With the best of intentions: Is it possible to meet the CARI guidelines?

The CARI1 draft dialysis guidelines propose evidence based targets for biochemical and haematological parameters in ESRF. As part of a prospective randomised trial we investigated our ability to apply the CARI and National Heart Foundation of Australia targets to a representative dialysis population. All patients aged between 18–80 yrs were encouraged to enroll regardless of prior history of non-compliance or co-morbidity. Patients were randomised to either usual care (U;n = 44) or focussed care (F;n = 45). Usual care involved monthly blood tests and pysician review second monthly. In addition focus care patients had a monthly review in a physician supervised trial clinic run by nurses. The groups were comparable at baseline in terms of age, gender, dialysis modality, proportion of diabetics, time on dialysis, haemoglobin, ferritin, % saturation, parathyroid hormone, serum corrected calcium, serum phosphate, total cholesterol and LDL. At 6 months there had been significant improvements in PTH (p < 0.05), total cholesterol (p < 0.05) and LDL (p < 0.001), and a trend to better BP control. The proportion of patients meeting targets at 6 months were as follows: tot chol < 5 mmol/l-U 63%, F 82%; LDL < 3 mmol/l-U 75%, F 91%; phosphate < 1.8 mmol/l- U 42%, F 62%; PTH < 21 pmol/l-U 21%, F 40%; BP sys < 140 mmHg-U 41% F 46%; Hb > 11.5 g/dl U 58% F 64%. In spite of an intensive programme to maximise management of the haematological and biochemical parameters in patients with ESRF it appears that in a significant proportion of patients these targets could not be reached. 1The CARI Guidelines (Caring for Australians with Renal Impairment). Australian Kidney Foundation & Australia New Zealand Society of Nephrology, 2001.

The impact of market forces on the sustainability of the biotechnology industry

his paper contains a warning for investors, executives, analysts and scientists about the sustainability of the biotechnology industry. The study upon which the paper is based examines the impact of market forces on the biotechnology industry and argues that the short-term focus of market driven policies and practices impacts on the sustainability of firms operating in the industry. The market is represented by the National Association of Securities Dealers, Automated Quotations Market (NASDAQ), considered to be one of the vehicles of the promotion of ''new economy'' companies and principles. Through the application of bibliometric data (using both refereed and non-refereed papers), matched with the long term tracking of the NASDAQ Biotechnology Index, the authors provide a clear indication that the short-term investment thinking is leading an industry that is characterised by long R&D cycles. There is an incompatibility between the shorter-term investment considerations and the long-term scientific developments the biotechnology industry is attempting to achieve. Graphs and illustrations are provided to portray the comparative data.

Electronic commerce investments, the resource-based view of the firm, and firm market value

Firms have embraced electronic commerce as a means of doing business, either because they see it as a way to improve efficiency, grow market share, expand into new markets, or because they view it as essential for survival. Recent research in the United States provides some evidence that the market does value investments in electronic commerce. Following research that suggests that, in certain circumstances, the market values noninnovative investments as well as innovative investments in new products, we partition electronic commerce investment project announcements into innovative and noninnovative to determine whether there are excess returns associated with these types of announcements. Apart from our overall results being consistent with the United States findings that the market values investments in electronic commerce projects, we also find that noninnovative investments are perceived as more valuable to the firm than innovative investments. On average, the market expects innovative investments to earn a return commensurate with their risk. We conclude that innovative electronic commerce projects are most likely seen by the capital market as easily replicable, and consequently have little, if any, competitive advantage period. On the other hand, we conclude from the noninnovative investment results that these types of investments are seen as being compatible with a firm's assets-in-place, in particular, its information technology capabilities, a view consistent with the resource-based view of the firm.

Access to parental leave in Australia: evidence from Negotiating the Life Course

Although unpaid parental leave has been available to most Australian employees for more than a decade, and public sector legislation and company policies provide at least some employees with an entitlement to paid parental leave, there is as yet little information available on accessibility, take-up rates or the extent to which current leave provisions meet the needs of parents. In this paper, data from the Negotiating the Life Course survey are used to examine the first of these issues: accessibility. Variations in perceptions of access to paid and unpaid parental leave are examined in bivariate and multivariate analyses, which emphasise marked divisions in the Australian labour market between permanent and casual status. The data also suggest that access to unpaid parental leave is more variable than might be expected from a reading of formal legislative provisions, and raise questions over the accessibility of paid parental leave to those who need it most-employees with young children.

The new age: Towards a market model

The problem of how the New Age may be defined is widely acknowledged among commentators. It is hard to delineate and does not fit easily into existing analytical categories. This paper will review how scholars have conceptualised the movement. It will discuss the problems inherent in attempting to specify its constituents, fix its limits, and characterise its organisational forms. The later sections advances the argument that some of its most distinctive characteristics may be accounted for by acknowledging the market dynamics at play in New Age milieux. It is proposed that the diffuse overall shape of the movement is the result of determinate commercial institutional arrangements.

Respiratory and cardiovascular responses to hypoxia in the Australian lungfish

Simultaneous measurements of pulmonary blood flow (qPA), coeliacomesenteric blood flow (qCoA), dorsal aortic blood pressure (PDA), heart rate (fH) and branchial ventilation frequency (fv) were made in the Australian lungfish, /Neoceratodus forsteri, /during air breathing and aquatic hypoxia. The cho­linergic and adrenergic influences on the cardiovascular system were investigated during normoxia using pharmacological agents, and the presence of catecholamines and serotonin in different tissues was investi­gated using histochemistry. Air breathing rarely occurred during normoxia but when it did, it was always associated with increased pulmonary blood flow. The pulmonary vasculature is influenced by both a cho­linergic and adrenergic tonus whereas the coeliacomesenteric vasculature is influenced by a β-adrenergic vasodilator mechanism. No adrenergic nerve fibers could be demonstrated in /Neoceratodus /but catecholamine-containing endothelial cells were found in the atrium of the heart. In addition, serotonin-­immunoreactive cells were demonstrated in the pulmonary epithelium. The most prominent response to aquatic hypoxia was an increase in gill breathing frequency followed by an increased number of air breaths together with increased pulmonary blood flow. It is clear from the present investigation that /Neoceratodus /is able to match cardiovascular performance to meet the changes in respiration during hypoxia.