Gain's in knowledge, attitude and skills of counselors across three trainings programs

The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) sponsored by the G20 nations has helped fund the development of training programs for HIV/AIDS counselors in India. To date no study has examined the effectiveness of these training programs. This study, therefore, aimed to examine the impact of a 12 training program in improving the knowledge of new HIV/AIDS counselors in West Bengal and compare benefits of three training programs. Pre and post measures were taken from 87 counsellors attending three training programs organized by the GFATM-7 team of the Department of Applied Psychology, University of Calcutta. Overall pre and post training scores of three training programs together show significant improvements in knowledge. The findings from this study provide confidence that the 12 day training program can be effectively implemented among West Bengal HIV/AIDS counsellors.

Gray matter deficits, mismatch negativity, and outcomes in schizophrenia

Reduced mismatch negativity (MMN) in response to auditory change is a well-established finding in schizophrenia and has been shown to be correlated with impaired daily functioning, rather than with hallmark signs and symptoms of the disorder. In this study, we investigated (1) whether the relationship between reduced MMN and impaired daily functioning is mediated by cortical volume loss in temporal and frontal brain regions in schizophrenia and (2) whether this relationship varies with the type of auditory deviant generating MMN. MMN in response to duration, frequency, and intensity deviants was recorded from 18 schizophrenia subjects and 18 pairwise age- and gender-matched healthy subjects. Patients’ levels of global functioning were rated on the Social and Occupational Functioning Assessment Scale. High-resolution structural magnetic resonance scans were acquired to generate average cerebral cortex and temporal lobe models using cortical pattern matching. This technique allows accurate statistical comparison and averaging of cortical measures across subjects, despite wide variations in gyral patterns. MMN amplitude was reduced in schizophrenia patients and correlated with their impaired day-to-day function level. Only in patients, bilateral gray matter reduction in Heschl’s gyrus, as well as motor and executive regions of the frontal cortex, correlated with reduced MMN amplitude in response to frequency deviants, while reduced gray matter in right Heschl’s gyrus also correlated with reduced MMN to duration deviants. Our findings further support the importance of MMN reduction in schizophrenia by linking frontotemporal cerebral gray matter pathology to an automatically generated event-related potential index of daily functioning.

Corneal confocal microscopy shown an improvement in small-fibre neuropathy in subjects with type 1 diabetes on continuous subcutaneous insulin infusion compared to multiple daily injection

Improved glycemic control is the only treatment that has been shown to be effective for diabetic peripheral neuropathy in patients with type 1 diabetes (1). Continuous subcutaneous insulin infusion (CSII) is superior to multiple daily insulin injection (MDI) for reducing HbA1c and hypoglycemic events (2). Here, we have compared the benefits of CSII compared withMDI for neuropathy over 24months....

Adverse breast cancer treatment effects: The economic case for making rehabilitative programs standard of care

Purpose: The purpose of this work was to evaluate the patient-borne financial cost of common, adverse breast cancer treatment-associated effects, comparing cost across women with or without these side-effects. Methods: 287 Australian women diagnosed with early-stage breast cancer were prospectively followed starting at six months post-surgery for 12 months, with three-monthly assessment of detailed treatment-related side effects and their direct and indirect patient costs attributable to breast cancer. Bootstrapping statistics were used to analyze cost data and adjusted logistic regression was used to evaluate the association between costs and adverse events from breast cancer. Costs were inflated and converted from 2002 Australian to 2014 US dollars. Results: More than 90% of women experienced at least one adverse effect (i.e. post-surgical issue, reaction to radiotherapy, upper-body symptoms or reduced function, lymphedema, fatigue or weight gain). On average, women paid $5,636 (95%CI: $4,694, $6,577) in total costs. Women with any one of the following symptoms (fatigue, reduced upper-body function, upper-body symptoms) or women who report ≥4 adverse treatment-related effects, have 1.5 to nearly 4 times the odds of having higher healthcare costs than women who do not report these complaints (p<0.05). Conclusions: Women face substantial economic burden due to a range of treatment-related health problems, which may persist beyond the treatment period. Improving breast cancer care by incorporating prospective surveillance of treatment-related side effects, and strategies for prevention and treatment of concerns (e.g., exercise) has real potential for reducing patient-borne costs.

Unusually cold and dry winters increase mortality in Australia

Seasonal patterns in mortality have been recognised for decades, with a marked excess of deaths in winter, yet our understanding of the causes of this phenomenon is not yet complete. Research has shown that low and high temperatures are associated with increased mortality independently of season; however, the impact of unseasonal weather on mortality has been less studied. In this study, we aimed to determine if unseasonal patterns in weather were associated with unseasonal patterns in mortality. We obtained daily temperature, humidity and mortality data from 1988 to 2009 for five major Australian cities with a range of climates. We split the seasonal patterns in temperature, humidity and mortality into their stationary and non-stationary parts. A stationary seasonal pattern is consistent from year-to-year, and a non-stationary pattern varies from year-to-year. We used Poisson regression to investigate associations between unseasonal weather and an unusual number of deaths. We found that deaths rates in Australia were 20–30% higher in winter than summer. The seasonal pattern of mortality was non-stationary, with much larger peaks in some winters. Winters that were colder or drier than a typical winter had significantly increased death risks in most cities. Conversely summers that were warmer or more humid than average showed no increase in death risks. Better understanding the occurrence and cause of seasonal variations in mortality will help with disease prevention and save lives.

Transit route occupancy load factor and passenger average travel time for quality of service assessment

This paper investigates quality of service (QoS) and resource productivity implications of transit route passenger loading and travel time. It highlights the value of occupancy load factor as a direct passenger comfort QoS measure. Automatic Fare Collection data for a premium radial bus route in Brisbane, Australia, is used to investigate time series correlation between occupancy load factor and passenger average travel time. Correlation is strong across the entire span of service in both directions. Passengers tend to be making longer, peak direction commuter trips under significantly less comfortable conditions than off-peak. The Transit Capacity and Quality of Service Manual uses segment based load factor as a measure of onboard loading comfort QoS. This paper provides additional insight into QoS by relating the two route based dimensions of occupancy load factor and passenger average travel time together in a two dimensional format, both from the passenger’s and operator’s perspectives. Future research will apply Value of Time to QoS measurement, reflecting perceived passenger comfort through crowding and average time spent onboard. This would also assist in transit service quality econometric modeling. The methodology can be readily applied in a practical setting where AFC data for fixed scheduled routes is available. The study outcomes also provide valuable research and development directions.

Transit route occupancy load factor and passenger average travel time for quality of service assessment

This presentation investigates quality of service (QoS) and resource productivity implications of transit route passenger loading and travel time. It highlights the value of occupancy load factor as a direct passenger comfort QoS measure. Automatic Fare Collection data for a premium radial bus route in Brisbane, Australia, is used to investigate time series correlation between occupancy load factor and passenger average travel time. Correlation is strong across the entire span of service in both directions. Passengers tend to be making longer, peak direction commuter trips under significantly less comfortable conditions than off-peak. The Transit Capacity and Quality of Service Manual uses segment based load factor as a measure of onboard loading comfort QoS. This paper provides additional insight into QoS by relating the two route based dimensions of occupancy load factor and passenger average travel time together in a two dimensional format, both from the passenger’s and operator’s perspectives. Future research will apply Value of Time to QoS measurement, reflecting perceived passenger comfort through crowding and average time spent onboard. This would also assist in transit service quality econometric modeling. The methodology can be readily applied in a practical setting where AFC data for fixed scheduled routes is available. The study outcomes also provide valuable research and development directions.

Effects of transit quality of service characteristics on daily bus ridership

This study explores how explicit transit quality of services (TQoS) measures including service frequency, service span, and travel time ratio, along with implicit environmental predictors such as topographic grade factor influence bus ridership using a case study city of Brisbane, Australia. The primary hypothesis tested was that bus ridership is higher within suburbs with high transit quality of service than suburbs that have limited service quality. Using Multiple Linear Regression (MLR) this study identifies a strong positive relationship between route intensity (bus-km/h-km2) and bus ridership, indicating that increasing both service frequency and spatial route density correspond to higher bus ridership. Additionally, travel time ratio (in-vehicle transit travel time to in-vehicle auto travel time) is also found to have significant negative association with ridership within a suburb, reflecting a decline in transit use with increased travel time ratio. Conversely, topographic grade and service span are not found to exert any significant impact on bus ridership in a suburb. Our study findings enhance the fundamental understanding of traveller behaviour which is informative to urban transportation policy, planning and provision.

Effects of transit quality of service characteristics on daily bus ridership

This study investigates whether an Australian city’s suburbs having high transit Quality of Service (QoS) are associated with higher transit ridership than those having low transit QoS •We explore how QoS measures including service frequency, service span, service coverage, and travel time ratio, along with implicit environmental predictors such as topographic grade factor influence bus ridership •We applied Multiple Linear Regression (MLR) to examine the relationship between QoS and ridership •Its outcomes enhance our understanding of transit user behavior, which is informative to urban transportation policy, planning, and provision

Stochastic analysis of transit route segments' passenger load variation for capacity and quality of service assessment

This paper investigates stochastic analysis of transit segment hourly passenger load factor variation for transit capacity and quality of service (QoS) analysis using Automatic Fare Collection data for a premium radial bus route in Brisbane, Australia. It compares stochastic analysis to traditional peak hour factor (PHF) analysis to gain further insight into variability of transit route segments’ passenger loading during a study hour. It demonstrates that hourly design load factor is a useful method of modeling a route segment’s capacity and QoS time history across the study weekday. This analysis method is readily adaptable to different passenger load standards by adjusting design percentile, reflecting either a more relaxed or more stringent condition. This paper also considers hourly coefficient of variation of load factor as a capacity and QoS assessment measure, in particular through its relationships with hourly average and design load factors. Smaller value reflects uniform passenger loading, which is generally indicative of well dispersed passenger boarding demands and good schedule maintenance. Conversely, higher value may be indicative of pulsed or uneven passenger boarding demands, poor schedule maintenance, and/or bus bunching. An assessment table based on hourly coefficient of variation of load factor is developed and applied to this case study. Inferences are drawn for a selection of study hours across the weekday studied.

A simulation model of the within-host dynamics of Plasmodium vivax infection

Background The benign reputation of Plasmodium vivax is at odds with the burden and severity of the disease. This reputation, combined with restricted in vitro techniques, has slowed efforts to gain an understanding of the parasite biology and interaction with its human host. Methods A simulation model of the within-host dynamics of P. vivax infection is described, incorporating distinctive characteristics of the parasite such as the preferential invasion of reticulocytes and hypnozoite production. The developed model is fitted using digitized time-series’ from historic neurosyphilis studies, and subsequently validated against summary statistics from a larger study of the same population. The Chesson relapse pattern was used to demonstrate the impact of released hypnozoites. Results The typical pattern for dynamics of the parasite population is a rapid exponential increase in the first 10 days, followed by a gradual decline. Gametocyte counts follow a similar trend, but are approximately two orders of magnitude lower. The model predicts that, on average, an infected naïve host in the absence of treatment becomes infectious 7.9 days post patency and is infectious for a mean of 34.4 days. In the absence of treatment, the effect of hypnozoite release was not apparent as newly released parasites were obscured by the existing infection. Conclusions The results from the model provides useful insights into the dynamics of P. vivax infection in human hosts, in particular the timing of host infectiousness and the role of the hypnozoite in perpetuating infection.

Bushfire responsive design : reconciling biodiversity conservation and bushfire safety with daily life

30 minute invited presentation on design-led bushfire risk mitigatition stategies for reconciling the two (otherwise) opposing managment goals of bushfire safety and biodiversity conservation. Targeted at the S E Queensland national audience participants.

Relationships between maternal overweight prior to pregnancy, feeding mode and infant feeding beliefs and practices

Aim To examine whether pre-pregnancy weight status was associated with maternal feeding beliefs and practices in the early post-partum period. Methods Secondary analysis of longitudinal data from Australian mothers. Participants (N=486) were divided into two weight status groups based on self-reported pre-pregnancy weight and measured height: healthy weight (BMI <25kg/m2; n=321) and overweight (BMI>25kg/m2; n=165). Feeding beliefs and practices were self-reported via an established questionnaire that assessed concerns about infant overeating and undereating, awareness of infant cues, feeding to a schedule, and using food to calm. Results Infants of overweight mothers were more likely to have been given solid foods in the previous 24hrs (29% vs 20%) and fewer were fully breastfed (50% vs 64%). Multivariable regression analyses (adjusted for maternal education, parity, average infant weekly weight gain, feeding mode and introduction of solids) revealed pre-pregnancy weight status was not associated with using food to calm, concern about undereating, awareness of infant cues or feeding to a schedule. However feeding mode was associated with feeding beliefs and practices. Conclusions Although no evidence for a relationship between maternal weight status and early maternal feeding beliefs and practices was observed, differences in feeding mode and early introduction of solids was observed. The emergence of a relationship between feeding practices and maternal weight status may occur when the children are older, solid feeding is established and they become more independent in feeding.

Knowledge gain or system benefit in environmental decision making?

The quality of environmental decisions are gauged according to the management objectives of a conservation project. Management objectives are generally about maximising some quantifiable measure of system benefit, for instance population growth rate. They can also be defined in terms of learning about the system in question, in such a case actions would be chosen that maximise knowledge gain, for instance in experimental management sites. Learning about a system can also take place when managing practically. The adaptive management framework (Walters 1986) formally acknowledges this fact by evaluating learning in terms of how it will improve management of the system and therefore future system benefit. This is taken into account when ranking actions using stochastic dynamic programming (SDP). However, the benefits of any management action lie on a spectrum from pure system benefit, when there is nothing to be learned about the system, to pure knowledge gain. The current adaptive management framework does not permit management objectives to evaluate actions over the full range of this spectrum. By evaluating knowledge gain in units distinct to future system benefit this whole spectrum of management objectives can be unlocked. This paper outlines six decision making policies that differ across the spectrum of pure system benefit through to pure learning. The extensions to adaptive management presented allow specification of the relative importance of learning compared to system benefit in management objectives. Such an extension means practitioners can be more specific in the construction of conservation project objectives and be able to create policies for experimental management sites in the same framework as practical management sites.

Classification of activities of daily living of individual with limb loss

The monitoring of the actual activities of daily living of individuals with lower limb amputation is essential for an evidence-based fitting of the prosthesis, more particularly the choice of components (e.g., knees, ankles, feet)[1-4]. The purpose of this presentation was to give an overview of the categorization of the load regime data to assess the functional output and usage of the prosthesis of lower limb amputees has presented in several publications[5, 6]. The objectives were to present a categorization of load regime and to report the results for a case.