Lateral bone density variations in the scoliotic spine

Adolescent Idiopathic Scoliosis (AIS) is the most common deformity of the spine, affecting 2-4% of the population. Previous studies have shown that the vertebrae in scoliotic spines undergo abnormal shape changes, however there has been little exploration of how scoliosis affects bone density distribution within the vertebrae. In this study, existing CT scans of 53 female idiopathic scoliosis patients with right-sided main thoracic curves were used to measure the lateral (right to left) bone density profile at mid-height through each vertebral body. Five key bone density profile measures were identified from each normalised bone density distribution, and multiple regression analysis was performed to explore the relationship between bone density distribution and patient demographics (age, height, weight, body mass index (BMI), skeletal maturity, time since Menarche, vertebral level, and scoliosis curve severity). Results showed a marked convex/concave asymmetry in bone density for vertebral levels at or near the apex of the scoliotic curve. At the apical vertebra, mean bone density at the left side (concave) cortical shell was 23.5% higher than for the right (convex) cortical shell, and cancellous bone density along the central 60% of the lateral path from convex to concave increased by 13.8%. The centre of mass of the bone density profile at the thoracic curve apex was located 53.8% of the distance along the lateral path, indicating a shift of nearly 4% toward the concavity of the deformity. These lateral bone density gradients tapered off when moving away from the apical vertebra. Multi-linear regressions showed that the right cortical shell peak bone density is significantly correlated with skeletal maturity, with each Risser increment corresponding to an increase in mineral equivalent bone density of 4-5%. There were also statistically significant relationships between patient height, weight and BMI, and the gradient of cancellous bone density along the central 60% of the lateral path. Bone density gradient is positively correlated with weight, and negatively correlated with height and BMI, such that at the apical vertebra, a unit decrease in BMI corresponds to an almost 100% increase in bone density gradient.

Project diagnostics : assessing the condition of projects and identifying poor health combing forces

In many cases, construction projects do not achieve the objectives that the project participants set for them. If participants could better understand how their project is performing overall, at various stages of its delivery, then the opportunities to achieve project success would almost certainly be greater. This paper documents a method of assessing the status of a project, at a point in its design or construction phase, or after completion. The status is assessed in terms of up to seven (7) key success factors. Any evidence of less than adequate performance in these performance areas is scrutinised to seek out the root causes of why this situation is happening. Using these identified root causes of under performance, general suggestions can then be made as to how to return the project to good health. A software package that assists in assessing the status of the project has been developed. The package is currently being calibrated before commercial release.

The critical in Ken

That Kenneth Frampton has had a significant impact on architectural thinking in Australia was recently demonstrated by his visit, which included two well-attended public lectures and a one-day symposium dedicated to his thinking and writing. Billed as part of the Year of the Built Environment celebrations, these were hosted by the New South Wales chapter of the RAIA, the UNSW Faculty of the Built Environment and the Museum of Contemporary Art. Richard Francis-Jones of FJMT coordinated the symposium, which comprised presentations divided into two sessions, entitled - predictably through no doubt with good intentions - 'Theory' and 'Practice', with four academics and four practitioners in each. Frampton sat to the side throughout, and delivered his own response between them,noting his discomfort in seemingly straddling this divide, as an architect first, then writer and academic, later. Predictably, the familiar Critical Regionalism argument was the mainstay of the day, perhaps the easiest to handle and now almost automatic, despite the fact that Frampton noted when questioned that he hasn't talked much about it in the last 10 years.

Stability of the learning and development survey : findings for mature aged local government and private healthcare organisations.

This article investigates work related learning and development amongst mature aged workers from a lifespan developmental psychology perspective. The current study follows on from research regarding the construction and revision of the Learning and Development Survey (LDS; Tones & Pillay, 2008). Designed to measure adaptive development for work related learning, the revised LDS (R-LDS) encompasses goal selection, engagement and disengagement from individual and organisational perspectives. Previous survey findings from a mixed age sample of local government workers suggest that mature aged workers aged over 45 years are less likely to report engagement in learning and development goals than younger workers, which is partly due to insufficient opportunities at work. In the current paper, exploratory factor analysis was used to investigate responses to the R-LDS amongst two groups of mature aged workers from a local government (LG) and private healthcare (PH) organisation to determine the stability of the R-LDS. Organisational constraints to development accounted for almost a quarter of the variance in R-LDS scores for both samples, while remaining factors emerged in different orders for each data set. Organisational opportunities for development explained about 17% of the variance in R-LDS scores in the LG sample, while the individual goal disengagement factor contributed a comparable proportion of variance to R-LDS scores for the PH sample. Findings from the current study indicate that opportunities for learning and development at work may be age structured and biased towards younger workers. Implications for professional practice are discussed and focus on improving the engagement of mature aged workers.

Wet potential

Water is so fundamental to everything that it is almost impossible to meaningfully conceptualise it, which is why it forms the basis of pretty much everything. To suggest that landscape architecture has some sort of privilege with it would be deluded. But, as alchemists of “the world”, we are both expected to deal with it professionally, as well as being forced to do so practically in making anything real, built in that same “world”. When people use words too much, that is the signifiers of things in sound, they become a kind of conceptual short hand to what they are referring to. You can hear this short hand when they use the word, as it gets grammatically dealt with differently – it becomes a conceptual object – a different type of noun. Water is one of these words, and as a supervisor I have almost universally seen students refer to it like this, by the end of their projects, and then have to force themselves to reconsider what it was about water that made them interested in water in the first place. This process is a transition of ideas and technology and technique, and will be the subject of this essay, tracking students responses to the weird substance in design subjects I have taught or projects I have supervised at RMIT since 1997, to and from and then again back to the qualities and issues of water for people generally, and landscape architecture in particular.

Formative and reflective measurement and validation mismatch in survey research : an archival analysis of information systems success constructs 1985-2007

The generic IS-success constructs first identified by DeLone and McLean (1992) continue to be widely employed in research. Yet, recent work by Petter et al (2007) has cast doubt on the validity of many mainstream constructs employed in IS research over the past 3 decades; critiquing the almost universal conceptualization and validation of these constructs as reflective when in many studies the measures appear to have been implicitly operationalized as formative. Cited examples of proper specification of the Delone and McLean constructs are few, particularly in light of their extensive employment in IS research. This paper introduces a four-stage formative construct development framework: Conceive > Operationalize > Respond > Validate (CORV). Employing the CORV framework in an archival analysis of research published in top outlets 1985-2007, the paper explores the extent of possible problems with past IS research due to potential misspecification of the four application-related success dimensions: Individual-Impact, Organizational-Impact, System-Quality and Information-Quality. Results suggest major concerns where there is a mismatch of the Respond and Validate stages. A general dearth of attention to the Operationalize and Respond stages in methodological writings is also observed.

Critical matters

This year, as it has been during most of the years that I can remember, AILA's various state awards have been controversial (depending on who you talk to). In at least one state, after only a small number of awards have been handed out, the local chapter is thinking of modifying the awards to (presumably) bring them into synch with the values of local member practices. In almost every case when an awards-related complaint has been made, the judges have been seen as the problem. After all, the judges make the determination so they must have poor judgement.

Growing demand for emergency health services in Queensland, Australia

Introduction: The demand for emergency health services (EHS), both in the prehospital (ambulance) and hospital (emergency departments) settings, is growing rapidly in Australia. Broader health system changes have reduced available health infrastructure, particularly hospital beds, resulting in reduced access to and congestion of the EHS as demonstrated by longer waiting times and ambulance “ramping”. Ambulance ramping occurring when patients have a prolonged wait on the emergency vehicle due to the unavailability of hospital beds. This presentation will outline the trends in EHS demand in Queensland compared with the rest of Australia and factors that appear to be contributing to the growth in demand. Methods: Secondary analysis was conducted using data from publicly available sources. Data from the Queensland Ambulance Service and Queensland Health Emergency Department Information System (EDIS) also were analyzed. Results: The demand for ambulance services and emergency departments has been increasing at 8% and 4% per year over the last decade, respectively; while accessible hospital beds have reduced by almost 10% contributing to the emergency department congestion and possibly contributing to the prehospital demand. While the increase in the proportion of the elderly population seems to explain a great deal of the demand for EHS, other factors also influence this growth including patient characteristics, institutional and societal factors, economic, EHS arrangements, and clinical factors. Conclusions: Overcrowding of facilities that provide EHS are causing considerable community concern. This overcrowding is caused by the growing demand and reduced access. The causes of this growing demand are complex, and require further detailed analysis in order to quantify and qualify these causes in order to provide a resilient foundation of evidence for future policy direction.

Defining friendworks : communication perspective on social networks types

This paper introduces friendwork as a new term in social networks studies. A friendwork is a network of friends. It is a specific case of an interpersonal social network. Naming this seemingly well known and familiar group of people as a friendwork facilitates its differentiation from the overall social network, while highlighting this subgroup's specific attributes and dynamics. The focus on one segment within social networks stimulates a wider discussion regarding the different subgroups within social networks. Other subgroups also discussed in this paper are: family dependent, work related, location based and virtual acquaintances networks. This discussion informs a larger study of social media, specifically addressing interactive communication modes that are in use within friendworks: direct (face-to-face) and mediated (mainly fixed telephone, internet and mobile phone). It explores the role of social media within friendworks while providing a communication perspective on social networks.

Translating tissue engineering technology platforms into cancer research

Technology platforms originally developed for tissue engineering applications produce valuable models that mimic three-dimensional (3D) tissue organization and function to enhance the understanding of cell/tissue function under normal and pathological situations. These models show that when replicating physiological and pathological conditions as closely as possible investigators are allowed to probe the basic mechanisms of morphogenesis, differentiation and cancer. Significant efforts investigating angiogenetic processes and factors in tumorigenesis are currently undertaken to establish ways of targeting angiogenesis in tumours. Anti-angiogenic agents have been accepted for clinical application as attractive targeted therapeutics for the treatment of cancer. Combining the areas of tumour angiogenesis, combination therapies and drug delivery systems is therefore closely related to the understanding of the basic principles that are applied in tissue engineering models. Studies with 3D model systems have repeatedly identified complex interacting roles of matrix stiffness and composition, integrins, growth factor receptors and signalling in development and cancer. These insights suggest that plasticity, regulation and suppression of these processes can provide strategies and therapeutic targets for future cancer therapies. The historical perspective of the fields of tissue engineering and controlled release of therapeutics, including inhibitors of angiogenesis in tumours is becoming clearly evident as a major future advance in merging these fields. New delivery systems are expected to greatly enhance the ability to deliver drugs locally and in therapeutic concentrations to relevant sites in living organisms. Investigating the phenomena of angiogenesis and anti-angiogenesis in 3D in vivo models such as the Arterio-Venous (AV) loop mode in a separated and isolated chamber within a living organism adds another significant horizon to this perspective and opens new modalities for translational research in this field.

Joseph A. Schumpeter, capitalism, socialism, and democracy

This is a review of "Capitalism, socialism, and democracy", by Joseph A. Schumpeter, New York, Harper Perennial, 1942 (first Harper Colophon edition published 1975). "The public mind has by now so thoroughly grown out of humor with it as to make condemnation of capitalism and all its works a foregone conclusion – almost a requirement of the etiquette of discussion. Whatever his political preference, every writer or speaker hastens to conform to this code and to emphasize his critical attitude, his freedom from ‘complacency’, his belief in the inadequacies of capitalist achievement, his aversion to capitalist and his sympathy with anti-capitalist interests. Any other attitude is voted not only foolish but anti-social and is looked upon as an indication of immoral servitude." We might easily mistake this for a voice weary of contemplating the implications for neo-liberal nostrums of our current global financial crisis were it not for the rather formal, slightly arch, style and the gender exclusive language. It was in fact penned in the depths of World War II by Harvard economist Joseph Schumpeter, who fell off the map only to re-emerge from the 1970s as oil shocks and stagflation in the west presaged the decline of the Keynesian settlement, as east Asian newly industrialising economies were modelling on his insistence that entrepreneurialism, access to credit and trade were the pillars of economic growth, and as innovation became more of a watchword for post-industrial economies in general. The second coming was perhaps affirmed when his work was dubbed by Forbes in 1983 – on the occasion of the 100th anniversary of the birth of both men – as of greater explanatory import than Keynes’. (And what of our present resurgent Keynesian moment?)...

Nutritional status and information needs of medical oncology patients receiving treatment at an Australian public hospital

This study aimed to identify: i) the prevalence of malnutrition according to the scored Patient Generated-Subjective Global Assessment (PG-SGA); ii) utilization of available nutrition resources; iii) patient nutrition information needs; and iv) external sources of nutrition information. An observational, cross-sectional study was undertaken at an Australian public hospital on 191 patients receiving oncology services. According to PG-SGA, 49% of patients were malnourished and 46% required improved symptom management and/or nutrition intervention. Commonly reported nutrition-impact symptoms included: peculiar tastes (31%), no appetite (24%) and nausea (24%). External sources of nutrition information were accessed by 37%, with popular choices being media/internet (n=19) and family/friends (n=13). In a sub-sample (n=65), 32 patients were aware of the available nutrition resources, 23 thought the information sufficient and 19 patients had actually read them. Additional information on supplements and modifying side effects was requested by 26 patients. Malnutrition is common in oncology patients receiving treatment at an Australian public hospital and almost half require improved symptom management and/or nutrition intervention. Patients who read the available nutrition information found it useful, however awareness of these nutrition resources and the provision of information on supplementation and managing symptoms requires attention.

Start Over and Survive : A Brief Intervention For Substance Abuse in Early Psychosis

Over the last decade, brief intervention for alcohol problems has become a well-validated and accepted treatment, with bried interventions frequently showing equivalence in terms of outcome to more extended treatments (Bien et al, 1993). A recent review of this studies found that heavy drinkers who received interventions of less than 1 h were almost twice as likely to moderate their drinking over the following 6-12 months as did those not receiving intervention (Wilk etal, 1997).Some studies have used motivational interviewing (MI) strategies (Monti et al, 1999); others have simply given information ajnd advice to reduce drinking (Fleming et al, 1997). Leaflets or information on strategies to assist in the attempt or follow-up sessions are sometimes provided (Fleming et al, 1997). In general practice research, provision of one or more follow-up sessions increases the reliability of intake reductions across studies (Poikolainen, 1999).

Achieving effective supervision

Supervision probably does have benefits both for the maintenance and improvement of clinical skills and for job satisfaction, but the data are very thin and almost non-existent in the area of alcohol and other drugs ser vices. Because of the potential complexity of objectives and roles in super vision, a structured agreement appears to be an important part of the effective supervision relationship. Because sessions can degenerate easily into unstructured socialization, agendas and session objectives may also be important. While a working alliance based on mutual respect and trust is an essential base for the supervision relationship, procedures for direct observation of clinical skills, demonstration of new procedures and skills practice with detailed feedback appear critical to super vision’s impact on practice. To ensure effective supervision, there needs not only to be a minimum of personnel and resources, but also a compatibility with the values and procedures of management and staff, access to supervision training and consultation and sufficient incentives to ensure it continues.

Longitudinal patterns of weight in women diagnosed with breast cancer [Conference Abstract]

Introduction: Weight gain is a common concern following breast cancer and has been associated with negative health outcomes. As such, prevention of weight gain is of clinical interest. This work describes weight change between 6- and 18-months following a breast cancer diagnosis and explores the personal, treatment and behavioural characteristics associated with gains in weight. Methods: Body mass index was objectively assessed, at three-monthly intervals, on a population-based sample of women newly diagnosed with unilateral breast cancer (n=185). Changes in BMI between 6- and 18-months post-diagnosis were calculated, with gains of one or more being considered clinically detrimental to future health. Results: Approximately 60% of participants were overweight or obese at 6-months post-diagnosis. While BMI remained relatively stable across the testing period (range=27.3-27.8), 24% of participants experienced clinically relevant gains in BMI (median gains=1.9). Following adjustment for potential confounders, younger age (<45 years; Odds ratio, OR=9.8), being morbidly obese at baseline (OR=4.6) and receiving hormone therapy (OR=4.8) were characteristics associated with an increased odds (p<0.05) of gaining BMI. Other characteristics associated with gains in BMI were more extensive surgery and having a history of smoking, although these relationships were not supported statistically. In contrast, caring for younger children was associated with reduced risk of gaining BMI (OR=0.3, p=0.20). Conclusions: Clinically relevant weight gain between 6- and 18-months post-breast cancer diagnosis is an issue for one in four women, with certain subgroups being particularly susceptible. However, the majority of women diagnosed with breast cancer are overweight or obese and gains in body weight are common. Thus, interventions that address the importance of achieving and sustaining a healthy body weight, delivered to all women with breast cancer, may have greater public health impact than interventions targeting any specific breast cancer subgroup.