Does quality of life among breast cancer survivors one year after diagnosis differ depending on urban and non-urban residence? A comparative study

Background: This study examined the quality of life (QOL), measured by the Functional Assessment of Cancer Therapy (FACT) questionnaire, among urban (n=277) and non-urban (n=323) breast cancer survivors and women from the general population (n=1140) in Queensland, Australia. ---------- Methods: Population-based samples of breast cancer survivors aged <75 years who were 12 months post-diagnosis and similarly-aged women from the general population were recruited between 2002 and 2007. ---------- Results: Age-adjusted QOL among urban and non-urban breast cancer survivors was similar, although QOL related to breast cancer concerns was the weakest domain and was lower among non-urban survivors than their urban counterparts (36.8 versus 40.4, P<0.01). Irrespective of residence, breast cancer survivors, on average, reported comparable scores on most QOL scales as their general population peers, although physical well-being was significantly lower among non-urban survivors (versus the general population, P<0.01). Overall, around 20%-33% of survivors experienced lower QOL than peers without the disease. The odds of reporting QOL below normative levels were increased more than two-fold for those who experienced complications following surgery, reported upper-body problems, had higher perceived stress levels and/or a poor perception of handling stress (P<0.01 for all). ---------- Conclusions: Results can be used to identify subgroups of women at risk of low QOL and to inform components of tailored recovery interventions to optimize QOL for these women following cancer treatment.

Assessing the effectiveness of water sensitive urban design in Southeast Queensland

Water Sensitive Urban Design (WSUD) systems have the potential mitigate the hydrologic disturbance and water quality concerns associated with stormwater runoff from urban development. In the last few years WSUD has been strongly promoted in South East Queensland (SEQ) and new developments are now required to use WSUD systems to manage stormwater runoff. However, there has been limited field evaluation of WSUD systems in SEQ and consequently knowledge of their effectiveness in the field, under storm events, is limited. The objective of this research project was to assess the effectiveness of WSUD systems installed in a residential development, under real storm events. To achieve this objective, a constructed wetland, bioretention swale and a bioretention basin were evaluated for their ability to improve the hydrologic and water quality characteristics of stormwater runoff from urban development. The monitoring focused on storm events, with sophisticated event monitoring stations measuring the inflow and outflow from WSUD systems. Data analysis undertaken confirmed that the constructed wetland, bioretention basin and bioretention swale improved the hydrologic characteristics by reducing peak flow. The bioretention systems, particularly the bioretention basin also reduced the runoff volume and frequency of flow, meeting key objectives of current urban stormwater management. The pollutant loads were reduced by the WSUD systems to above or just below the regional guidelines, showing significant reductions to TSS (70-85%), TN (40-50%) and TP (50%). The load reduction of NOx and PO4 3- by the bioretention basin was poor (<20%), whilst the constructed wetland effectively reduced the load of these pollutants in the outflow by approximately 90%. The primary reason for the load reduction in the wetland was due to a reduction in concentration in the outflow, showing efficient treatment of stormwater by the system. In contrast, the concentration of key pollutants exiting the bioretention basin were higher than the inflow. However, as the volume of stormwater exiting the bioretention basin was significantly lower than the inflow, a load reduction was still achieved. Calibrated MUSIC modelling showed that the bioretention basin, and in particular, the constructed wetland were undersized, with 34% and 62% of stormwater bypassing the treatment zones in the devices. Over the long term, a large proportion of runoff would not receive treatment, considerably reducing the effectiveness of the WSUD systems.

The National Aboriginal and Torres Strait Islander Women's Health Strategy on Talkin with Tiga Bayles, 98.9 AM National Indigenous Radio Service (NIRS), Wednesday 21 July 2010. (9.00 - 10.00am).

Radio Program. Talkin with Tiga Bayles, 98.9 AM National Indigenous Radio Service (NIRS), 9.00-10.00am, Wednesday 21 July 2010. (1 hour program).----- Bronwyn Fredericks discssed the National Aboriginal and Torres Strait Islander Women’s Health Strategy was launched at the Australian Women’s Health Network (AWHN) National Conference in Hobart on the 19 May 2010. Within this radio interview the background of the Strategy is discussed, funding, who did the consultations and the writing. In the interview Bronwyn Fredericks outlines the process of the Strategy’s development and its uses for the future.----- It is important to note that this Strategy does not replace other national or State and Territory documents which identify priorities and needs. The aim is to supplement existing work.

The role of traffic violations in police-reported bicycle crashes in Queensland

Media articles have promoted the view that cyclists are risktakers who disregard traffic regulations, but little is known about the contribution of cyclist risk-taking behaviours to crashes. This study examines the role of traffic violations in the 6774 police-reported bicycle crashes in Queensland between January 2000 and December 2008. Of the 6328 crashes involving bicycles and motor vehicles, cyclists were deemed to be at fault in 44.4% of the incidents. When motorists were determined to be at-fault, ‘failure to yield’ violations accounted for three of the four most reported contributing factors. In crashes where the cyclist was at fault, attention and inexperience were the most frequent contributing factors. There were 67 collisions between bicycles and pedestrians, with the cyclist at fault in 65.7%. During the data period, 302 single-bicycle crashes were reported. The most frequent contributing factors were avoidance actions to miss another road user and inattention or negligence.

Validation of the WHOQOL-BREF among women following childbirth

Background: There is an increasing interest in measuring quality of life (QOL) in clinical settings and in clinical trials. None of the commonly used QOL instrument have been validated for use postnatally. Aim: To assess the psychometric properties of the 26-item WHOQOL-BREF among women following childbirth. Methods: Using a prospective cohort design we recruited 320 women within the first few days of childbirth. At six weeks postpartum, participants were asked to complete the WHOQOL-BREF, the Edinburgh Postnatal Depression Index and the Australian Unity Wellbeing Index. Validation of the WHOQOL-BREF included an analysis of internal consistency, discriminate validity, convergent validity and an examination of the domain structure. Results: 221 (69.1%) women returned their six-week questionnaire. All domains of the WHOQOL-BREF met reliability standards (alpha coefficient exceeding 0.70). The questionnaire discriminated well between known groups (depressed and non-depressed women. P = <0.000) and demonstrated satisfactory correlations with the Australian Unity Wellbeing index (r = >0.45). The domain structure of the WHOQOL-BREF was also valid in this population of new mothers, with moderate to high correlation between individual items and the domain structure to which the items were originally assigned. Conclusion: The WHOQOL-BRF is well-accepted and valid instrument in this population and may be used in postnatal clinical settings or for assessing intervention effects in research studies.

Evaluating sewage associated JCV and BKV polyomaviruses for sourcing human fecal pollution in a coastal river in Southeast Queensland Australia

In this study, the host-sensitivity and -specificity of JCV and BKV polyomaviruses were evaluated by testing wastewater/fecal samples from nine host groups in Southeast Queensland, Australia. The JCV and BKV polyomaviruses were detected in 48 human wastewater samples collected from the primary and secondary effluent suggesting high sensitivity of these viruses in human wastewater. Of the 81 animal wastewater/fecal samples tested, 80 were PCR negative for this marker. Only one sample from pig wastewater was positive. Nonetheless, the overall host-specificity of these viruses to differentiate between human and animal wastewater/fecal samples was 0.99. To our knowledge, this is the first study in Australia that reports the high specificity of JCV and BKV polyomaviruses. To evaluate the field application of these viruses to detect human fecal pollution, 20 environmental samples were collected from a coastal river. Of the 20 samples tested, 15% and 70% samples exceeded the regulatory guidelines for E. coli and enterococci levels for marine waters. In all, 5 (25%) samples were PCR positive for JCV and BKV indicated the presence of human fecal pollution in the studied river. The results suggest that JCV and BKV detection using PCR could be a useful tool for the identification of human sourced fecal pollution in coastal waters.

Gender equity in the professoriate : a cohort study of new women professors in Australia

According to statistics and trend data, women continue to be substantially under- represented in the Australian professoriate, and growth in their representation has been slow despite the plethora of equity programs. While not disputing these facts, we propose that examining gender equity by cohort provides a complementary perspective on the status of gender equity in the professoriate. Based on over 500 survey responses, we detected substantial similarities between women and men who were appointed as professors or associate professors between 2005 and 2008. There were similar proportions of women and men appointed via external or internal processes or by invitation. Additionally, similar proportions of women and men professors expressed a marked preference for research over teaching. Furthermore, there were similar distributions between the genders in the age of appointment to the professoriate. However, a notable gender difference was that women were appointed to the professoriate on average 1.9 years later than mens. This later appointment provides one reason for the lower representation of women compared to men in the professoriate. It also raises questions of the typical length of time that women and men remain in the (paid) professoriate and reasons why they might leave it. A further similarity between women and men in this cohort was their identification of motivation and circumstances as key factors in their career orientation. However, substantially more women identified motivation than circumstances and the situation was reversed for men. The open-ended survey responses also provided confirmation that affirmative action initiatives make a difference to women’s careers.

No energy compensation at the meal following exercise indietary restrained and unrestrained women

The objective of this investigation was to compare the acute effects of exercise and diet manipulations on energy intake, between dietary restrained and unrestrained females. Comparisons of two studies using an identical 2 x 2 repeated-measures design (level of activity (rest or exercise) and lunch type (high-fat or low-fat)) including thirteen dietary unrestrained and twelve restrained females were performed. Energy expenditure during the rest session was estimated and the energy cost of exercise was measured by indirect calorimetry. Relative energy intake was calculated by subtracting the energy expenditure of the exercise session from the energy intake of the test meal. Post-meal hedonic ratings were completed after lunch. Energy intake and relative energy intake increased during high-fat conditions compared with the low-fat, independently of exercise (P < 0.001). There was a positive relationship between dietary restraint scores and energy intake or relative energy intake in the rest conditions only (r 0.54, P < 0.01). The decrease of relative energy intake between the rest and exercise conditions was higher in restrained than in unrestrained eaters (P < 0.01). These results confirm that a high-fat diet reversed the energy deficit due to exercise. There was no energy compensation in response to an acute bout of exercise during the following meal. In restrained eaters, exercise was more effective in creating an energy deficit than in unrestrained eaters. Exercise may help restrained eaters to maintain control over appetite.

Community voices, votes and action

The diversity of community voices in the SEQ ‘bellwether region’ has grown from a muted murmur in the mid twentieth century supporting provision of urban services, rural conservation and green belts, to the current clamour against over-development, and in favour of protecting local and regional open space, wetlands and natural habitats. This in turn has often resulted in vigorous campaigns against unpopular roads, dams, dumps and tall buildings. In the last twenty years community issues have played a major part in local government elections throughout the region and have even helped unseat (in 1995-1996) a state government which discounted their authenticity and community resolve.

What health services within rural communities tell us about Aboriginal people and Aboriginal health

There is a growing body of literature within social and cultural geography that explores notions of place, space, culture, race and identity. When health services in rural communities are explored using these notions, it can lead to multiple ways of understanding the cultural meanings inscribed within health services and how they can be embedded with an array of politics. For example, health services can often reflect the symbolic place that each individual holds within that rural community. Through the use of a rural health service case study, this paper will demonstrate how the physical sites and appearances of health services can act as social texts that convey messages of belonging and welcome, or exclusion and domination. They can also produce and reproduce power and control relations. In this way, they can influence the ways that Aboriginal people engage in health service environments – either as places where Aboriginal people feel welcome, comfortable, secure and culturally safe and happy to use the health service, or as places where they utilise the service provided with a great deal of effort, angst and energy. It is important to understand how these complex notions play out in rural communities if the health and wellbeing of Aboriginal people is going to be addressed.

Weaving yarns : the lived experience of Indigenous Australians with adult-onset disability in Brisbane

Indigenous Australians have lower levels of health than mainstream Australians and (as far as statistics are able to indicate) higher levels of disability, yet there is little information on Indigenous social and cultural constructions of disability or the Indigenous experience of disability. This research seeks to address these gaps by using an ethnographic approach, couched within a critical medical anthropology (CMA) framework and using the “three bodies” approach, to study the lived experience of urban Indigenous people with an adult-onset disability. The research approach takes account of the debate about the legitimacy of research into Indigenous Australians, Foucault‟s governmentality, and the arguments for different models of disability. The possibility of a cultural model of disability is raised. After a series of initial interviews with contacts who were primarily service providers, more detailed ethnographic research was conducted with three Indigenous women in their homes and with four groups of Indigenous women and men at an Indigenous respite centre. The research involved multiple visits over a period extending more than two years, and the establishment of relationships with all participants. An iterative inductive approach utilising constant comparison (i.e. a form of grounded theory) was adopted, enabling the generation and testing of working hypotheses. The findings point to the lack of an Indigenous construct of disability, related to the holistic construction of health among Indigenous Australians. Shame emerges as a factor which affects the way that Indigenous Australians respond to disability, and which operates in apparent contradiction to expectations of community support. Aspects of shame relate to governmentality, suggesting that self-disciplinary mechanisms have been taken up and support the more obvious exertion of government power. A key finding is the strength of Indigenous identity above and beyond other forms of identification, e.g. as a person with a disability, expressed in forms of resistance by individuals and service providers to the categories and procedures of the mainstream. The implications of a holistic construction of health are discussed in relation to the use of CMA, the interpretation of the “three bodies”, governmentality and resistance. The explanatory value of the concept of sympatricity is discussed, as is the potential value of a cultural model of disability which takes into account the cultural politics of a defiant Indigenous identity.

Wellness in older adults

Understanding perception of wellness in older adults is a question to be understood against the backdrop of concerns about whether global ageing and the ‘bulge’ of ageing baby boomers will increase health care cost beyond what modern economies can deal with. Older adults who age in a healthy way and who take responsibility for their own health offer a positive alternative and change the perception that older adults are a burden on their society’s health system. The concept of successful ageing introduced by Rowe and Kahn (1987; 1997) suggested that older adults age successfully if they avoid disease and disability, maintain high cognitive and physical functioning and remain actively engaged with life. This concept, however, did not reflect older adults’ own perceptions of what constitutes successful ageing or how perceptions of wellness or health-related quality of life influenced the older adult’s understanding of his or her own health and ageing. A research project was designed to examine older adults’ perceptions of wellness in order to gain an understanding of the factors that influence perception of their own wellness. Specifically, the research wanted to explore two aspects: whether belonging to a unique organisation, in this instance a Returned Services Club, influenced perceptions of wellness; and whether there are significant gender differences for the perception of wellness. A mixed method project with two consecutive studies was designed to answer these questions: a quantitative survey of members of a Returned Services Club and of the surrounding community in Queensland, Australia, and a qualitative study conducting focus groups to explore findings of the survey. The results of the survey were used to determine the composition of the focus groups. The participants for the first study, (N=257), community living adults 65 years and older, were chosen from the membership role of a Returned Services Club or recruited by personal approach from the community surrounding the Services Club. Participants completed a survey that consisted of a perception of wellness instrument, a health-related quality of life instrument, and questions on morbidities, modifiable life style factors and demographics. Data analysis found that a number of individual factors influenced perception of wellness and health-related quality of life. Positive influences were independent mobility, exercise and gambling at non-hazardous levels, and negative influences were hearing loss, memory problems, chronic disease and being single. Membership of the Services Club did not contribute to perception of wellness beyond being a member of a social group. While there may have been an expectation that members of an organisation that is traditionally associated with high alcohol use and problematic gambling may have lower perceptions of wellness, this study suggested that the negative influences may have been counteracted by the positive effects of social interaction, thus having neither negative nor positive influences on perception of wellness. There were significant differences in perception of wellness and in health-related quality of life for women and men. The most significant difference was for women aged 85-90 who had significantly lower scores for perception of wellness than men or than any other age group. This result was the impetus for conducting focus groups with adults aged 85-90 years of age. Focus groups were conducted with 24 women and four men aged 85-90 to explore the survey findings for this age group. Results from the focus groups indicated that for older adults perception of wellness was a multidimensional construct of more complexity than indicated by the survey instrument. Elite older women (women over 85 years of age) related their perception of wellness to their ability to do what they wanted to do, and what they wanted to do significantly more than anything else, was to stay connected to family, friends and the community to which they belonged. From the focus group results it appeared that elite older women identified with the three elements of successful ageing – low incidence of disability and disease, high physical and cognitive functioning, and active engagement with life – but not in a flat structure. It appears that for elite older women good physical and mental health function to enable social connectedness. It is the elements of health that impact on the ability to do what they wanted to do that were identified as key factors: independent mobility, hearing and memory - factors that impact on the ability to interact socially. These elements were only identified when they impacted on the person’s ability to do what they wanted to do, for example mobility problems that were managed were not considered a problem. The study also revealed that older women use selection, optimisation and compensation to meet their goal of staying socially connected. The shopping centre was a key factor in this goal and older women used shopping centres to stay connected to the community and for exercise as well as shopping. Personal and public safety and other environmental concerns were viewed in the same context of enabling or disabling social connectedness. This suggested that for elite older women the model of successful ageing was hierarchical rather than flat, with social connectedness at the top, supported by cognitive functioning and good physical and mental health. In conclusion, this research revealed that perception of wellness in older adults is a complex, multidimensional construct. For older adults good health is related to social connectedness and is not a goal in itself. Health professionals and the community at large have a responsibility to take into account the ability of the older adult to stay socially connected to their community and to enable this, if the goal is to keep older adults healthy for as long as possible. Maintaining or improving perception of wellness in older adults will require a broad biopsychosocial approach that utilises findings such as older adults’ use of shopping centres for non-shopping purposes, concerns about personal and environmental safety and supporting older adults to maintain or improve their social connectedness to their communities.

Resilience in critical infrastructures : the case of the Queensland electricity industry

The reliability of Critical Infrastructure is considered to be a fundamental expectation of modern societies. These large-scale socio-technical systems have always, due to their complex nature, been faced with threats challenging their ongoing functioning. However, increasing uncertainty in addition to the trend of infrastructure fragmentation has made reliable service provision not only a key organisational goal, but a major continuity challenge: especially given the highly interdependent network conditions that exist both regionally and globally. The notion of resilience as an adaptive capacity supporting infrastructure reliability under conditions of uncertainty and change has emerged as a critical capacity for systems of infrastructure and the organisations responsible for their reliable management. This study explores infrastructure reliability through the lens of resilience from an organisation and system perspective using two recognised resilience-enhancing management practices, High Reliability Theory (HRT) and Business Continuity Management (BCM) to better understand how this phenomenon manifests within a partially fragmented (corporatised) critical infrastructure industry – The Queensland Electricity Industry. The methodological approach involved a single case study design (industry) with embedded sub-units of analysis (organisations), utilising in-depth interviews and document analysis to illicit findings. Derived from detailed assessment of BCM and Reliability-Enhancing characteristics, findings suggest that the industry as a whole exhibits resilient functioning, however this was found to manifest at different levels across the industry and in different combinations. Whilst there were distinct differences in respect to resilient capabilities at the organisational level, differences were less marked at a systems (industry) level, with many common understandings carried over from the pre-corporatised operating environment. These Heritage Factors were central to understanding the systems level cohesion noted in the work. The findings of this study are intended to contribute to a body of knowledge encompassing resilience and high reliability in critical infrastructure industries. The research also has value from a practical perspective, as it suggests a range of opportunities to enhance resilient functioning under increasingly interdependent, networked conditions.

Development of pollutant build-up parameters for MIKE URBAN for Southeast Queensland, Australia

Accurate estimation of input parameters is essential to ensure the accuracy and reliability of hydrologic and water quality modelling. Calibration is an approach to obtain accurate input parameters for comparing observed and simulated results. However, the calibration approach is limited as it is only applicable to catchments where monitoring data is available. Therefore, methodology to estimate appropriate model input parameters is critical, particularly for catchments where monitoring data is not available. In the research study discussed in the paper, pollutant build-up parameters derived from catchment field investigations and model calibration using MIKE URBAN are compared for three catchments in Southeast Queensland, Australia. Additionally, the sensitivity of MIKE URBAN input parameters was analysed. It was found that Reduction Factor is the most sensitive parameter for peak flow and total runoff volume estimation whilst Build-up rate is the most sensitive parameter for TSS load estimation. Consequently, these input parameters should be determined accurately in hydrologic and water quality simulations using MIKE URBAN. Furthermore, an empirical equation for Southeast Queensland, Australia for the conversion of build-up parameters derived from catchment field investigations as MIKE URBAN input build-up parameters was derived. This will provide guidance for allowing for regional variations in the estimation of input parameters for catchment modelling using MIKE URBAN where monitoring data is not available.

The Queensland Cancer Physics Collaborative and the Quantitative Biomedical Imaging & Characterisation (Q-BIC) Research Group

a presentation about immersive visualised simulation systems, image analysis and GPGPU Techonology