Reproducibility and clinical utility of tendon palpation to detect patellar tendinopathy in young basketball players

Background—Palpation is an important clinical test for jumper's knee.

Objectives—To (a) test the reproducibility of palpation tenderness, (b) evaluate the sensitivity and specificity of palpation in subjects with clinical symptoms of jumper's knee, and (c) determine whether tenderness to palpation may serve as a useful screening test for patellar tendinopathy. The yardstick for diagnosis of patellar tendinopathy was ultrasonographic abnormality.

Methods—In 326 junior symptomatic and asymptomatic athletes' tendons, palpation was performed by a single examiner before ultrasonographic examination by a certified ultrasound radiologist. In 58 tendons, palpation was performed twice to test reliability. Tenderness to palpation was scored on a scale from 0 to 3 where 0 represented no pain, and 1, 2, and 3 represented mild, moderate, and severe tenderness respectively.

Results—Patellar tendon palpation was a reliable examination for a single examiner (Pearson r = 0.82). In symptomatic tendons, the positive predictive value of palpation was 68%. As a screening examination in asymptomatic subjects, the positive predictive value of tendon palpation was 36–38%. Moderate and severe palpation tenderness were better predictors of ultrasonographic tendon pathology than absent or mild tenderness (p<0.001). Tender and symptomatic tendons were more likely to have ultrasound abnormality than tenderness alone (p<0.01).

Conclusions—In this age group, palpation is a reliable test but it is not cost effective in detecting patellar tendinopathy in a preparticipation examination. In symptomatic tendons, palpation is a moderately sensitive but not specific test. Mild tenderness in the patellar tendons in asymptomatic jumping athletes should be considered normal.

'Green' treatment of acid mine drainage - a step towards sustainability

Sustainability is becoming increasingly important in the mining and mineral processing industries and must incorporate the associated waste products. Acid mine drainage (AMD) is one such by-product and is one of the most serious environmental problems facing the minerals industry today. The oxidation of sulphidic mine wastes often continues for a substantial period of time after mine closure, resulting in difficult and costly remediation and rehabilitation works. Mining companies are often reluctant to spend increasing amounts of money on waste treatment when the mine life is limited or even finished. Hence a simple, low maintenance and low-cost method of treating AMD is required. Whilst this paper does not address the issue of AMD, it does propose methods for removal of individual species from AMD with potential benefits, including raising AMD pH.

A novel concept of using biosolids as a biological adsorbent, or ‘biosorbent’, of metals from AMD is being investigated at a laboratory/pilot scale level. Biosolids are a by-product resulting from the biological treatment of wastewater, and have been previously shown to adsorb metals from aqueous solutions. This could lead to an environmentally sustainable or ‘green’ method for treating both AMD discharges and disposing/reusing the biosolids.

The result of a laboratory-scale study of the biosorption of Zn(II) is presented in this paper. Physical parameters including reaction kinetics, mixing speed and solution pH were investigated. Solution pH also rose an average of 2 pH units over the 24 hour equilibrium time – a valuable side effect when treating acid mine drainage. The outcome of the study highlights the usefulness of biosolids as a biosorbent for the removal/recovery of metal ions from acid mine drainage. A simple, low-cost treatment technology requiring low maintenance would be beneficial to the mining industry to address some issues relating to AMD and would help integrate environmental and economic considerations into sustainable environmental management.

Quantum cryptography - one step closer to reality

Most of cryptographic techniques today provide secure enough communications in society. However, none of them can provide unconditional security (except One-Time pad, which is the only such mechanism). They all have weaknesses. That is why they should be consistently updated and renovated along with changes in technology.

However, the quantum computers have potential to completely revolutionize cryptography. They would be so powerful that all complex computations and mathematical problems on which current cryptography rely, would become trivial. They would be able to solve them in a matter of seconds. At the same time quantum cryptography would offer perfectly secure communication.

This paper is brief introduction to quantum computing, quantum cryptography, and to existing quantum technology.

CIIP-RAM - a step-wise security risk analysis methodology for critical information infrastructure protection

Wilh the protection of critical information infrastructure becoming a priority for all levels of management. there is a need for a new security methodology to deal with the new and unique attack threats and vulnerabilities associated with the new information technology security paradigm. The fourth generation security risk analysis melhod which copes wilh the shift from computer/information security to critical information iinfrastructure protectionl is lhe next step toward handling security risk at all levels. The paper will present the methodology of
fourth generation models and their application to critical information infrastructure protection and the associated advantagess of this methodology.

The morality of the everyday: an initial step towards a research strategy

This paper attempts to problematise morality and to locate and investigate morality as an everyday activity. The paper draws extensively on the work of Zygmunt Bauman on the Holocaust and the challenges the Holocaust makes to social theory and to ethics. Following Bauman and Giddens, I argue that morality is pre-social and forms part of the social world in which we live and that it cannot and should not be codified. Some implications for future research on the morality of the everyday are made.

Evaluating public risk preferences in forest land-use choices using multi-attribute utility theory

Forest policy decisions inherently involve multiple attributes and risk and uncertainty as they largely deal with complex biological, ecological, and socio-political systems. Identifying risk preferences and quantifying their inter-relationships and tradeoffs are useful in formulating better forest policy. Often, technocrats and experts deal with risky decisions, but ideally, stakeholder risk characteristics should be explicitly considered in making policy decisions. This paper analysed societal risk preferences on public forest land-use attributes using multi-attribute utility theory (MAUT). The results indicate significant risk-averse behaviour towards old-growth forest conservation and forest-based recreation but less risk-averse behaviour towards native timber extraction. Overall, the respondents preferred a more conservative forest land-use option, which is consistent with their risk attitudes. The method provides insights into risk preferences of forest stakeholders, which could lead to better understanding of forest management conflicts. Moreover, the method explicitly distinguishes the technical and value components of the decision and is useful in unravelling public risk preferences in multiple-use forest planning situations.

The utility of a workplace injury instrument in prediction of workplace injury

Workplace injuries are common and destructive to persons, organisations, and society. Various instruments presently exist that are designed to assess the factors underlying workplace injury. The study reports on the construct and predictive validity of a 46-item instrument, the safety perception survey (SPS), currently used to assess safety climate in industrial organisations throughout Australia. Initially, factor analysis was conducted on the data from a sample of 1238 employees from nine organisations, which indicated a one-factor solution, was the best fit. A structural equation model (SEM) linking injury rates to the safety climate measure for 16 sub-groups of six industrial organisations indicated that the measure contributed just 23% of the variance in injury rates. Interestingly, the results indicated that the number of employees was a better and more significant predictor of injury (R² = 0.48). It is proposed that the SPS as is would need to be modified significantly from its current form to produce improvements in validity, as in its current form the survey is no more predictive of injury than organisational size. Future research into safety climate measures should incorporate predictive validity analysis on injury rates, as for many organisations; this is a performance outcome measure.

The utility of hypercoordination and secondary bonding for the synthesis of a binary organoelement oxo cluster

A strategy for the preparation of the otherwise difficult to obtain binary organometallic oxides containing two heavy main group elements is described and exemplified by the synthesis of [(p-MeOC₆H₄)₂Te(OSnt-Bu₂OH)₂]₂.

Validity of the assessment of quality of life (AQoL) utility instrument in patients with operable and inoperable lung cancer

There have been few longitudinal studies of quality of life in patients with all stages of lung cancer, particularly those that have included measures of utility. The purpose of this study was to examine the psychometric properties of the Assessment of Quality of Life instrument (AQoL) in patients with lung cancer. The AQoL is a health-related quality of life questionnaire and provides a descriptive system for a multi-attribute utility instrument (MAU), so that scores can be used in cost-utility evaluations. In the present study the reliability (internal consistency) of the AQoL was examined and the concurrent validity was assessed using the Medical Outcomes 36-item Short Form Health Survey (SF-36) as the comparator instrument. The sensitivity to different health states of the AQoL and the responsiveness to change over time was also examined. A prospective, non-experimental cohort study was undertaken. Ninety-two participants with all stages of lung cancer were recruited from a tertiary multi-disciplinary lung cancer clinic. Ninety participants had non-small cell lung cancer (NSCLC) and two had limited stage small cell lung cancer. The AQOL and SF-36 surveys were administered concurrently at baseline. In patients with NSCLC the surveys were then repeated 3 and 6 months later. Correlations between the baseline AQoL summary scales and SF-36 summary scales support the divergent and convergent validity of the AQoL. Reliability was also found to be sufficient (Cronbach's Alpha = 0.76). In addition, in patients with inoperable NSCLC, baseline AQoL scores were found to be predictive of survival at 6 months in Cox proportional hazards multivariate analysis. However, the physical components summary score of the SF-36 was more sensitive to differences in health states between patients with different stages of NSCLC at 6 months of follow-up and more responsive to change over time in both operable and inoperable patients with NSCLC than the AQoL. The findings support the construct validity and reliability of the AQoL in this population. However, there remains some uncertainty about whether the AQoL has sufficient sensitivity to different health states in this population. Further studies using other MAU instruments may determine whether alternative instruments are more sensitive to different health states in individuals with lung cancer.

Bayesian classification of catchments using spatial data: a first step to improved modelling of catchment effects on stream ecological condition

A major challenge facing freshwater ecologists and managers is the development of models that link stream ecological condition to catchment scale effects, such as land use. Previous attempts to make such models have followed two general approaches. The bottom-up approach employs mechanistic models, which can quickly become too complex to be useful. The top-down approach employs empirical models derived from large data sets, and has often suffered from large amounts of unexplained variation in stream condition.

We believe that the lack of success of both modelling approaches may be at least partly explained by scientists considering too wide a breadth of catchment type. Thus, we believe that by stratifying large sets of catchments into groups of similar types prior to modelling, both types of models may be improved. This paper describes preliminary work using a Bayesian classification software package, ‘Autoclass’ (Cheeseman and Stutz 1996) to create classes of catchments within the Murray Darling Basin based on physiographic data.

Autoclass uses a model-based classification method that employs finite mixture modelling and trades off model fit versus complexity, leading to a parsimonious solution. The software provides information on the posterior probability that the classification is ‘correct’ and also probabilities for alternative classifications. The importance of each attribute in defining the individual classes is calculated and presented, assisting description of the classes. Each case is ‘assigned’ to a class based on membership probability, but the probability of membership of other classes is also provided. This feature deals very well with cases that do not fit neatly into a larger class. Lastly, Autoclass requires the user to specify the measurement error of continuous variables.

Catchments were derived from the Australian digital elevation model. Physiographic data werederived from national spatial data sets. There was very little information on measurement errors for the spatial data, and so a conservative error of 5% of data range was adopted for all continuous attributes. The incorporation of uncertainty into spatial data sets remains a research challenge.

The results of the classification were very encouraging. The software found nine classes of catchments in the Murray Darling Basin. The classes grouped together geographically, and followed altitude and latitude gradients, despite the fact that these variables were not included in the classification. Descriptions of the classes reveal very different physiographic environments, ranging from dry and flat catchments (i.e. lowlands), through to wet and hilly catchments (i.e. mountainous areas). Rainfall and slope were two important discriminators between classes. These two attributes, in particular, will affect the ways in which the stream interacts with the catchment, and can thus be expected to modify the effects of land use change on ecological condition. Thus, realistic models of the effects of land use change on streams would differ between the different types of catchments, and sound management practices will differ.

A small number of catchments were assigned to their primary class with relatively low probability. These catchments lie on the boundaries of groups of catchments, with the second most likely class being an adjacent group. The locations of these ‘uncertain’ catchments show that the Bayesian classification dealt well with cases that do not fit neatly into larger classes.

Although the results are intuitive, we cannot yet assess whether the classifications described in this paper would assist the modelling of catchment scale effects on stream ecological condition. It is most likely that catchment classification and modelling will be an iterative process, where the needs of the model are used to guide classification, and the results of classifications used to suggest further refinements to models.