Postural control and movement performance during upper limb tasks in children with developmental co-ordination disorder (DCD)

At least 6% of primary school aged children present with DCD, where co-ordination is substantially below the normal range for the child’s age and intelligence. Motor skill difficulties negatively affect academic achievement, recreation and activities of daily living. Poor upper-limb co-ordination is a common difficulty for children with DCD. A possible cause of this problem is deviant muscle timing in proximal muscle groups, which results in poor postural and movement control. While studies have been published investigating postural control in response to external perturbations, detail about postural muscle activity during voluntary movement is limited even in children with normal motor development. No studies have investigated the relationship between muscle timing, resultant arm motion and upper-limb coordination deficits. Objectives: To investigate the relationship between functional difficulties with upper-limb motor skills and neuromuscular components of postural stability and coordination. Specifically, to investigate onset-timing of muscle activity, timing of arm movement, and resultant three-dimensional (3D) arm co-ordination during rapid, voluntary arm movement and to analyse differences arising due to the presence of DCD. This study is part of a larger research program investigating postural stability and control of upper limb movement in children. Design: A controlled, cross-sectional study of differences between children with and without DCD. Methods: This study included 50 children aged eight to 10 years (25 with DCD and 25 without DCD). Children participated in assessment of motor skills according to the Movement ABC Test and a laboratory study of rapid, voluntary arm movements. Parameters investigated included muscle activation timing of shoulder and trunk muscles (surface electromyography), arm movement timing (light sensor) and resultant 3D arm motion (Fastrak). Results: A MANOVA is being used to analyse between-group differences. Preliminary results indicate children with DCD demonstrate altered muscle timing during a rapid arm raise when compared with the control group of children. Conclusion: Differences in proximal muscle timing in children with DCD support the hypothesis that altered proximal muscle activity may contribute to poor proximal stability and consequently poor arm movement control. This has implications for clinical physiotherapy.

Prospective independent validation of APACHE III models in an Australian tertiary adult intensive care unit

Evaluation of the performance of the APACHE III (Acute Physiology and Chronic Health Evaluation) ICU (intensive care unit) and hospital mortality models at the Princess Alexandra Hospital, Brisbane is reported. Prospective collection of demographic, diagnostic, physiological, laboratory, admission and discharge data of 5681 consecutive eligible admissions (1 January 1995 to 1 January 2000) was conducted at the Princess Alexandra Hospital, a metropolitan Australian tertiary referral medical/surgical adult ICU. ROC (receiver operating characteristic) curve areas for the APACHE III ICU mortality and hospital mortality models demonstrated excellent discrimination. Observed ICU mortality (9.1%) was significantly overestimated by the APACHE III model adjusted for hospital characteristics (10.1%), but did not significantly differ from the prediction of the generic APACHE III model (8.6%). In contrast, observed hospital mortality (14.8%) agreed well with the prediction of the APACHE III model adjusted for hospital characteristics (14.6%), but was significantly underestimated by the unadjusted APACHE III model (13.2%). Calibration curves and goodness-of-fit analysis using Hosmer-Lemeshow statistics, demonstrated that calibration was good with the unadjusted APACHE III ICU mortality model, and the APACHE III hospital mortality model adjusted for hospital characteristics. Post hoc analysis revealed a declining annual SMR (standardized mortality rate) during the study period. This trend was present in each of the non-surgical, emergency and elective surgical diagnostic groups, and the change was temporally related to increased specialist staffing levels. This study demonstrates that the APACHE III model performs well on independent assessment in an Australian hospital. Changes observed in annual SMR using such a validated model support an hypothesis of improved survival outcomes 1995-1999.

Sexual dysfunction in the Australian population

AIM: To describe the prevalence and forms of sexual dysfunction experienced by Australians, and compare these with people in the United States. METHODS: A cross sectional, telephone interview survey of a randomly selected sample of men (n = 876) and women (n = 908) aged between 18 and 59 years on the electoral roll in all states and territories of Australia (response rate = 61%) was conducted between November 1999 and April 2000. RESULTS: Large proportions of Australian men (55.0%) and women (60.5%) reported at least one sexual problem within the preceding year. More serious sexual dysfunction (> 3 symptoms) was observed in 13.2% of men and 19.7% of women. DISCUSSION: Australia and the USA are similar with regard to the high rate of symptoms of sexual dysfunction observed in the population. The low rate of treatment points to both patient and doctor reluctance to discuss sexual performance and practices.

Returns from investing in Australian equity superannuation funds, 1991-1999

In this analysis of investment manager performance, two questions are addressed. First, do managers that actively trade stocks create value for investors? Second, can the multifactor model of Gruber capture the cross-section of average fund returns for the Australian setting? The answers from this study are as follows: as an industry, investment managers destroyed value for superannuation investors for the period 1991 through 1999, under-performing passive portfolio returns by 2.80-4.00 per cent per annum on a risk-unadjusted basis and 0.50-0.93 per cent per annum on a risk-adjusted basis. Evidence is provided in support of the four-factor model of Gruber; however, the model fails to capture the impact of investment style for the Australian setting. The findings suggest that Australian superannuation investors would transform their retirement savings into retirement income more efficiently through the use of passive alternatives to the stock selection problem.

The relationship between exchange rate exposure, currency risk management and performance of international equity funds

This paper assesses the currency risk management policies for a sample of Australian international equity trusts. The relevance of currency risk management is considered in the context of exchange rate exposure and performance measures. The study incorporates differing economic climates and particular emphasis is given to the Asian crisis in mid-1997. Our results indicate that a good proportion of funds do implement specific currency risk management policies. Furthermore, we find that for those funds managing currency risk, there is some evidence of a favourable impact on currency exposure and fund performance.

Optimising care of acute coronary syndromes in three Australian hospitals

Objective. To improve quality of in-hospital care of patients with acute coronary syndromes using a multifaceted quality improvement program. Design. Prospective, before and after study of the effects of quality improvement interventions between October 2000 and August 2002. Quality of care of patients admitted between 1 October 2000 and 16 April 2001 (baseline) was compared with that of those admitted between 15 February 2002 and 31 August 2002 (post-intervention). Setting. Three teaching hospitals in Brisbane, Australia. Study participants. Consecutive patients (n = 1594) admitted to hospital with acute coronary syndrome [mean age 68 years (SD 14 years); 65% males]. Interventions. Clinical guidelines, reminder tools, and educational interventions; 6-monthly performance feedback; pharmacist-mediated patient education program; and facilitation of multidisciplinary review of work practices. Main outcome measures. Changes in key quality indicators relating to timing of electrocardiogram (ECG) and thrombolysis in emergency departments, serum lipid measurement, prescription of adjunctive drugs, and secondary prevention. Results. Comparing post-intervention with baseline patients, increases occurred in the proportions of eligible patients: (i) undergoing timely ECG (70% versus 61%; P = 0.04); (ii) prescribed angiotensin-converting enzyme inhibitors (70% versus 60%; P = 0.002) and lipid-lowering agents (77% versus 68%; P = 0.005); (iii) receiving cardiac counselling in hospital (57% versus 48%; P = 0.009); and (iv) referred to cardiac rehabilitation (17% versus 8%; P < 0.001). Conclusions. Multifaceted approaches can improve care processes for patients hospitalized with acute coronary syndromes. Care processes under direct clinician control changed more quickly than those reliant on complex system factors. Identifying and overcoming organizational impediments to quality improvement deserves greater attention.

The incidence and intensity of employer funded training: Australian evidence on the impact of flexible work

The interaction between the growth of flexible forms of employment and employer funded training is important for understanding labour market performance. In particular, the idea of a trade-off has been advanced to describe potential market failures in the employment of flexible workers. This study finds that evidence of a trade-off is apparent in both the incidence and intensity of employer funded training. Flexible workers receive training that is 50-80% less intense than the workforce average. Casual workers - especially males - suffer more acutely from the trade-off. This suggests that flexible production externalities may seriously reduce human capital formation in the workforce.

The evaluation of the spatial and temporal stability of sugarcane farm performance based on yield and commercial cane sugar

In broader catchment scale investigations, there is a need to understand and ultimately exploit the spatial variation of agricultural crops for an improved economic return. In many instances, this spatial variation is temporally unstable and may be different for various crop attributes and crop species. In the Australian sugar industry, the opportunity arose to evaluate the performance of 231 farms in the Tully Mill area in far north Queensland using production information on cane yield (t/ha) and CCS ( a fresh weight measure of sucrose content in the cane) accumulated over a 12-year period. Such an arrangement of data can be expressed as a 3-way array where a farm x attribute x year matrix can be evaluated and interactions considered. Two multivariate techniques, the 3-way mixture method of clustering and the 3-mode principal component analysis, were employed to identify meaningful relationships between farms that performed similarly for both cane yield and CCS. In this context, farm has a spatial component and the aim of this analysis was to determine if systematic patterns in farm performance expressed by cane yield and CCS persisted over time. There was no spatial relationship between cane yield and CCS. However, the analysis revealed that the relationship between farms was remarkably stable from one year to the next for both attributes and there was some spatial aggregation of farm performance in parts of the mill area. This finding is important, since temporally consistent spatial variation may be exploited to improve regional production. Alternatively, the putative causes of the spatial variation may be explored to enhance the understanding of sugarcane production in the wet tropics of Australia.

A Complementary Economy? National Markets and International Product in Early Australian Theatre Managements

The international circulation of commercial theatre in the early twentieth century was driven not only from the centres of Great Britain and the USA, but by the specific enterprise and habitus of managers in ‘complementary’ production sites such as Australia, South Africa, and New Zealand. The activity of this period suggests a de-centred competitive trade in theatrical commodities – whether performers, scripts, or productions – wherein the perceived entertainment preferences and geographies of non-metropolitan centres were formative of international enterprise. The major producers were linked in complex bonds of partnerships, family, or common experience which crossed the globe. The fractures and commonalities displayed in the partnerships of James Cassius Williamson and George Musgrove, which came to dominate and shape the fortunes of the Australian industry for much of the century, indicate the contradictory commercial and artistic pressures bearing upon entrepreneurs seeking to provide high-quality entertainment and form advantageous combinations in competition with other local and international managements. Clarke, Meynell and Gunn mounted just such spirited competition from 1906 to 1911, and their story demonstrates both the opportunities and the centralizing logic bearing upon local managements shopping and dealing in a global market. The author, Veronica Kelly, works at the University of Queensland. She is presently undertaking a study of commercial stars and managements in late nineteenth- and early twentieth-century Australia, with a focus on the star performer as model of history, gender, and nation.

Performance of the Norwegian version of AUSCAN - a disease-specific measure of hand osteoarthritis

Objective: To examine the performance of the Norwegian version of the AUSCAN Index as a disease-specific health status measure in patients with hand osteoarthritis (OA). Methods: One hundred and ninety-nine patients with clinical hand OA (mean (SD) age 61.7 (5.7) years, 18 (9%) males) underwent a comprehensive examination including joint status, examination of grip strength and completion of several self-reported health status questionnaires. The Australian/Canadian OA hand index (AUSCAN) captures three different dimensions of hand OA: pain (5 items), stiffness (1 item), and difficulties with daily activities (9 items). Our pre-study hypothesis was to identify AUSCAN as a specific hand measure with strong correlations to hand measures and lower correlations to other general measures of health. Results: Patient completion of the AUSCAN Index was similar or better than other measures. The internal consistency of the AUSCAN was excellent. The pain and physical dimension of AUSCAN correlated substantially to, each other and moderately to the stiffness scale. The AUSCAN physical scale correlated moderately to substantially to other measures, the highest correlation being seen with the Arthritis Impact Measurement Scale (AIMS) 2 hand and finger function scale (r= 0.73). The standardised differences between patients with and without radiographic abnormalities were numerically larger for the AUSCAN pain and physical scales than for other measures. Conclusion: The Norwegian version of the AUSCAN has an acceptable clinimetric performance and is a suitable tool for assessment of hand OA. (C) 2005 OsteoArthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Perceived academic performance, self-esteem and locus of control as indicators of need for assessment of adolescent suicide risk: implications for teachers

Introduction: There is currently a need for research into indicators that could be used by non-clinical professionals working with young people, to inform the need for referral for further clinical assessment of those at risk of suicide. Method: Participants of this repeated measures longitudinal study, were 2603, 2485, and 2246 school students aged 13, 14, and 15, respectively, from 27 South Australian Schools. Results: Perceived academic performance, self-esteem and locus of control are significantly associated with suicidality. Further, logistic regression of longitudinal results suggests that perceived academic performance, over and above self-esteem and locus of control, in some instances, is a good long-term predictor of suicidality. (C) 2004 Published by Elsevier Ltd. on behalf of The Association for Professionals in Services for Adolescents.

Body-mass management of Australian lightweight rowers prior to and during competition

Purpose: Although the body-mass management strategies of athletes in high-participation weight-category sports such as wrestling have been thoroughly investigated, little is known about such practices among lightweight rowers. This study examined the body-mass management practices of lightweight rowers before competition and compared these with current guidelines of the International Federation of Rowing Association (FISA). Quantification of nutrient intake in the 1-2 h between weigh-in and racing was also sought. Methods: Lightweight rowers (N = 100) competing in a national regatta completed a questionnaire that assessed body-mass management practices during the 4 wk before and throughout a regatta plus recovery strategies after weigh-in. Biochemical data were collected immediately after weigh-in to validate questionnaire responses. Responses were categorized according to gender and age category (Senior B or younger than 23 yr old, i.e., U23, Senior A or OPEN, i.e., open age limit) for competition. Results: Most athletes (male U23 76.5%, OPEN 92.3%; female U23 84.0%, OPEN 94.1%) decreased their body mass in the weeks before the regatta at rates compliant with FISA guidelines. Gradual dieting, fluid restriction, and increased training load were the most popular methods of body-mass management. Although the importance of recovery after weigh-in was recognized by athletes, nutrient intake and especially sodium (male U23 5.3 &PLUSMN; 4.9, OPEN 7.7 &PLUSMN; 5.9; female U23 5.7 &PLUSMN; 6.8, OPEN 10.2 &PLUSMN; 5.4 mg-kg(-1)) and fluid intake (male U23 12.1 &PLUSMN; 7.1, OPEN 13.5 &PLUSMN; 8.1; female U23 9.4 &PLUSMN; 7.4, OPEN 14.8 &PLUSMN; 6.9 mL.kg(-1)) were below current sports nutrition recommendations. Conclusion: Few rowers were natural lightweights; the majority reduced their body mass in the weeks before a regatta. Nutritional recovery strategies implemented by lightweight rowers after weigh-in were not consistent with current guidelines.

Financial and economic performance of long-rotation hardwood plantation investments in Queensland, Australia

In Queensland, Australia, there is presently a high level of interest in long-rotation hardwood plantation investments for sawlog production, despite the consensus in Australian literature that such investments are not financially viable. Continuing genetics, silviculture and processing research, and increasing awareness about the ecosystem services generated by plantations, are anticipated to make future plantings profitable and socio-economically desirable in many parts of Queensland. Financial and economic models of hardwood plantations in Queensland are developed to test this hypothesis. The economic model accounts for carbon sequestration, salinity amelioration and other ecosystem service values of hardwood plantations. A carbon model estimates the value of carbon sequestered, while salinity and other ecosystem service values are estimated by the benefit transfer method. Where high growth rates (20-25 m(3) ha(-1) year(-1)) are achievable, long-rotation hardwood plantations are profitable in Queensland Hardwood Regions 1, 3 and 7 when rural land values are less than $2300/ha. Under optimistic assumptions, hardwood plantations growing at a rate of 15 in 3 ha-1 year 1 are financially viable in Hardwood Regions 2, 4 and 8, provided land values are less than $1600/ha. The major implication of the economic analysis is that long-rotation hardwood plantation forestry is socio-economically justified in most Hardwood Regions, even though financial returns from timber production may be negative. (c) 2003 Elsevier B.V. All rights reserved.