Description:
The Australian adverse drug reactions database is derived from 140,000 reports over 30 years, including many instances of multiple drugs and multiple reactions. There are several thousand different drugs and reactions, and so the drug-reaction table is large and sparse. To aid rapid expert assessment of new reports, Bayesian approaches are being compared with other statistical methods for the re-evaluation of historical data and to provide early indications of emerging trends. Bayesian methods provide more balanced detection criteria than either descriptive statistics such as relative risks, which are subject to large sampling variation for rare co-occurrences, or statistical significance levels which are conversely weighted towards the most common co-occurrences. In this paper the various methods are reviewed and some indicative early results are presented.
Description:
Objectives: This study aims to support the training of Traditional Chinese Medicine practitioners by embedding an expert diagnostic model for arthritis into an Intelligent Interactive Learning Environment (IILE). Background: The increasing prevalence of Traditional Chinese Medicine (TCM) outside China is characterised by the emergence of university level practitioner training and stringent regulatory requirements. TCM differential diagnosis is a difficult task that was traditionally taught by exposure to large numbers of patients in a master-apprentice context. In university degree programs, students and novice diagnosticians cannot have the exposure to cases possible in the traditional context. An online system that engages students in the interactive construction of a virtual case and provides immediate feedback on the appropriateness of student actions and the accuracy of diagnostic conclusions can enhance student learning. The system, an Intelligent Interactive Learning Environment (IILE) is based on an approach that has been shown to improve learning outcomes in intensive care nurse training. Methods: An expert model of diagnostic reasoning elicited from TCM expert practitioners lies at the core of the IILE. The knowledge acquisition is performed using an argumentation tree representation that has been shown to be effective in structuring complex knowledge and facilitating engineer - expert interactions. Problems associated with keeping knowledge bases up to date are mitigated with the use of a knowledge model known as ripple down rules permits dynamic updating of knowledge so that knowledge bases evolve over time. A simple narrative model builds up the virtual case study as user interaction proceeds. Results and discussion: This article reports preliminary results in the study that includes an overview of TCM differential diagnosis, the argument tree, the ripple down rule representation and the narrative based IILE. Segments of the knowledge model based solely on TCM literature are illustrated.
Description:
Objectives: This study aims to support the training of Traditional Chinese Medicine practitioners by embedding an expert diagnostic model for arthritis into an Intelligent Interactive Learning Environment (IILE). Background: The increasing prevalence of Traditional Chinese Medicine (TCM) outside China is characterised by the emergence of university level practitioner training and stringent regulatory requirements. TCM differential diagnosis is a difficult task that was traditionally taught by exposure to large numbers of patients in a master-apprentice context. In university degree programs, students and novice diagnosticians cannot have the exposure to cases possible in the traditional context. An online system that engages students in the interactive construction of a virtual case and provides immediate feedback on the appropriateness of student actions and the accuracy of diagnostic conclusions can enhance student learning. The system, an Intelligent Interactive Learning Environment (IILE) is based on an approach that has been shown to improve learning outcomes in intensive care nurse training. Methods: An expert model of diagnostic reasoning elicited from TCM expert practitioners lies at the core of the IILE. The knowledge acquisition is performed using an argumentation tree representation that has been shown to be effective in structuring complex knowledge and facilitating engineer - expert interactions. Problems associated with keeping knowledge bases up to date are mitigated with the use of a knowledge model known as ripple down rules permits dynamic updating of knowledge so that knowledge bases evolve over time. A simple narrative model builds up the virtual case study as user interaction proceeds. Results and discussion: This article reports preliminary results in the study that includes an overview of TCM differential diagnosis, the argument tree, the ripple down rule representation and the narrative based IILE. Segments of the knowledge model based solely on TCM literature are illustrated.
Description:
Culturally, philosophically and religiously diverse medical systems including Western medicine, Traditional Chinese Medicine, Ayurvedic Medicine and Homeopathic Medicine, once situated in places and times relatively unconnected from each other, currently co-exist to a point where patients must choose which system to consult. These decisions require comparative analyses, yet the divergence in key underpinning assumptions is so great that comparisons cannot easily be made. However, diverse medical systems can be meaningfully juxtaposed for the purpose of making practical decisions if relevant information is presented appropriately. Information regarding privacy provisions inherent in the typical practice of each medical system is an important element in this juxtaposition. In this paper the information needs of patients making decisions regarding the selection of a medical system, are examined.
Recent reports have underlined the potential of gamma (γ)-rays as tools for seed priming, a process used in seed industry to increase seed vigor and to enhance plant tolerance to biotic/abiotic stresses. However, the impact of γ-rays on key aspects of plant metabolism still needs to be carefully evaluated. In the present study, rice seeds were challenged with different doses of γ-rays and grown in absence/presence of NaCl to assess the impact of these treatments on the early stages of plant life. Enhanced germination efficiency associated with increase in radicle and hypocotyl length was observed, while at later stages no increase in plant tolerance to salinity stress was evident. APX, CAT, and GR were enhanced at transcriptional level and in terms of enzyme activity, indicating the activation of antioxidant defence. The profiles of DNA damage accumulation were obtained using SCGE and the implication of TC-NER pathway in DNA damage sensing and repair mechanisms is discussed. OsXPB2, OsXPD, OsTFIIS, and OsTFIIS-like genes showed differential modulation in seedlings and plantlets in response to γ-irradiation and salinity stress. Altogether, the synergistic exposure to γ-rays and NaCl resulted in enhanced oxidative stress and proper activation of antioxidant mechanisms, thus being compatible with plant survival.
Description:
The emerging High Efficiency Video Coding (HEVC) standard introduces a number of innovative and powerful coding tools to acquire better compression efficiency compared to its predecessor H.264. The encoding time complexities have also increased multiple times that is not suitable for realtime video coding applications. To address this limitation, this paper employs a novel coding strategy to reduce the time complexity in HEVC encoder by efficient selection of appropriate block-partitioning modes based on human visual features (HVF). The HVF in the proposed technique comprise with human visual attention modelling-based saliency feature and phase correlation-based motion features. The features are innovatively combined through a fusion process by developing a content-based adaptive weighted cost function to determine the region with dominated motion/saliency (RDMS)- based binary pattern for the current block. The generated binary pattern is then compared with a codebook of predefined binary pattern templates aligned to the HEVC recommended block-paritioning to estimate a subset of inter-prediction modes. Without exhaustive exploration of all modes available in the HEVC standard, only the selected subset of modes are motion estimated and motion compensated for a particular coding unit. The experimental evaluation reveals that the proposed technique notably down-scales the average computational time of the latest HEVC reference encoder by 34% while providing similar rate-distortion (RD) performance for a wide range of video sequences.
Description:
The emerging High Efficiency Video Coding (HEVC) standard introduces a number of innovative and powerful coding tools to acquire better compression efficiency compared to its predecessor H.264. The encoding time complexities have also increased multiple times that is not suitable for realtime video coding applications. To address this limitation, this paper employs a novel coding strategy to reduce the time complexity in HEVC encoder by efficient selection of appropriate block-partitioning modes based on human visual features (HVF). The HVF in the proposed technique comprise with human visual attention modelling-based saliency feature and phase correlation-based motion features. The features are innovatively combined through a fusion process by developing a content-based adaptive weighted cost function to determine the region with dominated motion/saliency (RDMS)- based binary pattern for the current block. The generated binary pattern is then compared with a codebook of predefined binary pattern templates aligned to the HEVC recommended block-paritioning to estimate a subset of inter-prediction modes. Without exhaustive exploration of all modes available in the HEVC standard, only the selected subset of modes are motion estimated and motion compensated for a particular coding unit. The experimental evaluation reveals that the proposed technique notably down-scales the average computational time of the latest HEVC reference encoder by 34% while providing similar rate-distortion (RD) performance for a wide range of video sequences.
Description:
Abrasion injuries result in damage only to the surface layer of skin and can result in player discomfort and changes in performance. The perceived fear of abrasion injuries on artificial turf playing surfaces has significantly affected the adoption of these surfaces, particularly in sports that involve frequent player-surface interactions. The underreporting of abrasion injuries due to how time-loss injuries are defined and the lack of validity of the current abrasion measurement device highlight the need for more research to understand fully the incidence and nature of abrasions on artificial turf playing surfaces and the effect of these injuries on playing behaviour. Improved reporting of abrasion injuries and a more biofidelic test device could assist in both the development of abrasion-related injury prevention strategies and in dispelling players’ negative perceptions of abrasions on artificial turf.
Description:
Abrasion injuries result in damage only to the surface layer of skin and can result in player discomfort and changes in performance. The perceived fear of abrasion injuries on artificial turf playing surfaces has significantly affected the adoption of these surfaces, particularly in sports that involve frequent player-surface interactions. The underreporting of abrasion injuries due to how time-loss injuries are defined and the lack of validity of the current abrasion measurement device highlight the need for more research to understand fully the incidence and nature of abrasions on artificial turf playing surfaces and the effect of these injuries on playing behaviour. Improved reporting of abrasion injuries and a more biofidelic test device could assist in both the development of abrasion-related injury prevention strategies and in dispelling players’ negative perceptions of abrasions on artificial turf.
Cadmium and human prostatic carcinoma : a study of the analytical procedures for the determination of cadmium and zinc in human prostatic tissue, and the investigation of an association between the incidence of prosatatic adencarcinoma and the occurrence of prostatic cadmium
Description:
The concentrations of the heavy metals cadmium and zinc in both benign nodular hyperplastic and malignant (adenocarcinoma) human prostatic tissue obtained from Trans Urethral Resections of the Prostate (TURP) have been investigated. Healthy normal human prostates obtained from post mortem cadavers were used as controls. The change in the prostatic cadmium concentration with age was investigated. Renal cortex cadmium and zinc concentration changes with age together with the metal concentration intterelationships between prostatic and renal cortex tissues were studied. "From abstract"
Description:
The concentrations of the heavy metals cadmium and zinc in both benign nodular hyperplastic and malignant (adenocarcinoma) human prostatic tissue obtained from Trans Urethral Resections of the Prostate (TURP) have been investigated. Healthy normal human prostates obtained from post mortem cadavers were used as controls. The change in the prostatic cadmium concentration with age was investigated. Renal cortex cadmium and zinc concentration changes with age together with the metal concentration intterelationships between prostatic and renal cortex tissues were studied. "From abstract"
Description:
This stimulating volume examines the many faces of Australias ageing population, the social and health issues they contend with, and the steps being takenand many that should be takento help ensure a more positive and productive later life. Individual and societal ageing are conceptualized as developmental in nature, socially diverse, and marked by daily life challenges stemming from the countrys economic structures, attitudes, geography, political landscape, and infrastructure. Wide-ranging coverage (e.g., health, inequalities, employment, transportation) assesses options available to older people, and the role of families, employers, service providers, government agencies, and others in promoting or expanding those choices. The books double emphasis on challenges in older peoples lives and opportunities for enhancing their quality of life is on clear display as case studies examine policy issuesand propose solutionsin a societal and individual context. Included in the coverage: · Australian developments in ageing: issues and history · Cultural diversity, health, and ageing · Indigenous Australians and ageing: responding to diversity in policy and practice · Enhancing the health and employment participation of older workers · Housing and the environments of ageing · Health services and care for older people The rich examples in Ageing in Australia contain a depth of understanding and evidence for sociologists, gerontologists and psychologists studying ageing, health care professionals providing care to older people, and policy analysts assessing areas for improvement.
Description:
Clinical practice is fundamental to the learning of undergraduate and entry-level nursing students. It provides the milieu whereby students apply classroom theory and simulated practice to the real world of nursing and become socialised into the profession. In contemporary nursing education, there is often competition among tertiary education providers to locate quality, appropriate placements; substantial costs may be incurred to access suitable placements.
Description:
The interrelationship between the public and private sectors, and formal and informal healthcare sectors effects market-level service quality, pricing behaviour and referral networks. However, health utilisation analysis of national survey data from many low and middle income countries is constrained by the lack of disaggregated health provider data. This study is concerned with the pattern of repeat outpatient consultations for a single episode of fever from public and private qualified providers and private unqualified providers. Cross-sectional survey data from 1173 adult respondents sampled from three districts within India's most populous state-Uttar Pradesh is analysed. Data was collected during the monsoon season-September to October-in 2012. Regression analysis focuses on the pattern of repeats visits for a single episode of mild-sever fever as the dependent variable. Results show that Women and Muslims in rural north India are more likely to not access healthcare, and if they do, consult with low quality unqualified outpatient healthcare providers. For fever durations of four or more days, men are more likely to access unqualified providers compared to women. Results of the current study supports the literature that women's utilisation of outpatient healthcare for communicable illnesses in LMICs is often less than men. A relative lack of access to household resources explains why fever duration parameter estimates for women and men differ.
Description:
Purpose To explore the experiences of women with breast cancer and pelvic floor (PF) dysfunction and the perceived enablers and barriers to uptake of treatment for PF dysfunction during their recovery. Method Purposive sampling was used to recruit 30 women with a past diagnosis of breast cancer and PF dysfunction. Semi-structured interviews were conducted, and data were analysed inductively to identify new concepts in the experiences of PF dysfunction in women with breast cancer and deductively according to the capability, opportunity, motivation and behaviour (COM-B) framework to identify the enablers and barriers to the uptake of treatment for PF dysfunction in women with breast cancer. Results Participants were aged between 31 and 88 years, diagnosed with stages I–IV breast cancer and experienced either urinary incontinence ( n = 24/30, 80%), faecal incontinence ( n = 6/30, 20%) or sexual dysfunction ( n = 20/30, 67%). They were either resigned to or bothered by their PF dysfunction bother was exacerbated by embarrassment from experiencing PF symptoms in public. Barriers to accessing treatment for PF dysfunction included a lack of awareness about PF dysfunction following breast cancer treatments and health care professionals not focussing on the management of PF symptoms during cancer treatment. An enabler was their motivation to resume their normal pre-cancer lives. Conclusion Participants in this study reported that there needs to be more awareness about PF dysfunction in women undergoing treatment for breast cancer. They would like to receive information about PF dysfunction prior to starting cancer treatment, be screened for PF dysfunction during cancer treatment and be offered therapies for their PF dysfunction after primary cancer treatment. Therefore, a greater focus on managing PF symptoms by clinicians may be warranted in women with breast cancer.
Description:
Purpose To explore the experiences of women with breast cancer and pelvic floor (PF) dysfunction and the perceived enablers and barriers to uptake of treatment for PF dysfunction during their recovery. Method Purposive sampling was used to recruit 30 women with a past diagnosis of breast cancer and PF dysfunction. Semi-structured interviews were conducted, and data were analysed inductively to identify new concepts in the experiences of PF dysfunction in women with breast cancer and deductively according to the capability, opportunity, motivation and behaviour (COM-B) framework to identify the enablers and barriers to the uptake of treatment for PF dysfunction in women with breast cancer. Results Participants were aged between 31 and 88 years, diagnosed with stages I–IV breast cancer and experienced either urinary incontinence ( n = 24/30, 80%), faecal incontinence ( n = 6/30, 20%) or sexual dysfunction ( n = 20/30, 67%). They were either resigned to or bothered by their PF dysfunction bother was exacerbated by embarrassment from experiencing PF symptoms in public. Barriers to accessing treatment for PF dysfunction included a lack of awareness about PF dysfunction following breast cancer treatments and health care professionals not focussing on the management of PF symptoms during cancer treatment. An enabler was their motivation to resume their normal pre-cancer lives. Conclusion Participants in this study reported that there needs to be more awareness about PF dysfunction in women undergoing treatment for breast cancer. They would like to receive information about PF dysfunction prior to starting cancer treatment, be screened for PF dysfunction during cancer treatment and be offered therapies for their PF dysfunction after primary cancer treatment. Therefore, a greater focus on managing PF symptoms by clinicians may be warranted in women with breast cancer.
Description:
The current investigation aimed to understand the positional profile of repeated high-intensity-effort activity (RHIE) across halves during elite rugby union match-play. Forty elite rugby union players ( n = 40) were monitored across match-play during a single season. Player’s locomotor profiles were recorded using wearable microtechnology (GPS Catapult S5, Australia). Locomotor activity was classified across total distance (m) running distance (m ≥ 4.4 m s −1 ) high-speed running (≥ 5.5 m s −1 ) sprint distance (≥ 7 m s −1 ) accelerations (≥ 2 m s −2 ) decelerations (≤ − 2 m s −2 ) and collisions (≥ 4 g). Peak velocity (m s −1 ) total efforts ( n ) high-intensity efforts (HIE), repeated high-intensity efforts (RHIE), total number of RHIE bouts ( n ), maximal number of efforts within a RHIE bout ( n ) and recovery times between RHIE (s) were also recorded across match-play. Players were shown to complete 164 ± 30 HIE per game. Overall players performed 11 ± 6 RHIE bouts. The mean efforts per RHIE bout was 4 ± 1 with a maximum of 6 ± 2. RHIE positional differences were reported with back-rows completing the most total efforts when compared to all positions within the forwards (ES: 1.33–5.29 moderate–very large ). Significant reductions were reported between halves for all running and repeated effort variables. The data highlight the potential consideration that RHIE should be given by coaches when preparing players for rugby union match-play. An understanding of the positional differences in RHIE can assist coaches in designing training drills that can expose players to these match-play requirements.
Description:
Background Military populations, including fast jet aircrew (FJA - aka fighter aircrew/pilots), commonly suffer from musculoskeletal complaints, which reduce performance and operational capability. Valid surveillance tools and agreed recordable injury definitions are lacking. Our objective was to develop and then evaluate the validity of a musculoskeletal complaints surveillance and monitoring tool for FJA. Methods A Delphi study with international experts sought consensus on recordable injury definitions and important content for use in a surveillance and monitoring tool for FJA. Using these results and feedback from end-users (FJA), the University of Canberra Fast Jet Aircrew Musculoskeletal Questionnaire (UC-FJAMQ) was developed. Following its use with 306 Royal Australian Air Force (RAAF) FJA over 4 × five-month reporting periods, validity of the UC-FJAMQ was evaluated via multi-level factor analysis (MFA) and compared with routine methods of injury surveillance. Results Consensus was achieved for: eight words/descriptors for defining a musculoskeletal complaint six definitions of recordable injury and 14 domains important for determining overall severity. The UC-FJAMQ was developed and refined. MFA identified three distinct dimensions within the 11 items used to determine severity: operational capability, symptoms, and care-seeking. MFA further highlighted that symptom severity and seeking medical attention were poor indicators of the impact musculoskeletal complaints have upon operational capability. One hundred and fifty-two episodes of time loss were identified, with the UC-FJAMQ identifying 79% of these, while routine methods identified 49%. Despite modest weekly reporting rates (61%), the UC-FJAMQ outperformed routine surveillance methods. Conclusions The UC-FJAMQ was developed to specifically address the complexities of injury surveillance with FJA, which are similar to those noted in other military and sporting populations. The results demonstrated the UC-FJAMQ to be sensitive and valid within a large group of FJA over 4 × five-month reporting periods. Adoption of consistent, sensitive, and valid surveillance methods will strengthen the FJA injury prevention literature, ultimately enhancing their health, performance, and operational capability.
Description:
Background Military populations, including fast jet aircrew (FJA - aka fighter aircrew/pilots), commonly suffer from musculoskeletal complaints, which reduce performance and operational capability. Valid surveillance tools and agreed recordable injury definitions are lacking. Our objective was to develop and then evaluate the validity of a musculoskeletal complaints surveillance and monitoring tool for FJA. Methods A Delphi study with international experts sought consensus on recordable injury definitions and important content for use in a surveillance and monitoring tool for FJA. Using these results and feedback from end-users (FJA), the University of Canberra Fast Jet Aircrew Musculoskeletal Questionnaire (UC-FJAMQ) was developed. Following its use with 306 Royal Australian Air Force (RAAF) FJA over 4 × five-month reporting periods, validity of the UC-FJAMQ was evaluated via multi-level factor analysis (MFA) and compared with routine methods of injury surveillance. Results Consensus was achieved for: eight words/descriptors for defining a musculoskeletal complaint six definitions of recordable injury and 14 domains important for determining overall severity. The UC-FJAMQ was developed and refined. MFA identified three distinct dimensions within the 11 items used to determine severity: operational capability, symptoms, and care-seeking. MFA further highlighted that symptom severity and seeking medical attention were poor indicators of the impact musculoskeletal complaints have upon operational capability. One hundred and fifty-two episodes of time loss were identified, with the UC-FJAMQ identifying 79% of these, while routine methods identified 49%. Despite modest weekly reporting rates (61%), the UC-FJAMQ outperformed routine surveillance methods. Conclusions The UC-FJAMQ was developed to specifically address the complexities of injury surveillance with FJA, which are similar to those noted in other military and sporting populations. The results demonstrated the UC-FJAMQ to be sensitive and valid within a large group of FJA over 4 × five-month reporting periods. Adoption of consistent, sensitive, and valid surveillance methods will strengthen the FJA injury prevention literature, ultimately enhancing their health, performance, and operational capability.
Description:
Understanding if maternal depression is a predictor of infant-parent attachment classification is important to furthering knowledge about the early pathways and predictors of socio-emotional development. Yet few studies that have utilised the Strange Situation Procedure, the gold standard for measurement of infant-parent attachment, have examined antenatal depression as a predictor of attachment, and none has also included a measure of maternal trauma. This study uses data on 224 women recruited in early pregnancy and followed up until 12 months postpartum. Maternal depression was measured in pregnancy using the Structured Clinical Interview for the DSM and repeat Edinburgh Postnatal Depression Scale as well as Stressful Life Events scale across pregnancy and postpartum including items on domestic violence. A past history of trauma was measured using the Childhood Trauma Questionnaire. Attachment was measured using the Strange Situation Procedure (SSP) at 12 months postpartum. We found that maternal depression was not associated with insecure or disorganized attachment. However, a maternal history of childhood trauma and current domestic violence both predicted insecure-avoidant attachment at 12 months, whereas increased number of stressful life events prior to conception and in pregnancy was associated with insecure-resistant attachment. Neither trauma, past or current, nor depression predicted disorganized attachment. In the first study to have included measures of antenatal depression, maternal childhood trauma, and current stressful events as predictors of infant attachment measured using the SSP, we found maternal experiences of past and current trauma but not depression were significant predictors of infant-parent attachment security.
Description:
Introduction Many disability prevention strategies are focused on acute injuries and brief illness episodes, but there will be growing challenges for employers to manage circumstances of recurrent, chronic, or fluctuating symptoms in an aging workforce. The goal of this article is to summarize existing peer-review research in this area, compare this with employer discourse in the grey literature, and recommend future research priorities. Methods The authors participated in a year-long sponsored collaboration that ultimately led to an invited 3-day conference, “Improving Research of Employer Practices to Prevent Disability”, held October 14–16, 2015, in Hopkinton, Massachusetts, USA. The collaboration included a topical review of the scientific and industry literature, group discussion to identify key areas and challenges, drafting of initial documents, and feedback from peer researchers and a special panel of experts with employer experience. Results Cancer and mental illness were chosen as examples of chronic or recurring conditions that might challenge conventional workplace return-to-work practices. Workplace problems identified in the literature included fatigue, emotional exhaustion, poor supervisor and co-worker support, stigma, discrimination, and difficulties finding appropriate accommodations. Workplace intervention research is generally lacking, but there is preliminary support for improving workplace self-management strategies, collaborative problem-solving, and providing checklists and other tools for job accommodation, ideas echoed in the literature directed toward employers. Research might be improved by following workers from an earlier stage of developing workplace concerns. Conclusions Future research of work disability should focus on earlier identification of at-risk workers with chronic conditions, the use of more innovative and flexible accommodation strategies matched to specific functional losses, stronger integration of the workplace into on-going rehabilitation efforts, and a better understanding of stigma and other social factors at work.