The problem investigated Four studies investigated the phenomenon of cancer-related fatigue (CRF) in women who had received adjuvant treatment for early-stage breast cancer, with a view to reducing the diagnostic uncertainty surrounding the syndrome and thus facilitating progress in both clinical management and aetiological research. Procedures and results A cross-sectional study of 109 women compared a ???cancer-specific??? self-report questionnaire (FACT-F) (canvassing fatigue symptoms) and a more generic questionnaire (SPHERE) (identifying depression and fatigue). Thirty-seven percent of women reported fatigue. Overall in 20%, fatigue was associated with psychological distress. Seventeen percent of women had fatigue but no depression. A qualitative study utilised focus groups to identify and compare the distinctive features of CRF with those of women with chronic fatigue syndrome (CFS). A similar set of symptoms was found in both groups, including overwhelming fatigue, un-refreshing sleep and subjective concentration problems. However, women with CFS also reported myalgia and arthralgia. Using the Structured Clinical Interview for Neurasthenia- SCIN, the third study compared the symptoms of three groups of women with fatigue: those with CRF, CFS or major depression. The detailed ???interviewer guide??? provided explicit directions for evaluating and classifying symptoms. This study confirmed the core symptom of ???profound fatigue unrelieved by rest???, and additional features that distinguished between the clinical diagnoses. The fourth study compared features of the evolution of clinically-identified fatigue syndromes in women from two prospective cohort studies; women with post-cancer fatigue (PCF) and women with post-infective fatigue syndrome (PIFS). Major conclusions A syndrome of PCF, present at least six months following adjuvant treatment and unexplained by medical or psychiatric disorder was investigated. The characteristics of PCF and those of CFS are very similar, with the fatigue state having indistinguishable descriptors. Longitudinal evaluation of the symptom complexes of PCF and PIFS suggests divergent pathways may be relevant. Co-morbid features like sleep disturbance; physical deconditioning and mood disturbance may be implicated as factors in the evolution and prolongation of PCF. These studies provide a basis for a more uniform and rigorous classification system - a necessary first step towards advancing the field both in investigating aetiology and new intervention strategies.

Bibliography: leaves 302-359. / xxvi, 392 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Psychology, 2000?

Typescript (photocopy) / 553 leaves : ill. ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Dept. of Psychiatry, 1982

A constructivist research paradigm informed an investigation of the relevance of music therapy (MT) in a cancer hospital, that is, (a) what did MT do(?) and (b) did it help? Over three months, criterion sampling was used to elicit interpretations from five sources: 128 patients who participated in MT, 27 patients who overheard or witnessed MT, 41 visitors, 62 staff, and the researcher who was also the MT clinician in this study. The researcher’s interpretations were recorded in a reflexive clinical journal and the respondents’ interpretations were written on anonymous open-ended questionnaires. The MT program was predominantly characterised by the use of patient and visitor selected live music. Thematic analysis, informed by grounded theory (Strauss & Corbin, 1990), and content analyses were performed on the five groups of data with the support of ATLAS/ti (Muhr, 1997) software. Many patients and visitors who experienced MT reported that MT elicited a range of affective responses and altered imaginings. Responses were especially characterised by memories being revisited but also characterised by the respondents’ “transportation” to new spaces or thoughts and physical sensations. Some staff and patients who overheard MT also reported similar experiences. The researcher, and often staff and visitors, also perceived that MT elicited affective and imagined sensations in patients.

Title page, contents and abstract only. The complete thesis in print form is available from the University of Adelaide Library. / "The objectives of this thesis were to characterise the effects fo AR-targeting agents on the growth of prostate cancer cells and to determine whether combining these agents to target the AR (androgen receptor) at more than one level in the signalling pathway would provide a more complete block of androgen signalling and prostate cancer cell growth." --p. v. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1289482 / Thesis (Ph.D.) -- University of Adelaide, School of Medicine,2006

As anti-cancer agents, retinoid induce cell growth arrest and differentiation, while HDACIs cause cell differentiation, growth inhibition, death and inhibit angiogenesis in many cancer types. However, a proportion of patients respond poorly to these therapies. My studies, presented here, aimed to improve the anti-cancer effects of these agents by identifying key factors which mediate cancer cell sensitivity or resistance to their action. In this study I have found that the clinically used retinoid, 13-cis RA, exerts its anti-cancer signal in a manner similar to atRA, by modulating the transcriptional response of retinoid-regulated genes. HDACI-induced cytotoxicity is significantly enhanced when combined with IFNα in 8 out of 9 cancer cell lines from various organ origins. Sensitivity to the combination treatment correlated with an absence of basal p21 protein expression, and cell cycle arrest. Knocking-down p21 gene expression further sensitized cancer cells to the combination therapy. Moreover, IFNα and HDACI co-operatively inhibited pro-angiogenic gene expression in cancer cells, and the combination therapy decreased endothelial cell migration, invasion, and capillary tubule formation. Further experiments on p21 as a resistance factor to anti-cancer treatment demonstrated that conditioned media from breast cancer MCF-7 cells transfected with p21 siRNA, induced significantly less endothelial cell migration, invasion and vascular sprouting, compared with media from cells transfected with scrambled siRNA. LC/MS analysis of the conditioned media revealed that Trx secretion was significantly reduced after p21 knockdown. The reduction in Trx secretion following p21 knockdown was due to a direct effect of p21 siRNA on the expression of intracellular TBP2 in neuroblastoma, prostate and lung cancer cells. Consistent with this result, media from MCF7 cells transfected with TBP2-specific siRNA alone, promoted endothelial cell invasion and vascular sprouting, Trx knockdown resulted in opposite effects, and the anti-angiogenic effect of p21 siRNA was offset by simultaneous TBP2 siRNA transfection. ChIP assay revealed that p21 directly bound to an E2F1-bindng site in the TBP2 gene promoter. These data indicate that p21 promoted tumour-driven angiogenesis through transcriptional repression of TBP2. Collectively, my experiments indicate several potential treatment targets directed toward enhancing the effectiveness of HDACIs and retinoids.

Electrocoagulation is an empirical (and largely heuristic) water treatment technology that has had many different applications over the last century. It has proven its viability by removing a wide range of pollutants. The approach to reactor design has been haphazard, however, with little or no reference to previous designs or underlying principles. This thesis reviewed these reactor designs, identifying key commonalities and synthesising a new design hierarchy, summarised by three main decisions: 1. Batch or continuous operation; 2. Coagulation only or coagulation plus flotation reactors, and; 3. Associated separation process if required. This design decision hierarchy thereby provides a consistent basis for future electrocoagulation reactor designs. Electrochemistry, coagulation, and flotation are identified as the key foundation sciences for electrocoagulation, and the relevant mechanisms (and their interactions) are extracted and applied in an electrocoagulation context. This innovative approach was applied to a 7 L batch electrocoagulation reactor treating clay-polluted water. Structured macroscopic experiments identified current (density), time, and mixing as the key operating parameters for electrocoagulation. A dynamic mass balance was conducted over the batch reactor, for the first time, thereby enabling the extraction of a concentration profile. For this batch system, three operating stages were then identifiable: lag, reactive, and stable stages. Each stage was systematically investigated (in contrast to the previous ad hoc approach) with reference to each of the foundation sciences and the key parameters of current and time. Electrochemical behaviour characterised both coagulant and bubble generation. Polarisation experiments were used to determine the rate-limiting step at each electrode�s surface. Consequently the appropriate Tafel parameters were extracted and hence the cell potential. At low currents both electrodes (anode and cathode) operated in the charge-transfer region. As the current increased, the mechanism shifted towards the diffusion-limited region, which increased the required potential. Polarisation experiments also define the operating potential at each electrode thereby enabling aluminium�s dissolution behaviour to be thermodynamically characterised on potential-pH (Pourbaix) diagrams. Active and passive regions were defined and hence the aluminium�s behaviour in an aqueous environment can now be predicted for electrocoagulation. Novel and detailed solution chemistry modelling of the metastable and stable aluminium species revealed the importance of oligomer formation and their rates in electrocoagulation. In particular, formation of the positively trimeric aluminium species increased solution pH (to pH 10.6), beyond the experimentally observed operable pH of 9. Thereby signifying the importance of the formation kinetics to the trimer as the active coagulant specie in electrocoagulation. Further leading insights to the changing coagulation mechanism in electrocoagulation were possible by comparison and contrast with the conventional coagulation method of alum dosing. Initially in the lag stage, little aggregation is observed until the coagulant concentration reaches a critical level. Simultaneously, the measured zeta potential increases with coagulant addition and the isoelectric point is attained in the reactive stage. Here a sorption coagulation mechanism is postulated; probably charge neutralisation, that quickly aggregates pollutant particles forming open structured aggregates as indicated by the low fractal dimension. As time progresses, pollutant concentration decreases and aluminium addition continues hence aluminium hydroxide/oxide precipitates. The bubbles gently sweep the precipitate through the solution, resulting in coagulation by an enmeshment mechanism (sweep coagulation). Consequently compact aggregates are formed, indicating by the high fractal dimension. Flotation is an inherent aspect of the batch electrocoagulation reactor via the production of electrolytic gases. In the reactor, pollutant separation occurs in situ, either by flotation or settling. From the concentration profiles extracted, original kinetic expressions were formulated to quantify these competing removal processes. As current increases, both settling and flotation rate constants increased due to the additional coagulant generation. This faster removal was offset by a decrease in the coagulant efficiency. Consequently a trade-off exists between removal time and coagulant efficiency that can be evaluated economically. A conceptual framework of electrocoagulation is developed from the synthesis of the systematic study to enable a priori prediction. This framework creates predictability for electrocoagulation, which is innovative and original for the technology. Predictability provides insights to knowledge transfer (between batch and continuous), efficient coagulant and separation path, to name just a few examples. This predictability demystifies electrocoagulation by providing a powerful design tool for the future development of scaleable, industrial electrocoagulation water treatment design and operation process.

The Continuously fed Stirred Tank Reactor (CSTR) is a popular design for anaerobic treatment of wastewater. This reactor type is simple in design and operation, independent of biomass type and low in capital costs. The CSTR has, however, to be operated at long Hydraulic Retention Times (HRT) of the order of 16 to 30 days since biomass is continuously lost with the effluent. Various alternate concepts of reactor design have, therefore, been developed to allow more rapid treatment. Treatment can be enhanced by retaining biomass within the digester so that the HRT is decoupled from solid biomass retention time (SRT). Unlike in continuous stirred tank digesters where the SRT is equal to HRT, the SRT in other designs are much greater than the HRT. This allows the wastewater to be treated at high throughputs while retaining the biocatalyst (or biomass) mediating the treatment within the digester. In this study the operation of a CSTR was intensified by separating SRT from HRT while taking into account the economical aspects. The intensification of operation is defined as increasing wastewater throughput or organic loading rate while at the same time maintaining efficiency of treatment and robustness to reject disturbances (changes in wastewater concentration and flow rate). The operation of existing CSTR was intensified by addition of carriers. It is hypothesized that by providing surfaces (or carriers) for bacterial attachment within the continuous stirred tank digester, biomass will be better retained and the wastewater throughput can be increased. The carriers or surfaces employed in this study were light carrier elements (shredded granular rubber tire having a density of 0.96 g/cm3) that move gently with the water in the reactor. This carrier material is much cheaper compared with other commercial carrier materials. This reactor type, called an Anaerobic Moving Bed Reactor (AMBR), was applied in this study to treat high strength synthetic wastewater, containing molasses as the main substrate. The improvement of reactor performance was clearly shown by the capability of the system to be operated without any difficulties at HRT of 6 days at an OLR of 5.8 g COD/l/d or at HRT of 1 day at an OLR of 4 g COD/l/d. The carriers were shown to be effective in retaining biomass aggregates. The AMBR was further intensified by changing the feeding strategy. It was shown that in stirred tank digester without carriers an intermittent feeding strategy resulted in better microbial capacity to degrade higher chain volatile fatty acids like propionic and butyric acids than the continuous feeding mode. An increase in degrading capacity of the intermittently fed digester was shown via degradation rates of pulse additions of propionic and butyric acids and by its capability of handling all changes in loading rates imposed. The continuously fed digester, receiving constant feed, on the other hand, suffered more when loading rates were changed, and the degradation rates of propionic and butyric acids were slower. The intermittent feeding mode was then implemented on the AMBR, and it was operated as a sequencing batch reactor with a fill, react, settle and decant period in each cycle. The sequencing batch mode when applied to the AMBR (now called an Anaerobic Moving Bed Sequencing Batch Reactor or AMBSBR) could increase capability of the digester to handle higher shock loads. At 3.8 d HRT the AMBSBR could handle an OLR of 10.8 g COD/l/d as opposed to 7.4 g COD/l/d by the AMBR. At 2.5 d HRT the AMBSBR could handle an OLR of 6.4 g COD/l/d while the AMBR could only be loaded at an OLR of 4.2 g COD/l/d. The ratio of SRT to HRT was at least 15 for this reactor. The reactor was able to handle concentrated feed flow rates at longer cycles or more dilute feed flow rates at frequent shorter cycles. The proposed operational strategies were verified by using a structured mathematical model which was developed based on the IWA ADM1 model. Several modifications were implemented to the model to obtain better predictions. The modified model was capable in predicting all the trends of the operating variables from both continuously and intermittently fed reactors. None of the two model versions (ADM1 and modified models) was, however, able to predict the increased propionate degradation capacity in intermittently fed digesters. The reason for this was the assumption of fixed stoichiometry of fermentative reactions for glucose mineralisation. By modifying the fractions of glucose mineralisation a better fit between experimental results and the model could be obtained.

Meat processing industries produce large volumes of high strength wastewater. Conventional technologies used in Australia and similar countries for treatment of effluent from meat processing and similar industries, such as wineries and processed food industry, are treatment ponds with or without a mechanical treatment system. A properly designed activated sludge treatment system would be capable of biological removal of phosphorus and nitrogen in addition to BOD5. These systems, however, require substantial electrical power, skilled operational support and produce large quantities of biosolids or sludge which require further on-site treatment or off site disposal. Application of sub-surface flow constructed wetland (SSF-CW) systems could provide a sustainable solution for treatment of meat processing industry effluent and other similar high strength wastewaters. There are, however, only very limited studies on application of SSF-CW for secondary treatment of high strength wastewaters. Although there have been a number of cases where SSF-CW have been used as the secondary treatment unit for municipal wastewater, this technology has not still become a common practice for the same purpose in Australia. Most of the applications are for either polishing of secondary or tertiary treated municipal wastewater or for greywater treatment. This research was funded by National Meat Industry Advisory Council (MINTRAC). Sustainable wastewater treatment has been taken up as a very important issue by meat industry. The industry provides Ph.D research scholarships through MINTRAC to develop new technologies for wastewater treatment and nutrient removal from meat processing effluent. The main objective of the research was to develop process engineering design parameters for sub-surface flow constructed wetland (SSF-CW) with Monto vetiver (Vetiveria zizanioides recently reclassified as Chrysopogon zizanioides) as the emergent vegetation for treatment of high strength, nutrient rich wastewater. The study also investigated the phosphorus retention properties of pea gravel for use in SSF-CW system as bed media or as an external phosphorus removal system for meat processing industry effluent. In addition, chemical methods for phosphorus removal from meat processing industry effluent were also investigated. The thesis is based on experimental research. The research consisted of three types of experimental set up; a) using two laboratory experimental SSF-CW reactors (one with vetiver grass and the other reactor with no vegetation) in a greenhouse with batch feeding of artificial wastewater that simulates meat industry effluent, b) experiment with pea gravel of different particle sizes and solutions of different phosphorus (P) concentrations in a constant temperature room, c) laboratory experiment using actual meat processing industry effluent with alum and sodium aluminate for P removal. The structure of the thesis is as follows. Following the Introduction is the section of Literature Review, then sections on the experiments that follow a journal paper format, followed by a General Discussion, Conclusions and Recommendations. A list of references is provided at the end of the thesis. The literature review section has four chapters (Chapter 2 to Chapter 5). Chapter 2 describes a review of meat processing industry effluent characteristics and current treatment technologies. Chapter 3 is a critical review of current literature on COD removal using sub-surface flow constructed wetlands (SSF-CW). Chapter 4 and 5 describe a review of various processes and models on the fate of nitrogen and phosphorus in SSF-CW system respectively. Chapters 6 to 10 deal with experimental research part of the thesis. Chapters, 6, 7 and 8 share a common methodology section which is described in Chapter 6. Results of the batch experiments with the laboratory SSF-CW systems on COD removal, nitrogen removal and phosphorus retention are discussed in Chapters 6, 7 and 8 respectively. Chapter 9 explains a detailed experimental study on phosphorus adsorption dynamics of pea gravel. Chapter 10 discusses the results on experiments using sodium aluminate and aluminium sulphate for P removal from meat processing industry effluent as an alternate P removal method for such effluent. An overview of the major results of the experimental section is discussed in chapter 11, in the General Discussion section. Conclusions and Recommendations of the research are provided in Chapter 12. In this study, it was observed that Monto vetiver grass performed better during nitrification than in denitrification, where the plant did not survive. Ammonium N removal followed a first order decay in both vegetated and un-vegetated experimental SSF-CW system with average removal ranging from 40 to 60 % of the influent. Denitrification was found to be the pathway for nitrate removal. As long as the carbon source was available, the denitrification followed a first order exponential decay, with over 80% of nitrate was removed in 48 hours. Vetiver grass sustained elevated ammonium levels of approximately 200 mg/L or more, however it was under stress during denitrification and it eventually died. The experimental SSF-CW systems with pea gravel as bed media could effectively retain soluble reactive phosphorus (SRP) in the wetland cells during experiments of COD reduction and nitrification (with ammonia and high COD input). However, during denitrification study, both experimental SSF-CW cells did not show significant removal of SRP from wastewater. The vegetated cell removed nearly 50% of the input SRP, however, the un-vegetated cell did not show any trend for SRP removal, and in some cases the effluent SRP was nearly 90% of the input value. The role of Monto vetiver grass for N and P removal was found to be very minor and this study concluded that nutrient removal (N & P) by plant uptake could be neglected in the design of SSF-CW system with Monto vetiver grass. Adsorption is the major mechanism for P removal from the experimental SSF-CW systems, where pea gravel was used as bed media. The P adsorption capacity of pea gravel increased with decrease in particle size. For 16 to 18 mm, the Langmuir adsorption maximum was 99 mg/kg, whereas for very fine pea gravel powder (<150 ìm) the maximum adsorption observed experimentally was 3950 mg/kg. In a typical wetland with pea gravel as bed media for meat processing industry, the media would be capable of P retention for about 2 to 3 years of operation. Supplementary chemical removal method is needed for sustainable P removal once the adsorption maximum of wetland cell is reached. A chemical P removal system using liquid alum and NaOH for pH stabilisation is more appropriate than sodium aluminate. Application of sodium aluminate for P removal for meat processing industry effluent is found to be less effective as it would need higher dosage, longer settling period, coloured supernatant, acid addition for pH adjustment. Liquid alum application rate is recommended to be between a molar ratio of Al: P of 3 for TP value of <1 mg/L in the treated effluent. This research study concludes that horizontal flow SSF-CW system with Monto vetiver grass is suitable for COD removal and nitrification from high strength wastewater. Current design equation of horizontal flow SSF-CW system is mostly plug flow exponential decay method, but in this study, it has been concluded that retarded first order rate constant is the most appropriate design method for horizontal flow SSF-CW system for COD removal.

Thesis (M. Sc.)--University of Western Sydney, Hawkesbury, 1991. / Includes bibliographical references.