Kava and St. John's wort : current evidence for use in mood and anxiety disorders

Background: Mood and anxiety disorders pose significant health burdens on the community. Kava and St John’s wort (SJW) are the most commonly used herbal medicines in the treatment of anxiety and depressive disorders, respectively. Objectives: To conduct a comprehensive review of kava and SJW, to review any evidence of efficacy, mode of action, pharmacokinetics, safety and use in Major Depressive Disorder (MDD), Bipolar Disorder (BP), Seasonal Affective Disorder (SAD), Generalized Anxiety Disorder (GAD), Social Phobia (SP), Panic Disorder (PD), Obsessive-Compulsive Disorder (OCD), and Post Traumatic Stress Disorder (PTSD). Methods: A systematic review was conducted using the electronic databases MEDLINE, CINAHL, and The Cochrane Library during late 2008. The search criteria involved mood and anxiety disorder search terms in combination with kava, Piper methysticum, kavalactones, St John’s wort, Hypericum perforatum, hypericin and hyperforin. Additional search criteria for safety, pharmacodynamics , and pharmacokinetics was employed. A subsequent forward search was conducted of the papers using Web of Science cited reference search. Results: Current evidence supports the use of SJW in treating mild-moderate depression, and for kava in treatment of generalized anxiety. In respect to the other disorders, only weak preliminary evidence exists for use of SJW in SAD. Currently there is no published human trial on use of kava in affective disorders, or in OCD, PTSD, PD or SP. These disorders constitute potential applications that warrant exploration. Conclusions: Current evidence for herbal medicines in the treatment of depression and anxiety only supports the use of Hypericum perforatum for depression, and Piper methysticum for generalized anxiety.

Disturbed appetite and nutrient intake in peritoneal dialysis patients

OBJECTIVE Malnutrition is common among peritoneal dialysis (PD) patients. Reduced nutrient intake contributes to this. It has long been assumed that this reflects disturbed appetite. We set out to define the appetite profiles of a group of PD patients using a novel technique. DESIGN Prospective, cross-sectional comparison of PD patients versus controls. SETTING Teaching hospital dialysis unit. PATIENTS 39 PD patients and 42 healthy controls. INTERVENTION Visual analog ratings were recorded at hourly intervals to generate daily profiles for hunger and fullness. Summary statistics were generated to compare the groups. Food intake was measured using 3-day dietary records. MAIN OUTCOME MEASURES Hunger and fullness profiles. Derived hunger and fullness scores. RESULTS Controls demonstrated peaks of hunger before mealtimes, with fullness scores peaking after meals. The PD profiles had much reduced premeal hunger peaks. A postmeal reduction in hunger was evident, but the rest of the trace was flat. The PD fullness profile was also flatter than in the controls. Mean scores were similar despite the marked discrepancy in the profiles. The PD group had lower peak hunger and less diurnal variability in their hunger scores. They also demonstrated much less change in fullness rating around mealtimes, while the mean and peak fullness scores were little different. The reported nutrient intake was significantly lower for PD. CONCLUSION The data suggest that PD patients normalize their mean appetite perception at a lower level of nutrient intake than controls, suggesting that patient-reported appetite may be misleading in clinical practice. There is a loss of the usual daily variation for the PD group, which may contribute to their reduced food intake. The technique described here could be used to assess the impact of interventions upon the abnormal PD appetite profile.

Industrial design in endoscopy : the development of a tissue and organ extractor

Throughout history, developments in medicine have aimed to improve patient quality of life, and reduce the trauma associated with surgical treatment. Surgical access to internal organs and bodily structures has been traditionally via large incisions. Endoscopic surgery presents a technique for surgical access via small (1 Omm) incisions by utilising a scope and camera for visualisation of the operative site. Endoscopy presents enormous benefits for patients in terms of lower post operative discomfort, and reduced recovery and hospitalisation time. Since the first gall bladder extraction operation was performed in France in 1987, endoscopic surgery has been embraced by the international medical community. With the adoption of the new technique, new problems never previously encountered in open surgery, were revealed. One such problem is that the removal of large tissue specimens and organs is restricted by the small incision size. Instruments have been developed to address this problem however none of the devices provide a totally satisfactory solution. They have a number of critical weaknesses: -The size of the access incision has to be enlarged, thereby compromising the entire endoscopic approach to surgery. - The physical quality of the specimen extracted is very poor and is not suitable to conduct the necessary post operative pathological examinations. -The safety of both the patient and the physician is jeopardised. The problem of tissue and organ extraction at endoscopy is investigated and addressed. In addition to background information covering endoscopic surgery, this thesis describes the entire approach to the design problem, and the steps taken before arriving at the final solution. This thesis contributes to the body of knowledge associated with the development of endoscopic surgical instruments. A new product capable of extracting large tissue specimens and organs in endoscopy is the final outcome of the research.

Flexural behaviour and design of the new built-up LiteSteel beams

LiteSteel Beam (LSB) is a new cold-formed steel beam produced by OneSteel Australian Tube Mills. The new beam is effectively a channel section with two rectangular hollow flanges and a slender web, and is manufactured using a combined cold-forming and electric resistance welding process. OneSteel Australian Tube Mills is promoting the use of LSBs as flexural members in a range of applications, such as floor bearers. When LSBs are used as back to back built-up sections, they are likely to improve their moment capacity and thus extend their applications further. However, the structural behaviour of built-up beams is not well understood. Many steel design codes include guidelines for connecting two channels to form a built-up I-section including the required longitudinal spacing of connections. But these rules were found to be inadequate in some applications. Currently the safe spans of builtup beams are determined based on twice the moment capacity of a single section. Research has shown that these guidelines are conservative. Therefore large scale lateral buckling tests and advanced numerical analyses were undertaken to investigate the flexural behaviour of back to back LSBs connected by fasteners (bolts) at various longitudinal spacings under uniform moment conditions. In this research an experimental investigation was first undertaken to study the flexural behaviour of back to back LSBs including its buckling characteristics. This experimental study included tensile coupon tests, initial geometric imperfection measurements and lateral buckling tests. The initial geometric imperfection measurements taken on several back to back LSB specimens showed that the back to back bolting process is not likely to alter the imperfections, and the measured imperfections are well below the fabrication tolerance limits. Twelve large scale lateral buckling tests were conducted to investigate the behaviour of back to back built-up LSBs with various longitudinal fastener spacings under uniform moment conditions. Tests also included two single LSB specimens. Test results showed that the back to back LSBs gave higher moment capacities in comparison with single LSBs, and the fastener spacing influenced the ultimate moment capacities. As the fastener spacing was reduced the ultimate moment capacities of back to back LSBs increased. Finite element models of back to back LSBs with varying fastener spacings were then developed to conduct a detailed parametric study on the flexural behaviour of back to back built-up LSBs. Two finite element models were developed, namely experimental and ideal finite element models. The models included the complex contact behaviour between LSB web elements and intermittently fastened bolted connections along the web elements. They were validated by comparing their results with experimental results and numerical results obtained from an established buckling analysis program called THIN-WALL. These comparisons showed that the developed models could accurately predict both the elastic lateral distortional buckling moments and the non-linear ultimate moment capacities of back to back LSBs. Therefore the ideal finite element models incorporating ideal simply supported boundary conditions and uniform moment conditions were used in a detailed parametric study on the flexural behaviour of back to back LSB members. In the detailed parametric study, both elastic buckling and nonlinear analyses of back to back LSBs were conducted for 13 LSB sections with varying spans and fastener spacings. Finite element analysis results confirmed that the current design rules in AS/NZS 4600 (SA, 2005) are very conservative while the new design rules developed by Anapayan and Mahendran (2009a) for single LSB members were also found to be conservative. Thus new member capacity design rules were developed for back to back LSB members as a function of non-dimensional member slenderness. New empirical equations were also developed to aid in the calculation of elastic lateral distortional buckling moments of intermittently fastened back to back LSBs. Design guidelines were developed for the maximum fastener spacing of back to back LSBs in order to optimise the use of fasteners. A closer fastener spacing of span/6 was recommended for intermediate spans and some long spans where the influence of fastener spacing was found to be high. In the last phase of this research, a detailed investigation was conducted to investigate the potential use of different types of connections and stiffeners in improving the flexural strength of back to back LSB members. It was found that using transverse web stiffeners was the most cost-effective and simple strengthening method. It is recommended that web stiffeners are used at the supports and every third points within the span, and their thickness is in the range of 3 to 5 mm depending on the size of LSB section. The use of web stiffeners eliminated most of the lateral distortional buckling effects and hence improved the ultimate moment capacities. A suitable design equation was developed to calculate the elastic lateral buckling moments of back to back LSBs with the above recommended web stiffener configuration while the same design rules developed for unstiffened back to back LSBs were recommended to calculate the ultimate moment capacities.

Development and validation of a novel approach to work sampling : a study of nurse practitioner work patterns

Objectives: This methodological paper reports on the development and validation of a work sampling instrument and data collection processes to conduct a national study of nurse practitioners’ work patterns. ---------- Design: Published work sampling instruments provided the basis for development and validation of a tool for use in a national study of nurse practitioner work activities across diverse contextual and clinical service models. Steps taken in the approach included design of a nurse practitioner-specific data collection tool and development of an innovative web-based program to train and establish inter rater reliability of a team of data collectors who were geographically dispersed across metropolitan, rural and remote health care settings. ---------- Setting: The study is part of a large funded study into nurse practitioner service. The Australian Nurse Practitioner Study is a national study phased over three years and was designed to provide essential information for Australian health service planners, regulators and consumer groups on the profile, process and outcome of nurse practitioner service. ---------- Results: The outcome if this phase of the study is empirically tested instruments, process and training materials for use in an international context by investigators interested in conducting a national study of nurse practitioner work practices. ---------- Conclusion: Development and preparation of a new approach to describing nurse practitioner practices using work sampling methods provides the groundwork for international collaboration in evaluation of nurse practitioner service.

Collaborative research to develop a specialist, post-graduate competency-based education curriculum and continuing professional development structure for health librarians in Australia

Through a grant received from the Australian Library and Information Association (ALIA), members of Health Libraries Australia (HLA) are collaborating with a researcher/educator to conduct a twelve month research project with the goal of developing an educational framework for the Australian health librarianship workforce of the future. The collaboration comprises the principal researcher and a representative group of practitioners from different sectors of the health industry who are affiliated with ALIA in various committees, advisory groups and roles. The research has two main aims: to determine the future skills requirements for the health librarian workforce in Australia; and to develop a structured, modular education framework for specialist post-graduate qualifications together with a structure for ongoing continuing professional development. The paper highlights some of the major trends in the health sector and some of the main environmental influences that may act as drivers for change for health librarianship as a profession, and particularly for educating the future workforce. The research methodology is outlined and the main results are described; the findings are discussed with regard to their implications for the development of a structured, competency-based education framework.

Female genital mutilation : Australian law, policy and practical challenges for doctors

As long ago as 1994, the Family Law Council accepted it was likely that female genital mutilation (FGM) was being conducted in Australia. In 2010, doctors and hospitals reported that it is being conducted and that they are seeing female patients who have experienced FGM. It is impossible to obtain precise data about the extent to which it is performed in Australia, but data indicates that FGM is a relevant issue for Australian medical practitioners. The medical profession has an interest in this topic because its members may be asked to conduct FGM, advise those considering it, or treat female patients with effects from the practice. This article provides a background on the practice of FGM, explains the relevant Australian law, considers whether the current legal prohibition on FGM is justified, and discusses the practical challenges facing individual practitioners and the profession. To inform further discussions about methods of responding to demand for FGM, reference is made to strategies being promoted in African nations to abolish this cultural practice.

Optimization problems for controlled mechanical systems : bridging the gap between theory and application

Mechanical control systems have become a part of our everyday life. Systems such as automobiles, robot manipulators, mobile robots, satellites, buildings with active vibration controllers and air conditioning systems, make life easier and safer, as well as help us explore the world we live in and exploit it’s available resources. In this chapter, we examine a specific example of a mechanical control system; the Autonomous Underwater Vehicle (AUV). Our contribution to the advancement of AUV research is in the area of guidance and control. We present innovative techniques to design and implement control strategies that consider the optimization of time and/or energy consumption. Recent advances in robotics, control theory, portable energy sources and automation increase our ability to create more intelligent robots, and allows us to conduct more explorations by use of autonomous vehicles. This facilitates access to higher risk areas, longer time underwater, and more efficient exploration as compared to human occupied vehicles. The use of underwater vehicles is expanding in every area of ocean science. Such vehicles are used by oceanographers, archaeologists, geologists, ocean engineers, and many others. These vehicles are designed to be agile, versatile and robust, and thus, their usage has gone from novelty to necessity for any ocean expedition.

Enhancing security and continuity management at international airports

Operators of busy contemporary airports have to balance tensions between the timely flow of passengers, flight operations, the conduct of commercial business activities and the effective application of security processes. In addition to specific onsite issues airport operators liaise with a range of organisations which set and enforce aviation-related policies and regulations as well as border security agencies responsible for customs, quarantine and immigration, in addition to first response security services. The challenging demands of coordinating and planning in such complex socio-technical contexts place considerable pressure on airport management to facilitate coordination of what are often conflicting goals and expectations among groups that have standing in respect to safe and secure air travel. What are, as yet, significantly unexplored issues in large airports are options for the optimal coordination of efforts from the range of public and private sector participants active in airport security and crisis management. A further aspect of this issue is how airport management systems operate when there is a transition from business-as-usual into an emergency/crisis situation and then, on recovery, back to ‘normal’ functioning. Business Continuity Planning (BCP), incorporating sub-plans for emergency response, continuation of output and recovery of degraded operating capacity, would fit such a context. The implementation of BCP practices in such a significant high security setting offers considerable potential benefit yet entails considerable challenges. This paper presents early results of a 4 year nationally funded industry-based research project examining the merger of Business Continuity Planning and Transport Security Planning as a means of generating capability for improved security and reliability and, ultimately, enhanced resilience in major airports. The project is part of a larger research program on the Design of Secure Airports that includes most of the gazetted ‘first response’ international airports in Australia, key Aviation industry groups and all aviation-related border and security regulators as collaborative partners. The paper examines a number of initial themes in the research, including: ? Approaches to integrating Business Continuity & Aviation Security Planning within airport operations; ? Assessment of gaps in management protocols and operational capacities for identifying and responding to crises within and across critical aviation infrastructure; ? Identification of convergent and divergent approaches to crisis management used across Austral-Asia and their alignment to planned and possible infrastructure evolution.

Codes of conduct for mobile device use in meetings : an exploratory analysis

The present paper addresses the findings of a preliminary investigation into policy and codes of conduct pertaining to the use of laptops and PDA’s in business meetings. The purpose of this study was to conduct a review of policies or codes of conduct pertaining to the use of laptops and PDAs in meetings. The investigation included academic literature, policy searches in the public domain of the Internet, as well as personal contact with target industries (large corporations – N=1000 + employees). The results highlight the dearth of policy and codes of conducts pertaining to the use of laptops and PDA’s in business meetings. Consequently, given the growing interdependence between mobile technologies and the contemporary workplace, there exists an opportunity for communication professionals to further research and develop policy and codes of conduct in this area. Implications for corporate communication policies and practices are also discussed.

Essays on irrigation development, farm production and unaccounted costs : theory and empirical evidence

A review of the literature related to issues involved in irrigation induced agricultural development (IIAD) reveals that: (1) the magnitude, sensitivity and distribution of social welfare of IIAD is not fully analysed; (2) the impacts of excessive pesticide use on farmers’ health are not adequately explained; (3) no analysis estimates the relationship between farm level efficiency and overuse of agro-chemical inputs under imperfect markets; and (4) the method of incorporating groundwater extraction costs is misleading. This PhD thesis investigates these issues by using primary data, along with secondary data from Sri Lanka. The overall findings of the thesis can be summarised as follows. First, the thesis demonstrates that Sri Lanka has gained a positive welfare change as a result of introducing new irrigation technology. The change in the consumer surplus is Rs.48,236 million, while the change in the producer surplus is Rs. 14,274 millions between 1970 and 2006. The results also show that the long run benefits and costs of IIAD depend critically on the magnitude of the expansion of the irrigated area, as well as the competition faced by traditional farmers (agricultural crowding out effects). The traditional sector’s ability to compete with the modern sector depends on productivity improvements, reducing production costs and future structural changes (spillover effects). Second, the thesis findings on pesticides used for agriculture show that, on average, a farmer incurs a cost of approximately Rs. 590 to 800 per month during a typical cultivation period due to exposure to pesticides. It is shown that the value of average loss in earnings per farmer for the ‘hospitalised’ sample is Rs. 475 per month, while it is approximately Rs. 345 per month for the ‘general’ farmers group during a typical cultivation season. However, the average willingness to pay (WTP) to avoid exposure to pesticides is approximately Rs. 950 and Rs. 620 for ‘hospitalised’ and ‘general’ farmers’ samples respectively. The estimated percentage contribution for WTP due to health costs, lost earnings, mitigating expenditure, and disutility are 29, 50, 5 and 16 per cent respectively for hospitalised farmers, while they are 32, 55, 8 and 5 per cent respectively for ‘general’ farmers. It is also shown that given market imperfections for most agricultural inputs, farmers are overusing pesticides with the expectation of higher future returns. This has led to an increase in inefficiency in farming practices which is not understood by the farmers. Third, it is found that various groundwater depletion studies in the economics literature have provided misleading optimal water extraction quantity levels. This is due to a failure to incorporate all production costs in the relevant models. It is only by incorporating quality changes to quantity deterioration, that it is possible to derive socially optimal levels. Empirical results clearly show that the benefits per hectare per month considering both the avoidance costs of deepening agro-wells by five feet from the existing average, as well as the avoidance costs of maintaining the water salinity level at 1.8 (mmhos/Cm), is approximately Rs. 4,350 for farmers in the Anuradhapura district and Rs. 5,600 for farmers in the Matale district.

Mining users’ opinions based on item folksonomy and taxonomy for personalized recommender systems

Item folksonomy or tag information is a kind of typical and prevalent web 2.0 information. Item folksonmy contains rich opinion information of users on item classifications and descriptions. It can be used as another important information source to conduct opinion mining. On the other hand, each item is associated with taxonomy information that reflects the viewpoints of experts. In this paper, we propose to mine for users’ opinions on items based on item taxonomy developed by experts and folksonomy contributed by users. In addition, we explore how to make personalized item recommendations based on users’ opinions. The experiments conducted on real word datasets collected from Amazon.com and CiteULike demonstrated the effectiveness of the proposed approaches.

Mooting and technology : to what extent does using technology improve the mooting experience for students?

It is generally acknowledged that mooting is an effective way to enhance the teaching of practical skills in legal education as well as to provide an authentic learning experience with links to the real world. However, there are a number of impediments to students participating in mooting; in particular being located off-campus, inexperience and lack of time. It has been suggested that technology may be a means of overcoming these impediments. However the use of technology in mooting has not been tested. This paper will report on a trial of the use of Second Life and Elluminate and videoconferencing as platforms for the conduct of moots. The trials identified limitations in the use of technology for mooting in particularly in relation to the development of advocacy skills. The paper will conclude that these limitations can be overcome by careful consideration of the appropriate technology to be used depending on the context and the objectives to be achieved by the moot. It will also suggest that in order to provide an authentic use of online communication technology in a court setting, the best available technology should be used for the conduct of moot competitions.

Court-provided trial technology : efficiency and fairness for criminal trials

In Australia, trials conducted as 'electronic trials' have ordinarily run with the assistance of commercial service providers, with the associated costs being borne by the parties. However, an innovative approach has been taken by the courts in Queensland. In October 2007 Queensland became the first Australian jurisdiction to develop its own court-provided technology, to facilitate the conduct of an electronic trial. This technology was first used in the conduct of civil trials. The use of the technology in the civil sphere highlighted its benefits and, more significantly, demonstrated the potential to achieve much greater efficiencies. The Queensland courts have now gone further, using the court-provided technology in the high proffle criminal trial of R v Hargraves, Hargraves and Stoten, in which the three accused were tried for conspiracy to defraud the Commonwealth of Australia of about $3.7 million in tax. This paper explains the technology employed in this case and reports on the perspectives of all of the participants in the process. The representatives for all parties involved in this trial acknowledged, without reservation, that the use of the technology at trial produced considerable overall efficiencies and costs savings. The experience in this trial also demonstrates that the benefits of trial technology for the criminal justice process are greater than those for civil litigation. It shows that, when skilfully employed, trial technology presents opportunities to enhance the fairness of trials for accused persons. The paper urges governments, courts and the judiciary in all jurisdictions to continue their efforts to promote change, and to introduce mechanisms to facilitate more broadly a shift from the entrenched paper-based approach to both criminal and civil procedure to one which embraces more broadly the enormous benefits trial technology has to offer.