Cholesterol-lowering management of stroke : inconsistencies of evidence and practice

Cholesterol-lowering treatment by statins is an important and costly issue; however, its role in stroke has not been well documented. The aim of the present study was to review literature and current practice regarding cholesterol-lowering treatment for stroke patients. A literature review was conducted on lipids in stroke and their management with both statins and diet, including the cost-effectiveness of medical nutrition therapy. Qualifying criteria and prescription procedures of the Pharmaceutical Benefits Scheme (PBS) were also reviewed. Data on lipid levels and statin prescriptions were analysed for 468 patients admitted to a stroke unit. The literature shows that management with both medication and diet can be effective, especially when combined; however, 60% of patients with an ischaemic event had fasting total cholesterol measures ≥4 mmol/L (n = 231), with only 52% prescribed statins on discharge (n = 120). Hypercholesterolaemia is an underdiagnosed and undertreated risk factor within the stroke population. It appears that the PBS has not kept pace with advances in the evidence in terms of statin use in the stroke population, and review is needed. The present review should address the qualifying criteria for the stroke population and recommendations on referral to dietitians for dietary advice. Cholesterol-lowering treatment for both stroke patients and the wider population is an area that needs awareness raising and review by the PBS, medical practitioners and dietitians. The role of dietary and pharmacological treatments needs to be clearly defined, including adjunct therapy, and the cost-effectiveness of medical nutrition therapy realised.

Adopting building information modeling (BIM) as collaboration platform in the design industry

This paper discusses the preliminary findings of an ongoing research project aimed at developing a technological, operational and strategic analysis of adopting BIM in AEC/FM (Architecture-Engineering-Construction/Facility Management) industry as a collaboration tool. Outcomes of the project will provide specifications and guidelines as well as establish industry standards for implementing BIM in practice. This research primarily focuses on BIM model servers as a collaboration platform, and hence the guidelines are aimed at enhancing collaboration capabilities. This paper reports on the findings from: (1) a critical review of latest BIM literature and commercial applications, and (2) workshops with focus groups on changing work-practice, role of technology, current perception and expectations of BIM. Layout for case studies being undertaken is presented. These findings provide a base to develop comprehensive software specifications and national guidelines for BIM with particular emphasis on BIM model servers as collaboration platforms.

Youth, femininity and self-shaping

The arguments in this paper concerned the manner in which young people learn to construct specific types of relationships with themselves. The analysis of this self-making is accomplished by applying Foucault’s four-part model of self-formation, to an examination of the role of manuals such as young women’s magazines in the shaping of various aspects of the ‘youthful self’. The intention has been to provide a set of tools for approaching the issue of young women's magazines which avoids some of the problems associated with critical theory - a paradigm which translates such magazines almost exclusively in terms of social control.

Health, Death, and Indigenous Australians in the Coronial system

This paper details research conducted in Queensland during the first year of operation of the new Coroners Act 2003. Information was gathered from all completed investigations between December 2003 and December 2004 across five categories of death: accidental, suicide, natural, medical and homicide. It was found that 25 percent of the total number of Indigenous deaths recorded in 2004 were reported to, and investigated by, the Coroner, in comparison to 9.4 percent of non-Indigenous deaths. Moreover, Indigenous people were found to be over-represented in each category of death, except in death in a medical setting, where they were absent.

Increasing the Information available to Coroners : the effect on autopsy decision making

This paper details research completed in 2007 which investigated autopsy decision making in a death investigation. The data was gathered during the first year of operation of a new Coroners Act in Queensland, Australia, which changed the process of death investigation in three ways which are important to this paper. First, it required a greater amount of information to be gathered at the scene by police, and this included a thorough investigation of the circumstances of the death, including statements from witnesses, friends and family, as well as evidence gathering at the scene. Second, it required Coroners, for the first time, to determine the level of invasiveness of the autopsy required to complete the death investigation. Third, it enabled the communication of a genuine family concern, to be communicated to the Coroner. The outcome of such information was threefold. First, a greater amount of information offered to the Coroner led to a decrease in the number of full internal autopsies ordered, but an increase in the number of partial internal autopsies ordered. Second, this shift in autopsy decision making by Coroners saw certain factors given greater importance than others in decisions to order full internal or external only autopsies. Third, a raised family concern had a significant impact on autopsy decision making and tended to decrease the invasiveness of the autopsy ordered by Coroners.

Crimes against morality

The purpose of this chapter is to discuss the relationship between crime and morality, with a specific focus on crimes against morality. While we argue that all crimes have a general moral basis, condemned as wrong or bad and proscribed by society, there is a specific group of offences in modern democratic nations labelled crimes against morality. Included within this group are offences related to prostitution, pornography and homosexuality. What do these crimes have in common? Most clearly they tend to have a sexual basis and are often argued to do sexual harm, in both a moral and /or psychological sense, as well as physically. Conversely they are often argued to be victimless crimes, especially when the acts occur between consenting adults. Finally they are considered essentially private acts but they often occur, and are regulated, in the public domain. Most importantly, each of these crimes against morality has only relatively recently (ie in the past 150 years) become identified and regulated by the state as a criminal offence.

Rethinking Prostitution : feminism, sex and the self

Prostitution is a difficult issue, particularly for feminists. Are prostitutes victims of exploitation or the most honest of women? Are clients perverts or just acting instinctively? Should prostitution be eliminated or supported? This book examines these contemporary questions and offers a way of thinking about the issues, which does not rely on these inappropriate and often ineffectual options. Repositioning the institution and its main players outside the confines of the prostitution debate offers new and exciting ways of thinking and acting for all those interested in moving this discussion into the twenty-first century.

The prostitute and the client : challenging the dualisms

Certain ways of knowing the prostitute and the client predominate. He is understood through the discourse of sexology, she is understood through the discourses of psychology, psychoanalysis, economics and feminism. However, while the prostitute and the client appear to be known through unrelated and diverse discourses, such ways of knowing are organised through the dualisms of sex and gender, victim and agent, mind and body. Moreover, these ways of knowing are directly related to popular discourse, policy and legislation on the topic. This paper examines the relationship between ways of knowing the prostitute and the client, and political action in Australia. it argues that inadequate theoretical conceptualisations are often at the heart of poorly conceived praxis - in this case Australian policy and legislation. This paper will demonstrate that re-thinking the theory can lead to new ways of acting.