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Book review: Corruption in the Contemporary World: Theory, Practice and Hotspots. Edited by Jonathan Mendilow and Ilan Peleg. Lanham, MD: Lexington Books, 2014. 280p. $100.00. Perspectives on Politics, 14(03), 908-909.
No full text‘This is the peer reviewed version of the following article: Graycar, A. (2016). Book review: Corruption in the Contemporary World: Theory, Practice and Hotspots. Edited by Jonathan Mendilow and Ilan Peleg. Lanham, MD: Lexington Books, 2014. 280p. $100.00. Perspectives on Politics, 14(03), 908-909. which has been published in final form at http://dx.doi.org/10.1017/S1537592716002498
COPYRIGHT: © American Political Science Association 201
Transitioning a home telehealth project into a sustainable, large-scale service: a qualitative study
No full text© 2016 Wade et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background
This study was a component of the Flinders Telehealth in the Home project, which tested adding home telehealth to existing rehabilitation, palliative care and geriatric outreach services. Due to the known difficulty of transitioning telehealth projects services, a qualitative study was conducted to produce a preferred implementation approach for sustainable and large-scale operations, and a process model that offers practical advice for achieving this goal.
Methods
Initially, semi-structured interviews were conducted with senior clinicians, health service managers and policy makers, and a thematic analysis of the interview transcripts was undertaken to identify the range of options for ongoing operations, plus the factors affecting sustainability. Subsequently, the interviewees and other decision makers attended a deliberative forum in which participants were asked to select a preferred model for future implementation. Finally, all data from the study was synthesised by the researchers to produce a process model.
Results
19 interviews with senior clinicians, managers, and service development staff were conducted, finding strong support for home telehealth but a wide diversity of views on governance, models of clinical care, technical infrastructure operations, and data management. The deliberative forum worked through these options and recommended a collaborative consortium approach for large-scale implementation. The process model proposes that the key factor for large-scale implementation is leadership support, which is enabled by 1) showing solutions to the problems of service demand, budgetary pressure and the relationship between hospital and primary care, 2) demonstrating how home telehealth aligns with health service policies, and 3) achieving clinician acceptance through providing evidence of benefit and developing new models of clinical care. Two key actions to enable change were marketing telehealth to patients, clinicians and policy-makers, and building a community of practice.
Conclusions
The implementation of home telehealth services is still in an early stage. Change agents and a community of practice can contribute by marketing telehealth, demonstrating policy alignment and providing potential solutions for difficult health services problems. This should assist health leaders to move from trials to large-scale services
Rickettsia Detected in the Reptile Tick Bothriocroton hydrosauri from the Lizard Tiliqua rugosa in South Australia
No full text© 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access
article distributed under the terms and conditions of the Creative Commons Attribution
(CC-BY) license (http://creativecommons.org/licenses/by/4.0/).Rickettsiosis is a potentially fatal tick borne disease. It is caused by the obligate intracellular bacteria Rickettsia, which is transferred to humans through salivary excretions of ticks during the biting process. Globally, the incidence of tick-borne diseases is increasing; as such, there is a need for a greater understanding of tick–host interactions to create more informed risk management strategies. Flinders Island spotted fever rickettsioses has been identified throughout Australia (Tasmania, South Australia, Queensland and Torres Strait Islands) with possible identifications in Thailand, Sri Lanka and Italy. Flinders Island spotted fever is thought to be spread through tick bites and the reptile tick Bothriocroton hydrosauri has been implicated as a vector in this transmission. This study used qPCR to assay Bothriocroton hydrosauri ticks collected from Tiliqua rugosa (sleepy lizard) hosts on mainland South Australia near where spotted fever cases have been identified. We report that, although we discovered Rickettsia in all tick samples, it was not Rickettsia honei. This study is the first to use PCR to positively identify Rickettsia from South Australian Bothriocroton hydrosauri ticks collected from Tiliqua rugosa (sleepy lizard) hosts. These findings suggest that B. hydrosauri may be a vector of multiple Rickettsia spp. Also as all 41 tested B. hydrosauri ticks were positive for Rickettsia this indicates an extremely high prevalence within the studied area in South Australia. View Full-Tex
Carbon uptake and water use in woodlands and forests in southern Australia during an extreme heat wave event in the “Angry Summer” of 2012/2013
No full text© Author(s) 2016. CC Attribution 3.0 License.As a result of climate change warmer temperatures are projected through the 21st century and are already increasing above modelled predictions. Apart from increases in the mean, warm/hot temperature extremes are expected to become more prevalent in the future, along with an increase in the frequency of droughts. It is crucial to better understand the response of terrestrial ecosystems to such temperature extremes for predicting land-surface feedbacks in a changing climate. While land-surface feedbacks in drought conditions and during heat waves have been reported from Europe and the US, direct observations of the impact of such extremes on the carbon and water cycles in Australia have been lacking. During the 2012/2013 summer, Australia experienced a record-breaking heat wave with an exceptional spatial extent that lasted for several weeks. In this study we synthesised eddy-covariance measurements from seven woodlands and one forest site across three biogeographic regions in southern Australia. These observations were combined with model results from BIOS2 (Haverd et al., 2013a, b) to investigate the effect of the summer heat wave on the carbon and water exchange of terrestrial ecosystems which are known for their resilience toward hot and dry conditions. We found that water-limited woodland and energy-limited forest ecosystems responded differently to the heat wave. During the most intense part of the heat wave, the woodlands experienced decreased latent heat flux (23 % of background value), increased Bowen ratio (154 %) and reduced carbon uptake (60 %). At the same time the forest ecosystem showed increased latent heat flux (151 %), reduced Bowen ratio (19 %) and increased carbon uptake (112 %). Higher temperatures caused increased ecosystem respiration at all sites (up to 139 %). During daytime all ecosystems remained carbon sinks, but carbon uptake was reduced in magnitude. The number of hours during which the ecosystem acted as a carbon sink was also reduced, which switched the woodlands into a carbon source on a daily average. Precipitation occurred after the first, most intense part of the heat wave, and the subsequent cooler temperatures in the temperate woodlands led to recovery of the carbon sink, decreased the Bowen ratio (65 %) and hence increased evaporative cooling. Gross primary productivity in the woodlands recovered quickly with precipitation and cooler temperatures but respiration remained high. While the forest proved relatively resilient to this short-term heat extreme the response of the woodlands is the first direct evidence that the carbon sinks of large areas of Australia may not be sustainable in a future climate with an increased number, intensity and duration of heat waves
Validity, reliability and ease of use of the disabilities of arm, shoulder and hand questionnaire in adults following stroke
Get PDFThis author accepted manuscript (post print) is made available following a 12 month embargo from date of publication 21 October 2016 in accordance with the publisher copyright policy.
“This is an Accepted Manuscript of an article published by Taylor & Francis in [Disability and Rehabilitaiton] on [21 October 2016], available online: http://www.tandfonline.com/10.1080/09638288.2016.12293”Purpose: The Disabilities of Arm, Shoulder and Hand (DASH) questionnaire is a patient reported outcome measure for evaluating upper limb function in people with musculoskeletal conditions. While the DASH has good psychometric properties when used with people with musculoskeletal conditions, it has not been tested with adults after stroke.
Methods: Data for n=61 adults following stroke (aged 32 to 93 years, 44% male) were analysed to test validity and reliability of the DASH for use with a stroke population. Data included demographic and clinical attributes, DASH scores (baseline and 4 weeks later) and Patient Rated Wrist Evaluation (PRWE) measures.
Results: Internal consistency was good (Cronbach alpha 0.92, SEM 6.65). Factor analysis and Rasch modelling suggested that the questionnaire comprised three subscales: pain, impact and function. Concurrent validity between the DASH and PRWE (Spearman’s Rho rs=0.41) was moderate. The scale was perceived by clinicians to be useful, quick and simple to administer. The DASH had low four-week test-retest reliability (ICC 0.56 [95% Cl 0.05-0.79).
Conclusion: The DASH is considered to have acceptable validity when used with adults following stroke. Test-retest reliability was low but further research is needed to establish whether this is a result of condition-related change or the stability of the measure
Advancing aged care: a systematic review of economic evaluations of workforce structures and care processes in a residential care setting
No full textThis is an open access article. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Long-term care for older people is provided in both residential and non-residential settings, with residential settings tending to cater for individuals with higher care needs. Evidence relating to the costs and effectiveness of different workforce structures and care processes is important to facilitate the future planning of residential aged care services to promote high quality care and to enhance the quality of life of individuals living in residential care. A systematic review conducted up to December 2015 identified 19 studies containing an economic component; seven included a complete economic evaluation and 12 contained a cost analysis only. Key findings include the potential to create cost savings from a societal perspective through enhanced staffing levels and quality improvement interventions within residential aged care facilities, while integrated care models, including the integration of health disciplines and the integration between residents and care staff, were shown to have limited cost-saving potential. Six of the 19 identified studies examined dementia-specific structures and processes, in which person-centred interventions demonstrated the potential to reduce agitation and improve residents’ quality of life. Importantly, this review highlights methodological limitations in the existing evidence and an urgent need for future research to identify appropriate and meaningful outcome measures that can be used at a service planning level
Biomechanics of Pharyngeal Deglutitive Function Following Total Laryngectomy
No full textCopyright © 2016 American Academy of Otolaryngology—Head and Neck Surgery Foundation. Reprinted by permission of SAGE PublicationsObjective: Post-laryngectomy surgery, pharyngeal weakness and pharyngoesophageal junction (PEJ) restriction are the underlying candidate mechanisms of dysphagia. We aimed to determine, in laryngectomees whether: 1) hypopharyngeal propulsion is reduced and/or PEJ resistance is increased; 2) endoscopic dilatation improves dysphagia; and 3) if so, whether symptomatic improvement correlate with reduction in resistance to flow across the PEJ.
Methods: Swallow biomechanics were assessed in 30 total laryngectomees. Average peak contractile pressure (hPP) and hypopharyngeal intrabolus pressure (hIBP) were measured from combined high resolution manometry and video-fluoroscopic recordings of barium swallows (2, 5&10ml). Patients were stratified into severe dysphagia (Sydney Swallow Questionnaire (SSQ)>500) and mild/nil dysphagia (SSQ≤500). In 5 patients, all measurements were repeated after endoscopic dilatation.
Results: Dysphagia was reported by 87%, and 57% had severe and 43% had minor/nil dysphagia. Laryngectomees had lower hPP than controls (110±14mmHg vs 170±15mmHg; p<0.05), while hIBP was higher (29±5mmHg vs 6±5mmHg; p<0.05). There were no differences in hPP between patient groups. However, hIBP was higher in severe than in mild/nil dysphagia (41±10mmHg vs 13±3mmHg; p<0.05). Pre-dilation hIBP (R2=0.97) and its decrement following dilatation (R2=0.98) were good predictors of symptomatic improvement.
Conclusion: Increased PEJ resistance is the predominant determinant of dysphagia as it correlates better with dysphagia severity than peak pharyngal contractile pressure. While both baseline PEJ resistance and its decrement following dilatation are strong predictors of outcome following dilatation, the peak pharyngeal pressure is not. PEJ resistance is vital to detect as it is the only potentially reversible component of dysphagia in this context
Superparamagnetic Fe3O4- PEG2K-FA@Ce6 Nanoprobes for in Vivo Dual-mode Imaging and Targeted Photodynamic Therapy
No full textThis work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/The development of targeted nanoprobes is a promising approach to cancer diagnostics and therapy. In the present work, a novel multifunctional photo/magnet-diagnostic nanoprobe (MNPs-PEG2K-FA@Ce6) has been developed. This nanoprobe is built using folic acid (FA), bifunctional polyethylene glycol (PEG2K) and photosensitizer chlorin e6 (Ce6). The MNPs-PEG2K-FA@Ce6 nanoprobes are superparamagnetic, can be synthesized on a large scale by a one-pot hydrothermal process without further surface modification and are stable in an aqueous environment for eight months. Compared with free Ce6 nanoprobes in vitro studies, the MNPs-PEG2K-FA@Ce6 nanoprobes significantly enhance cellular uptake efficiency and promote the effectiveness of photodynamic therapy (PDT) with the assistance of 633 nm laser irradiation. The unique nanoprobes show superior penetration and a retention time of more than six days with less accumulation in the liver allowing highly effective tumor recognition and monitoring. Additionally, there was little damage to healthy organs or tissues. These exciting new nanoprobes could be potential building blocks to develop new clinical therapies and translational medicine
Response to Comments on Whiley Legionella Risk Management and Control in Potable Water Systems: Argument for the Abolishment of Routine Testing. Int. J. Environ. Res. Public Health 2017, 14, 12
No full text© 2016 by the author; licensee MDPI, Basel, Switzerland. This article is an open access
article distributed under the terms and conditions of the Creative Commons Attribution
(CC-BY) license (http://creativecommons.org/licenses/by/4.0/).Legionella is an opportunistic pathogen of public health significance. One of the main sources of Legionella is potable water systems. As a consequence of aging populations there is an increasing demographic considered at high risk for Legionellosis and, as such, a review of the guidelines is required. Worldwide, Legionella has been detected from many potable water sources, suggesting it is ubiquitous in this environment. Previous studies have identified the limitations of the current standard method for Legionella detection and the high possibility of it returning both false negative and false positive results. There is also huge variability in Legionella test results for the same water sample when conducted at different laboratories. However, many guidelines still recommend the testing of water systems. This commentary argues for the removal of routine Legionella monitoring from all water distribution guidelines. This procedure is financially consuming and false negatives may result in managers being over-confident with a system or a control mechanism. Instead, the presence of the pathogen should be assumed and focus spent on managing appropriate control measures and protecting high-risk population groups. View Full-Tex
Two-in-one: cathode modification and improved solar cell blend stability through addition of modified fullerenes
No full textOpen Access Article. This article is licensed under a Creative Commons Attribution 3.0 Unported Licence.The synthesis of dual purpose modified fullerenes with pyridine- as well as amine-functional groups is reported. Addition of these fullerenes to a polymer : fullerene bulk-heterojunction blend based on a thiophene–quinoxaline donor polymer is found to modify the active layer/cathode interface of inverted solar cells (glass/ITO/active layer/MoO3/Al). In particular the open-circuit voltage of devices is increased from 0.1 V to about 0.7 V, which results in a drastic rise in photovoltaic performance with a power conversion efficiency of up to 3%. At the same time, presence of the functionalised fullerene additives prevents the detrimental formation of micrometre-sized fullerene crystals upon annealing at 140 °C. As a result, the device performance is retained, which promises significantly increased thermal stability of the bulk-heterojunction blend nanostructure