Showing papers by "University of South Australia published in 2006"

Demonstrating Rigor Using Thematic Analysis: A Hybrid Approach of Inductive and Deductive Coding and Theme Development

Abstract: In this article, the authors describe how they used a hybrid process of inductive and deductive thematic analysis to interpret raw data in a doctoral study on the role of performance feedback in the self-assessment of nursing practice. The methodological approach integrated data-driven codes with theory-driven ones based on the tenets of social phenomenology. The authors present a detailed exemplar of the staged process of data coding and identification of themes. This process demonstrates how analysis of the raw data from interview transcripts and organizational documents progressed toward the identification of overarching themes that captured the phenomenon of performance feedback as described by participants in the study.

Colistin: the re-emerging antibiotic for multidrug-resistant Gram-negative bacterial infections

Abstract: Increasing multidrug resistance in Gram-negative bacteria, in particular Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae, presents a critical problem. Limited therapeutic options have forced infectious disease clinicians and microbiologists to reappraise the clinical application of colistin, a polymyxin antibiotic discovered more than 50 years ago. We summarise recent progress in understanding the complex chemistry, pharmacokinetics, and pharmacodynamics of colistin, the interplay between these three aspects, and their effect on the clinical use of this important antibiotic. Recent clinical findings are reviewed, focusing on evaluation of efficacy, emerging resistance, potential toxicities, and combination therapy. In the battle against rapidly emerging bacterial resistance we can no longer rely entirely on the discovery of new antibiotics; we must also pursue rational approaches to the use of older antibiotics such as colistin.

Plasma Methods for the Generation of Chemically Reactive Surfaces for Biomolecule Immobilization and Cell Colonization ‐ A Review

Abstract: This review surveys methods for the fabrication, by plasma surface treatments or plasma polymerization, of polymeric surfaces and thin plasma polymer coatings that contain reactive chemical groups useful for the subsequent covalent immobilization, by solution chemical reactions or vapor phase grafting, of molecules or polymers that can exert bio-specific interfacial responses. Surfaces containing amine, carboxy, hydroxy, and aldehyde groups are the subject of this review. Aminated surfaces have been fabricated using various plasma vapors or mixtures and have found wide use for bio-interface applications. However, in many cases the amine surfaces have a rather limited shelf life, with post-plasma oxidation reactions and surface adaptation leading to the disappearance of amine groups from the surface. Aging is a widespread phenomenon that often has not been recognized, particularly in some of the earlier studies on the use of plasma-fabricated surfaces for bio-interfacial applications, and can markedly alter the surface chemistry. Plasma-fabricated surfaces that contain carboxy groups have also been well documented. Fewer reports exist on hydroxy and aldehyde surfaces prepared by plasma methods. Hydroxy surfaces can be prepared by water plasma treatment or the plasma polymerization of alkyl alcohol vapors. Water plasma treatment on many polymer substrates suffers from aging, with surface adaptation leading to the movement of surface modification effects into the polymer. Both hydroxy and aldehyde surfaces have been used for the covalent immobilization of biologically active molecules. Aging effects are less well documented than for amine surfaces. This review also surveys studies using such surfaces for cell colonization assays. Generally, these surface chemistries show good ability to support cell colonization, though the effectiveness seems to depend on the process vapor and the plasma conditions. Carboxylate co-polymer surfaces have shown excellent ability to support the colonization of some human cell lines of clinical interest. Immobilization of proteins onto plasma-carboxylated surfaces is also well established.

Attitudes and barriers to incident reporting: a collaborative hospital study

Abstract: Objectives: To assess awareness and use of the current incident reporting system and to identify factors inhibiting reporting of incidents in hospitals. Design, setting and participants: Anonymous survey of 186 doctors and 587 nurses from diverse clinical settings in six South Australian hospitals (response rate = 70.7% and 73.6%, respectively). Main outcome measures: Knowledge and use of the current reporting system; barriers to incident reporting. Results: Most doctors and nurses (98.3%) were aware that their hospital had an incident reporting system. Nurses were more likely than doctors to know how to access a report (88.3% v 43.0%; relative risk (RR) 2.05, 95% CI 1.61 to 2.63), to have ever completed a report (89.2% v 64.4%; RR 1.38, 95% CI 1.19 to 1.61), and to know what to do with the completed report (81.9% v 49.7%; RR 1.65, 95% CI 1.27 to 2.13). Staff were more likely to report incidents which are habitually reported, often witnessed, and usually associated with immediate outcomes such as patient falls and medication errors requiring corrective treatment. Near misses and incidents which occur over time such as pressure ulcers and DVT due to inadequate prophylaxis were least likely to be reported. The most frequently stated barrier to reporting for doctors and nurses was lack of feedback (57.7% and 61.8% agreeing, respectively). Conclusions: Both doctors and nurses believe they should report most incidents, but nurses do so more frequently than doctors. To improve incident reporting, especially among doctors, clarification is needed of which incidents should be reported, the process needs to be simplified, and feedback given to reporters.

The relationship between the big five personality factors and burnout: a study among volunteer counselors

Abstract: In the present study of 80 volunteer counselors who cared for terminally ill patients, the authors examined the relationship between burnout as measured by the Maslach Burnout Inventory (C. Maslach, S. E. Jackson, & M. P. Leiter, 1996) and the 5 basic (Big Five) personality factors (A. A. J. Hendriks, 1997): extraversion, agreeableness, conscientiousness, emotional stability, and intellect/autonomy. The results of 3 separate stepwise multiple regression analyses showed that (a) emotional exhaustion is uniquely predicted by emotional stability; (b) depersonalization is predicted by emotional stability, extraversion, and intellect/autonomy; and (c) personal accomplishment is predicted by extraversion and emotional stability. In addition, some of the basic personality factors moderated the relationship between relative number of negative experiences and burnout, suggesting that personality may help to protect against known risks of developing burnout in volunteer human service work.

Transition: a literature review

Abstract: Aim. This paper reports a comprehensive literature review exploring how the term ‘transition’ has been used in the health literature. Background. The meaning of transition has varied with the context in which the term has been used. The last 3 decades have seen altered understandings in the concept of transition in the social science and health disciplines, with nurses contributing to more recent understandings of the transition process as it relates to life and health. Method. The CINAHL, Medline, Sociofile and Psychlit databases were accessed and papers published between 1994 and 2004 were retrieved to answer the questions ‘How is the word transition used?’ and ‘What is the concept of transition informing?’ Transition theoretical frameworks were also explored. Findings. Widespread use of the word ‘transition’ suggests that it is an important concept. Transitional definitions alter according to the disciplinary focus, but most agree that transition involves people's responses during a passage of change. Transition occurs over time and entails change and adaptation, for example developmental, personal, relational, situational, societal or environmental change, but not all change engages transition. Reconstruction of a valued self-identity is essential to transition. Time is an essential element in transition and therefore longitudinal studies are required to explore the initial phase, midcourse experience and outcome of the transition experience. Conclusion. Transition is the way people respond to change over time. People undergo transition when they need to adapt to new situations or circumstances in order to incorporate the change event into their lives. Transition is a concept that is important to nursing; however, to further develop understandings, research must extend beyond single events or single responses. Longitudinal comparative and longitudinal cross-sectional inquiries are required to further develop the concept.

Antimicrobial resistance in bacteria isolated from aquaculture sources in Australia

Abstract: Aims: To carry out a preliminary assessment of the occurrence of resistance to antimicrobials in bacteria that has been isolated from a variety of aquaculture species and environments in Australia. Method and Results: A total of 100 Gram-negative (Vibrio spp. and Aeromonas spp. predominantly) and four Gram-positive bacteria isolated from farmed fish, crustaceans and water from crab larval rearing tanks were obtained from diagnostic laboratories from different parts of Australia. All the isolates were tested for sensitivity to 19 antibiotics and Minimal Inhibitory Concentrations were determined by the agar dilution method. Plasmid DNA was isolated by the alkali lysis method. Resistance to ampicillin, amoxycillin, cephalexin and erythromycin was widespread; resistance to oxytetracycline, tetracycline, nalidixic acid and sulfonamides was common but resistance to chloramphenicol, florfenicol, ceftiofur, cephalothin, cefoperazone, oxolinic acid, gentamicin, kanamycin and trimethoprim was less common. All strains were susceptible to ciprofloxacin. Multiple resistance was also observed and 74·4% of resistant isolates had between one and ten plasmids with sizes ranging 2–51 kbp. Conclusions: No antibiotics are registered for use in aquaculture in Australia but these results suggest that there has been significant off-label use. Significance and impact of study: Transfer of antibiotic resistant bacteria to humans via the food chain is a significant health concern. In comparison with studies on terrestrial food producing animals, there are fewer studies on antibiotic resistance in bacteria from aquaculture enterprises and this study provides further support to the view that there is the risk of transfer of resistant bacteria to humans from consumption of aquaculture products. From the Australian perspective, although there are no products registered for use in aquaculture, antimicrobial resistance is present in isolates from aquaculture and aquaculture environments.

Application of Accessibility Based Methods for Vulnerability Analysis of Strategic Road Networks

Abstract: This paper describes the development of a method for strategic assessment of vulnerability in road networks. Our vulnerability analysis considers the socio-economic impacts of network degradation, on the basis of changes in the levels of accessibility provided by the degraded network. A number of standard indices of accessibility are considered, including generalised travel cost, the Hansen integral accessibility index, and the ARIA index used in Australia to assess levels of remoteness in rural areas. Simple case studies of a national strategic road network and a regional road network are used to illustrate both the general approach and specific implementations.

Internationalization of Australian Family Businesses: A Managerial Capabilities Perspective

Abstract: Successful international expansion requires the managerial capabilities necessary to configure and leverage a firm's resources in the international marketplace. Because family firms can face unique...

Complementary and alternative therapies for pain management in labour

Abstract: Background Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of alternative and complementary therapies for pain management in labour. Objectives To examine the effects of complementary and alternative therapies for pain management in labour on maternal and perinatal morbidity. Search methods We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (February 2006), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2006, Issue 1), MEDLINE (1966 to February 2006), EMBASE (1980 to February 2006) and CINAHL (1980 to February 2006). Selection criteria The inclusion criteria included published and unpublished randomised controlled trials comparing complementary and alternative therapies (but not biofeedback) with placebo, no treatment or pharmacological forms of pain management in labour. All women whether primiparous or multiparous, and in spontaneous or induced labour, in the first and second stage of labour were included. Data collection and analysis Meta-analysis was performed using relative risks for dichotomous outcomes and mean differences for continuous outcomes. The outcome measures were maternal satisfaction, use of pharmacological pain relief and maternal and neonatal adverse outcomes. Main results Fourteen trials were included in the review with data reporting on 1537 women using different modalities of pain management; 1448 women were included in the meta-analysis. Three trials involved acupuncture (n = 496), one audio-analgesia (n = 24), two trials acupressure (n = 172), one aromatherapy (n = 22), five trials hypnosis (n = 729), one trial of massage (n = 60), and relaxation (n = 34). The trials of acupuncture showed a decreased need for pain relief (relative risk (RR) 0.70, 95% confidence interval (CI) 0.49 to 1.00, two trials 288 women). Women taught self-hypnosis had decreased requirements for pharmacological analgesia (RR 0.53, 95% CI 0.36 to 0.79, five trials 749 women) including epidural analgesia (RR 0.30, 95% CI 0.22 to 0.40) and were more satisfied with their pain management in labour compared with controls (RR 2.33, 95% CI 1.15 to 4.71, one trial). No differences were seen for women receiving aromatherapy, or audio analgesia. Authors' conclusions Acupuncture and hypnosis may be beneficial for the management of pain during labour; however, the number of women studied has been small. Few other complementary therapies have been subjected to proper scientific study.

Relationship between adiposity and body size reveals limitations of BMI.

Abstract: The aims of this study were to assess 1) whether the stature-adjusted body mass index (BMI) is a valid proxy for adiposity across both athletic and nonathletic populations, and 2) whether skinfold measurements increase in proportion to body size, thus obeying the principle of geometric similarity. The research design was cross-sectional, allowing the relationship between skinfold calliper readings (at eight sites and between specific athletic and nonathletic groups, n = 478) and body size (either mass, stature, or both) to be explored both collectively, using proportional allometric MANCOVA, and individually (for each site) with follow-up ANCOVAs. Skinfolds increase at a much greater rate relative to body mass than that assumed by geometric similarity, but taller subjects had less rather than more adiposity, calling into question the use of the traditional skinfold-stature adjustment, 170.18/stature. The best body-size index reflective of skinfold measurements was a stature-adjusted body mass index similar to the BMI. However, sporting differences in skinfold thickness persisted, having controlled for differences in body size (approximate BMI) and age, with male strength- and speed-trained athletes having significantly lower skinfolds (32% and 23%, respectively) compared with controls. Similarly, female strength athletes had 29% lower skinfold measurements compared to controls, having controlled for body size and age. These results cast serious doubts on the validity of BMI to represent adiposity accurately and its ability to differentiate between populations. These findings suggest a more valid (less biased) assessment of fatness will be obtained using surface anthropometry such as skinfolds taken by experienced practitioners following established procedures.

The role of plant residues in pH change of acid soils differing in initial pH

Abstract: Reports on the effect of plant residues on soil pH have been contradictory. The conflicting accounts have been suggested to result from differences in compositions and types of plant residues and characteristics of soils. This incubation study examined the effect of plant residues differing in concentrations of N (3–49 g kg−1) and of alkalinity (excess cations) (220–1560 mmol kg−1) on pH change of three soils differing in initial pH (3.9–5.1 in 0.01 M CaCl2). The addition of plant residues at a rate of 15 g kg−1 soil weight increased the pH of all soils by up to 3.4 units and the pH reached the maximum at day 42 after incubation for Wodjil (initial pH 3.87) and Bodallin (pH 4.54) soils and day 14 for Lancelin soil (pH 5.1). The amount of pH buffering was decreased by residue addition in Wodjil soil, increased in Bodallin soil and remained unchanged in Lancelin soil, which closely related to changes of soil pH. Residue addition increased NH 4 + concentration and the increase in NH 4 + concentration generally correlated positively with the concentration of residue N. The NH 4 + concentration increased with time, reached the peak at Days 42–105 for Wodjil soil, Days 14–105 for Bodallin soil and Days 14–42 for Lancelin soil, and then decreased only in Lancelin soil. The concentration of NO 3 − was kept minimal in Wodjil and Bodallin soils. In Lancelin soil, NO 3 − concentrations increased with incubation time from days 14–28. Irrespective of plant residue and incubation time, the amounts of alkalinity produced due to residue addition correlated highly with the sum of the alkalinity added as plant residues (excess cations) and those resulting from mineralization of residue N, with the slope of regression lines decreasing with increase of the initial soil pH. Direct shaking of soil with the residues at the same rate of alkalinity (excess cations) under sterile conditions increased the pH of the Wodjil soil but decreased it in the Lancelin soil. It is suggested that the decarboxylation of organic anions (as indicated by excess cations) of added plant residues and ammonification of the residue N causes soil pH increase whereas nitrification of mineralised residue nitrogen causes soil pH decrease, and that the association/dissociation of organic compounds also plays a role in soil pH change, depending initial pH of the soil. The overall effect on soil pH after addition of plant residues would therefore depend on the extent of each of these processes under given conditions.

Peer and teacher bullying/victimization of South Australian secondary school students: Prevalence and psychosocial profiles

Abstract: This study examined the nature and prevalence of bullying/victimization by peers and teachers reported by 1,284 students (mean age = 15.2 years) drawn from a representative sample of 25 South Australian government and private schools. Students completed a self-report survey containing questions relating to teacher and peer-related bullying, measures of psychosocial adjustment, and personality. The results showed that students could be clearly differentiated according to the type of victimization they had experienced. Students reporting peer victimization typically showed high levels of social alienation, poorer psychological functioning, and poorer self-esteem and self-image. By contrast, victims of teacher victimization were more likely to be rated as less able academically, had less intention to complete school and were more likely to be engaged in high-risk behaviours such as gambling, drug use and under-age drinking. Most bullying was found to occur at school rather than outside school and involved verbal aggression rather than physical harm. Boys were significantly more likely to be bullied than girls, with the highest rates being observed amongst boys attending single-sex government schools. Girls were more likely to be subject to bullying if they attended coeducational private schools. The implications of this work for enhancing school-retention rates and addressing psychological distress amongst adolescent students are discussed.

Expressed Readiness of Australian Schoolchildren to Act as Bystanders in Support of Children who are Being Bullied

Abstract: Promoting interventive action on the part of student bystanders witnessing peer victimisation is currently seen as a promising way of reducing bullying in schools. A video depicting bullying in the presence of bystanders was viewed by late primary (n = 200) and early secondary school students (n = 200). Some 43% of the students indicated that they were likely to help the victim. Questionnaires were employed to assess student attitudes towards victims, beliefs about the expectations of parents, friends, and teachers, perceived self‐efficacy, and social desirability response set. Multiple regression analysis identified as significant predictors of expressed intention to intervene: attending primary school, having rarely or never bullied others, having (reportedly) previously intervened, positive attitude to victims, and believing that parents and friends (but not teachers) expected them to act to support victims. Implications for action to reduce bullying in schools are discussed.

Acceptance and denial: implications for people adapting to chronic illness: literature review.

Abstract: Aim This paper reports an exploration of the terms acceptance and denial by exploring the literature, with the aim of understanding the implications of using these concepts to categorize people's responses to living with chronic illness Background People learning to live with a chronic illness or condition may be judged and labelled by others as being in denial, particularly when they do not adhere to prescribed treatment regimes Method A literature search for the period between 1989 and 2003 was conducted using the electronic databases Medline, CINAHL, PSYCArticles, Health Source Nursing/Academic Edition, Academic Search Elite and Sociological Abstracts Key terms used were ‘acceptance and denial’ and variations of such themes as ‘chronic illness’, ‘disability’, ‘adjustment’, ‘illness discourse’, ‘medical discourse’, ‘illness experience’, ‘labelling’, ‘self’ and ‘identity’ Discussion The theoretical background of the common constructs ‘acceptance and denial’ are discussed using the psychoanalytic theories of Freud and Kubler-Ross's work on death and dying Healthcare professionals and lay people commonly refer to the terms acceptance and denial when describing a person's response to chronic illness Those whose understanding of the illness experience relies on the acceptance–denial framework may not listen when people with chronic illness attempt to tell their own unique story of how they have experienced life with illness Instead, their listening antennae may be focused on fitting aspects of the experience with stages of adjustment When others use labels of acceptance and denial, people who are learning to live with a chronic illness may internalize these labels as reflections of the self This may be most likely when the person using the label is perceived to have authority, such as a healthcare professional The internalization of negative information associated with these labels may obstruct the reshaping of self-identity that is fundamental when making a transition to living well with chronic illness Conclusion Healthcare professionals are urged to challenge the stage model of adjustment as a way of understanding the response to illness and to listen instead to the stories people tell They are encouraged to privilege the person's experience as the basis for developing a sensitive, client-focussed response that takes into account the wider social context of people's lives as well as the medical aspects

In Vivo Assessment of Arsenic Bioavailability in Rice and Its Significance for Human Health Risk Assessment

Abstract: Arsenic contamination of groundwater has been reported in many countries throughout the world, most notably in Southeast Asia. In recent years, much attention has focused on the As calamity in Bangladesh and West Bengal, India, following the highly publicized reports of vast populations being exposed to As-contaminated groundwater. Recently, Chakraborti et al. (2004) reported that As levels in groundwater from 50 districts in Bangladesh (representing ~ 2,000 villages) exceeded the Bangladesh drinking water guidelines for As of 50 μ with As concentrations in some cases > 1,500 μ(Tondel et al. 1999). The issue in Bangladesh has been described as “the largest poisoning of a population in history” (Smith et al. 2000), with an estimated 35–70 million inhabitants being at risk of drinking As-contaminated water (Khan et al. 1997). Chronic exposure to As causes significant human health effects including various cancers (skin, lungs, bladder, and kidneys), skin disorders (hyperkeratosis and pigment changes), vascular disease, and diabetes mellitus (Guha Mazumder et al. 1998; Guo et al. 1997; Lein et al. 2001; Mandal and Suzuki 2002; Rahman et al. 2001). The increased incidence of these health effects have been observed in Bangladesh and West Bengal populations exposed to As (Ahmed et al. 2006; Mukherjee et al. 2006). In addition to drinking water, consumption of As-contaminated food is another major source of As exposure. In Bangladesh, As-contaminated water is also used for irrigating crops, particularly rice (Oryza sativa L.), which represents approximately 83% of the total irrigated area in Bangladesh (Dey et al. 1996). As a consequence of irrigating with As-contaminated water, rice may contain elevated levels of As. Arsenic concentrations ranging from 160 to 580 μ have been reported in rice from the Jessore district in Bangladesh (Alam et al. 2002), whereas Meharg and Rahman (2003) reported As concentrations > 1,830 μg/kg in rice from other regions of Bangladesh. Because rice is a staple food in Bangladesh, providing > 70% of the daily calorific intake (Ninno and Dorosh 2001), consumption of contaminated rice may represent a significant As exposure pathway. In fact, Meharg (2004) estimated that consumption of As-contaminated rice may contribute as much as 60% of the daily Bangladeshi dietary As intake based on conservative As concentrations in rice. In addition, absorption of As-contaminated water during the rice cooking process may significantly increase the amount of As in cooked rice (Ackerman et al. 2005; Bae et al. 2002), which is often overlooked when calculating As daily intake values. A number of studies have reported the presence of As in rice, ranging in concentration from 32 to 1,830 μg As/kg (Abedin et al. 2002a, 2002b; Alam et al. 2002; D’Amato et al. 2004; Heitkemper et al. 2001; Kohlmeyer et al. 2003; Meharg 2004; Meharg and Rahman 2003; Schoof et al. 1998; Williams et al. 2005); however, few studies have determined the proportion of inorganic to organic As in rice. In terms of human health risk assessment, As speciation is important because the toxicity of organic, inorganic, trivalent, and pentavalent As species vary greatly (Petrick et al. 2000; Vahter and Concha 2001). In addition, there is a dearth of information on the bioavailability of As in rice after consumption. Bioavailability, in the context of human health risk assessment, refers to the fraction of an administered dose that reaches the central (blood) compartment from the gastrointestinal tract (Ruby et al. 1999). After consumption of As-contaminated rice, it is unclear what proportion of the rice-bound As is absorbed and whether As speciation influences absorption from the gastrointestinal tract. To reduce the uncertainties in estimating exposure and to provide a more accurate estimate of risk, assessment of As bioavailability is critical. In this study, we investigated the concentration and speciation of As in supermarket-bought rice, in rice grown under greenhouse conditions using As-contaminated irrigation water, and in rice cooked in As-contaminated water. In addition, we assessed the bioavailability of As in rice using an in vivo swine assay—an animal model used to predict As uptake for human health risk assessment. We assessed As bioavailability in two different rice preparations to determine whether the mode of As accumulation in the grain (translocation by the plant vs. absorption during cooking) influenced As uptake in the swine model.

High-resolution in situ x-ray study of the hydrophobic gap at the water-octadecyl-trichlorosilane interface

Abstract: The knowledge of the microscopic structure of water at interfaces is essential for the understanding of interfacial phenomena in numerous natural and technological environments. To study deeply buried liquid water–solid interfaces, high-energy x-ray reflectivity measurements have been performed. Silicon wafers, functionalized by a self-assembled monolayer of octadecyl-trichlorosilane, provide strongly hydrophobic substrates. We show interfacial density profiles with angstrom resolution near the solid–liquid interface of water in contact with an octadecyl-trichlorosilane layer. The experimental data provide clear evidence for the existence of a hydrophobic gap on the molecular scale with an integrated density deficit ρd = 1.1 A g cm−3 at the solid–water interface. In addition, measurements on the influence of gases (Ar, Xe, Kr, N2, O2, CO, and CO2) and HCl, dissolved in the water, have been performed. No effect on the hydrophobic water gap was found.

Accumulation of trimethylamine and trimethylamine- N -oxide in end-stage renal disease patients undergoing haemodialysis

Abstract: BACKGROUND Trimethylamine (TMA) is a short-chain tertiary aliphatic amine that is derived from the diet either directly from the consumption of foods high in TMA or by the intake of food high in precursors to TMA, such as trimethylamine-N-oxide (TMNO), choline and L-carnitine. The clinical significance of TMA may be related to its potential to contribute to neurological toxicity and 'uraemic breath' in patients with end-stage renal disease (ESRD). METHODS Concentrations of TMA and TMNO in plasma from 10 healthy adults (not on haemodialysis) and 10 adults with ESRD undergoing haemodialysis (pre- and post-dialysis) were determined by gas chromatography-mass spectrometry. RESULTS The concentrations of TMA and TMNO in pre-dialysis plasma (1.39+/-0.483 and 99.9+/-31.9 microM, respectively) were significantly (P<0.05) higher than the corresponding levels in healthy subjects (0.418+/-0.124 and 37.8+/-20.4 microM, respectively). However, there were no significant differences between post-dialysis and healthy subject plasma concentrations. In the ESRD patients, there was a significant (P<0.05) reduction in plasma TMA (from 1.39+/-0.483 to 0.484+/-0.164 microM) and TMNO (from 99.9+/-31.9 to 41.3+/-18.8 microM) during a single haemodialysis session. CONCLUSIONS TMA and TMNO accumulate between haemodialysis sessions in ESRD patients, but are efficiently removed during a single haemodialysis session.