Drug administration guides in dysphagia

Aim: The aim of this evaluation was to evaluate the use of Individualised Medication Administration Guides (IMAGs) for patients with dysphagia on one stroke ward over a 6month period. Background: Patients with dysphagia (PWD) are more likely to suffer an administration error than patients without swallowing difficulties. To both standardise and improve medicines administration to patients with dysphagia I-MAGs were introduced on one stroke ward over a 6 month period. Methods: A software package supported with data on current national guidelines on the administration of medicines to PWD was designed by a specialised pharmacist in dysphagia to enable him to create individualised medication administration guides for patients with dysphagia which stated how each medicine should be optimally prepared and administered. On completion of the pilot service a questionnaire was given to all nurses, pharmacist and speech and language therapists who had experienced the I-MAGs. All the professionals received the same questionnaire but questions relevant only to their practice were added to the nurse’s questionnaire. Results: Of 26 Healthcare professionals (HCPs) approached, 19 returned completed questionnaires. Higher variability was found in the 13 responses from the nurse respondents than in the ones from the 3 pharmacist and the 3 SALTs. 8 (61%) of the nurses felt more confident in their practice when I-MAGs were in place. 10 (76%) of the nurses admitted that the guides could sometimes increase the time of the administration, but saw that it made practice safer. All the pharmacists considered the recommendations in the guides useful and all the respondents with the exception of one nurse (12:13) would like this service to continue. Conclusion: I-MAGs were well received on the ward and they support individualised care for patients with dysphagia. But the guides needed additional pharmacist input and greater nursing time. Research to determine the cost effectiveness of I-MAGs is needed.

The ethics of corporate governance: A (South)African perspective

Purpose – The purpose of this paper is to review the developments in South African corporate governance since the end of apartheid, with a view to identifying themes and points of convergence and/or divergence with other models. Design/methodology/approach – The paper presents a critical review of South African corporate governance in the context of political and economic developments. Where relevant, aspects of corporate governance theory (in particular the stakeholder and shareholder debate) are considered in the South African context. Findings – South African corporate governance can be seen to broadly follow Anglo‐American examples with the notable exception of the stakeholder approach of the two King reports. This approach emphasises the responsibilities of companies to various stakeholders and encourages stakeholder engagement as an integral element of company strategy. There has not, however, been any substantial incorporation of stakeholder interests into formal corporate governance structures such as board structure and financial reporting. Practical implications – The ongoing consideration of corporate governance developments in South Africa is important for its continued development in the country and the region. Originality/value – A review of South African corporate governance is timely given the probable release of the third King report in 2009, together with new company legislation.

Exploring the Potential to Educate “Good Citizens” through the Australian Civics and Citizenship Curriculum.

This chapter examines the ways in which notions of ‘a good citizen’ and ‘civic virtue’ have been conceptualized in the new Civics and Citizenship Curriculum for students in Years 3 – 10 in Australia. It argues that whilst Civics and Citizenship Education (CCE) has, over time and in various ways, been recognized as a significant aspect of Australian education, only recently has attention been given to the relational and multidimensional conceptions of citizenship. Considerations of ‘morality’, ‘a good citizen’ and ‘civic virtue’ offer possibilities to engage with multidimensional notions of citizenship, which acknowledge that citizenship perspectives can be affected by personal, social, spatial and temporary situations (Cogan & Derricott, 2000). In the current statement on national goals for schooling in Australia, which informed the development of CCE, the Melbourne Declaration (MCEETYA, 2008) called for young Australians to be educated to “act with moral and ethical integrity” and be “committed to national values of democracy, equity and justice, and participate in Australia’s civic life” (MCEETYA, 2008, pp. 8–9). The chapter claims that this maximal emphasis (McLaughlin, 1992), based on active, values based and interpretive approaches to democratic citizenship which encourage debate and participation in civil society, was evident in the new Civics and Citizenship Curriculum. However, it contends that the recommendations of the recent Review of the Australian Curriculum: Final report (Australian Government, 2014a & b), will now limit CCE’s potential to deliver the sort of active and informed citizenship heralded by the Melbourne Declaration. This is because the Review advocates for a content-focused minimal (McLaughlin, 1992) emphasis on civic knowledge, with diminished attention to citizenship participation and processes. In doing so, the Review foregrounds conceptions of the ‘good citizen’ in more limited terms of responsibility, obligations and compliance with the status quo.

Recovery after an Ironman triathlon: Sustained inflammatory responses and muscular stress

Ultra-endurance exercise, such as an Ironman triathlon, induces muscle damage and a systemic inflammatory response. As the resolution of recovery in these parameters is poorly documented, we investigated indices of muscle damage and systemic inflammation in response to an Ironman triathlon and monitored these parameters 19 days into recovery. Blood was sampled from 42 well-trained male triathletes 2 days before, immediately after, and 1, 5 and 19 days after an Ironman triathlon. Blood samples were analyzed for hematological profile, and plasma values of myeloperoxidase (MPO), polymorphonuclear (PMN) elastase, cortisol, testosterone, creatine kinase (CK) activity, myoglobin, interleukin (IL)-6, IL-10 and high-sensitive C-reactive protein (hs-CRP). Immediately post-race there were significant (P < 0.001) increases in total leukocyte counts, MPO, PMN elastase, cortisol, CK activity, myoglobin, IL-6, IL-10 and hs-CRP, while testosterone significantly (P < 0.001) decreased compared to prerace. With the exception of cortisol, which decreased below prerace values (P < 0.001), these alterations persisted 1 day post-race (P < 0.001; P < 0.01 for IL-10). Five days post-race CK activity, myoglobin, IL-6 and hs-CRP had decreased, but were still significantly (P < 0.001) elevated. Nineteen days post-race most parameters had returned to prerace values, except for MPO and PMN elastase, which had both significantly (P < 0.001) decreased below prerace concentrations, and myoglobin and hs-CRP, which were slightly, but significantly higher than prerace. Furthermore, significant relationships between leukocyte dynamics, cortisol, markers of muscle damage, cytokines and hs-CRP after the Ironman triathlon were noted. This study indicates that the pronounced initial systemic inflammatory response induced by an Ironman triathlon declines rapidly. However, a low-grade systemic inflammation persisted until at least 5 days post-race, possibly reflecting incomplete muscle recovery.

After the gold rush: Patent law and biological inventions

In response to scientific breakthroughs in biotechnology, the development of new technologies, and the demands of a hungry capitalist marketplace, patent law has expanded to accommodate a range of biological inventions. There has been much academic and public debate as to whether gene patents have a positive impact upon research and development, health-care, and the protection of the environment. In a satire of prevailing patenting practices, the English poet and part-time casino waitress, Donna MacLean, sought a patent application - GB0000180.0 - in respect of herself. She explained that she had satisfied the usual patent criteria - in that she was novel, inventive, and useful: It has taken 30 years of hard labor for me to discover and invent myself, and now I wish to protect my invention from unauthorized exploitation, genetic or otherwise. I am new: I have led a private existence and I have not made the invention of myself public. I am not obvious (2000: 18). MacLean said she had many industrial applications. ’For example, my genes can be used in medical research to extremely profitable ends - I therefore wish to have sole control of my own genetic material' (2000: 18). She observed in an interview: ’There's a kind of unpleasant, grasping, greedy atmosphere at the moment around the mapping of the human genome ... I wanted to see if a human being could protect their own genes in law' (Meek, 2000). This special issue of Law in Context charts a new era in the long-standing debate over biological inventions. In the wake of the expansion of patentable subject matter, there has been great strain placed upon patent criteria - such as ’novelty', ’inventive step', and ’utility'. Furthermore, there has been a new focus upon legal doctrines which facilitate access to patented inventions - like the defence of experimental use, the ’Bolar' exception, patent pooling, and compulsory licensing. There has been a concerted effort to renew patent law with an infusion of ethical principles dealing with informed consent and benefit sharing. There has also been a backlash against the commercialisation of biological inventions, and a call by some activists for the abolition of patents on genetic inventions. This collection considers a wide range of biological inventions - ranging from micro-organisms, plants and flowers and transgenic animals to genes, express sequence tags, and research tools, as well as genetic diagnostic tests and pharmaceutical drugs. It is thus an important corrective to much policy work, which has been limited in its purview to merely gene patents and biomedical research. This collection compares and contrasts the various approaches of a number of jurisdictions to the legal problems in respect of biological inventions. In particular, it looks at the complexities of the 1998 European Union Directive on the Legal Protection of Biotechnological Inventions, as well as decisions of member states, such as the Netherlands, and peripheral states, like Iceland. The edition considers US jurisprudence on patent law and policy, as well as recent developments in Canada. It also focuses upon recent developments in Australia - especially in the wake of parallel policy inquiries into gene patents and access to genetic resources.

The Piper Fatigue Scale-Revised: Translation and psychometric evaluation in Spanish-speaking breast cancer survivors

Background Cancer-related fatigue (CRF) is the most common and distressing symptom reported by breast cancer survivors. The primary aim of this study was to translate and evaluate psychometrically for the first time a Spanish version of the Piper Fatigue Scale-Revised (S-PFS-R). Methods One hundred and eleven women with stage I–IIIA breast cancer who had completed their primary cancer therapy in the previous 6 months with the exception of hormone therapy completed the S-PFS-R, the Profile of Mood States (POMS) Fatigue (POMS-F) and Vigor subscales (POMS-V), and bilateral force handgrip testing. Data analysis included test–retest reliability, construct validity, criterion-related validity, and exploratory factor analyses. Results Test–retest reliability was satisfactory (r > 0.86), and all subscales showed moderate to high construct validity estimates [corrected item-subscale correlations (Pearson r = ≥ 0.65)]. The exploratory factor analysis revealed four dimensions with 75.5 % of the common variance explained. The S-PFS-R total score positively correlated with the POMS-F subscale (r = 0.50–0.78) and negatively with the POMS-V subscale (r = −0.13 to −0.44) confirming criterion-related validity. Negative correlations among force handgrip testing, subscales, and total scores were weak (r = −0.26 to −0.29). Conclusions The Spanish version of PFS-R shows satisfactory psychometric properties in a sample of breast cancer survivors. This is the first study to translate the PFS-R into Spanish and further testing is warranted.

Genetic and environmental influences on neuroimaging phenotypes: A meta-analytical perspective on twin imaging studies

Because brain structure and function are affected in neurological and psychiatric disorders, it is important to disentangle the sources of variation in these phenotypes. Over the past 15 years, twin studies have found evidence for both genetic and environmental influences on neuroimaging phenotypes, but considerable variation across studies makes it difficult to draw clear conclusions about the relative magnitude of these influences. Here we performed the first meta-analysis of structural MRI data from 48 studies on >1,250 twin pairs, and diffusion tensor imaging data from 10 studies on 444 twin pairs. The proportion of total variance accounted for by genes (A), shared environment (C), and unshared environment (E), was calculated by averaging A, C, and E estimates across studies from independent twin cohorts and weighting by sample size. The results indicated that additive genetic estimates were significantly different from zero for all metaanalyzed phenotypes, with the exception of fractional anisotropy (FA) of the callosal splenium, and cortical thickness (CT) of the uncus, left parahippocampal gyrus, and insula. For many phenotypes there was also a significant influence of C. We now have good estimates of heritability for many regional and lobar CT measures, in addition to the global volumes. Confidence intervals are wide and number of individuals small for many of the other phenotypes. In conclusion, while our meta-analysis shows that imaging measures are strongly influenced by genes, and that novel phenotypes such as CT measures, FA measures, and brain activation measures look especially promising, replication across independent samples and demographic groups is necessary.

Cognitive functioning in older twins: The Older Australian Twins Study

Aim: To examine the concordance rates of common medical conditions and neurocognitive performance in monozygotic (MZ) and dizygotic (DZ) older twins. Methods: Twins aged ≥65 years and living in the three Eastern states of Australia were recruited through the Australian Twin Registry and underwent detailed neuropsychological and medical assessment. Results: Assessments were conducted on 113 MZ and 96 DZ twin pairs, with a mean age of 70.5 years. MZ twins were more concordant than DZ twins for hypertension and asthma. MZ twins had higher correlations than DZ twins on most neuropsychological tests, with the exception of some tests related to processing speed. The concordance rate for mild cognitive impairment or dementia was 76.2% in MZ twins and 42.9% in DZ twins, a non-significant difference. Conclusions: Except for some aspects of processing speed, most cognitive functions in older individuals show significant heritability. The heritability of neurocognitive disorders is, however, low.

Towards adaptive management of QoS-aware service compositions - Functional architecture

Service compositions enable users to realize their complex needs as a single request. Despite intensive research, especially in the area of business processes, web services and grids, an open and valid question is still how to manage service compositions in order to satisfy both functional and non-functional requirements as well as adapt to dynamic changes. In this paper we propose an (functional) architecture for adaptive management of QoS-aware service compositions. Comparing to the other existing architectures this one offers two major advantages. Firstly, this architecture supports various execution strategies based on dynamic selection and negotiation of services included in a service composition, contracting based on service level agreements, service enactment with flexible support for exception handling, monitoring of service level objectives, and profiling of execution data. Secondly, the architecture is built on the basis of well know existing standards to communicate and exchange data, which significantly reduces effort to integrate existing solutions and tools from different vendors. A first prototype of this architecture has been implemented within an EU-funded Adaptive Service Grid project. © 2006 Springer-Verlag.

Mid-Holocene Aboriginal occupation of offshore islands in northern Australia? A reassessment of Wurdukanhan, Mornington Island, southern Gulf of Carpentaria, Australia

Claims for mid-Holocene Aboriginal occupation at the shell matrix site of Wurdukanhan, Mornington Island, Gulf of Carpentaria, Australia, are reassessed through an analysis of the excavated assemblage coupled with new surveys and an extensive dating program. Memmott et al. (2006, pp. 38, 39) reported basal ages of c.5000–5500 years from Wurdukanhan as 'the oldest date yet obtained for any archaeological site on the coast of the southern Gulf of Carpentaria' and used these dates to argue for 'a relatively lengthy occupation since at least the mid-Holocene'. If substantiated, with the exception of western Torres Strait, these claims make Mornington Island the only offshore island used across northern Australia in the mid-Holocene where it is conventionally thought that Aboriginal people only (re)colonised islands after sea-level maximum was achieved after the mid-Holocene. Our analysis of Wurdukanhan demonstrates high shellfish taxa diversity, high rates of natural shell predation and high densities of foraminifera throughout the deposit demonstrating a natural origin for the assemblage. Results are considered in the context of other dated shell matrix sites in the area and a geomorphological model for landscape development of the Sandalwood River catchment.

Patent law and biological inventions

In response to scientific breakthroughs in biotechnology, the development of new technologies, and the demands of a hungry capitalist marketplace, patent law has expanded to accommodate a range of biological inventions. There has been much academic and public debate as to whether gene patents have a positive impact upon research and development, health-care, and the protection of the environment. In a satire of prevailing patenting practices, the English poet and part-time casino waitress, Donna MacLean, sought a patent application - GB0000180.0 - in respect of herself. She explained that she had satisfied the usual patent criteria - in that she was novel, inventive, and useful: It has taken 30 years of hard labor for me to discover and invent myself, and now I wish to protect my invention from unauthorized exploitation, genetic or otherwise. I am new: I have led a private existence and I have not made the invention of myself public. I am not obvious (2000: 18). MacLean said she had many industrial applications. 'For example, my genes can be used in medical research to extremely profitable ends - I therefore wish to have sole control of my own genetic material' (2000: 18). She observed in an interview: 'There's a kind of unpleasant, grasping, greedy atmosphere at the moment around the mapping of the human genome ... I wanted to see if a human being could protect their own genes in law' (Meek, 2000). This special issue of Law in Context charts a new era in the long-standing debate over biological inventions. In the wake of the expansion of patentable subject matter, there has been great strain placed upon patent criteria - such as 'novelty', 'inventive step', and 'utility'. Furthermore, there has been a new focus upon legal doctrines which facilitate access to patented inventions - like the defence of experimental use, the 'Bolar' exception, patent pooling, and compulsory licensing. There has been a concerted effort to renew patent law with an infusion of ethical principles dealing with informed consent and benefit sharing. There has also been a backlash against the commercialisation of biological inventions, and a call by some activists for the abolition of patents on genetic inventions. This collection considers a wide range of biological inventions - ranging from micro-organisms, plants and flowers and transgenic animals to genes, express sequence tags, and research tools, as well as genetic diagnostic tests and pharmaceutical drugs. It is thus an important corrective to much policy work, which has been limited in its purview to merely gene patents and biomedical research. This collection compares and contrasts the various approaches of a number of jurisdictions to the legal problems in respect of biological inventions. In particular, it looks at the complexities of the 1998 European Union Directive on the Legal Protection of Biotechnological Inventions, as well as decisions of member states, such as the Netherlands, and peripheral states, like Iceland. The edition considers US jurisprudence on patent law and policy, as well as recent developments in Canada. It also focuses upon recent developments in Australia - especially in the wake of parallel policy inquiries into gene patents and access to genetic resources.

Who killed fair use? A copyright murder mystery down under

Fair Use Week has been celebrated this week in the United States, with great gusto and enthusiasm. At Harvard Library, Kyle Courtney commented: ‘Fair use is critical and important to innovation, scholarship and research in the United States.’ Kenneth Crews emphasized that ‘the new technological ventures, like other creative pursuits, require fair use and other copyright limitations for experimentation and success.’ Legal director Corynne McSherry of the Electronic Frontier Foundation has highlighted the significance and the importance of the defence of fair use: ‘Fair use provides breathing space in copyright law, making sure that control of the right to copy and distribute doesn’t become control of the right to create and innovate.’ For Techdirt, Mike Masnick has emphasized that fair use is a right – and not an exception or a mere defence. Peter Jaszi and Pat Aufderheide have highlighted the contextual operation of fair use in particular artistic communities. Molly Van Houweling of the Authors Alliance has written about the ecstasy of influence – the role of inspiration and appropriation in all acts of artistic creation. Fair use has been celebrated as a many-splendored legal creation.

The path towards greening the Malaysian construction industry

Construction industry contributes significantly to environmental degradation, and governments in many countries which are endeavouring to address the situation. Malaysia is no exception. This paper examines the path towards green construction project delivery in Malaysia, focusing on current green policies and initiatives by governments. The historical waves in Malaysian approaches to tackling environmental issues are described, starting from the early 20th century, through the 1990s to the present, and the influence of these approaches on construction practices is analysed. Based on the findings of policy review, essential green construction practices aimed at mitigating the adverse effects of construction activities on the environment in Malaysia were identified. This paper paves the way for future studies in construction and sustainability in Malaysia, especially for the Southeast Asian region where sustainability practices are urgently needed.

Bank guarantees and the reasonable expectations of beneficiaries

A bank guarantee has traditionally been viewed as a cash equivalent. This view is supported by the operation of the autonomy principle. However, the autonomy principle is subject to certain recognised exceptions both at common law and under statute. One of these exceptions is commonly referred to as the negative stipulation or underlying contract exception. In recent times the operation of this particular exception has given rise to a wealth of case law. This article examines whether this recent case law appropriately recognises the reasonable expectations of the beneficiary of a bank guarantee that a bank guarantee should function not only as a security but as a risk allocation device.

Legal translation

Legal translation theory brooks little interference with the source legal text. With few exceptions (Joseph 2005; Hammel 2008; Harvey 2002; Kahaner 2005; Kasirer 2001; Lawson 2006), lawyers and linguists tend to tether themselves to the pole of literalism. More a tight elastic band than an unyielding rope, this tether constrains — rather than prohibits — liberal legal translations. It can stretch to accommodate a degree of freedom by the legal translator however, should it go too far, it snaps back to the default position of linguistic fidelity. This ‘stretch and snap’ gives legal translation a unique place in general translation theory. In the general debate over the ‘degree of freedom’ the translator enjoys in conveying the meaning of the text, legal translation theory has reached its own settlement. Passivity is the default; creativity, the ‘qualified’ exception (Hammel 2008: 275).