Practice Links [Issue 52, April 2013]

Practice Links is a free e-publication for practitioners working in Irish social services, voluntary and nongovernmental sectors. Practice Links was created to enable practitioners to keep up-to-date with new publications, electronic resources and conference opportunities. Issue 52 contains reviews on publications covering Irish adoption stories, hospital to home discharge planning, cyber technology for social workers and meeting the service needs of young care-leavers.

Explanatory Model for the Use of Traditional Medicines in Kilimanjaro, Tanzania

Introduction: Traditional medicines are one of the most important means of achieving total health care coverage globally, and their importance in Tanzania extends beyond the impoverished rural areas. Their use remains high even in urban settings among the educated middle and upper classes. They are a critical component healthcare in Tanzania, but they also can have harmful side effects. Therefore we sought to understand the decision-making and reasoning processes by building an explanatory model for the use of traditional medicines in Tanzania.

Methods: We conducted a mixed-methods study between December 2013 and June 2014 in the Kilimanjaro Region of Tanzania. Using purposive sampling methods, we conducted focus group discussions (FGDs) and in-depth interviews of key informants, and the qualitative data were analyzed using an inductive Framework Method. A structured survey was created, piloted, and then administered it to a random sample of adults. We reported upon the reliability and validity of the structured survey, and we used triangulation from multiple sources to synthesize the qualitative and quantitative data.

Results: A total of five FGDs composed of 59 participants and 27 in-depth interviews were conducted in total. 16 of the in-depth interviews were with self-described traditional practitioners or herbal vendors. We identified five major thematic categories that relate to the decision to use traditional medicines in Kilimanjaro: healthcare delivery, disease understanding, credibility of the traditional practices, health status, and strong cultural beliefs.

A total of 473 participants (24.1% male) completed the structured survey. The most common reasons for taking traditional medicines were that they are more affordable (14%, 12.0-16.0), failure of hospital medicines (13%, 11.1-15.0), they work better (12%, 10.7-14.4), they are easier

to obtain (11%, 9.48-13.1), they are found naturally or free (8%, 6.56-9.68), hospital medicines have too many chemical (8%, 6.33-9.40), and they have fewer side effects (8%, 6.25-9.30). The most common uses of traditional medicines were for symptomatic conditions (42%), chronic diseases (14%), reproductive problems (11%), and malaria and febrile illnesses (10%). Participants currently taking hospital medicines for chronic conditions were nearly twice as likely to report traditional medicines usage in the past year (RR 1.97, p=0.05).

Conclusions: We built broad explanatory model for the use of traditional medicines in Kilimanjaro. The use of traditional medicines is not limited to rural or low socioeconomic populations and concurrent use of traditional medicines and biomedicine is high with frequent ethnomedical doctor shopping. Our model provides a working framework for understanding the complex interactions between biomedicine and traditional medicine. Future disease management and treatment programs will benefit from this understanding, and it can lead to synergistic policies with more effective implementation.

A comparison of two zooplankton time series data collected in the Gulf of Maine

Interannual and seasonal trends of zooplankton abundance and species composition were compared between the Bongo net and Continuous Plankton Recorder (CPR) time series in the Gulf of Maine. Data from 5799 Bongo and 3118 CPR samples were compared from the years 1978–2006. The two programs use different sampling methods, with the Bongo time series composed of bimonthly vertically integrated samples from locations throughout the region, while the CPR was towed monthly at 10 m depth on a transect that bisects the region. It was found that there was a significant correlation between the interannual (r = 0.67, P < 0.01) and seasonal (r = 0.95, P < 0.01) variability of total zooplankton counts. Abundance rankings of individual taxa were highly correlated and temporal trends of dominant copepods were similar between samplers. Multivariate analysis also showed that both time series equally detected major shifts in community structure through time. However, absolute abundance levels were higher in the Bongo and temporal patterns for many of the less abundant taxa groups were not similar between the two devices. The different mesh sizes of the samplers probably caused some of the discrepancies; but diel migration patterns, damage to soft bodied animals and avoidance of the small CPR aperture by some taxa likely contributed to the catch differences between the two devices. Nonetheless, Bongo data presented here confirm the previously published patterns found in the CPR data set, and both show that the abundance increase of the 1990s has been followed by average to below average levels from 2002 to 06.

Assessing abundance and diversity patterns of soil microarthropod assemblages in northern Victoria Land (Antarctica)

This study aimed to: (1) assess differences between two quantitative sampling methods of soil microarthropods (visual census vs. stone washing) in ice-free areas located along a latitudinal gradient (from 72 degrees 37'S to 74 degrees 42'S) in northern Victoria Land (Antarctica); (2) furnish preliminary results on the abundance and diversity of mites and springtails in the studied areas. Visual census yielded reliable density estimates for adult collembolans and larger prostigmatic mites but did not detect small species. The study updates the distribution of several mites, including the southernmost record of an Oribatida species at global scale. Species composition was correlated with latitude but the uneven abundance distribution and local high beta-diversity probably reflect habitat fragmentation and population isolation. Under this circumstance nested sampling design should be usefully employed. Priorities and suitable methods for studying terrestrial microarthropod communities in continental Antarctica are discussed.

The positive impact of cytological specimens for EGFR mutation testing in non-small cell lung cancer:a single South East Asian laboratory's analysis of 670 cases

To compare the rejection rates of non-small cell lung cancer (NSCLC) samples obtained by differing sampling methods for testing by Sanger sequencing for epidermal growth factor receptor (EGFR) mutations. To assess the association between unsatisfactory outcomes and the quantity of DNA extracted from cytological versus histological samples.

Paediatricians' opinions of microneedle-mediated monitoring: a key stage in the translation of microneedle technology from laboratory into clinical practice

Microneedle (MN) arrays could offer an alternative method to traditional drug delivery and blood sampling methods. However, acceptance among key end-users is critical for new technologies to succeed. MNs have been advocated for use in children and so, paediatricians are key potential end-users. However, the opinions of paediatricians on MN use have been previously unexplored. The aim of this study was to investigate the views of UK paediatricians on the use of MN technology within neonatal and paediatric care. An online survey was developed and distributed among UK paediatricians to gain their opinions of MN technology and its use in the neonatal and paediatric care settings, particularly for MN-mediated monitoring. A total of 145 responses were obtained, with a completion response rate of 13.7 %. Respondents believed an alternative monitoring technique to blood sampling in children was required. Furthermore, 83 % of paediatricians believed there was a particular need in premature neonates. Overall, this potential end-user group approved of the MN technology and a MN-mediated monitoring approach. Minimal pain and the perceived ease of use were important elements in gaining favour. Concerns included the need for confirmation of correct application and the potential for skin irritation. The findings of this study provide an initial indication of MN acceptability among a key potential end-user group. Furthermore, the concerns identified present a challenge to those working within the MN field to provide solutions to further improve this technology. The work strengthens the rationale behind MN technology and facilitates the translation of MN technology from lab bench into the clinical setting.

Interactions of cetaceans with Spanish and Portuguese fisheries in Atlantic waters : costs, benefits and implications for management

With the aim to provide new insights into operational cetacean-fishery interactions in Atlantic waters, this thesis assesses interactions of cetaceans with Spanish and Portuguese fishing vessels operating in Iberian and South West Atlantic waters. Different opportunistic research methodologies were applied, including an interview survey with fishers (mainly skippers) and onboard observations by fisheries observers and skippers, to describe different types of interactions and to identify potential hotspots for cetacean-fishery interactions and the cetacean species most involved, and to quantify the extent and the consequences of these interactions in terms of benefits and costs for cetaceans and fisheries. In addition, the suitability of different mitigation strategies was evaluated and discussed. The results of this work indicate that cetaceans interact frequently with Spanish and Portuguese fishing vessels, sometimes in a beneficial way (e.g. cetaceans indicate fish schools in purse seine fisheries), but mostly with negative consequences (depredation on catch, gear damage and cetacean bycatch). Significant economic loss and high bycatch rates are, however, only reported for certain fisheries and associated with particular cetacean species. In Galician fisheries, substantial economic loss was reported as a result of bottlenose dolphins damaging artisanal coastal gillnets, while high catch loss may arise from common dolphins scattering fish in purse seine fisheries. High cetacean bycatch mortality arises in trawl fisheries, mainly of common dolphin and particularly during trawling in water depths below 350 m, and in coastal set gillnet fisheries (mainly common and bottlenose dolphins). In large-scale bottom-set longline fisheries in South West Atlantic waters, sperm whales may significantly reduce catch rates through depredation on catch. The high diversity of cetacean-fishery interactions observed in the study area indicates that case-specific management strategies are needed to reduce negative impacts on fisheries and cetaceans. Acoustic deterrent devices (pingers) may be used to prevent small cetaceans from approaching and getting entangled in purse seines and set gillnets, although possible problems include cetacean habituation to the pinger sounds, as well as negative side effects on non-target cetaceans (habitat exclusion) and fisheries target species (reduced catch rates). For sardine and horse mackerel, target species of Iberian Atlantic fisheries, no aversive reaction to pinger sounds was detected during tank experiments conducted in the scope of this thesis. Bycatch in trawls may be reduced by the implementation of time/area restrictions of fishing activity. In addition, the avoidance of fishing areas with high cetacean abundance combined with the minimization of fishery-specific sound cues that possibly attract cetaceans, may also help to decrease interactions. In large-scale bottom-set longline fisheries, cetacean depredation on catch may be reduced by covering hooked fish with net sleeves ("umbrellas") provided that catch rates are not negatively affected by this gear modification. Trap fishing, as an alternative fishing method to bottom-set gillnetting and longlining, also has the potential to reduce cetacean bycatch and depredation, given that fish catch rates are similar to the rates obtained by bottom-set gillnets and longlines, whereas cetacean by-catch is unlikely. Economic incentives, such as the eco-certification of dolphin-safe fishing methods, should be promoted in order to create an additional source of income for fishers negatively affected by interactions with cetaceans, which, in turn, may also increase fishers’ willingness to accept and adopt mitigation measures. Although the opportunistic sampling methods applied in this work have certain restrictions concerning their reliability and precision, the results are consistent with previous studies in the same area. Moreover, they allow for the active participation of fishers that can provide important complementary ecological and technical knowledge required for cetacean management and conservation.

Using a Bayesian model for bankruptcy prediction : a comparative approach

The purpose of this study is to examine the impact of the choice of cut-off points, sampling procedures, and the business cycle on the accuracy of bankruptcy prediction models. Misclassification can result in erroneous predictions leading to prohibitive costs to firms, investors and the economy. To test the impact of the choice of cut-off points and sampling procedures, three bankruptcy prediction models are assessed- Bayesian, Hazard and Mixed Logit. A salient feature of the study is that the analysis includes both parametric and nonparametric bankruptcy prediction models. A sample of firms from Lynn M. LoPucki Bankruptcy Research Database in the U. S. was used to evaluate the relative performance of the three models. The choice of a cut-off point and sampling procedures were found to affect the rankings of the various models. In general, the results indicate that the empirical cut-off point estimated from the training sample resulted in the lowest misclassification costs for all three models. Although the Hazard and Mixed Logit models resulted in lower costs of misclassification in the randomly selected samples, the Mixed Logit model did not perform as well across varying business-cycles. In general, the Hazard model has the highest predictive power. However, the higher predictive power of the Bayesian model, when the ratio of the cost of Type I errors to the cost of Type II errors is high, is relatively consistent across all sampling methods. Such an advantage of the Bayesian model may make it more attractive in the current economic environment. This study extends recent research comparing the performance of bankruptcy prediction models by identifying under what conditions a model performs better. It also allays a range of user groups, including auditors, shareholders, employees, suppliers, rating agencies, and creditors' concerns with respect to assessing failure risk.

Échantillonnage et modélisation de l’habitat des communautés de poissons de rivière des basses Laurentides

Plusieurs études à grande échelle ont identifié la modification ou la perte d’habitats comme menace principale à la conservation des communautés de poissons d’eau douce. Au Canada, « aucune perte nette dans la capacité productive des habitats » (NNL) est le principe directeur de la politique de gestion des habitats du ministère des Pêches et Océans. Le respect du NNL implique l’avancement des connaissances au niveau des relations entre les poissons et leurs habitats, de même que des outils pour quantifier l’impact de la modification des habitats sur les poissons. Les modèles d’utilisation de l’habitat des poissons (FHUM) sont des outils qui permettent d’améliorer nos connaissances des relations poissons – habitat, de prédire la distribution des espèces, mais aussi leurs densités, biomasses ou abondances, sur la base des caractéristiques de l’environnement. L’objectif général de mon mémoire est d’améliorer la performance des FHUM pour les rivières des basses Laurentides, en suggérant des perfectionnements au niveau de 2 aspects cruciaux de l’élaboration de tels modèles : la description précise de la communauté de poissons et l’utilisation de modèles statistiques efficaces. Dans un premier chapitre, j’évalue la performance relative de la pêcheuse électrique et de l’échantillonnage en visuel (plongée de surface) pour estimer les abondances des combinaisons d’espèces et de classes de taille des poissons en rivière. J’évalue aussi l’effet des conditions environnementales sur les différences potentielles entre les communautés observées par ces 2 méthodes d’échantillonnage. Pour ce faire, 10 sections de rivière de 20 m de longueur ont été échantillonnées à l’aide de ces 2 méthodes alors qu’elles étaient fermées par des filets de blocage. 3 plongeurs performèrent l’échantillonnage en visuel en se déplaçant de l’aval vers l’amont des sections, tout en dénombrant les espèces et classes de taille. Par la suite, nous avons fait 3 passages de pêcheuse électrique et les abondances furent estimées grâce à un modèle restreint de maximum de vraisemblance, basé sur la diminution des abondances observées. De plus grandes abondances de poissons furent observées en visuel qu’avec la pêcheuse électrique à tous les sites. La richesse spécifique observée en visuel était plus élevée (6/10) ou égale (4/10) à celle observée avec la pêcheuse électrique. Les différences entre les communautés de poissons observées à l’aide de ces 2 méthodes ne purent être reliées aux conditions environnementales. Les résultats de cette expérience sont contraires à ceux de toutes les études comparant ces 2 méthodes d’échantillonnage, lesquels suggèrent une supériorité de la pêcheuse électrique. Les conditions environnementales de notre expérience étaient distinctes de celles observées dans les autres études (absence d’arbres tombés dans l’eau, très peu de substrats grossiers), mais la différence la plus marquante était en terme de communauté de poissons observée (dominance des cyprinidés et des centrarchidés plutôt que des salmonidés). Je termine ce chapitre en suggérant que les caractéristiques comportementales favorisant l’évitement de la capture (formation de bancs) et facilitant l’observation en visuel (curiosité) sont responsables de la supériorité de la plongée de surface pour échantillonner les communautés dans les rivières des basses Laurentides. Dans un deuxième chapitre, je développe des FHUM pour des communautés de poissons de rivière ayant plusieurs espèces. Dans le but de simplifier la modélisation de telles communautés et d’améliorer notre compréhension des relations poissons – habitat, j’utilise les concepts de guilde écologique et de filtre environnemental pour explorer les relations entre les guildes formées sur la bases de différents types de traits (reproducteurs, taxonomiques, éco-morphologiques et alimentaires) et les conditions environnementales locales à l’échelle du méso-habitat. Les modèles d’habitats basés sur les guildes reproductrices ont clairement surpassé les autres modèles, parce que l’habitat de fraie reflète l’habitat de préférence en dehors de la période de reproduction. J’ai également utilisé l’approche inverse, c’est à dire définir des guildes d’utilisation de l’habitat et les mettre en relation avec les traits des espèces. Les traits reliés à l’alimentation des poissons ont semblés être les meilleurs pour expliquer l’appartenance aux groupes d’utilisation de l’habitat, mais le modèle utilisé ne représentait pas bien la relation entre les groupes. La validation de notre modèle basé sur les guildes reproductrices avec un jeu de données indépendant pourrait confirmer notre découverte, laquelle représente une manière prometteuse de modéliser les relations poissons – environnement dans des communautés de poissons complexes. En conclusion, mon mémoire suggère d’importantes améliorations aux FHUM pour les communautés de poissons des basses Laurentides, en suggérant de prendre en compte les caractéristiques biologiques des cours d’eau dans le choix d’une méthode d’échantillonnage, et également en utilisant une méthode prometteuse pour simplifier les FHUM de communautés de poissons complexes : les guildes reproductrices.

Développement d’une approche quantitative pour l’étude du poumon équin : fixation et échantillonnage pour l’application des principes de la stéréologie

La présente étude visait à développer un protocole de fixation et d'échantillonnage pour le poumon équin suivant les directives publiées sur l’utilisation d’une approche stéréologique de type « design-based ». Les poumons gauches de chevaux contrôles et atteints du souffle ont été fixés avec du formaldéhyde 10% pendant 48h à une pression constante de 25-30 cm d’H2O. Les poumons ont été sectionnés en 20-21 tranches d’une épaisseur d'environ 2,5 cm chacune; de 10-11 tranches ont été sélectionnées de façon aléatoire et systématique pour la mesure du volume de référence avec la méthode de Cavalieri. Un protocole d’échantillonnage systématique, aléatoire et uniforme utilisant le principe du « smooth fractionator » et un poinçon à biopsie de 17 mm ont été utilisés pour échantillonner une fraction représentative de chaque poumon. Les méthodes d’échantillonnage de sections verticales, uniformes et aléatoires (VUR) et d’échantillonnage isotropique, uniforme et aléatoire (IUR) ont toutes deux été effectuées pour comparer le nombre de voies respiratoires en coupe perpendiculaire obtenues à partir de chaque méthode. L'architecture globale et la qualité des tissus fixés ont également été évaluées. Des spécimens pulmonaires équins ont été échantillonnés avec succès selon un protocole visant à produire des données morphométriques valides. Les tissus ont été fixés avec un minimum d'artéfacts et contenaient une quantité suffisante de voies respiratoires en coupe perpendiculaire dans les deux types d’échantillons. En conclusion, un protocole de fixation et d'échantillonnage adapté au poumon équin permettant l'utilisation d'une approche stéréologique de type « design-based » a été élaboré pour l’étude du remodelage des voies respiratoires.

Contributions of local, lateral and contextual habitat variables to explaining variation in fisheries productivity metrics in the littoral zone of a reservoir

Puisque l’altération des habitats d’eau douce augmente, il devient critique d’identifier les composantes de l’habitat qui influencent les métriques de la productivité des pêcheries. Nous avons comparé la contribution relative de trois types de variables d’habitat à l’explication de la variance de métriques d’abondance, de biomasse et de richesse à l’aide de modèles d’habitat de poissons, et avons identifié les variables d’habitat les plus efficaces à expliquer ces variations. Au cours des étés 2012 et 2013, les communautés de poissons de 43 sites littoraux ont été échantillonnées dans le Lac du Bonnet, un réservoir dans le Sud-est du Manitoba (Canada). Sept scénarios d’échantillonnage, différant par l’engin de pêche, l’année et le moment de la journée, ont été utilisés pour estimer l’abondance, la biomasse et la richesse à chaque site, toutes espèces confondues. Trois types de variables d’habitat ont été évalués: des variables locales (à l’intérieur du site), des variables latérales (caractérisation de la berge) et des variables contextuelles (position relative à des attributs du paysage). Les variables d’habitat locales et contextuelles expliquaient en moyenne un total de 44 % (R2 ajusté) de la variation des métriques de la productivité des pêcheries, alors que les variables d’habitat latérales expliquaient seulement 2 % de la variation. Les variables les plus souvent significatives sont la couverture de macrophytes, la distance aux tributaires d’une largeur ≥ 50 m et la distance aux marais d’une superficie ≥ 100 000 m2, ce qui suggère que ces variables sont les plus efficaces à expliquer la variation des métriques de la productivité des pêcheries dans la zone littorale des réservoirs.

Evaluation of major feed resources in crop-livestock mixed farming systems, southern Ethiopia: Indigenous knowledge versus laboratory analysis results

Evaluation of major feed resources was conducted in four crop-livestock mixed farming systems of central southern Ethiopia, with 90 farmers, selected using multi-stage purposive and random sampling methods. Discussions were held with focused groups and key informants for vernacular name identification of feed, followed by feed sampling to analyse chemical composition (CP, ADF and NDF), in-vitro dry matter digestibility (IVDMD), and correlate with indigenous technical knowledge (ITK). Native pastures, crop residues (CR) and multi-purpose trees (MPT) are the major feed resources, demonstrated great variations in seasonality, chemical composition and IVDMD. The average CP, NDF and IVDMD values for grasses were 83.8 (ranged: 62.9–190), 619 (ranged: 357–877) and 572 (ranged: 317–743) g kg^(−1) DM, respectively. Likewise, the average CP, NDF and IVDMD for CR were 58 (ranged: 20–90), 760 (ranged: 340–931) and 461 (ranged: 285–637)g kg^(−1) DM, respectively. Generally, the MPT and non-conventional feeds (NCF, Ensete ventricosum and Ipomoea batatas) possessed higher CP (ranged: 155–164 g kg^(−1) DM) and IVDMD values (611–657 g kg^(−1) DM) while lower NDF (331–387 g kg^(−1) DM) and ADF (321–344 g kg^(−1) DM) values. The MPT and NCF were ranked as the best nutritious feeds by ITK while crop residues were the least. This study indicates that there are remarkable variations within and among forage resources in terms of chemical composition. There were also complementarities between ITK and feed laboratory results, and thus the ITK need to be taken into consideration in evaluation of local feed resources.

Experimental verification of suction sampler capture efficiency in grasslands of differing vegetation height and structure

1. Suction sampling is a popular method for the collection of quantitative data on grassland invertebrate populations, although there have been no detailed studies into the effectiveness of the method. 2. We investigate the effect of effort (duration and number of suction samples) and sward height on the efficiency of suction sampling of grassland beetle, true bug, planthopper and spider Populations. We also compare Suction sampling with an absolute sampling method based on the destructive removal of turfs. 3. Sampling for durations of 16 seconds was sufficient to collect 90% of all individuals and species of grassland beetles, with less time required for the true bugs, spiders and planthoppers. The number of samples required to collect 90% of the species was more variable, although in general 55 sub-samples was sufficient for all groups, except the true bugs. Increasing sward height had a negative effect on the capture efficiency of suction sampling. 4. The assemblage structure of beetles, planthoppers and spiders was independent of the sampling method (suction or absolute) used. 5. Synthesis and applications. In contrast to other sampling methods used in grassland habitats (e.g. sweep netting or pitfall trapping), suction sampling is an effective quantitative tool for the measurement of invertebrate diversity and assemblage structure providing sward height is included as a covariate. The effective sampling of beetles, true bugs, planthoppers and spiders altogether requires a minimum sampling effort of 110 sub-samples of duration of 16 seconds. Such sampling intensities can be adjusted depending on the taxa sampled, and we provide information to minimize sampling problems associated with this versatile technique. Suction sampling should remain an important component in the toolbox of experimental techniques used during both experimental and management sampling regimes within agroecosystems, grasslands or other low-lying vegetation types.

Measuring bee diversity in different European habitats and biogeographical regions

Bee pollinators are currently recorded with many different sampling methods. However, the relative performances of these methods have not been systematically evaluated and compared. In response to the strong need to record ongoing shifts in pollinator diversity and abundance, global and regional pollinator initiatives must adopt standardized sampling protocols when developing large-scale and long-term monitoring schemes. We systematically evaluated the performance of six sampling methods (observation plots, pan traps, standardized and variable transect walks, trap nests with reed internodes or paper tubes) that are commonly used across a wide range of geographical regions in Europe and in two habitat types (agricultural and seminatural). We focused on bees since they represent the most important pollinator group worldwide. Several characteristics of the methods were considered in order to evaluate their performance in assessing bee diversity: sample coverage, observed species richness, species richness estimators, collector biases (identified by subunit-based rarefaction curves), species composition of the samples, and the indication of overall bee species richness (estimated from combined total samples). The most efficient method in all geographical regions, in both the agricultural and seminatural habitats, was the pan trap method. It had the highest sample coverage, collected the highest number of species, showed negligible collector bias, detected similar species as the transect methods, and was the best indicator of overall bee species richness. The transect methods were also relatively efficient, but they had a significant collector bias. The observation plots showed poor performance. As trap nests are restricted to cavity-nesting bee species, they had a naturally low sample coverage. However, both trap nest types detected additional species that were not recorded by any of the other methods. For large-scale and long-term monitoring schemes with surveyors with different experience levels, we recommend pan traps as the most efficient, unbiased, and cost-effective method for sampling bee diversity. Trap nests with reed internodes could be used as a complementary sampling method to maximize the numbers of collected species. Transect walks are the principal method for detailed studies focusing on plant-pollinator associations. Moreover, they can be used in monitoring schemes after training the surveyors to standardize their collection skills.

Epidemic K-Means clustering

The K-Means algorithm for cluster analysis is one of the most influential and popular data mining methods. Its straightforward parallel formulation is well suited for distributed memory systems with reliable interconnection networks. However, in large-scale geographically distributed systems the straightforward parallel algorithm can be rendered useless by a single communication failure or high latency in communication paths. This work proposes a fully decentralised algorithm (Epidemic K-Means) which does not require global communication and is intrinsically fault tolerant. The proposed distributed K-Means algorithm provides a clustering solution which can approximate the solution of an ideal centralised algorithm over the aggregated data as closely as desired. A comparative performance analysis is carried out against the state of the art distributed K-Means algorithms based on sampling methods. The experimental analysis confirms that the proposed algorithm is a practical and accurate distributed K-Means implementation for networked systems of very large and extreme scale.