With a little help from my friends: Developing an assisted automated peritoneal dialysis program in Western Australia

Background: Nurse-assisted automated peritoneal dialysis (AAPD) offers a model of care that has been successfully used in frail dialysis populations internationally. AAPD offers cost savings over hospitalisation on peritoneal dialysis (PD) or in-centre haemodialysis (HD). Method: A pilot AAPD model of care was developed in Western Australia (WA). Patient evaluation was measured utilising a perceptions of dialysis survey, clinical events, hospitalisation and peritonitis rates, Charlson Comorbidity Index (CCI), KDQoL-SF 36 and a survey. Staff opinions and perceived competency were measured by an online survey. Economic analysis was undertaken. Results: A successful collaborative model was developed. 40 staff were trained and competency significantly improved during program delivery (p < 0.0001). 15 patients with an average CCI score of 8.7 used the service for 18 periods of care over 18 months (mean 33 days SD 47). Two non-renal cause deaths and two episodes of peritonitis occurred. Patient opinions were extremely positive. Cost savings were estimated at $620,000. Conclusion: In WA, an AAPD pilot program has been successfully developed and delivered. A sustainable model has overcome initial hurdles. Staff have gained new skills and delivered effective care, demonstrated by high patient acceptance. The program was cost-effective compared to staying in hospital or transferring to HD

Southern Argentina Agile Meteor Radar: System design and initial measurements of large-scale winds and tides

The Southern Argentina Agile Meteor Radar (SAAMER) was installed at Rio Grande on Tierra del Fuego (53.8°S, 67.8°W) in May 2008 and has been operational for ∼24 months. This paper describes the motivations for the radar design and its placement at the southern tip of South America, its operating modes and capabilities, and observations of the mean winds, planetary waves, and tides during its first ∼20 months of operation. SAAMER was specifically designed to provide very high resolution of large-scale motions and hopefully enable direct measurements of the vertical momentum flux by gravity waves, which have only been possible previously with dual- or multiple-beam radars and lidars or in situ measurements. SAAMER was placed on Tierra del Fuego because it was a region devoid of similar measurements, the latitude was anticipated to provide high sensitivity to an expected large semidiurnal tide, and the region is now recognized to be a "hot spot" of small-scale gravity wave activity extending from the troposphere into the mesosphere and lower thermosphere, perhaps the most dynamically active location on Earth. SAAMER was also intended to permit simultaneous enhanced meteor studies, including "head echo" and "nonspecular" measurements, which were previously possible only with high-power large-aperture radars. Initial measurements have defined the mean circulation and structure, exhibited planetary waves at various periods, and revealed large semidiurnal tide amplitudes and variability, with maximum amplitudes at higher altitudes often exceeding 60 m s-1 and amplitude modulations at periods from a few to ∼30 days.Universidad Nacional De La Plat

Southern Argentina Agile Meteor Radar: System design and initial measurements of large-scale winds and tides

The Southern Argentina Agile Meteor Radar (SAAMER) was installed at Rio Grande on Tierra del Fuego (53.8°S, 67.8°W) in May 2008 and has been operational for ∼24 months. This paper describes the motivations for the radar design and its placement at the southern tip of South America, its operating modes and capabilities, and observations of the mean winds, planetary waves, and tides during its first ∼20 months of operation. SAAMER was specifically designed to provide very high resolution of large-scale motions and hopefully enable direct measurements of the vertical momentum flux by gravity waves, which have only been possible previously with dual- or multiple-beam radars and lidars or in situ measurements. SAAMER was placed on Tierra del Fuego because it was a region devoid of similar measurements, the latitude was anticipated to provide high sensitivity to an expected large semidiurnal tide, and the region is now recognized to be a "hot spot" of small-scale gravity wave activity extending from the troposphere into the mesosphere and lower thermosphere, perhaps the most dynamically active location on Earth. SAAMER was also intended to permit simultaneous enhanced meteor studies, including "head echo" and "nonspecular" measurements, which were previously possible only with high-power large-aperture radars. Initial measurements have defined the mean circulation and structure, exhibited planetary waves at various periods, and revealed large semidiurnal tide amplitudes and variability, with maximum amplitudes at higher altitudes often exceeding 60 m s-1 and amplitude modulations at periods from a few to ∼30 days.Universidad Nacional De La Plat

Southern Argentina Agile Meteor Radar: System design and initial measurements of large-scale winds and tides

The Southern Argentina Agile Meteor Radar (SAAMER) was installed at Rio Grande on Tierra del Fuego (53.8°S, 67.8°W) in May 2008 and has been operational for ∼24 months. This paper describes the motivations for the radar design and its placement at the southern tip of South America, its operating modes and capabilities, and observations of the mean winds, planetary waves, and tides during its first ∼20 months of operation. SAAMER was specifically designed to provide very high resolution of large-scale motions and hopefully enable direct measurements of the vertical momentum flux by gravity waves, which have only been possible previously with dual- or multiple-beam radars and lidars or in situ measurements. SAAMER was placed on Tierra del Fuego because it was a region devoid of similar measurements, the latitude was anticipated to provide high sensitivity to an expected large semidiurnal tide, and the region is now recognized to be a "hot spot" of small-scale gravity wave activity extending from the troposphere into the mesosphere and lower thermosphere, perhaps the most dynamically active location on Earth. SAAMER was also intended to permit simultaneous enhanced meteor studies, including "head echo" and "nonspecular" measurements, which were previously possible only with high-power large-aperture radars. Initial measurements have defined the mean circulation and structure, exhibited planetary waves at various periods, and revealed large semidiurnal tide amplitudes and variability, with maximum amplitudes at higher altitudes often exceeding 60 m s-1 and amplitude modulations at periods from a few to ∼30 days.Universidad Nacional De La Plat

Linking missions to scenarios for analysis of military macro-systems

Military Operations Research studies often involve the analysis of structured descriptions of plausible contingencies called ‘scenarios’. While scenarios attempt to provide a sufficient account of an unfolding contingency they do not typically include details of specific types of missions undertaken at the operational level or even the broad roles of the military forces undertaking those missions. Some means of linking key events, decision points and military activities in the chosen scenario to the roles and missions undertaken by a military force was thus sought for recent studies in joint operations. This article discusses a Mission-to-Scenario methodology developed, which provides a repeatable framework to structure the analysis of related problems. Application of the Mission-to-Scenario methodology for military macro-system analysis may then be used to explore the efficacy of military capabilities, operational effectiveness of specific platforms and the impact of proposed insertion of new technologies or organisational changes.Charles Vandepeer, Terry Moon and Garth De Visse

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Southern Argentina Agile Meteor Radar: System design and initial measurements of large-scale winds and tides

The Southern Argentina Agile Meteor Radar (SAAMER) was installed at Rio Grande on Tierra del Fuego (53.8°S, 67.8°W) in May 2008 and has been operational for ∼24 months. This paper describes the motivations for the radar design and its placement at the southern tip of South America, its operating modes and capabilities, and observations of the mean winds, planetary waves, and tides during its first ∼20 months of operation. SAAMER was specifically designed to provide very high resolution of large-scale motions and hopefully enable direct measurements of the vertical momentum flux by gravity waves, which have only been possible previously with dual- or multiple-beam radars and lidars or in situ measurements. SAAMER was placed on Tierra del Fuego because it was a region devoid of similar measurements, the latitude was anticipated to provide high sensitivity to an expected large semidiurnal tide, and the region is now recognized to be a “hot spot” of small-scale gravity wave activity extending from the troposphere into the mesosphere and lower thermosphere, perhaps the most dynamically active location on Earth. SAAMER was also intended to permit simultaneous enhanced meteor studies, including “head echo” and “nonspecular” measurements, which were previously possible only with high-power large-aperture radars. Initial measurements have defined the mean circulation and structure, exhibited planetary waves at various periods, and revealed large semidiurnal tide amplitudes and variability, with maximum amplitudes at higher altitudes often exceeding 60 m s−1 and amplitude modulations at periods from a few to ∼30 days.Fil: Fritts, D. C.. Colorado Research Associates division, Boulder; Estados UnidosFil: Janches, D.. Colorado Research Associates division, Boulder; Estados UnidosFil: Iimura, H.. Colorado Research Associates division, Boulder; Estados UnidosFil: Hocking, W. K.. University of Western Ontario. Department of Physics; CanadáFil: Mitchell, N. J.. University Of Bath; Reino UnidoFil: Stockwell, R. G.. Colorado Research Associates division, Boulder; Estados UnidosFil: Fuller, B.. Genesis Software Pty; AustraliaFil: Vandepeer, B.. Genesis Software Pty; AustraliaFil: Hormaechea, Jose Luis. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico San Juan; Argentina. Universidad Nacional de La Plata; ArgentinaFil: Brunini, Claudio Antonio. Universidad Nacional de la Plata. Facultad de Ciencias Astronómicas y Geofísicas; Argentina. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico San Juan; ArgentinaFil: Levato, Orlando Hugo. Consejo Nacional de Investigaciones Cientificas y Tecnicas. Centro Cientifico Tecnologico San Juan. Instituto de Ciencias Astronomicas de la Tierra y del Espacio; Argentin