The promise of Iceland

Memoir, 288 pages. An account of journeys made by the author from Australia to Iceland as a way of interrogating notions of cultural belonging, family, and homecoming. "In 1990, Kári Gíslason travelled to Iceland to meet his father for the first time. What he finds is not what he expected. Born from a secret liaison between a British mother and an Icelandic father, Kári Gíslason was the subject of a promise – a promise elicited from his father to not reveal his identity. The Icelandic city of Reykjavík, where Kári was born, was also home to his father and his father’s wife and five children – none of whom knew of Kári’s existence. Moving regularly between Iceland and Australia, he grew up aware of his father’s identity, but understanding that it was the subject of a secret pact between his parents. At the age of 27, he makes a decision to break the pact and contacts his father’s other family. What follows, and what leads him there, makes for a riveting journey over landscapes, time and memory. Kári travels from the freezing cold winters of Iceland to the shark net at Sydney’s Balmoral, an unsettled life in the English countryside and the harsh yellow summer of Brisbane, and back again. He traces the steps of his mother who answered an ad in The Times for an English-speaking secretary in 1970 and found herself in Iceland among the ‘Army of Foreign Secretaries’, and in the arms of a secret lover. Iceland becomes the substitute for the father Kári never really knew as he discovers the meaning of ‘home’ and closes the circle of his own fatherless life."-- publisher website

Asylum seekers living in the community on Bridging Visa E : community sector’s response to detrimental policies

In 1997, the Australian government introduced regulations restricting work rights, income and Medicare access to asylum seekers living in the community on Bridging Visa E (BVE). These visa conditions have resulted in unacceptable hardship for asylum seekers. In response, a variety of community-based agencies have been established across Australia. This study documents and collates the experiences of some of these agencies working in Victoria. These organizations maintain a high degree of inter-agency communication and liaison, have an extensive community support network by way of volunteer work and financial assistance from philanthropic organizations and the public, and have developed successful alternative models of care for asylum seekers. However, many of the agencies have been unprepared and under-resourced for the specific legal, cultural, and health concerns common to asylum seekers on BVE. A discussion of the issues faced by the community sector in the current asylum seeker/refugee political context is presented

Research data finder : an institutional metadata repository

QUT’s new metadata repository (data registry), Research Data Finder, has been designed to promote the visibility and discoverability of QUT research datasets. Funded by the Australian National Data Service (ANDS), it will provide a qualitative snapshot of research data outputs created or collected by members of the QUT research community that are available via open or mediated access. As a fully integrated metadata repository Research Data Finder aligns with institutional sources of truth, such as QUT’s research administrative system, ResearchMaster, as well as QUT’s Academic Profiles system to provide high quality data descriptions that increase awareness of, and access to, shareable research data. In addition, the repository and its workflows are designed to foster smoother data management practices, enhance opportunities for collaboration and research, promote cross-disciplinary research and maximize existing research datasets. The metadata schema used in Research Data Finder is the Registry Interchange Format - Collections and Services (RIF-CS), developed by ANDS in 2009. This comprehensive schema is potentially complex for researchers; unlike metadata for publications, which are often made publicly available with the official publication, metadata for datasets are not typically available and need to be created. Research Data Finder uses a hybrid self-deposit and mediated deposit system. In addition to automated ingests from ResearchMaster (research project information) and Academic Profiles system (researcher information), shareable data is identified at a number of key “trigger points” in the research cycle. These include: research grant proposals; ethics applications; Data Management Plans; Liaison Librarian data interviews; and thesis submissions. These ingested records can be supplemented with related metadata including links to related publications, such as those in QUT ePrints. Records deposited in Research Data Finder are harvested by ANDS and made available to a national and international audience via Research Data Australia, ANDS’ discovery service for Australian research data. Researcher and research group metadata records are also harvested by the National Library of Australia (NLA) and these records are then published in Trove (the NLA’s digital information portal). By contributing records to the national infrastructure, QUT data will become more visible. Within Australia and internationally, many funding bodies have already mandated the open access of publications produced from publicly funded research projects, such as those supported by the Australian Research Council (ARC), or the National Health and Medical Research Council (NHMRC). QUT will be well placed to respond to the rapidly evolving climate of research data management. This project is supported by the Australian National Data Service (ANDS). ANDS is supported by the Australian Government through the National Collaborative Research Infrastructure Strategy Program and the Education Investment Fund (EIF) Super Science Initiative.

Predicting vitamin D deficiency in older Australian adults

OBJECTIVE There has been a dramatic increase in vitamin D testing in Australia in recent years, prompting calls for targeted testing. We sought to develop a model to identify people most at risk of vitamin D deficiency. DESIGN AND PARTICIPANTS This is a cross-sectional study of 644 60- to 84-year-old participants, 95% of whom were Caucasian, who took part in a pilot randomized controlled trial of vitamin D supplementation. MEASUREMENTS Baseline 25(OH)D was measured using the Diasorin Liaison platform. Vitamin D insufficiency and deficiency were defined using 50 and 25 nmol/l as cut-points, respectively. A questionnaire was used to obtain information on demographic characteristics and lifestyle factors. We used multivariate logistic regression to predict low vitamin D and calculated the net benefit of using the model compared with 'test-all' and 'test-none' strategies. RESULTS The mean serum 25(OH)D was 42 (SD 14) nmol/1. Seventy-five per cent of participants were vitamin D insufficient and 10% deficient. Serum 25(OH)D was positively correlated with time outdoors, physical activity, vitamin D intake and ambient UVR, and inversely correlated with age, BMI and poor self-reported health status. These predictors explained approximately 21% of the variance in serum 25(OH)D. The area under the ROC curve predicting vitamin D deficiency was 0·82. Net benefit for the prediction model was higher than that for the 'test-all' strategy at all probability thresholds and higher than the 'test-none' strategy for probabilities up to 60%. CONCLUSION Our model could predict vitamin D deficiency with reasonable accuracy, but it needs to be validated in other populations before being implemented.

The great divide : bridging the gap

Learning Objective: To describe a collaborative system of clinical allocations using a dedicated, discipline specific administrative coordinator. Methods: The Clinical Placement Coordinator is the liaison person between the student, the academic staff and the clinical sites, and fills an important role in bridging the gap to enhance the student learning experience. With this in mind the Coordinator is very discipline focused and works closely with the academic staff who coordinate the clinical units within the program. This person is the ‘‘face’’ of QUT to the external stakeholders, and ensures that all parties experience a smooth process. This no mean feat given that there are over 350 students to be placed annually, across 14 separate clinical blocks ranging from 1 to 6 weeks in length at various sites. The processes involved in clinical placement allocation will be presented, and the roles of the staff in facilitating students’ placement preferences and matching with clinical site offers will be described. In many allied health programs in Australia, the clinical placement activity is carried out by an academic member of staff. However, this can result in delays in communications due to other workload requirements such as lecture, tutorial and practical class commitments. Having a dedicated knowledgeable administration officer has resulted in a person being available to take calls from clinical staff, meet with students to discuss allocation needs and ensure that academic staff are consulted if and when necessary. The Clinical Placement Coordinator is very much a part of the course team and attends professional meetings and conferences as an avenue of networking and meeting clinical staff. Results: The success in having a dedicated administrative officer as the Clinical Placement Coordinator acting as the conduit between academic staff and students, and the university and clinical staff has been highly successful to date. This was noted in commendations from the 2010 Course Accreditation Panel Report which stated: ‘‘The very positive perception in the professional community of Ms Margaret McBurney’s effective and efficient organization of student clinical placements. Students and clinical professionals commented favourably on the approachability of staff. There is confidence that program staff will follow up on issues raised urgently in clinical centres.’’

Principal component and linkage analysis of cardiovascular risk traits in the Norfolk isolate

OBJECTIVE(S): An individual's risk of developing cardiovascular disease (CVD) is influenced by genetic factors. This study focussed on mapping genetic loci for CVD-risk traits in a unique population isolate derived from Norfolk Island. METHODS: This investigation focussed on 377 individuals descended from the population founders. Principal component analysis was used to extract orthogonal components from 11 cardiovascular risk traits. Multipoint variance component methods were used to assess genome-wide linkage using SOLAR to the derived factors. A total of 285 of the 377 related individuals were informative for linkage analysis. RESULTS: A total of 4 principal components accounting for 83% of the total variance were derived. Principal component 1 was loaded with body size indicators; principal component 2 with body size, cholesterol and triglyceride levels; principal component 3 with the blood pressures; and principal component 4 with LDL-cholesterol and total cholesterol levels. Suggestive evidence of linkage for principal component 2 (h(2) = 0.35) was observed on chromosome 5q35 (LOD = 1.85; p = 0.0008). While peak regions on chromosome 10p11.2 (LOD = 1.27; p = 0.005) and 12q13 (LOD = 1.63; p = 0.003) were observed to segregate with principal components 1 (h(2) = 0.33) and 4 (h(2) = 0.42), respectively. CONCLUSION(S): This study investigated a number of CVD risk traits in a unique isolated population. Findings support the clustering of CVD risk traits and provide interesting evidence of a region on chromosome 5q35 segregating with weight, waist circumference, HDL-c and total triglyceride levels.

A genome-wide scan provides evidence for loci influencing a severe heritable form of common migraine

Migraine is a prevalent neurovascular disease with a significant genetic component. Linkage studies have so far identified migraine susceptibility loci on chromosomes 1, 4, 6, 11, 14, 19 and X. We performed a genome-wide scan of 92 Australian pedigrees phenotyped for migraine with and without aura and for a more heritable form of “severe” migraine. Multipoint non-parametric linkage analysis revealed suggestive linkage on chromosome 18p11 for the severe migraine phenotype (LOD*=2.32, P=0.0006) and chromosome 3q (LOD*=2.28, P=0.0006). Excess allele sharing was also observed at multiple different chromosomal regions, some of which overlap with, or are directly adjacent to, previously implicated migraine susceptibility regions. We have provided evidence for two loci involved in severe migraine susceptibility and conclude that dissection of the “migraine” phenotype may be helpful for identifying susceptibility genes that influence the more heritable clinical (symptom) profiles in affected pedigrees. Also, we concluded that the genetic aetiology of the common (International Headache Society) forms of the disease is probably comprised of a number of low to moderate effect susceptibility genes, perhaps acting synergistically, and this effect is not easily detected by traditional single-locus linkage analyses of large samples of affected pedigrees.

A typical migraine susceptibility region localizes to chromosome 1q31

Migraine (with and without aura) is a prevalent neurovascular disease that shows strong familial aggregation, although the number of genes involved and the mode of inheritance is not clear. Some insight into the disease has been gained from genetic studies into a rare and very severe migraine subtype known as familial hemiplegic migraine (FHM). In this study, we took a family-based linkage and association approach to investigate the FHM susceptibility region on chromosome 1q31 for involvement in typical migraine susceptibility in affected Australian pedigrees. Initial multipoint ALLEGRO analysis provided strong evidence for linkage of Chrlq31 markers to typical migraine in a large multigenerational pedigree. The 1-LOD* unit support interval for suggestive linkage spanned approximately 18 cM with a maximum allele sharing LOD* score of 3.36 obtained for marker D1S2782 (P=0.00004). Subsequent analysis of an independent sample of 82 affected pedigrees added support to the initial findings with a maximum LOD* of 1.24 (P=0.008). Utilising the independent sample of 82 pedigrees, we also performed a family-based association test. Results of this analysis indicated distortion of allele transmission at marker D1S249 [global chi2 (5) of 15.00, P=0.010] in these pedigrees. These positive linkage and association results will need further confirmation by independent researchers. However, overall they provide good evidence for the existence of a typical migraine locus near these markers on Chrlq3l, and reinforce the idea that an FHM gene in this genomic region may also contribute to susceptibility to the more common forms of migraine.

Scanning the genome for essential hypertension loci

1. Essential hypertension occurs in people with an underlying genetic predisposition who subject themselves to adverse environmental influences. The number of genes involved is unknown, as is the extent to which each contributes to final blood pressure and the severity of the disease. 2. In the past, studies of potential candidate genes have been performed by association (case-control) analysis of unrelated individuals or linkage (pedigree or sibpair) analysis of families. These studies have resulted in several positive findings but, as one may expect, also an enormous number of negative results. 3. In order to uncover the major genetic loci for essential hypertension, it is proposed that scanning the genome systematically in 100- 200 affected sibships should prove successful. 4. This involves genotyping sets of hypertensive sibships to determine their complement of several hundred microsatellite polymorphisms. Those that are highly informative, by having a high heterozygosity, are most suitable. Also, the markers need to be spaced sufficiently evenly across the genome so as to ensure adequate coverage. 5. Tests are performed to determine increased segregation of alleles of each marker with hypertension. The analytical tools involve specialized statistical programs that can detect such differences. Non- parametric multipoint analysis is an appropriate approach. 6. In this way, loci for essential hypertension are beginning to emerge.

Familial typical migraine: Linkage to chromosome 19p13 and evidence for genetic heterogeneity

Migraine is a frequent familial disorder that, in common with most multifactorial disorders, has an unknown etiology. The authors identified several families with multiple individuals affected by typical migraine using a single set of diagnostic criteria and studied these families for cosegregation between the disorder and markers on chromosome 19, the location of a mutation that causes a rare form of familial hemiplegic migraine (FHM). One large tested family showed both cosegregation and significant allele sharing for markers situated within or adjacent to the FHM locus. Multipoint GENEHUNTER results indicated significant excess allele sharing across a 12.6- cM region containing the FHM Ca2+ channel gene, CACNL1A4 (maximum nonparametric linkage Z score = 6.64, p = 0.0026), with a maximum parametric lod score of 1.92 obtained for a (CAG)(n) triplet repeat polymorphism situated in exon 47 of this gene. The CAG expansion did not, however, appear to be the cause of migraine in this pedigree. Other tested families showed neither cosegregation nor excess allele sharing to chromosome 19 markers. HOMOG analysis indicated heterogeneity, generating a maximum HLOD score of 3.6. It was concluded that Chr19 mutations either in the CACNL1A4 gene or a closely linked gene are implicated in some pedigrees with familial typical migraine, and that the disorder is genetically heterogeneous.

The interface of acute and aged care : the role of the nurse in a provincial area

Objective This study was to investigate issues that arose from pre-admission to post-discharge, for people in Toowoomba, Queensland over the age of 65 admitted to an acute facility. This paper concentrates on a significant concern that emerged from the large amount of data collected during this project, that is,the role of the nurse in the continuum of health care involving elderly people. Method The study involved a multi-site, multi-agency and multi-method (qualitative and quantitative) approach. Data was collected from regional service providers, the Department of Health and Aged Care (DHAC), the Australian Bureau of Statistics (ABS), Home and Community Care (HACC), the Aged Care Assessment Team (ACAT), elderly people who had been discharged from regional hospitals and their carers, residents of regional aged care facilities, area health professionals and elderly regional hospital inpatients. Results The data indicated that nurses in this provincial area currently play a limited role in preadmission planning, being mostly concerned with elective surgery, especially joint replacements. While nurses deliver the majority of care during hospitalisation, they do not appear to be cognizant of the needs of the elderly regarding post-acute discharge. Conclusion The recent introduction of the model of nurse case management in the acute sector appears to be a positive development that will streamline and optimise the health care of the elderly across the continuum in the Toowoomba area. The paper recommends some strategies, such as discharge liaison nurses based in Emergency Departments and the expansion of the nurse case management role, which would optimise care for the elderly person at the interface of care.

Genuine community engagement in remote dryland regions : natural resource management in Lake Eyre Basin

Remote dryland regions are characterised by sparse populations and socially marginalised voices which pose particular challenges to natural resource management. This paper considers the issue of how to achieve community engagement in regions with these characteristics. In doing so, the paper contributes to an expanding international research agenda focusing on the distinct characteristics of arid and semi-arid regions under the heading of 'dryland syndrome'. The paper draws on government liaison officer and local community perspectives of successful engagement in the case-study region of Lake Eyre Basin, Australia. The results demonstrate that widely recognised characteristics of successful engagement are required but insufficient for genuine engagement in remote dryland regions. In addition to building trust through community ownership, being inclusive, effective communication, and adequate resources, genuine community engagement in drylands also requires respecting the extreme conditions and extraordinary variability of these areas. Residents of dryland regions seek genuine engagement yet engage opportunistically when seasons are conducive and when tangible outcomes are visible. © 2011 The Authors. Geographical Research © 2011 Institute of Australian Geographers.

Tools for successful NRM in the Lake Eyre Basin : achieving effective engagement

This chapter was developed as part of the ‘People, communities and economies of the Lake Eyre Basin’ project. It has been written for communities, government agencies and interface organisations involved in natural resource management (NRM) in the Lake Eyre Basin (LEB). Its purpose is to identify the key factors for successful community engagement processes relevant to the LEB and present tools and principles for successful engagement processes. The term ‘interface organisation’ is used here to refer to the diverse range of local and regional organisations (such as Catchment Committees or NRM Regional Bodies) that serve as linkages, or translators, between local communities and broader Australian and State Governments. The importance of fostering and harnessing effective processes of community engagement has been identified as crucial to building a prosperous future for rural and remote regions in Australia. The chapter presents an overview of the literature on successful community engagement processes for NRM, as well as an overview of the current NRM arrangements in the LEB. The main part of the chapter presents findings of the series of interviews conducted with the government liaison officers representing both state and federal organisations who are responsible for coordinating and facilitating regional NRM in the LEB, and with the members of communities of the LEB.

What now?

On her first day as a liaison librarian not so long ago, Kelly Johnson was filled with excitement but also trepidation. Core duties such as learning and teaching support were safely in her comfort zone. Collection management, however, was still more theory than practice.