Non-alcoholic fatty liver disease : can ultrasound assist in early diagnosis of prediabetes and delay progression to type2 diabetes mellitus

Non Alcoholic Fatty Liver Disease (NAFLD) is a condition that is frequently seen but seldom investigated. Until recently, NAFLD was considered benign, self-limiting and unworthy of further investigation. This opinion is based on retrospective studies with relatively small numbers and scant follow-up of histology data. (1) The prevalence for adults, in the USA is, 30%, and NAFLD is recognized as a common and increasing form of liver disease in the paediatric population (1). Australian data, from New South Wales, suggests the prevalence of NAFLD in “healthy” 15 year olds as being 10%.(2) Non-alcoholic fatty liver disease is a condition where fat progressively invades the liver parenchyma. The degree of infiltration ranges from simple steatosis (fat only) to steatohepatitis (fat and inflammation) steatohepatitis plus fibrosis (fat, inflammation and fibrosis) to cirrhosis (replacement of liver texture by scarred, fibrotic and non functioning tissue).Non-alcoholic fatty liver is diagnosed by exclusion rather than inclusion. None of the currently available diagnostic techniques -liver biopsy, liver function tests (LFT) or Imaging; ultrasound, Computerised tomography (CT) or Magnetic Resonance Imaging (MRI) are specific for non-alcoholic fatty liver. An association exists between NAFLD, Non Alcoholic Steatosis Hepatitis (NASH) and irreversible liver damage, cirrhosis and hepatoma. However, a more pervasive aspect of NAFLD is the association with Metabolic Syndrome. This Syndrome is categorised by increased insulin resistance (IR) and NAFLD is thought to be the hepatic representation. Those with NAFLD have an increased risk of death (3) and it is an independent predictor of atherosclerosis and cardiovascular disease (1). Liver biopsy is considered the gold standard for diagnosis, (4), and grading and staging, of non-alcoholic fatty liver disease. Fatty-liver is diagnosed when there is macrovesicular steatosis with displacement of the nucleus to the edge of the cell and at least 5% of the hepatocytes are seen to contain fat (4).Steatosis represents fat accumulation in liver tissue without inflammation. However, it is only called non-alcoholic fatty liver disease when alcohol - >20gms-30gms per day (5), has been excluded from the diet. Both non-alcoholic and alcoholic fatty liver are identical on histology. (4).LFT’s are indicative, not diagnostic. They indicate that a condition may be present but they are unable to diagnosis what the condition is. When a patient presents with raised fasting blood glucose, low HDL (high density lipoprotein), and elevated fasting triacylglycerols they are likely to have NAFLD. (6) Of the imaging techniques MRI is the least variable and the most reproducible. With CT scanning liver fat content can be semi quantitatively estimated. With increasing hepatic steatosis, liver attenuation values decrease by 1.6 Hounsfield units for every milligram of triglyceride deposited per gram of liver tissue (7). Ultrasound permits early detection of fatty liver, often in the preclinical stages before symptoms are present and serum alterations occur. Earlier, accurate reporting of this condition will allow appropriate intervention resulting in better patient health outcomes. References 1. Chalasami N. Does fat alone cause significant liver disease: It remains unclear whether simple steatosis is truly benign. American Gastroenterological Association Perspectives, February/March 2008 www.gastro.org/wmspage.cfm?parm1=5097 Viewed 20th October, 2008 2. Booth, M. George, J.Denney-Wilson, E: The population prevalence of adverse concentrations with adiposity of liver tests among Australian adolescents. Journal of Paediatrics and Child Health.2008 November 3. Catalano, D, Trovato, GM, Martines, GF, Randazzo, M, Tonzuso, A. Bright liver, body composition and insulin resistance changes with nutritional intervention: a follow-up study .Liver Int.2008; February 1280-9 4. Choudhury, J, Sanysl, A. Clinical aspects of Fatty Liver Disease. Semin in Liver Dis. 2004:24 (4):349-62 5. Dionysus Study Group. Drinking factors as cofactors of risk for alcohol induced liver change. Gut. 1997; 41 845-50 6. Preiss, D, Sattar, N. Non-alcoholic fatty liver disease: an overview of prevalence, diagnosis, pathogenesis and treatment considerations. Clin Sci.2008; 115 141-50 7. American Gastroenterological Association. Technical review on nonalcoholic fatty liver disease. Gastroenterology.2002; 123: 1705-25

Context and models for the analysis of individual and group needs

This paper summarizes the papers presented in the thematic stream Models for the Analysis of Individual and Group Needs, at the 2007 IAEVG-SVP-NCDA Symposium: Vocational Psychology and Career Guidance Practice: An International Partnership. The predominant theme which emerged from the papers was that theory and practice need to be positioned within their contexts. For this paper, context has been formulated as a dimension ranging from the individual’s experience of himself or herself in conversations, including interpersonal transactions and body culture, through to broad higher levels of education, work, nation, and economy.

Chinese young children’s strategies on basic addition facts

Kindergartens in China offer structured full-day programs for children aged 3-6. Although formal schooling does not commence until age 7, the mathematics program in kindergartens is specifically focused on developing young children’s facility with simple addition and subtraction. This study explored young Chinese children’s strategies for solving basic addition facts as well as their intuitive understanding of addition via interview methods. Results indicate a strong impact that teacher-directed teaching methods have on young children’s cognitions in relation to addition.

Twisted Edwards curves revisited

This paper introduces fast algorithms for performing group operations on twisted Edwards curves, pushing the recent speed limits of Elliptic Curve Cryptography (ECC) forward in a wide range of applications. Notably, the new addition algorithm uses for suitably selected curve constants. In comparison, the fastest point addition algorithms for (twisted) Edwards curves stated in the literature use . It is also shown that the new addition algorithm can be implemented with four processors dropping the effective cost to . This implies an effective speed increase by the full factor of 4 over the sequential case. Our results allow faster implementation of elliptic curve scalar multiplication. In addition, the new point addition algorithm can be used to provide a natural protection from side channel attacks based on simple power analysis (SPA).

Group metacognition during mathematical problem solving

Although various studies have shown that groups are more productive than individuals in complex mathematical problem solving, not all groups work together cooperatively. This review highlights that addressing organisational and cognitive factors to help scaffold group mathematical problem solving is necessary but not sufficient. Successful group problem solving also needs to incorporate metacognitive factors in order for groups to reflect on the organisational and cognitive factors influencing their group mathematical problem solving.

A participative education program to reduce speeding in a group of work-related drivers

A number of intervention approaches have been developed to improve work-related driving safety. However, past interventions have been limited in that they have been data-driven, and have not been developed within a theoretical framework. The aim of this study is to present a theory-driven intervention. Based on the methodology developed by Ludwig and Geller (1991), this study evaluates the effectiveness of a participative education intervention on a group of work-related drivers (n = 28; experimental group n = 19, control n = 9). The results support the effectiveness of the intervention in reducing speeding over a six month period, while a non significant increase was found in the control group. The results of this study have important implications for organisations developing theory-driven interventions designed to improve work-related driving behaviour.

Estimating total cross sections from neutron-nucleus collisions using a simple functional form

Total cross sections for neutron scattering from nuclei, with energies ranging from 10 to 600 MeV and from many nuclei spanning the mass range 6Li to 238U, have been analyzed using a simple, three-parameter, functional form. The calculated cross sections are compared with results obtained by using microscopic (g-folding) optical potentials as well as with experimental data. The functional form reproduces those total cross sections very well. When allowance is made for Ramsauer-like effects in the scattering, the parameters of the functional form required vary smoothly with energy and target mass. They too can be represented by functions of energy and mass.

Report on Innovation Working Group : The Mathematics Education into the 21st Century Project. Dresden, Saxony

This document reports on the Innovations Working Group that met at the 10th International Conference “Models in Developing Mathematics Education” from the 11-17th September 2009 in Dresden, Saxony. It briefly describes the over arching and consistent themes that emerged from the numerous papers presented. The authors and titles of each of the papers presented will be listed in Table 2.

The effectiveness of using a simple ARIA based geographical classification to identify road crash patterns in rural and urban areas of Queensland

Research has noted a ‘pronounced pattern of increase with increasing remoteness' of death rates in road crashes. However, crash characteristics by remoteness are not commonly or consistently reported, with definitions of rural and urban often relying on proxy representations such as prevailing speed limit. The current paper seeks to evaluate the efficacy of the Accessibility / Remoteness Index of Australia (ARIA+) to identifying trends in road crashes. ARIA+ does not rely on road-specific measures and uses distances to populated centres to attribute a score to an area, which can in turn be grouped into 5 classifications of increasing remoteness. The current paper uses applications of these classifications at the broad level of Australian Bureau of Statistics' Statistical Local Areas, thus avoiding precise crash locating or dedicated mapping software. Analyses used Queensland road crash database details for all 31,346 crashes resulting in a fatality or hospitalisation occurring between 1st July, 2001 and 30th June 2006 inclusive. Results showed that this simplified application of ARIA+ aligned with previous definitions such as speed limit, while also providing further delineation. Differences in crash contributing factors were noted with increasing remoteness such as a greater representation of alcohol and ‘excessive speed for circumstances.' Other factors such as the predominance of younger drivers in crashes differed little by remoteness classification. The results are discussed in terms of the utility of remoteness as a graduated rather than binary (rural/urban) construct and the potential for combining ARIA crash data with census and hospital datasets.

Writing together, learning together : the value and effectiveness of a research writing group for doctoral students

The high level of scholarly writing required for a doctoral thesis is a challenge for many research students. However, formal academic writing training is not a core component of many doctoral programs. Informal writing groups for doctoral students may be one method of contributing to the improvement of scholarly writing. In this paper, we report on a writing group that was initiated by an experienced writer and higher degree research supervisor to support and improve her doctoral students’ writing capabilities. Over time, this group developed a workable model to suit their varying needs and circumstances. The model comprised group sessions, an email group, and individual writing. Here, we use a narrative approach to explore the effectiveness and value of our research writing group model in improving scholarly writing. The data consisted of doctoral students’ reflections to stimulus questions about their writing progress and experiences. The stimulus questions sought to probe individual concerns about their own writing, what they had learned in the research writing group, the benefits of the group, and the disadvantages and challenges to participation. These reflections were analysed using thematic analysis. Following this analysis, the supervisor provided her perspective on the key themes that emerged. Results revealed that, through the writing group, members learned technical elements (e.g., paragraph structure), non-technical elements (e.g., working within limited timeframes), conceptual elements (e.g., constructing a cohesive arguments), collaborative writing processes, and how to edit and respond to feedback. In addition to improved writing quality, other benefits were opportunities for shared writing experiences, peer support, and increased confidence and motivation. The writing group provides a unique social learning environment with opportunities for: professional dialogue about writing, peer learning and review, and developing a supportive peer network. Thus our research writing group has proved an effective avenue for building doctoral students’ capability in scholarly writing. The proposed model for a research writing group could be applicable to any context, regardless of the type and location of the university, university faculty, doctoral program structure, or number of postgraduate students. It could also be used within a group of students with diverse research abilities, needs, topics and methodologies. However, it requires a group facilitator with sufficient expertise in scholarly writing and experience in doctoral supervision who can both engage the group in planned writing activities and also capitalise on fruitful lines of discussion related to students’ concerns as they arise. The research writing group is not intended to replace traditional supervision processes nor existing training. However it has clear benefits for improving scholarly writing in doctoral research programs particularly in an era of rapidly increasing student load.

Prediction of outcome with group cognitive therapy for depression

Tested a social–cognitive model of depressive episodes and their treatment within a predictive study of treatment response. 42 clinically depressed volunteers (aged 22–60 yrs) were given self-efficacy (SE) questionnaires and other measures before and after treatment with cognitive therapy. Results support the idea that SE and skills regarding control of negative cognition mediates a sustained response to cognitive treatment for depression. Not only did mood-control variables correlate highly with concurrent changes in depression scores during treatment, but the posttreatment SE measure discriminated Ss who relapsed over the next 12 mo.

Flexural behaviour and design of cold-formed steel beams with rectangular hollow flanges

Until recently, the hot-rolled steel members have been recognized as the most popular and widely used steel group, but in recent times, the use of cold-formed high strength steel members has rapidly increased. However, the structural behavior of light gauge high strength cold-formed steel members characterized by various buckling modes is not yet fully understood. The current cold-formed steel sections such as C- and Z-sections are commonly used because of their simple forming procedures and easy connections, but they suffer from certain buckling modes. It is therefore important that these buckling modes are either delayed or eliminated to increase the ultimate capacity of these members. This research is therefore aimed at developing a new cold-formed steel beam with two torsionally rigid rectangular hollow flanges and a slender web formed using intermittent screw fastening to enhance the flexural capacity while maintaining a minimum fabrication cost. This thesis describes a detailed investigation into the structural behavior of this new Rectangular Hollow Flange Beam (RHFB), subjected to flexural action The first phase of this research included experimental investigations using thirty full scale lateral buckling tests and twenty two section moment capacity tests using specially designed test rigs to simulate the required loading and support conditions. A detailed description of the experimental methods, RHFB failure modes including local, lateral distortional and lateral torsional buckling modes, and moment capacity results is presented. A comparison of experimental results with the predictions from the current design rules and other design methods is also given. The second phase of this research involved a methodical and comprehensive investigation aimed at widening the scope of finite element analysis to investigate the buckling and ultimate failure behaviours of RHFBs subjected to flexural actions. Accurate finite element models simulating the physical conditions of both lateral buckling and section moment capacity tests were developed. Comparison of experimental and finite element analysis results showed that the buckling and ultimate failure behaviour of RHFBs can be simulated well using appropriate finite element models. Finite element models simulating ideal simply supported boundary conditions and a uniform moment loading were also developed in order to use in a detailed parametric study. The parametric study results were used to review the current design rules and to develop new design formulae for RHFBs subjected to local, lateral distortional and lateral torsional buckling effects. Finite element analysis results indicate that the discontinuity due to screw fastening has a noticeable influence only for members in the intermediate slenderness region. Investigations into different combinations of thicknesses in the flange and web indicate that increasing the flange thickness is more effective than web thickness in enhancing the flexural capacity of RHFBs. The current steel design standards, AS 4100 (1998) and AS/NZS 4600 (1996) are found sufficient to predict the section moment capacity of RHFBs. However, the results indicate that the AS/NZS 4600 is more accurate for slender sections whereas AS 4100 is more accurate for compact sections. The finite element analysis results further indicate that the current design rules given in AS/NZS 4600 is adequate in predicting the member moment capacity of RHFBs subject to lateral torsional buckling effects. However, they were inadequate in predicting the capacities of RHFBs subject to lateral distortional buckling effects. This thesis has therefore developed a new design formula to predict the lateral distortional buckling strength of RHFBs. Overall, this thesis has demonstrated that the innovative RHFB sections can perform well as economically and structurally efficient flexural members. Structural engineers and designers should make use of the new design rules and the validated existing design rules to design the most optimum RHFB sections depending on the type of applications. Intermittent screw fastening method has also been shown to be structurally adequate that also minimises the fabrication cost. Product manufacturers and builders should be able to make use of this in their applications.

Primary students' group metacognitive processes in a computer supported collaborative learning environment

The current understanding of students’ group metacognition is limited. The research on metacognition has focused mainly on the individual student. The aim of this study was to address the void by developing a conceptual model to inform the use of scaffolds to facilitate group metacognition during mathematical problem solving in computer supported collaborative learning (CSCL) environments. An initial conceptual framework based on the literature from metacognition, cooperative learning, cooperative group metacognition, and computer supported collaborative learning was used to inform the study. In order to achieve the study aim, a design research methodology incorporating two cycles was used. The first cycle focused on the within-group metacognition for sixteen groups of primary school students working together around the computer; the second cycle included between-group metacognition for six groups of primary school students working together on the Knowledge Forum® CSCL environment. The study found that providing groups with group metacognitive scaffolds resulted in groups planning, monitoring, and evaluating the task and team aspects of their group work. The metacognitive scaffolds allowed students to focus on how their group was completing the problem-solving task and working together as a team. From these findings, a revised conceptual model to inform the use of scaffolds to facilitate group metacognition during mathematical problem solving in computer supported collaborative learning (CSCL) environments was generated.

Space and Cyberspace: on the enclosure of consciousness

In this chapter I argue that the global privatisation of elctromagnetic spectrum marks this period as historically unique. I also put forward conceptual categories for understanding the nature of an emergent cybereconomy. They correspond to classical conceptions of property, value and labour, but in no way treat these categories as singular, simple or unproblematic. From a perspective informed largely by Marx’s critique of classical political economy, I frame the creation of a global cyberspace as the enclosure, or “privatisation”, of conscious activity. I argue that a full and formally defined cyberspace, at least as it is currenty conceived of, must prefigure the eventual alienation of human social existence at its most fundamental and definitive level: consciousness.

Sex offenders in denial : a study into a group of forensic psychologists' attitudes regarding the corresponding impact upon risk assessment calculations and parole eligibility

A considerable proportion of convicted sex offenders maintain a stance of innocence and thus do not engage in recommended treatment programs. As a result, such offenders are often deemed to have outstanding criminogenic needs which may negatively impact upon risk assessment procedures and parole eligibility. This paper reports on a study that aimed to investigate a group of forensic psychologists’ attitudes regarding the impact of denial on risk assessment ratings as well as parole eligibility. Participants completed a confidential open-ended questionnaire. Analysis indicated that considerable variability exists among forensic psychologists in regards to their beliefs about the origins of denial and what impact such denial should have on post-prison release eligibility. In contrast, there was less disparity regarding beliefs about the percentage of innocent yet incarcerated sex offenders. This paper also reviews current understanding regarding the impact of denial on recidivism as well as upon general forensic assessments.