Clinical features of patellar tendinopathy and their implications for rehabilitation

This study investigated the clinical features of patellar tendinopathy (PT), with focus on individuals with unilateral and bilateral PT. A cross-sectional study design was employed to compare individuals with unilateral (n = 14) or bilateral (n = 13) PT and those without PT (control, n = 31). Features assessed included thigh strength (normalized peak knee extensor torque) and flexibility (sit-and-reach and active knee extension), calf endurance (heel-rise test), ankle flexibility (dorsiflexion), alignment measures (arch height and leg length difference), and functional measures (hop for distance and 6 m hop test). Groups were matched for age and height; however, unilateral and bilateral PT had greater mass with a higher body mass index (BMI) than control. Also, bilateral PT performed more sport hours per week than both unilateral PT and control. Unilateral PT had less thigh strength than control and bilateral PT, whereas bilateral PT had more thigh flexibility than control and unilateral PT. Both unilateral and bilateral PT had altered alignment measures compared to control. Features that predicted symptoms in PT were lower thigh flexibility and strength, whereas those that predicted function were higher thigh strength and lower ankle flexibility.  These findings indicate that unilateral and bilateral PT represent distinct entities, and that thigh strength appears particularly important in PT as it predicted both symptoms and function in PT.

Influence of preexercise muscle glycogen content on transcrptional activity of metabolic and myogenic genes in well-trained humans

To determine whether preexercise muscle glycogen content influences the transcription of several early-response genes involved in the regulation of muscle growth, seven male strength-trained subjects performed one-legged cycling exercise to exhaustion to lower muscle glycogen levels (Low) in one leg compared with the leg with normal muscle glycogen (Norm) and then the following day completed a unilateral bout of resistance training (RT). Muscle biopsies from both legs were taken at rest, immediately after RT, and after 3 h of recovery. Resting glycogen content was higher in the control leg (Norm leg) than in the Low leg (435 ± 87 vs. 193 ± 29 mmol/kg dry wt; P < 0.01). RT decreased glycogen content in both legs (P < 0.05), but postexercise values remained significantly higher in the Norm than the Low leg (312 ± 129 vs. 102 ± 34 mmol/kg dry wt; P < 0.01). GLUT4 (3-fold; P < 0.01) and glycogenin mRNA abundance (2.5-fold; not significant) were elevated at rest in the Norm leg, but such differences were abolished after exercise. Preexercise mRNA abundance of atrogenes was also higher in the Norm compared with the Low leg [atrogin: 14-fold, P < 0.01; RING (really interesting novel gene) finger: 3-fold, P < 0.05] but decreased for atrogin in Norm following RT (P < 0.05). There were no differences in the mRNA abundance of myogenic regulatory factors and IGF-I in the Norm compared with the Low leg. Our results demonstrate that 1) low muscle glycogen content has variable effects on the basal transcription of select metabolic and myogenic genes at rest, and 2) any differences in basal transcription are completely abolished after a single bout of heavy resistance training. We conclude that commencing resistance exercise with low muscle glycogen does not enhance the activity of genes implicated in promoting hypertrophy.

Transglobalism of self-exiled Hindus: the case of Australia

Hindu diaspora is now a global phenomenon, from the early immigrant experience as coolie labourers through the transnational movement of professional Hindus/Indians to many corners of the globe. In this paper, I intend to contextualize Hindu diaspora experience in Australia in the broader theoretical thinking on transnational migration, globalization and heterogeneity. One concern is to understand how distinctive is the religious diaspora experience of Hindus in Australia from those of the international South Asia diaspora. Much literature on South Asians in the West neglect religion, while recent studies disclose the considerable prominence of religion in various communities, especially in comparison with the secularizing tendencies typical of many white societies.

Guest editorial

An examination of Australian media reports over the last twelve months on the subject of Indigenous arts suggests a number of significant contradictions. Indigenous affairs Minister Amanda Vanstone called Aboriginal arts ‘Australia’s greatest cultural gift to the world’ (Australian, 24 January 2006), while the always-controversial expatriate Germaine Greer argued that much Indigenous art was in fact poor quality and ‘a big con’ (West Australian, 13 December 2005). Curators at France’s Musee du Quai Branly dedicated a wing of the new gallery to Aboriginal art. Yet many Indigenous leaders – including David Ross from the Central Land Council and Hetti Perkins, curator of Indigenous Arts at the Art Gallery of NSW – continue to publicise the widespread exploitation of Aboriginal artists in Central Australia by unscrupulous art dealers (Northern Territory News, 22 December 2005). Former head of the Northern Land Council and former Australian of the Year, Galarrwuy Yunupingu, who twenty years ago presented Bob Hawke with the painting Barunga Statement in celebration of the government’s commitment to a treaty, recently threatened to take the painting back from Parliament House in protest against ‘successive governments’’ neglect of Indigenous policy (Sydney Morning Herald, 21 January 2006). And in the performing arts, Richard Walley drew attention to the lack of professional recognition of Indigenous performing artists (Australian, 24 January 2006).

Such contradictions within the management and marketing of Indigenous arts have persisted for several years, and it was in response that this special issue of the Asia Pacific Journal of Arts and Cultural Management was initiated. As guest editors, we sought to present research that examines, more deeply and constructively, the marketing of Indigenous arts in Australia both historically and in the present. What emerges from this collection of five papers is a familiar scholarly theme: a tension between the ‘periphery’ and the ‘centre’, between outback and city, between larger and smaller Australian states and between Australia and other nations.

Jonathan Sweet’s ‘UNESCO and cultural heritage practice in Australia in the 1950s’ looks at the evolving relationship between Australia and the United Nations through an analysis of a significant touring exhibition: Australian Aboriginal Culture. Sweet pinpoints the 1950s as a period in which Australian museology’s approach to Indigenous cultures gradually changed, and in which Australian participation in UNESCO through the exhibition helped shape the ideological position UNESCO advocated. His article provides a useful historical contrast against which the following four articles may be read.

Chapman, Cardamone, Manahan and Rentschler look at local and contemporary issues in Indigenous arts marketing. Katrina Chapman’s ‘Positioning urban Aboriginal art in the Australian Indigenous art market’ investigates perceptions about contemporary urban Aboriginal art, concluding that the estrangement – and indeed stereotyping – of urban and traditional art creates a false set of values that urban artists are challenging. Similarly, Megan Cardamone, Esmai Manahan and Ruth Rentschler contrast perceptions of Aboriginal arts from the northern and south-eastern states, identifying crucial misconceptions that contribute to the value system applied to these arts. As Ruth Rentschler is a joint editor of this issue, the review process for this article has been managed by Katya Johanson as co-editor.

Two case studies of marketing the arts – which look at different artforms and in opposite sides of the country – then follow. Jennifer Radbourne, Janet Campbell and Vera Ding’s ‘Building audiences for Indigenous theatre’ analyses research on audiences and potential audiences for Kooemba Jdarra – Brisbane’s Indigenous performing arts company – to identify the ways in which audience attendance may be encouraged.

Finally, Jacqui Healy’s ‘Balgo 4-04’ provides a close examination of a unique art exhibition: a major commercial exhibition of the kind usually seen in Sydney and Melbourne, held in an arts centre in the middle of the Tanami Desert and retailing directly to collectors.

The editors are grateful to Warlayirti Artists Art Centre for permission to use the photographs that accompany Jacqui Healy’s article. We would also like to thank the contributors, Jo Caust for the opportunity to present this special issue, and Pearl Field for her assistance in putting it all together.

Lost in translation? William Wardell's St John's College, Sydney and Convent and School, Kew

This paper considers two Colleges designed by the nineteenth century architect William Wardell (1823-99): St John’s College, within the University of Sydney (1858-59) and Convent and School, Kew, now known as Genazzano FCJ College Kew, Melbourne (1889). The approach of significant anniversaries for each of the Colleges has been the major impetus behind the current research. Both commissions demonstrate laudable aspirations; difficulty in comprehending and realising the design; partial completions and accretions over time which testify to changes in economic fortune and taste; inappropriate additions; and decades of neglect fuelled by a general misunderstanding of the 19th century for much of the 20th century. At the beginning of the 21st century conservation management plans were commissioned independently for both projects. Using the two Colleges as case studies, this paper examines tradition and its transformation, design and its translation, heritage and its significance.

Cellular adaption to repeated eccentric exercise-induced muscle damage

Eccentrically biased exercise results in skeletal muscle damage and stimulates adaptations in muscle, whereby indexes of damage are attenuated when the exercise is repeated. We hypothesized that changes in ultrastructural damage, inflammatory cell infiltration, and markers of proteolysis in skeletal muscle would come about as a result of repeated eccentric exercise and that gender may affect this adaptive response. Untrained male (n = 8) and female (n = 8) subjects performed two bouts (bout 1 and bout 2), separated by 5.5 wk, of 36 repetitions of unilateral, eccentric leg press and 100 repetitions of unilateral, eccentric knee extension exercises (at 120% of their concentric single repetition maximum), the subjects' contralateral nonexercised leg served as a control (rest). Biopsies were taken from the vastus lateralis from each leg 24 h postexercise. After bout 2, the postexercise force deficit and the rise in serum creatine kinase (CK) activity were attenuated. Women had lower serum CK activity compared with men at all times (P < 0.05), but there were no gender differences in the relative magnitude of the force deficit. Muscle Z-disk streaming, quantified by using light microscopy, was elevated vs. rest only after bout 1 (P < 0.05), with no gender difference. Muscle neutrophil counts were significantly greater in women 24 h after bout 2 vs. rest and bout 1 (P < 0.05) but were unchanged in men. Muscle macrophages were elevated in men and women after bout 1 andbout 2 (P < 0.05). Muscle protein content of the regulatory calpain subunit remained unchanged whereas ubiquitin-conjugated protein content was increased after both bouts (P < 0.05), with a greater increase after bout 2. We conclude that adaptations to eccentric exercise are associated with attenuated serum CK activity and, potentially, an increase in the activity of the ubiquitin proteosome proteolytic pathway.

Gender differences in muscle inflammation after eccentric exercise

Unaccustomed exercise is followed by delayed-onset muscle soreness and morphological changes in skeletal muscle. Animal studies have demonstrated that women have an attenuated response to muscle damage. We studied the effect of eccentric exercise in untrained male (n = 8) and female (n = 8) subjects using a unilateral exercise design [exercise (Ex) and control (Con) legs]. Plasma granulocyte counts [before (Pre) and 48 h after exercise (+48h)] and creatine kinase activity [Pre, 24 h after exercise (+24h), +48h, and 6 days after exercise (+6d)] were determined before (Pre) and after (+24h, +48h, +6d) exercise, with biopsies taken from the vastus lateralis of each leg at +48h for determination of muscle damage and/or inflammation. Plasma granulocyte counts increased for men and decreased for women at +48h (P < 0.05), and creatine kinase activity increased for both genders at +48h and +6d (P < 0.01). There were significantly greater areas of both focal (P < 0.001) and extensive (P < 0.01) damage in the Ex vs. Con leg for both genders, which was assessed by using toluidine blue staining. The number of leukocyte common antigen-positive cells/mm2 tissue increased with exercise (P < 0.05), and men tended to show more in their Ex vs. Con leg compared with women (P = 0.052). Men had a greater total (Ex and Con legs) number of bcl-2-positive cells/mm2 tissue vs. women (P < 0.05). Atrophic fibers with homogeneous bcl-2-positive staining were seen only in men (n = 3). We conclude that muscle damage is similar between genders, yet the inflammatory response is attenuated in women vs. men. Finally, exercise may stimulate the expression of proteins involved in apoptosis in skeletal muscle.

Effects of long-term tennis playing on the muscle-bone relationship in the dominant and non-dominant forearms

The relationship between muscle strength and bone mineral density illustrates the positive effect of mechanical loading on bone. But local and systemic factors may affect both muscle and bone tissues. This study investigated the effects of long-term tennis playing on the relationship between lean tissue mass and bone mineral content in the forearms, taking the body dimensions into account. Fifty-two tennis players (age 24.2 +/- 5.8 yrs, 16.2 +/- 6.1 yrs of practice) were recruited. Lean tissue mass (LTM), bone area, bone mineral content (BMC), and bone mineral density were measured at the forearms from a DXA whole-body scan. Grip strength was assessed with a dynamometer. A marked side-to-side difference (p < 0.0001) was found in favor of the dominant forearm in all parameters. Bone area and BMC correlated with grip strength on both sides (r = 0.81 - 0.84, p < 0.0001). The correlations were still significant after adjusting for whole-body BMC body height, or forearm length. This result reinforced the putative role of the muscles in the mechanical loading on bones. In addition, forearm BMC adjusted to LTM or grip strength was higher on the dominant side, suggesting that tennis playing exerts a direct effect on bone.

Bone geometry in response to long-term tennis playing and its relationship with muscle volume : a quantitative magnetic resonance imaging study in tennis players

The benefit of impact-loading activity for bone strength depends on whether the additional bone mineral content (BMC) accrued at loaded sites is due to an increased bone size, volumetric bone mineral density (vBMD) or both. Using magnetic resonance imaging (MRI) and dual energy X-ray absorptiometry (DXA), the aim of this study was to characterize the geometric changes of the dominant radius in response to long-term tennis playing and to assess the influence of muscle forces on bone tissue by investigating the muscle–bone relationship. Twenty tennis players (10 men and 10 women, mean age: 23.1 ± 4.7 years, with 14.3 ± 3.4 years of playing) were recruited. The total bone volume, cortical volume, sub-cortical volume and muscle volume were measured at both distal radii by MRI. BMC was assessed by DXA and was divided by the total bone volume to derive vBMD. Grip strength was evaluated with a dynamometer. Significant side-to-side differences (P < 0.0001) were found in muscle volume (+9.7%), grip strength (+13.3%), BMC (+13.5%), total bone volume (+10.3%) and sub-cortical volume (+20.6%), but not in cortical volume (+2.6%, ns). The asymmetry in total bone volume explained 75% of the variance in BMC asymmetry (P < 0.0001). vBMD was slightly higher on the dominant side (+3.3%, P < 0.05). Grip strength and muscle volume correlated with all bone variables (except vBMD) on both sides (r = 0.48–0.86, P < 0.05–0.0001) but the asymmetries in muscle parameters did not correlate with those in bone parameters. After adjustment for muscle volume or grip strength, BMC was still greater on the dominant side. This study showed that the greater BMC induced by long-term tennis playing at the dominant radius was associated to a marked increase in bone size and a slight improvement in volumetric BMD, thereby improving bone strength. In addition to the muscle contractions, other mechanical stimuli seemed to exert a direct effect on bone tissue, contributing to the specific bone response to tennis playing.

Short-term and long-term site-specific effects of tennis playing on trabecular and cortical bone at the distal radius

Mechanical loading during growth magnifies the normal increase in bone diameter occurring in long bone shafts, but the response to loading in long bone ends remains unclear. The aim of the study was to investigate the effects of tennis playing during growth at the distal radius, comparing the bone response at trabecular and cortical skeletal sites. The influence of training duration was examined by studying bone response in short-term (children) and long-term (young adults) perspectives. Bone area, bone mineral content (BMC), and bone mineral density (BMD) of the radius were measured by DXA in 28 young (11.6 ± 1.4 years old) and 47 adult tennis players (22.3 ± 2.7 years old), and 70 age-matched controls (12 children, 58 adults) at three sites: the ultradistal region (trabecular), the mid-distal region, and the third-distal region (cortical). At the ultradistal radius, young and adult tennis players displayed similar side-to-side differences, the asymmetry in BMC reaching 16.3% and 13.8%, respectively (P < 0.0001). At the mid- and third-distal radius, the asymmetry was much greater in adults than in children (P < 0.0001) for all the bone parameters (mid-distal radius, +6.6% versus +15.6%; third-distal radius, +6.9% versus +13.3%, for BMC). Epiphyseal bone enduring longitudinal growth showed a great capacity to respond to mechanical loading in children. Prolonging tennis playing into adulthood was associated with further increase in bone mineralization at diaphyseal skeletal sites. These findings illustrate the benefits of practicing impact-loading sports during growth and maintaining physical activity into adulthood to enhance bone mass accrual and prevent fractures later in life.

Nietzsche as 'Europe's Buddha' and 'Asia's superman'

Nietzsche represents in an interesting way the well-worn Western approach to Asian philosophical and religious thinking: initial excitement, then neglect by appropriation, and swift rejection when found to be incompatible with one’s own tradition, whose roots are inexorably traced back to the ‘ancient’ Greeks. Yet, Nietzsche’s philosophical critique and methods - such as ‘perspectivism’ - offer an instructive route through which to better understand another tradition even if the sole purpose of this exercise is to perceive one’s own limitations through the eyes of the other: a self-destruktion of sorts. To help correct this shortcoming and begin the long overdue task of even-handed dialogue - or contemporary comparative philosophy - we will be served well by looking at Nietzsche’s mistakes, which in turn informed the tragic critic of the West of the last century, Martin Heidegger. We may learn here not to cast others in one’s own troubled image; and not to reverse cultural icons: Europe’s Superman, and Asia’s Buddha.

Importance of assessing family dysfunction in conjunction with standardised measures when treating substance abuse

In this thesis, the link between substance abuse and family dysfunction is examined, and an argument is made for the assessment of family dysfunction when treating clients with substance abuse issues. Family dysfunction has been associated with a broad range of problems in children (e.g., low self esteem, increased risk of child abuse) through to adolescence and adulthood (e.g., increased risk of mental disorders such as depressive disorders, substance abuse disorders, and personality disorders) (Kaplan & Sadock, 1998). It is not the purpose of this thesis to suggest that family dysfunction causes substance abuse but rather to highlight that family dysfunction can in some cases place the individual at greater risk of substance abuse. Therefore, in order to understand the reasons why substance abuse developed and how it is maintained in the present requires the assessment of family dysfunction. Further, the importance of assessing the role and impact that family dysfunction may have had on the client, may help to better understand the nature and extent of substance abuse so that relevant and appropriate treatment goals for change may be set, progress monitored, and risk of relapse reduced. Chapter 1 provides a brief introduction to this thesis, and Chapter 2 is a review of the literature on the impact of family dysfunction including poor parental attachment and supervision, neglect, physical and sexual abuse, in adolescence and adulthood. Four case studies are presented to illustrate how family dysfunction and substance abuse may be related, thus highlighting the importance of assessing family dysfunction when treating substance abuse clients. All of the case studies include an individual with a substance abuse disorder (namely heroin) but they are diverse in terms of the types and extent of family dysfunction. The final chapter discusses the case studies in relation to the literature reviewed. Lastly, it gives consideration to the implication of a history of family dysfunction, and how it may impact negatively on treatment and therefore prognosis.