Service use in children aged 6-8 years with attention deficit hyperactivity disorder

OBJECTIVE: This study investigated prevalence, types and predictors of professional service use in families of children identified with attention deficit hyperactivity disorder (ADHD) in the community.

DESIGN: SETTING: children with ADHD were identified through 43 schools using parent and teacher screening questionnaires (Conners 3 ADHD Index) followed by case confirmation using the Diagnostic Interview Schedule for Children Version IV. Parents completed a survey about professional service use in the last 12 months.

MAIN OUTCOME MEASURES: data on variables potentially associated with service use were collected from parents (interview and questionnaires), teachers (questionnaires) and children (direct assessment). Logistic regression was used to examine predictors of service use in univariate and multivariable analyses.

RESULTS: The sample comprised 179 children aged 6-8 years with ADHD. Over one-third (37%) had not received professional services in the last 12 months. The strongest predictors of service use were older child age (adjusted OR=3.0, 95% CI 1.0 to 8.9, p=0.05), and the degree to which the child's behaviour impacted on the family (adjusted OR=2.0, 95% CI 1.3 to 3.3, p=0.007), after controlling for ADHD subtype and severity, externalising comorbidities, academic achievement and parent-reported impairment.

CONCLUSIONS: A substantial proportion of children with ADHD are not accessing professional services. Our findings suggest that the child's age and the impact of the child's behaviour on the family are the strongest predictors of service use. Given the demonstrated benefits from various interventions in ADHD, there is a need to improve case identification and referral for services.

Reforestation with native mixed-species plantings in a temperate continental climate effectively sequesters and stabilizes carbon within decades.

Reforestation has large potential for mitigating climate change through carbon sequestration. Native mixed-species plantings have a higher potential to reverse biodiversity loss than do plantations of production species, but there are few data on their capacity to store carbon. A chronosequence (5-45 years) of 36 native mixed-species plantings, paired with adjacent pastures, was measured to investigate changes to stocks among C pools following reforestation of agricultural land in the medium rainfall zone (400-800 mm yr(-1) ) of temperate Australia. These mixed-species plantings accumulated 3.09 ± 0.85 t C ha(-1)  yr(-1) in aboveground biomass and 0.18 ± 0.05 t C ha(-1)  yr(-1) in plant litter, reaching amounts comparable to those measured in remnant woodlands by 20 years and 36 years after reforestation respectively. Soil C was slower to increase, with increases seen only after 45 years, at which time stocks had not reached the amounts found in remnant woodlands. The amount of trees (tree density and basal area) was positively associated with the accumulation of carbon in aboveground biomass and litter. In contrast, changes to soil C were most strongly related to the productivity of the location (a forest productivity index and soil N content in the adjacent pasture). At 30 years, native mixed-species plantings had increased the stability of soil C stocks, with higher amounts of recalcitrant C and higher C : N ratios than their adjacent pastures. Reforestation with native mixed-species plantings did not significantly change the availability of macronutrients (N, K, Ca, Mg, P, and S) or micronutrients (Fe, B, Mn, Zn, and Cu), content of plant toxins (Al, Si), acidity, or salinity (Na, electrical conductivity) in the soil. In this medium rainfall area, native mixed-species plantings provided comparable rates of C sequestration to local production species, with the probable additional benefit of providing better quality habitat for native biota. These results demonstrate that reforestation using native mixed-species plantings is an effective alternative for carbon sequestration to standard monocultures of production species in medium rainfall areas of temperate continental climates, where they can effectively store C, convert C into stable pools and provide greater benefits for biodiversity.

Stakeholder satisfaction with the Australian Rheumatology Association Database (ARAD)

Background: The Australian Rheumatology Association Database (ARAD) is a voluntary national registry for monitoring the long-term benefits and safety of biological disease-modifying anti-rheumatic drugs (bDMARDs) for inflammatory arthritis. Both rheumatologists and patients contribute data to the ARAD.

Objective: To evaluate the satisfaction of patients and rheumatologists with the ARAD.

Methods: Cross-sectional surveys were distributed to a random sample of 100 community-dwelling ARAD patients in 2007 and to rheumatologists attending the 2007 AustralianRheumatologyAssociation (ARA) annual scientific meeting.

Survey questions included items about the usefulness of the ARAD, workload for participants, frequency of questionnaires, and experience of contact with ARAD staff.

Results: A total of 92.5% of patients perceived the ARAD as very important (scoring 9-10 on a numeric rating scale). Patients reported minimal difficulty in completing questionnaires, and 95.0% indicated that a 6-month interval between questionnaires was reasonable. Of responding rheumatologists, 32.3%, 62.1%, and 53.8% indicated that the ARAD was very important (scoring 8-10) with respect to clinical information, research, and the profession, respectively, while 68% of those participating in the ARAD reported that the workload required to enroll patients was manageable and 30% found it difficult or onerous.

Conclusion: Key stakeholders in the ARAD view it as an important resource and are satisfied with its operations. Efforts will be directed towards assisting those rheumatologists who find the associated workload difficult and to improving the perceived clinical value of information available from the ARAD.

Bipolar missed states : the diagnosis and clinical salience of bipolar mixed states

Objective: To explore diagnostic and treatment issues concerning bipolar mixed states.

Method: Bipolar mixed states are described and concerns about diagnostic and treatment difficulties are summarized and discussed.

Result: Mixed states can present with equal admixtures of depressive or manic symptoms, or more commonly one component predominates. There is fair consensus, although little data, regarding the management of manic mixed states. However depressive mixed states are far more complex both in terms of recognition and management. People suffering from mixed states characteristically present with complaints of depression.

Conclusions: The boundaries between depressive mixed states and agitated depression are vague, yet carry substantial therapeutic implications. Bipolar mixed states are often difficult to treat, and tend to take much longer to settle than either pure mania or depression.  Furthermore there is data that treatment with antidepressants can worsen the course of mixed states. Hence missed diagnoses can potentially have negative clinical implications.  Therefore in this paper the clinical presentation, diagnosis and therapy of mixed states is reviewed with a view to improving management.

A prospective study of the impact of subthreshold mixed states on the 24-month clinical outcomes of bipolar I disorder or schizoaffective disorder

Objectives: Subthreshold mixed states are common, yet their clinical significance is unclear. This study investigated the clinical outcomes of subthreshold mixed states in participants with bipolarI disorder or schizoaffective disorder, using the Cassidy and Benazzi criteria for manic and depressive mixed states, respectively.

Methods: The Bipolar Comprehensive Outcomes Study (BCOS) is a prospective observational study of treatment and outcomes for patients with bipolar I or schizoaffective disorder, bipolar type. Participants (N=239) were grouped based on study entry clinical presentation as having pure depression (n=63) if they satisfied DSM-IV-TR criteria for a Major Depressive Episode (MDE), depressive mixed state (DMX) if they also had at least three concurrent hypomanic symptoms (n=33), or not depressed (n=143) if they did not satisfy the criteria for MDE. Participants were similarly grouped as having pure mania (n=3) if they satisfied DSM-IV criteria for a Manic Episode, manic mixed state (MMX) if they also had at least two concurrent depressive symptoms (n=33), or not manic (n=203). Clinical data were collected by interview every 3-months over a 24-month period.

Results: Measures of quality of life, mental and physical health over the 24-month period were significantly worse for participants who were classified as having mixed states at study entry on most outcome measures compared to participants who were not in an illness episode at study entry. DMX was predictive of greater manic symptomatology over the 24 months compared to participants with pure depression.

Conclusion: In participants with a current episode of mood disorder, the presence of subthreshold symptoms of opposite polarity was associated with poorer clinical outcomes over a 24-month period.

Atmos (piano and guitar)

Atmos (Piano and Guitar) is a short instrumental with piano and guitar.

Synthesis of 4-amino substituted 1,8-naphthalimide derivatives using palladium-mediated amination

Successful amination of 4-bromo-1,8-naphthalimides with 'lengthy' imide N-functionality has been achieved using a general palladium mediated approach (conventional thermal protocols were sub-optimal). Only readily available Pd/ligand combinations were considered and the resulting Buchwald-Hartwig procedure using Pd2(dba)3, Xantphos and Cs 2CO3 is high yielding, relatively mild (40-80 °C, 24 h, yields 50-90%), requires only a modest excess of amine (3.0 equiv) and works equally well with other imide N-substituents. As such, the protocol complements existing methods but is superior for more complex substrates. Herein we compare this Pd mediated approach to the methods most commonly used and further demonstrate its utility by synthesising a number of new, highly fluorescent, 4-aminonaphthalimides. © 2014 Elsevier Ltd. All rights reserved.

The subjectivities of ‘included’ students with disabilities in schools

The contextual precept of this paper is to re-theorise inclusive education beyond technical rational solutions to the ‘problem’ of disability. Drawing on Foucauldian and critical disability theories, I make the case for the analysis of inclusive schooling through the lens of students’ ‘included’ subjectivities – notwithstanding the presence of diagnosed special educational needs. I contend that there is a theoretical mismatch between humanist inclusive schooling and the posthumanist position of disability: an epistemic fissure that impedes inclusive development. Through analysis of the voices of students with disabilities from two different schooling contexts in Australia and Spain, I demonstrate how fragmented virtues of normalcy suffused their subjectivities. I conclude the paper with a discussion of the roles that DisHuman disability studies might play in recasting inclusive schooling by troubling normative discourse.

Metabolic power method underestimates energy expenditure in field sport movements using a GPS tracking system

The purpose of this study was to assess the validity of a GPS tracking system to estimate energy expenditure (EE) during exercise and field sport locomotor movements. Twenty-seven participants each completed one 90 minute exercise session on an outdoor synthetic futsal pitch. During the exercise session participants wore a 5 Hz GPS unit interpolated to 15 Hz (SPI HPU, GPSports Pty Ltd, Australia) and a portable gas analyser (Metamax® 3B, Cortex Pty Ltd, Germany) which acted as the criterion measure of EE. The exercise session was comprised of alternating five minute exercise bouts of randomised walking, jogging, running or a field sport circuit (x3) followed by 10 minutes of recovery. One-way ANOVA showed significant (p<0.01) and very large underestimations between GPS metabolic power derived EE and VO2 derived EE for all field sport circuits (% difference ≈ -44%). No differences in EE were observed for the jog (7.8%) and run (4.8%) while very large overestimations were found for the walk (43.0%). The GPS metabolic power EE over the entire 90 minute session was significantly lower (p<0.01) than the VO2 EE, resulting in a moderate underestimation overall (-19%). The results of this study suggest that a GPS tracking system using the metabolic power model of EE does not accurately estimate EE in field sport movements or over an exercise session consisting of mixed locomotor activities interspersed with recovery periods; however is able to provide a reasonably accurate estimation of EE during continuous jogging and running.

Engagement and retention of participants in a physical activity website

Background: Websites have the potential to deliver enhanced versions of targeted and tailored physical activity programs to large numbers of participants. We describe participant engagement and retention with a stage-based physical activity website in a workplace setting. Methods:  We analyzed data from participants in the website condition of a randomized trial designed to test the efficacy of a print- vs. website-delivered intervention. They received four stage-targeted e-mails over 8 weeks, with hyperlinks to the website. Both objective and self-reported website use data were collected and analyzed. Results: Overall, 327 were randomized to the website condition and 250 (76%) completed the follow-up survey. Forty-six percent (n = 152) visited the website over the trial period. A total of 4,114 hits to the website were recorded. Participants who entered the site spent on average 9 min per visit and viewed 18 pages. Website use declined over time; 77% of all visits followed the first e-mail. Conclusions: Limited website engagement, despite the perceived usefulness of the materials, demonstrates possible constraints on the use of e-mails and websites in delivering health behavior change programs. In the often-cluttered information environment of workplaces, issues of engagement and retention in website-delivered programs require attention.

Photocatalytic degradation of dyes in wastewater using TiO2/UV in a flat-plate reactor

The photocatalyst TiO₂ with UV irradiation was used to degrade dyes in textile effluent in a flat-plate photoreactor. A test system was built with the reactor area of 1 x 0.3m2, UV light of six 36W-blacklight. TiO₂ powder P25 with BET surface area 50±15m2/g, average primary particle size 21 nm, purity> 99.5% and content of 83.9% anatase and 16.1 % rutile was used as the photocatalyst. A number of dyes commonly present in dyeing wastewater were tested in this study. The different operating parameters, such as dosage of photocatalyst, the structure of the reactor, flow rates through the flat-plate reactor, UV radiation intensity and tilted angle of the reactor, were investigated. The results showed that the photocatalytic process could efficiently remove most of the colour contained in the dyeing wastewater. It was experimentally observed that first-order kinetics was adequate for characterising the process. The flow rate and the tilted angle had some influence on the film thickness of the fluid in the reactor and the empirical correlation between the film thickness of the fluid and these two parameters was developed. The photoreaction rate was mainly determined by the film thickness of the fluid on the reactor surface and the dosage of the photocatalyst. Optimum operating parameters of the system were found to be at the film thickness of about 1.4mm and a TiO₂ dosage of 1 gIL. The higher the UV intensity, the faster the reaction rate was. The results of these experiments showed that this method has the great potential for colour removal from wastewater at commercial scale.

To overcome the common difficulty of separating the used TiO₂ suspension after treatment precipitation followed with filtration was used in this study to determine the separation efficiencies. On the other hand, TiO₂ in a small pillar shape was also studied for photocatalytic degradation of textile dye effluent. The pillar pellet was made in Oegussa Company, Germany ranging from 2.5 to 5.3mm long and with a diameter of 3.7mm. It was almost pure TiO₂ (83.2% anatase and 16.8% rutile), with a S-content of <20 ppm and a CI content of the order of 0.1 wt. %. No further elements are present in contents above 0.05 wt.%. The TiO₂ pillars were placed on the flat-plate reactor that was divided by the rectangular slots and irradiated under UV light when the treated solution went through the reactor. Four dyes and their mixtures were tested. The results showed that the photocatalytic process under this configuration efficiently remove the colour from textile dyeing effluent, and pillar shape TiO₂ photocatalyst was not dissolved in water and very easy to be separated from solution, enabling it to be reused many times. The first-order kinetics was adequate for characterising the photocatalytic degradation process and the photocatalytic performance was comparable to TiO₂ powder. It is believed that the TiO₂ pellet would be a preferable form of photocatalyst in applications for textile effluent treatment process, and other wastewater treatment processes.

Investigation of the value chain for creative products : a phenomenological study of the perceptions of music intermediaries

During the past decade, innovative digital technology and Internet marketplaces have created a variety of 'phenomena' of businesses, media and institutions considered to be important interaction channels in the music industry, along with an influx of Peer-to-Peer services such as Napster, and Kazaa shifting the business models of major music labels and distributors. Considering the Australian Music Association reported an annual retail turnover of approximately $300 million in 1992 and later in 1999, an increase in figures reported at $396.8 million with the inclusion of music DVD sales, the notion of value-adding to a music product emerges as a profitable venture at each length of the music industry's value chain. In spite of this, Australian studies have often overlooked the underlying perceptions, fears and ideas of those working within the value chain, especially regarding the impact of new technology on their roles. This paper identifies the perceptions of various intermediaries within the Australian Music Industry, identifying common themes and viewpoints amongst the study's participants. Consequently, the paper concluded that the perception of value in the music industry is somewhat influenced by a variety of factors, including music knowledge, communication and dependence on intermediaries to name a few. Common themes were revealed throughout the study include the perception of competitive advantage, new opportunities from new technology and the notion of defining a gimmick versus Value-Adding emerged as indicative of adding value from the study participants.

Mapping the Australian archaic: reflections on black medea

Wesley Enoch’s Black Medea is explicit about what is, and what is not, its project: the chorus implores the audience not to read the narrative of its infanticidal heroine as one that demonises black women. Instead, the play affirms that its narrative can be understood differently and in a way that has a wider social significance. Taking my cue from the claim that the story is somehow ‘about everyone,’ I would like to begin unravelling the play’s relevance to contemporary contentions of Australian and indeed ‘Unaustralian’ subjectivity, particularly in relation to the discourses that seek to construct ‘Australian’ identity through an appeal to antiquity and what I describe as ‘the archaic.’ It seems to me that Black Medea presents an opportunity for thinking about the ways in which the discourses of aboriginal and classical antiquity operate to inform contemporary, contesting definitions of Australian identity. Regardless of whether these discourses of antiquity are claimed as ‘Australian’ or abjected as Other or ‘Unaustralian’ – and they have been used in both ways – they remain, I argue, formative to current conceptions of Australian identity and are positioned in the economy of discourses that comprise that arena. As will be seen, the mixed reception or ambivalence with which these complementary discourses of antiquity are treated in Australian culture gives Black Medea the potential to be situated among them in subversive and questioning ways, and in ways that may highlight the reasons for their ambivalent status.

Retention of essential amino acids during extrusion of protein and reducing sugars

This research investigates the retention of essential amino acid profiles of products during the extrusion of proteins and reducing sugars. Animal proteins (egg and milk protein at 10 and 30% levels) and reducing sugars (fructose and galactose at 0, 2, and 8% levels), with pregelatinized wheat flour, were extruded at 110 and 125 °C product temperatures and feed moistures of 19 and 23.5% for egg protein and 13.75 and 16% for milk protein. The nutritional property analyzed was essential amino acid retention, and sugar retention was also considered to understand the relationship of sugars with retention of amino acids. Lysine showed the lowest retention (up to 40%) of all the essential amino acids. Retention of other essential amino acids varied from 80 to 100% in most situations. Apart from lysine,  tryptophan, threonine, and methionine were found to be significantly changed (P < 0.05) with processing conditions. Increased protein and sugar levels resulted in a significant degradation of lysine. Greater lysine retention was found at a lower temperature and higher feed moisture. Results of sugar retention also showed similar patterns. The products made from fructose had greater lysine retention than products made from galactose with any type of protein. The outcomes of this research suggested that the combination of milk protein and fructose at a lower temperature and higher feed moisture is most favorable for developing high-protein extruded products.

Intertester reliability of sonography in patellar tendinopathy

Objective. Intertester reliability is imperative during the sonographic assessment of patellar tendinopathy because hypoechoic areas can change over time, and repeated examination may involve multiple examiners. Given that, to our knowledge, it has not been reported in the literature, the objective of this study was to investigate the intertester reliability of sonography for the detection and measurement of hypoechoic areas associated with patellar tendinopathy.

Methods. The study cohort comprised 8 patients with clinically diagnosed patellar tendinopathy and 4 patients with bilateral asymptomatic patellar tendons. Two equally experienced musculoskeletal radiologists imaged both patellar tendons from each patient (n = 24). All 24 tendons were assessed on the same day with the use of identical sonography machines.

Results. The radiologists had 100% chance-corrected agreement for detecting 12 normal (hypoechoic free) and 12 abnormal (hypoechoic) tendons. All measurement data were normally distributed (P > .05), and a range of hypoechoic area sizes was evident. No statistically significant differences were found for the measurements of hypoechoic area, axial plane height and width, and sagittal plane height (P > .05). In addition, these measurements were equally highly correlated (Pearson r > 0.87; P < .01).

Conclusions. The results reported in this study suggest that the intertester
reliability of sonography for the assessment of patellar tendinopathy is high. Although these results are encouraging, a small sample was analyzed, and this increases the probability of type II measurement error. Larger studies are therefore required to confirm these findings. High intertester reliability indicates that multiple experienced radiologists can reliably assess the same tendon and provides researchers with a necessary foundation for furthering research in tendon rehabilitation.