Life impact of ankle fractures : qualitative analysis of patient and clinician experiences

Background: Ankle fractures are one of the more commonly occurring forms of trauma managed by orthopaedic teams worldwide. The impacts of these injuries are not restricted to pain and disability caused at the time of the incident, but may also result in long term physical, psychological, and social consequences. There are currently no ankle fracture specific patient-reported outcome measures with a robust content foundation. This investigation aimed to develop a thematic conceptual framework of life impacts following ankle fracture from the experiences of people who have suffered ankle fractures as well as the health professionals who treat them. Methods: A qualitative investigation was undertaken using in-depth semi-structured interviews with people (n=12) who had previously sustained an ankle fracture (patients) and health professionals (n=6) that treat people with ankle fractures. Interviews were audio-recorded and transcribed. Each phrase was individually coded and grouped in categories and aligned under emerging themes by two independent researchers. Results: Saturation occurred after 10 in-depth patient interviews. Time since injury for patients ranged from 6 weeks to more than 2 years. Experience of health professionals ranged from 1 year to 16 years working with people with ankle fractures. Health professionals included an Orthopaedic surgeon (1), physiotherapists (3), a podiatrist (1) and an occupational therapist (1). The emerging framework derived from patient data included eight themes (Physical, Psychological, Daily Living, Social, Occupational and Domestic, Financial, Aesthetic and Medication Taking). Health professional responses did not reveal any additional themes, but tended to focus on physical and occupational themes. Conclusions: The nature of life impact following ankle fractures can extend beyond short term pain and discomfort into many areas of life. The findings from this research have provided an empirically derived framework from which a condition-specific patient-reported outcome measure can be developed.

A qualitative study of the determinants of dieting and non-dieting approaches in overweight/obese Australian adults.

Background Dieting has historically been the main behavioural treatment paradigm for overweight/obesity, although a non-dieting paradigm has more recently emerged based on the criticisms of the original dieting approach. There is a dearth of research contrasting why these approaches are adopted. To address this, we conducted a qualitative investigation into the determinants of dieting and non-dieting approaches based on the perspectives and experiences of overweight/obese Australian adults. Methods Grounded theory was used inductively to generate a model of themes contrasting the determinants of dieting and non-dieting approaches based on the perspectives of 21 overweight/obese adults. Data was collected using semi-structured interviews to elicit in-depth individual experiences and perspectives. Results Several categories emerged which distinguished between the adoption of a dieting or non-dieting approach. These categories included the focus of each approach (weight/image or lifestyle/health behaviours); internal or external attributions about dieting failure; attitudes towards established diets, and personal autonomy. Personal autonomy was also influenced by another category; the perceived knowledge and self-efficacy about each approach, with adults more likely to choose an approach they knew more about and were confident in implementing. The time perspective of change (short or long-term) and the perceived identity of the person (fat/dieter or healthy person) also emerged as determinants of dieting or non-dieting approaches respectively. Conclusions The model of determinants elicited from this study assists in understanding why dieting and non-dieting approaches are adopted, from the perspectives and experiences of overweight/obese adults. Understanding this decision-making process can assist clinicians and public health researchers to design and tailor dieting and non-dieting interventions to population subgroups that have preferences and characteristics suitable for each approach.

Capitalisation of interest on short term loan “irreconcilable with what is right”

Higher than usual rates of interest charged by lenders on short term loans is not of itself considered to be a penalty or evidence of unconscionable conduct. These types of lenders often charge higher rates to take account of increased losses from higher than usual defaults by borrowers.

The legal effect of settlement statements

The decision of Carrapetta v. Rado [2012] NSWCA 202 raises a short but very practical point relating to the right to deliver a notice to complete or have otherwise called for completion where time is of the essence of the contract in circumstances where a settlement statement subsequently sent from the seller has overstated the amount owing under the contract. It was common ground , following the oft quoted High Court decisions of Neeta (Epping) Pty Ltd v Phillips(1974) 131 CLR 286 and Louinder v Leis (1982) 149 CLR 509 that a Notice to Complete which called for completion outside the terms of the contract would be invalid. These decisions also further confirm the long accepted principles that a seller who is not “ready willing and able” to perform all their obligations or who is otherwise in breach of contract at the time could not deliver a Notice to Complete (at[27]).The issue in this case did not so much concern the efficacy of the Notice to Complete at the time was delivered ,but the legal effect upon the Notice to Complete of the later delivery of a settlement statement for what the buyer considered to be performance beyond that required by the contract.

Long terminal repeats act as androgen-responsive enhancers for the PSA-Kallikrein locus

The androgen receptor (AR) signaling pathway is a common therapeutic target for prostate cancer, because it is critical for the survival of both hormone-responsive and castrate-resistant tumor cells. Most of the detailed understanding that we have of AR transcriptional activation has been gained by studying classical target genes. For more than two decades, Kallikrein 3 (KLK3) (prostate-specific antigen) has been used as a prototypical AR target gene, because it is highly androgen responsive in prostate cancer cells. Three regions upstream of the KLK3 gene, including the distal enhancer, are known to contain consensus androgen-responsive elements required for AR-mediated transcriptional activation. Here, we show that KLK3 is one of a specific cluster of androgen-regulated genes at the centromeric end of the kallikrein locus with enhancers that evolved from the long terminal repeat (LTR) (LTR40a) of an endogenous retrovirus. Ligand-dependent recruitment of the AR to individual LTR-derived enhancers results in concurrent up-regulation of endogenous KLK2, KLK3, and KLKP1 expression in LNCaP prostate cancer cells. At the molecular level, a kallikrein-specific duplication within the LTR is required for maximal androgen responsiveness. Therefore, KLK3 represents a subset of target genes regulated by repetitive elements but is not typical of the whole spectrum of androgen-responsive transcripts. These data provide a novel and more detailed understanding of AR transcriptional activation and emphasize the importance of repetitive elements as functional regulatory units

Underground power cable environment on-line monitoring and analysis

Knowledge of cable parameters has been well established but a better knowledge of the environment in which the cables are buried lags behind. Research in Queensland University of Technology has been aimed at obtaining and analysing actual daily field values of thermal resistivity and diffusivity of the soil around power cables. On-line monitoring systems have been developed and installed with a data logger system and buried spheres that use an improved technique to measure thermal resistivity and diffusivity over a short period. Results based on long term continuous field data are given. A probabilistic approach is developed to establish the correlation between the measured field thermal resistivity values and rainfall data from weather bureau records. This data from field studies can reduce the risk in cable rating decisions and provide a basis for reliable prediction of “hot spot” of an existing cable circuit

Probabilistic cable rating based on cable thermal environment studying

This paper describes a new approach to establish the probabilistic cable rating based on cable thermal environment studies. Knowledge of cable parameters has been well established. However the environment in which the cables are buried is not so well understood. Research in Queensland University of Technology has been aimed at obtaining and analysing actual daily field values of thermal resistivity and diffusivity of the soil around power cables. On-line monitoring systems have been developed and installed with a data logger system and buried spheres that use an improved technique to measure thermal resistivity and diffusivity over a short period. Based on the long-term continuous field data for more than 4 years, a probabilistic approach is developed to establish the correlation between the measured field thermal resistivity values and rainfall data from weather bureau records. Hence, a probabilistic cable rating can be established based on monthly probabilistic distribution of thermal resistivity

Static vertical displacement measurement of bridges using Fiber Bragg Grating (FBG) sensors

Vertical displacements are one of the most relevant parameters for structural health monitoring of bridges in both the short and long terms. Bridge managers around the globe are always looking for a simple way to measure vertical displacements of bridges. However, it is difficult to carry out such measurements. On the other hand, in recent years, with the advancement of fiber-optic technologies, fiber Bragg grating (FBG) sensors are more commonly used in structural health monitoring due to their outstanding advantages including multiplexing capability, immunity of electromagnetic interference as well as high resolution and accuracy. For these reasons, using FBG sensors is proposed to develop a simple, inexpensive and practical method to measure vertical displacements of bridges. A curvature approach for vertical displacement measurements using curvature measurements is proposed. In addition, with the successful development of FBG tilt sensors, an inclination approach is also proposed using inclination measurements. A series of simulation tests of a full- scale bridge was conducted. It shows that both of the approaches can be implemented to determine vertical displacements for bridges with various support conditions, varying stiffness (EI) along the spans and without any prior known loading. These approaches can thus measure vertical displacements for most of slab-on-girder and box-girder bridges. Besides, the approaches are feasible to implement for bridges under various loading. Moreover, with the advantages of FBG sensors, they can be implemented to monitor bridge behavior remotely and in real time. A beam loading test was conducted to determine vertical displacements using FBG strain sensors and tilt sensors. The discrepancies as compared with dial gauges reading using the curvature and inclination approaches are 0.14mm (1.1%) and 0.41mm (3.2%), respectively. Further recommendations of these approaches for developments will also be discussed at the end of the paper.

Magnetic flux analysis in superconducting Fault Current Limiters under short-circuit conditions

In order to obtain a more compact Superconducting Fault Current limiter (SFCL), a special geometry of core and AC coil is required. This results in a unique magnetic flux pattern which differs from those associated with conventional round core arrangements. In this paper the magnetic flux density within a Fault Current Limiter (FCL) is described. Both experimental and analytical approaches are considered. A small scale prototype of an FCL was constructed in order to conduct the experiments. This prototype comprises a single phase. The analysis covers both the steady state and the short-circuit condition. Simulation results were obtained using commercial software based on the Finite Element Method (FEM). The magnetic flux saturating the cores, leakage magnetic flux giving rise to electromagnetic forces and leakage magnetic flux flowing in the enclosing tank are computed.

Glider path-planning for optimal sampling of mesocale eddies

Ocean gliders constitute an important advance in the highly demanding ocean monitoring scenario. Their effciency, endurance and increasing robustness make these vehicles an ideal observing platform for many long term oceanographic applications. However, they have proved to be also useful in the opportunis-tic short term characterization of dynamic structures. Among these, mesoscale eddies are of particular interest due to the relevance they have in many oceano-graphic processes.

Modeling destination brand equity in an emerging long haul market

The destination branding literature emerged as recently as 1998, and there remains a dearth of empirical data that tests the effectiveness of brand campaigns over time. This paper reports the results of an investigation into consumer-based brand equity for Australia as a long haul destination in an emerging South American market. In spite of the high level of academic interest in the measurement of perceptions of destinations since the 1970s, few previous studies have examined perceptions held by South American consumers. Findings suggest that destination brand awareness, brand image, and brand value are positively related to brand loyalty for a long-haul destination. The results also indicate that Australia is a more compelling destination brand for previous visitors compared to non-visitors.

Dimensions of short break destination attractiveness : a comparison of cognitive, affective and conative perceptions

Although there has been exponential growth in the number of studies of destination image appearing in the tourism literature, few have addressed the role of affective perceptions. This paper analyses the market positions held by a competitive set of destinations, through a comparison of cognitive, affective and conative perceptions. Cognitive perceptions were measured by trialling a factor analytic adaptation of importance-performance analysis. Affective perceptions were measured using an affective response grid. The alignment of the results from these techniques identified leadership positions held by two quite different destinations on two quite different dimensions of short break destination attractiveness.

Rapid, long-distance dispersal by pumice rafting

Pumice is an extremely effective rafting agent that can dramatically increase the dispersal range of a variety of marine organisms and connect isolated shallow marine and coastal ecosystems. Here we report on a significant recent pumice rafting and long-distance dispersal event that occurred across the southwest Pacific following the 2006 explosive eruption of Home Reef Volcano in Tonga. We have constrained the trajectory, and rate, biomass and biodiversity of transfer, discovering more than 80 species and a substantial biomass underwent a .5000 km journey in 7–8 months. Differing microenvironmental conditions on the pumice, caused by relative stability of clasts at the sea surface, promoted diversity in biotic recruitment. Our findings emphasise pumice rafting as an important process facilitating the distribution of marine life, which have implications for colonisation processes and success, the management of sensitive marine environments, and invasive pest species.

The deep trauma of secondary victimisation : parents of sex offenders

The publication of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) introduced the notion that a life-threatening illness can be a stressor and catalyst for Posttraumatic Stress Disorder (PTSD). Since then a solid body of research has been established investigating the post-diagnosis experience of cancer. These studies have identified a number of short and long-term life changes resulting from a diagnosis of cancer and associated treatments. In this chapter, we discuss the psychosocial response to the cancer experience and the potential for cancer-related distress. Cancer can represent a life-threatening diagnosis that may be associated with aggressive treatments and result in physical and psychological changes. The potential for future trauma through the lasting effects of the disease and treatment, and the possibility of recurrence, can be a source of continued psychological distress. In addition to the documented adverse repercussions of cancer, we also outline the recent shift that has occurred in the psycho-oncology literature regarding positive life change or posttraumatic growth that is commonly reported after a diagnosis of cancer. Adopting a salutogenic framework acknowledges that the cancer experience is a dynamic psychosocial process with both negative and positive repercussions. Next, we describe the situational and individual factors that are associated with posttraumatic growth and the types of positive life change that are prevalent in this context. Finally, we discuss the implications of this research in a therapeutic context and the directions of future posttraumatic growth research with cancer survivors. This chapter will present both quantitative and qualitative research that indicates the potential for personal growth from adversity rather than just mere survival and return to pre-diagnosis functioning. It is important to emphasise however, that the presence of growth and prevalence of resilience does not negate the extremely distressing nature of a cancer diagnosis for the patient and their families and the suffering that can accompany treatment regimes. Indeed, it will be explained that for growth to occur, the experience must be one that quite literally shatters previously held schemas in order to act as a catalyst for change.