Development and feasibility testing of an education program to improve knowledge and self-care among Aboriginal and Torres Strait Islander patients with heart failure

Background/Aim There is a 70% higher age-adjusted incidence of heart failure (HF) amongst Aboriginal and Torres Strait Islander people, three times more hospitalisations and twice as many deaths than non-Aboriginal people. There is a need to develop holistic yet individualised approaches in accord with the values of Aboriginal community healthcare to support patient education and self-care. The aim of this study was to re-design an existing HF educational resource (Fluid Watchers-Pacific Rim©) to be culturally safe for Aboriginal and Torres Strait Islander peoples, working in collaboration with the local community, and to conduct feasibility testing. Methods This study was conducted in two phases and utilised a mixed methods approach (qualitative and quantitative). Phase 1 of this study used action research methods to develop a culturally safe electronic resource to be provided to Aboriginal HF patients via a tablet computer. A HF expert panel adapted the existing resource to ensure it was evidence-based and contained appropriate language and images that reflects Aboriginal culture. A stakeholder group (which included Aboriginal workers and HF patients, as well as researchers and clinicians) then reviewed the resources and changes were made accordingly. In Phase 2, the new resource was tested on a sample of Aboriginal HF patients to assess feasibility and acceptability. Patient knowledge, satisfaction and self-care behaviours were measured using a before and after design with validated questionnaires. As this was a pilot test to determine feasibility, no statistical comparisons were made. Results - Phase 1: Throughout the process of resource development, two main themes emerged from the stakeholder consultation. These were the importance of identity, meaning that it was important to ensure that the resource accurately reflected the local community, with the appropriate clothing, skin tone and voice. The resource was adapted to reflect this and of the local community voiced the recordings for the resource. The other theme was comprehension; images were important and all text was converted to the first person and used plain language. - Phase 2: Five Aboriginal participants, mean age 61.6 ± 10.0 years, with NYHA Class III and IV heart failure were enrolled. Participants reported a high level of satisfaction with the resource (83.0%). HF knowledge (percentage of correct responses) increased from 48.0 ± 6.7% to 58.0 ± 9.7%, a 20.8% increase and results of the self-care index indicated that the biggest change was in patient confidence for self-care with a 95% increase in confidence score (46.7 ± 16.0 to 91.1 ± 11.5). Changes in management and maintenance scores varied between9275 patients. Conclusion By working in collaboration with HF experts, Aboriginal researchers and patients, a culturally safe HF resource has been developed for Aboriginal and Torres Strait Islander patients. Engaging Aboriginal researchers, capacity-building, and being responsive to local systems and structures enabled this pilot study to be successfully completed with the Aboriginal community and positive participant feedback demonstrated that the methodology used in this study was appropriate and acceptable; participants were able to engage with willingness and confidence.

Now that I have had this experience I am looking at studying…

The Community Aspirations Program in Education (CAP-ED) was started by CQUniversity’s Office of Indigenous Engagement in 2013. CAP-ED’s aim was to focus on building aspirations through small manageable learning projects, and to increase Aboriginal and Torres Strait Islander students’ participation in higher education. Initially the scope of the project was to develop and deliver an accredited certificate-level program to help Indigenous students transition into tertiary education by a) improving pathways and b) addressing their current knowledge gaps. However, the initial investigatory process and community consultation found that a more localised, targeted and intimate approach would work more effectively. In addition, a free or affordable certificate course that would meet community needs was beyond the financial scope of the project. From here, the Office of Indigenous Engagement began to explore other possibilities.

NMR studies of phase transition in ammonium hydrogen bischloroacetate, NH4H(CH2ClCOOO)2

Proton second moment (M2) and spin-lattice relaxation time (T1) of Ammonium Hydrogen Bischloroacetate (ABCA) have been measured in the range 77-350 K. A value of 6.5 G2 has been observed for the second moment at room temperature, which is typical of NH4+ reorientation and also a second moment transition in the range 170-145 K indicates the freezing of NH4+ motion. The NMR signal disappears dicontinuously at 128 K. Proton spin-lattice relaxation time (T1) Vs temperature, yielded only one sharp miniumum of 1.9 msec which is again typical of NH4+ reorientation. A slope change at 250 K is also observed, prbably due to CH2 motion. Further, the FID signal disappears at 128 K. Thus the Tc appears to be 128 K (of two reported values 120 K and 128 K). Activation energies have been calculated and the mechanism of the phase transition is discussed.

Epithelial-mesenchymal transition in oral squamous carcinoma cells

In epithelial-mesenchymal transition (EMT), epithelial cells acquire traits typical for mesenchymal cells, dissociate their cell-cell junctions and gain the ability to migrate. EMT is essential during embryogenesis, but may also mediate cancer progression. Basement membranes are sheets of extracellular matrix that support epithelial cells. They have a major role in maintaining the epithelial phenotype and, in cancer, preventing cell migration, invasion and metastasis. Laminins are the main components of basement membranes and may actively contribute to malignancy. We first evaluated the differences between cell lines obtained from oral squamous cell carcinoma and its recurrence. As the results indicated a change from epithelial to fibroblastoid morphology, E-cadherin to N-cadherin switch, and change in expression of cytokeratins to vimentin intermediate filaments, we concluded that these cells had undergone EMT. We further induced EMT in primary tumour cells to gain knowledge of the effects of transcription factor Snail in this cell model. The E-cadherin repressors responsible for the EMT in these cells were ZEB-1, ZEB-2 and Snail, and ectopic expression of Snail was able to augment the levels of ZEB-1 and ZEB-2. We produced and characterized two monoclonal antibodies that specifically recognized Snail in cell lines and patient samples. By immunohistochemistry, Snail protein was found in mesenchymal tissues during mouse embryonal development, in fibroblastoid cells of healing skin wounds and in fibromatosis and sarcoma specimens. Furthermore, Snail localized to the stroma and borders of tumour cell islands in colon adenocarcinoma, and in laryngeal and cervical squamous cell carcinomas. Immunofluorescence labellings, immunoprecipitations and Northern and Western blots showed that EMT induced a progressive downregulation of laminin-332 and laminin-511 and, on the other hand, an induction of mesenchymal laminin-411. Chromatin immunoprecipitation revealed that Snail could directly bind upstream to the transcription start sites of both laminin α5 and α4 chain genes, thus regulating their expression. The levels of integrin α6β4, a receptor for laminin-332, as well as the hemidesmosomal complex proteins HD1/plectin and BP180 were downregulated in EMT-experienced cells. The expression of Lutheran glycoprotein, a specific receptor for laminin-511, was diminished, whereas the levels of integrins α6β1 and α1β1 and integrin-linked kinase were increased. In quantitative cell adhesion assays, the cells adhered potently to laminin-511 and fibronectin, but only marginally to laminin-411. Western blots and immunoprecipitations indicated that laminin-411 bound to fibronectin and could compromise cell adhesion to fibronectin in a dose-dependent manner. EMT induced a highly migratory and invasive tendency in oral squamous carcinoma cells. Actin-based adhesion and invasion structures, podosomes and invadopodia, were detected in the basal cell membranes of primary tumour and spontaneously transformed cancer cells, respectively. Immunofluorescence labellings showed marked differences in their morphology, as podosomes organized a ring structure with HD1/plectin, αII-spectrin, talin, focal adhesion kinase and pacsin 2 around the core filled with actin, cortactin, vinculin and filamin A. Invadopodia had no division between ring and core and failed to organize the ring proteins, but instead assembled tail-like, narrow actin cables that showed a talin-tensin switch. Time-lapse live-cell imaging indicated that both podosomes and invadopodia were long-lived entities, but the tails of invadopodia vigorously propelled in the cytoplasm and were occasionally released from the cell membrane. Invadopodia could also be externalized outside the cytoplasm, where they still retained the ability to degrade matrix. In 3D confocal imaging combined with in situ gelatin zymography, the podosomes of primary tumour cells were large, cylindrical structures that increased in time, whereas the invadopodia in EMT-driven cells were smaller, but more numerous and degraded the underlying matrix in significantly larger amounts. Fluorescence recovery after photobleaching revealed that the substructures of podosomes were replenished more rapidly with new molecules than those of invadopodia. Overall, our results indicate that EMT has a major effect on the transcription and synthesis of both intra- and extracellular proteins, including laminins and their receptors, and on the structure and dynamics of oral squamous carcinoma cells.

A Novel Structural Transition In Poly(Dg-Me5dc) - Z Reversible B Reversible Z

Poly(dG-Me5dC) is known to exhibit a B→Z transition in the presence of very high concentrations of NaCl. For the first time, we report the presence of a Z-structure in sodium concentrations as low as 0.5 mM. A novel Z B Z transition is observed as the salt concentration is gradually increased. The role of water structure in B to Z transitions is discussed.

Interatomic Auger transitions in transition-metal oxides

Interatomic L3(M)M23(M)V(O) and L3(M)V(O)V(O) Auger transitions of some transition-metal oxides are reported for the first time. The interatomic mode of decay becomes progressively more dominant (relative to the intra-atomic mode) as the metal d level gets depleted or as the oxidation state of the metal increases. The usefulness of interatomic Auger transitions in studying oxidation of metals has been examined.

An investigation of migration and possible stock structuring by the stout whiting, Sillago robusta, in southern Queensland waters, and its impact on managing the fishery. Final Report on the Pilot Program

A highly polymorphic genetic locus of Stout Whiting was examined for evidence of geographical subdivision amongst samples collected from three locales in southern Queensland waters. Statistical indicators of subdivision were not significantly different from zero, suggesting that it is unlikely that the Stout Whiting resource in southern Queensland is genetically subdivided into separate stocks. It is recommended that the full-scale genetic program not proceed and that the resource be managed as a single stock.

Adsorption of CO and N2 on modified transition-metal surfaces

Electron spectroscopic studies clearly demonstrate that modification of the surfaces of Mn, Fe and Ni metals by chlorine significantly decreases the strength of interaction between the metal and adsorbed molecules such as CO and N2. This is in contrast to the effect of electropositive additives such as Ba and Al which increase the adsorption bond strength significantly.

Metal Auger intensity ratios as a probe for change-transfer effects in aluminum-covered transition metal

Marked changes in the LVV/LMV and LVV/LMM Auger intensity ratios of Co, Ni and Cu are observed on depositing Al on their surfaces. These changes, ascribed to charge-transfer or hybridization effects, are accompanied by changes in the intensity of the satellites next to the core levels of the transition metals.

Gear selectivity of large-mesh nets and drumlines used to catch sharks in the Queensland Shark Control Program.

Catches of sharks and bycatch in large-mesh nets and baited drumlines used by the Queensland Shark Control Program were examined to determine the efficacy of both gear types and assess fishing strategies that minimise their impacts. There were few significant differences in the size of both sharks and bycatch in the two gear types, apart from significantly smaller (p < 0.05) tiger sharks Galeocerdo cuvier being taken on drumlines and smaller green turtles Chelonia mydas in nets. Catch per unit effort showed orders of magnitude differences among species, even within the same family. Hammerhead sharks and rays were particularly vulnerable to net capture, whereas higher catch rates of tiger sharks were observed for drumlines. Nets caught more marine mammals, teleost fish and rays, whereas drumlines exhibited higher catch rates of the threatened loggerhead turtle Caretta caretta. Survival of most taxa (particularly obligate ram ventilators) was lower in nets than drumlines. Bycatch species (turtles and marine mammals) were able to swim to the surface to breathe when they were hooked on drumlines, enhancing their survival potential. Fishing strategies that recognise the different selectivity patterns of the gear can be developed to suit local biotic and abiotic conditions, although it is recognised that quantification of both ecological risk and risk to bathers is not a simple task.

DEEDI Paddock Modelling Program

The project objective is to undertake paddock modelling across the Great Barrier Reef catchments to determine magnitude of sediment and particulate nutrient reductions from agricultural lands to GBR lagoon achieved over 5 years. Discussions, development and design of a plan (including a monitoring, evaluation, reporting and improvement plan) for GRASP paddock modelling will be undertaken to determine changes in water quality as a result of land management practices adopted by pastoralists. Biophysical outputs will be derived from range of land types, starting conditions and grazing management strategies. GRASP derived outputs will then be incorporated into water models to determine sediment and nutrient estimates for the catchments.

Development of a Gulf community based natural resource monitoring program.

Development of a Gulf community based natural resource monitoring program, with sawfish as an initial focus.

Glass-Transition In Isopentane - A Monte-Carlo Study

Monte Carlo simulations with realistic interaction potentials have been carried out on isopentane to investigate the glass transition. Intermolecular pair-correlation functions of the glass show distinct differences from those of the liquid, the CH-CH pair-correlation function being uniquely different from the other pair-correlation functions. The coordination number of the glass is higher than that of the liquid, and the packing in the glass seems to be mainly governed by the geometrical constraints of the molecule. Annealing affects the properties of the glass significantly.

Art changing the world: one person at a time

Dr Michael Whelan from Autism Queensland talks about a mentoring program supporting young people to develop creative industries skills… Following the extreme social stresses of high school, a lot of young people on the autism spectrum retreat to their bedrooms and computers to hibernate for extended periods of time. Online gaming communities and digital media hubs often provide a more accessible forum for young adults on the autism spectrum to establish and maintain social connections. A recent study suggests that school leavers on the autism spectrum in Queensland spend an average of 9.5 hours per day (68 hours per week) engaged in solitary technology-based activities. While this astonishing figure has its foundations in the sobering fact that most of these young people have limited social networks and experience significant anxiety and depression, it also serves to illustrate the extraordinary skill sets that these extended hours of technological engagement can facilitate.