Podiatry scope of practice: The role of gender in identification as a specialist

Background Ensuring efficient and effective delivery of health care to an aging population has been a major driver for a review of the health workforce in Australia. As part of this review a new National Registration and Accreditation Scheme (NRAS) has evolved with one goal being to improve workforce flexibility. With increased flexibility there have been discussions about the role specialist scopes of practice plays. This study explored the role of gender and other work related characteristics in relation to contemporary scope of podiatry practice and specialisation in Australia. Methods A cross sectional survey was administered through an on-line survey tool on behalf of the Australasian Podiatry Council. Descriptive data was collected over a three-week period. Queensland University of Technology Human Research Ethics approval was sought and confirmed exemption from review, exemption number 1400000791. Results Of the podiatrists participating in this survey (n=218), they were predominately female (66%), early career (34%, 0-9 years) and work in private practices (78%) in multi-podiatrists centres (41%). Relationship between clinical activities performed and “self-perception” of performing a “specialist role” was significant for practitioners who undertook treatment of specific patient groups. The largest area of interest was biomechanics (n=65), followed closely by diabetes (n=61), a third area identified was paediatrics (n=26). Self-perception of specialist status was compared with gender, years of experience, location, primary work environment and clinical practice. When practitioners are asked to categorise themselves to be either “generalist” or “specialist/ generalist with a special interest” podiatrist, male gender was identified as being the only factor which would predict perception of status; 64% males identified as specialist, as opposed to 49% of female survey respondents (Chi square, df = 1, P = 0.044). Self-perception of specialist status was not explained by years of experience, location, working in rural versus urban environment, state worked in, or part-time/full-time work status. Conclusions In conclusion; gender, work environment plus area of interest form a complex relationship, which appear to influence both perception and reality of service provision. Incorporation of specialisation activity (surgical podiatry along with endorsement for use of scheduled medicines) will have lasting impact on the scope of the podiatry profession in Australia. To meet community expectation and maintain high standards, the addition of new subspecialties may be indicated.

Total body potassium in cystic fibrosis

To further evaluate the nature of malnutrition, define at-risk groups, and confirm the efficacy of nutritional supplementation on body composition in cystic fibrosis (CF), we have conducted longitudinal and cross-sectional studies of total body potassium (TBK) in 161 unselected CF subjects aged 1 month to 17 years. TBK was determined by measurement of40K in a whole body counter, reflecting body cell mass (BCM), the vital work-performing and growing cellular component of the body. Compared with normal TBK data for age and sex from pooled measurements of 1,629 healthy children aged 1 week to 17 years, CF infants (n = 12) diagnosed by newborn screening were depleted in TBK at diagnosis and showed catch-up with therapy by 1 year; CF children aged 2-17 years (n = 140) showed a tendency for inadequate accretion of TBK (and thus BCM) with increasing age, although the normal correlation between TBK and weight and height was maintained in the majority suggesting a pattern of nutritional stunting of growth; and malnourished CF children (n = 9) showed significant catchup in TBK with long-term nutritional rehabilitation (85-98% of TBK predicted for weight and height). These studies suggest that potentially serious, but possibly correctable deficits, in the growth of the body cell mass as measured by TBK occur commonly in CF. These deficits may be established very early in life and if not corrected lead to progressive nutritional growth retardation with increasing age. © 1989 Raven Press, Ltd., New York.

A spatially explicit multi-competitor coexistence model of penaeid (shrimp) distribution on the Australian Great Barrier Reef

A spatially explicit multi-competitor coexistence model was developed for meta-populations of prawns (shrimp) occupying habitat patches across the Great Barrier Reef, where dispersal was localised and dispersal rates varied between species. Prawns were modelled as individuals moving to and from patches or cells according to pre-set decision rules. The landscape was simulated as a matrix of cells with each cell having a spatially explicit survival index for each species. Mixed species prawn assemblages moved over this simplified spatially explicit landscape. A low level of chronic random environmental disturbance was assumed (cyclone and tropical storm damage) with additional acute spatially confined disturbance due to commercial trawling, modelled as an increase in mortality affecting inter-specific competition. The general form of the results was for increased disturbance to favour good-colonising "generalist" species at the expense of good-competitor "specialists". Increasing fishing mortality (local patch extinctions) combined with poor colonising ability resulted in low equilibrium abundance for even the best competitor, while in the same circumstances the poorest competitor but best coloniser could have the highest equilibrium abundance. This mimics the switch from high-value prawn species to lower-value prawn species as trawl effort increases, reflected in historic catch and effort logbook data and reported anecdotaly from the north Queensland trawl fleet. To match the observed distribution and behaviour of prawn assemblages, a combination inter-species competition, a spatially explicit landscape, and a defined pattern of disturbance (trawling) was required. Modelling this combination could simulate not only general trends in spatial distribution of each of prawn species but also localised concentrations observed in the survey data

Recovery and succession in a multi-species tropical seagrass meadow following experimental disturbance: the role of sexual and asexual reproduction

Recolonisation and succession in a multi-species tropical seagrass meadow was examined by creating gaps (50×50 cm) in the meadow and manipulating the supply of sexual and asexual propagules. Measurements of leaf shoot density and estimates of above-ground biomass were conducted monthly to measure recovery of gaps between September 1995 and November 1997. Measurements of the seeds stored in the sediment (seed bank) and horizontal rhizome growth of colonising species were also conducted to determine their role in the recovery process. Asexual colonisation through horizontal rhizome growth from the surrounding meadow was the main mechanism for colonisation of gaps created in the meadow. The seed bank played no role in recolonisation of cleared plots. Total shoot density and above-ground biomass (all species pooled) of cleared plots recovered asexually to the level of the undisturbed controls in 10 and 7 months, respectively. There was some sexual recruitment into cleared plots where asexual colonisation was prevented but seagrass abundance (shoot density and biomass) did not reach the level of unmanipulated controls. Seagrass species did not appear to form seed banks despite some species being capable of producing long-lived seeds. The species composition of cleared plots remained different to the undisturbed controls throughout the 26-month experiment. Syringodium isoetifolium was a rapid asexual coloniser of disturbed plots and remained at higher abundances than in the control treatments for the duration of the study. S. isoetifolium had the fastest horizontal rhizome growth of species asexually colonising cleared plots (6.9 mm day−1). Halophila ovalis was the most successful sexual coloniser but was displaced by asexually colonising species. H. ovalis was the only species observed to produce fruits during the study. Small disturbances in the meadow led to long-term (>2 years) changes in community composition. This study demonstrated that succession in tropical seagrass communities was not a deterministic process. Variations in recovery observed for different tropical seagrass communities highlighted the importance of understanding life history characteristics of species within individual communities to effectively predict their response to disturbance. A reproductive strategy involving clonal growth and production of long-lived, locally dispersed seeds is suggested which may provide an evolutionary advantage to plants growing in tropical environments subject to temporally unpredictable major disturbances such as cyclones

Embedding EfS in teacher education through a multi-level systems approach: Lessons from Queensland

This paper reports on the fourth stage of an evolving study to develop a systems model for embedding education for sustainability (EfS) into pre-service teacher education. The fourth stage trialled the extension of the model to a comprehensive state-wide systems approach involving representatives from all eight Queensland teacher education institutions and other key policy agencies and professional associations. Support for trialling the model included regular meetings among the participating representatives and an implementation guide. This paper describes the first three stages of developing and trialling the model before presenting the case study and action research methods employed, four key lessons learned from the project, and the implications of the major outcomes for teacher education policies and practices. The Queensland-wide multi-site case study revealed processes and strategies that can enable institutional change agents to engage productively in building capacity for embedding EfS at the individual, institutional and state levels in pre-service teacher education. Collectively, the project components provide a system-wide framework that offers strategies, examples, insights and resources that can serve as a model for other states and/or territories wishing to implement EfS in a systematic and coherent fashion.

Luce Irigaray's Philosophy of Feminine Being : Body, Desire and Wisdom

Luce Irigaray is a Belgian-born philosopher, psychoanalyst and linguist. Irigaray s concept of woman is crucial for understanding her own work but also for examining and developing the theoretical and methodological basis of feminist theory. This thesis argues that, ultimately, Irigaray s exploration of woman s being challenges our traditional notion of philosophy as a neutral discourse and the traditional notion of ourselves as philosophizing persons or human beings. However, despite its crucial role, Irigaray s idea of woman still lacks a comprehensive explication. This is because the discourse of sexual difference is blurred by the ideas of essentialism and biologism. --- Irigaray s concept of woman has been interpreted and criticized from the perspectives of metaphysical essentialism, strategic essentialism, realist essentialism and deconstructionism. This thesis argues that a reinterpretation is necessary to account for Irigaray s claims about the the traditional woman , mimesis, the specificity of the feminine body, feminine expression and sexual difference. Moreover, any reading should account for the differences between women and avoid giving a prescriptive function to the essence of woman. --- My thesis develops a new interpretation of Irigaray s concept of woman on the basis of the phenomenology of the body. It argues that Irigaray s discourse on woman can and must be understood by an idea of existential style. Existential style is embodied, affective and spiritual and it is constituted in relation to oneself, to others and to the world. It is temporal, it evolves and changes but preserves its open unity in its transformations. Stylistic unities, such as femininity or philosophy, are constituted in and by the singulars. -- This study discusses and analyses feminine existential style as a central theme and topic of Irigaray s works and shows how her work operates as a primary and paradigmatic example of the feminine style. These tasks are performed by studying the mimetic positions available for women and by explicating the phenomenological background of Irigaray s conceptions of the philosophical method, and the lived, expressive and affective body. The critical occupation and transformation of these mimetic positions, the inquiry into the first-person pre-discursive experience, and the cultivation of feminine expressivity open up the possibility of becoming a woman writer, a woman lover and a woman philosopher. The appearance of these new feminine figures is a precondition for the realization of sexual difference. So Irigaray opens up the possibility of sexual difference by instituting and constituting a feminine subject of love and wisdom, and by problematizing the idea of a neutral and absolute subject.

Many-body effects in electrochemisorption : Part III. Beyond mean field and hartree-fock

Several channels provided by many-body couplings — both fermion-fermion and fermion-boson — for the evolution of the chemisorption system are discussed. This provides an opportunity of a systematic study of the effects of correlations reflected through the intricate pole structure of the absorbate Green functions. The results of Newns, Anda and others in the context of chemisorption are generalized.

A DC-link Capacitor Voltage Balancing with CMV Elimination using only the Switching State Redundancies for a Reduced Switch Count Multi-Level Inverter fed IM Drive

Common mode voltage (CMV) variations in PWM inverter-fed drives generate unwanted shaft and bearing current resulting in early motor failure. Multilevel inverters reduce this problem to some extent, with higher number of levels. But the complexity of the power circuit increases with an increase in the number of inverter voltage levels. In this paper a five-level inverter structure is proposed for open-end winding induction motor (IM) drives, by cascading only two conventional two-level and three-level inverters, with the elimination of the common mode voltage over the entire modulation range. The DC link power supply requirement is also optimized by means of DC link capacitor voltage balancing, with PWM control., using only inverter switching state redundancies. The proposed power circuit gives a simple power bits structure.

Tree species diversity and ecosystem function: Can tropical multi-species plantations generate greater productivity?

Results from the humid tropics of Australia demonstrate that diverse plantations can achieve greater productivity than monocultures. We found that increases in both the observed species number and the effective species richness were significantly related to increased levels of productivity as measured by stand basal area or mean individual tree basal area. Four of five plantation species were more productive in mixtures with other species than in monocultures, offering on average, a 55% increase in mean tree basal area. A general linear model suggests that species richness had a significant effect on mean individual tree basal area when environmental variables were included in the model. As monoculture plantations are currently the preferred reforestation method throughout the tropics these results suggest that significant productivity and ecological gains could be made if multi-species plantations are more broadly pursued.

The process for implementation of a Quality Management System within a multi-functional cereal laboratory

The intent of this study was to design, document and implement a Quality Management System (QMS) into a laboratory that incorporated both research and development (R&D) and routine analytical activities. In addition, it was necessary for the QMS to be easily and efficiently maintained to: (a) provide documented evidence that would validate the system's compliance with a certifiable standard, (b) fit the purpose of the laboratory, (c) accommodate prevailing government policies and standards, and (d) promote positive outcomes for the laboratory through documentation and verification of the procedures and methodologies implemented. Initially, a matrix was developed that documented the standards' requirements and the necessary steps to be made to meet those requirements. The matrix provided a check mechanism on the progression of the system's development. In addition, it was later utilised in the Quality Manual as a reference tool for the location of full procedures documented elsewhere in the system. The necessary documentation to build and monitor the system consisted of a series of manuals along with forms that provided auditable evidence of the workings of the QMS. Quality Management (QM), in one form or another, has been in existence since the early 1900's. However, the question still remains: is it a good thing or just a bugbear? Many of the older style systems failed because they were designed by non-users, fiercely regulatory, restrictive and generally deemed to be an imposition. It is now considered important to foster a sense of ownership of the system by the people who use the system. The system's design must be tailored to best fit the purpose of the operations of the facility if maximum benefits to the organisation are to be gained.

Effects of particle size distribution in the response of model granular materials in multi-ring shear

Rail track undergoes complex loading patterns under moving traffic conditions compared to roads due to its continued and discontinued multi-layered structure, including rail, sleepers, ballast layer, sub-ballast layer, and subgrade. Particle size distributions (PSDs) of ballast, subballast, and subgrade layers can be critical in cyclic plastic deformation of rail track under moving traffic on frequent track degradation of rail tracks, especially at bridge transition zones. Conventional test approaches: static shear and cyclic single-point load tests are however unable to replicate actual loading patterns of moving train. Multi-ring shear apparatus; a new type of torsional simple shear apparatus, which can reproduce moving traffic conditions, was used in this study to investigate influence of particle size distribution of rail track layers on cyclic plastic deformation. Three particle size distributions, using glass beads were examined under different loading patterns: cyclic sin-gle-point load, and cyclic moving wheel load to evaluate cyclic plastic deformation of rail track under different loading methods. The results of these tests suggest that particle size distributions of rail track structural layers have significant impacts on cyclic plastic deformation under moving train load. Further, the limitations in con-ventional test methods used in laboratories to estimate the plastic deformation of rail track materials lead to underestimate the plastic deformation of rail tracks.

Pole placement in multi-input systems via elementary transformations

This paper is concerned with the development of an algorithm for pole placement in multi-input dynamic systems. The algorithm which uses a series of elementary transformations is believed to be simpler, computationally more efficient and numerically stable when compared with earlier methods. In this paper two methods have been presented.

Investigation of Missile-Shaped Body with Forward-Facing Cavity at Mach 8

A blunt-nosed hypersonic missile mounted with a forward-facing cavity is a good alternative to reduce the stagnation heating rates. The effects of a forward-racing cavity on heat transfer and aerodynamic coefficients are addressed in this paper. Tests were carried out in hypersonic shock tunnel HST2, at a hypersonic Mach number of 8 using a 41 deg apex-angle blunt cone. The aerodynamic forces on the test model with and without a forward-facing cavity at various angles of attack are measured by using an internally mountable accelerometer force balance system. Heat flux measurements have been carried out on the test model with and without a forward-facing cavity of the entire surface at zero degree angle of attack with platinum sensors. A numerical simulation was also carried out using the computational fluid dynamics code (CFX-Ansys 5.7). An important result of this study is that the smaller cavity diameter has the highest lift-to-drag ratio, whereas the medium cavity has the highest heat flux reduction. Theshock structure around the test model has also been visualized using the Schlieren flow visualization technique. The visualized shock structure and the measured aerodynamic forces on the missile-shaped body with cavity configurations agree well with the axisymmetric numerical simulations.

A dosimetric retrospective planning study comparing volumetric arc therapy (VMAT) and stereotactic body radiotherapy (SBRT) treatment plans for non-small cell lung cancer (NSCLC)

Purpose A retrospective planning study comparing volumetric arc therapy (VMAT) and stereotactic body radiotherapy (SBRT) treatment plans for non-small cell lung cancer (NSCLC). Methods and materials Five randomly selected early stage lung cancer patients were included in the study. For each patient, four plans were created: the SBRT plan and three VMAT plans using different optimisation methodologies. A total of 20 different plans were evaluated. The dose parameters of dose conformity results and the target dose constraints results were compared for these plans. Results The mean planning target volume (PTV) for all the plans (SBRT and VMAT) was 18·3 cm3, with a range from 15·6 to 20·1 cm3. The maximum dose tolerance to 1 cc of all the plans was within 140% (84 Gy) of the prescribed dose, and 95% of the PTV of all the plans received 100% of the prescribed dose (60 Gy). In all the plans, 99% of the PTV received a dose >90% of the prescribed dose, and the mean dose in all the plans ranged from 67 to 72 Gy. The planning target dose conformity for the SBRT and the VMAT (0°, 15° collimator single arc plans and dual arc) plans showed the tightness of the prescription isodose conformity to the target. Conclusions SBRT and VMAT are radiotherapy approaches that increase doses to small tumour targets without increasing doses to the organs at risk. Although VMAT offers an alternative to SBRT for NSCLC and the potential advantage of VMAT is the reduced treatment times over SBRT, the statistical results show that there was no significant difference between the SBRT and VMAT optimised plans in terms of dose conformity and organ-at-risk sparing.

Multi Pattern Dynamic Time Warping For Automatic Speech Recognition

We are addressing the problem of jointly using multiple noisy speech patterns for automatic speech recognition (ASR), given that they come from the same class. If the user utters a word K times, the ASR system should try to use the information content in all the K patterns of the word simultaneously and improve its speech recognition accuracy compared to that of the single pattern based speech recognition. T address this problem, recently we proposed a Multi Pattern Dynamic Time Warping (MPDTW) algorithm to align the K patterns by finding the least distortion path between them. A Constrained Multi Pattern Viterbi algorithm was used on this aligned path for isolated word recognition (IWR). In this paper, we explore the possibility of using only the MPDTW algorithm for IWR. We also study the properties of the MPDTW algorithm. We show that using only 2 noisy test patterns (10 percent burst noise at -5 dB SNR) reduces the noisy speech recognition error rate by 37.66 percent when compared to the single pattern recognition using the Dynamic Time Warping algorithm.