895 resultados para Regional differences
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The focus of this paper is on two World Heritage Areas: the Great Barrier Reef in Queensland, Australia and the Everglades in Florida. While both are World Heritage listed by the UNESCO, the Everglades is on the "World Heritage in Danger" list and the Great Barrier Reef could be on this list within the next year if present pressures continue. This paper examines the planning approaches and governance structures used in these two areas (Queensland and Florida) to manage the growth and development pressures. To make the analysis manageable, given the scale of these World Heritage areas, case studies at the local government level will be used: the Cairns Regional Council in Queensland and Monroe County in Florida. The case study analysis will involve three steps: (1) examination of the various plans at the federal, state, local levels that impact upon environmental quality in the Great Barrier Reef and Everglades; (2) assessing the degree to which these plans have been implemented; and (3) determine if (and how) the plans have improved environmental quality. In addition to the planning analysis we will also examine the governance structures (Lebel et al. 2006) within which planning operates. In any comparative analysis context is important (Hantrais 2009). Contextual differences between Queensland and Florida have previously been examined by Sipe, et al. (2007) and will be used as the starting point for this analysis. Our operating hypothesis and preliminary analysis suggests that the planning approaches and governance structures used in Florida and Queensland are considerably different, but the environmental outcomes may be similar. This is based, in part, on Vella (2004) who did a comparative analysis of environmental practices in the sugar industry in Florida and Queensland. This research re-examines this hypothesis and broadens the focus beyond the sugar industry to growth and development more broadly.
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Objective: This paper reflects on the recent growth of cancer research being conducted through some of Australia’s rural centres. It encompasses work being done across the fields of clinical, translational and health services research. Design: This is a collaborative piece with contributions from rural health researchers, clinical and cancer services staff from several different regions. Conclusion: The past decade has seen an expansion in cancer research in rural and regional Australia driven in part by the recognition that cancer patients in remote areas experience poorer outcomes than their metropolitan counterparts. This work has led to the development of more effective cancer networks and new models of care designed to meet the particular needs of the rural cancer patient. It is hoped that the growth of cancer research in regional centres will, in time, reduce the disparity between rural and urban communities and improve outcomes for cancer patients across both populations.
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During Pavlovian auditory fear conditioning a previously neutral auditory stimulus (CS) gains emotional significance through pairing with a noxious unconditioned stimulus (US). These associations are believed to be formed by way of plasticity at auditory input synapses on principal neurons of the lateral nucleus of the amygdala (LA). While the LA has been implicated as a key brain structure for fear learning, how its network of cellular components performs these operations is not yet known...
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Context Older oncology patients have unique needs associated with the many physical, psychological,and social changes associated with the aging process. The mechanisms underpinning and the impact of these changes are not well understood. Identification of clusters of symptoms is one approach that has been used to elicit hypotheses about the biological and/or psychological basis for variations in symptom experiences. Objectives The purposes of this study were to identify and compare symptom clusters in younger (<60 years) and older ($60 years) patients undergoing cancer treatment. Methods. Symptom data from one Australian study and two U.S. studies were combined to conduct this analysis. A total of 593 patients receiving active treatment were dichotomized into younger (<60 years) and older ($60 years) groups. Separate exploratory factor analyses (EFAs) were undertaken within each group to identify symptom clusters from occurrence ratings of the 32 symptoms assessed by the Memorial Symptom Assessment Scale. Results In both groups, a seven-factor solution was selected. Four partially concordant symptom clusters emerged in both groups (i.e., mood/cognitive, malaise, body image, and genitourinary). In the older patients, the three unique clusters reflected physiological changes associated with aging, whereas in the younger group the three unique clusters reflected treatment-related effects. Conclusion The symptom clusters identified in older patients typically included a larger and more diverse range of physical and psychological symptoms. Differences also may be reflective of variations in treatment approaches between age groups. Findings highlight the need for better understanding of variation in treatment and symptom burden between younger and older adults with cancer.
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- Objective To better understand how to plan for an ageing demographic that resides in ever-changing community typologies. Design: Semi-structured in-depth interviews. - Setting Community settings in rural and regional towns in Queensland. - Participants Twenty-two people aged over 65 years living in regional and rural Australia. - Interventions Qualitative study of social connectedness. - Main outcome measure(s) Thematic qualitative analysis. - Results Formal and informal social contact, through family, friends and social groups, was found to be important to the everyday lives of the participants. - Conclusions Social connections for older adults are important in maintaining independence and community engagement.
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Background A comprehensive hospital discharge summary sent to the patient's general practitioner in a timely manner can ease patient transition between care settings. Aim To investigate the quality of discharge summaries sent by a regional hospital to GPs; and to evaluate GPs' satisfaction with the medication list contained in the discharge summary. Method A questionnaire was mailed to a sample of 80 Gold Coast GPs who had made more than five referrals to the Gold Coast Hospital during June 2009. Results 18 responses (23% response rate) were received from September to October 2009. The majority (67%) of GPs received discharge summaries from the hospital and they were mostly in an electronic format with attached medication lists. The reasons for changing medications were not well explained and the timeframe for receiving summaries was considered unsatisfactory. Overall, the majority of GPs were satisfied with the quality of the discharge summaries. Conclusion GPs mostly received the discharge summaries and the majority received them electronically. The majority of GPs indicated that the medication lists were often attached to the discharge summaries and changes to medications recorded.
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Biomass is an important energy resource for producing bioenergy and growing the global economy whilst minimising greenhouse gas emissions. Many countries, like Australia have a huge amount of biomass with the potential for bioenergy, but non-edible feedstock resources are significantly under-exploited. Hence it is essential to map the availability of these feedstocks to identify the most appropriate bioenergy solution for each region and develop supply chains for biorefineries. Using Australia as a case study,we present the spatial availability and opportunities for second and third generation feedstocks. Considerations included current land use, the presence of existing biomass industries and climatic conditions. Detailed information on the regional availability of biomass was collected from government statistics, technical reports and energy assessments as well as from academic literature. Second generation biofuels have the largest opportunity in New South Wales, Queensland and Victoria (NSW, QLD and VIC) and the regions with the highest potential for microalgae are Western Australia and Northern Territory (WA, NT), based on land use opportunity cost and climate. The approach can be used in other countries with a similar climate. More research is needed to overcome key technical and economic hurdles.
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We examined whether self-ratings of “being active” among older people living in four different settings (major city high and lower density suburbs, a regional city, and a rural area) were associated with out-of-home participation and outdoor physical activity. A mixed-methods approach (survey, travel diary, and GPS tracking over a one-week period) was used to gather data from 48 individuals aged over 55 years. Self-ratings of “being active” were found to be positively correlated with the number of days older people spent time away from home but unrelated to time traveled by active means (walking and biking). No significant differences in active travel were found between the four study locations, despite differences in their respective built environments.The findings suggest that additional strategies to the creation of “age-friendly” environments are needed if older people are to increase their levels of outdoor physical activity. “Active aging” promotion campaigns may need to explicitly identify the benefits of walking outdoors to ambulatory older people as a means of maintaining their overall health, functional ability, and participation within society in the long-term and also encourage the development of community-based programs in order to facilitate regular walking for this group.
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Partial evaluation of infrastructure investments have resulted in expensive mistakes, unsatisfactory outcomes and increased uncertainties for too many stakeholders, communities and economies in both developing and developed nations. "Complex Stakeholder Perception Mapping" (CSPM), is a novel approach that can address existing limitations by inclusively framing, capturing and mapping the spectrum of insights and perceptions using extended Geographic Information Systems. Maps generated in CSPM offer presentations of flexibly combined, complex perceptions of stakeholders on multiple aspects of development. CSPM extends the applications of GIS software in non-spatial mapping and of Multi-Criteria Analysis with a multidimensional evaluation platform and augments decision science capabilities in addressing complexities. Application of CSPM can improve local and regional economic gains from infrastructure projects and aid any multi-objective and multi-stakeholder decision situations.
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On the 18th of July 2013, three hundred local members of Gladstone, Queensland erupted into song and dance performing the fraught history of their community harbourside through tug boat ballets, taiko drumming, German bell ringing and BMX bike riding. Over 17,500 people attended the four performances of Boomtown, a Queensland Music Festival event. This was the largest regional, outdoor community-engaged musical performance staged in Australia. The narrative moved beyond the dominant, pejorative view of Gladstone as an industrial town to include the community members’ sense of purpose and aspirations. It was a celebratory, contentious and ambitious project that sought to disrupt the traditional conventions of performance-making through working in artistically democratic ways. This article explores the potential for Australian Community Engaged Arts (CEA) projects such as Boomtown to democratically engage community members and co-create culturally meaningful work within a community. Research into CEA projects rarely consider how the often delicate conversations between practitioners and the community work. The complex processes of finding and co-writing the narrative, casting, and rehearsing Boomtown are discussed with reference to artistic director/dramaturge Sean Mee’s innovative approaches. Boomtown began with and concluded with community conversations. Skilful negotiation ensured congruence between the townspeople’s stories and the “community story” presented on stage, abrogating potential problems of narrative ownership. To supplement the research, twenty-one personal interviews were undertaken with Gladstone community members invested in the production before, during and after the project: performers, audience members and local professionals. The stories shared and emphasised in the theatricalised story were based on propitious, meaningful, local stories from lived experiences rather than preconceived, trivial or tokenistic matters, and were underpinned by a consensus formed on what was in the best interests of the majority of community members. Boomtown exposed hidden issues in the community and gave voice to thoughts, feelings and concerns which triggered not just engagement, but honest conversation within the community.
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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.
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Electrical impedance tomography is a novel technology capable of quantifying ventilation distribution in the lung in real time during various therapeutic manoeuvres. The technique requires changes to the patient’s position to place the electrical impedance tomography electrodes circumferentially around the thorax. The impact of these position changes on the time taken to stabilise the regional distribution of ventilation determined by electrical impedance tomography is unknown. This study aimed to determine the time taken for the regional distribution of ventilation determined by electrical impedance tomography to stabilise after changing position. Eight healthy, male volunteers were connected to electrical impedance tomography and a pneumotachometer. After 30 minutes stabilisation supine, participants were moved into 60 degrees Fowler’s position and then returned to supine. Thirty minutes was spent in each position. Concurrent readings of ventilation distribution and tidal volumes were taken every five minutes. A mixed regression model with a random intercept was used to compare the positions and changes over time. The anterior-posterior distribution stabilised after ten minutes in Fowler’s position and ten minutes after returning to supine. Left-right stabilisation was achieved after 15 minutes in Fowler’s position and supine. A minimum of 15 minutes of stabilisation should be allowed for spontaneously breathing individuals when assessing ventilation distribution. This time allows stabilisation to occur in the anterior-posterior direction as well as the left-right direction.
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With organisations facing significant challenges to remain competitive, Business Process Improvement (BPI) initiatives are often conducted to improve the efficiency and effectiveness of their business processes, focussing on time, cost, and quality improvements. Event logs which contain a detailed record of business operations over a certain time period, recorded by an organisation's information systems, are the first step towards initiating evidence-based BPI activities. Given an (original) event log as a starting point, an approach to explore better ways to execute a business process was developed, resulting in an improved (perturbed) event log. Identifying the differences between the original event log and the perturbed event log can provide valuable insights, helping organisations to improve their processes. However, there is a lack of automated techniques to detect the differences between two event logs. Therefore, this research aims to develop visualisation techniques to provide targeted analysis of resource reallocation and activity rescheduling. The differences between two event logs are first identified. The changes between the two event logs are conceptualised and realised with a number of visualisations. With the proposed visualisations, analysts will then be able to identify the changes related to resource and time, resulting in a more efficient business process. Ultimately, analysts can make use of this comparative information to initiate evidence-based BPI activities.
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Background Physical conditions through gait and other functional task are parameters to consider for frailty detection. The aim of the present study is to measure and describe the variability of acceleration, angular velocity and trunk displacement in the ten meter Extended Timed Get-Up-and-Go test in two groups of frail and non-frail elderly people through instrumentation with the iPhone4® smartphone. Secondly, to analyze the differences and performance of the variance between the study groups (frail and non-frail). This is a cross-sectional study of 30 subjects aged over 65 years, 14 frail subjects and 16 non-frail subjects. Results The highest difference between groups in the Sit-to-Stand and Stand-to-Sit subphases was in the y axis (vertical vector). The minimum acceleration in the Stand-to-Sit phase was -2.69 (-4.17 / -0.96) m/s2 frail elderly versus -8.49 (-12.1 / -5.23) m/s2 non-frail elderly, p < 0.001. In the Gait Go and Gait Come subphases the biggest differences found between the groups were in the vertical axis: -2.45 (-2.77 /-1.89) m/s2 frail elderly versus -5.93 (-6.87 / -4.51) m/s2 non-frail elderly, p < 0.001. Finally, with regards to the turning subphase, the statistically significant differences found between the groups were greater in the data obtained from the gyroscope than from the accelerometer (the gyroscope data for the mean maximum peak value for Yaw movement angular velocity in the frail elderly was specifically 25.60°/s, compared to 112.8°/s for the non-frail elderly, p < 0.05). Conclusions The inertial sensor fitted in the iPhone4® is capable of studying and analyzing the kinematics of the different subphases of the Extended Timed Up and Go test in frail and non-frail elderly people. For the Extended Timed Up and Go test, this device allows more sensitive differentiation between population groups than the traditionally used variable, namely time.
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There is a strong genetic risk for late-onset Alzheimer's disease (AD), but so far few gene variants have been identified that reliably contribute to that risk. A newly confirmed genetic risk allele C of the clusterin (CLU) gene variant rs11136000 is carried by ~88% of Caucasians. The C allele confers a 1.16 greater odds of developing late-onset AD than the T allele. AD patients have reductions in regional white matter integrity. We evaluated whether the CLU risk variant was similarly associated with lower white matter integrity in healthy young humans. Evidence of early brain differences would offer a target for intervention decades before symptom onset. We scanned 398 healthy young adults (mean age, 23.6 ± 2.2 years) with diffusion tensor imaging, a variation of magnetic resonance imaging sensitive to white matter integrity in the living brain. We assessed genetic associations using mixed-model regression at each point in the brain to map the profile of these associations with white matter integrity. Each C allele copy of the CLUvariant was associated with lower fractional anisotropy-a widely accepted measure of white matter integrity-in multiple brain regions, including several known to degenerate in AD. These regions included the splenium of the corpus callosum, the fornix, cingulum, and superior and inferior longitudinal fasciculi in both brain hemispheres. Young healthy carriers of the CLU gene risk variant showed a distinct profile of lower white matter integrity that may increase vulnerability to developing AD later in life.