The impact of diabetic ketoacidosis and age on behavior six months post-diagnosis in children with type 1 diabetes

Objectives: Children with type 1 diabetes mellitus (DM1) may be at increased risk of psychosocial and adjustment difficulties. We examined behavioral outcomes six months post-diagnosis in a group of children with newly diagnosed DM1. Methods: This study formed part of a larger longitudinal project examining pathophysiology and neuropsychological outcomes in diabetic patients with or without diabetic ketoacidosis (DKA). Participants were 61 children (mean age 11.8 years, SD 2.7 years) who presented with a new diagnosis of DM1 at the Royal Children’s Hospital, Melbourne. Twenty-three (11 female) presented in DKA and 38 (14 female) without DKA. Parents completed the behavior assessment system for children, second edition six months post-diagnosis. Results: There was a non-linear relationship between age and behavior. Internalising problems (i.e. anxiety depression, withdrawal) peaked in the transition from childhood to adolescence; children aged 10–13 years had elevated rates relative to the normal population (t = 2.55, P = 0.018). There was a non-significant trend for children under 10 to display internalising problems (P = 0.052), but rates were not elevated in children over 13 (P = 0.538). Externalising problems were not significantly elevated in any age group. Interestingly, children who presented in DKA were at lower risk of internalising problems than children without DKA (t = 3.83, P < 0.001). There was no effect of DKA on externalising behaviors. Conclusions: Children transitioning from childhood to adolescence are at significant risk for developing internalising problems such as anxiety and lowered mood after diagnosis of DM1. Somewhat counter-intuitively, parents of children presenting in DKA reported fewer internalising symptoms than parents of children without DKA. These results highlight the importance of monitoring and supporting psychosocial adjustment in newly diagnosed children even when they seem physically well.

Contradictions and the Appropriation of ERP Packages

Enterprise Resource Planning (ERP) software typically takes the form of a package that is licensed for use to those in a client organisation and is sold as being able to automate a wide range of processes within organisations. ERP packages have become an important feature of information and communications technology (ICT) infrastructures in organizations. However, a number of highly publicised failures have been associated with the ERP packages too. For example: Hershey, Aero Group and Snap-On have blamed the implementation of ERP packages for negative impacts upon earnings (Scott and Vessey 2000); Cadbury Schweppes implemented plans to fulfil 250 orders where normally they would fulfil 1000 due to the increased complexity and the need to re-train staff post implementation (August 1999) and FoxMeyer drug company’s implementation of an ERP package has been argued to have lead to bankruptcy proceedings resulting in litigation against SAP, the software vendor in question (Bicknell 1998). Some have even rejected a single vendor approach outright (Light et. al. 2001). ERP packages appear to work for some and not for others, they contain contradictions. Indeed, if we start from the position that technologies do not provide their own explanation, then we have to consider the direction of a technological trajectory and why it moves in one way rather than another (Bijker and Law 1994). In other words, ERP appropriation cannot be predetermined as a success, despite the persuasive attempts of vendors via their websites and other marketing channels. Moreover, just because ERP exists, we cannot presume that all will appropriate it in the same fashion, if at all. There is more to the diffusion of innovations than stages of adoption and a simple demarcation between adoption and rejection. The processes that are enacted in appropriation need to be conceptualised as a site of struggle, political and imbued with power (Hislop et. al. 2000; Howcroft and Light, 2006). ERP appropriation and rejection can therefore be seen as a paradoxical phenomenon. In this paper we examine these contradictions as a way to shed light on the presence and role of inconsistencies in ERP appropriation and rejection. We argue that much of the reasoning associated with ERP adoption is pro-innovation biased and that deterministic models of the diffusion of innovations such as Rogers (2003), do not adequately take account of contradictions in the process. Our argument is that a better theoretical understanding of these contradictions is necessary to underpin research and practice in this area. In the next section, we introduce our view of appropriation. Following this is an outline of the idea of contradiction, and the strategies employed to ‘cope’ with this. Then, we introduce a number of reasons for ERP adoption and identify their inherent contradictions using these perspectives. From this discussion, we draw a framework, which illustrates how the interpretive flexibility of reasons to adopt ERP packages leads to contradictions which fuel the enactment of appropriation and rejection.

Laying equitable claims to rest : key concerns in estate litigation post death

Equitable claims now increasingly arise in Australian estate litigation, particularly in conjunction with family provision applications.

Post-fire mechanical properties of cold-formed steels

Cold-formed steel members have been widely used in residential, industrial and commercial buildings as primary load-bearing and non-load bearing structural elements. These buildings must be properly evaluated after a fire event to assess the nature and extent of structural damage. If the general appearance of the structure is satisfactory after a fire event then the question that has to be answered is how the structural capacity of cold-formed steel members in these buildings has been affected. Elevated temperatures during a fire event affect the structural performance of cold-formed steel members even after cooling down to ambient temperature due to the possible detrimental changes in their mechanical properties. However, the post-fire behaviour of cold-formed steel members has not been investigated in the past and hence there is a need to investigate the post-fire mechanical properties of cold-formed steels. Therefore an experimental study was undertaken at the Queensland University of Technology to understand the residual mechanical properties of cold-formed steels after fire events. Tensile coupon tests were conducted on three different steel grades and thicknesses to obtain their stress-strain curves and relevant mechanical properties after cooling them down from different elevated temperatures. It was found that the post-fire mechanical properties of cold-formed steels are different to the original ambient temperature mechanical properties. Hence a new set of equations is proposed to predict the reduced mechanical properties of cold-formed steels after a fire event.

Multiliteracies pedagogy : creating claymations with adolescent, post-beginner English language learners

In addressing literacy in high school education, it is important to foreground the particular issues faced by growing numbers of English Language Learners (ELLs). In our increasingly culturally and linguistically diverse classrooms, this is a matter for all literacy teachers, as well as ELL specialists. In Australia, teachers of ELLs are experimenting with Multiliteracies pedagogy which provides rich opportunities to explore language learning experiences and outcomes that stretch beyond exercises in reproduction in written and oral modes only. This paper documents the practice of a high school teacher who uses a claymation project, producing a movie by stop-motion filming of clay figures, with a class of low-level English literacy learners. Drawing on observations of three particular students, the paper outlines a number of possibilities of this approach for English language learners. These include increased individual agency; enhanced engagement through collaboration; and the opportunity to explore various elements of multimodal text design.

The knowledge: a project by Boxcopy at Post-Museum, Singapore

‘The Knowledge’ was part of the Next Wave/Asialink project 'Invisible Structures: Australian artist collectives in Tokyo, Singapore and Yogyakarta' in January 2011. For this project, Brisbane ARI Boxcopy undertook a two-week residency at Post Musuem in Singapore. In this project, the Boxcopy artists Channon Goodwin, Joseph Breikers, Timothy P Kerr, Daniel McKewen, Raymonde Rajkowski, Tim Woodward, attempted to acquire an intimate knowledge of the city of Singapore by forming a free delivery company, The Boxcopy Publics Carriage Office of Singapore (BPCOS), which provided services around the city by foot, bike and public transport. In addition to committing to memory and documenting the streets and sites of Singapore, the BPCOS team also performed tasks such as delivering goods or messages, travel a particular route or visit a site, as requested by the people of Singapore. The project comprised this process of public interaction as well as an exhibition and website.

Determination of urinary thymidine glycol using affinity chromatography, HPLC and post-column reaction detection : a biomarker of oxidative DNA damage upon kidney transplantation

Reactive oxygen species are generated during ischaemia-reperfusion of tissue. Oxidation of thymidine by hydroxyl radicals (HO) leads to the formation of 5,6-dihydroxy-5,6-dihydrothymidine (thymidine glycol). Thymidine glycol is excreted in urine and can be used as biomarker of oxidative DNA damage. Time dependent changes in urinary excretion rates of thymidine glycol were determined in six patients after kidney transplantation and in six healthy controls. A new analytical method was developed involving affinity chromatography and subsequent reverse-phase high-performance liquid chromatography (RP-HPLC) with a post-column chemical reaction detector and endpoint fluorescence detection. The detection limit of this fluorimetric assay was 1.6 ng thymidine glycol per ml urine, which corresponds to about half of the physiological excretion level in healthy control persons. After kidney transplantation the urinary excretion rate of thymidine glycol increased gradually reaching a maximum around 48 h. The excretion rate remained elevated until the end of the observation period of 10 days. Severe proteinuria with an excretion rate of up to 7.2 g of total protein per mmol creatinine was also observed immediately after transplantation and declined within the first 24 h of allograft function (0.35 + 0.26 g/mmol creatinine). The protein excretion pattern, based on separation of urinary proteins on sodium dodecyl sulphate-polyacrylamide gel electrophorosis (SDS-PAGE), as well as excretion of individual biomarker proteins, indicated nonselective glomerular and tubular damage. The increased excretion of thymidine glycol after kidney transplantation may be explained by ischaemia-reperfusion induced oxidative DNA damage of the transplanted kidney.

Changes in outdoor workers' sun-related attitudes, beliefs, and behaviors : a pre-post workplace intervention

OBJECTIVE To evaluate changes in outdoor workers' sun-related attitudes, beliefs, and behaviors in response to a health promotion intervention using a participatory action research process. METHODS Fourteen workplaces across four outdoor industry types worked collaboratively with the project team to develop tailored sun protection action plans. Workers were assessed before and after the 18-month intervention. RESULTS Outdoor workers reported increases in workplace support for sun protection (P < 0.01) and personal use of sun protection (P < 0.01). More workers reported seeking natural shade (+20%) and wearing more personal protective equipment, including broad-brimmed hats (+25%), long-sleeved collared shirts (+19%), and long trousers (+16%). The proportion of workers reporting sunburn over the past 12 months was lower at postintervention (-14%) (P = 0.03); however, the intensity of reported sunburn increased. CONCLUSIONS This intervention was successful in increasing workers' sun protective attitudes, beliefs, and behaviors.

Ethnic differences in lipid metabolism in two groups of obese South African women

There is a higher prevalence of ischemic heart disease (IHD) in South African white than black women. The objective of this study was to determine biochemical explanations for this prevalence. The study group contained 15 obese black women (OBW) and 14 obese white women (OWW), ah premenopausal, who were examined after an overnight fast. Anthropometric measurements and blood concentrations of glucose, non-esterified fatty acids (NEFAs), catecholamines, plasminogen activator inhibitor-1, C-peptide, proinsulin, lipograms, cortisol, growth hormone, and post-heparin Lipoprotein Lipase activity were measured during an oral glucose tolerance test (OGTT), Body composition was measured using bioelectrical impedance analysis, and subcutaneous and visceral fat mass were assessed with CT-scans. Visceral fat area was higher in OWW (139.7 +/- 10.7 cm(2)) than in OBW (72.3 +/- 3.9 cm(2)) (P < 0.01), as were fasting and 3 h triglyceride concentrations (P < 0.05 for all). OWW also had higher NEFA levels than OBW at 3 and 4 h compared, with OBW (P < 0.05 for both). Fasting cortisol (266 +/- 24 vs. 197 +/- 19 nmol/l; P < 0.05) was higher in OWW than in OBW. These data demonstrate that OWW have higher visceral fat mass than OBW, which may lead to a more atherogenic fasting and postprandial Lipid profile. The higher cortisol levels of the OWW may promote visceral fat deposition. - Punyadeera, C., M-T. van der Merwe, N.J. Crowther, M. Toman, C. P. Schlaphoff, and I. P. Gray. Ethnic differences in lipid metabolism in two groups of obese South African women.

Expression and regulation of vascular endothelial growth factor ligands and receptors during menstruation and post-menstrual repair of human endometrium

Regeneration and growth of the human endometrium after shedding of the functional layer during menstruation depends on an adequate angiogenic response. We analysed the mRNA expression levels of all known vascular endothelial growth factor (VEGF) ligands and receptors in human endometrium collected in the menstrual and proliferative phases of the menstrual cycle. In addition, we evaluated the expression of VEGF-A, VEGF-R2 and NRP-1 at the protein level. Two periods of elevated mRNA expression of ligands and receptors were observed, separated by a distinct drop at cycle days (CDs) 9 and 10. Immunohistochemical staining showed that VEGF and VEGF-R2 were expressed in epithelial, stromal and endothelial cells. NRP-1 was mainly confined to stroma and blood vessels; only in late-proliferative endometrium, epithelial staining was also observed. Except for endothelial VEGF-R2 expression in CDs 6-8, there were no significant differences in the expression of VEGF, VEGF-R2 or NRP-1 in any of the cell compartments. In contrast, VEGF release by cultured human endometrium explants decreased during the proliferative phase. This output was significantly reduced in menstrual and early-proliferative endometrium by estradiol (E2) treatment. Western blot analysis indicated that part of the VEGF-A was trapped in the extracellular matrix (ECM). Changes in VEGF ligands and receptors were associated with elevated expression of the hypoxia markers HIF1 alpha and CA-IX in the menstrual and early proliferative phases. HIF1 alpha was also detected in late-proliferative phase endometrium. Our findings indicate that VEGF-A exerts its actions mostly during the first half of the proliferative phase. Furthermore, VEGF-A production appears to be triggered by hypoxia in the menstrual phase and subsequently suppressed toy estrogen during the late proliferative phase.

Did Brisbane grow smartly? Drivers of city growth 1991-2001 and lessons for current policies

Urban areas are growing unsustainably around the world; however, the growth patterns and their associated drivers vary between contexts. As a result, research has highlighted the need to adopt case study based approaches to stimulate the development of new theoretic understandings. Using land-cover data sets derived from Landsat images (30 m × 30 m), this research identifies both patterns and drivers of urban growth in a period (1991-2001) when a number of policy acts were enacted aimed at fostering smart growth in Brisbane, Australia. A linear multiple regression model was estimated using the proportion of lands that were converted from non-built-up (1991) to built-up usage (2001) within a suburb as a dependent variable to identify significant drivers of land-cover changes. In addition, the hot spot analysis was conducted to identify spatial biases of land-cover changes, if any. Results show that the built-up areas increased by 1.34% every year. About 19.56% of the non-built-up lands in 1991 were converted into built-up lands in 2001. This conversion pattern was significantly biased in the northernmost and southernmost suburbs in the city. This is due to the fact that, as evident from the regression analysis, these suburbs experienced a higher rate of population growth, and had the availability of habitable green field sites in relatively flat lands. The above findings suggest that the policy interventions undertaken between the periods were not as effective in promoting sustainable changes in the environment as they were aimed for.

When the five giants of post war reconstruction meet the four pillars of welfare reform-young people lose out, again

This paper discusses proposed changes to the Australian welfare state in the Welfare Review chaired by Patrick McClure and launched by Kevin Andrews, Minister for Social Services in the Abbott government, in a recent address to the Sydney Institute. Andrews cited the Beveridge Report of 1942, referring to Lord William Beveridge as the “godfather of the British post-war welfare state”, commending him for putting forward a plan for a welfare state providing a minimal level of support, constituting a bare safety net, rather than “stifling civil society and personal responsibility” through generous provision. In line with a key TASA conference theme of challenging institutions and identifying social and political change at local and global levels, this paper examines both the Beveridge Report and the McClure Report, identifying key issues and themes of relevance to current times in Australia.

Medical negligence, causation and liability for non-disclosure of risk : a post-wallace framework and critique

Through an examination of Wallace v Kam, this article considers and evaluates the law of causation in the specific context of a medical practitioner’s duty to provide information to patients concerning material risks of treatment. To supply a contextual background for the analysis which follows, Part II summarises the basic principles of causation law, while Part III provides an overview of the case and the reasoning adopted in the decisions at first instance and on appeal. With particular emphasis upon the reasoning in the courts of appeal, Part IV then examines the implications of the case in the context of other jurisprudence in this field and, in so doing, provides a framework for a structured consideration of causation issues in future non-disclosure cases under the Australian civil liability legislation. As will become clear, Wallace was fundamentally decided on the basis of policy reasoning centred upon the purpose behind the legal duty violated. Although the plurality in Rogers v Whitaker rejected the utility of expressions such as ‘the patient’s right of self-determination’ in this context, some Australian jurisprudence may be thought to frame the practitioner’s duty to warn in terms of promoting a patient’s autonomy, or right to decide whether to submit to treatment proposed. Accordingly, the impact of Wallace upon the protection of this right, and the interrelation between it and the duty to warn’s purpose, is investigated. The analysis in Part IV also evaluates the courts’ reasoning in Wallace by questioning the extent to which Wallace’s approach to liability and causal connection in non-disclosure of risk cases: depends upon the nature and classification of the risk(s) in question; and can be reconciled with the way in which patients make decisions. Finally, Part V adopts a comparative approach by considering whether the same decision might be reached if Wallace was determined according to English law.