Victimization experiences of adolescents in Malaysia

Purpose There has been little community-based research regarding multiple-type victimization experiences of young people in Asia, and none in Malaysia. This study aimed to estimate prevalence, explore gender differences, as well as describe typical perpetrators and family and social risk factors among Malaysian adolescents. Methods A cross-sectional survey of 1,870 students was conducted in 20 randomly selected secondary schools in Selangor state (mean age: 16 years; 58.8% female). The questionnaire included items on individual, family, and social background and different types of victimization experiences in childhood. Results Emotional and physical types of victimization were most common. A significant proportion of adolescents (22.1%) were exposed to more than one type, with 3% reporting all four types. Compared with females, males reported more physical, emotional, and sexual victimization. The excess of sexual victimization among boys was due to higher exposure to noncontact events, whereas prevalence of forced intercourse was equal for both genders (3.0%). Although adult male perpetrators predominate, female adults and peers of both genders also contribute substantially. Low quality of parent–child relationships and poor school and neighborhood environments had the strongest associations with victimization. Family structure (parental divorce, presence of step-parent or single parent, or household size), parental drug use, and rural/urban location were not influential in this sample. Conclusion This study extends the analysis of multiple-type victimization to a Malaysian population. Although some personal, familial, and social factors correlate with those found in western nations, there are cross-cultural differences, especially with regard to the nature of sexual violence based on gender and the influence of family structure.

PARP inhibition induces BAX/BAK-independent synthetic lethality of BRCA1-deficient non-small cell lung cancer

Evasion of apoptosis contributes to both tumourigenesis and drug resistance in non-small cell lung carcinoma (NSCLC). The pro-apoptotic BCL-2 family proteins BAX and BAK are critical regulators of mitochondrial apoptosis. New strategies for targeting NSCLC in a mitochondria-independent manner should bypass this common mechanism of apoptosis block. BRCA1 mutation frequency in lung cancer is low; however, decreased BRCA1 mRNA and protein expression levels have been reported in a significant proportion of lung adenocarcinomas. BRCA1 mutation/deficiency confers a defect in homologous recombination DNA repair that has been exploited by synthetic lethality through inhibition of PARP (PARPi) in breast and ovarian cells; however, it is not known whether this same synthetic lethal mechanism exists in NSCLC cells. Additionally, it is unknown whether the mitochondrial apoptotic pathway is required for BRCA1/PARPi-mediated synthetic lethality. Here we demonstrate that silencing of BRCA1 expression by RNA interference sensitizes NSCLC cells to PARP inhibition. Importantly, this sensitivity was not attenuated in cells harbouring mitochondrial apoptosis block induced by co-depletion of BAX and BAK. Furthermore, we demonstrate that BRCA1 inhibition cannot override platinum resistance, which is often mediated by loss of mitochondrial apoptosis signalling, but can still sensitize to PARP inhibition. Finally we demonstrate the existence of a BRCA1-deficient subgroup (11–19%) of NSCLC patients by analysing BRCA1 protein levels using immunohistochemistry in two independent primary NSCLC cohorts. Taken together, the existence of BRCA1-immunodeficient NSCLC suggests that this molecular subgroup could be effectively targeted by PARP inhibitors in the clinic and that PARP inhibitors could be used for the treatment of BRCA1-immunodeficient, platinum-resistant tumours.

Hospital to home outreach for malnourished elders (HHOME) : a feasibility pilot

Objectives: Malnutrition is common in older hospitalised patients, and barriers to adequate intake in hospital limit the effectiveness of hospital-based nutrition interventions. This pilot study was undertaken to determine whether nutrition-focussed care at discharge and in the early post-hospital period is feasible and acceptable to patients and carers, and improves nutritional status. Design: Prospective cohort study Setting: Internal medicine wards of a tertiary teaching hospital in Brisbane, Australia Participants: Patients aged 65 and older admitted for at least 3 days, identified as malnourished or at risk of malnutrition using Mini Nutritional Assessment (MNA). Interventions: An interdisciplinary discharge team (specialist discharge planning nurse and accredited practicing dietitian) provided nutrition-focussed education, advice, service coordination and follow-up (home visits and telephone) for 6 weeks following hospitalisation Measurements: Nutritional intake, weight, functional status and MNA were recorded 6 and 12 weeks after discharge. Service intensity and changes to care were noted, and hospital readmissions recorded. Service feedback from patients and carers was sought using a brief questionnaire. Results: 12 participants were enrolled during the 6 week pilot (mean age 82 years, 50% male). All received 1-2 home visits, and 3-8 telephone calls. Four participants had new community services arranged, 4 were commenced on oral nutritional supplements, and 7 were referred to community dietetics services for follow-up. Two participants had a decline in MNA score of more than 10% at 12 week follow-up, while the remainder improved by at least 10%. Individualised care including community service coordination was valued by participants. Conclusion: The proposed model of care for older adults was feasible, acceptable to patients and carers, and associated with improved nutritional status at 12 weeks for most participants. The pilot data will be useful for design of intervention trials.

Malnutrition screening tools : comparison against two validated nutrition assessment methods in older medical inpatients

Objective Although several validated nutritional screening tools have been developed to “triage” inpatients for malnutrition diagnosis and intervention, there continues to be debate in the literature as to which tool/tools clinicians should use in practice. This study compared the accuracy of seven validated screening tools in older medical inpatients against two validated nutritional assessment methods. Methods This was a prospective cohort study of medical inpatients at least 65 y old. Malnutrition screening was conducted using seven tools recommended in evidence-based guidelines. Nutritional status was assessed by an accredited practicing dietitian using the Subjective Global Assessment (SGA) and the Mini-Nutritional Assessment (MNA). Energy intake was observed on a single day during first week of hospitalization. Results In this sample of 134 participants (80 ± 8 y old, 50% women), there was fair agreement between the SGA and MNA (κ = 0.53), with MNA identifying more “at-risk” patients and the SGA better identifying existing malnutrition. Most tools were accurate in identifying patients with malnutrition as determined by the SGA, in particular the Malnutrition Screening Tool and the Nutritional Risk Screening 2002. The MNA Short Form was most accurate at identifying nutritional risk according to the MNA. No tool accurately predicted patients with inadequate energy intake in the hospital. Conclusion Because all tools generally performed well, clinicians should consider choosing a screening tool that best aligns with their chosen nutritional assessment and is easiest to implement in practice. This study confirmed the importance of rescreening and monitoring food intake to allow the early identification and prevention of nutritional decline in patients with a poor intake during hospitalization.

Whe' yu' from?

"Whe' yu' from?" The question was put to me as I wandered, camera in hand, in the old square of Spanish Town, Jamaica's former capital. The local man, lounging in the shade of one of the colonial Georgian buildings that enclose the square, was mildly curious about what he took to be a typical white tourish photgraphing the sights of the decayed historic town. At that time, my home was in Kingston where i lived with my wife and baby son. I was then working in the Jamaican Government Town Planning Department in a job that took me all over the island. Turning to my questioner, I replied, "Kingston". There was a brief pause, and then the man spoke again: "No Man! Whe' yu' really from?" I still have difficulties when asked this question. Where am I from? What does this question mean? Does it refer to where I was born, where I spent my previous life or where I live now? Does it have a broader meaning, an enquiry about my origins in terms of background and previous experience? The following chapters are my attempt to answer these questions for my own satisfaction and, I hope, for the amusement of others who may be interested in the life of an ordinary English boy whose dream to travel and see the world was realized in ways he could not possibly have imagined. Finding an appropriate title for this book was difficult. Thursday's Child, North and South and War and Peace all came to mind but, unfortunately for me, those titles had been appropriated by other writers. Thursdays's Child is quite a popular book title, presumably because people who were born on that day and, in the words of the nursery rhyme, had 'far to go', are especially likely to have travellers' tales to tell or life stories of the rags-to-riches variety. Born on a Thursday, I have travelled a lot and I suppose that I have gone far in life. Coming from a working class family, I 'got on' by 'getting a good education' and a 'good job'. I decided against adding to the list of Thursday's Children. North and South would have reflected my life in Britain, spent in both the North and South of England, and my later years, divided between the Northern and Southern Hemispheres of the globe, as well as in countries commonly referred to as the 'advanced' North and the 'underdeveloped' South. North and South has already been appropriated by Mrs Gaskell, something that did not deter one popular American writer from using the title for a book of his. My memories of World War Two and the years afterwards made War and Peace a possible candidate, but readers expectnig an epic tale of Tolstoyan proportions may have been disappointed. To my knowledge, no other book has the title "Whe' Yu' From?". I am grateful to the Jamaican man whose question lingered in my memory and provided the title of this memoir, written decades later. This book is a word picture. It is, in a sense, a self-portrait, and like all portraits, it captures something of the character, it attempts to tell the truth, but it is not the whole truth. This is because it is not my intention to write my entire life story; rather I wish to tell about some of the things in my experience of life that have seemed important or interesting to me. Unlike a painted portrait, the picture I have created is intended to suggest the passage of time. While, for most of us in Western society, time is linear and unidirectional, like the flight of an arrov or the trajectory of a bullet, memory rearranges things, calling up images of the past in no particular order, making connections that may link events in various patterns, circular, web-like, superimposed. The stream of consciousness is very unlike that of streams we encounter in the physical world. Connections are made in all directions; thoughts hop back and forth in time and space, from topic to topic. My book is a composition drawn from periods, events and thoughts as I remember them. Like life itself, it is made up of patches, some good, some bad, but in my experience, always fascinating. In recording my memories, I have been as accurate as possible. Little of what I have written is about spectacular sights and strange customs. Much of it focuses on my more modest explorations includng observations of everyday things that have attracted my attention. Reading through the chapters, I am struck by my childhood freedom to roam and engage in 'dangerous' activities like climbing trees and playing beside streams, things that many children today are no longer allowed to enjoy. Also noticeable is the survival of traditions and superstitions from the distant past. Obvious too, is my preoccupation with place names, both official ones that appear on maps and sign boards and those used by locals and children, names rarely seen in print. If there is any uniting theme to be found in what I have written, it must be my education in the fields, woods and streets of my English homeland, in the various other countries in which I have lived and travelled, as well as more formally from books and in classrooms. Much of my book is concerned with people and places. Many of the people I mention are among those who have been, and often have remained, important and close to me. Others I remember from only the briefest of encounters, but they remain in my memory because of some specific incident or circumstance that fixed a lasting image in my mind. Some of my closest friends and relatives, however, appear nowhere in these pages or they receive only the slightest mention. This is not because they played an unimportant roles in my life. It is because this book is not the whole story. Among those whe receive little or no mention are some who are especially close to me, with whom I have shared happy and sad times and who have shown me and my family much kindness, giving support when this was needed. Some I have known since childhood and have popped up at various times in my life, often in different parts of the world. Although years may pass without me seeing them, in an important sense they are always with me. These people know who they are. I hope that they know how much I love and appreciate them. When writing my memoir, I consulted a few of the people mentioned in this book, but in the main, I have relied on my own memory, asided by daiary and notebook entries and old correspondence. In the preparation of this manuscript, I benefited greatly from the expert advice and encouragement of Neil Marr of BeWrite Books. My wife Anne, inspiration for this book, also contributed in the valuable role of critic. She has my undying gratitude.

A Systems-level approach to building sustainable assessment cultures : moderation, quality task design and dependability of judgement

This paper considers the conditions that are necessary at system and local levels for teacher assessment to be valid, reliable and rigorous. With sustainable assessment cultures as a goal, the paper examines how education systems can support local level efforts for quality learning and dependable teacher assessment. This is achieved through discussion of relevant research and consideration of a case study involving an evaluation of a cross-sectoral approach to promoting confidence in school-based assessment in Queensland, Australia. Building on the reported case study, essential characteristics for developing sustainable assessment cultures are presented, including: leadership in learning; alignment of curriculum, pedagogy and assessment; the design of quality assessment tasks and accompanying standards, and evidence-based judgement and moderation. Taken together, these elements constitute a new framework for building assessment capabilities and promoting quality assurance.

Explicit, latent and meta-criteria : types of criteria at play in professional judgement practice

This paper engages with debates about whether comprehensive prior specification of criteria and standards is sufficient for informed professional judgement. A preoccupation has emerged with the specificity and explication of criteria intended to regulate judgement. This has resulted in criteria-compliance in the use of defined standards to validate judgements and improve reliability and consistency. Compliance has become a priority, the consequence being the prominence of explicit criteria, to the lack of acknowledgement of the operation of latent and meta-criteria within judgement practice. This paper examines judgement as a process involving three categories of assessment criteria in the context of standards-referenced systems: explicit, latent and meta-criteria. These are understood to be wholly interrelated and interdependent. A conceptualisation of judgement involving the interplay of the three criteria types is presented with an exploration of how they function to focus or alter assessments of quality in judgements of achievement in English and Mathematics.

Studies of bone cell adhesion and proliferation on ion implanted titanium discs

Argon ions were implanted on titanium discs to study its effect on bone cell adhesion and proli feration. Polished titanium discs were prepared and implanted with argon ions with different doses. Afterwards the samples were sterilized using UV light, inocu lated with human bone cells and incubated. Once fixed and rinsed, image analysis has been used to quantify the number of cells attached to the titanium discs. Cell proliferation tests were also conducted after a period of 120 hours. Cell adhesion was seen to be higher with ion im planted surface. SEM analysis has shown that the cells attached spread more on ion implanted surface. The numbers of cells attached were seen to be higher on implanted surfaces; they tend to occupy wider areas with healthier cells.

Literacy in Early Childhood and Primary Education : Issues, Challenges and Solutions

Literacy in Early Childhood and Primary Education provides a comprehensive introduction to literacy teaching and learning. The book explores the continuum of literacy learning and children’s transitions from early childhood settings to junior primary classrooms, and then to senior primary and beyond. Reader-friendly and accessible, this book equips pre-service teachers with the theoretical underpinnings and practical strategies and skills needed to teach literacy. It places the ‘reading wars’ firmly in the past as it examines contemporary research and practices. The book covers important topics such as literacy acquisition, family literacies and multiliteracies, foundation skills for literacy learning, reading difficulties, assessment, and supporting diverse literacy learners in early childhood and primary classrooms. It also addresses some of the challenges that teachers may face in the classroom and provides solutions to these. Each chapter includes learning objectives, reflective questions and definitions to key terms to engage and assist readers. Further resources are also available at www.cambridge.edu.au/academic/literacy. Written by an expert author team and featuring real-world examples from literacy teachers and learners. Literacy in Early Childhood and Primary Education will help pre-service teachers feel confident teaching literacy to diverse age groups and abilities.

Promotion and succession management and associated retention issues in Australian law firms

The focus of this research was promotion and succession management in Australian law firms. Two staff retention issues currently faced by the Australian legal industry were identified as suggesting possible failures in this area: 1) Practitioners are leaving law firms early in their careers, 2) Female representation is disproportionally low at partnership level. The research described current Australian law firm promotion and succession practices and then explained their possible relevance to the two retention issues. The overall aim of the research was to uncover key findings and present practical recommendations to law firm managers and partners ready for incorporation into their future promotion and succession planning practice. In so doing the research aimed to benefit the Australian legal community as a whole. Four areas of literature relevant to the topic were reviewed, 1) law firm governance concluding that the fundamental values of the P²-Form remained constant (Cooper, Hinings, Greenwood & Brown, 1996; Morris & Pinnington, 1998) with ownership and strategic control of law firms remaining in the hands of partners; 2) the importance of individual practitioners to law firms concluding that the actual and opportunity costs relating to practitioner turnover were significant due to the transient nature of knowledge as a key asset of law firms (Gottschalk & Khandelwal, 2004; Rebitzer & Taylor, 2007); 3) generational differences concluding with support for the work of Finegold, Mohrman and Spreitzer (2002), Davis, Pawlowski and Houston (2006), Kuhnreuther (2003), and Avery, McKay, and Wilson (2007) which indicated that generational cohort differences were of little utility in human resources management practice; and 4) previous research relating to law firm promotion and succession practices indicating that five practices were relevant in law firm promotion outcomes; 1) firm billing requirements (Gorman & Kmec, 2009; Phillips, 2001; Noonan & Corcoran, 2004; Webley & Duff, 2007); 2) mentoring programs (Phillips, 2001; Noonan & Corcoran, 2004); 3) the existence of female partners (Gorman & Kmec, 2009; Beckman & Phillips, 2005); 4) non-partner career paths (Phillips, 2001; Corcoran & Noonan, 2004); and 5) the existence of family friendly policies (Gorman & Kmec, 2009; Phillips, 2001; Noonan & Corcoran, 2004; Webley & Duff, 2007.) The research was carried out via a sequential mixed method approach. The initial quantitative study was based upon a theoretical framework grounded in the literature and provided baseline information describing Australian law firm promotion and succession practices. The study was carried out via an on-line survey of Australian law firm practitioners. The results of the study provided the basis for the second qualitative study. The qualitative study further explained the statistically generated results and focused specifically on the two identified retention issues. The study was conducted via one-on-one interviews with Australian law firm partners and experienced law firm managers. The results of both studies were combined within the context of relevant literature resulting in eight key findings: Key findings 1) Organisational commitment levels across generational cohorts are more homogenous than different. 2) Law firm practitioners are leaving law firms early in their careers due to the heavy time commitment behaviour demanded of them, particularly by clients. 3) Law firm promotion and succession practices reinforce practitioner time commitment behaviour marking it as an indicator of practitioner success. 4) Law firm practitioners believe that they have many career options outside law firms and are considering these options. 5) Female practitioners are considering opting out of law firms due to time commitment demands related to partnership conflicting with family commitment demands. 6) A masculine, high time commitment culture in law firms is related to the decision by female practitioners to leave law firms. 7) The uptake of alternative work arrangements by female practitioners is not fatal to their partnership prospects particularly in firms with supportive policies, processes and organisational culture. 8) Female practitioners are less inclined than their male counterparts to seek partnership as an ultimate goal and are more likely to opt out of law firms exhibiting highly competitive, masculine cultures. Practical recommendations Further review of the data collected in relation to the key findings provided the basis for nine practical recommendations specifically geared towards implementation by law firm managers and partners. The first recommendation relates to the use of generational differences in practitioner management. The next six relate to recommended actions to reduce the time commitment demands on practitioners. The final two recommendations relate to the practical implementation of these actions both at an individual and organisational level. The recommendations are as follows: 1) "Generationally driven," age based generalisations should not be utilised in law firm promotion and succession management practice. 2) Expected levels of client access to practitioners be negotiated on a client by client basis and be included in client retention agreements. 3) Appropriate alternative working arrangements such as working off-site, flexible working hours or part-time work be offered to practitioners in situations where doing so will not compromise client serviceability. 4) The copying of long working hour behaviours of senior practitioners should be discouraged particularly where information technology can facilitate remote client serviceability. 5) Refocus the use of timesheets from an employer monitoring tool to an employee empowerment tool. 6) Policies and processes relating to the offer of alternative working arrangements be supported and reinforced by law firm organisational culture. 7) Requests for alternative working arrangements be determined without regard to gender. 8) Incentives and employment conditions offered to practitioners to be individualised based on the subjective need of the individual and negotiated as a part of the current employee performance review process. 9) Individually negotiated employment conditions be negotiated within the context of the firm’s overall strategic planning process. Through the conduct of the descripto-explanatory study, a detailed discussion of current law firm promotion and succession practices was enabled. From this discussion, 7 eight key findings and nine associated recommendations were generated as well as an insight into the future of the profession being given. The key findings and recommendations provide practical advice to law firm managers and partners in relation to their everyday promotion and succession practice. The need to negotiate individual employee workplace conditions and their integration into overall law firm business planning was put forward. By doing so, it was suggested that both the individual employee and the employing law firm would mutually benefit from the arrangement. The study therefore broadened its practical contribution from human resources management to a contribution to the overall management practice of Australian law firms. In so doing, the research has provided an encompassing contribution to the Australian legal industry both in terms of employee welfare as well as firm and industry level success.

Using the collaborative evidence based practice model : a systematic review and uptake of chlorhexidine-impregnated sponge dressings on central venous access devices in a tertiary cancer centre

Background: Greater research utilisation in cancer nursing practice is needed, in order to provide well-informed and effective nursing care to people affected by cancer. This paper aims to report on the implementation of evidence-based practice in a tertiary cancer centre. Methods: Using a case report design, this paper reports on the use of the Collaborative Model for Evidence Based Practice (CMEBP) in an Australian tertiary cancer centre. The clinical case is the uptake of routine application of chlorhexidine-impregnated sponge dressings for preventing centrally inserted catheter-related bloodstream infections. In this case report, a number of processes that resulted in a service-wide practice change are described. Results: This model was considered a feasible method for successful research utilisation. In this case report, chlorhexidine-impregnated sponge dressings were proposed and implemented in the tertiary cancer centre with an aim of reducing the incidence of centrally inserted catheter-related bloodstream infections and potentially improving patient health outcomes. Conclusion: The CMEBP is feasible and effective for implementing clinical evidence into cancer nursing practice. Cancer nurses and health administrators need to ensure a supportive infrastructure and environment for clinical inquiry and research utilisation exists, in order to enable successful implementation of evidence-based practice in their cancer centres.

Anti-infectives

18.1 Antibiotics 18.1.1 Introduction to bacteria 18.1.2 Introduction to antibiotics 18.1.3 Inhibitors of bacterial cell wall synthesis 18.1.3.1 β-Lactams 18.1.3.2 Glycopeptides 18.1.4 Inhibitors of bacterial protein synthesis 18.1.4.1 Tetracyclines 18.1.4.2 Aminoglycosides 18.1.4.3 Chloramphenicol 18.1.4.4 Macrolides 18.1.4.5 Lincosamides 18.1.4.6 Oxalazidones 18.1.5 Inhibitors of DNA synthesis 18.2. Anti-tuberculotic drugs 18.2.1 Introduction 18.2.2 Isoniazid 18.2.3 Ethambutol 18.2.4 Rifamycin 18.2.5 Pyrazinamide 18.3. Anti-viral drugs 18.3.1 Introduction to viruses 18.3.2 Drugs used to treat herpesviruses 18.3.3 Drugs used to treat the flu 18.3.4 Drugs used to treat HIV/AIDS 18.4. Antifungal drugs 18.4.1 Introduction to Fungi 18.4.2 Antifungal drugs