Kronic hysteria: Exploring the intersection between Australian synthetic cannabis legislation, the media, and drug-related harm

Background Having first appeared in Europe, synthetic cannabis emerged as a drug of concern in Australia during 2011. Kronic is the most well-known brand of synthetic cannabis in Australia and received significant media attention. Policy responses were reactive and piecemeal between state and federal governments. In this paper we explore the relationship between media reports, policy responses, and drug-related harm. Methods Google search engine applications were used to produce time–trend graphs detailing the volume of media stories being published online about synthetic cannabis and Kronic, and also the amount of traffic searching for these terms. A discursive analysis was then conducted on those media reports that were identified by Google as ‘key stories’. The timing of related media stories was also compared with self-reported awareness and month of first use, using previously unpublished data from a purposive sample of Australian synthetic cannabis users. Results Between April and June 2011, mentions of Kronic in the media increased. The number of media stories published online connected strongly with Google searches for the term Kronic. These stories were necessarily framed within dominant discourses that served to construct synthetic cannabis as pathogenic and created a ‘moral panic’. Australian state and federal governments reacted to this moral panic by banning individual synthetic cannabinoid agonists. Manufacturers subsequently released new synthetic blends that they claimed contained new unscheduled chemicals. Conclusion Policies implemented within in the context of ‘moral panic’, while well-intended, can result in increased awareness of the banned product and the use of new yet-to-be-scheduled drugs with unknown potential for harm. Consideration of regulatory models should be based on careful examination of the likely intended and unintended consequences. Such deliberation might be limited by the discursive landscape

Examining the Focus of SoTL Literature—Teaching and Learning?

Although the Scholarship of Teaching and Learning (SoTL) claims to focus on student learning, some have argued that SoTL studies often adopt a narrow view of learning and focus more on teaching than on learning. In this paper, we explore whether teaching is the primary focus of recent articles published from 2013-2017 in three international, self-identified SoTL journals: Teaching and Learning Inquiry: The ISSOTL Journal (TLI), The International Journal for the Scholarship of Teaching and Learning (ijSOTL), and The Journal of the Scholarship of Teaching and Learning (JoSoTL). Based on our analysis of the 299 empirical articles, we argue that they portray SoTL as a field focused primarily on teacher activity rather than student learning, despite efforts to broaden its scope

Corticosteroids for the management of cancer-related pain in adults (Review)

Background: One of the most feared symptoms associated with cancer is pain. Opioids remain the mainstay of pain treatment but corticosteroids are often used concurrently as co- or adjuvant analgesics. Due to their anti-inflammatory mechanism of action, corticosteroids are said to provide effective analgesia for pain associated with inflammation and in the management of cancer-related complications such as brain metastasis and spinal cord compression. However, corticosteroids have a wide range of adverse effects that are dose and time dependent. Objectives: To evaluate the efficacy of corticosteroids in treating cancer-related pain in adults. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2014, Issue 4), MEDLINE (OVID) (1966 to 29 September 2014), EMBASE (OVID) (1970 to 29 September 2014), CINAHL (1982 to 29 September 2014), Science Citation Index (Web of Science) (1899 to 29 September 2014) and Conference Proceedings Citation Index - Science (Web of Science) (1990 to 29 September 2014). Selection criteria: Any randomised or prospective controlled trial that included patients over 18 years with cancer-related pain were eligible for the review. Corticosteroids were compared to placebo or usual treatment and/or supportive care. Data collection and analysis: All review authors independently assessed trial quality and extracted data. We used arithmetic means and standard deviations for each outcome to report the mean difference (MD) with 95% confidence interval (CI). Main results: Fifteen studies met the inclusion criteria, enrolling 1926 participants. The trial size varied from 20 to 598 patients. Most studies compared corticosteroids, particularly dexamethasone, to standard therapy. We included six studies with data at one week in the meta-analysis for pain intensity; no data were available at that time point for the remaining studies. Corticosteroid therapy resulted in less pain (measured on a scale of 0 to 10 with a lower score indicating less pain) compared to control at one week (MD 0.84 lower pain, 95% CI 1.38 to 0.30 lower; low quality evidence). Adverse events were poorly documented. Factors limiting statistical analysis included the lack of standardised measurements of pain and the use of different agents, dosages, comparisons and routes of drug delivery. Subgroup analysis according to type of cancer was not possible. The quality of this evidence was limited by the risk of bias of the studies and small sample size. The results were also compromised by attrition, with data missing for the enrolled patients. Authors' conclusions: The evidence for the efficacy of corticosteroids for pain control in cancer patients is weak. Significant pain relief was noted in some studies, albeit only for a short period of time. This could be important for patients with poor clinical status. Further trials, with increased numbers of participants, are needed to evaluate the safety and effectiveness of corticosteroids for the management cancer pain in adults, and to establish an ideal dose, duration of therapy and route of administration

Nurses’ education, knowledge and perceptions of peripheral intravenous catheter management: A web-based, cross-sectional survey

Background: Peripheral intravenous catheters (PIVCs) are the most used invasive medical device. Unfortunately, PIVCs fail for a variety of reasons and failure often results in serious adverse events leading to patient discomfort, infection, delays in treatment, increased healthcare costs, and even death. In Australia, qualified nurses assess, manage, and remove a PIVC as part of their clinical role. To date, no study has described the current state of knowledge and confidence (self-efficacy) about PIVCs from the perspectives of qualified nurses working in Australian hospital settings. Aims: To describe the current state of knowledge and confidence (self-efficacy) about PIVC management from the perspectives of qualified nurses working in Australian hospital settings. To explore how these related to the education received by these nurses. Methods: An online cross-sectional survey. Findings: Qualified nurses in Australia thought that education about PIVCs was important and that it should be underpinned by evidence-based guidelines. Knowledge Test score for the sample was 12.4/17 (SD 2.1), this equates to a mean grade of 73.0%. Respondents reported very high levels of confidence about caring for a patient with a PIVC in situ. Conclusion: Despite the frequent and increasing use of PIVCs and importantly the documented adverse events associated with poor assessment, management and inappropriate removal, qualified nurses’ knowledge and confidence remain poorly reported. We demonstrated fundamental gaps in qualified nurses’ knowledge in relation to assessment, management, and removal of PIVCs

Protecting Migratory Species in the Australian Marine Environment: A Cross-Jurisdictional Analysis of Policy and Management Plans

Marine migratory species are difficult to manage because animal movements can span large areas and are unconstrained by jurisdictional boundaries. We reviewed policy and management plans associated with four case studies protected under the Australian Environment Protection and Biodiversity Conservation Act 1999 (EPBC Act 1999) in order to identify the coherence of policy and management plans for managing marine migratory species in Australia. Environmental policies (n = 23) and management plans (n = 115) relevant to marine turtles, dugongs, humpback whales, and migratory shorebirds were reviewed. Few of the reviewed policies (n = 7) listed protected species and even fewer (n = 4) listed protected marine migratory species. Marine turtles were most represented in the reviewed policies (n = 7), while migratory shorebirds were most represented in management plans (n = 59). Policies and management plans were much more likely to identify relationships to other policies or plans within the same jurisdiction than to different jurisdictions. The EPBC Act 1999 served as the central link between reviewed policies and plans, but the requirements of that Act were weakly integrated into the other documents. This weak integration and the biases toward specific migratory species in environmental policies and management plans are detrimental to the conservation of these Matters of National Environmental Significance in Australia. Any changes to the EPBC Act 1999 will affect all environmental policy and management plans in Australia and highlights a need for cooperative, multi-level governance of migratory species. Our findings may have relevance to the conservation of marine migratory species in a broader international context

Congenital and neonatal malaria in a rural Kenyan district hospital: An eight-year analysis

<p>Abstract</p> <p>Background</p> <p>Malaria remains a significant burden in sub-Saharan Africa. However, data on burden of congenital and neonatal malaria is scarce and contradictory, with some recent studies reporting a high burden. Using prospectively collected data on neonatal admissions to a rural district hospital in a region of stable malaria endemicity in Kenya, the prevalence of congenital and neonatal malaria was described.</p> <p>Methods</p> <p>From 1^stJanuary 2002 to 31^stDecember 2009, admission and discharge information on all neonates admitted to Kilifi District Hospital was collected. At admission, blood was also drawn for routine investigations, which included a full blood count, blood culture and blood slide for malaria parasites.</p> <p>Results</p> <p>Of the 5,114 neonates admitted during the eight-year surveillance period, blood slide for malaria parasites was performed in 4,790 (93.7%). 18 (0.35%) neonates with <it>Plasmodium falciparum </it>malaria parasitaemia, of whom 11 were admitted within the first week of life and thus classified as congenital parasitaemia, were identified. 7/18 (39%) had fever. Parasite densities were low, ≤50 per μl in 14 cases. The presence of parasitaemia was associated with low haemoglobin (Hb) of <10 g/dl (χ²10.9 P = 0.001). The case fatality rate of those with and without parasitaemia was similar. <it>Plasmodium falciparum </it>parasitaemia was identified as the cause of symptoms in four neonates.</p> <p>Conclusion</p> <p>Congenital and neonatal malaria are rare in this malaria endemic region. Performing a blood slide for malaria parasites among sick neonates in malaria endemic regions is advisable. This study does not support routine treatment with anti-malarial drugs among admitted neonates with or without fever even in a malaria endemic region.</p

Bicontinuous minimal surface nanostructures for polymer blend solar cells

This paper presents the first examination of the potential for bicontinuous structures such as the gyroid structure to produce high efficiency solar cells based on conjugated polymers. The solar cell characteristics are predicted by a simulation model that shows how the morphology influences device performance through integration of all the processes occurring in organic photocells in a specified morphology. In bicontinuous phases, the surface de. ning the interface between the electron and hole transporting phases divides the volume into two disjoint subvolumes. Exciton loss is reduced because the interface at which charge separation occurs permeates the device so excitons have only a short distance to reach the interface. As each of the component phases is connected, charges will be able to reach the electrodes more easily. In simulations of the current-voltage characteristics of organic cells with gyroid, disordered blend and vertical rod (rods normal to the electrodes) morphologies, we find that gyroids have a lower than anticipated performance advantage over disordered blends, and that vertical rods are superior. These results are explored thoroughly, with geminate recombination, i.e. recombination of charges originating from the same exciton, identified as the primary source of loss. Thus, if an appropriate materials choice could reduce geminate recombination, gyroids show great promise for future research and applications