Developing an evidence-based clinical pathway for the assessment, diagnosis and management of acute Charcot Neuro-Arthropathy : a systematic review

Background: Charcot Neuro-Arthropathy (CN) is one of the more devastating complications of diabetes. To the best of the authors' knowledge, it appears that no clinical tools based on a systematic review of existing literature have been developed to manage acute CN. Thus, the aim of this paper was to systematically review existing literature and develop an evidence-based clinical pathway for the assessment, diagnosis and management of acute CN in patients with diabetes. Methods: Electronic databases (Medline, PubMed, CINAHL, Embase and Cochrane Library), reference lists, and relevant key websites were systematically searched for literature discussing the assessment, diagnosis and/or management of acute CN published between 2002-2012. At least two independent investigators then quality rated and graded the evidence of each included paper. Consistent recommendations emanating from the included papers were then fashioned in a clinical pathway. Results: The systematic search identified 267 manuscripts, of which 117 (44%) met the inclusion criteria for this study. Most manuscripts discussing the assessment, diagnosis and/or management of acute CN constituted level IV (case series) or EO (expert opinion) evidence. The included literature was used to develop an evidence-based clinical pathway for the assessment, investigations, diagnosis and management of acute CN. Conclusions: This research has assisted in developing a comprehensive, evidence-based clinical pathway to promote consistent and optimal practice in the assessment, diagnosis and management of acute CN. The pathway aims to support health professionals in making early diagnosis and providing appropriate immediate management of acute CN, ultimately reducing its associated complications such as amputations and hospitalisations.

Global indigenous studies in the first world: some reflections and epistemological matters

Indigenous studies in First World nation states such as Australia, Canada, New Zealand, the United States of America and Hawaii, appear to have acquired the status of a discipline, although the accounts of its formation vary. Indigenous studies is formally recognised as part of university curricula in these countries and is included in inter‐disciplinary contexts and degree programs or is offered as a program and a degree in its own right. Indigenous scholarship is being published in unprecedented numbers with publishing houses competing for manuscripts. Indigenous studies journals have proliferated having emerged in the 1970s though most were, and continue to be, edited by non‐Indigenous people. In addition, Indigenous studies professional associations have been established organising research related activities as well as convening conferences to enable intellectual engagement and the formation of national and international networks. The nature and extent of this institutionalisation and the conditions of existence, though often marginalised and under resourced, may allude to the coherence of Indigenous Studies as a discipline with global reach but what remains unclear are its epistemological boundaries and the degree to which it perpetuates cultural entrapment . This paper will reflect on some of these epistemological matters.

Benthic shift in a Solomon Islands' lagoon : corals to cyanobacteria

In June 2011 a large phytoplankton bloom resulted in a catastrophic mortality event that affected a large coastal embayment in the Solomon Islands. This consisted of an area in excess of 20 km2 of reef and soft sandy habitats in Marovo Lagoon, the largest double barrier lagoon in the world. This embayment is home to over 1200 people leading largely subsistence lifestyles depending on the impacted reefs for majority of their protein needs. A toxic diatom (Psuedo-nitzchia spp.) and toxic dinoflagellate (Pyrodinium bahamense var. compressum) reached concentrations of millions of cells per litre. The senescent phytoplankton bloom led to complete de-oxygenation of the water column that reportedly caused substantial mortality of marine animal life in the immediate area within a rapid timeframe (24 h). Groups affected included holothurians, crabs and reef and pelagic fish species. Dolphins, reptiles and birds were also found dead within the area, indicating algal toxin accumulation in the food chain. Deep reefs and sediments, whilst initially unaffected, have now been blanketed in large cyanobacterial mats which have negatively impacted live coral cover especially within the deep reef zone (> 6 m depth). Reef recovery within the deep zone has been extremely slow and may indicate an alternative state for the system.

School-based physical activity programs for adolescent wellness improvement : an investigation of the association between wellness and physical activity

This thesis by publication included seven manuscripts that advanced contemporary understanding of the association between physical activity and wellness among adolescents. The findings suggested that due to potential interrelatedness between various aspects of wellness, changes in physical activity may also influence co-existing wellness domains; highlighting the potential for physical activity interventions to have a broad range of benefits among youth. These findings also added to the body of literature supporting the potential inclusion of physical activity as a component within multifaceted youth wellness programs. Findings reported in this thesis have implications for those seeking to initiate youth wellness interventions.

Assessing community resilience to climate change

Settlements and communities in the Great Barrier Reef (GBR) are highly vulnerable to climate change and face an uncertain social, economic and environmental future. The concept of community resilience is gaining momentum as stakeholders and institutions seek to better understand the social, economic and governance factors which affect community capacity to adapt in the face of climate change. This paper defines a framework to benchmark community resilience and applies it to a case study in the Wet Tropics in tropical Queensland within the GBR catchment. It finds that rural, indigenous and some urban populations are highly vulnerable and sensitive to climate change, particularly in terms of economic vitality, community knowledge, aspirations and capacity for adaptation. Without early and substantive action, this could result in declining social and economic wellbeing and natural resource health. Capacity to manage the possible shocks associated with the impacts of climate change and extreme climatic events is emerging and needs to be carefully fostered and further developed to achieve broader community resilience outcomes. Better information about what actions, policies and arrangements build community resilience and mobilise adaptive capacity in the face of climate change is needed.

Discussion on the wind climate of Kuwait and Dubai

Historical wind data for Kuwait and Dubai have been analysed to determine the design wind speed for the region. Kuwait and Dubai are located near the northern and southern end of the Persian Gulf respectively. The winds in this region just north of the Tropic of Capricorn are dominated by the Shamal, literally 'north' in Arabic. The winds have traditional Bedouin names such as Al-Haffar (the driller), and Barih Thorayya (morning star). The Al-Dabaran is generally the strongest Shamal in late summer, and can last up to 40 days bringing sand and duststorms.

Editorial : is it the time for railway industry to reinvent itself?

Editorial: is it the time for railway industry to reinvent itself? Railway infrastructure plays a critical role in urban development, mobility, and economic growth of society. This focus issue of the Electronic Journal of Structural Engineering is devoted to a special theme, “Advances in Rail Track Infrastructure and Practice - ARTRP”. It contains articles, which were rigorously peer reviewed and accepted from a list of invited manuscripts that demonstrate significant innovation in the area of the structural engineering aspects of the rail track infrastructure...

The validity and reliability of the Parent Fever Management Scale: A study from Palestine

Background Parental fever phobia and overuse of antipyretics to control fever is increasing. Little is known about childhood fever management among Arab parents. No scales to measure parents’ fever management practices in Palestine are available. Aims The aims of this study were to translate and examine the psychometric properties of the Arabic version of the Parent Fever Management Scale (PFMS). Methods A standard “forward–backward” procedure was used to translate PFMS into Arabic language. It was then validated on a convenience sample of 402 parents between July and October 2012. Descriptive statistics were used, and instrument reliability was assessed for internal consistency using Cronbach's alpha coefficient. Validity was confirmed using convergent and known group validation. Results Applying the recommended scoring method, the median (interquartile range) score of the PFMS was 26 (23-30). Acceptable internal consistency was found (Cronbach’s alpha = 0.733) and the test–retest reliability value was 0.92 (P < 0.001). The chi-squared (χ2) test showed a significant relationship between PFMS groups and frequent daily administration of antipyretic groups (χ2 = 52.86; P < 0.001). The PFMS sensitivity and specificity were 77.67% and 57.75%, respectively. The positive and negative predictive values were 67.89% and 32.11%, respectively. Conclusions The findings of this validation study indicate that the Arabic version of the PFMS is a reliable and valid measure which can be used as a useful tool for health professionals to identify parents’ fever management practices and thus provide targeted education to reduce the unnecessary burden of care they place on themselves when concerned for a febrile child.

Furthering the discourse in postcolonial education

This editorial provides a rationale for launching the new journal 'Postcolonial Directions in Education'. It discusses the term 'postcolonialism', applying it to the study of processes of domination that have their origin in European colonialism, extending beyond the period of direct colonisation to take on new forms, notably those of neo-colonialism, dependency and the intensification of globalisation. Postcolonial theory probes identity, knowledge, and social, cultural and economic structures in historical context, and challenges structures rooted in colonialism and imperialism.The editors invite the submission of manuscripts applying such perspectives to many aspects of education.

Stories have the power to save us: A neurological framework for the imperative to tell stories

The evolutionary advantage of humans is in our unique ability to process stories – we have highly evolved ‘narrative organs.’ Through storytelling, vicarious knowledge, even guarded knowledge, is used to help our species to survive. We learn, regardless of whether the story being told is ‘truth’ or ‘fiction.’ This article discusses how humans place themselves in stories, as both observer and participant, to create a ‘neural balance’ or sweet spot that allows them to be immersed in a story without being entirely threatened by it – and how this involvement in story is the formation of empathy – an empathy that is integral to forging a future humanity. It is through empathy, we argue, that stories have the power to save us.

DNA molecules and future blockbuster therapeutics

Deoxyribonucleic acid molecules are heralding a new generation of reverse - engineered biopharmaceuticals. In terms of potential application in gene medicine, plasmid DNA (pDNA) vectors have exceptional therapeutic and immunological profiles as they are free from safety concerns associated with viral vectors, display non-toxicity and are simpler to develop. This presentation will discuss the potential applications of pDNA molecules in vaccine development and gene therapy, pilot-scale production of pDNA-based biopharmaceuticals and the controlled delivery of therapeutic sequences in biodegradable polymers to different target cells via the nasal route.

The Arab Spring on Twitter: Language Communities in #egypt and #libya

Building on hashtag datasets gathered since January 2011, this paper will compare patterns of Twitter usage during the popular revolution in Egypt and the civil war in Libya. Using custom-made tools for processing ‘big data’ (boyd & Crawford, 2011), we will examine the volume of tweets sent by English-, Arabic-, and mixed-language Twitter users over time, and examine the networks of interaction (variously through @replying, retweeting, or both) between these groups as they developed and shifted over the course of these uprisings. Examining @reply and retweet traffic, we will identify general patterns of information flow between the English- and Arabic-speaking sides of the Twittersphere, and highlight the roles played by key boundary riders connecting both language spheres. Further, we will examine the URLs shared in these hashtags by Twitter participants, to identify the most prominent overall information sources, examine differences in the information diet experienced by English- and Arabic-language users, and investigate whether there are any online sources whose URLs are transcending language boundaries more frequently than others.

Electronic medical record systems in Saudi Arabia: Knowledge and preferences of healthcare professionals

Background The use of Electronic Medical Record (EMR) systems is increasing internationally, though developing countries, such as Saudi Arabia, have tended to lag behind in the adoption and implementation of EMR systems due to several barriers. The literature shows that the main barriers to EMR in Saudi Arabia are lack of knowledge or experience using EMR systems and staff resistance to using the implemented EMR system. Methods A quantitative methodology was used to examine health personnel knowledge and acceptance of and preference for EMR systems in seven Saudi public hospitals in Jeddah, Makkah and Taif cities. Results Both English literacy and education levels were significantly correlated with computer literacy and EMR literacy. Participants whose first language was not Arabic were more likely to prefer using an EMR system compared to those whose first language was Arabic. Conclusion This study suggests that as computer literacy levels increase, so too do staff preferences for using EMR systems. Thus, it would be beneficial for hospitals to assess English language proficiency and computer literacy levels of staff prior to implementing an EMR system. It is recommended that hospitals need to offer training and targeted educational programs to the potential users of the EMR system. This would help to increase English language proficiency and computer literacy levels of staff as well as staff acceptance of the system.

A review of: "Wrong-Doing, Truth-Telling: The Function of Avowal in Justice. By Michel Foucault. Edited by Fabienne Brion and Bernard E. Harcourt. Translated by Stephen W. Sawyer"

Wrong-Doing, Truth-Telling: The Function of Avowal in Justice is a collection of seven lectures delivered by French philosopher and historian Michel Foucault at the Catholic University of Louvain in 1981. Compiled from audiovisual recordings and Foucault’s original manuscripts, these lectures explore the notion of avowal and its place within criminal justice processes. Accompanied by three contemporaneous interviews given by Foucault (only one of which has previously been available in English), and a preface and concluding essay by the editors contextualizing these lectures in Foucault’s oeuvre, this volume contributes much to Foucaultian scholarship, particularly when considered alongside the recently published volumes of Foucault’s lecture courses at the Collège de France. However, while the book promises to offer some insights of relevance to criminology, it is important to remember that this is not its key purpose, and criminologists should read it with this caveat in mind...

South Asians' cardiac medication adherence

Aim This paper is a report of a narrative review examining the current state of knowledge regarding adherence with cardiac medication among South Asian cardiac patients. Background South Asians experience higher rates of cardiovascular disease than any other ethnic group. South Asians may be less adherent with a cardiac medication regimen than Caucasians. The factors contributing to adherence are important to discover to assist South Asians to optimize their cardiac health. Data sources CINAHL, Medline (Ovid), PsychINFO, EMB Reviews-(Cochrane), and EMBASE were accessed using the key words: 'South Asian', 'Asia', 'East India', 'India', 'Pakistan', 'Bangladesh', 'Sri Lanka', 'medication compliance', 'medication noncompliance' and 'medication adherence'. English language papers published from January 1980 to January 2013 were eligible for inclusion. Review methods Abstracts were reviewed for redundancy and eligibility by the primary author. Manuscripts were then retrieved and reviewed for eligibility and validity by the first and last authors. Content analysis strategies were used for the synthesis. Results Thirteen papers were in the final data set; most were conducted in India and Pakistan. Medication side-effects, cost, forgetfulness and higher frequency of dosing contributed to non-adherence. South Asian immigrants also faced language barriers, which contributed to non-adherence. Knowledge regarding the medications prescribed was a factor that increased adherence. Conclusion South Asians' non-adherence to cardiac medications is multifaceted. How South Asians who newly immigrate to Western countries make decisions regarding their cardiac medication adherence ought to be explored in greater detail.