Kidney and related chronic disease profiles and risk factors in three remote Australian Aboriginal communities

Morbidities and deaths from noncommunicable chronic diseases are greatly increased in remote Australian Aboriginal communities, but little is known of the underlying community-based health profiles. We describe chronic-disease profiles and their risk factors in 3 remote communities in the Northern Territory. Consenting adults (18+ years of age) in 3 communities participated in a brief history and examination between 2000 and mid-2003 as part of a systematic program to improve chronic-disease awareness and management. Participation was 67%,128%, and 62% in communities A, B, and C, respectively with a total of 1070 people examined. Current smokers included 41% of females and 72% of males. Most men were current drinkers, but most women were not. Parameters of body weight differed markedly by community, with mean body mass index (BMC) varying from 21.4 to 27.9 kg/m(2). Rates of chronic diseases were excessive but differed markedly; an almost threefold difference in the likelihood of any morbidity existed between communities A and C. Rates increased with age, but the greatest numbers of people with morbidities were in the middle-aged group. Most people had multiple morbidities with tremendous overlap. Hypertension and kidney disease appear to be early manifestations of the integrated chronic-disease syndrome, while diabetes is a late manifestation or complication. Substantial numbers of new cases of disease were identified by testing, and blood pressure improved in treated people with hypertension. Wide variations occur in body habitus, risk factors, and chronic-disease rates among communities, but an overwhelming need for effective smoking interventions exists in all. Systematic screening is useful in identifying high-risk individuals, most at early treatable stages there. Findings are very important for estimating current treatment needs, future burdens of disease, and for needs-based health services planning. Resources required will vary according to the burden of disease. (C) 2005 by the National Kidney Foundation, Inc.

Atypical prostatic glandular proliferations on needle biopsy - Diagnostic implications, use of immunohistochemistry, and clinical significance

In recent times, PSA screening and a substantial increase in prostate needle biopsies have not only resulted in detection of minute foci of cancer but have also very likely resulted in increased detection of atypical glandular proliferations. Not uncommonly, there are only a limited number of atypical glands in these biopsies, and these require careful evaluation to enable an accurate diagnosis. We describe diagnostic implications, use of immunohistochemistry, and clinical significance of these lesions. Foci of atypical glands, also labeled atypical small acinar proliferation of uncertain significance, have features suspicious for but not diagnostic of cancer. Atypical foci include a broad group of lesions of differing clinical significance. These include benign, small acinar proliferations mimicking prostate cancer and atypical glandular proliferations suspicious for carcinoma. Definite diagnosis requires accurate histopathologic assessment and judicious use of immunohistochemistry. Patients with atypical glands on prostate needle biopsy have a high risk for harboring cancer and therefore have an increased risk for having cancer detected in subsequent biopsies.

Social support and postpartum depressive symptomatology: The mediating role of maternal self-efficacy

Research shows that social support and maternal self-efficacy are inversely related to postpartum depression; however, little is known about the mechanisms by which these variables impact on depressive symptomatology. This study uses path analysis to examine the proposal that maternal self-efficacy mediates the effects of social support on postpartum depressive symptomatology. Primiparous women (n=247) completed questionnaires during their last trimester and then again at 4 weeks' postpartum (n=192). It was hypothesized that higher levels of parental support, partner support, and maternal self-efficacy would be associated with lower levels of depressive symptomatology postpartum and that the relationship between social support and depressive symptomatology would be mediated by maternal self-efficacy. Results indicated that as expected, higher parental support and maternal self-efficacy were associated with lower levels of depressive symptomatology postpartum. Partner support was found to be unrelated to both depressive symptomatology and maternal self-efficacy. Results from the path analysis supported the mediation model. Findings suggest that parental support lowers depressive symptomatology by the enhancement of maternal self-efficacy.

Sexual partner preferences: evolutionary imperative, emotional attachment or hedonism?

Data are taken from a representative sample of the Australian population to determine the qualities that are desired in a sexual partner. These qualities are considered in three categories: those reflecting the perceived reproductive value of the partner (evolutionary imperative), the emotional attachment to a partner and the pure pleasure associated with having sex. Subjects completed a telephone-based survey 876 males; 908 females; aged 18-59). The qualities respondents report they most desire in a sexual partner are that the person is someone who cares about them, and whom they love. They also rank highly the criterion that their partner should enjoy sex, and much less highly that they themselves should enjoy the sex. Evolutionary imperatives are ranked fairly low as criteria sought in a sexual partner. Males and females generally expressed similar preferences in a sexual partner, as do persons in different age groups, and persons in different marital status categories. Heterosexual males appear to place a higher emphasis on the physical appearance of a partner when compared with non-heterosexuals. [PUBLICATION ABSTRACT]

A new instrument for targeting falls prevention interventions was accurate and clinically applicable in a hospital setting

Background and Objective: To describe the diagnostic accuracy and practical application of the Peter James Centre Falls Risk Assessment Tool (PJC-FRAT), a multidisciplinary falls risk screening and intervention deployment instrument. Methods: In phase 1, the accuracy of the PJC-FRAT was prospectively compared to a gold standard (the STRATIFY) on a cohort of subacute hospital patients (n = 122). In phase 2, the PJC-FRAT was temporally reassessed using a subsequent cohort (n = 316), with results compared to those of phase 1. Primary outcomes were falls (events), fallers (patients who fell), and hospital completion rates of the PJC-FRAT. Results: In phase 1, PJC-FRAT accuracy of identifying falters showed sensitivity of 73% (bootstrap 95% confidence interval CI = 55, 90) and specificity of 75% (95% CI = 66, 83), compared with the STRATIFY (cutoff >= 2/5) sensitivity of 77% (95% CI = 59, 92) and specificity of 51% (95% CI = 41, 61). This difference was not significant. In phase 2, accuracy of nursing staff using the PJC-FRAT was lower. PJC-FRAT completion rates varied among disciplines over both phases: nurses and physiotherapists, >= 90%; occupational therapists, >= 82%; and medical officers, >= 57%. Conclusion: The PJC-FRAT was practical and relatively accurate as a predictor of falls and a deployment instrument for falls prevention interventions, although continued staff education may be necessary to maintain its accuracy. (c) 2006 Elsevier Inc. All rights reserved.

Analysis of line x environment interactions for yield in navy beans. 2. Pattern analysis of lines and environment within years

Seven years of multi-environment yield trials of navy bean (Phaseolus vulgaris L.) grown in Queensland were examined. As is common with plant breeding evaluation trials, test entries and locations varied between years. Grain yield data were analysed for each year using cluster and ordination analyses (pattern analyses). These methods facilitate descriptions of genotype performance across environments and the discrimination among genotypes provided by the environments. The observed trends for genotypic yield performance across environments were partly consistent with agronomic and disease reactions at specific environments and also partly explainable by breeding and selection history. In some cases, similarities in discrimination among environments were related to geographic proximity, in others management practices, and in others similarities occurred between geographically widely separated environments which differed in management practices. One location was identified as having atypical line discrimination. The analysis indicated that the number of test locations was below requirements for adequate representation of line x environment interaction. The pattern analyses methods used were an effective aid in describing the patterns in data for each year and illustrated the variations in adaptive patterns from year to year. The study has implications for assessing the number and location of test sites for plant breeding multi-environment trials, and for the understanding of genetic traits contributing to line x environment interactions.

Essays on Development Policy and the Political Economy of Conflict

Electoral Rules and Leader Selection: Experimental Evidence from Ugandan Community Groups. Despite a large body of work documenting how electoral systems affect policy outcomes, less is known about their impact on leader selection. We study this by comparing two types of participatory decision making in Ugandan community groups: (i) vote by secret ballot and (ii) open discussion with consensus. Random assignment allows us to estimate the causal impact of the rules on leader types and social service delivery. Vote groups are found to elect leaders more similar to the average member while discussion group leaders are positively selected on socio-economic characteristics. Further, dropout rates are significantly higher in discussion groups, particularly for poorer members. After 3.5 years, vote groups are larger in size and their members save less and get smaller loans. We conclude that the secret ballot vote creates more inclusive groups while open discussion groups favor the already economically successful. Preparing for Genocide: Community Meetings in Rwanda. How do political elites prepare the civilian population for participation in violent conflict? We empirically investigate this question using data from the Rwandan Genocide in 1994. Every Saturday before 1994, Rwandan villagers had to meet to work on community infrastructure. The practice was highly politicized and, according to anecdotal evidence, regularly used by the political elites for spreading propaganda in the years before the genocide. This paper presents the first quantitative evidence of this abuse of the community meetings. To establish causality, we exploit cross-sectional variation in meeting intensity induced by exogenous weather fluctuations. We find that an additional rainy Saturday resulted in a five percent lower civilian participation rate in genocide violence. Selection into Borrowing: Survey Evidence from Uganda. In this paper, I study how changes to the standard credit contract affect loan demand and selection into borrowing, using a representative sample of urban micro enterprises, most with no borrowing experience. Hypothetical loan demand questions are used to test whether firm owners respond to changes in loans' contractual terms and whether take-up varies by firms' risk type and other firm owner characteristics. The results indicate that contracts with lower interest rates and less stringent collateral requirements attract less risky borrowers, suggesting that there is scope for improvement of standard financial contract terms. Credit Contract Structure and Firm Growth: Evidence from a Randomized Control Trial. We study the effects of credit contract structure on firm outcomes among small and medium sized firms. A randomized control trial was carried out to distinguish between some of the key constraints to efficient credit use connected to the firms' business environment and production function, namely (i) backloaded returns (ii) uncertain returns and (iii) indivisible fixed costs. Each firm was followed for the 1-year loan cycle. We describe the experiment and present preliminary results from the first 754 out of 2,340 firms to have completed the loan cycle. Firms offered a grace period have higher profits and higher household income than firms receiving a rebate later on as well as the control group. They also increased the number of paid employees  and reduced the number of unpaid employees, an effect also found among firms that received a cash subsidy at the beginning of the loan cycle. We discuss potential mechanisms behind these effects.

New product screening in fast moving consumer goods

Theory suggests that the dimensions that are incorporated in the new product screening decision will differ according to the stage of the development process. The outcome of the application of different screening dimensions would be quicker, realistic and more reliable screening decisions. This research project builds on existing new product development and screening literature by investigating new product screening in international fast moving consumer goods companies. It further builds on the existing literature by measuring decision-making relating to projects in 'real time', as managers' responses refer to projects they are currently working on. The introduction of branded consumer products allows us to evolve scales used in new product research by further developing variables relating to branding, promotion and retailer power. The project uncovers multiple dimensions of new product screening and evaluation within this branded product sector. These dimensions are found to differ in their ability to discriminate between two groups of accepted and rejected projects at each of four stages of the new product development process. This investigation provides the intelligence with which managers can determine the likelihood of project acceptance and rejection at different stages of the development process. It highlights the need for managers to apply stage-specific dimensions in the new product screening decision and advocates the redefinition of new product screening from both an academic and managerial perspective. The screening decision should not be viewed as a single, early decision in a product development process, but as a series of stage specific decisions regarding future project potential.

Evolutionary neurobiology and art

In his important book on evolutionary theory, Darwin's Dangerous Idea, Daniel Dennett warns that Darwin's idea seeps through every area of human discourse like a "universal acid" (Dennett, 1995). Art and the aesthetic response cannot escape its influence. So my approach in this chapter is essentially naturalistic. Friedrich Nietzsche writes of observing the human comedy from afar, "like a cold angel...without anger, but without warmth" (Nietzsche, 1872, p. 164). Whether Nietzsche, of all people, could have done this is a matter of debate. But we know what he means. It describes a stance outside the human world as if looking down on human folly from Mount Olympus. From this stance, humans, their art and neurology are all part of the natural world, all part of the evolutionary process, the struggle for existence. The anthropologist David Dutton, in his contribution to the Routledge Companion to Aesthetics, says that all humans have an aesthetic sense (Dutton, 2001). It is a human universal. Biologists argue that such universals have an evolutionary basis. Furthermore, many have argued that not only humans but also animals, at least the higher mammals and birds, have an appreciation of the beautiful and the ugly (Eibl-Eibesfeldt, 1988).11Charles Darwin indeed writes "Birds appear to be the most aesthetic of all animals, excepting, of course, man, and they have nearly the same sense of the beautiful that we have" (1871, The Descent of Man and Selection in Relation to Sex, London: John Murray, vol.2, xiii, 39). This again suggests that aesthetics has an evolutionary origin. In parenthesis here, I should perhaps say that I am well aware of the criticism leveled at evolutionary psychology. I am well aware that it has been attacked as just so many "just-so" stories. This is neither the time nor the place to mount a defense but simply just to say that I believe that a defense is eminently feasible. © 2006 Elsevier Inc. All rights reserved.

Human resource management in the Indian public and private sectors:an empirical comparison

This study compares human resource management (HRM) practices in Indian public- and private-sector organizations. The investigation is based on a questionnaire survey of 137 large manufacturing firms (public sector = 81: private sector = 56). The key areas of analysis include the structure of human resource (HR) department, the role of HR function in corporate change, recruitment and selection, pay and benefits, training and development, employee relations and emphasis on key HRM strategies. Internal labour markets (ILMs) are used to make the comparative analysis. The statistical results show a number of similarities and differences in the HRM systems of Indian public-and private-sector organizations. Against the established notion, the results of this study reveal that the gap between Indian private- and public-sector HRM practices is not very significant. Moreover, in a few HR functional areas (for example, compensation and training and development), Indian private-sector firms have adopted a more rational approach than their public-sector counterparts. © 2004 Taylor and Francis Ltd.

Mild cognitive decline. A position statement of the Cognitive Decline Group of the European Innovation Partnership for Active and Healthy Ageing (EIPAHA)

Introduction Mild cognitive impairment (MCI) is a term used to describe a level of decline in cognition which is seen as an intermediate stage between normal ageing and dementia, and which many consider to be a prodromal stage of neurodegeneration that may become dementia. That is, it is perceived as a high risk level of cognitive change. The increasing burden of dementia in our society, but also our increasing understanding of its risk factors and potential interventions, require diligent management of MCI in order to find strategies that produce effective prevention of dementia. Aim To update knowledge regarding mild cognitive impairment, and to bring together and appraise evidence about the main features of clinical interest: definitions, prevalence and stability, risk factors, screening, and management and intervention. Methods Literature review and consensus of expert opinion. Results and conclusion MCI describes a level of impairment in which deteriorating cognitive functions still allow for reasonable independent living, including some compensatory strategies. While there is evidence for some early risk factors, there is still a need to more precisely delineate and distinguish early manifestations of frank dementia from cognitive impairment that is less likely to progress to dementia, and furthermore to develop improved prospective evidence for positive response to intervention. An important limitation derives from the scarcity of studies that take MCI as an endpoint. Strategies for effective management suffer from the same limitation, since most studies have focused on dementia. Behavioural changes may represent the most cost-effective approach.

Decision support system for project selection

The evaluation and selection of industrial projects before investment decision is customarily done using marketing, technical, and financial information. Subsequently, environmental impact assessment and social impact assessment are carried out mainly to satisfy the statutory agencies. Because of stricter environment regulations in developed and developing countries, quite often impact assessment suggests alternate sites, technologies, designs, and implementation methods as mitigating measures. This causes considerable delay to complete project feasibility analysis and selection as complete analysis requires to be taken up again and again until the statutory regulatory authority approves the project. Moreover, project analysis through the above process often results in suboptimal projects as financial analysis may eliminate better options as more environment friendly alternative will always be cost intensive. In this circumstance, this study proposes a decision support system which analyses projects with respect to market, technicalities, and social and environmental impact in an integrated framework using analytic hierarchy process, a multiple attribute decision-making technique. This not only reduces duration of project evaluation and selection, but also helps select an optimal project for the organization for sustainable development. The entire methodology has been applied to a cross-country oil pipeline project in India and its effectiveness has been demonstrated. © 2008, IGI Global.

War crimes, conditionality and EU integration in the Western Balkans

The baleful legacy of the wars of the 1990s continues to dog the states and societies of the former Yugoslavia and has overshadowed the disappointingly slow and hesitant trajectory of the region towards the EU. At the start of the new millennium, with the removal of key wartime leaders from the political scene in both Croatia and Serbia, it was widely hoped that the region would prove able to ‘leave the past behind’ and rapidly move on to the hopeful new agenda of EU integration. The EU’s Copenhagen criteria, which in 1993 first explicitly set out the basic political conditions expected of aspirant EU Member States, proved effective in the case of the new democracies of Central and Eastern Europe in supporting the entrenchment of democratic norms and practices, and stimulating reconciliation and good neighbourly relations among countries with turbulent histories. Building on this experience, the Stabilisation and Association Process, launched for the countries of the Western Balkans in 1999, included both full cooperation with the International Criminal Tribunal for the former Yugoslavia (ICTY) and regional reconciliation among the political conditions set for advancing these countries on the path to EU integration. EU political conditionality was intended to support the efforts of new political leaders to redefine national goals away from the nationalist enmities of the past and focus firmly on forging a path to a better future. This Chaillot Paper examines the extent to which this strategy has worked, especially in the light of the difficulties it has encountered in the face of strong resistance to cooperation among sections of the former Yugoslav population, many of whom have not yet fully acknowledged the crimes committed during the 1990s. Key chapters in the volume raise the vital questions of leadership and political will. EU political conditionality does not work unless the EU has a partner ready and willing to ‘play the game’, which presupposes that EU integration has become the overriding priority on the national political agenda.

Aspects of the design and control of manufacturing systems subject to demand uncertainty

The recent explosive growth in advanced manufacturing technology (AMT) and continued development of sophisticated information technologies (IT) is expected to have a profound effect on the way we design and operate manufacturing businesses. Furthermore, the escalating capital requirements associated with these developments have significantly increased the level of risk associated with initial design, ongoing development and operation. This dissertation has examined the integration of two key sub-elements of the Computer Integrated Manufacturing (CIM) system, namely the manufacturing facility and the production control system. This research has concentrated on the interactions between production control (MRP) and an AMT based production facility. The disappointing performance of such systems has been discussed in the context of a number of potential technological and performance incompatibilities between these two elements. It was argued that the design and selection of operating policies for both is the key to successful integration. Furthermore, policy decisions are shown to play an important role in matching the performance of the total system to the demands of the marketplace. It is demonstrated that a holistic approach to policy design must be adopted if successful integration is to be achieved. It is shown that the complexity of the issues resulting from such an approach required the formulation of a structured design methodology. Such a methodology was subsequently developed and discussed. This combined a first principles approach to the behaviour of system elements with the specification of a detailed holistic model for use in the policy design environment. The methodology aimed to make full use of the `low inertia' characteristics of AMT, whilst adopting a JIT configuration of MRP and re-coupling the total system to the market demands. This dissertation discussed the application of the methodology to an industrial case study and the subsequent design of operational policies. Consequently a novel approach to production control resulted. A central feature of which was a move toward reduced manual intervention in the MRP processing and scheduling logic with increased human involvement and motivation in the management of work-flow on the shopfloor. Experimental results indicated that significant performance advantages would result from the adoption of the recommended policy set.

The investigation of crime:the myths and the reality

Initially the study focussed on the factors affecting the ability of the police to solve crimes. An analysts of over twenty thousand police deployments revealed the proportion of time spent investigating crime contrasted to its perceived importance and the time spent on other activities. The fictional portrayal of skills believed important in successful crime investigation were identified and compared to the professional training and 'taught skills’ given to police and detectives. Police practitioners and middle management provided views on the skills needed to solve crimes. The relative importance of the forensic science role. fingerprint examination and interrogation skills were contrasted with changes in police methods resulting from the Police and Criminal Evidence Act and its effect on confessions. The study revealed that existing police systems for investigating crime excluding specifically cases of murder and other serious offences, were unsystematic, uncoordinated, unsupervised and unproductive in using police resources. The study examined relevant and contemporary research in the United States and United Kingdom and with organisational support introduced an experimental system of data capture and initial investigation with features of case screening and management. Preliminary results indicated increases in the collection of essential information and more effective use of investigative resources. In the managerial framework within which this study has been conducted, research has been undertaken in the knowledge elicitation area as a basis for an expert system of crime investigation and the potential organisational benefits of utilising the Lap computer in the first stages of data gathering and investigation. The conclusions demonstrate the need for a totally integrated system of criminal investigation with emphasis on an organisational rather than individual response. In some areas the evidence produced is sufficient to warrant replication, in others additional research is needed to further explore other concepts and proposed systems pioneered by this study.