimicroRNA and small hairpin RNA, to cancer cells or function as a targeting ligand to guide nanoparticles containing therapeutic nucleic acids. This review focuses on recent progress in aptamer-mediated gene therapy for the treatment of hepatocellular carcinoma and other types of cancers, shedding light on the potential of this novel approach of targeted cancer gene therapy.

An overview of new progresses in understanding pipeline corrosion

An approach to achieving the ambitious goal of cost effectively extending the safe operation life of energy pipeline to 100 years is the application of health monitoring and life prediction tools that are able to provide both long-term remnant pipeline life prediction and in-situ pipeline condition monitoring. A critical step is the enhancement of technological capabilities that are required for understanding and quantifying the effects of key factors influencing buried steel pipeline corrosion and environmentally assisted materials degradation, and the development of condition monitoring technologies that are able to provide in-situ monitoring and site-specific warning of pipeline damage. This paper provides an overview of our current research aimed at developing new sensors and electrochemical cells for monitoring, categorising and quantifying the level and nature of external pipeline and coating damages under the combined effects of various inter-related variables and processes such as localised corrosion, coating cracking and disbondment, cathodic shielding, transit loss of cathodic protection.

Advances in molecular genetic systems in malaria

Robust tools for analysing gene function in Plasmodium parasites, which are the causative agents of malaria, are being developed at an accelerating rate. Two decades after genetic technologies for use in Plasmodium spp. were first described, a range of genetic tools are now available. These include conditional systems that can regulate gene expression at the genome, transcriptional or protein level, as well as more sophisticated tools for gene editing that use piggyBac transposases, integrases, zinc-finger nucleases or the CRISPR-Cas9 system. In this Review, we discuss the molecular genetic systems that are currently available for use in Plasmodium falciparum and Plasmodium berghei, and evaluate the advantages and limitations of these tools. We examine the insights that have been gained into the function of genes that are important during the blood stages of the parasites, which may help to guide the development and improvement of drug therapies and vaccines.

Formica

The title of the work, Formica, speaks both to the work’s insect motif – formica is Latin for ant - but also to the 2-dimensional nature of the projection screen – Formica is also a kind of decorative laminate surface. This is Grennan’s second video installation work commissioned specifically for the Kingston Art Centre’s Bridge Space. Following on from the first project - which transformed a dilapidated 3rd story pedestrian corridor into a virtual swimming pool - this work continues to explore the residual meanings of the corridor as a liminal, in-between, or non-space. The new work seeks to again reply aesthetically and poetically to the site’s external setting dominated as it is by the heavy commuter traffic along the Nepean Highway. Scale is central to the work. In Formica, Grennan constructs a scaled-down Perspex replica of the walk-bridge, and with the help of Patrick Honan and Museum Victoria (where Patrick, an entomologist, is head of live exhibits), he populates the corridor with live Bull Ants. The work records these colossal ants as they negotiate the non-space of the corridor and fulfil their metaphorical roles as standardised commuters. With nowhere to go, however, the ants subvert this assigned role and exhibit far more nuanced and individuated behaviour as they investigate, probe, prevaricate, dawdle, or preen idly as though performing some insectile version of Waiting for Godot.

Toward a standard approach to measurement and reporting of perioperative mortality rate as a global indicator for surgery

INTRODUCTION: The proportion of patients who die during or after surgery, otherwise known as the perioperative mortality rate (POMR), is a credible indicator of the safety and quality of operative care. Its accuracy and usefulness as a metric, however, particularly one that enables valid comparisons over time or between jurisdictions, has been limited by lack of a standardized approach to measurement and calculation, poor understanding of when in relation to surgery it is best measured, and whether risk-adjustment is needed. Our aim was to evaluate the value of POMR as a global surgery metric by addressing these issues using 4, large, mixed, surgical datasets that represent high-, middle-, and low-income countries. METHODS: We obtained data from the New Zealand National Minimum Dataset, the Geelong Hospital patient management system in Australia, and purpose-built surgical databases in Pietermaritzburg, South Africa, and Port Moresby, Papua New Guinea. For each site, we calculated the POMR overall as well as for nonemergency and emergency admissions. We assessed the effect of admission episodes and procedures as the denominator and the difference between in-hospital POMR and POMR, including postdischarge deaths up to 30 days. To determine the need for risk-adjustment for age and admission urgency, we used univariate and multivariate logistic regression to assess the effect on relative POMR for each site. RESULTS: A total of 1,362,635 patient admissions involving 1,514,242 procedures were included. More than 60% of admissions in Pietermaritzburg and Port Moresby were emergencies, compared with less than 30% in New Zealand and Geelong. Also, Pietermaritzburg and Port Moresby had much younger patient populations (P < .001). A total of 8,655 deaths were recorded within 30 days, and 8-20% of in-hospital deaths occurred on the same day as the first operation. In-hospital POMR ranged approximately 9-fold, from 0.38 per 100 admissions in New Zealand to 3.44 per 100 admissions in Pietermaritzburg. In New Zealand, in-hospital 30-day POMR underestimated total 30-day POMR by approximately one third. The difference in POMR if procedures were used instead of admission episodes ranged from 7 to 70%, although this difference was less when central line and pacemaker insertions were excluded. Age older than 65 years and emergency admission had large, independent effects on POMR but relatively little effect in multivariate analysis on the relative odds of in-hospital death at each site. CONCLUSION: It is possible to collect POMR in countries at all level of development. Although age and admission urgency are strong, independent associations with POMR, a substantial amount of its variance is site-specific and may reflect the safety of operative and anesthetic facilities and processes. Risk-adjustment is desirable but not essential for monitoring system performance. POMR varies depending on the choice of denominator, and in-hospital deaths appear to underestimate 30-day mortality by up to one third. Standardized approaches to reporting and analysis will strengthen the validity of POMR as the principal indicator of the safety of surgery and anesthesia care.

Zinc doped ferrite magnetic resonance imaging contrast agent for atherosclerosis

 This project focuses on the development of zinc doped ferrite nanoparticle based MRI contrast agents with enhanced contrast and site-specific targeting for atherosclerosis diagnosis. The engineered nanocomplexes developed were validated through MRI scans using rat models with potential for multimodal imaging and effective therapy.

Diving horses

Diving Horses was created by second year students studying performance at Deakin University’s School of Communication and Creative Arts (SCCA) to bring to life the ghosts of a bygone era through visual installation and performance. You are invited to enter backstage and interact with the working life behind the spectacle and explore the untold stories and private moments behind the scenes of Wirth’s Circus- ‘the greatest show on earth’. Students have been asked to respond to the rich history of the Arts Centre Melbourne site and undertake research into the lives of the workers that inhabited the site from 1907 until the Wirth’s buildings were destroyed by fire in 1953. Some of the characters you will encounter are based on actual historical figures and others are drawn from archetypical sources as the students explored the fascinating backstage world of Australian circus life.

Using otolith microchemistry and shape to assess the habitat value of oil structures for reef fish

Over 7500 oil and gas structures (e.g. oil platforms) are installed in offshore waters worldwide and many will require decommissioning within the next two decades. The decision to remove such structures or turn them into reefs (i.e. 'rigs-to-reefs') hinges on the habitat value they provide, yet this can rarely be determined because the residency of mobile species is difficult to establish. Here, we test a novel solution to this problem for reef fishes; the use of otolith (earstone) properties to identify oil structures of residence. We compare the otolith microchemistry and otolith shape of a site-attached coral reef fish (Pseudanthias rubrizonatus) among four oil structures (depth 82-135 m, separated by 9.7-84.2 km) on Australia's North West Shelf to determine if populations developed distinct otolith properties during their residency. Microchemical signatures obtained from the otolith edge using laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) differed among oil structures, driven by elements Sr, Ba and Mn, and to a lesser extent Mg and Fe. A combination of microchemical data from the otolith edge and elliptical Fourier (shape) descriptors allowed allocation of individuals to their 'home' structure with moderate accuracy (overall allocation accuracy: 63.3%, range: 45.5-78.1%), despite lower allocation accuracies for each otolith property in isolation (microchemistry: 47.5%, otolith shape: 45%). Site-specific microchemical signatures were also stable enough through time to distinguish populations during 3 separate time periods, suggesting that residence histories could be recreated by targeting previous growth zones in the otolith. Our results indicate that reef fish can develop unique otolith properties during their residency on oil structures which may be useful for assessing the habitat value of individual structures. The approach outlined here may also be useful for determining the residency of reef fish on artificial reefs, which would assist productivity assessments of these habitats.

Cancer risk among people with type 1 and type 2 diabetes: disentangling true associations, detection bias, and reverse causation

 OBJECTIVE: Evidence indicates an increased risk of certain cancers among people with type 2 diabetes. Evidence for rarer cancers and for type 1 diabetes is limited. We explored the excess risk of site-specific cancer incidence and mortality among people with type 1 and type 2 diabetes, compared with the general Australian population. RESEARCH DESIGN AND METHODS: Registrants of a national diabetes registry (953,382) between 1997 and 2008 were linked to national death and cancer registries. Standardized incidence and mortality ratios (SIRs/SMRs) are reported. RESULTS: For type 1 diabetes, significant elevated SIRs were observed for pancreas, liver, esophagus, colon and rectum (females only [F]), stomach (F), thyroid (F), brain (F), lung (F), endometrium, and ovary, and decreased SIRs were observed for prostate in males. Significantly increased SMRs were observed for pancreas, liver, and kidney (males only), non-Hodgkin's lymphoma, brain (F), and endometrium. For type 2 diabetes, significant SIRs were observed for almost all site-specific cancers, with highest SIRs observed for liver and pancreas, and decreased risks for prostate and melanoma. Significant SMRs were observed for liver, pancreas, kidney, Hodgkin's lymphoma, gallbladder (F), stomach (F), and non-Hodgkin's lymphoma (F). Cancer risk was significantly elevated throughout follow-up time but was higher in the first 3 months postregistration, suggesting the presence of detection bias and/or reverse causation. CONCLUSIONS: Type 1 and type 2 diabetes are associated with an excess risk of incidence and mortality for overall and a number of site-specific cancers, and this is only partially explained by bias. We suggest that screening for cancers in diabetic patients is important.