Sonography of paediatric appendicitis and its secondary signs

Sonographic diagnosis of appendicitis in children is an important clinical tool, often obviating the need for potentially harmful ionising radiation from computed tomography (CT) scans and unnecessary appendectomies. Established criteria do not commonly account for the sonographic secondary signs of acute appendicitis as an adjunct or corollary to an identifiably inflamed appendix. If one of, or combinations of these secondary signs are a reliable positive and/or negative indicator of the condition, diagnostic accuracy may be improved. This will be of particular importance in cases where the appendix cannot be easily identified, possibly providing referring clinicians with a less equivocal diagnosis. Acute appendicitis (AA) is the most common emergency presentation requiring surgical intervention among both adults and children. During 2010-11 in Australia 25000 appendicectomies were performed on adults and children, more than double the number of the next most common surgical procedure [1]. Ultrasound has been commonly used to diagnose AA since the 1980s, however the best imaging modality or combination of modalities to accurately and cost-effectively diagnose the condition is still debated. A study by Puylaert advocated ultrasound in all presentations [2], whereas others suggested it only as a first line modality [3–5]. Conversely, York et al state that it is not appropriate as it delays treatment [6]. CT has been shown to more accurately diagnose AA than ultrasound, however its inherent radiation risks warrant cautionary use in children [7]. Improved accuracy in the diagnosis of suspected AA using ultrasound would enable surgeons to make a decision without the need to expose children to the potentially harmful effects of CT. Secondary signs of appendicitis are well established [8], although research into their predictive values has only recently been undertaken [9,10] indicating their potential diagnostic benefit in the absence of an identifiable appendix. The purpose of this review is to examine the history of appendiceal sonography, established sonographic criteria, paediatric specific techniques and the predictive value of secondary signs.

Editorial of "International Journal of Critical Indigenous Studies Volume 2, Number 1, 2009"

Over the past two decades neo liberalism has shaped global economic activity. The international reach of the current economic crisis propelled by the subprime mortgage meltdown in the United States has affected Indigenous communities in different ways to those whose investments were depleted by the Wall Street activities of an unregulated corporate and banking sector. Throughout this roller coaster economic ride the low socio-economic position of Indigenous peoples continued in Canada, the United States of America, New Zealand, Hawaii and Australia. The logic, or illogic of capital, failed to extend the boom of the economic upturn to Indigenous peoples, but is poised to extend the repercussions of the current downturn deep into Indigenous lives. The consistency of the Indigenous socio-economic position across these countries, even where treaties exist, indicates that the phenomenon is based on a shared Indigenous reality. In this special edition, the commonality in the way in which Indigenous people are engaged in and positioned by market forces and regulation by their respective nation states is proposed as one of the foundation plates of that Indigenous positioning...

Evaluation of tomato production systems at Bowen in mitigating the risk of fruit fly infestation: a systems approach for market access

Queensland fruit flies Bactrocera tryoni and B. neohumeralis are considered major quarantine pests of tomato, a major crop in the horticultural production district around Bowen, North Queensland, Australia. Preharvest and/or postharvest treatments are required to meet the market access requirements of both domestic and international trading partners. The suspension from use of dimethoate and fenthion, the two insecticides used for fruit fly control, has resulted in the loss of both pre and postharvest uses in fresh tomato. Research undertaken quantitatively at Bowen evaluated the effectiveness of pre-harvest production systems without specific fruit fly controls and postharvest mitigation measures in reducing the risk of fruit fly infestation in tomato. A district-wide trapping using cue-lure baited traps was undertaken to determine fruit fly seasonal patterns in relation to the cropping seasons. A total of 17,626 field-harvested and 11,755 pack-house tomatoes were sampled from ten farms over three cropping seasons (2006-2009). The fruit were incubated and examined for fruit fly infestation. No fruit fly infested fruit were recorded over the three seasons in either the field or the pack-house samples. Statistical analyses showed that upper infestation levels were extremely low (between 0.025 and 0.062%) at the 95% confidence level. The trap catches showed a seasonal pattern in fruit fly activity, with low numbers during the autumn and winter months, rising slightly in spring and peaking in summer. This seasonal pattern was similar over the four seasons. The main two species of fruit fly caught were B. tryoni and B. neohumeralis. Based on the results, it is clear that the risk of fruit fly infestation is extremely low under the current production systems in the Bowen region.

Variation in the Understanding of Lutheranism and Its Implications for Religious Education : Meaning Discernment of Students and Teachers in Finnish Upper Secondary Schools

The study investigated variation in the ways in which a group of students and teachers of Evangelical Lutheran religious education in Finnish upper secondary schools understand Lutheranism and searched for educational implications for learning in religious education. The aim of understanding the qualitative variation in understanding Lutheranism was explored through the relationship between the following questions, which correspond to the results reported in the following original refereed publications: 1) How do Finnish students understand Lutheranism? 2) How do Finnish teachers of religious education constitute the meaning of Lutheranism? 3) How could phenomenography and the Variation Theory of Learning contribute to learning about and from religion in the context of Finnish Lutheran Religious Education as compared to religious education in the UK? Two empirical studies (Hella, 2007; Hella, 2008) were undertaken from a phenomenographic research perspective (e.g., Marton, 1981) and the Variation Theory of Learning (e.g., Marton & Tsui et al. 2004) that developed from it. Data was collected from 63 upper secondary students and 40 teachers of religious education through written tasks with open questions and complementary interviews with 11 students and 20 teachers for clarification of meanings. The two studies focused on the content and structure of meaning discernment in students and teachers expressed understandings of Lutheranism. Differences in understandings are due to differences in the meanings that are discerned and focused on. The key differences between the ways students understand varied from understanding Lutheranism as a religion to personal faith with its core in mercy. The logical relationships between the categories that describe variation in understanding express a hierarchy of ascending complexity, according to which more developed understandings are inclusive of less developed ones. The ways the teachers understand relate to student s understandings in a sequential manner. Phenomenography and Variation Theory were discussed in the context of religious education in Finland and the UK in relation to the theoretical notion of learning about and from religion (Hella & Wright, 2008). The thesis suggests that variation theory enables religious educators to recognise the unity of learning about and from religion, as learning is always learning about something and involves simultaneous engagement with the object of learning and development as a person. The study also suggests that phenomenography and variation theory offer a means by which it is possible for academics, policy makers, curriculum designers, teachers and students to learn to discern different ways of understanding the contested nature of religions. Keywords: Lutheranism, understanding, variation, teaching, learning, phenomenography, religious education

Antecedents of SME export intensity in a Latin American market

Small and medium-sized enterprises (SMEs) from emerging markets in Latin America are increasingly engaging in export-related activities. Nevertheless, limited research exists into the export behavior of such firms. This study proposes and tests a conceptual model that includes the main drivers and inhibitors of export intensity for SMEs from Chile. The model uses confirmatory factor analysis (CFA) to develop the underlying multi-item constructs and structural equation modeling (SEM) to test the model. Results show that manager’s export commitment as well as managerial and organizational resources and capabilities are drivers of export intensity. In addition, the results show that managerial perceptions of internal barriers, such as a manager’s lack of international experience and knowledge, act as significant barriers to developing exports. However, unlike previous findings from developed countries no evidence exists of external cost barriers having a significant impact on export intensity, which is possibly an indication of a competitive business environment in Chile.

Studies on Wage Differentials and Labour Market Transitions

This thesis consists of four studies. The first study examines wage differentials between women and men in the Finnish manufacturing sector. A matched employer-employee data set is used to decompose the overall gender wage gap into the contributions of sex differences in human capital, labour market segregation, and residual within-job wage differentials. The topic of the second study is the relationship between the extended unemployment benefits and labour market transitions of older workers. The analysis exploits a quasi-experimental setting caused by a change in the law that raised the eligibility age of workers benefiting from extended benefits. Roughly half of the unemployed workers with extended benefits are estimated to be effectively withdrawn from labour market search. The risk of unemployment declined and the re-employment probability increased among the age groups directly affected by the reform. The third study provides an empirical analysis of a structural equilibrium search model. Estimation results from various model specifications are compared and discussed. The last study is a methodological study where the difficulties of interpreting the results of competing risks hazard models are discussed and a solution for a particular class of models is proposed. It is argued that a common practice of reporting the results of qualitative response models in terms of marginal effects is also useful in the context of competing risks duration models.

Essays on Labor Market Frictions, Technological Change and Macroeconomic Fluctuations

The dissertation consists of an introductory chapter and three essays that apply search-matching theory to study the interaction of labor market frictions, technological change and macroeconomic fluctuations. The first essay studies the impact of capital-embodied growth on equilibrium unemployment by extending a vintage capital/search model to incorporate vintage human capital. In addition to the capital obsolescence (or creative destruction) effect that tends to raise unemployment, vintage human capital introduces a skill obsolescence effect of faster growth that has the opposite sign. Faster skill obsolescence reduces the value of unemployment, hence wages and leads to more job creation and less job destruction, unambiguously reducing unemployment. The second essay studies the effect of skill biased technological change on skill mismatch and the allocation of workers and firms in the labor market. By allowing workers to invest in education, we extend a matching model with two-sided heterogeneity to incorporate an endogenous distribution of high and low skill workers. We consider various possibilities for the cost of acquiring skills and show that while unemployment increases in most scenarios, the effect on the distribution of vacancy and worker types varies according to the structure of skill costs. When the model is extended to incorporate endogenous labor market participation, we show that the unemployment rate becomes less informative of the state of the labor market as the participation margin absorbs employment effects. The third essay studies the effects of labor taxes on equilibrium labor market outcomes and macroeconomic dynamics in a New Keynesian model with matching frictions. Three policy instruments are considered: a marginal tax and a tax subsidy to produce tax progression schemes, and a replacement ratio to account for variability in outside options. In equilibrium, the marginal tax rate and replacement ratio dampen economic activity whereas tax subsidies boost the economy. The marginal tax rate and replacement ratio amplify shock responses whereas employment subsidies weaken them. The tax instruments affect the degree to which the wage absorbs shocks. We show that increasing tax progression when taxation is initially progressive is harmful for steady state employment and output, and amplifies the sensitivity of macroeconomic variables to shocks. When taxation is initially proportional, increasing progression is beneficial for output and employment and dampens shock responses.

Tibetan Market Participation in China

Since the Chinese government began implementing economic reforms in the late 1970s, China has experienced profound economic change and growth. Like other parts of China, Tibetan areas of China have also experienced wide-ranging economic change with growth even higher than the China-wide average in certain years. Though China s strategic policy of developing the West provided many opportunities for economic and business activities, Tibetans have proven poorly equipped to respond to and take advantage of these opportunities. This study is about people, about market participation and specifically about why Tibetans do not effectively participate in the market in the context of China s economic development process. Many political, social, cultural and environmental factors explain the difficulties met by Tibetan communities. However, this study focuses on three factors: the social and culture context, government policy and education. The Buddhistic nature of Tibetan communities, particularly the political and economic system in traditional Tibetan society, explains this, especially after implementation of new national economic policies. An inclusive economic development policy that promotes local people s participation in the market demands serious consideration of local conditions. Unfortunately, such considerations often ignore local Tibetan realities. The economic development policy in Tibetan areas in China is nearly always an attempt to replicate the inland model and open up markets, even though economic and sociopolitical conditions in Tibet are markedly unlike much of China. A consequence of these policies is increasing numbers of non-Tibetan migrants flowing into Tibetan areas with the ensuing marginalization of Tibetans in the marketplace. Poor quality education is another factor contributing to Tibetan inability to effectively participate in the market. Vocational and business education targeting Tibetans is of very low quality and reflective of government failing to consider local circumstances when implementing education policy. The relatively few Tibetans who do receive education are nearly always unable to compete with non-Tibetan migrants in commercial activity. Encouraging and promoting Tibetan participation in business development and access to quality education are crucial for a sustainable and prosperous society in the long term. Particularly, a localized development policy that considers local environmental conditions and production as well as local culture is crucial. Tibet s economic development should be based on local environmental and production conditions, while utilizing Tibetan culture for the benefit of creating a sustainable economy. Such a localized approach best promotes Tibetan market participation. Keywords: Tibet cultural policy education market participation

Synthesis and Structure-Activity Correlation Studies of Secondary- and Tertiary-Amine-Based Glutathione Peroxidase Mimics

In this study, a series of seeondary- and tertiary-amino-substituted diaryl diselenides were synthesized and studied for their glutathione peroxidase (GPx) like antioxidant activities with H2O2, cumene hydroperoxide, or tBuOOH as substrates and with PhSH or glutathione (GSH) as thiol cosubstrates. This study reveals that replacement of the tert-amino groups in benzylamine-based diselenides by sec-amino moieties drastically enhances the catalytic activities in both the aromatic thiol (PhSH) and GSH assay systems. Particularly, the N-propyl- and N-isopropylamino-substituted diselenides are 8-18 times more active than the corresponding N,N-dipropyl- and N,N-diisopropylamine-based compounds in all three peroxide systems when GSH is used as the thiol cosubstrate. Although the catalytic mechanism of sec-amino-substituted disclenides is similar to that of the tert-amine-based compounds, differences in the stability and reactivity of some of the key intermediates account for the differences in the GPx-like activities. it is observed that the sec-amino groups are better than the tert-amino moieties for generating the catalytically active selenols. This is due to the absence of any significant thiol-exchange reactions in the selenenyl sulfides derived from sec-amine-based diselenides. Furthermore, the seleninic acids (RSeO2H) derived from the sec-amine-based compounds are more stable toward further reactions with peroxides than their tert-amine-based analogues.

Some investigations on secondary breakdown in p-n junctions considering the effect of thermally generated carriers

The V-I characteristic of a p-n junction under breakdown is calculated taking the thermally generated carriers into account. The current density distributions computed under different conditions have been given. The light emission and other characteristics reported by Chiang and Lauritzen and others have been explained.

An NAD(P)(+)-dependent secondary-alcohol dehydrogenase of Alcaligenes eutrophus: Purification, characterization and its application for the production of chiral alcohols

A soil micro-organism identified as Alcaligenes eutrophus capable of utilizing nerolidol, a sesquiterpene alcohol as the sole source of carbon, contains an inducible NAD(P)(+)-linked secondary-alcohol dehydrogenase (SADH), The enzyme was purified 252-fold from crude cell-free extract by a combination of salt precipitation, ion-exchange and affinity-matrix chromatography, Native and SDS/PAGE PAGE of the purified enzyme showed a single protein band and the enzyme appears to be a homotetramer having an apparent molecular mass of 139 kDa comprising four identical subunits of 38.5 kDa, The isoelectric point (pi) of SADH was determined to be 6.2, Depending on pH of the reaction media, the enzyme carried out both oxidation and reductions of various terpenoids and steroids, At pH 5.5, the enzyme catalysed the stereospecific reduction of prochiral ketones to optically active (S)-alcohols and the oxidation reaction was predominated over the former at pH 9.5, NADP(+) and NADPH were respectively preferred over NAD(+) and NADH for oxidation and reduction reactions, The K-m values for testosterone, NADP(+) and NAD(+) were 11.8, 55.6, and 122 mu M respectively, Neither enzyme was significantly inhibited by metal-binding agents, but some thiol-blocking compounds inhibited it, SADH tolerates moderate concentrations of water-miscible organic solvents such as ethanol, methanol, acetone and dioxan, Some of the properties of this enzyme were found to be significantly different from those thus far described.

Market access and welfare: Is there a conflict?

Well known tariff reform rules that are guaranteed to increase welfare will not necessarily increase market access, while rules that are guaranteed to increase market access will not necessarily increase welfare. The present paper proposes a new set of tariff reforms that can achieve both objectives at the same time.