There are always two sides to a story: the use of social dramas as a mode of data analysis in information systems

With the continually evolving social nature of information systems research there is a need to identify different “modes of analysis” (Myers, 1997) to uncover our understanding of the complex, messy and often chaotic nature of human factors. One suggested mode of analysis is that of social dramas, a tool developed in the anthropological discipline by Victor Turner. The use of social dramas also utilises the work by Goffman (1959; 1997) and enables the researcher to investigate events from the front stage, reporting obvious issues in systems implementation, and from the back stage, identifying the hidden aspects of systems implementation and the underpinning discourses. A case study exploring the social dramas involved in systems selection and implementation has been provided to support the use of this methodological tool.

Addressing the potential adverse effects of school-based BMI assessments on children

Introduction. Do child obesity prevention research and intervention measures have the potential to generate adverse concerns about body image by focussing on food, physical activity and body weight? Research findings now demonstrate the emergence of body image concerns in children as young as 5 years. In the context of a large school-community-based child health promotion and obesity prevention study, we aimed to address the potential negative effects of height and weight measures on child wellbeing by developing and implementing an evidence-informed protocol to protect and prevent body image concerns. fun 'n healthy in Moreland! is a cluster randomised controlled trial of a child health promotion and obesity prevention intervention in 23 primary schools in an inner urban area of Melbourne, Australia. Body image considerations were incorporated into the study philosophies, aims, methods, staff training, language, data collection and reporting procedures of this study. This was informed by the published literature, professional body image expertise, pilot testing and implementation in the conduct of baseline data collection and the intervention. This study is the first record of a body image protection protocol being an integral part of the research processes of a child obesity prevention study. Whilst we are yet to measure its impact and outcome, we have developed and tested a protocol based on the evidence and with support from stakeholders in order to minimise the adverse impact of study processes on child body image concerns.

Alcohol and drug use in Australian male sex workers: its relationship to the safety outcome of the sex encounter

This paper describes the self-reporting patterns of alcohol and drug consumption among male sex workers (MSWs) in three Australian cities during commercial sex encounters, and examines to what extent alcohol and drugs are used and whether this is related to the safe/unsafe outcome of the commercial sex encounter. One hundred and eighty-six MSWs from Brisbane, Sydney and Melbourne completed a diary following each commercial sex encounter over a two-week period. MSWs reported 2,087 commercial sex encounters during the study period. Alcohol or drug consumption was reported in 50.5% of the encounters.

Complex interventions or complex systems? Implications for health economic evaluation

Health researchers commonly use the notion of complexity to indicate the problems faced in evaluating the effectiveness of many non-drug interventions.^1-3 However, although it is rarely delineated, complexity has two meanings. In the first it is a property of the intervention, and in the second it is a property of the system in which the intervention is implemented. We examine the implications of these two views for economic evaluation.

Ambulance call triage outcomes for patients reporting pain : a retrospective cross-sectional analysis of pain score versus traige level

Objective: To identify any association between the response priority code generated during calls to the ambulance communication centre and patient reports of pain severity.

Methods: A retrospective analysis of patient care records was undertaken for all patients transported by paramedics over a 7-day period. The primary research interest was the association between the response code allocated at the time of telephone triage and the initial pain severity score recorded using a numeric rating scale (NRS). Univariate and multivariate logistic regression methods were used to analyse the association between the response priority variable and explanatory variables.

Results: There were 1246 cases in which both an initial pain score using the NRS and a response code were recorded. Of these cases, 716/1246 (57.5%) were associated with a code 1 ("time-critical") response. After adjusting for gender, age, cause of pain and duration of pain, a multivariate logistic regression analysis found no significant change in the odds of a patient in pain receiving a time-critical response compared with patients who had no pain, regardless of their initial pain score (NRS 1–3, odds ratio (OR) 1.11, 95% CI 0.7 to 1.8; NRS 4–7, OR 1.12, 95% CI 0.7 to 1.8; NRS 8–10, OR 0.84, 95% CI 0.5 to 1.4).

Conclusion: The severity of pain experienced by the patient appeared to have no influence on the priority (urgency) of the dispatch response. Triage systems used to prioritise ambulance calls and decide the urgency of response or type of referral options should consider pain severity to facilitate timely and humane care.

Thermodynamics of lipophilic drug binding to intestinal fatty acid binding protein and permeation across membranes

Intestinal fatty acid binding protein (I-FABP) is present at high levels in the absorptive cells of the intestine (enterocytes), where it plays a role in the intracellular solubilization of fatty acids (FA). However, I-FABP has also been shown to bind to a range of non-FA ligands, including some lipophilic drug molecules. Thus, in addition to its central role in FA trafficking, I-FABP potentially serves as an important intracellular carrier of lipophilic drugs. In this study we provide a detailed thermodynamic analysis of the binding and stability properties of I-FABP in complex with a series of fibrate and fenamate drugs to provide an insight into the forces driving drug binding to I-FABP. Drug binding and selectivity for I-FABP are driven by the interplay of protein−ligand interactions and solvent processes. The Gibbs free energies (ΔG°) determined from dissociation constants at 25 °C ranged from −6.2 to −10 kcal/mol. The reaction energetics indicate that drug binding to I-FABP is an enthalpy−entropy driven process. The relationship between I-FABP stability and drug binding affinity was examined by pulse proteolysis. There is a strong coupling between drug binding and I-FABP stability. The effect of an I-FABP protein sink on the kinetics and thermodynamics of tolfenamic acid permeation across an artificial phospholipid membrane were investigated. I-FABP significantly decreased the energy barrier for desorption of tolfenamic acid from the membrane into the acceptor compartment. Taken together, these data suggest that the formation of stable drug−I-FABP complexes is thermodynamically viable under conditions simulating the reactant concentrations likely observed in vivo and maybe a significant biochemical process that serves as a driving force for passive intestinal absorption of lipophilic drugs.

Quality of reporting of randomized clinical trials in abstracts of the 2005 annual meeting of the American College of Rheumatology.

Objective: To determine the quality of abstracts reporting randomized clinical trials (RCT) at the 2005 Annual Scientific Meeting of the American College of Rheumatology.

Methods: All 2005 abstracts including late-breaking abstracts were assessed. An abstract was deemed to be reporting an RCT if it indicated that participants were randomized in the title or body of the abstract. RCT were excluded if they included only pharmacokinetic data. The CONSORT checklist was applied and relevant data extracted. We defined manufacturer support as acknowledgment of industry support or industry employee as co-author.

Results: Of 2146 abstracts, 143 (6.7%) reported RCT. Of these, 78.3% were drug trials, and 63.6% indicated manufacturer support. Only 30.8% of abstracts used "randomized" in the title, 44.1% did not explicitly state whether blinding was undertaken, and only 7.0% clearly stated who was blinded. Thirty percent of studies did not give an explicit definition of eligibility criteria of participants. While 84.6% explicitly described the experimental intervention, only 37.1% explicitly described the comparator intervention. Only 21% explicitly stated that an intention to treat analysis was performed. Baseline demographic and clinical characteristics were reported in 48.3%. While most abstracts reported summary results for each treatment group, only 35.7% reported effect size with its precision.

Conclusion: The quality of reporting is suboptimal in many RCT abstracts. Abstracts reporting RCT would benefit from a structured approach that ensures more detailed reporting of eligibility criteria, active and comparator interventions, flow of participants, and adequate summary and precision of results.

Management of cardiovascular diseases with micro systems and nanotechnology

Cardiovascular diseases are the leading cause of death and morbidity in industrialized nations and are becoming an urgent health problem for all nations due to the unstoppable trend of an ageing and obese population. Due to the rapid development of micro total analysis systems (μTAS) and nanotechnology in recent years, they will play an important role in the diagnosis, management, and therapy of cardiovascular diseases. It is envisaged that the micro and nanotechnologies developed for treating other diseases shall be explored for cardiovascular applications to reduce the research effort required for commercializing the devices and drugs to meet the increasing demand of the cardiovascular patients.

Investigation of the postcure reaction and surface energy of epoxy resins using time-of-flight secondary ion mass spectrometry and contact-angle measurements

Time-of-flight secondary ion mass spectrometry (ToF-SIMS) was used to investigate correlations between the molecular changes and postcuring reaction on the surface of a diglycidyl ether of bisphenol A and diglycidylether of bisphenol F based epoxy resin cured with two different amine-based hardeners. The aim of this work was to present a proof of concept that ToF-SIMS has the ability to provide information regarding the reaction steps, path, and mechanism for organic reactions in general and for epoxy resin curing and postcuring reactions in particular. Contact-angle measurements were taken for the cured and postcured epoxy resins to correlate changes in the surface energy with the molecular structure of the surface. Principal components analysis (PCA) of the ToFSIMS positive spectra explained the variance in the molecular information, which was related to the resin curing and postcuring reactions with different hardeners and to the surface energy values. The first principal component captured information related to the chemical phenomena of the curing reaction path, branching, and network density based on changes in the relative ion density of the aliphatic hydrocarbon and the C₇H₇O⁺ positive ions. The second principal component captured information related to the difference in the surface energy, which was correlated to the difference in the relative intensity of the C_xH_yN_z⁺ ions of the samples. PCA of the negative spectra provided insight into the extent of consumption of the hardener molecules in the curing and postcuring reactions of both systems based on the relative ion intensity of the nitrogen-containing negative ions and showed molecular correlations with the sample surface energy.

Women as carers of alcoholic and drug addicted men

This article looks at some of the experiences of women who care for alcoholic and drug addicted men. Through biographical interviews it describes how this group of women has dealt with the problems which women have to confront in the face of difficulties with the health and welfare systems, as well as their own expectations of what it means to be good wives and partners in very stressful situations. The article argues that the normative expectations of women as wives and mothers is to care for families, and while there is now an extensive literature on women's caring, the group of women described in these pages is generally ignored by this same literature.

Reporting of the ACT heroin trials

The aim of this research is to analyse the reports of the proposed heroin maintenance trials in the Australian Capital Territory (A.C.T.), in Melbourne print media during 1997. The proposal for trials of heroin-prescription to long-term users in the A.C.T. was based on extensive scientific research. The rejection of this proposal by Prime Minister Howard raised many questions. This study was designed to help understand what discourses and rhetorical devices were used in the reporting of heroin issues in the media and what part some sections of the media played in the government’s decision. Discourse analysis was conducted of newspaper articles from two major Melbourne newspapers, The Age and the Herald-Sun for the year 1997. All articles relating to heroin and drug-policy from the newspapers were included for analysis. Those in favour of the trials used predominantly health and social discourses. Those opposed used moral discourses supported with stereotypes, metaphors, emotive practices and ‘inaccuracies’. There were considerable differences in discourses presented by The Age and the Herald-Sun. This study demonstrates that opposition to the heroin trials relied on rhetorical strategies and sensationalistic arguments, rather than meaningful debate of scientific and social issues. Researchers should act to identify the stereotypes and metaphors used in the discourses surrounding an issue and act to disarm them.

Prediction of chlorine and THMs concentration profile in bulk drinking water distribution systems from laboratory data

Nearly all drinking water distribution systems experience a "natural" reduction of disinfection residuals. The most frequently used disinfectant is chlorine, which can decay due to reactions with organic and inorganic compounds in the water and by liquid/solids reaction with the biofilm, pipe walls and sediments. Usually levels of 0.2-0.5 mg/L of free chlorine are required at the point of consumption to maintain bacteriological safety. Higher concentrations are not desirable as they present the problems of taste and odour and increase formation of disinfection by-products. It is usually a considerable concern for the operators of drinking water distribution systems to manage chlorine residuals at the "optimum level", considering all these issues. This paper describes how the chlorine profile in a drinking water distribution system can be modelled and optimised on the basis of readily and inexpensively available laboratory data. Methods are presented for deriving the laboratory data, fitting a chlorine decay model of bulk water to the data and applying the model, in conjunction with a simplified hydraulic model, to obtain the chlorine profile in a distribution system at steady flow conditions. Two case studies are used to demonstrate the utility of the technique. Melbourne's Greenvale-Sydenham distribution system is unfiltered and uses chlorination as its only treatment. The chlorine model developed from laboratory data was applied to the whole system and the chlorine profile was shown to be accurately simulated. Biofilm was not found to critically affect chlorine decay. In the other case study, Sydney Water's Nepean system was modelled from limited hydraulic data. Chlorine decay and trihalomethane (THM) formation in raw and treated water were measured in a laboratory, and a chlorine decay and THM model was derived on the basis of these data. Simulated chlorine and THM profiles agree well with the measured values available. Various applications of this modelling approach are also briefly discussed.

Prediction of chlorine and trihalomethanes concentration profile in bulk drinking water distribution systems from laboratory data

Nearly all drinking water distribution systems experience a "natural" reduction of disinfection residuals. The most frequently used disinfectant is chlorine, which can decay due to reactions with organic and inorganic compounds in the water and by liquid/solids reaction with the biofilm, pipe walls and sediments. Usually levels of 0.2-0.5 mg/L of free chlorine are required at the point of consumption to maintain bacteriological safety. Higher concentrations are not desirable as they present the problems of taste and odour and increase formation of disinfection by-products. It is usually a considerable concern for the operators of drinking water distribution systems to manage chlorine residuals at the "optimum level", considering all these issues. This paper describes how the chlorine profile in a drinking water distribution system can be modelled and optimised on the basis of readily and inexpensively available laboratory data. Methods are presented for deriving the laboratory data, fitting a chlorine decay model of bulk water to the data and applying the model, in conjunction with a simplified hydraulic model, to obtain the chlorine profile in a distribution system at steady flow conditions. Two case studies are used to demonstrate the utility of the technique. Melbourne's Greenvale-Sydenham distribution system is unfiltered and uses chlorination as its only treatment. The chlorine model developed from laboratory data was applied to the whole system and the chlorine profile was shown to be accurately simulated. Biofilm was not found to critically affect chlorine decay. In the other case study, Sydney Water's Nepean system was modelled from limited hydraulic data. Chlorine decay and trihalomethane (THM) formation in raw and treated water were measured in a laboratory, and a chlorine decay and THM model was derived on the basis of these data. Simulated chlorine and THM profiles agree well with the measured values available. Various applications of this modelling approach are also briefly discussed.

Evaluation of chlorine decay kinetics expressions for drinking water distribution systems modelling

The decay of chlorine in drinking water involves a complex set of reactions that is usually simplified to first order kinetics in models of water quality in distribution systems. However, to be useful in optimising chlorine dosing regimes, the kinetics expression should accurately describe the shape of the chlorine decay curve for different chlorine doses and be able to simulate re-chlorination. After considering the nature of the reactions involved in chlorine decay, five simplified reaction schemes were evaluated for their suitability to describe chlorine concentration in bulk water. Each scheme was fitted to a sample of experimental data of chlorine decay in raw water obtained from Warragamba Dam (the major source of water supplied to Sydney, Australia). A scheme involving two parallel reactions of organic carbon compounds with chlorine is both necessary and sufficient to satisfy the requirements of modelling chlorine decay accurately.

Contextualising psychological distress among regular ecstasy users : the importance of sociodemographic factors and patterns of drug use

Introduction and Aims. Considerable concern has been raised about associations between ecstasy use and mental health. Studies of ecstasy users typically investigate varying levels of lifetime use of ecstasy, and often fail to account for other drug use and sociodemographic characteristics of participants, which may explain mixed findings. The current study aimed to examine the relationship between patterns of recent (last six months) ecstasy use and psychological distress among current, regular ecstasy users, controlling for sociodemographic risk factors and patterns of other drug use.

Design and Methods. Data were collected from regular ecstasy users (n = 752) recruited from each capital city in Australia as part of the Ecstasy and related Drugs Reporting System (EDRS). Psychological distress was assessed using the Kessler Psychological Distress Scale (K10). Data were analysed using multinomial logistic regression.

Results. Seven per cent of the sample scored in the ‘high’ distress category and 55% in the ‘medium’ distress category. Patterns of ecstasy use were not independently associated with psychological distress. The strongest predictors of distress were female sex, lower education, unemployment, ‘binge’ drug use including ecstasy (use for >48 h without sleep), frequent cannabis use and daily tobacco use.

Discussion and Conclusions. Regular ecstasy users have elevated levels of psychological distress compared with the general population; however, ecstasy use per se was not independently related to such distress. Other factors, including sociodemographic characteristics and other drug use patterns, appear to be more important. These findings highlight the importance of targeting patterns of polydrug use in order to reduce drug-related harm among regular ecstasy users