Non-alcoholic fatty liver disease : can ultrasound assist in early diagnosis of prediabetes and delay progression to type2 diabetes mellitus

Non Alcoholic Fatty Liver Disease (NAFLD) is a condition that is frequently seen but seldom investigated. Until recently, NAFLD was considered benign, self-limiting and unworthy of further investigation. This opinion is based on retrospective studies with relatively small numbers and scant follow-up of histology data. (1) The prevalence for adults, in the USA is, 30%, and NAFLD is recognized as a common and increasing form of liver disease in the paediatric population (1). Australian data, from New South Wales, suggests the prevalence of NAFLD in “healthy” 15 year olds as being 10%.(2) Non-alcoholic fatty liver disease is a condition where fat progressively invades the liver parenchyma. The degree of infiltration ranges from simple steatosis (fat only) to steatohepatitis (fat and inflammation) steatohepatitis plus fibrosis (fat, inflammation and fibrosis) to cirrhosis (replacement of liver texture by scarred, fibrotic and non functioning tissue).Non-alcoholic fatty liver is diagnosed by exclusion rather than inclusion. None of the currently available diagnostic techniques -liver biopsy, liver function tests (LFT) or Imaging; ultrasound, Computerised tomography (CT) or Magnetic Resonance Imaging (MRI) are specific for non-alcoholic fatty liver. An association exists between NAFLD, Non Alcoholic Steatosis Hepatitis (NASH) and irreversible liver damage, cirrhosis and hepatoma. However, a more pervasive aspect of NAFLD is the association with Metabolic Syndrome. This Syndrome is categorised by increased insulin resistance (IR) and NAFLD is thought to be the hepatic representation. Those with NAFLD have an increased risk of death (3) and it is an independent predictor of atherosclerosis and cardiovascular disease (1). Liver biopsy is considered the gold standard for diagnosis, (4), and grading and staging, of non-alcoholic fatty liver disease. Fatty-liver is diagnosed when there is macrovesicular steatosis with displacement of the nucleus to the edge of the cell and at least 5% of the hepatocytes are seen to contain fat (4).Steatosis represents fat accumulation in liver tissue without inflammation. However, it is only called non-alcoholic fatty liver disease when alcohol - >20gms-30gms per day (5), has been excluded from the diet. Both non-alcoholic and alcoholic fatty liver are identical on histology. (4).LFT’s are indicative, not diagnostic. They indicate that a condition may be present but they are unable to diagnosis what the condition is. When a patient presents with raised fasting blood glucose, low HDL (high density lipoprotein), and elevated fasting triacylglycerols they are likely to have NAFLD. (6) Of the imaging techniques MRI is the least variable and the most reproducible. With CT scanning liver fat content can be semi quantitatively estimated. With increasing hepatic steatosis, liver attenuation values decrease by 1.6 Hounsfield units for every milligram of triglyceride deposited per gram of liver tissue (7). Ultrasound permits early detection of fatty liver, often in the preclinical stages before symptoms are present and serum alterations occur. Earlier, accurate reporting of this condition will allow appropriate intervention resulting in better patient health outcomes. References 1. Chalasami N. Does fat alone cause significant liver disease: It remains unclear whether simple steatosis is truly benign. American Gastroenterological Association Perspectives, February/March 2008 www.gastro.org/wmspage.cfm?parm1=5097 Viewed 20th October, 2008 2. Booth, M. George, J.Denney-Wilson, E: The population prevalence of adverse concentrations with adiposity of liver tests among Australian adolescents. Journal of Paediatrics and Child Health.2008 November 3. Catalano, D, Trovato, GM, Martines, GF, Randazzo, M, Tonzuso, A. Bright liver, body composition and insulin resistance changes with nutritional intervention: a follow-up study .Liver Int.2008; February 1280-9 4. Choudhury, J, Sanysl, A. Clinical aspects of Fatty Liver Disease. Semin in Liver Dis. 2004:24 (4):349-62 5. Dionysus Study Group. Drinking factors as cofactors of risk for alcohol induced liver change. Gut. 1997; 41 845-50 6. Preiss, D, Sattar, N. Non-alcoholic fatty liver disease: an overview of prevalence, diagnosis, pathogenesis and treatment considerations. Clin Sci.2008; 115 141-50 7. American Gastroenterological Association. Technical review on nonalcoholic fatty liver disease. Gastroenterology.2002; 123: 1705-25

Regioregular poly(3-hexyl-thiophene) helical self-organization on carbon nanotubes

Mixtures of Regioregular Poly(3-hexyl-thiophene) (rrP3HT) and multi wall carbon nanotubes have been investigated by Scanning Tunneling Microscopy in Ultra High Vacuum. Carbon nanotubes covered by rrP3HT have been imaged and analyzed, providing a clear evidence that this polymer self assembles on the nanotube surface following geometrical constraints and adapting its equilibrium chain-to-chain distance. Largely spaced covered nanotubes have been analyzed to investigate the role played by nanotube chirality in the polymer wrapping, evidencing strong rrP3HT interactions along well defined directions.

The adjustment of leadership styles in intercultural workplace – some evidences from the multinational construction companies in Hong Kong

This study investigates the existence of intercultural adjustment in the multicultural construction workplaces by examining the leadership orientations (task-/people-orientation), communication and conflict resolution skills (high/low-context culture), and power relationship styles (high/low power distance) of local Chinese and the British expatriate project managers in the multinational construction companies in Hong Kong. A sample of project managers (N = 40) and their subordinates (N = 61) were surveyed using the structured questionnaires. Statistical techniques (independent-samples t-test, and Pearson correlation analysis) were employed to evaluate the data. The results revealed a number of interesting findings. First, it was found that both project manager groups equally considered the importance of task performance and interpersonal relationship. The results of correlations analysis provide support for the linkages of the length of working abroad with the change in task/people orientation for Chinese and expatriate managers. The analysis revealed that those Chinese managers who have the longest length of time living or working in Western countries tended to measure higher on task-orientation. Similarly, those British expatriate managers who have the longest period of working in Hong Kong tended to be less task-orientated. Second, local Chinese managers were found to be more confrontational when they strongly disagree with their team members than their British expatriate counterparts. It would appear that stress from project deadline which increase the directness and terseness in communication acts, and retain the composure of project managers in dealing with the subordinates. Finally, our findings show that there is significant difference between local Chinese and British expatriate managers in their power relationship with subordinates. This implies that although the intercultural adjustment might influence perceptions of local and expatriate managers, some dominant deep-rooted cultural values and beliefs are still not easily altered. Conclusions are presented along with suggestions for future studies.

Towards a literacy of attention

In 1997, business trend analyst Linda Stone proposed the term "continuous partial attention" to characterise the contemporary experience of wanting to be ‘a live node on the network’. She argued that while it can be a positive and functional behaviour, it also has the potential to be disabling, compromising reflective and creative thought. Subsequent studies have explored the ways in which technology has slowly disrupted the idea and experience of a "centred" and "bounded" self. Studies of ‘Gen Y’ show the ease with which young people accommodate this multiplying of the self as they negotiate their partial friendships and networks of interest with family and work. In teaching and learning circles in tertiary education we talk a lot about problems of student ‘disengagement’. In characterising our challenge this way, are we undermining our potential to understand the tendencies of contemporary learners? This paper begins a consideration of how traditional models, frameworks and practices might oppose these partially engaged but continuously connected and interpersonal "dividuals". What questions does this provoke for learning environments towards harnessing yet counterpointing the crisis students might experience; to recognise but also integrate their multiple selves towards what they aim to become through the process of learning?

The Euro-American psyche and the imaging of Samoa in the early 20th century

Drawing on English language sources and material from Western Samoa (now Samoa), this examination of photographically illustrated serial encyclopaedia and magazines proposes an alternative historical analysis of the colonial photographs of Samoa, the most extensively covered field in Oceanic photographic studies. Photographs published between the 1890s and World War II were not necessarily from that era, and despite claims in the text of illustrated publications of an unchanged, enduring, archaic tradition in Samoa, the amazing variety of content and subject matter often offered contradictory evidence, depicting a modern, adaptive and progressive Samoa. Contrary to orthodox historical analysis, the images of Samoa in illustrated magazines and encyclopaedia were not limited to a small, repetitive gallery of partially clothed women and costumed chiefs.

The use of online counselling within an Australian secondary school setting: a practitioner’s viewpoint

This paper proposes that the provision of online counselling services for young people accessed through their local school website has the potential to assist students with mental health issues as well as increasing their help seeking behaviours. It stems from the work of the authors who trialled an online counselling service within one Australian secondary school. In Australia, online counselling with the adult population is now an accepted part of the provision of mental health services. Online provision of mental health information for young people is also well accepted. However, online counselling for young people is provided by only a few community organisations such as Kids Help Line within Australia. School based counselling services which are integral to most secondary schools in Australia, seem slow to provide this service in spite of initial interest and enthusiasm by individual school counsellors. This discussion is the product of reflection on the potential benefits of this trial with a consideration of relevant research of the issues raised. It highlights the need for further research into the use of computer mediated communication in the provision of counselling within a school setting.

Media Studies: "Media, History and Society", and "Thinking Popular Culture".

“When cultural life is re-defined as a perpetual round of entertainments, when serious public conversation becomes a form of baby talk, when, in short, a people become an audience and their public business a vaudeville act, then a nation finds itself at risk.” (Postman) The dire tones of Postman quoted in Janet Cramer’s Media, History, Society: A Cultural History of US Media introduce one view that she canvasses, in the debate of the moment, as to where popular culture is heading in the digital age. This is canvassed, less systematically, in Thinking Popular Culture: War Terrorism and Writing by Tara Brabazon, who for example refers to concerns about a “crisis of critical language” that is bothering professionals—journalists and academics or elsewhere—and deplores the advent of the Internet, as a “flattening of expertise in digital environments”.

ICT integration and teachers' confidence in using ICT for teaching and learning in Queensland state schools

Information and communication technology (ICT) curriculum integration is the apparent goal of an extensive array of educational initiatives in all Australian states and territories. However, ICT curriculum integration is neither value neutral nor universally understood. The literature indicates the complexity of rationales and terminology that underwrite various initiatives; various dimensions and stages of integration; inherent methodological difficulties; obstacles to integration; and significant issues relating to teacher professional development and ICT competencies (Jamieson-Proctor, Watson, & Finger, 2003). This paper investigates the overarching question: Are ICT integration initiatives making a significant impact on teaching and learning in Queensland state schools? It reports the results from a teacher survey that measures the quantity and quality of student use of ICT. Results from 929 teachers across all year levels and from 38 Queensland state schools indicate that female teachers (73% of the full time teachers in Queensland state schools in 2005) are significantly less confident than their male counterparts in using ICT with students for teaching and learning, and there is evidence of significant resistance to using ICT to align curriculum with new times and new technologies. This result supports the hypothesis that current initiatives with ICT are having uneven and less than the desired results system wide. These results require further urgent investigation in order to address the factors that currently constrain the use of ICT for teaching and learning.

Technical support and professional development : using remote desktops to address bottlenecks in music technology

This paper presents research findings about the use of remote desktop applications to teach music sequencing software. It highlights the successes, shortcomings and interactive issues encountered during a pilot project with a theoretical focus on a specific interactive bottleneck. The paper proposes a new delivery and partnership model to widen this bottleneck, which currently hinders interactions between the technical support, education and professional development communities in music technology.