If you can't comply with dialysis, how do you expect me to trust you with transplantation? Australian nephrologists' views on indigenous Australians' 'non-compliance' and their suitability for kidney transplantation

<p>Abstract</p> <p>Introduction</p> <p>Indigenous Australians suffer markedly higher rates of end-stage kidney disease (ESKD) but are less likely than their non-Indigenous counterparts to receive a transplant. This difference is not fully explained by measurable clinical differences. Previous work suggests that Indigenous Australian patients may be regarded by treating specialists as 'non-compliers', which may negatively impact on referral for a transplant. However, this decision-making is not well understood. The objectives of this study were to investigate: whether Indigenous patients are commonly characterised as 'non-compliers'; how estimations of patient compliance factor into Australian nephrologists' decision-making about transplant referral; and whether this may pose a particular barrier for Indigenous patients accessing transplants.</p> <p>Methods</p> <p>Nineteen nephrologists, from eight renal units treating the majority of Indigenous Australian renal patients, were interviewed in 2005-06 as part of a larger study. Thematic analysis was undertaken to investigate how compliance factors in specialists' decision-making, and its implications for Indigenous patients' likelihood of obtaining transplants.</p> <p>Results</p> <p>Specialists commonly identified Indigenous patients as both non-compliers and high-risk transplant candidates. Definition and assessment of 'compliance' was neither formal nor systematic. There was uncertainty about the value of compliance status in predicting post-transplant outcomes and the issue of organ scarcity permeated participants' responses. Overall, there was marked variation in how specialists weighed perceptions of compliance and risk in their decision-making.</p> <p>Conclusion</p> <p>Reliance on notions of patient 'compliance' in decision-making for transplant referral is likely to result in continuing disadvantage for Indigenous Australian ESKD patients. In the absence of robust evidence on predictors of post-transplant outcomes, referral decision-making processes require attention and debate.</p

Ants as ecological indicators of rainforest restoration: community convergence and the development of an Ant Forest Indicator Index in the Australian wet tropics

Ecosystem restoration can help reverse biodiversity loss, but whether faunal communities of forests undergoing restoration converge with those of primary forest over time remains contentious. There is a need to develop faunal indicators of restoration success that more comprehensively reflect changes in biodiversity and ecosystem function. Ants are an ecologically dominant faunal group and are widely advocated as ecological indicators. We examine ant species and functional group responses on a chronosequence of rainforest restoration in northern Australia, and develop a novel method for selecting and using indicator species. Four sampling techniques were used to survey ants at 48 sites, from grassland, through various ages (1–24 years) of restoration plantings, to mature forest. From principal components analysis of seven vegetation metrics, we derived a Forest Development Index (FDI) of vegetation change along the chronosequence. A novel Ant Forest Indicator Index (AFII), based on the occurrences of ten key indicator species associated with either grassland or mature forest, was used to assess ant community change with forest restoration. Grasslands and mature forests supported compositionally distinct ant communities at both species and functional levels. The AFII was strongly correlated with forest development (FDI). At forest restoration sites older than 5–10 years that had a relatively closed canopy, ant communities converged on those of mature rainforest, indicating a promising restoration trajectory for fauna as well as plants. Our findings reinforce the utility of ants as ecological indicators and emphasize the importance of restoration methods that achieve rapid closed‐canopy conditions. The novel AFII assessed restoration status from diverse and patchily distributed species, closely tracking ant community succession using comprehensive species‐level data. It has wide applicability for assessing forest restoration in a way that is relatively independent of sampling methodology and intensity, and without a need for new comparative data from reference sites

MARIA M4:clinical evaluation of a prototype ultrawideband radar scanner for breast cancer detection

A microwave imaging system has been developed as a clinical diagnostic tool operating in the 3- to 8-GHz region using multistatic data collection. A total of 86 patients recruited from a symptomatic breast care clinic were scanned with a prototype design. The resultant three-dimensional images have been compared “blind” with available ultrasound and mammogram images to determine the detection rate. Images show the location of the strongest signal, and this corresponded in both older and younger women, with sensitivity of [Formula: see text] , which was found to be maintained in dense breasts. The pathway from clinical prototype to clinical evaluation is outlined

Evaluation of Two Approaches for Breast Surface Measurement Applied to a Radar-Based Imaging System

Locating the surface of an object, in this case the breast, is an important first step in many imaging situations; this surface information may be a necessary part of the reconstruction, it may be needed for the cancellation of the surface reflection, or (as herein) it may be needed as a preparatory step before imaging. This paper presents two complementary approaches developed for the purpose of surface localisation. The proposed approaches are evaluated using data from both phantom measurements and volunteer scans

Mid-Late Quaternary Fluvial Archives near the Margin of the MIS 12 Glaciation in Southern East Anglia, UK: Amalgamation of Multi-Disciplinary and Citizen-Science Data Sources

This paper presents an updated geological reconstruction of the Quaternary evolution of the River Thames at its downstream extremities, close to the North Sea coast, based on new data from multi-disciplinary and citizen-science sources. In this area, the interaction of the Thames with the MIS 12 (Anglian) glaciation is an important part of the Quaternary archive. The Anglian ice sheet, which reached parts of north and east London, was responsible for diverting the Thames southwards into its present course, although the footprint of the maximum ice sheet(s) does not reach the North Sea coast south of Hollesley, Suffolk. Further south, the coastal zone hosts pre-Anglian and early Anglian river-terrace deposits of the pre-diversion Thames system, superimposed upon which are products of later post-Anglian rivers, of both Middle and Late Pleistocene age. On the peninsula between the Stour and Blackwater–Colne estuaries, the lowest and most recent terrace of the pre-diversion Thames includes evidence directly pertaining to the glacial disruption event, for which geochronological data are reported here for the first time. The first post-diversion terrace of the Thames also reaches this peninsula, the river having essentially re-joined its original valley before crossing the alignment of the modern coastline. This terrace passes beneath Clacton-on-Sea, where it includes the type locality of the Clactonian Palaeolithic Industry. The area of interest to this paper, in NE Essex and southern Suffolk, includes a number of interglacial and Palaeolithic sites, the data from which assist in constraining the chronostratigraphy of the sequence. In some cases, there has been uncertainty as to whether these sites represent pre-Anglian environments and hominin occupations, part of the palaeo-Thames sequence, or whether they are the product of later post-Anglian streams, formed after the Thames had migrated southwards. This paper compiles evidence from a wide range of recent sources, including developer-funded archaeological appraisal and citizen-science activities, to explore and update the evidence from sites at Ipswich, Upper Dovercourt and Thorpe-le-Soken, as well as a number of localities associated with the Clacton Channel Deposits (host to the type-Clactonian), amongst others. The resulting new data are placed within the wider context of the Quaternary fluvial archives in southern Britain, with a discussion of how disparate sources of information, including the work of citizen scientists, have contributed