Detection of dsRNA from Cleistothecia and Conidia of the Grape Powdery Mildew Pathogen, Uncinula Necator

Double-stranded RNA species ranging in molecular weight from 0.95 to 6.3 �� 106 were detected in grapevines in New York. We recently showed that two of the species (Mr = 5.3 and 4.4 �� 106) are associated with rupestris stem pitting disease. In this report, we show that the other eight detectable dsRNA species are associated with the powdery mildew fungus, Uncinula necator. These dsRNAs associated with the powdery mildew fungus were previously detected in leaves and epidermal stem tissue of grapevines infected with powdery mildew. The same dsRNA species were also detected from extracts of isolated cleistothecia and conidia of U. necator devoid of plant tissue. Isometric and rigid rodlike particles were observed in single cleistothecia preparations when examined under transmission electron microscopy.

Detection of dsRNA in Grapevines Showing Symptoms of Rupestris Stem Pitting Disease and the Variabilities Encountered

Rupestris stem pitting (rSP), a graft-transmissible grapevine disease, can be identified only by its reaction (pitted wood) on inoculated Vitis rupestris ���St. George.��� DsRNA was extracted from grapevines from California and Canada that indexed positive for rSP on St. George. Two distinct dsRNA species (B and C) (Mr = 5.3 �� 106 and 4.4 �� 106, respectively) were detected from the stem tissue of rSP-positive samples. Although similar dsRNA species (B and C) were detected in extracts of grapevines from New York, the association of dsRNA B and C with rSP in New York samples was not consistent. Also, eight different dsRNAs, known to be associated with the powdery mildew fungus, Uncinula necator, were detected in leaves of New York samples. In New York, the dsRNAs were not observed in leaves or stem samples collected from June through late August during the 1988 and 1989 growing seasons, suggesting that dsRNA detection in the grape tissue is variable throughout the season. We suggest that dsRNA species B and C are associated with rSP disease. The inconsistent results with New York samples are discussed.

Purification and Properties of Closteroviruslike Particles Associated with Grapevine Corky Bark Disease

Closteroviruslike particles, designated as grapevine corky bark-associated virus (GCBaV), were purified from mature leaves and stem phloem tissue of a corky bark-affected grapevine that had indexed negative for other grapevine viruses. Electron microscopy of purified preparations revealed the presence of flexuous rod-shaped viruslike particles that were about 13 nm in diameter and between 1,400 and 2,000 nm long, with a helical pitch of 3.4 nm. In purified preparations, the GCBaV particles degraded within a few weeks, unlike grapevine leafroll associated virus (GLRaV), which was stable for more than 1 mo under the same storage condition. The molecular weight of the coat protein of GCBaV was 24,000. A large dsRNA molecule (about 15.3 kbp), along with lower molecular weight species, was detected in tissues of corky bark-diseased grapevines, but not in healthy grapevines. Polyclonal antisera were produced in rabbits against purified or partially purified virus preparations. In direct enzyme-linked immunosorbent assay (ELISA), antisera to GCBaV did not react to the serologically distinct types (II and III) of the long closteroviruses associated with grapevine leafroll disease and grapevine virus A (GVA), and vice versa. This antiserum also reacted in ELISA with other corky bark-affected grapevines. Our data suggest that closteroviruslike particles, designated as GCBaV, may be the causal agent of corky bark disease. However, definitive proof is still lacking. The inclusion of GCBaV in the group of closteroviruses with citrus tristeza virus is proposed.

Differentiation of Rice Tungro Bacilliform Virus Strains by Restriction Analysis and DNA Hybridization

Rice tungro bacilliform virus (RTBV) is one of the two viruses that cause tungro disease. Four RTBV strains maintained in the greenhouse for 4 years, G1, G2, Ic, and L, were differentiated by restriction fragment length polymorphism (RFLP) analysis of the native viral DNA. Although strains G1 and Ic had identical restriction patterns when cleaved with Pst1, BamHI, EcoRI, and EcoRV, they can be differentiated from strains G2 and L by EcoRI and EcoRV digestion. These same endonucleases also differentiate strain G2 from strain L. When total DNA extracts from infected plants were used instead of viral DNA, and digested with EcoRV, identical restriction patterns for each strain (G2 and L) were obtained from roots, leaves, and leaf sheaths of infected plants. The restriction patterns were consistent from plant to plant, in different varieties, and at different times after inoculation. This technique can be used to differentiate RTBV strains and determine the variability of a large number of field samples.

Flower animals

The coral reefs around the world may be likened to canaries down the mineshaft of global warming. These sensitive plant-like animals have evolved for life in tropical seas. Their needs are quite specific ��� not too cold, not too hot. A rise of as little as one degree Celsius is enough to cause some bleaching of these colourful jewels of the sea. Many climate models indicate we can expect sea temperature increases of between two and six degrees Celsius. Research - such as that detailed in a 2004 report by the University of Queensland���s Centre for Marine Studies ��� indicates that by the year 2050 most of the worlds major reef systems will be dead. Many of us have heard this kind of information, but it remains difficult to comprehend. It���s almost impossible to imagine the death of the Great Barrier Reef. Some six to nine thousand years old and visible from space, it is the world���s largest structure created by living organisms. Yet whilst it is hard to believe, this gentle, sensitive giant is at grave risk because it cannot adapt quickly enough to the changes in the environment. This cluster of fluffy felt brain coral sculptures are connected in real time to temperature data collected by monitoring stations within the Great Barrier Reef, that form part of the Australian Institute of Marine Science���s Great Barrier Reed Ocean Observing System. These corals display illumination patterns showing changes in sea temperature at Heron Reef, one of the 2,900 reefs that comprise the Great Barrier Reef. Their spectrum of colour ranges from cool hues, through warm tones to bright white when temperatures exceed those that tropical corals are able to tolerate over sustained periods. The Flower Animals also blush in colour and make sound when people come within close proximity. In a reef, fishes and other creatures generate significant amounts of sound. These cacophonies are considered an indicator of reef health, and are used by reef fish to determine where they can best live and forage.

Contemporary take on deconstructed Medea : a review

THEATRE: The New Dead: Medea Material. By Heiner Muller. Stella Electrika in association with La Boite Theatre Company, Brisbane, November 19. THERE has been a lot of intensity in independent theatre in Brisbane during the past year, as companies, production houses and producers have begun building new programs and platforms to support an expansion of pathways within the local theatre ecology. Audiences have been exposed to works signalling the diversity of what Brisbane theatre makers want to see on stage, from productions of new local and international pieces to new devised works, and the results of residencies and development programs. La Boite Theatre Company closes its inaugural indie season with a work that places it at the contemporary, experimental end of the spectrum. The New Dead: Medea Material is emerging director Kat Henry's interpretation of Heiner Muller's 1981 text Despoiled Shore Medea Material Landscape with Argonauts. Start of sidebar. Skip to end of sidebar. End of sidebar. Return to start of sidebar. Muller is known for his radical adaptations of historical dramas, from the Greeks to Shakespeare, and for deconstructed texts in which the characters - in this case, Medea - violently reject the familial, cultural and political roles society has laid out for them. Muller's combination of deconstructed characters, disconnected poetic language and constant references to aspects of popular culture and the Cold War politics he sought to abjure make his texts challenging to realise. The poetry entices but the density, together with the increasing distance of the Cold War politics in the texts, leaves contemporary directors with clear decisions to make about how to adapt these open texts. In The New Dead: Medea Material, Henry works with some interesting imagery and conceptual territory. Lucinda Shaw as Medea, Guy Webster as Jason and Kimie Tsukakoshi as King Creon's daughter Glauce, the woman for whom Jason forsakes his wife Medea, each reference different aspects of contemporary culture. Medea is a bitter, drunken, satin-gowned diva with bite; Jason - first seen lounging in front of the television with a beer in an image reminiscent of Sarah Kane's in-yer-face characterisation of Hippolytus in Phaedra's Love - has something of the rock star about him; and Glauce is a roller-skating, karaoke-singing, pole-dancing young temptress. The production is given a contemporary tone, dominated by Medea's twisted love and loss, rather than by any commentary on her circumstances. Its strength is the aesthetic Henry creates, supported by live electro-pop music, a band stage that stands as a metaphor for Jason's sea voyage, and multimedia that inserts images of the story unfolding beyond these characters' speeches as sorts of subconscious flashes. While Tsukakoshi is engaging throughout, there are moments when Shaw and Webster's performances - particularly in the songs - are diminished by a lack of clarity. The result is a piece that, while slightly lacking in its realisation at times, undoubtedly flags Henry's facility as an emerging director and what she wants to bring to the Brisbane theatre scene.

Informational city

Many cities worldwide face the prospect of major transformation as the world moves towards a global information order. In this new era, urban economies are being radically altered by dynamic processes of economic and spatial restructuring. The result is the creation of ���informational cities��� or its new and more popular name, ���knowledge cities���. For the last two centuries, social production had been primarily understood and shaped by neo-classical economic thought that recognized only three factors of production: land, labor and capital. Knowledge, education, and intellectual capacity were secondary, if not incidental, factors. Human capital was assumed to be either embedded in labor or just one of numerous categories of capital. In the last decades, it has become apparent that knowledge is sufficiently important to deserve recognition as a fourth factor of production. Knowledge and information and the social and technological settings for their production and communication are now seen as keys to development and economic prosperity. The rise of knowledge-based opportunity has, in many cases, been accompanied by a concomitant decline in traditional industrial activity. The replacement of physical commodity production by more abstract forms of production (e.g. information, ideas, and knowledge) has, however paradoxically, reinforced the importance of central places and led to the formation of knowledge cities. Knowledge is produced, marketed and exchanged mainly in cities. Therefore, knowledge cities aim to assist decision-makers in making their cities compatible with the knowledge economy and thus able to compete with other cities. Knowledge cities enable their citizens to foster knowledge creation, knowledge exchange and innovation. They also encourage the continuous creation, sharing, evaluation, renewal and update of knowledge. To compete nationally and internationally, cities need knowledge infrastructures (e.g. universities, research and development institutes); a concentration of well-educated people; technological, mainly electronic, infrastructure; and connections to the global economy (e.g. international companies and finance institutions for trade and investment). Moreover, they must possess the people and things necessary for the production of knowledge and, as importantly, function as breeding grounds for talent and innovation. The economy of a knowledge city creates high value-added products using research, technology, and brainpower. Private and the public sectors value knowledge, spend money on its discovery and dissemination and, ultimately, harness it to create goods and services. Although many cities call themselves knowledge cities, currently, only a few cities around the world (e.g., Barcelona, Delft, Dublin, Montreal, Munich, and Stockholm) have earned that label. Many other cities aspire to the status of knowledge city through urban development programs that target knowledge-based urban development. Examples include Copenhagen, Dubai, Manchester, Melbourne, Monterrey, Singapore, and Shanghai. Knowledge-Based Urban Development To date, the development of most knowledge cities has proceeded organically as a dependent and derivative effect of global market forces. Urban and regional planning has responded slowly, and sometimes not at all, to the challenges and the opportunities of the knowledge city. That is changing, however. Knowledge-based urban development potentially brings both economic prosperity and a sustainable socio-spatial order. Its goal is to produce and circulate abstract work. The globalization of the world in the last decades of the twentieth century was a dialectical process. On one hand, as the tyranny of distance was eroded, economic networks of production and consumption were constituted at a global scale. At the same time, spatial proximity remained as important as ever, if not more so, for knowledge-based urban development. Mediated by information and communication technology, personal contact, and the medium of tacit knowledge, organizational and institutional interactions are still closely associated with spatial proximity. The clustering of knowledge production is essential for fostering innovation and wealth creation. The social benefits of knowledge-based urban development extend beyond aggregate economic growth. On the one hand is the possibility of a particularly resilient form of urban development secured in a network of connections anchored at local, national, and global coordinates. On the other hand, quality of place and life, defined by the level of public service (e.g. health and education) and by the conservation and development of the cultural, aesthetic and ecological values give cities their character and attract or repel the creative class of knowledge workers, is a prerequisite for successful knowledge-based urban development. The goal is a secure economy in a human setting: in short, smart growth or sustainable urban development.

Host use and crop impacts of Oribius Marshall species (Coleoptera: Curculionidae) in Eastern Highlands Province, Papua New Guinea

Oribius species are small flightless weevils endemic to the island of New Guinea and far northern Cape York, Australia. The adults feed externally on leaves, developing fruit and green bark, but their impact as pests and general host use patterns are poorly known. Working in Eastern Highlands Province, Papua New Guinea, we carried out structured host use surveys, farmer surveys, shade-house growth trials, and on-farm and on-station impact trials to: (i) estimate the host range of the local Oribius species; (ii) understand adult daily activity patterns; (iii) elucidate feeding habits of the soil dwelling larvae; and (iv) quantify the impacts of adult feeding damage. Oribius inimicus and O. destructor accounted for nearly all the Oribius species encountered locally: of these two O. inimicus was the most abundant. Weevils were collected from 31 of 33 plants surveyed in the Aiyura Valley and a combination of farmer interviews and literature records provided evidence for the beetles being pestiferous on 43 crops currently or previously grown in the Highlands. Adult weevils had a distinct diurnal pattern of being in the upper plant canopy early in the morning and, to a lesser extent, again late in the afternoon. For the remainder of the day beetles resided within the canopy, or possibly off the plant. Movement of adults between plants appeared frequent. Pot trials confirmed the larvae are root feeders. Quantified impact studies showed that the weevils are damaging to a range of vegetable and orchard crops (broccoli, capsicum, celery, French bean, Irish potato, lettuce, orange and strawberry), causing average yield losses of around 30-40%, but up to 100% on citrus. Oribius weevils pose a significant and apparently growing problem for Highland���s agriculture.

Engaging students in clinical bacteriology: A fresh look

Frequently there is a disconnectedness, either perceived or actual, between theoretical principles and laboratory practice in science education and this holds true for clinical microbiology where traditionally knowledge is delivered in ���chunks��� in a lecture format with the misguided belief that students have to know ���everything about everything���. This preoccupation with content delivery often leaves no time for active class discussion or reflection. Moreover, laboratory classes are treated as add-ons to the process, rather than an integrated part of the whole learning experience. In redesigning our units (subjects) we have bridged the gap between the theory and practice of clinical bacteriology. In doing so, we have seen a transformation in the learning experiences of our students and in the way we teach.

Ethical fashion : the human stories driving a fashion movement

This paper examines and compares two stories, the novel Helen Fleetwood (Elizabeth, 1841) and the film China Blue (Teddy Bear Films, 2005), in relation to the Ethical Fashion movement. In 2005, more than 50 designers from around the world took part in The Ethical Fashion Show in Paris. This movement dictates that designers ensure that their garments are produced in an ethical manner, rather than support the ���sweatshop��� environments of some industrialists determined to make a profit at the expense of workers rights. The momentum of the Ethical Fashion movement suggests that it is possible for fashion to be ethical, desirable and profitable in the 21st century. In 1841, after extensive research, Charlotte Elizabeth Tonna (using the pseudonym Charlotte Elizabeth) began to write about the atrocities of the factory system in industrialised England. Her novel, Helen Fleetwood, is one of the earliest examples of this kind of work, providing the reader with an extensive insight into the life of English factory workers in the mid-19th century. The story is about the Widow Green and her orphan dependents who are led, through circumstance, to leave their rural home and take up employment in the cotton mills of Manchester, with the hope of having an independent existence. Instead they discover the realities of factory life ��� extremely long hours, unsafe conditions, poor wages and a steady decline into extreme poverty. In his film China Blue (Teddy Bear Films, 2005), director Micha X. Peled tells an alarmingly similar tale set in 21st century China. This ���docu-drama��� (a recreation from actual interviews and diary entries) tells the story of ���Little Jasmine��� who leaves her family���s farm to pursue an independent life in Southern China���s manufacturing district. It is not long before the realities of modern factory life are revealed to the teenage ���heroine��� ��� crowded dormitories, long working hours, arbitrary fines and wages that do not compare with those of workers in the Western world. While much of the human story remains unchanged, there have been significant improvements in technology and safety in the last 165 years that result in the reality that not all clothing manufacture is performed in ���sweatshop��� conditions. After a recent visit to a manufacturing plant in China, consultation with peers in the industry and having worked in the Australian fashion industry for many years, the author compares these stories with her own experiences.

Genome-wide identification and expression analysis of the NF-Y family of transcription factors in Triticum aestivum

Nuclear Factor Y (NF-Y) is a trimeric complex that binds to the CCAAT box, a ubiquitous eukaryotic promoter element. The three subunits NF-YA, NF-YB and NF-YC are represented by single genes in yeast and mammals. However, in model plant species (Arabidopsis and rice) multiple genes encode each subunit providing the impetus for the investigation of the NF-Y transcription factor family in wheat. A total of 37 NF-Y and Dr1 genes (10 NF-YA, 11 NF-YB, 14 NF-YC and 2 Dr1) in Triticum aestivum were identified in the global DNA databases by computational analysis in this study. Each of the wheat NF-Y subunit families could be further divided into 4-5 clades based on their conserved core region sequences. Several conserved motifs outside of the NF-Y core regions were also identified by comparison of NF-Y members from wheat, rice and Arabidopsis. Quantitative RT-PCR analysis revealed that some of the wheat NF-Y genes were expressed ubiquitously, while others were expressed in an organ-specific manner. In particular, each TaNF-Y subunit family had members that were expressed predominantly in the endosperm. The expression of nine NF-Y and two Dr1 genes in wheat leaves appeared to be responsive to drought stress. Three of these genes were up-regulated under drought conditions, indicating that these members of the NF-Y and Dr1 families are potentially involved in plant drought adaptation. The combined expression and phylogenetic analyses revealed that members within the same phylogenetic clade generally shared a similar expression profile. Organ-specific expression and differential response to drought indicate a plant-specific biological role for various members of this transcription factor family.

TaNF-YB3 is involved in the regulation of photosynthesis genes in Triticum aestivum

Nuclear Factor Y (NF-Y) transcription factor is a heterotrimer comprised of three subunits: NF-YA, NF-YB and NF-YC. Each of the three subunits in plants is encoded by multiple genes with differential expression profiles, implying the functional specialisation of NF-Y subunit members in plants. In this study, we investigated the roles of NF-YB members in the light-mediated regulation of photosynthesis genes. We identified two NF-YB members from Triticum aestivum (TaNF-YB3 & 7) which were markedly upregulated by light in the leaves and seedling shoots using quantitative RT-PCR. A genome-wide coexpression analysis of multiple Affymetrix Wheat Genome Array datasets revealed that TaNF-YB3-coexpressed transcripts were highly enriched with the Gene Ontology term photosynthesis. Transgenic wheat lines constitutively overexpressing TaNF-YB3 had a significant increase in the leaf chlorophyll content, photosynthesis rate and early growth rate. Quantitative RT-PCR analysis showed that the expression levels of a number of TaNF-YB3-coexpressed transcripts were elevated in the transgenic wheat lines. The mRNA level of TaGluTR encoding glutamyl-tRNA reductase, which catalyses the rate limiting step of the chlorophyll biosynthesis pathway, was significantly increased in the leaves of the transgenic wheat. Significant increases in the expression level in the transgenic plant leaves were also observed for four photosynthetic apparatus genes encoding chlorophyll a/b-binding proteins (Lhca4 and Lhcb4) and photosystem I reaction center subunits (subunit K and subunit N), as well as for a gene coding for chloroplast ATP synthase ��� subunit. These results indicate that TaNF-YB3 is involved in the positive regulation of a number of photosynthesis genes in wheat.

Microscopic modelling of freeway operations

Freeways are divided roadways designed to facilitate the uninterrupted movement of motor vehicles. However, many freeways now experience demand flows in excess of capacity, leading to recurrent congestion. The Highway Capacity Manual (TRB, 1994) uses empirical macroscopic relationships between speed, flow and density to quantify freeway operations and performance. Capacity may be predicted as the maximum uncongested flow achievable. Although they are effective tools for design and analysis, macroscopic models lack an understanding of the nature of processes taking place in the system. Szwed and Smith (1972, 1974) and Makigami and Matsuo (1990) have shown that microscopic modelling is also applicable to freeway operations. Such models facilitate an understanding of the processes whilst providing for the assessment of performance, through measures of capacity and delay. However, these models are limited to only a few circumstances. The aim of this study was to produce more comprehensive and practical microscopic models. These models were required to accurately portray the mechanisms of freeway operations at the specific locations under consideration. The models needed to be able to be calibrated using data acquired at these locations. The output of the models needed to be able to be validated with data acquired at these sites. Therefore, the outputs should be truly descriptive of the performance of the facility. A theoretical basis needed to underlie the form of these models, rather than empiricism, which is the case for the macroscopic models currently used. And the models needed to be adaptable to variable operating conditions, so that they may be applied, where possible, to other similar systems and facilities. It was not possible to produce a stand-alone model which is applicable to all facilities and locations, in this single study, however the scene has been set for the application of the models to a much broader range of operating conditions. Opportunities for further development of the models were identified, and procedures provided for the calibration and validation of the models to a wide range of conditions. The models developed, do however, have limitations in their applicability. Only uncongested operations were studied and represented. Driver behaviour in Brisbane was applied to the models. Different mechanisms are likely in other locations due to variability in road rules and driving cultures. Not all manoeuvres evident were modelled. Some unusual manoeuvres were considered unwarranted to model. However the models developed contain the principal processes of freeway operations, merging and lane changing. Gap acceptance theory was applied to these critical operations to assess freeway performance. Gap acceptance theory was found to be applicable to merging, however the major stream, the kerb lane traffic, exercises only a limited priority over the minor stream, the on-ramp traffic. Theory was established to account for this activity. Kerb lane drivers were also found to change to the median lane where possible, to assist coincident mergers. The net limited priority model accounts for this by predicting a reduced major stream flow rate, which excludes lane changers. Cowan's M3 model as calibrated for both streams. On-ramp and total upstream flow are required as input. Relationships between proportion of headways greater than 1 s and flow differed for on-ramps where traffic leaves signalised intersections and unsignalised intersections. Constant departure onramp metering was also modelled. Minimum follow-on times of 1 to 1.2 s were calibrated. Critical gaps were shown to lie between the minimum follow-on time, and the sum of the minimum follow-on time and the 1 s minimum headway. Limited priority capacity and other boundary relationships were established by Troutbeck (1995). The minimum average minor stream delay and corresponding proportion of drivers delayed were quantified theoretically in this study. A simulation model was constructed to predict intermediate minor and major stream delays across all minor and major stream flows. Pseudo-empirical relationships were established to predict average delays. Major stream average delays are limited to 0.5 s, insignificant compared with minor stream delay, which reach infinity at capacity. Minor stream delays were shown to be less when unsignalised intersections are located upstream of on-ramps than signalised intersections, and less still when ramp metering is installed. Smaller delays correspond to improved merge area performance. A more tangible performance measure, the distribution of distances required to merge, was established by including design speeds. This distribution can be measured to validate the model. Merging probabilities can be predicted for given taper lengths, a most useful performance measure. This model was also shown to be applicable to lane changing. Tolerable limits to merging probabilities require calibration. From these, practical capacities can be estimated. Further calibration is required of traffic inputs, critical gap and minimum follow-on time, for both merging and lane changing. A general relationship to predict proportion of drivers delayed requires development. These models can then be used to complement existing macroscopic models to assess performance, and provide further insight into the nature of operations.

Motivational Interviewing changes the treatment trajectory of group Cognitive-Behavioural Therapy for anxiety

Anxiety disorders have been viewed as manifestations of broad underlying predisposing personality constructs such as neuroticism combined with more specific individual differences of unhelpful information processing styles. Given the high prevalence of anxiety and the significant impairment that it causes, there is an important need to continue to explore successful treatments for this disorder. Research indicates that there is still room for significantly improving attrition rates and treatment adherence. Traditionally Motivational Interviewing (MI) has been used to facilitate health behaviour change. Recently MI has been applied to psychotherapy and has been shown to improve the outcome of CBT. However, these studies have been limited to only considering pre- and post-treatment measures and neglected to consider when changes occur along the course of therapy. This leaves the unanswered question of what is the impact of pre-treatment MI on the treatment trajectory of therapy. This study provides preliminary research into answering this question by tracking changes on a weekly basis along the course of group CBT. Prior to group CBT, 40 individuals with a principal anxiety disorder diagnosis were randomly assigned to receive either 3 individual sessions of MI or placed on a waitlist control group. All participants then received the same dosage of 10 weekly 2 hour sessions of group CBT. Tracking treatment outcome trajectory over the course of CBT, the pre-treatment MI group, compared to the control group, experienced a greater improvement early on in the course of therapy in their symptom distress, interpersonal relationships and quality of life. This early advantage over the control group was then maintained throughout therapy. These results not only demonstrate the value of adding MI to CBT, but also highlight the immediacy of MI effects. Further research is needed to determine the robustness of these effects to inform clinical implications of how to best apply MI to improve treatment adherence to CBT for anxiety disorders.

Inequitable Provision of Optimal Services for Patients with Chronic Heart failure: A National Geo-Mapping Study

Objective: To compare the location and accessibility of current Australian chronic heart failure (CHF) management programs and general practice services with the probable distribution of the population with CHF. Design and setting: Data on the prevalence and distribution of the CHF population throughout Australia, and the locations of CHF management programs and general practice services from 1 January 2004 to 31 December 2005 were analysed using geographic information systems (GIS) technology. Outcome measures: Distance of populations with CHF to CHF management programs and general practice services. Results: The highest prevalence of CHF (20.3���79.8 per 1000 population) occurred in areas with high concentrations of people over 65 years of age and in areas with higher proportions of Indigenous people. Five thousand CHF patients (8%) discharged from hospital in 2004���2005 were managed in one of the 62 identified CHF management programs. There were no CHF management programs in the Northern Territory or Tasmania. Only four CHF management programs were located outside major cities, with a total case load of 80 patients (0.7%). The mean distance from any Australian population centre to the nearest CHF management program was 332 km (median, 163 km; range, 0.15���3246 km). In rural areas, where the burden of CHF management falls upon general practitioners, the mean distance to general practice services was 37 km (median, 20 km; range, 0���656 km). Conclusion: There is an inequity in the provision of CHF management programs to rural Australians.