Issues for sustainability of non‐government organisations in the alcohol and other drugs sector

Introduction and Aims. The study aimed to identify issues for sustainability of non‐government organisations in the alcohol and other drugs sector (AODS) in Australia within the current neoliberal context. Design and Methods. Six key‐informant group consultations were conducted in Sydney, Melbourne, Darwin (Australia). Participants were professionals working in the AODS from non‐government AOD organisations, government departments, philanthropic organisations and academic institutions (n = 40). Qualitative data were collected according to a discussion guide. Results. Issues related to problems with workforce capacity, independence, governance and funding. Factors contributing to these issues related to the competitive tendering funding model, for example: accountability requirements and tied funding. Discussion and Conclusions. Issues identified by the AODS were mostly similar to those identified by the broader non‐government organisations sector. There is much to learn from outside the AODS. Strategies to improve sustainability will include workforce development, improving governance and developing relationships within the sector and with government. These require a commitment to innovation and will entail movement of resources from service provision in the short term to organisational development for the long term.[Spooner C, Dadich A. Issues for sustainability of non‐government organisations in the alcohol and other drugs sector. Drug Alcohol Rev 2009]     

Long-Term Efficacy of Anchored Barbed Sutures in the Face and Neck

BACKGROUND The thread lift is a minimally invasive procedure that uses barbed sutures, inserted subcutaneously, to produce lifting of ptotic tissue of the face and neck. There are currently very limited data on longevity and patient satisfaction following barbed suture lifting procedures.
OBJECTIVE The purpose of this study was to assess long-term efficacy following the use of barbed sutures.
MATERIALS AND METHODS A satisfaction survey was mailed to 20 patients who were a minimum of 6 months (range, 6 to 16 months) postprocedure. Physician assessment of pre- and postprocedure photographs was also performed.
RESULTS At an average of 11.5 months postprocedure, patients felt that the barbed suture lift met their expectations, rating their satisfaction a 6.9 on a scale of 1 to 10. Independent physicians rated the overall improvement an average of 4.6 of 10. Higher scores were noted in Zone 1 (tear trough/malar fat pad and nasolabial folds) compared to Zone 2 (marionette lines, jowls, and jawline definition) and Zone 3 (platysmal bands and neck contour).
CONCLUSION The barbed suture lift procedure provides moderate long-term and sustained improvement for facial laxity, with most improvement seen in the tear trough/malar fat pads and nasolabial folds. In this study, clinical efficacy was seen up to 16 months postprocedure.     

Impacting Awareness of Child Abuse through a Spiritually Based Performing Arts Project

Using indigenous religious folklore images, a folk opera explored issues of child abuse, sexual assault and violence through a psychologically fictionalized character of Mary Magdalene. Befriended by an understanding Mary, Mary Magdalene is healed of her childhood ‘wounds through a religious conversion after almost refusing to encounter Jesus. Six hundred secondary students attended three daytime performances and 486 returned a Likert‐scaled questionnaire. The results indicated that most students perceived abuse as a personally relevant social problem, with this felt relevance increasing with age. Significant trends supported initial expectations that the play may help increase community and personal awareness of child abuse and sexual assault and that the play may also help increase a personal and community interest and effort toward helping others. Perplexing differences in school responses suggest that the schools in which prior discussion occurred may have led to students gaining more social insight and benefit from the play, although some of these same schools also tended to reject the personal relevance of the play. The latter may indicate community risk factors contributing to denial. More Hispanics responded positively to the sense of benefit, which may reflect the fact that there is a Hispanic Catholic majority in the community that sponsored the play itself. Overall, the findings suggest that performing arts can help increase awareness of child abuse as well as personal and community interest in helping and that this benefit increases with teacher discussion and age. In spite of procedural deprivations, the authors felt it was a relatively rare and useful effort to collect some data, hopefully to inspire more social scientists with more resources to consider collaborating with socially and spiritually meaningful fine arts productions in order to document scientifically the impact of the arts on human attitudes and behaviour. The reader's tolerance for the obvious limitations of investigation are requested and appreciated. A discussion of psychospiritual models of creativity and healing concludes the paper.     

Results from the First 2 Years of a Clinical Trial with Recombinant DNA-derived Human Growth Hormone (Somatrem) in Turner's Syndrome

A total of 70 subjects with Turner's syndrome from 11 centres were enrolled in a study of somatrem. After an initial observation period, they were randomly assigned to one of four groups, receiving no treatment (Group 1, control); oxandrolone, 0.125 mg/kg/day (Group 2); somatrem, 0.125 mg/kg 3 times/week (Group 3); or a combination of somatrem and oxandrolone on the above dose regimens (Group 4). After 12–20 months, Groups 1 (control), 2 (oxandrolone) and 4 (combination) were treated with somatrem, 0.125 mg/kg 3 times/week, and oxandrolone, 0.0625 mg/kg/day; Group 3 remained on somatrem, 0.125 mg/kg 3 times/week. All three treatment groups showed a statistically significant increase during year 1 in growth velocity over both their pretreatment growth rates and the control group growth rate. These increases were slightly less in year 2 for the somatrem and combination therapy groups, but remained significantly higher than the year 1 control group growth rate. Plasma IGF-1 levels were elevated in years 1 and 2 in the somatrem and combination groups. Adverse events were few with the somatrem group, though mild virilization occurred with oxandrolone, alone or in combination. Bone age advancement was observed with all treatments but was greater with combination therapy; it was accompanied by height age advancement. The effect of this therapy on predicted adult height was also evaluated.     

Should patients with mild atypia in a cervical smear be referred for colposcopy?

Summary. Significant premalignant disease of the cervix was found in 37% of women referred to a colposcopy clinic because of a smear that showed no more than mildly atypical cells, and in 49% of women whose smears showed mild dyskaryosis. This did not seem to be related to the number of times the abnormal smear had been repeated and was not confined to patients whose smears had been reported by only one laboratory. In another group of 102 women whose first abnormal smear was graded as atypical: 10 had cervical intraepithelial neoplasia; 9 still had abnormal smears and 27 had been lost to follow-up, possibly because the potential importance of this finding was not recognised by the doctor to whom the smear report had been returned. Women with mildly atypical or mildly dyskaryotic smears are at considerable risk of having cervical intraepithelial neoplasia. All patients with a smear report showing dyskaryosis of any degree of severity should be referred for colposcopy. Those with atypical cytology should be referred for colposcopy if a second smear, repeated after 3 months, is not normal.     

Effects of Cl-949, a Novel Antiallergy Compound, on Host Resistance in Mice

Effects of CI-949, a Novel Antiallergy Compound, on Host Resistancein Mice. BLEAVINS, M. R., MARTIN, R. A., DE LA IGLESIA, F. A.,MUNSON, A. E., MCCAY, J. A., FOUANT, M. M., AND WHITE, K. L.,JR. (1991). Fundam. Appl. Toxicol. 17, 723–732. The effectof CI-949, a novel inhibitor of allergic mediator release, onimmune function was assessed with holistic mouse models of immunocompetence.Resistance to the bacterial pathogens Listeria monocytogenesand Streptococcus pneumoniae and the B16F10 melanoma cell linewas used to evaluate the potential of CI-949 to affect immunefunction. CI-949 treatment of female B₆C₃F₁, mice increasedpulmonary tumor burden at 100 mg/kg/day in the B16F10 melanomamodel, with a no effect level of at least 50 mg/kg/day. A correlationwas seen between decreased clearance of the B16F10 cells andincreased tumor burden. However, CI-949 produced this effectonly at the maximum tolerated dose. No effect of the drug wasseen in the S. pneumoniae model. Host resistance to L. monocytogeneswas increased after CI-949 administration, with the no adverseeffect level in this model being at least equivalent to thetop dose of 100 mg/kg/day. Therefore, the immune system doesnot appear to be adversely affected or to be a specific targetfor CI-949 even at an overtly toxic.     

Time-dependent heterogeneity of filtration rate in the autoreguiating rat kidney

Experiments were performed to study the regulation of the single-nephron glomerular filtration rate (SNGFR) in superficial and juxtamedullary nephrons, as the left kidney of Sprague Dawley rats was submitted to a reduced arterial pressure of 70 mmHg by means of an aortic clamp. The SNGFR at different cortical levels was measured 0.5, 1, 5, 20 or 45 min after the reduction, in order to ascertain whether the effects of the regulatory mechanisms are modified with time. A Hanssen technique was used, which allows one determination of filtration rates per animal. At a renal arterial pressure (RAP) of 100 mmHg (= control animals) the SNGFR amounted to 20±1.2 and 23± 0.8 nlmin^-1–g^-1 kidney weight in the outer and inner cortical (OC, IC) nephrons. When RAP was further reduced to 70 mmHg, the autoregulation of SNGFR, determined after 0.5 min, was highly efficient for both OC and IC nephrons (19 ± 2.0, 23 ± 2.6). A prolonged reduction in RAP caused a gradual decline in SNGFR. The filtration rate measured after 5 min was 15 ±1.4 for OC and 20 ± 1.8 for IC nephrons. The decline was most pronounced for OC nephrons, which led to a fractional redistribution in favour of IC nephrons. Thus, SNGFR_IC/SNGFR_oc was 1.16± 0.065 when RAP was 100 mmHg and 1.41 ± 0.126 after 5 min with an RAP of 70 mmHg. It is well documented that suprarenal aortic occlusion is a powerful stimulus for the release of renin. This was manifested as an increase in the arterial pressure proximal to the aortic clamp. The fractional redistribution to IC nephrons and the loss of autoregulation, when the renal hypotension was sustained, may be an expression of the intrarenal mechanisms attempting to restore RAP. It is likely that the renin/angiotensin system is involved in these processes.     

REGIONAL DISTRIBUTION OF 11C-LABELED LIDOCAINE,BUPIVACAINE, AND ROPIVACAINE IN THE HEART,LUNGS, AND SKELETAL MUSCLE OF PIGS STUDIED WITH POSITRON EMISSION TOMOGRAPHY

The regional myocardial uptake and kinetics of ¹¹C-lidocaine, ¹¹C-bupivacaine, and ¹¹C-ropivacaine were examined in the pig, utilizing positron emission tomography to determine whether disproportionate distribution exists among these agents. The three drugs were rapidly distributed to the myocardium and lung with mean peak radioactivities occurring between 0·35 and 0·48 min post-injection in myocardium and 0·35 and 0·65 min in lung. Radioactivities peaked later in skeletal muscle than in the myocardium and lung, occurring between 1·1 and 2·7 min post-end injection. Blood radioactivities for bupivacaine and ropivacaine were significantly higher than those of lidocaine, whereas myocardial, lung, and muscle uptakes for the three agents were not significantly different. Myocardium–blood partition coefficients were similar for bupivacaine and ropivacaine (0·55 and 0·49 respectively), while it was three times higher for lidocaine (1·4). A similar relationship existed for skeletal muscle– and lung–blood partition coefficients. Bupivacaine and ropivacaine t_1/2z in skeletal muscle were significantly longer than those of lidocaine. The results of this study indicate that the increased cardiotoxicity associated with bupivacaine does not appear to be related to disproportionate distribution in the myocardium when compared to lidocaine and ropivacaine. © 1997 by John Wiley & Sons, Ltd.