This Other Eden: Exploring a Sense of Place in Twentieth-Century Reconstructions of Australian Childhoods

This thesis explores the sense of place formed during childhood, as remembered by adult Australians who reconstruct their youth through various forms of life writing. While Australian writers do utilize traditional tropes of Western autobiography, such as the mythology of Eden and the Wordsworthian image of the child communing with Nature, these themes are frequently transformed to meet a uniquely Australian context. Isolation and distance from Europe, and the apparent indifference of our landscape towards white settlement, have received much critical attention in Australian studies generally and, indeed, broadly influence the formation of children’s sense of place across the continent. However, writers are also concerned with the role of place on a more local level. Through a comparison of writing from Western Australia, Queensland and Victoria, this thesis explores regional landscape preoccupations that create an awareness of local identity, variously contributing to or frustrating the child’s sense of belonging. Western Australian writing is dominated by images of isolation, the fragility of white settlement in a dry land lacking fresh water, and a pervasive beach culture. A strong sense of the littoral pervades writing from this region. Queensland’s frontier mythology is of a different flavour: warm and tropical, nature here is exuberant, constantly threatening to overwhelm culture, already perceived as transient due to the flimsy aspect of the “Queenslander” house. Writing from Victoria, to some extent, tends to more closely follow English models, juxtaposing country and city environments, although there is a distinctly local flavour to many representations of urban Melbourne and its flat, grid-like organization. As Australian society becomes more concentrated on the coastal fringe, the beach is an increasingly significant environment. Though more prominent in writing from some regions than others, coastal imagery broadly reflects the modern Australian’s sense of inhabiting a liminal zone with negotiable boundaries

Asymmetric thickness of the left ventricular wall resulting from asynchronous electric activation : a study in dogs with ventricular pacing and in patients with left bundle branch block

Various kinds of abnormal, asynchronous electric activation of the left ventricle (LV) decrease mechanical load in early versus late activated regions of the ventricular wall. Because myocardium usually adapts its mass to changes in workload, we investigated by echocardiography whether regional differences in wall thickness are present in two kinds of asynchronous electric activation of different origin and conduction pathway: epicardial ventricular pacing in dogs and left bundle branch block (LBBB) in patients. In six dogs, 3 months of epicardial LV pacing at physiologic heart rates decreased the thickness of the early activated anterior wall by 20.5 +/- 8.1% without significantly changing LV cavity area and septal thickness. In a retrospective study of 228 LBBB patients, the early activated septum was significantly thinner than the late activated posterior wall. The asymmetry most pronounced was as large as 10% in 28 patients with LBBB and paradoxic septal motion. No difference in regional wall thickness was present in 154 control patients. In conclusion, chronic asynchronous electric activation in the heart induces redistribution of cardiac mass. This redistribution occurs in hearts, which differ in impulse conduction pathway, disease, and species and is characterized by thinning of early versus late activated myocardium. [Journal Article; In English; United States

Asymmetric thickness of the left ventricular wall resulting from asynchronous electric activation : a study in dogs with ventricular pacing and in patients with left bundle branch block

Various kinds of abnormal, asynchronous electric activation of the left ventricle (LV) decrease mechanical load in early versus late activated regions of the ventricular wall. Because myocardium usually adapts its mass to changes in workload, we investigated by echocardiography whether regional differences in wall thickness are present in two kinds of asynchronous electric activation of different origin and conduction pathway: epicardial ventricular pacing in dogs and left bundle branch block (LBBB) in patients. In six dogs, 3 months of epicardial LV pacing at physiologic heart rates decreased the thickness of the early activated anterior wall by 20.5 +/- 8.1% without significantly changing LV cavity area and septal thickness. In a retrospective study of 228 LBBB patients, the early activated septum was significantly thinner than the late activated posterior wall. The asymmetry most pronounced was as large as 10% in 28 patients with LBBB and paradoxic septal motion. No difference in regional wall thickness was present in 154 control patients. In conclusion, chronic asynchronous electric activation in the heart induces redistribution of cardiac mass. This redistribution occurs in hearts, which differ in impulse conduction pathway, disease, and species and is characterized by thinning of early versus late activated myocardium. [Journal Article; In English; United States

The DD genotype of the angiotensin converting enzyme gene is negatively associated with right ventricular hypertrophy in male patients with chronic obstructive pulmonary disease.

Departments of Pathology, Cardiology, Pulmonology and Asthmacentre, Cardiovascular Research Institute Maastricht, The Netherlands. The renin angiotensin system plays an important role in the development of pulmonary artery remodeling and right ventricular hypertrophy in hypoxia-induced pulmonary hypertension as may occur in patients with COPD. Several polymorphisms of genes encoding for components of the renin angiotensin system such as the M235T polymorphism in the angiotensinogen gene, the 287-base-pair insertion (I)/deletion (D) polymorphism at intron 16 of the ACE gene, and the A1166C polymorphism in the angiotensin II type 1 receptor gene have been associated with an increased risk of cardiovascular diseases. With respect to the pulmonary circulation, only limited data exist on possible associations between polymorphisms of these genes and pulmonary hypertension and/or right ventricular hypertrophy. The objective of the present study was to investigate a possible relationship between polymorphisms of the renin angiotensin system and electrocardiographic evidence of right ventricular hypertrophy in patients with COPD. We therefore determined the angiotensinogen (M235T), angiotensin converting enzyme (I/D), and angiotensin II type 1 receptor (A1166C) genotypes in 87 patients with severe COPD and correlated these data with electrocardiographic parameters of right ventricular hypertrophy. Thirty-one patients (36%) of 87 patients with COPD showed electrocardiographic evidence of right ventricular hypertrophy. In the male, but not in the female, subgroup, the angiotensin-converting enzyme DD genotype was negatively associated with electrocardiographic evidence of right ventricular hypertrophy (male: chi2 = 3.8, p = 0.05; female: chi2 = 0.05, p = 0.82). We found no associations between the investigated polymorphisms in the angiotensinogen and angiotensin II type 1 receptor genes and electrocardiographic evidence of right ventricular hypertrophy

Influence of fluid status on techniques used to assess body composition in peritoneal dialysis patients

Influence of fluid status on techniques used to assess body composition in peritoneal dialysis patients. Konings CJ, Kooman JP, Schonck M, van Kreel B, Heidendal GA, Cheriex EC, van der Sande FM, Leunissen KM. Department of Internal Medicine, University Hospital Maastricht, The Netherlands. OBJECTIVE: A reliable assessment of nutritional state in peritoneal dialysis (PD) patients is of great importance. Nevertheless, techniques used to assess body composition in patients on PD may be affected by abnormalities in fluid status. The primary aim of the present study was to compare different techniques used to evaluate body composition and to assess the influence of fluid status on the assessment of body composition. The secondary aim was to assess the relevance of handgrip muscle strength in the nutritional evaluation of the patient. METHODS: In 40 PD patients, dual-energy x-ray absorptiometry (DEXA), multifrequency bioimpedance analysis (MF-BIA), and anthropometry were compared with respect to the evaluation of body composition [fat mass and lean body mass (LBM; by DEXA), and fat-free mass (FFM; by MF-BIA, anthropometry]. The influence of fluid status on the measurement of LBM/FFM by the various techniques was assessed by their relation to left ventricular end-diastolic diameter (LVEDD), assessed by echocardiography, and by estimating the ratio between extracellular water (ECW) and total body water (TBW), assessed by bromide and deuterium dilution, with LBM (DEXA). The relevance of handgrip muscle strength as a nutritional parameter was assessed by its relation to LBM and other nutritional parameters. RESULTS: Despite highly significant correlations, wide limits of agreement between the various techniques were present with respect to assessment of body composition (expressed as % body weight) and were most pronounced for anthropometry: LBM (DEXA) - FFM (MF-BIA) = 3.4% +/- 12.2%; LBM (DEXA) - FFM (anthropometry) = -5.7% +/- 7.8%; fat mass (DEXA - MF-BIA) = -4.2% +/- 7.9%; fat mass (DEXA - anthropometry) = 2.9% +/- 7.2%. The ratio between ECW and LBM (DEXA) was 0.36 +/- 0.08 L/kg (range 0.25 - 0.67 L/kg), and the ratio between TBW and LBM was 0.75 +/- 0.06 L/kg (range 0.63 - 0.86 L/kg), which shows the variability in hydration state of LBM/FFM between individual patients. LBM/FFM measured by all three techniques was significantly related to LVEDD, suggesting an important influence of hydration state on this parameter. Handgrip muscle strength was significantly related to LBM/FFM, as measured by all three techniques, but not to other nutritional parameters. CONCLUSION: Wide limits of agreement were found between various techniques used to assess body composition in PD patients. The assessment of body composition was strongly influenced by hydration state.The handgrip test is related to body composition, but not to other nutritional parameters