First-Stage Development of the Pitjantjatjara Translation of the World Health Organization’s Alcohol, Smoking and Substance Involvement Screening Test (ASSIST)

Substance use is a leading contributor to global disease, illness and death. Compared with non-Indigenous Australians, Aboriginal and Torres Strait Islander Australians are at an increased risk of substance-related harms due to the experience of additional social, cultural, and economic factors. While preventive approaches, including screening and early interventions are promising, currently there are limited options available to healthcare workers that are culturally appropriate for use in Aboriginal and Torres Strait Islander populations. Therefore, the aim of this research was to translate and culturally adapt the World Health Organization endorsed, Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) into Pitjantjatjara. This paper first describes the process of translation and adaptation of the instrument (Phase 1). The process of focus-group testing the translated instrument for accuracy and cultural appropriateness is also discussed (Phase 2). Key findings from both phases are presented in the context of how the research team worked with key stakeholders in the community to identify facilitators and work through barriers to implementation. The findings from this paper will be used to inform the development of a digital, app-based version of the instrument for the purposes of pilot-testing and validation

Multiple Myeloma

The clinical, biochemical and immunochemical features of 52 patients suffering from multiple myelomatosis are reported. Three major criteria were used to establish the diagnosis: serum and urine protein chemistry, bone marrow morphology and the radiological appearances of bone. The fact that abnormalities of gamma globulin synthesis were present in 49 of the 52 patients indicates the importance of adequate examination of urine by electrophores's and immunochemical techniques in the early diagnosis of multiple myeloma. Bradshaw's test, which is a simple screening test for fence-Jones proteinuria, was positive in 63% of patients.S. Afr. Med. J., 48, 1023 (1974)

Multiple Myeloma

The results of the use of melphalan in 52 patients with multiple myeloma have been analysed. The median survival of the whole group of patients was 30 months, and of those w:th renal insufficiency only 12,5 months. Bence-lones proteinuria was also a poor prognostic finding,. but only because of its association with renal failure. Patients with Bence-Jones protcinur;a and normal renal function had a median survival of 41 months. Responsiveness to therapy by criteria based on those of the Chronic Leukemial Multip!e Myeloma Task Force could be assessed in 25 patients. Dramatic symptomatic relief occurred in all but one of the responsive patients, but in only one-fifth of those who did not respond to therapy.S. Afr. Med. J., 48, 1026 (1974

RCTs: How compatible are they with policy-making?

Randomised controlled trials (RCTs) have been promoted as a means of improving policy-making by testing new policies. While testing before full-scale roll-out is commendable, this paper discusses the challenges of using RCTs in contemporary (national) health policy-making in England. There are at least two challenges in particular that are currently underrepresented in the debate: The first arises from the complexity of many policies which are often too diffuse and unclear in focus to allow for the clear distinction between a policy ‘mechanism’ and its context to be drawn that is required for a RCT. The second challenge relates to the timing of RCTs, which tend to take place either too early in the life of a policy to be meaningful or too late to have an effect on policy formulation. We therefore encourage policy-makers and researchers to be clear about the types of uncertainties ‘field experiments’ are meant to address which may be addressed better by other types of knowledge generation

Bilateral ischemic optic neuropathy after transurethral prostatic resection: a case report

BACKGROUND: Nonarteritic ischemic optic neuropathy affects the anterior portion of the optic nerve and is characterized by sudden, painless visual loss. The affected eye has a relative afferent pupillary defect. The typical funduscopic appearance includes optic disc edema, with associated nerve fiber layer hemorrhage. Risk factors include advanced age, systemic hypertension, nocturnal hypotension, diabetes mellitus, and a small cup-to-disc ratio. Bilateral presentation is rare. Postoperative optic neuropathy has been associated with nonocular surgery; risk factors include a combination of prolonged surgical times, acute systemic hypotension, anemia due to blood loss, or prone positioning. We report for the first time a patient with bilateral, simultaneous anterior ischemic optic neuropathy after elective transurethral prostatic resection. CASE PRESENTATION: A 66-year old man underwent surgery for benign prostatic hyperplasia. The preoperative blood pressure was 140/85 mmHg, hemoglobin 15.9 g/dL, and hematocrit 48.6%. Two hours postoperatively, the blood pressure, hemoglobin, and hematocrit dropped dramatically. One day later, transient horizontal diplopia developed. Funduscopy showed a congenitally small cup-to-disc ratio without papillary edema. Other ocular findings were unremarkable. By 4 days postoperatively, sudden and painless amaurosis bilaterally developed when the patient awoke with nausea and vomiting. Visual acuity was no light perception bilaterally. The optic discs were swollen with small hemorrhages. Scans of the head and orbits and electrolyte levels were normal. There were no responses on visual evoked potentials bilaterally. The blood pressure was 90/50 mm Hg, the hemoglobin 7.0 g/dL, and the hematocrit 22.9%, necessitating infusion of three units of packed red blood cells. The blood pressure, hematocrit, and hemoglobin increased to normal levels. Three months later the visual acuity remained no light perception. The pupils were unreactive and there was marked optic disc atrophy bilaterally. CONCLUSION: Bilateral and simultaneous acute ischemic optic neuropathy may be a rare but devastating surgical complication. The combination of anemia and hypotension may increase the risk of anterior ischemic optic neuropathy postoperatively after transurethral prostatic resection

Ultrafast changes in lattice symmetry probed by coherent phonons

The electronic and structural properties of a material are strongly determined by its symmetry. Changing the symmetry via a photoinduced phase transition offers new ways to manipulate material properties on ultrafast timescales. However, in order to identify when and how fast these phase transitions occur, methods that can probe the symmetry change in the time domain are required. We show that a time-dependent change in the coherent phonon spectrum can probe a change in symmetry of the lattice potential, thus providing an all-optical probe of structural transitions. We examine the photoinduced structural phase transition in VO2 and show that, above the phase transition threshold, photoexcitation completely changes the lattice potential on an ultrafast timescale. The loss of the equilibrium-phase phonon modes occurs promptly, indicating a non-thermal pathway for the photoinduced phase transition, where a strong perturbation to the lattice potential changes its symmetry before ionic rearrangement has occurred.Comment: 14 pages 4 figure

Nonlinear landscape and cultural response to sea-level rise

Rising sea levels have been associated with human migration and behavioral shifts throughout prehistory, often with an emphasis on landscape submergence and consequent societal collapse. However, the assumption that future sea-level rise will drive similar adaptive responses is overly simplistic. While the change from land to sea represents a dramatic and permanent shift for preexisting human populations, the process of change is driven by a complex set of physical and cultural processes with long transitional phases of landscape and socioeconomic change. Here, we use reconstructions of prehistoric sea-level rise, paleogeographies, terrestrial landscape change, and human population dynamics to show how the gradual inundation of an island archipelago resulted in decidedly nonlinear landscape and cultural responses to rising sea levels. Interpretation of past and future responses to sea-level change requires a better understanding of local physical and societal contexts to assess plausible human response patterns in the future

Camouflage Effects of Various Colour-Marking Morphs against Different Microhabitat Backgrounds in a Polymorphic Pygmy Grasshopper Tetrix japonica

Colour-marking polymorphism is widely distributed among cryptic species. To account for the adaptive significance of such polymorphisms, several hypotheses have been proposed to date. Although these hypotheses argue over the degree of camouflage effects of marking morphs (and the interactions between morphs and their microhabitat backgrounds), as far as we know, most empirical evidence has been provided under unnatural conditions (i.e., using artificial prey).Tetrix japonica, a pygmy grasshopper, is highly polymorphic in colour-markings and occurs in both sand and grass microhabitats. Even within a microhabitat, T. japonica is highly polymorphic. Using humans as dummy predators and printed photographs in which various morphs of grasshoppers were placed against different backgrounds, we addressed three questions to test the neutral, background heterogeneity, and differential crypsis hypotheses in four marking-type morphs: 1) do the morphs differ in the degree of crypsis in each microhabitat, 2) are different morphs most cryptic in specific backgrounds of the microhabitats, and 3) does the morph frequency reflect the degree of crypsis?The degree of camouflage differed among the four morphs; therefore, the neutral hypothesis was rejected. Furthermore, the order of camouflage advantage among morphs differed depending on the two types of backgrounds (sand and grass), although the grass background consistently provided greater camouflage effects. Thus, based on our results, we could not reject the background heterogeneity hypothesis. Under field conditions, the more cryptic morphs comprised a minority of the population. Overall, our results demonstrate that the different morphs were not equivalent in the degree of crypsis, but the degree of camouflage of the morphs was not consistent with the morph frequency. These findings suggest that trade-offs exist between the camouflage benefit of body colouration and other fitness components, providing a better understanding of the adaptive significance of colour-markings and presumably supporting the differential crypsis hypothesis

Biomechanical predictors of ball velocity during punt kicking in elite rugby league kickers

Punt kicking is integral to the attacking and defensive elements of rugby league and the ability to kick the ball with high velocity is desirable. This study aimed to identify important technical aspects of kicking linked to the generation of ball velocity. Maximal punt kicks were obtained from six elite rugby league kickers using a 10-camera motion capture system. Three-dimensional kinematics of the lower extremities was obtained. Regression analysis with ball velocity as criterion was used to identify the kinematic parameters associated with the development of ball velocity. The regression model yielded an adj R2¼0.76, p�0.01. Two parameters were identified: knee extension angular velocity of the kicking limb at impact (R2¼0.50) and peak flexion angular velocity of the kicking hip (R2¼0.26, p�0.01). It is conceivable that players may benefit from exposure to coaching and strength techniques geared toward the modification of kicking mechanics specific to this stud