Group Riding in Western Australia: An Examination of Crashes, Outcomes and Behaviour

This study aimed to gain an understanding of the safety issues affecting group riders in Perth, Western Australia. Phase 1 consisted of an in-depth longitudinal study of cyclists hospitalised in an on-road crash. Phase 2 involved a naturalistic study of unsafe events and traffic violations observed among group riders. The findings suggest that interventions targeting the road environment, group rider training and motorist education have the potential to improve safety for group riders

Impact of cataract surgery on driving difficulty and quality of life for older drivers

The demand for cataract surgery is set to increase due to the ageing population of Australia. Cataracts are usually bilateral, but cataract surgery is almost always performed one eye at a time. Previous investigations of the impact of cataract surgery seldom analysed the separate effects of each surgery. Instead, patients who underwent first, second or both eye surgeries were combined in the analyses. In Western Australia, public hospital patients wait substantial periods of time between first and second eye cataract surgeries. For these patients, understanding the separate effects of first eye surgery on driving difficulty, vision-related quality of life and depressive symptoms is of considerable importance for their safety and well-being.This before and after study aimed to gain a better understanding of the impact of first eye cataract surgery on self-reported driving difficulty, vision-related quality of life and depressive symptoms for older drivers. It also aimed to investigate how changes in these outcomes were associated with changes in objective visual measures after cataract surgery.The sample consisted of 99 bilateral cataract patients who drove and were about to undergo first eye cataract surgery. Participants were recruited consecutively from the Ophthalmology Departments of Royal Perth, Sir Charles Gairdner and Fremantle Hospitals in Perth, Western Australia. Participants were assessed during the week before and approximately 12 weeks after first eye cataract surgery. Data on major study outcomes including self-reported driving difficulty, vision-related quality of life and depressive symptoms, were collected using previously developed questionnaires, administered by the researcher. Three objective visual measures, namely visual acuity, contrast sensitivity and stereopsis, and two cognitive tests, namely the Mini Mental State Examination and a useful field of view test, were also conducted. In addition, demographic and health information were collected from participants.Separate generalised linear estimating equations were used to ascertain the changes in driving difficulty, vision-related quality of life and depressive symptoms after first eye surgery. Multiple linear regression modelling was then undertaken to determine whether changes in the major outcomes after surgery were associated with changes in objective visual measures.After first eye cataract surgery, there were significant mean improvements of approximately 10 points in overall driving difficulty (p<0.001) and vision-related quality of life (p<0.001) scores. There was a statistically significant but not clinically meaningful improvement in depressive symptoms of approximately one point after surgery (p=0.024). Before first eye surgery, 18% of participants did not meet the visual standards for licensing in Western Australia. After surgery this proportion was reduced to 4%.After controlling for confounding factors, change in surgery eye contrast sensitivity was the only objective visual measure significantly associated with change in driving difficulty after first eye cataract surgery (p<0.001). Change in surgery eye contrast sensitivity was also the only visual measure associated with change in vision-related quality of life (p<0.001). Stereopsis was the only visual measure associated with change in depressive symptoms after first eye surgery (p<0.032). Only 22% of participants received new glasses after first eye cataract surgery. Receiving new glasses after surgery was significantly associated with greater improvement in driving difficulty (p<0.001), vision-related quality of life (p<0.001) and depressive symptoms (p=0.001).Despite overall improvements, some participants did not improve or even declined in driving difficulty (19%), vision-related quality of life (14%) or depressive symptoms (47%) after first eye cataract surgery. For all three of the major outcomes, those who did not improve experienced significant improvements in surgery eye visual acuity and surgery eye contrast sensitivity after surgery, but not in stereopsis.Results found that first eye cataract surgery had significant benefits in terms of driving difficulty, vision-related quality of life and maintenance of levels of vision required for driver licensing, but not depressive symptoms. This provides strong grounds for Ophthalmologists to recommend cataract surgery to all suitable drivers with bilateral cataract, and for funding to be increased to reduce the waiting period for cataract surgery for public patients. Contrast sensitivity and/ or stereopsis, but not visual acuity, were associated with changes in the major outcomes after surgery. This challenges the current reliance on visual acuity for assessment and prioritisation of cataract patients for surgery, and in driver licensing. In addition, results suggest that the stereopsis measure may be useful for identifying bilateral cataract patients who do not improve after first eye cataract surgery, so they can be advised and possibly prioritised for second eye surgery.Further research is required to determine the additional effects of second eye cataract surgery for older drivers, to further uncover factors associated with non-improvement of cataract patients after first eye surgery and to develop appropriate visual tests for driver licensing

Effect of Preventive Home Visits by a Nurse on the Outcomes of Frail Elderly People in the Community: a randomized controlled trial

Background: Timely recognition and prevention of health problems among elderly people have been shown to improve their health. In this randomized controlled trial the authors examined the impact of preventive home visits by a nurse compared with usual care on the outcomes of frail elderly people living in the community. Methods: A screening questionnaire identified eligible participants (those aged 70 years or more at risk of sudden deterioration in health). Those randomly assigned to the visiting nurse group were assessed and followed up in their homes for 14 months. The primary outcome measure was the combined rate of deaths and admissions to an institution, and the secondary outcome measure the rate of health services utilization, during the 14 months; these rates were determined through a medical chart audit by a research nurse who was blind to group allocation. Results: The questionnaire was mailed to 415 elderly people, of whom 369 (88.9%) responded. Of these, 198 (53.7%) were eligible, and 142 consented to participate and were randomly assigned to either the visiting nurse group (73) or the usual care group (69). The combined rate of deaths and admissions to an institution was 10.0% in the visiting nurse group and 5.8% in the usual care group (p = 0.52). The rate of health services utilization did not differ significantly between the 2 groups. Influenza and pneumonia vaccination rates were significantly higher in the visiting nurse group (90.1% and 81.9%) than in the usual care group (53.0% and 0%) (p \u3c 0.001). Interpretation: The trial failed to show any effect of a visiting nurse other than vastly improved vaccination coverage

Screening Seniors for Risk of Functional Decline: Results of a Survey in Family Practice

To measure functional status, determine risk of functional decline and assess consistency between responses and standardized instruments. Design: A mailed survey which measured functional impairment, recent hospitalization and bereavement. A positive response on at least one of these factors indicated that the individual was “at risk” for functional decline. A random sample (n=73) of “at risk” subjects (specifically, family practice patients aged 70 and older) were assessed by a nurse. Results: The response rate was 89% (369/415), 59% of seniors were female and the mean age was 77.1 (SD=5.5) years. Self-reported risk, based on activities of daily living (ADLs), was associated with impairment in at least one basic ADL (p\u3c0.0005) using a standardized instrument. The positive predictive value of the survey for ADL impairment was 65%. Conclusion: Response to a mailed survey was high and self-reported ADL risks were consistent with findings from standardized assessment tools

CCL19-sorted mature dendritic cells have enhanced lymph node migratory capacity and function

No abstract available

Long-Term Fate of an Emplaced Coal Tar Creosote Source

An emplaced source of coal tar creosote within the sandy Borden research aquifer has provided an opportunity to document the long term (5140 days) natural attenuation for this complex mixture. Plumes of dissolved chemicals were produced by the essentially horizontal groundwater flowing at about 9 cm/day. Eleven chemicals were extensively sampled seven times using a monitoring network of ~280 14-point multilevel samplers. A model of source dissolution using Raoult’s Law adequately predicted the dissolution of nine of eleven compounds analysed. Mass transformation has limited the extent of the plumes as groundwater flowed more than 500 m yet the plumes are no longer than 50 m. Phenol and xylenes were removed and naphthalene was attenuated from its maximum extent on day 1357. Some compound plumes reached an apparent steady state and the plumes of other compounds (dibenzofuran and phenanthrene) are expected to continue to expand due to an increasing mass flux and limited degradation potential. Biotransformation is the major process controlling natural attenuation at the site. The greatest organic mass loss is associated with the high solubility compounds. However, the majority of the mass loss for most compounds has occurred in the source zone. Oxygen is the main electron acceptor yet the amount of organics lost cannot be accounted for by aerobic mineralization or partial mineralization alone. After 10 years the source zone was treated with permanganate in situ to reduce the flux of contaminants into the dissolved plume and to permit natural attenuation to further reduce the plume extent. A sufficient mass of permanganate was injected to oxidize ~10% of the residual source. Laboratory experiments demonstrated that eight of ten of the study compounds were readily oxidized by permanganate. Once treated oxidized compounds displayed a reduced plume mass and mass discharge while they migrated through the monitoring network. Once beyond the monitoring network the mass discharge and plume mass of these compounds returned to pre-treatment trends. Non-reactive compounds displayed no significant decrease in mass discharge or plume mass. Overall the partial in situ chemical oxidation of the coal tar creosote source produced no long-term effect on the dissolved plumes emanating from the source

Die Alraune als künstliches Geschöpf in der deutschen phantastischen Literatur : Eine Studie zu Achim von Arnim, E.T.A. Hoffmann und Hanns Heinz Ewers

[À l'origine dans / Was originally part of : Thèses et mémoires - FAS - Département de littératures et de langues modernes]La forme humaine de la racine de la mandragore est sans doute à l’origine de la fascination que cette plante exerce depuis des millénaires. On lui attribue des qualités surnaturelles : entre autres, elle rendrait son propriétaire infiniment riche. Les détails lugubres se rapportant au mythe de la mandragore font d’elle un thème de prédilection pour la littérature fantastique. Le but de ce travail est d’analyser la légende de la mandragore dans trois œuvres de la littérature fantastique allemande (Isabelle d’Égypte (1812) d’Achim von Arnim, Petit Zacharie surnommé Cinabre (1819) d’E.T.A. Hoffmann et Mandragore (1911) de Hanns Heinz Ewers), dans lesquelles ce motif est combiné avec un thème aussi très prisé du genre fantastique : l’homme artificiel. Dans une perspective intertextuelle, j’analyserai comment chaque auteur s’approprie le mythe de la mandragore et représente le personnage-mandragore. Je me concentrerai ensuite sur les nouvelles qualités créées par son statut de créature artificielle et sur la relation de cette dernière avec son créateur. Puis, j’examinerai le rôle du personnage-mandragore dans chacune des œuvres dans son contexte historique. Ainsi, je montrerai que les personnages-mandragores possèdent bel et bien des caractéristiques qui se réfèrent à la légende de la mandragore, mais que leur nature de créature artificielle leur fait endosser dans leur récit un rôle d’antagoniste qui s’apparente à celui du trickster. Finalement, j’expliquerai comment les auteurs utilisent le motif de la mandragore et la littérature fantastique pour dénoncer la corruption, critiquer les partisans des Lumières et créer une atmosphère de décadence qui justifie l’utilisation du thème de la femme fatale.The fascination with the mandrake for thousands of years originates, without a doubt, from the human form of the plant root. Many supernatural qualities are linked to the mandrake. It is believed, among other things, to be able to make its owner rich. The gloomy details surrounding the mandrake myth make it a theme of predilection for fantastic literature. The aim of this thesis is to analyse the legend of the mandrake in three works of German fantastic literature — Achim von Arnim’s Isabella of Egypt (1812), E.T.A. Hoffmann’s Little Zaches, Surnamed Zinnober (1819) and Hanns Heinz Ewers’ Alraune (1911). These authors also combine the mandrake motif with another theme, much appreciated by the fantastic genre: the artificial man. In an intertextual perspective, I will examine how each author adapts the mandrake myth and represents his mandrake character. Then, I will analyze the new qualities created by their artificial creature status and the relationship of the character with its creator. Finally, I will bring to light the role of the mandrake character in each work in regards to the historical context. It will be proven that the mandrake characters do own qualities that refer to the mandrake mythos, but that their nature as artificial creatures puts them, in their story, in the antagonist role that is similar to the trickster’s one. In the end, I will explain how the authors use the mandrake motif and the fantastic literature to respectively denounce corruption, criticize the Enlightenment advocates and create a decadent atmosphere that justifies the use of the femme fatale theme.Die menschliche Form der Alraunenwurzel verursachte eine seit Jahrtausenden von dieser Pflanze ausgehende Faszination. Übernatürliche Eigenschaften werden mit ihr verbunden: Sie würde unter anderem ihren Besitzer sehr reich machen. Die unheimlichen Einzelheiten, die mit der Alraune assoziiert werden, machen es zu einem beliebten Thema der phantastischen Literatur. Das Ziel dieser Arbeit ist, die Alraunensage in drei Werken der deutschen phantastischen Literatur zu analysieren: Isabella von Ägypten (1812) von Achim von Arnim, Klein Zaches genannt Zinnober (1819) von E.T.A. Hoffmann und Alraune (1911) von Hanns Heinz Ewers, die dieses Motiv mit einem anderen sehr beliebten Thema des Phantastischen in Zusammenhang bringen: dem künstlichen Menschen. In einer intertextuellen Hinsicht analysiere ich, wie sich jeder Autor den Alraunenmythos zu eigen macht und seine Alraunenfigur darstellt. Ich untersuche außerdem die neuen Vorzüge, die ihre Natur künstlichen Menschen schaffen, und das Verhältnis der Alraunenfigur zu ihrem Schöpfer. Schließlich konzentriere ich mich auf ihre Rolle im geschichtlichen Kontext. Es wird dann gezeigt, dass die Alraunenfiguren tatsächlich Eigenschaften haben, die sich auf die Alraunensage beziehen. Zudem stellen sie wegen ihrer Erscheinung als künstliches Geschöpf einen Antagonisten, der dem Trickster ähnlich ist, in der Erzählung dar. Schließlich erkläre ich, wie die Autoren das Alraunenmotiv durch die phantastische Literatur verwenden, um die Korruption anzuprangern, die aufgeklärten Menschen zu kritisieren und eine dekadente Stimmung zu kreieren, die die Verwendung des Themas der femme fatale rechtfertigt

Discovery of novel plasma biomarker ratios to discriminate traumatic brain injury

Background: Traumatic brain injury (TBI) is a major cause of death and disability. Despite increased awareness, reliable biomarkers are urgently needed to aid in all forms of traumatic brain injury diagnosis and prognosis. Methods: Here, we aim to assess the diagnostic utility of known and novel TBI biomarkers in a pilot patient cohort of severe TBI (sTBI) patients and healthy controls. We analyzed concentrations of S100 calcium binding protein B (S100B), neuron specific enolase (NSE), human kallikrein 6 (hK6) and prostaglandin D2 synthase (PGDS) using ELISA immunoassays. Results: Plasma levels of hK6 and PGDS were significantly lower in sTBI compared with controls, while S100B and NSE were significantly higher. Furthermore, we show that ratios of NSE and S100B with hK6 and PGDS may be able to determine the presence of sTBI better than single markers alone. Conclusions: The findings presented here represent a starting point for future validation, where biomarker ratios can be tested in independent TBI cohorts

The Utilitarian Virtual Self - Using Embodied Personalized Avatars to Investigate Moral Decision-Making in Semi-Autonomous Vehicle Dilemmas

Embodied personalized avatars are a promising new tool to investigate moral decision-making by transposing the user into the &amp;#x201C;middle of the action&amp;#x201D; in moral dilemmas. Here, we tested whether avatar personalization and motor control could impact moral decision-making, physiological reactions and reaction times, as well as embodiment, presence and avatar perception. Seventeen participants, who had their personalized avatars created in a previous study, took part in a range of incongruent (i.e., harmful action led to better overall outcomes) and congruent (i.e., harmful action led to trivial outcomes) moral dilemmas as the drivers of a semi-autonomous car. They embodied four different avatars (counterbalanced - personalized motor control, personalized no motor control, generic motor control, generic no motor control). Overall, participants took a utilitarian approach by performing harmful actions only to maximize outcomes. We found increased physiological arousal (SCRs and heart rate) for personalized avatars compared to generic avatars, and increased SCRs in motor control conditions compared to no motor control. Participants had slower reaction times when they had motor control over their avatars, possibly hinting at more elaborate decision-making processes. Presence was also higher in motor control compared to no motor control conditions. Embodiment ratings were higher for personalized avatars, and generally, personalization and motor control were perceptually positive features. These findings highlight the utility of personalized avatars and open up a range of future research possibilities that could benefit from the affordances of this technology and simulate, more closely than ever, real-life action.</p