Pandemic (H1N1) Influenza 2009 and Australian emergency departments : implications for policy, practice and pandemic preparedness

Objective: To describe the reported impact of Pandemic (H1N1) 2009 on EDs, so as to inform future pandemic policy, planning and response management. Methods: This study comprised an issue and theme analysis of publicly accessible literature, data from jurisdictional health departments, and data obtained from two electronic surveys of ED directors and ED staff. The issues identified formed the basis of policy analysis and evaluation. Results: Pandemic (H1N1) 2009 had a significant impact on EDs with presentation for patients with ‘influenza-like illness’ up to three times that of the same time in previous years. Staff reported a range of issues, including poor awareness of pandemic plans, patient and family aggression, chaotic information flow to themselves and the public, heightened stress related to increased workloads and lower levels of staffing due to illness, family care duties and redeployment of staff to flu clinics. Staff identified considerable discomfort associated with prolonged times wearing personal protective equipment. Staff believed that the care of non-flu patients was compromised during the pandemic as a result of overwork, distraction from core business and the difficulties associated with accommodating infectious patients in an environment that was not conducive. Conclusions: This paper describes the breadth of the impact of pandemics on ED operations. It identifies a need to address a range of industrial, management and procedural issues. In particular, there is a need for a single authoritative source of information, the re-engineering of EDs to accommodate infectious patients and organizational changes to enable rapid deployment of alternative sources of care.

Disaster triage : evidence, consistency and standard practice

Triage has military origins, with the initial purpose being to direct care to those most likely to be able to return to the battlefield. Conversely, modern disaster triage attempts to ensure both the prioritisation of care for those who need it most and a fair distribution of resources, so that health responders are able to ‘do the most for the most’...

Implantation of osteogenic differentiated donor mesenchymal stem cells causes recruitment of host cells

The interaction between host and donor cells is believed to play an important role in osteogenesis. However, it is still unclear how donor osteogenic cells behave and interact with host cells in vivo. The purpose of this study was to track the interactions between transplanted osteogenic cells and host cells during osteogenesis. In vitro migration assay was carried out to investigate the ability of osteogenic differentiated humanmesenchymal stemcells (O-hMSCs) to recruit MSCs. At the in vivo level, O-hMSCs were implanted subcutaneously or into skull defects in severe combined immunodeficient (SCID) mice. New bone formation was observed bymicro-CT and histological procedures. In situ hybridization (ISH) against human Alu sequences was performed to distinguish donor osteogenic cells from host cells. In vitro migration assay revealed an increased migration potential of MSCs by co-culturing with O-hMSCs. In agreement with the results of in vitro studies, ISH against human Alu sequences showed that host mouse MSCs migrated in large numbers into the transplantation site in response to O-hMSCs. Interestingly, host cells recruited by O-hMSCs were the major cell populations in newly formed bone tissues, indicating that O-hMSCs can trigger and initiate osteogenesis when transplanted in orthotopic sites. The observations fromthis study demonstrated that in vitro induced O-hMSCs were able to attract hostMSCs in vivo andwere involved inosteogenesis togetherwith host cells,whichmay be of importance for bone tissue-engineering applications.

Prevalence of breast cancer treatment sequelae over 6 years of follow-up

Background: There is a need to better describe and understand the prevalence of breast cancer treatment-related adverse effects amenable to physical therapy and rehabilitative exercise. Prior studies have been limited to single issues and lacked long term follow-up. The Pulling Through Study provides data on prevalence of adverse effects in breast cancer survivors followed over six years. Methods: A population-based sample of Australian women (n=287) diagnosed with invasive, unilateral breast cancer was followed for a median of 6.6 years and prospectively assessed for treatment-related complications at 6, 12, 18 months, and 6 years post-diagnosis. Assessments included post-surgical complications, skin or tissue reaction to radiation therapy, upper-body symptoms, lymphedema, 10% weight gain, fatigue, and upper-quadrant function. The proportion of women with positive indication for each complication and one or more complication was estimated using all available data at each time point. Women were only considered to have a specific complication if they reported the highest two levels of the Likert scale for self-reported issues. Results: At six years post-diagnosis over 60% of women experienced one or more side effects amenable to rehabilitative intervention. The proportion of women experiencing 3 or more side effects decreased throughout follow-up, while the proportion experiencing no side effects remained stable around 40% from 12 months to six years. Weight gain was the only complication to increase in prevalence over time. Conclusion: These data support the development of a multi-disciplinary prospective surveillance approach for the purposes of managing and treating adverse effects in breast cancer survivors.

Education in City and Suburban Communities

This chapter will discuss how environmental factors, specifically one’s backgrounds and where one lives, has an impact on teaching and learning. You have learned from previous chapters that inclusive education is underpinned by human rights and social justice issues. This chapter takes up that argument by identifying the diversity of students in city and suburban schools and how some are excluded, leading to disengagement with learning. We suggest possible pedagogy such as differentiated instruction and a ‘pedagogy of hope’ to counter student disengagement. Inclusive education, as an ‘act of imagination’ engages students in creative ways with the curriculum, where they can find meaning and purpose in what they are doing. Such engagement allows student to make connections between their school work and their own life worlds.

Forecasting success on large projects : developing reliable scales to predict multiple perspectives by multiple stakeholders over multiple time frames

Our aim is to develop a set of leading performance indicators to enable managers of large projects to forecast during project execution how various stakeholders will perceive success months or even years into the operation of the output. Large projects have many stakeholders who have different objectives for the project, its output, and the business objectives they will deliver. The output of a large project may have a lifetime that lasts for years, or even decades, and ultimate impacts that go beyond its immediate operation. How different stakeholders perceive success can change with time, and so the project manager needs leading performance indicators that go beyond the traditional triple constraint to forecast how key stakeholders will perceive success months or even years later. In this article, we develop a model for project success that identifies how project stakeholders might perceive success in the months and years following a project. We identify success or failure factors that will facilitate or mitigate against achievement of those success criteria, and a set of potential leading performance indicators that forecast how stakeholders will perceive success during the life of the project's output. We conducted a scale development study with 152 managers of large projects and identified two project success factor scales and seven stakeholder satisfaction scales that can be used by project managers to predict stakeholder satisfaction on projects and so may be used by the managers of large projects for the basis of project control.

Experimental studies of gypsum plasterboards and composite panels under fire conditions

Gypsum plasterboards are commonly used to protect the light gauge steel-framed walls in buildings from fires. Single or multiple plasterboards can be used for this purpose, whereas recent research has proposed a composite panel with a layer of external insulation between two plasterboards. However, a good understanding of the thermal behaviour of these plasterboard panels under fire conditions is not known. Therefore, 15 small-scale fire tests were conducted on plasterboard panels made of 13 and 16 mm plasterboards and four different types of insulations with varying thickness and density subject to standard fire conditions in AS 1530.4. Fire performance of single and multiple layers of gypsum plasterboards was assessed including the effects of interfaces between adjacent plasterboards. Effects of using external insulations such as glass fibre, rockwool and cellulose fibre were also determined. The thermal performance of composite panels developed from different insulating materials of varying densities and thicknesses was examined and compared. This paper presents the details of the fire tests conducted in this study and their valuable time–temperature data for the tested plasterboard panels. These data can be used for the purpose of developing and validating accurate thermal numerical models of these panels.

The α5 neuronal nicotinic acetylcholine receptor subunits plays an important role in the sedative effects of ethanol but does not modulate consumption in mice

Alcohol use disorders (AUDs) are a major public health problem, and the few treatment options available to those seeking treatment offer only modest success rates. There remains a need to identify novel targets for the treatment of AUDs. The neuronal nicotinic acetylcholine receptors (nAChRs) represent a potential therapeutic target in the brain, as recent human genetic studies have implicated gene variants in the α5 nAChR subunit as high risk factors for developing alcohol dependence. Here, we evaluate the role of 5* nAChR for ethanol-mediated behaviors using α5+/+ and α5-/- mice. We characterized the effect of hypnotic doses of ethanol and investigated drinking behavior using an adapted Drinking-in-the Dark (DID) paradigm that has been shown to induce high ethanol consumption in mice. We found the α5 subunit to be critical in mediating the sedative effects of ethanol. The α5-/- mice showed slower recovery from ethanol-induced sleep, as measured by loss of righting reflex. Additionally the α5-/- mice showed enhanced impairment to ethanol-induced ataxia. We found the initial sensitivity to ethanol and ethanol metabolism to be similar in both α5+/+ and α5-/- mice. Hence the enhanced sedation is likely due to a difference in the acute tolerance of ethanol in mice deficient of the α5 subunit. However the α5 subunit did not play a role in ethanol consumption for ethanol concentrations ranging from 5% to 30% in the DID paradigm. Additionally, varenicline (Chantix®) was effective in reducing ethanol intake in α5-/- mice. Together, our data suggest that the α5 nAChR subunit is important for the sedative hypnotic doses of ethanol but does not play a role in ethanol consumption. Varenicline can be a treatment option even when there is loss of function of the α5 nAChR subunit.

Towards an inclusive education for all

Chapter 1: Presents international perspectives and understandings of what inclusion means, and explains why it is necessary for teachers to develop their own deep understanding of the beliefs and values that inform teaching. The chapter introduces the construct of an inclusive school community, which is an important focus of inclusive schooling, and explains how the theoretical framework for inclusion informs our thinking, and the ongoing processes of review and development. This framework also informs the stance we take on preparing teachers to work in more inclusive ways in schools. The chapter aims to encourage an appreciation of what it means to be included and excluded, and invites the reader to consider the challenges ahead.

The social and political underpinnings of the inclusive education movement

In this chapter we look at inclusive education as part of a number of wider social movements for social justice. Inclusive education is thus understood as a transformation of education systems, rather than simply the addition of new groups of students to schools, or the development of new techniques (Slee, 2006). We illustrate the ways movements for social change can occur at many levels. Resistance to social change also occurs at many levels. Movements for social justice often include a goal of changing what happens in education. This is because education is often seen as one of the important social institutions that can reinforce the status quo. Education is also seen as an important means of changing the status quo, giving more people access to a more meaningful education. It’s not uncommon to hear various political parties criticising each other’s educational policies as ‘social engineering.’ Movements for social justice in education understand that education has always been about social engineering. The questions of interest are thus: Social engineering for what?; Who benefits; and At whose expense?

Teaching in Inclusive School Communities

"Teaching in Inclusive School Communities, 1st Edition is the essential resource to provide pre-service teachers with the most contemporary, ethical and useful framework for incorporating diversity and inclusive practices in today’s classroom. Fourteen concise chapters compose a focused picture of the values and beliefs that inform the inclusive education approach, with the most up-to-date connections to curriculum and pedagogy throughout. Complemented by the latest research in the field, this text provides the practical knowledge and skills needed for inclusive classroom teaching in Australia and New Zealand, as well as a thorough analysis of exactly what is required to build respectful relationships in modern school communities."--publisher website

Developing relationships that support learning and participation

Developing supportive, authentic and collaborative partnerships between all partners is crucial to inclusive school culture. This chapter highlights understandings of collaboration within such a culture. It also draws attention to what is involved in achieving these relationships, and identifies associated characteristics. In addition, it describes how successful collegial teams can be developed and ways in which teachers can work as collaborative members of these teams for students with disabilities within inclusive educational settings.

Preparation, characterization, and in vitro bioactivity of nagelschmidtite bioceramics

The aim of this study is to prepare Ca, P and Si-containing ternary oxide nagelschmidtite (NAGEL, Ca7Si2P2O16) bioceramics and explore their in vitro bioactivity for potential bone tissue regeneration. We prepared dense NAGEL ceramics through high-temperature sintering of NAGEL ceramic powders. The apatite-mineralization ability, dissolution rate, and human osteoblast response (including cytotoxicity analysis, attachment, morphology, proliferation, and bone-related gene expression) to NAGEL ceramics have been systematically studied by comparing with conventional β-tricalcium phosphate (β-TCP) ceramics. The results showed that NAGEL ceramics possessed more obvious apatite mineralization and dissolution (degradation) and stimulated bone-related gene expression (OCN and OPN) of osteoblasts than β-TCP ceramics. NAGEL ceramics also showed no significant cytotoxicity. NAGEL ceramics supported osteoblast attachment, proliferation, and osteogenic gene expression, with a comparable cell proliferation activity with β-TCP ceramics. These results indicate that novel NAGEL bioceramics with the specific composition of Ca7Si2P2O16, are a promising biomaterial for bone tissue regeneration application.

Early inflammatory and myogenic responses to resistance exercise in the elderly

Introduction and Methods: This study compared changes in myokine and myogenic genes following resistance exercise (3 sets of 12 repetitions of maximal unilateral knee extension) in 20 elderly men (67.8 ± 1.0 years) and 15 elderly women (67.2 ± 1.5 years). Results: Monocyte chemotactic protein (MCP)-1, macrophage inhibitory protein (MIP)-1β, interleukin (IL)-6 and MyoD mRNA increased significantly (P < 0.05), whereas myogenin and myostatin mRNA decreased significantly after exercise in both groups. Macrophage-1 (Mac-1) and MCP-3 mRNA did not change significantly after exercise in either group. MIP-1β, Mac-1 and myostatin mRNA were significantly higher before and after exercise in men compared with women. In contrast, MCP-3 and myogenin mRNA were significantly higher before and after exercise in the women compared with the men. Conclusions: In elderly individuals, gender influences the mRNA expression of certain myokines and growth factors, both at rest and after resistance exercise. These differences may influence muscle regeneration following muscle injury