Sustained low-efficiency dialysis with filtration (SLEDD-f) in the management of acute sodium valproate intoxication

Hemodialysis is only infrequently used in drug overdosage situations. The efficacy of hemodialysis to remove the drug depends upon the pharmacokinetics and pharmacodynamics of the drug. At normal therapeutic concentrations, valproic acid is predominantly protein bound and therefore removal by hemodialysis is limited. In an overdose situation, protein binding is rapidly saturated and therefore the substantially larger quantities of the free drug can rapidly cause toxicity. Slow low-efficient daily diafiltration (SLEDD) has not previously been utilized in a drug overdose situation. We report the effective use of SLEDD to remove high toxic concentrations of valproic acid in an overdose situation. Slow low-efficient daily diafiltration also prevented the rebound phenomenon that can occur as the excess drug is released from its protein-bound stores. Hybrid dialysis therapies deserve further evaluation in the management of other poisonings where extra-corporeal therapy is indicated.

Groin injecting in injectable opioid treatment service users in South London

Femoral (or groin) injecting is an emerging public health challenge to all drug-related services within the UK. Recent work in the area has proposed that groin injecting in the UK has moved from being a ‘risk boundary’ to an ‘acceptable behaviour’. This article uses data from 10 in-depth qualitative interviews with service users from a supervised injectable opiate treatment service in South London to report on pathways to, and reasons for, groin injecting. Our findings indicate that even though groin injecting constitutes a risk boundary for some injectors, the practice is no longer heavily stigmatised and is perceived by some to be an acceptable risk. Narratives also pointed to the importance of peers in the initiation of groin injecting. Interviewees described the groin as a site of ‘last resort’ in contrast to ‘convenience’ groin injectors described in some previous research. We conclude that it might be helpful to distinguish between convenience and last resort groin injectors and support the call for innovative interventions which aim to reduce modelling of groin injection and which promote social norms supportive of using peripheral injecting sites.

Multi-level virtual ring : a foundation network architecture to support peer-to-peer application in wireless sensor network

Two main problems prevent the deployment of peer-to-peer application in a wireless sensor network: the index table, which should be distributed stored rather than uses a central server as the director; the unique node identifier, which cannot use the global addresses. This paper presents a multi-level virtual ring (MVR) structure to solve these two problems.

The index table in MVR is distributed stored by using the DHT technique. MVR is constructed decentralized and runs on mobile nodes themselves, requiring no central server or interruption. Naming system in MVR uses natural names rather than global addresses to identify sensor nodes. The MVR can route directly on the name identifiers of the sensor nodes without being aware the location. Some sensor nodes are selected as the backbone nodes by the backbone selection algorithm and are placed on the different levels of the virtual rings. MVR hashes nodes’ identifiers on the virtual ring, and stores them at the backbone nodes. Furthermore, MVR adopts cross-level routing to improve the routing efficiency.

Experiments using ns2 simulator for up to 200 nodes show that the storage and bandwidth requirements of MVR grow slowly with the size of the network. Furthermore, MVR has demonstrated as self-administrating, fault-tolerant, and resilient under the different workloads.

Psychometric properties of the DASS-21 in Malaysia

The use of scales to measure constructs in populations or contexts other than that in which they were normed is highly controversial. Despite this, the use of scales without reference to 'local' norms is still widespread. In this study we examine the reliability, factor structure and convergent validity of the short form of the Depression, Anxiety and Stress Scales (DASS-21), in a convenience sample of 191 people recruited from the general population in Malaysia. Confirmatory factor analysis suggests that a three factor solution provides an acceptable fit, however these three factors are highly correlated. Scores on the depression, anxiety, and stress scales of the DASS-21 correlate with the BDI-II at only moderate levels, suggesting that convergent validity of the depression scale is weak, and that there are not differential relationships between the BDI-II and the three DASS scales. Issues related to the possible role of cultural factors in response patterns, and the need for a greater understanding of the manifestations of psychological distress and how it relates the DASS-21 scales in Malaysia are discussed.

Entrepreneurship and mass media : audiences' perceptions of entrepreneurship stories in mass media

Using a set ofvariables measured in the Danish population survey related to the international Global Entrepreneurship Monitor project (GEM), this study explored what influences how people perceive stories about entrepreneurship in mass media. It was found that demographics influence how people perceived entrepreneurship stores, whereas social stratifications had no influence. Further on, the findings revealed a reinforcing effect from entrepreneurship stories in mass media. People already engaged in entrepreneurship perceived media stories differently from people not engaged, and people’s existing values were also reinforced. Together, these findings provide some crucial implications for policy initiatives trying to promote entrepreneurship. First, such initiatives need to consider who the actual targets are as different people decode and perceive the same messages differently. Second, such initiatives have to be longitudinal and long termed in order to function through more influential agencies like family, peer group, school, occupational group and so forth, and not only through the mass media as secondary socialisation.

Piggyback hunting-browsing the internet in Australia via unsecured wireless networks : virtual theft or acceptable behaviour in an online world?

In a world that is increasingly dominated by the Internet, there is a growing demand for low cost access at the users convenience. The expansion of wireless Internet networks, in particular unsecured wireless Internet networks, gives rise to novel challenges for the regulation of Internet access. The ability to access unsecured wireless Internet networks with ease and with very little impact upon the owner of the network suggests that such 'piggybacking' may be criminal behaviour or may amount to an actionable civil wrong. This paper will explore the legal ramifications of piggybacking an unsecured wireless network with knowledge that there is no entitlement to the use of the network and will consider what Australian authorities should do about this situation. This paper will look at the position in Australia and juxtapose this with that of the United Kingdom and the United States of America. In both the United Kingdom and the United States of America prosecutions have taken place of individuals who knowingly accessed unsecured wireless
networks for their own personal use.

Improving the quality of diabetes care in general practice

Objective: The evidence treatment gap for patients with type 2 diabetes.
Design: A summary of convenience sample of seven general practices.
Setting: Metropolitan and rural Victoria, Australia.
Participants: 561 patients of general practices (75% from rural general practices).
Main outcome measures: Demographic data, duration of diabetes, diabetes complications, HbA1c and lipid levels, blood pressure and score on PHQ-9.
Results: Patients with depression show more severe, progressive and intensively treated diabetes. The prevalence of depression in diabetes is about twice that of the general population.
Conclusion: Australian guidelines for diabetes should recommend screening for depression.

Self-concept clarity and women's sexual well-being

The purpose of this study was to examine the role of self-concept clarity, a core structural aspect of self-concept, in women's sexual well-being. A convenience sample of 261 women aged 18 years and over {M=25.8, £D=7.9) completed an online survey that measured self-concept clarity, three aspects of sexual well-being (sexual self-efñcacy, sexual self-esteem and sexual satisfaction), and four structural dimensions of sexual identity (commitment, synthesis/integration, exploration, and orientation identity uncertainty). A series of multiple mediation analyses, followed by post-hoc bootstrap tests of the difference between mediation effects, revealed that self-concept clarity is indirectly related to the measures of sexual well-being, and that these relationships are mediated by the two "investment-related" dimensions of sexual identity: commitment and synthesis/integration. These results suggest that women with a more broadly and coherently integrated sexual identity are also better able to make healthy and positive choices in the sexual domain and experience more satisfaction with their sex lives, i^ore generally, the results highlight the potential importance of including structural aspects of self-concept in explanations of women's sexual well-being.

Why do some socioeconomically disadvantaged women eat better than others? An investigation of the personal, social and environmental correlates of fruit and vegetable consumption

The purpose of this paper was to examine the contribution of individual, social and environmental factors to predicting fruit and vegetable consumption among women of low socioeconomic position (SEP). An Australian community sample of 355 women of low SEP provided survey data on sociodemographic information, diet (fruit and vegetable consumption), and various cognitive, behavioural, social and perceived environmental influences on healthy eating. Information on the availability and accessibility of major chain supermarkets and fruit and vegetable stores from participant's residence was collected through objective audits. Women who were older, dieting to lose weight, had a greater taste preference for fruit and perceived the cost of fruit to be lower were more likely to be high fruit consumers. Women who had a high BMI were more likely to be high vegetable consumers. Women who perceived a greater availability of healthy foods in their neighbourhoods were more likely to be high fruit and vegetable consumers. Strategies aimed at increasing fruit and vegetable consumption among low SEP women should focus on modifying perceptions about the cost, availability and taste of fruits and vegetables. Tailoring nutrition interventions to accommodate differences in age, weight-control practices and weight status may also prove beneficial.

Trends in food and nutritional intakes of French adults from 1999 to 2007 : results from the INCA surveys

Two independent cross-sectional dietary surveys (the Individual and National Food Consumption Surveys, INCA), performed in 1998–99 (INCA1) and in 2006–07 (INCA2) on nationally representative samples of French people, were used to analyse trends in the dietary habits and nutritional intake of French adults. Food consumption was recorded through 7-d dietary records, and nutritional intakes were assessed using the French food composition database. After exclusion of under-reporters, analyses were performed on 3267 adults, aged 18–79 years: 1345 from INCA1 and 1922 from INCA2. The trends highlighted over the 8-year period showed a decrease in consumption of dairy products, meat, bread, potatoes, pastries/croissant-like pastries/cakes/biscuits and sugar/confectionery. In contrast, the consumption of fruits and vegetables, rice, ice cream and chocolate increased. Other food groups, like fish and snacking foods, remained stable. Food choices were mostly age specific. These age differences remained consistent over the years and underlined two opposite dietary trends: a ‘traditional’ one mainly followed by the elderly, and a ‘snacking and convenience’ one mainly adopted by young adults. The overall trends in food consumption did not influence the mean energy intake, but did slightly modify the contribution of each macronutrient to energy intake. These repeated surveys highlighted the fact that trends in French food habits have moved towards an average European diet at the crossroads between Mediterranean and Northern diets, and that food consumption changes impacted, to a lesser extent, nutritional intake.

Occupational therapy students' attitudes towards inclusion education in Australia, United Kingdom, United States and Taiwan

This international, cross-cultural study investigated the attitudes of occupational therapy students from Australia, United Kingdom, United States and Taiwan towards inclusive education for students with disabilities. The possible impact of professional education on students' attitudes was also explored. A total of 485 students from 11 entry level occupational therapy education programmes from Australia, the United Kingdom, the United Sates and Taiwan participated in the study. Among them, 264 were freshmen (first-year students) and 221 were seniors (final-year students). Data collected from a custom-designed questionnaire were analysed both quantitatively and qualitatively.

In general, the occupational therapy students reported having positive attitudes towards inclusion. Considerable differences, however, existed among the student groups from the four countries. Professional education appeared to have a significant impact on students' attitudes towards inclusion from first year to senior year. Although students were in favour of inclusion, they also cautioned that their support for inclusive practices depended on various factors such as adequate preparation, support and assistance to students with disabilities.

Limitations of the study included the small, convenience sample and different degree structures of the participating programmes. Future research studies need to compare occupational therapy students' attitudes with students from other health care professions. A longitudinal study on the impact of the professional education programme on students' attitudes towards inclusive education is warranted.

Play and cultural transition

In many countries, early childhood educators have to confront the issue of how to assist immigrant children adapt to life in a new context. For example, in 2007-08, 44 771 children aged 0- 14 years old came to Australia with their familes to start life afresh (Australian Government 2009). Countries need to put into place policies and Practices that minimise the dislocation that immigrant families and their children face. Knowledge of what other countries are doing to educationally support immigrant children can assist professionals to better understand what is sound practice and what should be avoided. This chapter discusses some of the identified immigration issues of a small sample of Chinese children who have PMR parents/caregivers in Hong Kong. This chapter also examines how the
role of play in early childhood settings can help immigrant children adjust to their new teaching and learning context. Seven early childhood teachers and the principal of a local childcare centre were invited to participate in a small scalc study that is reported on in this chapter. Using convenience sampling, interviews were conducted for qualitative data collection.

Lipid composition of Australian pork cuts 2005/2006

A study of the cholesterol content and fatty acid composition of fresh retail Australian pork was undertaken to determine whether new breeding, feeding and processing methods had resulted in any compositional changes in fresh pork in the market place since surveys undertaken in previous decades. Samples of 13 popular pork cuts were purchased from randomly selected supermarkets and butchers’ stores in urban areas across the socioeconomic scale in three States of Australia, and analysed, separable fat and separable lean, in late 2005 and early 2006. Variability was low across States for saturated and monounsaturated fatty acids, but more pronounced for polyunsaturated acids. The separable lean portions of all pork cuts contained levels of n-3 fatty acids and conjugated linoleic acid (C18:1c9t11) in measurable but not nutritionally claimable amounts, whilst total trans fatty acid levels were very low. There appeared to be some differences in fatty acid composition across States that may have resulted from feeding method. Cholesterol contents were similar to levels in the 80s and 90s for separable lean pork tissue, but presently are lower for separable fat tissue than for separable lean.

Potential applications of discrete-event simulation and fuzzy rule-based systems to structural reliability and availability

This chapter discusses and illustrates some potential applications of discrete-event simulation (DES) techniques in structural reliability and availability analysis, emphasizing the convenience of using probabilistic approaches in modern building and civil engineering practices. After reviewing existing literature on the topic, some advantages of probabilistic techniques over analytical ones are highlighted. Then, we introduce a general framework for performing structural reliability and availability analysis through DES. Our methodology proposes the use of statistical distributions and techniques – such as survival analysis – to model component-level reliability. Then, using failure- and repair-time distributions and information about the structural logical topology (which allows determination of the structural state from their components’ state), structural reliability, and availability information can be inferred. Two numerical examples illustrate some potential applications of the proposed methodology to achieving more reliable and structural designs. Finally, an alternative approach to model uncertainty at component level is also introduced as ongoing work. This new approach is based on the use of fuzzy rule-based systems and it allows the introduction of experts’ opinions and evaluations in our methodology.

Australian farmers' and food processors' values

Purpose – The aim of this exploratory study was to examine and compare a range of business values held by farmers and food processors.

Design/methodology/approach – Questionnaires with a section on business values were posted to 200 farmers and 200 food processing businesses in Victoria, Australia, with response rates of 44 per cent (n=69) and 31 per cent (n=48), respectively, achieved.

Findings – The most important of the 28 value items for farmers were high quality produce, honesty, and caring for employees. For processors, the most important values were quality products, customer value, and caring for employees. Between group differences reached statistical significance for one-third of the items. In particular, processor businesses valued innovation and convenience products more highly and had a stronger process orientation than did farming businesses. Environmental sustainability, caring for the community, and providing healthy products were more integral to farming than processing businesses.

Research limitations/implications – The main limitation was the small sample sizes, although it is likely that response bias was not high. Future research could survey a larger sample of food industry representatives and examine the values held by other food industry sectors.

Practical implications – This information could increase the effectiveness of communications with industry groups on a range of issues and in the formulation of appropriate health and environmental policies.

Originality/value – To the authors' knowledge, this is the first study to compare the values of farmers and food processors. This information is particularly important for those in the food industry and health and environmental policy makers.