Aggressive surgical interventions for severe stroke: Impact on quality of life, caregiver burden and family outcomes

Introduction: Decompressive hemicraniectomy, clot evacuation, and aneurysmal interventions are considered aggressive surgical therapeutic options for treatment of massive cerebral artery infarction (MCA), intracerebral hemorrhage (ICH), and severe subarachnoid hemorrhage (SAH) respectively. Although these procedures are saving lives, little is actually known about the impact on outcomes other than short-term survival and functional status. The purpose of this study was to gain a better understanding of personal and social consequences of surviving these aggressive surgical interventions in order to aid acute care clinicians in helping family members make difficult decisions about undertaking such interventions. Methods: An exploratory mixed method study using a convergent parallel design was conducted to examine functional recovery (NIHSS, mRS & BI), cognitive status (Montreal Cognitive Assessment Scale, MoCA), quality of life (Euroqol 5-D), and caregiver outcomes (Bakas Caregiver Outcome Scale, BCOS) in a cohort of patients and families who had undergone aggressive surgical intervention for severe stroke between the years 2000–2007. Data were analyzed using descriptive statistics, univariate and multivariate analysis of variance, and multivariate logistic regression. Content analysis was used to analyze the qualitative interviews conducted with stroke survivors and family members. Results: Twenty-seven patients and 13 spouses participated in this study. Based on patient MOCA scores, overall cognitive status was 25.18 (range 23.4-26.9); current functional outcomes scores: NIHSS 2.22, mRS 1.74, and BI 88.5. EQ-5D scores revealed no significant differences between patients and caregivers (p=0.585) and caregiver outcomes revealed no significant differences between male/female caregivers or patient diagnostic group (MCA, SAH, ICH; p=""0.103).<"/span><"/span> Discussion: Overall, patients and families were satisfied with quality of life and decisions made at the time of the initial stroke. There was consensus among study participants that formal community-based support (e.g., handibus, caregiving relief, rehabilitation assessments) should be continued for extended periods (e.g., years) post-stroke. Ongoing contact with health care professionals is valuable to help them navigate in the community as needs change over time.

Perceptions on the causes of individual and fraudulent co-offending: Views of forensic accountants

Individual and/or co-offenders fraudulent activities can have a devastating effect on a company’s reputation and credibility. Enron, Xerox, WorldCom, HIH Insurance and One.Tel are examples where stakeholders incurred substantial financial losses as a result of fraud and led to a loss of confidence in corporate dealings by the public in general. There are numerous theoretical approaches that attempt to explain how and why fraudulent acts occur, drawing on the fields of sociology, organisational, management and economic literature, but there is limited empirical evidence published in accounting literature. This qualitative inductive study analyses perceptions and experiences of forensic accountants to gain insights into individual fraud and co-offending in order to determine whether the conceptual framework developed from literature accurately depicts the causes of fraud committed by individuals and groups in the twenty-first century. Findings from the study both support and extend the conceptual framework, demonstrating that strain and anomie can result in fraud, that deviant sub-groups recruit and coerce members by providing relief from strain, and that inadequate corporate governance mechanisms both contribute to fraud occurring, and provide the opportunity for fraudulent activities to be executed and often remain undetected. Additional factors emerging from this study (the ‘technoconomy’, addiction and IT measures) were also identified as contributors to fraud, particularly relevant to the twenty-first century, and consequently, a refined conceptual framework is presented in the discussion and conclusion to the paper.

Food security in welfare capitalism: Comparing social entitlements to food in Australia and Norway

The concept of food security is often anchored in popular understandings of the challenge to produce and supply enough food. However, decades of policies for intensive agriculture have not alleviated hunger and malnutrition, with an absence of food security featuring in both economically developing and developed nations. Despite perceptions that the economic growth in advanced, capitalist societies will ensure freedom from hunger, this is not universal across so-called ‘wealthy nations’. To explore the dynamics of food security in economically developed countries, this paper considers institutional approaches to domestic food security primarily through responses to poverty and welfare entitlements, and, secondarily, through food relief. Through the lens of social entitlements to food and their formation under various expressions of welfare capitalism, we highlight how the specific institutional settings of two economically developed nations, Australia and Norway, respond to uncertain or insufficient access to food. Whilst Norway's political agenda on agricultural support, food pricing regulation and universal social security support offers a robust, although indirect, safety net in ensuring entitlements to food, Australia's neoliberal trajectory means that approaches to food security are ad hoc and rely on a combination of self-help, charitable and market responses. Despite its extensive food production Australia appears less capable of ensuring food security for all its inhabitants compared to the highly import-dependent Norway.

Landscape painting

The images in this exhibition were based on questioning relationships between the histories of painting and photography, which helped to establish the indexical references that became both photography’s most powerful attribute and most subtle illusion. Debates over the objectivity or subjectivity of the photograph and the uneasy relationship between painting and photography, as played out in the history of art, have been brought into sharp relief with the contemporary proliferation of digital images. The digital realm of photography gives rise to a general and relative skepticism of verity, but it can be argued that to artist/photographers, this representational malleability is precisely what their purpose becomes. In researching current issues of the indexical in photographic practice, landscape provides a potent vehicle for exploring issues of representation and illusion, the nexus of painting and photography, and the digital realm. One of contemporary photography’s most resonant themes is a return to pictorial subjects and methods, including a renewed interest in floribunda, still life and landscape. The resulting deconstruction and reconstruction of landscape ‘painting’ in this body of work- the monochrome, linear abstraction, painterly representationalsism and pictorialist detail is presented as a perceptual, aesthetic and digital act. The exhibition incorporates landscape painting’s simplicity and complexity, photography’s significance of representation and minimalist aesthetics in an over-mediated world.

Biocontrol of Chromolaena odorata in Papua New Guinea

The status of biocontrol of Chromolaena odorata, a weed of significant agricultural importance in Papua New Guinea, is assessed. Chromolaena is confirmed present in 391 sites in 12 of the 20 provinces of PNG. A collaborative project on the biocontrol of chromolaena involving the PNG National Agricultural Research Institute and the Queensland Department of Primary Industries and Fisheries began in1998, with funding from ACIAR. Three agents, the moth Pareuchaetes pseudoinsulata, which has established only in Morobe Province, the stem-galling fly Cecidochares connexa, which has established in all 12 provinces and the leaf mining fly Calycomyza eupatorivora, which is currently being monitored for establishment, have been introduced. Cecidochares connexa has been the most effective of the agents so far and it has spread more than 100 km in five years from some release sites. Preliminary field data have shown that the numbers of galls per plant have increased, coupled with a decrease in plant height and percent plant cover. In parts of New Ireland and Sandaun provinces, C. connexa has controlled chromolaena, resulting in the regeneration of natural vegetation. In addition, some food gardens have been re-established where chromolaena had once taken over. Consequently, food production has increased and income generated from selling agricultural produce has increased two fold. There is also less time spent in clearing chromolaena from food gardens and plantations. The effectiveness of C. connexa has brought relief to many communities, which are helping in the distribution of the gall fly to other areas affected by chromolaena.

Reproduction of portrait of field chaplain Rabbi Dr. Sali Levi Military; World War I; Portraits

Feldrabbiner Dr. Sali Lewi, Breslau

Magnetic resonance microimaging of cancer cell spheroid constructs

BACKGROUND Hydrogel-based cell cultures are excellent tools for studying physiological events occurring in the growth and proliferation of cells, including cancer cells. Diffusion magnetic resonance is a physical technique that has been widely used for the characterisation of biological systems as well as hydrogels. In this work, we applied diffusion magnetic resonance imaging (MRI) to hydrogel-based cultures of human ovarian cancer cells. METHODS Diffusion-weighted spin-echo MRI measurements were used to obtain spatially-resolved maps of apparent diffusivities for hydrogel samples with different compositions, cell loads and drug (Taxol) treatment regimes. The samples were then characterised using their diffusivity histograms, mean diffusivities and the respective standard deviations, and pairwise Mann-Whitney tests. The elastic moduli of the samples were determined using mechanical compression testing. RESULTS The mean apparent diffusivity of the hydrogels was sensitive to the polymer content, cell load and Taxol treatment. For a given sample composition, the mean apparent diffusivity and the elastic modulus of the hydrogels exhibited a negative correlation. CONCLUSIONS Diffusivity of hydrogel-based cancer cell culture constructs is sensitive to both cell proliferation and Taxol treatment. This suggests that diffusion-weighted imaging is a promising technique for non-invasive monitoring of cancer cell proliferation in hydrogel-based, cellularly-sparse 3D cell cultures. The negative correlation between mean apparent diffusivity and elastic modulus suggests that the diffusion coefficient is indicative of the average density of the physical microenvironment within the hydrogel construct.

Genetic studies of body mass index yield new insights for obesity biology

Obesity is heritable and predisposes to many diseases. To understand the genetic basis of obesity better, here we conduct a genome-wide association study and Metabochip meta-analysis of body mass index (BMI), a measure commonly used to define obesity and assess adiposity, in up to 339,224 individuals. This analysis identifies 97 BMI-associated loci (P < 5 × 10−8), 56 of which are novel. Five loci demonstrate clear evidence of several independent association signals, and many loci have significant effects on other metabolic phenotypes. The 97 loci account for ~2.7% of BMI variation, and genome-wide estimates suggest that common variation accounts for >20% of BMI variation. Pathway analyses provide strong support for a role of the central nervous system in obesity susceptibility and implicate new genes and pathways, including those related to synaptic function, glutamate signalling, insulin secretion/action, energy metabolism, lipid biology and adipogenesis.

‘Lemon Laws’: an inquiry into consumer protections and remedies for buyers of new motor vehicles

1. Under the Terms of Reference for the Committee’s Inquiry, ‘lemons’ are defined as ‘new motor vehicles with numerous, severe defects that re-occur despite multiple repair attempts or where defects have caused a new motor vehicle to be out of service for a prolonged period of time’. Consumers are currently protected in relation to lemon purchases by the Australian Consumer Law (ACL) located in Schedule 2 of the Competition and Consumer Act 2010 (Cth) (CCA). The ACL applies as a law of Queensland pursuant to the Fair Trading Act 1989 (Qld). The voluntary recall and consumer guarantees law took effect on 1 January 2011. 2. In 2006, the Government of Victoria made a commitment to introduce a lemon law into the provisions of the then Fair Trading Act 1999 (Vic). The public consultation process on the proposal to introduce a lemon law for motor vehicle purchases in Victoria was conducted by Ms Janice Munt MP, with the assistance of Consumer Affairs Victoria (CAV). CAV released an Issues Paper to canvas with industry and the community options for the development and introduction of a motor vehicle lemon law.(Consumer Affairs Victoria, Introducing Victorian motor vehicle lemon laws, Issues Paper, (September, 2007). 3. A CAV report prepared by Janice Munt MP was released in July, 2008 (Consumer Affairs Victoria, Motor Cars: A report on the motor vehicle lemon law consultations (July 2008) (Victorian Lemon Law Report). However, the Victorian proposal was overtaken by events leading to the adoption of a uniform consumer protection law in all Australian jurisdictions, the ACL. 4. The structure of this submission is to consider first the three different bases upon which consumers can obtain relief for economic loss arising from defects in motor vehicles. The second part of the submission considers the difficulties encountered by consumers in litigating motor vehicle disputes in the courts and tribunals. The third part of the submission examines the approach taken in other jurisdictions to resolving motor vehicle disputes. The final part of the submission considers a number of possible reforms that could be made to the existing law and its enforcement to reduce consumer detriment arising from the purchase of ‘lemon’ motor vehicles. 5. There are three principal bases upon which a consumer can obtain redress for defects in new motor vehicles under the ACL. The first is where the manufacturer admits liability and initiates the voluntary recall procedure provided for in s 128 of the ACL. Under this basis the manufacturer generally repairs or replaces the part subject to the recall free of charge. The second basis is where the manufacturer or dealer denies liability and the consumer is initiates proceedings in the court or tribunal seeking a statutory remedy under the ACL, the nature of which will depend on whether the failure to comply with the consumer guarantee was major or not. The third basis upon which a consumer can obtain redress is pursuant to public enforcement by the ACCC. Each basis will be considered in this part. What all three bases have in common is the need to conduct an investigation to identify the nature of the defect and how it arose.

Bubble play

Observing peculiar entoptic phenomena relating to a large air bubble inside his eye provided a little comedy relief for Professor Nathan Efron during his otherwise taxing ophthalmic journey of retinopexy, cryopexy, vitrectomy and IOL surgery.

Portrait of Ya'akov Meir [Jacob Meyer], Head of the Rabbinical Court and President of the Consistorium of the Community of Strasbourg; France.

Caption: J. Meyer, Grand-Rabbin et President du Consistoire Israelite du Department du Bas-Rhin a Strasbourg; also translated in Hebrew

Israel Museum Jerusalem Coin

Obverse: Silver 5 Lirot coin. Replica of the capital and part of a pillar, of the 7th century BCE found at Ramat Rachel on the outskirts of Jerusalem. Reverse: A stylized relief of the buildings of Israeli Museum in Jerusalem.

Ernest W. Michel Papers, 1698, 1938-1996 (bulk 1946-1987)

This collection contains the papers of Ernest W. Michel, Holocaust Survivor Journalist and public speaker,including clippings of newspaper articles written by and about Michel, correspondence between Michel and many important Jewish and political figures and autograph files, which Michel collected. Many of these files concern Michel’s Holocaust experiences, speaking engagements, the World Gathering of Jewish Holocaust Survivors, and Michel’s work with the United Jewish Appeal.

Large-scale characterization of drought pattern: a continent-wide modelling approach applied to the Australian wheatbelt – spatial and temporal trends

* Plant response to drought is complex, so that traits adapted to a specific drought type can confer disadvantage in another drought type. Understanding which type(s) of drought to target is of prime importance for crop improvement. * Modelling was used to quantify seasonal drought patterns for a check variety across the Australian wheatbelt, using 123 yr of weather data for representative locations and managements. Two other genotypes were used to simulate the impact of maturity on drought pattern. * Four major environment types summarized the variability in drought pattern over time and space. Severe stress beginning before flowering was common (44% of occurrences), with (24%) or without (20%) relief during grain filling. High variability occurred from year to year, differing with geographical region. With few exceptions, all four environment types occurred in most seasons, for each location, management system and genotype. * Applications of such environment characterization are proposed to assist breeding and research to focus on germplasm, traits and genes of interest for target environments. The method was applied at a continental scale to highly variable environments and could be extended to other crops, to other drought-prone regions around the world, and to quantify potential changes in drought patterns under future climates.

Lod Commemorative Coin

Obverse: Front view of a plane, airport buildings, in the background relief of old buildings in the city. Reverse: City coin of Lod, minted at the beginn9ng of the third century CE by Emperor Caracalla, on the coin a head of Tyche (Fortune) looking to the left, she wears a crown representing city-walls and towers.