Clients’ understanding of the role of nurse practitioners

Introduction: Nurse Practitioners (NPs) have an emerging role in the Australian healthcare system. However, there remains a dearth of available data about public understanding of the NP role. ---------- Aim: To evaluate clients’ understanding of the role of the NP and their satisfaction with education received, quality of care and NP knowledge and skill. ---------- Method: All authorised NPs working in a designated NP position in Western Australia and those working in three area health services in New South Wales (NSW) were invited to recruit five consecutive clients to complete the self-administered survey. ---------- Results: Thirty two NPs (NP response rate 93%) recruited 129 clients (client response rate 90%). Two thirds of clients (63%) were aware they were consulting an NP. The majority rated the following NP related outcomes as ‘excellent’ or ‘very good’: education provided (89%); quality of care (95%); and knowledge and skill (93%). Less than half reported an understanding that NPs could prescribe medications (40.5%) or interpret X-rays (33.6%). Clients of NPs practising in a rural or remote setting were more likely than those in an urban setting to have previously consulted an NP (p=0.005), and where applicable would to prefer to see a NP rather than a doctor (p=0.022). ---------- Discussion: Successful implementation and expansion of the NP role requires NP visibility in the community. Despite high levels of satisfaction more awareness of the scope of the NP role is required.

Ladies on the loose : contemporary female travel as a 'promiscuous' excursion

This paper maps gendered trouble spots in contemporary works of female travel. Since travel itself is a metaphor for the slippage or displacement of cultural knowledge, there is need for closer and more complex readings of the female practice. This paper locates the contemporary female traveller on ground and on page, and flags some of the cultural myths and misconceptions that affect how she moves through the world. When women travel, they inscribe themselves across landscapes that have been previously overlooked, openly discarded and largely unexamined. In doing so, they travel intricate courses due to historical connections between wandering and promiscuity and continuing confusions between issues of mobility and morality in the modern world. Taking gender then as its interpretative parameter, this paper explores the troublesome nature of women’s travel, citing various texts as examples.

Eat, pray, loathe : women’s travel memoir as moving metaphysical journey or narcissistic new-age babble?

This paper considers the contentious space between self-affirmation and selfpreoccupation in Elizabeth Gilbert’s popular travel memoir, Eat, Pray, Love. Following the surveillance of the female confessant, the female traveller has recently come under close scrutiny and public suspicion. She is accused of walking a fine line between critical self-insight and obsessive selfimportance and her travel narratives are branded as accounts of navel gazing that are less concerned with what is seen than with who is doing the seeing. In reading these themes against the backdrop of women’s travel, the possibility arises that the culture of narcissism is increasingly read as a female discursive practice, concerned with authorship, privacy and the subjectivity of truth. The novel, which has been praised by some as ‘the ultimate guide to balanced living’ and dismissed by others as ‘self-serving junk’, poses questions about the requisites in Western culture for being a female traveller and for telling a story that focuses primarily on the self.

The waddlia genome: A window into chlamydial biology

Growing evidence suggests that a novel member of the Chlamydiales order, Waddlia chondrophila, is a potential agent of miscarriage in humans and abortion in ruminants. Due to the lack of genetic tools to manipulate chlamydia, genomic analysis is proving to be the most incisive tool in stimulating investigations into the biology of these obligate intracellular bacteria. 454/Roche and Solexa/Illumina technologies were thus used to sequence and assemble de novo the full genome of the first representative of the Waddliaceae family, W. chondrophila. The bacteria possesses a 2′116′312bp chromosome and a 15′593 bp low-copy number plasmid that might integrate into the bacterial chromosome. The Waddlia genome displays numerous repeated sequences indicating different genome dynamics from classical chlamydia which almost completely lack repetitive elements. Moreover, W. chondrophila exhibits many virulence factors also present in classical chlamydia, including a functional type III secretion system, but also a large complement of specific factors for resistance to host or environmental stresses. Large families of outer membrane proteins were identified indicating that these highly immunogenic proteins are not Chlamydiaceae specific and might have been present in their last common ancestor. Enhanced metabolic capability for the synthesis of nucleotides, amino acids, lipids and other co-factors suggests that the common ancestor of the modern Chlamydiales may have been less dependent on their eukaryotic host. The fine-detailed analysis of biosynthetic pathways brings us closer to possibly developing a synthetic medium to grow W. chondrophila, a critical step in the development of genetic tools. As a whole, the availability of the W. chondrophila genome opens new possibilities in Chlamydiales research, providing new insights into the evolution of members of the order Chlamydiales and the biology of the Waddliaceae.

Osteopontin is a downstream effector of the PI3-kinase pathway in melanomas that is inversely correlated with functional PTEN

The tumor suppressor PTEN antagonizes phosphatidylinositol 3-kinase (PI3K), which contributes to tumorigenesis in many cancer types. While PTEN mutations occur in some melanomas, their precise mechanistic consequences have yet to be elucidated. We sought to identify novel downstream effectors of PI3K using a combination of genomic and functional tests. Microarray analysis of 53 melanoma cell lines identified 610 genes differentially expressed (P<0.05) between wild-type lines and those with PTEN aberrations. Many of these genes are known to be involved in the PI3K pathway and other signaling pathways influenced by PTEN. Validation of differential gene expression by qRT-PCR was performed in the original 53 cell lines and an independent set of 18 melanoma lines with known PTEN status. Osteopontin (OPN), a secreted glycophosphoprotein that contributes to tumor progression, was more abundant at both the mRNA and protein level in PTEN mutants. The inverse correlation between OPN and PTEN expression was validated (P<0.02) by immunohistochemistry using melanoma tissue microarrays. Finally, treatment of cell lines with the PI3K inhibitor LY294002 caused a reduction in expression of OPN. These data indicate that OPN acts downstream of PI3K in melanoma and provides insight into how PTEN loss contributes to melanoma development.

Hydrogen-bonding in the structures of the hydrated proton-transfer compounds of isonipecotamide with the isomeric indole-2 and indole-3-carboxylic acids

The structures of two hydrated proton-transfer compounds of 4-piperidinecarboxamide (isonipecotamide) with the isomeric heteroaromatic carboxylic acids indole-2-carboxylic acid and indole-3-carboxylic acid, namely 4-carbamoylpiperidinium indole-2-carboxylate dihydrate (1) and 4-carbamoylpiperidinium indole-3-carboxylate hemihydrate (2) have been determined at 200 K. Crystals of both 1 and 2 are monoclinic, space groups P21/c and P2/c respectively with Z = 4 in cells having dimensions a = 10.6811(4), b = 12.2017(4), c = 12.5456(5) Å, β = 96.000(4)o (1) and a = 15.5140(4), b = 10.2908(3), c = 9.7047(3) Å, β = 97.060(3)o (2). Hydrogen-bonding in 1 involves a primary cyclic interaction involving complementary cation amide N-H…O(carboxyl) anion and anion hetero N-H…O(amide) cation hydrogen bonds [graph set R22(9)]. Secondary associations involving also the water molecules of solvation give a two-dimensional network structure which includes weak water O-H…π interactions. In the three-dimensional hydrogen-bonded structure of 2, there are classic centrosymmetric cyclic head-to-head hydrogen-bonded amide-amide interactions [graph set R22(8)] as well as lateral cyclic amide-O linked amide-amide extensions [graph set R24(8)]. The anions and the water molecule, which lies on a twofold rotation axis, are involved in secondary extensions.

Reorienting diaspora : China and India as franchise nations

In this paper, I outline a new approach towards media and diaspora using the concept of the ‘franchise nation’. It is my contention that current theories on migration, media and diaspora with their emphasis on exile, multiple belongings, hybrid identities and their representations are inadequate to the task of explaining the emergence of a new trend in diaspora, home and host nation relationship. This, I suggest, is a recent shift most notable in the attitudes of the Chinese and Indian governments toward their diasporas. From earlier eras where Chinese sojourners were regarded as disloyal and Indians overseas left to fend for themselves, Chinese and Indian migrants are today directly addressed and wooed by their nations of origin. This change is motivated in part by the realisation that diasporic populations are, in fact, resources that can bring significant influence to bear on home nation interests within host nations. Such sway in foreign lands gains greater importance as China and India are, by virtue of their economic rise and prominence on the world stage, subject to ever more intense international scrutiny. Members of these diasporas have willingly responded to these changes by claiming and cultivating pivotal roles for themselves within host nations as spokespersons, informants and representatives, trading on their assumed familiarity with home cultures, language and commerce. As a result, China and India have initiated a number of statecraft strategies in recent years to (re)engage their diasporas. Both nations have identified media as amongst the key instruments of their strategies. New media enhances the ability of all parties—home and host states, institutions and individuals—to participate, interact and reciprocate. While China’s centralised government has utilised the notion of soft power (ruan shili) to describe its practices, India’s efforts are diffused along the lines of nation branding via myriad labels like India Inc. and the Global Indian. To explain this emergent trend, I propose a new framework, franchise nation, defined as a reciprocal relationship between nation and diaspora that is characterised by mutual obligations and benefits. In appropriating this phrase from Stephenson, I liken contemporary statecraft operating in China and India to a business franchising system wherein benefits may be economic or cultural and; those thus connected signal their willingness for mutual exchange and concede a sense of obligation. As such, franchise nation is not concerned with remote, unidirectional interference in home nation affairs a la Anderson’s ‘long-distance nationalism’. Rather, it is a framework that seeks to reflect more closely the dynamism of the relationship between diaspora, home and host nations.

Thomas Young’s investigations in gradient-index optics

Purpose: James Clerk Maxwell is usually recognized as being the first, in 1854, to consider using inhomogeneous media in optical systems. However, some fifty years earlier Thomas Young, stimulated by his interest in the optics of the eye and accommodation, had already modeled some applications of gradient-index optics. These applications included using an axial gradient to provide spherical aberration-free optics and a spherical gradient to describe the optics of the atmosphere and the eye lens. We evaluated Young’s contributions. Method: We attempted to derive Young’s equations for axial and spherical refractive index gradients. Raytracing was used to confirm accuracy of formula. Results: We did not confirm Young’s equation for the axial gradient to provide aberration-free optics, but derived a slightly different equation. We confirmed the correctness of his equations for deviation of rays in a spherical gradient index and for the focal length of a lens with a nucleus of fixed index surrounded by a cortex of reducing index towards the edge. Young claimed that the equation for focal length applied to a lens with part of the constant index nucleus of the sphere removed, such that the loss of focal length was a quarter of the thickness removed, but this is not strictly correct. Conclusion: Young’s theoretical work in gradient-index optics received no acknowledgement from either his contemporaries or later authors. While his model of the eye lens is not an accurate physiological description of the human lens, with the index reducing least quickly at the edge, it represented a bold attempt to approximate the characteristics of the lens. Thomas Young’s work deserves wider recognition.

Re-constructing Asianness in Australia : Yumi Umiumare, Owen Leong, and the remobilisation of monstrosity

In the late twentieth and early twenty-first centuries, Australia’s relationship with its Asian neighbours has been the subject of ongoing aesthetic, cultural and political contestations. As Alison Richards has noted, Australia’s colonial legacy, its Asia-Pacific location, and its ‘white’ self-perception have always made Australia’s relations with Asia fraught. In the latter part of the twentieth century, the paradoxes inherent in Australia’s relationships with and within the Asian region became a dominant theme in debates about nation, nationhood and identity, and prompted a shift in the construction of ‘Asianness’ on Australian stages. On the one hand, anxiety about the multicultural policy of the 1970s and 1980s, and then Prime Minister Paul Keating’s push for greater economic, cultural and artistic exchange with Asia via policies such as the Creative Nation Cultural Policy (1994), saw large numbers of Australians latch on to the reactionary, racist politics of Pauline Hanson’s One Nation Party. As Jacqueline Lo has argued, in this period Asian-Australians were frequently represented as an unassimilable Other, a threat to Australia’s ‘white’ identity, and to individual Australians’ jobs and opportunities. On the other hand, during the same period, a desire to counter the racism in Australian culture, and develop a ‘voice’ that would distinguish Australian cultural products from European theatrical traditions, combined with the new opportunities for cross-cultural exchange that came with the Creative Nation Cultural Policy to produce what Helen Gilbert and Jacqueline Lo have characterised as an Asian turn in Australian theatre...

The evolutionary history of cockatoos (Aves: Psittaciformes: Cacatuidae)

Cockatoos are the distinctive family Cacatuidae, a major lineage of the order of parrots (Psittaciformes) and distributed throughout the Australasian region of the world. However, the evolutionary history of cockatoos is not well understood. We investigated the phylogeny of cockatoos based on three mitochondrial and three nuclear DNA genes obtained from 16 of 21 species of Cacatuidae. In addition, five novel mitochondrial genomes were used to estimate time of divergence and our estimates indicate Cacatuidae diverged from Psittacidae approximately 40.7 million years ago (95% CI 51.6–30.3 Ma) during the Eocene. Our data shows Cacatuidae began to diversify approximately 27.9 Ma (95% CI 38.1–18.3 Ma) during the Oligocene. The early to middle Miocene (20–10 Ma) was a significant period in the evolution of modern Australian environments and vegetation, in which a transformation from mainly mesic to xeric habitats (e.g., fire-adapted sclerophyll vegetation and grasslands) occurred. We hypothesize that this environmental transformation was a driving force behind the diversification of cockatoos. A detailed multi-locus molecular phylogeny enabled us to resolve the phylogenetic placements of the Palm Cockatoo (Probosciger aterrimus), Galah (Eolophus roseicapillus), Gang-gang Cockatoo (Callocephalon fimbriatum) and Cockatiel (Nymphicus hollandicus), which have historically been difficult to place within Cacatuidae. When the molecular evidence is analysed in concert with morphology, it is clear that many of the cockatoo species’ diagnostic phenotypic traits such as plumage colour, body size, wing shape and bill morphology have evolved in parallel or convergently across lineages.

Direct evaluation of IEC 61850-9-2 process bus network performance

This letter presents a technique to assess the overall network performance of sampled value process buses based on IEC 61850-9-2 using measurements from a single location in the network. The method is based upon the use of Ethernet cards with externally synchronized time stamping, and characteristics of the process bus protocol. The application and utility of the method is demonstrated by measuring latency introduced by Ethernet switches. Network latency can be measured from a single set of captures, rather than comparing source and destination captures. Absolute latency measures will greatly assist the design testing, commissioning and maintenance of these critical data networks.