The influence of psychosocial factors on expectations and persistent symptom report after mild traumatic brain injury

This thesis examines how psychosocial factors influence the report of persistent symptoms after mild traumatic brain injury. Using quasi-experimental methods, the research program demonstrates how factors unrelated to trauma-induced physiological brain damage can contribute to persistent symptoms after a mild traumatic brain injury. The results of this thesis highlight the possibility that outcome from mild traumatic brain injury could be improved by targeting psychosocial factors.

Differential effects of refractive blur on day and night-time driving performance

Purpose To investigate the effect of different levels of refractive blur on real-world driving performance measured under day and nighttime conditions. Methods Participants included 12 visually normal, young adults (mean age = 25.8 ± 5.2 years) who drove an instrumented research vehicle around a 4 km closed road circuit with three different levels of binocular spherical refractive blur (+0.50 diopter sphere [DS], +1.00 DS, +2.00 DS) compared with a baseline condition. The subjects wore optimal spherocylinder correction and the additional blur lenses were mounted in modified full-field goggles; the order of testing of the blur conditions was randomized. Driving performance was assessed in two different sessions under day and nighttime conditions and included measures of road signs recognized, hazard detection and avoidance, gap detection, lane-keeping, sign recognition distance, speed, and time to complete the course. Results Refractive blur and time of day had significant effects on driving performance (P < 0.05), where increasing blur and nighttime driving reduced performance on all driving tasks except gap judgment and lane keeping. There was also a significant interaction between blur and time of day (P < 0.05), such that the effects of blur were exacerbated under nighttime driving conditions; performance differences were evident even for +0.50 DS blur relative to baseline for some measures. Conclusions The effects of blur were greatest under nighttime conditions, even for levels of binocular refractive blur as low as +0.50 DS. These results emphasize the importance of accurate and up-to-date refractive correction of even low levels of refractive error when driving at night.

Nanoscale texture on glass and titanium substrates by physical vapor deposition process

The aim of the paper is to give a feasibility study on the material deposition of Nanoscale textured morphology of titanium and titanium oxide layers on titanium and glass substrates. As a recent development in nanoscale deposition, Physical Vapor Deposition (PVD) based DC magnetron sputtering has been the choice for the deposition process. The nanoscale morphology and surface roughness of the samples have been characterized using Atomic Force Microscope (AFM). The surface roughnesses obtained from AFM have been compared using surface profiler. From the results we can say that the roughness values are dependent on the surface roughness of the substrate. The glass substrate was relatively smoother than the titanium plate and hence lower layer roughness was obtained. From AFM a unique nano-pattern of a boomerang shaped titanium oxide layer on glass substrate have been obtained. The boomerang shaped nano-scale pattern was found to be smaller when the layer was deposited at higher sputtering power. This indicated that the morphology of the deposited titanium oxide layer has been influenced by the sputtering power.

Establishing the impact of temporary tissue expanders on electron and photon beam dose distributions

Purpose: This study investigates the effects of temporary tissue expanders (TTEs) on the dose distributions in breast cancer radiotherapy treatments under a variety of conditions. Methods: Using EBT2 radiochromic film, both electron and photon beam dose distribution measurements were made for different phantoms, and beam geometries. This was done to establish a more comprehensive understanding of the implant’s perturbation effects under a wider variety of conditions. Results: The magnetic disk present in a tissue expander causes a dose reduction of approximately 20% in a photon tangent treatment and 56% in electron boost fields immediately downstream of the implant. The effects of the silicon elastomer are also much more apparent in an electron beam than a photon beam. Conclusions: Evidently, each component of the TTE attenuates the radiation beam to different degrees. This study has demonstrated that the accuracy of photon and electron treatments of post-mastectomy patients is influenced by the presence of a tissue expander for various beam orientations. The impact of TTEs on dose distributions establishes the importance of an accurately modelled high-density implant in the treatment planning system for post-mastectomy patients.

Socioeconomic status and its effect on pregnancy and childbirth : paramedic considerations in the prehospital setting

This poster aims to identify the role that socioeconomic status plays in determining poor health outcomes in pregnancy and childbirth. It brings to light the limitations and complications that a person in a lower socioeconomic society may face, and the effect that this possibly has on the health of the mother and child. A review of the peer reviewed literature was undertaken which identified three key areas relating to pregnancy in lower socioeconomic areas. These were social and emotional matters, lifestyle factors and financial issues. Particular focus has been put on understanding these issues from a paramedic perspective and how this can assist in both the treatment and education of patients in the pre-hospital environment. While there has been sufficient research into the three individual areas highlighted in the literature which affect pregnant patients living in lower socioeconomic communities, this poster has drawn these topics together to create an overview of a subject which is complex and multifaceted.

Developing an epidemic forecasting model for Influenza A in Brisbane, Australia, based on climate and Hong Kong Influenza A surveillance data

Influenza is associated with substantial disease burden [ 1]. Development of a climate-based early warning system for in fluenza epidemics has been recommended given the signi fi - cant association between climate variability and influenza activity [2]. Brisbane is a subtropical city in Australia and offers free in fluenza vaccines to residents aged ≥65 years considering their high risks in developing life-threatening complications, especially for in fluenza A predominant seasons. Hong Kong is an international subtropical city in Eastern Asia and plays a crucial role in global infectious diseases transmission dynamics via the international air transportation network [3, 4]. We hypothesized that Hong Kong in fluenza surveillance data could provide a signal for in fluenza epidemics in Brisbane [ 4]. This study aims to develop an epidemic forecasting model for influenza A in Brisbane elders, by combining climate variability and Hong Kong in fluenza A surveillance data. Weekly numbers of laboratoryconfirmed influenza A positive isolates for people aged ≥65 years from 2004 to 2009 were obtained for Brisbane from Queensland Health, Australia, and for Hong Kong from Queen Mary Hospital (QMH). QMH is the largest public hospital located in Hong Kong Island, and in fluenza surveillance data from this hospital have been demonstrated to be representative for influenza circulation in the entirety of Hong Kong [ 5]. The Brisbane in fluenza A epidemics occurred during July –September, whereas the Hong Kong in fluenza A epidemics occurred during February –March and May –August.

Prospective ten-month exercise intervention in premenarcheal girls: Positive effects on bone and lean mass

Enhancement of bone mineral acquisition during growth may be a useful preventive strategy against osteoporosis. The aim of this study was to explore the lean mass, strength, and bone mineral response to a 10-month, high-impact, strength-building exercise program in 71 premenarcheal girls, aged 9–10 years. Lean body mass, total body (TB), lumbar spine (LS), proximal femur (PF), and femoral neck (FN) bone mineral were measured using the Hologic QDR 2000+ bone densitometer. Strength was assessed using a grip dynamometer and the Cybex isokinetic dynamometer (Cybex II). At baseline, no significant difference in body composition, pubertal development, calcium intake, physical activity, strength, or bone mineral existed between groups. At completion, there were again no differences in height, total body mass, pubertal development, calcium intake, or external physical activity. In contrast, the exercise group gained significantly more lean mass, less body fat content, greater shoulder, knee and grip strength, and greater TB, LS, PF, and FN BMD (exercise: TB 3.5%, LS 4.8%, PF 4.5%, and FN 12.0%) compared with the controls (controls: TB 1.2%, LS 1.2%, PF 1.3%, and FN 1.7%). TB bone mineral content (BMC), LS BMC, PF BMC, FN BMC, LS bone mineral apparent density (BMAD), and FN bone area also increased at a significantly greater rate in the exercise group compared with the controls. In multiple regression analysis, change in lean mass was the primary determinant of TB, FN, PF, and LS BMD accrual. Although a large proportion of bone mineral accrual in the premenarcheal skeleton was related to growth, an osteogenic effect was associated with exercise. These results suggest that high-impact, strength building exercise is beneficial for premenarcheal strength, lean mass gains, and bone mineral acquisition.

A roadmap for interpreting the literature on vision and driving

Over the past several decades there has been a sharp increase in the number of studies focused on the relationship between vision and driving. The intensified attention to this topic has most likely been stimulated by the lack of an evidence basis for determining vision standards for driving licensure and a poor understanding about how vision impairment impacts driver safety and performance. Clinicians depend on the literature on vision and driving to advise visually impaired patients appropriately about driving fitness. Policy makers also depend on the scientific literature in order to develop guidelines that are evidence-based and are thus fair to persons who are visually impaired. Thus it is important for clinicians and policy makers alike to understand how various study designs and measurement methods should be interpreted so that the conclusions and recommendations they make are not overly broad, too narrowly constrained, or even misguided. We offer a methodological framework to guide interpretations of studies on vision and driving that can also serve as a heuristic for researchers in the area. Here, we discuss research designs and general measurement methods for the study of vision as they relate to driver safety, driver performance, and driver-centered (self-reported) outcomes.

Women's perceptions of communication in pregnancy and childbirth: Influences on participation and satisfaction with care

In this study, 3531 Queensland women, who had recently given birth, completed a questionnaire that included questions about their participation in decision making during pregnancy, their ratings of client centred care and perceived quality of care. These data tested a version of Street’s (2001) linguistic model of patient participation in care (LMOPPC), adapted to the maternity context. We investigated how age and education influenced women’s perceptions of their participation and quality of care. Hierarchical multiple regressions revealed that women’s perceived ability to make decisions, and the extent of client-centred communication with maternity care providers were the most influential predictors of participation and perceived quality of care. Participation in care predicted perceived quality of care, but the influence of client-centred communication by a care provider and a woman’s confidence in decision making were stronger predictors of perceived quality of care. Age and education level were not important predictors. These findings extend and support the use of LMOPPC in the maternity context.

Comparison of kinematic variables obtained by inertial sensors among stroke survivors and healthy older adults in the Functional Reach Test: cross-sectional study

Background Balance dysfunction is one of the most common problems in people who suffer stroke. To parameterize functional tests standardized by inertial sensors have been promoted in applied medicine. The aim of this study was to compare the kinematic variables of the Functional Reach Test (FRT) obtained by two inertial sensors placed on the trunk and lumbar region between stroke survivors (SS) and healthy older adults (HOA) and to analyze the reliability of the kinematic measurements obtained. Methods Cross-sectional study. Five SS and five HOA over 65. A descriptive analysis of the average range as well as all kinematic variables recorded was developed. The intrasubject and intersubject reliability of the measured variables was directly calculated. Results In the same intervals, the angular displacement was greater in the HOA group; however, they were completed at similar times for both groups, and HOA conducted the test at a higher speed and greater acceleration in each of the intervals. The SS values were higher than HOA values in the maximum and minimum acceleration in the trunk and in the lumbar region. Conclusions The SS show less functional reach, a narrower, slower and less accelerated movement during the FRT execution, but with higher peaks of acceleration and speed when they are compared with HOA.

Submission to Senate Standing Committee on Legal and Constitutional Affairs on the Copyright Amendment (Online Infringement) Bill 2015

We argue that safeguards are necessary to ensure human rights are adequately protected. All systems of blocking access to online content necessarily raise difficult and problematic issues of infringement of freedom of speech and access to information. Given the importance of access to information across the breadth of modern life, great care must be taken to ensure that any measures designed to protect copyright by blocking access to online locations are proportionate. Any measures to block access to online content must be carefully tailored to avoid serious and disproportionate impact on human rights. This means first that the measures must be effective and adapted to achieve a legitimate purpose. The experience of foreign jurisdictions suggests that this legislation is unlikely to be effective. Unless and until there is clear evidence that the proposed scheme is likely to increase effective returns to Australian creators, this legislation should not be introduced. Second, the principle of proportionality requires ensuring that the proposed legislation does not unnecessarily burden legitimate speech or access to information. As currently worded, the draft legislation may result in online locations being blocked even though they would, if operated in Australia, not contravene Australian law. This is unacceptable, and if introduced, the law should be drafted so that it is clearly limited only to foreign locations where there is clear and compelling evidence that the location would authorise copyright infringement if it were in Australia. Third, proportionality requires that measures are reasonable and strike an appropriate balance between competing interests. This draft legislation provides few safeguards for the public interest or the interests of private actors who would access legitimate information. New safeguards should be introduced to ensure that the public interest is well represented at both the stage of the primary application and at any applications to rescind or vary injunctions. We recommend that: The legislation not be introduced unless and until there is compelling evidence that it will have a real and significant positive impact on the effective incomes of Australian creators. The ‘facilitates an infringement’ test in s 115A(1)(b) should be replaced with ‘authorises infringement’. The ‘primary purpose’ test in s 115A(1)(c) should be replaced with: “the online location has no substantial non-infringing uses”. An explicit role for public interest groups as amici curiae should be introduced. Costs of successful applications should be borne by applicants. Injunctions should be valid only for renewable two year terms. Section 115A(5) should be clarified, and cl (b) and (c) be removed. The effectiveness of the scheme should be evaluated in two years.

Gender-specific differences of interaction between obesity and air pollution on stroke and cardiovascular diseases in Chinese adults from a high pollution range area: A large population based cross sectional study

Background Little information exists regarding the interaction effects of obesity with long-term air pollution exposure on cardiovascular diseases (CVDs) and stroke in areas of high pollution. The aim of the present study is to examine whether obesity modifies CVD-related associations among people living in an industrial province of northeast China. Methods We studied 24,845 Chinese adults, aged 18 to 74 years old, from three Northeastern Chinese cities in 2009 utilizing a cross-sectional study design. Body weight and height were measured by trained observers. Overweight and obesity were defined as a body mass index (BMI) between 25–29.9 and ≥ 30 kg/m2, respectively. Prevalence rate and related risk factors of cardiovascular and cerebrovascular diseases were investigated by a questionnaire. Three-year (2006–2008) average concentrations of particulate matter (PM10), sulfur dioxide (SO2), nitrogen dioxides (NO2), and ozone (O3) were measured by fixed monitoring stations. All the participants lived within 1 km of air monitoring sites. Two-level logistic regression (personal level and district-specific pollutant level) was used to examine these effects, controlling for covariates. Results We observed significant interactions between exposure and obesity on CVDs and stroke. The associations between annual pollutant concentrations and CVDs and stroke were strongest in obese subjects (OR 1.15–1.47 for stroke, 1.33–1.59 for CVDs), less strong in overweight subjects (OR 1.22–1.35 for stroke, 1.07–1.13 for CVDs), and weakest in normal weight subjects (OR ranged from 0.98–1.01 for stroke, 0.93–1.15 for CVDs). When stratified by gender, these interactions were significant only in women. Conclusions Study findings indicate that being overweight and obese may enhance the effects of air pollution on the prevalence of CVDs and stroke in Northeastern metropolitan China. Further studies will be needed to investigate the temporality of BMI relative to exposure and onset of disease.

Info-active and info-passive: The new type of consumer classification

Social media platforms, that foster user generated content, have altered the ways consumers search for product related information. Conducting online searches, reading product reviews, and comparing products ratings, is becoming a more common information seeking pathway. This research demonstrates that info-active consumers are becoming less reliant on information provided by retailers or manufacturers, hence marketing generated online content may have a reduced impact on their purchasing behaviour. The results of this study indicate that beyond traditional methods of segmenting consumers, in the online context, new classifications such as info-active and info-passive would be beneficial in digital marketing. This cross-sectional, mixed-methods study is based on 43 in-depth interviews and an online survey with 500 consumers from 30 countries.