Use of a semi-automated object based analysis to map benthic composition,Heron Reef,Southern Great Barrier Reef

Coral reef scientists and managers require detailed information of reef environments to develop, implement and evaluate management strategies. Maps showing the distribution of corals, seagrass, algae, sand, rubble and rock are an essential component of this information. Using a semi-automated, object-based image analysis (OBIA) approach this study created a benthic community map for Heron Reef (area: approximately 27 km²), Southern Great Barrier Reef, Australia. Benthic cover information was acquired for calibration and validation via georeferenced photograph transects, which coincided with high spatial resolution Quickbird-2 satellite image capture in 2007. Through combination of these data sets and modification of a semi-automated OBIA classification scheme previously developed for seagrass environments to account for the heterogeneous nature of reef benthic communities, a benthic community map was created for Heron Reef with an overall accuracy of 61.6%. The robustness and repeatability of our method provide future opportunity to apply the semi-automated approach to a time series of field and high spatial resolution image data sets to create a time series of benthic community maps for Heron Reef. The results presented in this study therefore open up the opportunity to assess and understand the spatial and temporal dynamics of the reef environment.     

Black hypertension: A transcultural case study using the Betty Neuman model of nursing care

A case study approach was used to study a 36‐year‐old Southern black female for several weeks following a hypertensive crisis episode. The purpose of the study was to establish trust and understanding between the culturally different black client and white nurse. The Betty Neuman model of nursing care was used in developing an ethnocare plan for the subject. Cultural Stressors identified were: (1) obesity and dietary habits, evidence of the “soul food”; diet and salt, saturated fats, and cholesterol; (2) smoking, used as a coping mechanism when under self‐perceived stress; (3) noncom‐pliance in taking hypertensive drugs, which reflects cultural beliefs and feelings; (4) lack of understanding about the disease process, an example of cultural difference in language and beliefs; (5) inability to be a biological mother (the ability to produce children is perceived by the black culture as necessary to the fulfillment of the woman's role); and (6) living in a hostile environment. The ethnocare plan addressed each of these Stressors and was designed to fit this client's individual perception of nursing care and its value to her.     

Rasch analysis of the Patient and Observer Scar Assessment Scale (POSAS) in burn scars

Purpose  

The Patient and Observer Scar Assessment Scale (POSAS) is a questionnaire that was developed to assess scar quality. It consists of two separate six-item scales (Observer Scale and Patient Scale), both of which are scored on a 10-point rating scale. After many years of experience with this scale in burn scar assessment, it is appropriate to examine its psychometric properties using Rasch analysis.     

The influence of waiting times on cost-effectiveness: a case study of colorectal cancer mass screening

When a cost-effectiveness analysis is implemented, the health-care system is usually assumed to adjust smoothly to the proposed new strategy. However, technological innovations in health care may often induce friction in the organization of care supply, implying the congestion of services and subsequent waiting times. Our objective here is to measure how these short run rigidities can challenge cost-effectiveness recommendations favorable to an innovative mass screening test for colorectal cancer. Using Markov modeling, we compare the standard Guaiac fecal occult blood test (gFOBT) with an innovative screening test for colorectal cancer, namely the immunological fecal occult blood test (iFOBT). Waiting time can occur between a positive screening test and the subsequent confirmation colonoscopy. Five scenarios are considered for iFOBT: no further waiting time compared with gFOBT, twice as much waiting time for a period of 5 or 10 years, and twice as much waiting time for a period of 5 or 10 years combined with a 25 % decrease in participation to confirmation colonoscopies. According to our modeling, compared with gFOBT, iFOBT would approximately double colonoscopy demand. Probabilistic sensitivity analysis enables concluding that the waiting time significantly increases the uncertainty surrounding recommendations favorable to iFOBT if it induces a decrease in the adherence rate for confirmation colonoscopy.     

The Effect of Malaria and Intestinal Helminth Coinfection on Birth Outcomes in Kumasi, Ghana

This study was conducted to investigate the effect of Plasmodium falciparum and intestinal helminth coinfection on maternal anemia and birth outcomes. A cross-sectional study of 746 women who delivered in two hospitals in Kumasi was conducted. Data were collected using an investigator-administered questionnaire and from patients'' medical records. Blood was collected for determination of P. falciparum and hemoglobin levels. Adverse pregnancy outcomes were high (44.6%). Coinfection (versus no infection) was associated with 3-fold increase in low birth weight. For women with anemia, coinfection was 2.6 times and 3.5 times as likely to result in preterm deliveries and small for gestational age infants. The odds of having anemia was increased almost 3-fold by coinfection. Coinfection (versus helminth only) resulted in increased risks of anemia, low birth weight, and small for gestational age infants. This study demonstrates that women with malaria and intestinal helminth coinfection are at particular risk of adverse birth outcomes.