The role of the multiple banded antigen of ureaplasma parvum in intra-amniotic infection : major virulence factor or decoy?

The multiple banded antigen (MBA) is a predicted virulence factor of Ureaplasma species. Antigenic variation of the MBA is a potential mechanism by which ureaplasmas avoid immune recognition and cause chronic infections of the upper genital tract of pregnant women. We tested whether the MBA is involved in the pathogenesis of intra-amniotic infection and chorioamnionitis by injecting virulent or avirulent-derived ureaplasma clones (expressing single MBA variants) into the amniotic fluid of pregnant sheep. At 55 days of gestation pregnant ewes (n = 20) received intra-amniotic injections of virulent-derived or avirulent-derived U. parvum serovar 6 strains (2×104 CFU), or 10B medium (n = 5). Amniotic fluid was collected every two weeks post-infection and fetal tissues were collected at the time of surgical delivery of the fetus (140 days of gestation). Whilst chronic colonisation was established in the amniotic fluid of animals infected with avirulent-derived and virulent-derived ureaplasmas, the severity of chorioamnionitis and fetal inflammation was not different between these groups (p>0.05). MBA size variants (32–170 kDa) were generated in vivo in amniotic fluid samples from both the avirulent and virulent groups, whereas in vitro antibody selection experiments led to the emergence of MBA-negative escape variants in both strains. Anti-ureaplasma IgG antibodies were detected in the maternal serum of animals from the avirulent (40%) and virulent (55%) groups, and these antibodies correlated with increased IL-1β, IL-6 and IL-8 expression in chorioamnion tissue (p<0.05). We demonstrate that ureaplasmas are capable of MBA phase variation in vitro; however, ureaplasmas undergo MBA size variation in vivo, to potentially prevent eradication by the immune response. Size variation of the MBA did not correlate with the severity of chorioamnionitis. Nonetheless, the correlation between a maternal humoral response and the expression of chorioamnion cytokines is a novel finding. This host response may be important in the pathogenesis of inflammation-mediated adverse pregnancy outcomes.

A fragment of the LG3 peptide of endorepellin is present in the urine of physically active mining workers : a potential marker of physical activity

Biomarker analysis has been implemented in sports research in an attempt to monitor the effects of exertion and fatigue in athletes. This study proposed that while such biomarkers may be useful for monitoring injury risk in workers, proteomic approaches might also be utilised to identify novel exertion or injury markers. We found that urinary urea and cortisol levels were significantly elevated in mining workers following a 12 hour overnight shift. These levels failed to return to baseline over 24h in the more active maintenance crew compared to truck drivers (operators) suggesting a lack of recovery between shifts. Use of a SELDI-TOF MS approach to detect novel exertion or injury markers revealed a spectral feature which was associated with workers in both work categories who were engaged in higher levels of physical activity. This feature was identified as the LG3 peptide, a C-terminal fragment of the anti-angiogenic / anti-tumourigenic protein endorepellin. This finding suggests that urinary LG3 peptide may be a biomarker of physical activity. It is also possible that the activity mediated release of LG3 / endorepellin into the circulation may represent a biological mechanism for the known inverse association between physical activity and cancer risk / survival.

Beyond the walls of academia : architectural internships

A full architectural education typically involves five years of formal education and two years of practice experience under the supervision of a registered architect. In many architecture courses some of this period of internship can be taken either as a ‘year out’ between years of study, or during enrolment as credited study; work place learning or work integrated learning. This period of learning can be characterised as an internship in which the student, as an adult learner, is supervised by their employer. This is a highly authentic learning environment, but one in which the learner is both student and employee, and the architect is both teacher and employer; at times conflicting roles. While the educational advantages of such authentic practice experience are well recognised, there are also concerns about the quality and variability of such experiences. This paper reviews the current state of practice, with respect to architectural internships, and analyses such practice using Laurillard’s ‘conversational framework’ (2002). The framework highlights the interactions and affordances between teacher and student in the form of concepts, adaptations, reflections, actions and feedback. A review of common practice in architectural work place learning, internships in other fields of education, and focused research at the author’s own university, are discussed, then analysed for ‘affordances’ of learning. Such analysis shows both the potential of work place learning to offer a unique environment for learning, and the need to organise and construct such experiences in ways that facilitates learning.

Defining standards for modelling the biomechanics of the foot and ankle : a systematic review

The complex interaction of the bones of the foot has been explored in detail in recent years, which has led to the acknowledgement in the biomechanics community that the foot can no longer be considered as a single rigid segment. With the advance of motion analysis technology it has become possible to quantify the biomechanics of simplified units or segments that make up the foot. Advances in technology coupled with reducing hardware prices has resulted in the uptake of more advanced tools available for clinical gait analysis. The increased use of these techniques in clinical practice requires defined standards for modelling and reporting of foot and ankle kinematics. This systematic review aims to provide a critical appraisal of commonly used foot and ankle marker sets designed to assess kinematics and thus provide a theoretical background for the development of modelling standards.

Some reflections about P2M : the place of the mirror

The purpose of this paper is to provide some insights about P2M, and more specifically, to develop some thoughts about Project Management seen as a Mirror, a place for reflection…, between the Mission of organisation and its actual creation of Values (with s: a source of value for people, organisations and society). This place is the realm of complexity, of interactions between multiple variables, each of them having a specific time horizon and occupying a specific place, playing a specific role. Before developing this paper I would like to borrow to my colleague and friend, Professor Ohara, the following, part of a paper going to be presented at IPMA World Congress, in New Delhi later this year in November 2005. “P2M is the Japanese version of project & program management, which is the first standard guide for education and certification developed in 2001. A specific finding of P2M is characterized by “mission driven management of projects” or a program which harness complexity of problem solving observed in the interface between technical system and business model.” (Ohara, 2005, IPMA Conference, New Delhi) “The term of “mission” is a key word in the field of corporate strategy, where it expresses raison d’être or “value of business”. It is more specifically used for expressing “the client needs” in terms of a strategic business unit. The concept of mission is deemed to be a useful tool to share essential content of value and needs in message for complex project.” (Ohara, 2005, IPMA Conference, New Delhi) “Mission is considered as a significant “metamodel representation” by several reasons. First, it represents multiple values for aspiration. The central objective of mission initiative is profiling of ideality in the future from reality, which all stakeholders are glad to accept and share. Second, it shall be within a stretch of efforts, and not beyond or outside of the realization. Though it looks like unique, it has to depict a solid foundation. The pragmatic sense of equilibrium between innovation and adaptation is required for the mission. Third, it shall imply a rough sketch for solution to critical issues for problems in reality.” (Ohara, 2005, IPMA Conference, New Delhi) “Project modeling” idea has been introduced in P2M program management. A package of three project models of “scheme”, “system” and “service” are given as a reference type program. (Ohara, 2005, IPMA Conference, New Delhi) If these quotes apply to P2M, they are fully congruent with the results of the research undertaken and the resulting meta-model & meta-method developed by the CIMAP, ESC Lille Research Centre in Project & Program Management, since the 80’s. The paper starts by questioning the common Project Management (PM) paradigm. Then discussing the concept of Project, it argues that an alternative epistemological position should be taken to capture Page 2 / 11 the very nature of the PM field. Based on this, a development about “the need of modelling to understand” is proposed grounded on two theoretical roots. This leads to the conclusion that, in order to enables this modelling, a standard approach is necessary, but should be understood under the perspective of the Theory of Convention in order to facilitate a situational and contextual application.

Books, toys and tablets : playing and learning in the age of digital media

Introduction During a recent study of how parents source information about children‘s early learning, one of us made our first serious foray into a local store licensed to the global chain Toys'R' Us. While walking the aisles, closely observing layout, signage and stock, several things became obvious. Firstly, large numbers of toys were labeled'educational'. Secondly, many toys in that category were intended for children under the age of two years. These were further differentiated as intended for 'babies' or 'infants', and sub-categorized on packaging or shelving using even smaller age increments (e.g. 0-3 months, 12-18 months, and so on). Thirdly, many products were labeled as 'interactive' and 'learning' toys that promised to assist children‘s early learning and development. The activation of some of these toys relied on embedded computer chip technology and promised to 'connect' children with the home television, computer and the Internet. These products were hybrids between a toy and a platform for digital media interaction. Closer inspection of toy packaging and other promotional material suggested that industry had begun to invest heavily in developing highly differentiated children‘s markets for products that yoked together concepts of learning and development, the 'fun toy' that incorporates digital technology, and offline- and online participation. In this chapter we explore the growth of this contemporary cultural phenomenon that now connects books, toys and mobile digital media with children‘s play and learning.

Academics’ work and the concept of “profession” : an Australian case study

Universities in Australia and elsewhere have changed considerably in recent years. Inevitably, this has meant that the work of academics has also changed. Academics’ work is of importance because they are key players in universities and universities matter to the nation economically and intellectually in advancing knowledge and its practical application. Through the changes and challenges that have characterised academia in recent years, there is an assumption that academics’ work is representative of a profession. This research study investigates how academics construct their own perspectives regarding the academic "profession". The study is theoretically informed by Freidson’s theory that conceptualises professions as occupations if they are in control of their work rather than it being under the control of either the market or of their employing institutions. Two research questions guide this study. The first question investigates how academics might construct their work in ideal terms and the second one investigates the extent to which such constructions might constitute a "profession". A qualitative case study was conducted within two Australian universities. In all, twenty academics from ten disciplines took part in the study that consisted of a focus group and fifteen individual interviews. The study was conducted in three phases during which a conceptual framework of academics’ work was developed across three versions. This framework acted both a prompt to discussion and as a potential expression of academics’ work. The first version of the framework was developed from the literature during the first phase of the study. This early framework was used during the second phase of the study when five academics took part in a focus group. After the focus group, the second version of the framework was developed and used with fifteen academics in individual interviews during phase three of the study. The third version of the framework was the outcome of a synthesis of the themes that were identified in the data. The discussion data from the focus group and the individual interviews were analysed through a content analysis approach that identified four major themes. The first theme was that academics reported that their work would ideally be located within universities committed to using their expert knowledge to serve the world. The second theme was that academics reported that they wanted sufficient thinking time and reasonable workloads to undertake the intellectual work that they regard as their core responsibility, particularly in relation to undertaking research. They argued against heavy routine administrative workloads and sought a continuation of current flexible working arrangements. The third theme was that teaching qualifications should not be mandated but that there should be a continuation of the present practice of universities offering academics the opportunity to undertake formal teaching qualifications if they wish to. Finally, academics reported that they wanted values that have traditionally mattered to academia to continue to be respected and practised: autonomy, collegiality and collaborative relationships, altruism and service, and intellectual integrity. These themes are sympathetic to Freidson’s theory of professions in all but one matter: the non-mandatory nature of formal qualifications which he regards as absolutely essential for the performance of the complex intellectual work that characterises occupations that are professions. The study places the issue of academic professionalism on the policy agenda for universities wishing to identify academics’ work as a profession. The study contributes a theory-based and data-informed conceptual framework for academics’ work that can be considered in negotiating the nature and extent of their work. The framework provides a means of analysing what "academic professionalism" might mean; it adds specificity to such discussions by exploring a particular definition of profession, namely Freidson’s theory of professions as occupations that are in control of their own work. The study contributes to the development of theories around higher education concepts of academic professionalism and, in so doing, links that theoretical contribution to the wider professions field.

Orals ain’t orals : the role of prepared oral presentations in the classroom and beyond. How do instruction and feedback practices guide delivery choices?

Despite an ostensibly technology-driven society, the ability to communicate orally continues to feature as an essential ability for students at school and university, as it is for graduates in the workplace. Pedagogically, one rationale is that the need to develop effective oral communication skills is tied to life-long learning which includes successful participation in future work-related tasks. One tangible way that educators have assessed proficiency in the area of communication is through prepared oral presentations. While much of the literature uses the terms 'oral communication' and 'oral presentation' interchangeably, some writers question the role more formal presentations play in the overall development of oral communication skills. However, such formal speaking tasks continue to be a recognised assessment practice in both the secondary school and academy, and, therefore, worthy of further investigation. Adding to the discussion, this thesis explores the knowledge and skills students bring into the academy from previous educational experiences. It examines some of the teaching and assessment methods used in secondary schools to develop oral communication skills through the use of formal oral presentations. Specifically, it investigates criterion-referenced assessment sheets and how these tools are used as a form of instruction, as well as their role and effectiveness in the evaluation of student ability. The focus is on the student's perspective and includes 12 semi-structured interviews with school students. The purpose of this thesis is to explore key thematics underpinning oral communication and to identify tensions between expectations and practice. While acknowledging the breadth and depth of material available under the heading of 'communication theory', this study specifically draws on an expanded view of the rhetorical tradition to fully interrogate the assumptions supporting the practice of assessing oral presentations. Finally, this thesis recommends reconnecting with an updated understanding of rhetoric as a way of assisting in the development of expressive, articulate and discerning communicators.

Investigating the dynamics of the psychological contract : how and why individuals' contract beliefs change

The overall objective of this thesis is to explore how and why the content of individuals' psychological contracts changes over time. The contract is generally understood as "individual beliefs, shaped by the organisation, regarding the terms of an exchange agreement between individuals and their organisation" (Rousseau, 1995, p. 9). With an overall study sampling frame of 320 graduate organisational newcomers, a mixed method longitudinal research design comprised of three sequential, inter-related studies is employed in order to capture the change process. From the 15 semi-structured interviews conducted in Study 1, the key findings included identifying a relatively high degree of mutuality between employees' and their managers' reciprocal contract beliefs around the time of organisational entry. Also, at this time, individuals had developed specific components of their contract content through a mix of social network information (regarding broader employment expectations) and perceptions of various elements of their particular organisation's reputation (for more firm-specific expectations). Study 2 utilised a four-wave survey approach (available to the full sampling frame) over the 14 months following organisational entry to explore the 'shape' of individuals' contract change trajectories and the role of four theorised change predictors in driving these trajectories. The predictors represented an organisational-level informational cue (perceptions of corporate reputation), a dyadic-level informational cue (perceptions of manager-employee relationship quality) and two individual difference variables (affect and hardiness). Through the use of individual growth modelling, the findings showed differences in the general change patterns across contract content components of perceived employer (exhibiting generally quadratic change patterns) and employee (exhibiting generally no-change patterns) obligations. Further, individuals differentially used the predictor variables to construct beliefs about specific contract content. While both organisational- and dyadic-level cues were focused upon to construct employer obligation beliefs, organisational-level cues and individual difference variables were focused upon to construct employee obligation beliefs. Through undertaking 26 semi-structured interviews, Study 3 focused upon gaining a richer understanding of why participants' contracts changed, or otherwise, over the study period, with a particular focus upon the roles of breach and violation. Breach refers to an employee's perception that an employer obligation has not been met and violation refers to the negative and affective employee reactions which may ensue following a breach. The main contribution of these findings was identifying that subsequent to a breach or violation event a range of 'remediation effects' could be activated by employees which, depending upon their effectiveness, served to instigate either breach or contract repair or both. These effects mostly instigated broader contract repair and were generally cognitive strategies enacted by an individual to re-evaluate the breach situation and re-focus upon other positive aspects of the employment relationship. As such, the findings offered new evidence for a clear distinction between remedial effects which serve to only repair the breach (and thus the contract) and effects which only repair the contract more broadly; however, when effective, both resulted in individuals again viewing their employment relationships positively. Overall, in response to the overarching research question of this thesis, how and why individuals' psychological contract beliefs change, individuals do indeed draw upon various information sources, particularly at the organisational-level, as cues or guides in shaping their contract content. Further, the 'shapes' of the changes in beliefs about employer and employee obligations generally follow different, and not necessarily linear, trajectories over time. Finally, both breach and violation and also remedial actions, which address these occurrences either by remedying the breach itself (and thus the contract) or the contract only, play central roles in guiding individuals' contract changes to greater or lesser degrees. The findings from the thesis provide both academics and practitioners with greater insights into how employees construct their contract beliefs over time, the salient informational cues used to do this and how the effects of breach and violation can be mitigated through creating an environment which facilitates the use of effective remediation strategies.

The effect of Tenofovir on vitamin D metabolism in HIV-infected adults is dependent on sex and ethnicity

Background: Tenofovir has been associated with renal phosphate wasting, reduced bone mineral density, and higher parathyroid hormone levels. The aim of this study was to carry out a detailed comparison of the effects of tenofovir versus non-tenofovir use on calcium, phosphate and, vitamin D, parathyroid hormone (PTH), and bone mineral density. Methods: A cohort study of 56 HIV-1 infected adults at a single centre in the UK on stable antiretroviral regimes comparing biochemical and bone mineral density parameters between patients receiving either tenofovir or another nucleoside reverse transcriptase inhibitor. Principal Findings: In the unadjusted analysis, there was no significant difference between the two groups in PTH levels (tenofovir mean 5.9 pmol/L, 95% confidence intervals 5.0 to 6.8, versus non-tenofovir; 5.9, 4.9 to 6.9; p = 0.98). Patients on tenofovir had significantly reduced urinary calcium excretion (median 3.01 mmol/24 hours) compared to non-tenofovir users (4.56; p,0.0001). Stratification of the analysis by age and ethnicity revealed that non-white men but not women, on tenofovir had higher PTH levels than non-white men not on tenofovir (mean difference 3.1 pmol/L, 95% CI 5.3 to 0.9; p = 0.007). Those patients with optimal 25-hydroxyvitamin D (.75 nmol/L) on tenofovir had higher 1,25-dihydroxyvitamin D [1,25(OH)2D] (median 48 pg/mL versus 31; p = 0.012), fractional excretion of phosphate (median 26.1%, versus 14.6;p = 0.025) and lower serum phosphate (median 0.79 mmol/L versus 1.02; p = 0.040) than those not taking tenofovir. Conclusions: The effects of tenofovir on PTH levels were modified by sex and ethnicity in this cohort. Vitamin D status also modified the effects of tenofovir on serum concentrations of 1,25(OH)2D and phosphate.

A spatiotemporal analysis of gait freezing and the impact of pedunculopontine nucleus stimulation

Gait freezing is an episodic arrest of locomotion due to an inability to take normal steps. Pedunculopontine nucleus stimulation is an emerging therapy proposed to improve gait freezing, even where refractory to medication. However, the efficacy and precise effects of pedunculopontine nucleus stimulation on Parkinsonian gait disturbance are not established. The clinical application of this new therapy is controversial and it is unknown if bilateral stimulation is more effective than unilateral. Here, in a double-blinded study using objective spatiotemporal gait analysis, we assessed the impact of unilateral and bilateral pedunculopontine nucleus stimulation on triggered episodes of gait freezing and on background deficits of unconstrained gait in Parkinson’s disease. Under experimental conditions, while OFF medication, Parkinsonian patients with severe gait freezing implanted with pedunculopontine nucleus stimulators below the pontomesencephalic junction were assessed during three conditions; off stimulation, unilateral stimulation and bilateral stimulation. Results were compared to Parkinsonian patients without gait freezing matched for disease severity and healthy controls. Pedunculopontine nucleus stimulation improved objective measures of gait freezing, with bilateral stimulation more effective than unilateral. During unconstrained walking, Parkinsonian patients who experience gait freezing had reduced step length and increased step length variability compared to patients without gait freezing; however, these deficits were unchanged by pedunculopontine nucleus stimulation. Chronic pedunculopontine nucleus stimulation improved Freezing of Gait Questionnaire scores, reflecting a reduction of the freezing encountered in patients’ usual environments and medication states. This study provides objective, double-blinded evidence that in a specific subgroup of Parkinsonian patients, stimulation of a caudal pedunculopontine nucleus region selectively improves gait freezing but not background deficits in step length. Bilateral stimulation was more effective than unilateral.

The extent of the insured’s duty of disclosure : a comparative analysis of the disclosure obligations of insured in Australia, Singapore and China

Pre-contractual material disclosure and representation from an insurance policy proposer is the most important element for insurers to make a decision on whether a proposer is insurable and what are the terms and conditions if the proposal by the proposer is able to be insured. The issue this thesis researches and investigates focus on the issues related to the pre-contractual non-disclosures and misrepresentations of an insured under the principle of utmost good faith, by operation of laws, can achieve with different results in different jurisdiction. A similar disputed claim involving material non-disclosed personal information or misrepresentation at the pre-contractual stage from an insured with respect to both general and life insurance policies settled by an insurer in Australia could be that the policy is set aside ab initio by the insurers in Singapore or China. The jurisdictions this thesis examines are • Australia; • Singapore; and • China including Hong Kong.

The development of a supportive care needs assessment tool for Indigenous people with cancer

Background: Little is known about the supportive care needs of Indigenous people with cancer and to date, existing needs assessment tools have not considered cultural issues for this population. We aimed to adapt an existing supportive care needs assessment tool for use with Indigenous Australians with cancer. Methods: Face-to-face interviews with Indigenous cancer patients (n = 29) and five focus groups with Indigenous key-informants (n = 23) were conducted to assess the face and content validity, cultural acceptability, utility and relevance of the Supportive Care Needs Survey - Short Form 34 (SCNS-SF34) for use with Indigenous patients with cancer. Results: All items from the SCNS-SF34 were shortened and changed to use more appropriate language (e.g. the word 'anxiety' was substituted with 'worry'). Seven questions were omitted (e.g. items on death and future considerations) as they were deemed culturally inappropriate or irrelevant and 12 items were added (e.g. accessible transport). Optional instructions were added before the sexual items. The design and response format of the SCNS-SF34 was modified to make it easier to use for Indigenous cancer patients. Given the extensive modifications to the SCNS-SF34 and the liklihood of a different factor structure we consider this tool to be a new tool rather than a modification. The Supportive care needs assessment tool for Indigenous people (SCNAT-IP) shows promising face and content validity and will be useful in informing services where they need to direct their attention for these patients. Conclusions: Indigenous people with cancer have language, customs and specific needs that are not accommodated within the standard SCNS-SF34. Our SCNAT-IP improves acceptability, relevance and face validity for Indigenous-specific concerns. Our SCNAT-IP will allow screening for supportive care needs that are specific to Indigenous cancer patients' and greatly inform targeted policy development and practice.

Socioeconomic inequalities in cardiovascular mortality and the role of childhood socioeconomic conditions and adulthood risk factors : a prospective cohort study with 17-years of follow up

Background The mechanisms underlying socioeconomic inequalities in mortality from cardiovascular diseases (CVD) are largely unknown. We studied the contribution of childhood socioeconomic conditions and adulthood risk factors to inequalities in CVD mortality in adulthood. Methods The prospective GLOBE study was carried out in the Netherlands, with baseline data from 1991, and linked with the cause of death register in 2007. At baseline, participants reported on adulthood socioeconomic position (SEP) (own educational level), childhood socioeconomic conditions (occupational level of respondent’s father), and a broad range of adulthood risk factors (health behaviours, material circumstances, psychosocial factors). This present study is based on 5,395 men and 6,306 women, and the data were analysed using Cox regression models and hazard ratios (HR). Results A low adulthood SEP was associated with increased CVD mortality for men (HR 1.84; 95% CI: 1.41-2.39) and women (HR 1.80; 95%CI: 1.04-3.10). Those with poorer childhood socioeconomic conditions were more likely to die from CVD in adulthood, but this reached statistical significance only among men with the poorest childhood socioeconomic circumstances. About half of the investigated adulthood risk factors showed significant associations with CVD mortality among both men and women, namely renting a house, experiencing financial problems, smoking, physical activity and marital status. Alcohol consumption and BMI showed a U-shaped relationship with CVD mortality among women, with the risk being significantly greater for both abstainers and heavy drinkers, and among women who were underweight or obese. Among men, being single or divorced and using sleep/anxiety drugs increased the risk of CVD mortality. In explanatory models, the largest contributor to adulthood CVD inequalities were material conditions for men (42%; 95% CI: −73 to −20) and behavioural factors for women (55%; 95% CI: -191 to −28). Simultaneous adjustment for adulthood risk factors and childhood socioeconomic conditions attenuated the HR for the lowest adulthood SEP to 1.34 (95% CI: 0.99-1.82) for men and 1.19 (95% CI: 0.65-2.15) for women. Conclusions Adulthood material, behavioural and psychosocial factors played a major role in the explanation of adulthood SEP inequalities in CVD mortality. Childhood socioeconomic circumstances made a modest contribution, mainly via their association with adulthood risk factors. Policies and interventions to reduce health inequalities are likely to be most effective when considering the influence of socioeconomic circumstances across the entire life course and in particular, poor material conditions and unhealthy behaviours in adulthood.