Artigos de revistas sobre o tema "Mild Misunderstanding"

This paper casts light on the myth, current in China before the Opium War, that the Europeans could not survive without rhubarb. The myth has its roots in differences between pharmaceutical theories and material culture in the Chinese and Western traditions. In China, rhubarb was considered a drastic purgative, indicated only in case of grave illness. In the West, in consequence of a specific method of processing, it was regarded as a mild and gentle drug, albeit wonderfully effective in ridding the body of superfluous humoral substances. Thus the same herb acquired completely different images in China and in the West. An important factor that fostered the myth was the Russian government's termination of the rhubarb monopoly in the prelude to the Sino-Russian border conflict in the late eighteenth century. This gave rise to increased smuggling, which was misinterpreted in China as evidence that Russia stood in desperate need of rhubarb. When the border conflict came to an end in 1792, Russia's unusually submissive attitude tended to confirm this misapprehension. This article not only explains why the Qjng government adopted an embargo on rhubarb; it also shows how differing pharmaceutical views influenced international affairs.

IntroductionDetection of mild cognitive impairment (MCI) is essential in slowing progression to dementia. Primary care plays a vital role in detecting and managing MCI. The chronic care model (CCM) provides effective methods to manage chronic diseases.ObjectiveThis study aimed to explore how MCI services are delivered in primary care in China.MethodsFocus group interviews were conducted face to face among MCI stakeholders from six community health centres (CHCs) involved in the ‘friendly community programme’ in Shanghai, China. A total of 124 MCI stakeholders were interviewed, consisting of 6 groups (n=42) of general practitioners (GPs), 3 groups (n=18) of CHC managers, 4 groups (n=32) of people with MCI and 4 groups (n=32) of informal caregivers. Content and thematic analyses were performed using a combination of induction and deduction approaches.ResultsThree major themes emerged from the data corresponding to the CCM framework: hesitant patients, unprepared providers and misaligned environments. While the public are hesitant to seek medical attention for MCI problems, due to misunderstanding, social stigma and a lack of perceived benefits, GPs and CHCs are not well prepared either, due to lack of knowledge and a shortage of GPs, and a lack of policy, funding and information support. None of these issues can be addressed separately without tackling the others.ConclusionThis study combined the diverse perceptions of all the main stakeholders to detect and manage MCI in primary care settings in China. A vicious circle was found among the three interconnected CCM domains, creating a gridlock that should be addressed through a system’s approach targeting all of the above-mentioned aspects.

COVID-19 pandemic situations generate myths that create doubt in society that things have to follow due to some misunderstanding and inadequate shreds of evidence ancient medicine lacking behind despite tremendous potential. Various modalities are in force to prevent a pandemic situation; the Dept of AYUSH is playing a very vital role in this condition. The dept. of AYUSH, Govt. of India giving rise to funding to various research institutes, private organizations, and deemed universities. Simultaneously, to combat pandemic situation AYUSH department focusing on Yoga, Pranayama, consumption of immunomodulatory drugs, herbal medicines, diet regimen and release protocol for COVID-19 mild, moderate and severe conditions. In Ayurveda the Kriyakalpa have mentioned: the therapeutic procedures used to cure the disease and practicably act with prescribed guidelines for specific disorders related to the eyes and ear. The Gandush (oil pulling), one of the types of Kriyakalpa, also can be useful to prevent airborne infections. This procedure helps for the oral cavity's excellent health, which can avoid diseases through the air, increasing the immunity power of surrounding organs and avoiding favorable conditions to get infected. It is readily responsive to clear nasal and oral route and decrease Kapha Dosha. This is a very cost effective and easily adoptable procedure having a negligible diet regime and precautionary measures.

Sources of public concern regarding the Covid-19 vaccine are about the safety and efficacy of the vaccine, vaccine side effects, misunderstanding of the need for vaccination, lack of trust in the health care system, and also the lack of public knowledge of vaccine-preventable Covid-19 disease (Halpin, 2019). Anxiety Feeling experienced by the community can make people doubt or not willing to be vaccinated. The purpose of this study was to determine the relationship between perceptions about the Covid-19 vaccine and anxiety when undergoing a Covid-19 vaccination. The research method used cross sectional with 60 respondents was selected by purposive sampling technique. The Data analysis used statistical test fisher's Exact Test using SPSS 25 for windows obtained negative perceptions as many as 47 respondents (78.3%) and moderate anxiety as many as 43 respondents (71.7%) the significance value of fisher's Exact Test perceptions with anxiety in the community in Tembokrejo village was 0.004 < = 0.05 then H0 was rejected Ha was accepted which means there was a relationship between perceptions about the Covid-19 vaccine and anxiety when going to undergo Covid-19 vaccination in Tembokrejo village in 2022. Positive perceptions will cause mild anxiety while negative perceptions will cause moderate to severe anxiety in the community.

AimsFilms are known to influence the public's perception about mental health conditions. Dementia's prevalence in society has been increasing due to the ageing population. Cinema has long struggled with its depiction of mental health as seen with the depiction of schizophrenia, autism and psychosis in many blockbusters and award winning films. However, the depiction of dementia in films has not been as widely explored. The aim of this paper is to evaluate the depiction of dementia in films to assess its clinically accuracy.MethodsA systematic search of keywords related to dementia was completed on the Internet Movie Database. The search was conducted in May 2022. Non-foreign language feature films were used in this paper. Films from 2000 and onwards were used. The films were analysed on the type of dementia they portrayed. 8 themes and tropes were assessed for each film. The portrayal of healthcare was also assessed. Each film was measured against the Neuropsychiatric Inventory-Questionnaire.Results42 films were used from an initial sample of 1,320. Alzheimer's was found to be the most frequently portrayed cause of dementia. Time-shifting was the most common theme. There was a predominantly negative portrayal of care homes with a positive portrayal of carers. The films, measured against the NPI-Q, produced on average a lower severity of neuropsychiatric symptom score and carer distress score.ConclusionThe depiction of dementia was mild in comparison to dementia's clinical manifestation. Films showed a positive portrayal of healthcare workers which can be considered rare when looking at cinema's history with psychiatry. Overall, films did not accurately portray the clinical aspect of dementia as they tended to focus more on the early stages of the diagnosis. However, films were realistic in their depiction of the emotional challenges that comes with a diagnosis of dementia. Film's powerful role in influencing the public's perception could be used to help reduce stigma and misunderstanding. Filmmakers could work with clinicians to help produce accurate portrayals of dementia. Patients experience the emotive aspect of their diagnosis but also equally experience the symptomatic aspects and cinema should be able to embody that. An accurate portrayal can still maintain the appeal of cinema and at the same time help with reducing misunderstanding and stigma held by the public about dementia which can help improve health outcomes.

At present there is no consensus on defining “Recovery” in schizophrenia,while there is an accepted definition of “Remission”. Remission model considers “stability” the treatment primary goal and, once achieved, focus is on mainteining stability and preventing relapse. This model reflects a condition where are absent prominent symptoms but may be present some mild symptoms of schizophrenia, retaining not realistic absence of any symptoms. It would require treating an acute psychotic episode,then there still may be a range of no detectable or persistent and disabling symptoms:remission and level of functioning are related but not the same. Some patients could have good level of functioning despite persistent symptoms and others could meet remission criteria despite considerable impairments. Remission is an obteinable outcome for many psychotic outpatients:the point of departure between manteinance and recovery-oriented model happens only after “stability” is achieved;no one could recover in face of repeated crisis,hospitalisation or unrelenting psychotic symptoms. Unfortunately two causes have resulted in a relative neglect of the concept of recovery from psychotic illness:the divide between mainstream biologically oriented psychiatry and the psychiatric rehabilitation movement;the misunderstanding fact that term “recovery movement” is sometimes construed as anti-medication or anti-psychiatry orientation. Irrefuteble point is that recovery model not rejects the importance of remission:stability and relapse prevention. The recovery model besides asserts that achieving remission is the beginning and not the end of treatment plan:then there will be continued efforts to work with patient,family,caregiver,to continue to achieve further improvements in life goals. The “Recovery” patient-centred model have to be embraced as prymary goal by mainstream organizations and services in Mental Health.

AbstractObjective:To determine the reliability of ST-segment interpretation by paramedics from lead-II rhythm strips obtained in the prehospital setting.Design:Prospective, blinded study of 127 patients transported by an urban/rural emergency medical services system with complaints consistent with ischemic heart disease.Methods:Emergency department physicians asked emergency medical technician-paramedics (EMT-P) via radio to evaluate ST-segments for elevation or depression and grade it as “mild,” “moderate,” or “severe.” Then, this rhythm strip was interpreted blindly by emergency physicians who also interpreted the lead-II obtained from a 12-lead electrocardiogram (ECG) obtained in the emergency department (ED). The field interpretation was compared with the subsequent readings and the final in-patient diagnosis using positive predictive value (PPV), negative predictive value (NPV), and the Kappa statistic. Markedly discrepant interpretations were analyzed separately.Results:Using physician interpretation as the reference standard, paramedic interpretation of the lead-II ST-segments obtained in the prehospital setting was correct (within ±1 gradation) in 113 out of 127 total cases (89%). Of 105 patients for whom final hospital diagnosis was available, the ST-segment on the rhythm strip obtained in the prehospital setting, had a positive predictive value of 74% and a negative predictive value of 85% for myocardial ischemia or myocardial infarction (MI) (p <0.001, Kappa = 0.59). Discordant interpretations between the paramedics and emergency physicians often were related to a basic misunderstanding of rhythm strip morphology.Conclusion:Field interpretation of ST-segments by paramedics is fairly accurate as judged both by emergency physicians and correlation with final patient outcome, but its clinical utility is unproved. A small but clinically significant number of outliers, consisting of markedly discrepant false positives, reflects paramedic uncertainty in identifying the deviations of the ST-segment.

Employing different meanings of classical concepts of saving, capital, investment, and money, and incorrectly attributing the assumption of full employment of labor and a world of certainty to classical analysis, John Maynard Keynes ([1936] 1974) faulted Say’s Law as irrelevant to the real world. Roy Grieve (2016) ignores previous clarifications of Keynes’s misrepresentations and misunderstandings of John Stuart Mill’s restatements of the law. He employs similar misrepresentations and misunderstandings of Mill’s explanations as Keynes did. His model of Mill’s analysis is incapable of explaining how variations in relative prices, the value of money, and interest rates coordinate production, consumption, and savings decisions in a monetary economy.

Relevance. Today LUTS cause a lot of complexity and misunderstanding among doctors and patients. Among the symptoms, nocturia is the most difficult to interpret. Nocturia affects a significant part of the population, especially in older age groups. Currently, there are no data on the ratio of nocturia in various diseases of neurological etiology which are manifested by nocturia. Nocturia can be classified only according to urination diaries: diurnal polyuria, nocturnal polyuria, decreased bladder capacity, sleep disorders, and circadian rhythm disorders. Nocturia is also classified by degree of severity: mild severity from 1 to 3 episodes of nocturnal urination and severe when the number of nocturnal awakenings for urination is more than 3.Objective. To prove the effectiveness of the analysis of additional data on the daily diary of urination, together with the determination of the specific gravity of urine in the daytime and at night in patients with nocturia.Material and methods. Two hundred eleven male patients were examined, with nocturia from 1 to 6 times and with a diagnosis of benign prostatic hyperplasia (BPH). The average age of the patients was 71 ± 4.7 years, the age interval of patients ranged from 50 to 84 years. the presence of symptoms of the lower urinary tract (LUTS), the total score on the I-PSS scale> 21, an indicator of the quality of life index QOL> 3, the maximum flow rate of urine (Qmax)> 10ml / s, residual urine volume (OOM) <150 ml.Discussions. The lack of improvement in urination disorders and the inability to determine the type of nocturia led to an in-depth analysis of urination diaries taking into account the duration of night sleep, determination of night and day diuresis, and also, features of deviation of the urine specific gravity at night. Together with one of the days of urination diary filling, it was recommended to perform a urinalysis according to Zimnitsky. In 4 (1.8%) patients, daily polyuria with diuresis of more than 40 ml / kg per day was determined. One hundred thirty-nine (65.8%) people had nocturnal polyuria with a predominance of nocturnal diuresis of 1.8 ± 0.8 ml / min. over daytime 1.32 ± 0.3 ml / min. A decrease in bladder capacity was detected in 56 (26.5%) male patients. Twelve (5.6%) patients had various sleep disorders, which was the reason for their awakening.Findings. An in-depth analysis of urination diary data, including information on the duration of sleep and the determination of the circadian rhythm of the specific gravity of urine, is the key to successfully determining the cause of nocturia, especially in patients with nocturnal polyuria.

Having in the General Theory quoted a passage from John Stuart Mill’s Principles as representative of ancient confusion, John Maynard Keynes has been accused of misinterpreting that passage and thus mistakenly identifying Mill as an upholder of the “classical” proposition that “supply creates its own demand.” Certain critics, seizing on Keynes’s misunderstanding, draw the conclusion that little was actually wrong with Mill’s analysis and that Keynes’s attack on Mill was therefore without justification.Our contention, however, is that, despite his error with respect, so to say, to the “letter” of Mill’s exposition, Keynes was right about the essential “substance” of Mill’s thesis. Mill’s thinking, we suggest, was deeply in thrall to the ideas of his father and Jean-Baptiste Say. The purpose of this paper is to demonstrate that Mill did indeed stand for a “classical” position, albeit qualified, but nevertheless vulnerable to Keynes’s critique as developed in the General Theory.

The question, “Why has Harriet Taylor MM appeared in the history of philosophy as she has?” has several answers. The answers intertwine the personality and polities of Harriet, the sexism of those who wrote of her (which was a reflection of the overall status of women during the period the commentator wrote), misunderstandings of the means and meaning of her collaboration with John Stuart Mill, and the disturbing challenge of her questioning.

Abstract It is confusing: many common colds are caused by coronaviruses, but not all coronaviruses cause colds. Some, like SARS-CoV-2, the coronavirus responsible for COVID-19, can cause serious health complications and death. To reduce the risk of the public innocently (and understandably) conflating COVID-19 with the mild sicknesses associated with a common cold, one job of public health would need to be to “make the familiar strange and the strange familiar.” But wait, that is the work of anthropology. I argue that what is missing from many public discussions of COVID-19 is a straight answer to a simple question central to the public’s uptake of science, health guidelines, mandates, and even vaccines: “How do viruses work, that is, infect our cells and make us sick?” The essay that follows attempts to answer this question, contributing to public health by making a critical anthropological distinction between “sickness” and “infection.”

AbstractModern research has established the prejudice that Diocletian focused on defending Roman law against the influence of primitive legal concepts of non-Roman origin and aimed to protect classical law from any kind of change. This is based, on the one hand, on circular textual criticism, which declared all innovations in the jurisprudence of Diocletian’s chancellery to be the result of later alterations of the primary texts, and, on the other hand, on the assumption that the parties to a dispute confronted the emperor directly with their own legal ideas, even though they knew that he judged only according to Roman law. An unbiased examination of Diocletian’s decisions on the law of obligations reveals a completely different picture: The rulings by which Diocletian’s chancellery purportedly reacted to popular legal ideas can almost always be explained by misunderstandings which stem from the concepts of classical Roman law itself. And once liberated from the exaggerated textual criticism of the 20th century, one can identify a variety of innovations that are more in keeping with Diocletian’s character than the obstinate conservatism that is commonly attributed to him in legal matters.

Abstract A question raised again and again over many decades by pulp and paper mill personnel and local authorities in many countries is, "Does the finding of large numbers of coliform enteric bacteria in the mill water or biotreatment system indicate a real health hazard for the mill workers or the downstream public?" Some of the difficulties in answering this question arise from the widespread misunderstanding of what coliform indicator (enumeration) tests can tell us. Increasing scientific understanding over the last 30 years has greatly altered the coliform indicator tests, the types of bacteria enumerated, and our ability to distinguish harmless from pathogenic (disease-producing) bacteria. This brief review discusses our current understanding of where and when it is appropriate to use coliform indicator assays and the meaning of the results.

Rampant caries is a multifactorial disease that interacts with each other. Factors in the incidence of dental caries include factors from food, oral hygiene, and habits that are not in accordance with health such as eating food and feeding through bottles. In addition, parents' misunderstanding of the causes of caries, such as using milk, further exacerbates the occurrence of rampant caries in children. This study aims to determine the relationship between mother's behavior regarding bottle feeding with rampant caries in TK Negeri 7 Sabang City. This research is analytic with cross-sectional approach. Sampling used total sampling, namely all 45 children of TK Negeri 7 Sabang City and their mothers as respondents, by conducting dental examinations on children and interviews with mothers. The research instrument used a diagnostic set and a questionnaire. The results of the study were tested statistically using the SPSS program with a chi-square test (a = 0.05). It can be concluded that there is a relationship between mother's behavior about bottle feeding and rampant caries in TK Negeri 7 Sabang City. It is recommended to further improve good behavior towards children when giving bottle milk to avoid rampant caries.

Abstract Deficiency of clotting factors VIII (Hemophilia A) and IX (Hemophilia B) represent one of the most debilitating inherited groups of bleeding disorders. According to the most recent survey report from the World Hemophilia Federation, an estimated 178,500 patients suffer from hemophilia globally (143,000 Hemophilia A, 28,000 with Hemophilia B approximately). By most recent estimates from 2014 India has surpassed every country in the global database with a total of 17,470 patients with hemophilia ahead of USA with its 17,131 reported cases. Infectious disease and perinatal mortality take precedence for resource allocation in evolving economies like India, presenting an ongoing challenge for "rare" diseases like hemophilia. This study assesses the quality of hemophilia care at the SMS Medical School which is the flagship medical care center in the northwestern Indian city of Jaipur, the capital of the largest Indian state with an area of 0.34 million square kilometers and population of 68.55 million. Since the introduction of the free factor distribution in the fall of 2012, the program grew from a modest patient population size of 60 patients to a robust 700 plus patients within 4 years aided by the World Hemophilia Twinning program grant. A standardized self-administered questionnaire was administered to all the hemophilia patients seen at the outpatient comprehensive hemophilia program (CHP) at the SMS Medical College between February 1, 2016 and May 5, 2016. Two hundred patients met the inclusion criteria and participated in the study. One hundred eighty-seven (94%) and 13 (6) patients were diagnosed with hemophilia A and B respectively; 126 (63) had severe disease while 65 (33) had moderate and 9 (5) had mild hemophilia. In an expected male predominant sample (n=198 males [99.5]), the median age at the time of study was 12 years (range=1-53 years), and 144 (72) patients were from rural outskirts of the resource poor state visiting the tertiary care center for hemophilia care. Contrary to popular belief, only a minority 11% and 1% of patients identified themselves of the Muslim and Sindhi faith respectively, versus a majority 87% who followed Hinduism. Tenets of consanguinity and family size have often led to misunderstanding and stigmatization of the disease in the Asian subcontinent prior to this study thus far. Despite a majority 63% patients suffering from severe hemophilia, nearly half (44%) reported a delay of more than 6 months in diagnosis time from the first bleed. Remarkably, 96 % reported to know their diagnosis fully and 93% reported understanding that hemophilia is a genetically transmitted disorder but approximately 82.5 % did not know if they ever underwent testing for viral infections (H.I.V, Hepatitis B, C ) since their diagnosis . Nearly 45 % were offered genetic counseling services at some point during their care, a remarkable feat for a hemophilia program in a resource strapped environment. Inpatient stay for bleeds and complications in this predominantly severe mix of patients was encouragingly less than 1-5 days in 93% of the patients but despite free drug delivery program 79% families reported an out of pocket expense of more than 10,000 Indian rupees (INR; approximately 147 USD) during the hospital stay. This in a state where 65% of patients reported per capital household income less than 100,000 INR (1,485 USD) was particularly concerning. Nearly 18 % of the respondents identified themselves as below poverty (BPL) and enjoyed the benefits of free transportation under the governmental subsidies through a BPL card. Household income and below poverty status were not associated with hemophilia care outcomes (p-values <0.1). Reported favorable patient satisfaction (86%) and continued access to free factor infusion services irrespective of socio economic status as demonstrated by this study, for a resource limited setting caring for over 600 hemophilia patients should be considered a success. New epidemiologic insights from this study will help researchers and clinicians alike to design care delivery models for hemophilia. Not only does this study reflect the power of international collaborations in remarkably improving services for such ignored debilitating diseases in the resource limited nations but also presents as a unique first quality assessment tool for the nation with the largest number of identified hemophilia patients in the world. Disclosures Parnes: Pfizer: Consultancy; Baxalta: Research Funding. Neufeld:Pfizer: Consultancy; baxalta: Consultancy, Research Funding.

Colleen Hoover's novel entitled Regretting You was first published in 2019. The novel reflects the intricate layers of human relationships of self-discovery, forgiveness, and lifelong family connections. Morgan and her teenage daughter, Clara, is dealing with the tragic deaths of Morgan's husband and Clara's father. As they deal with their grief and try to rebuild their lives, secrets and misunderstandings emerge, straining their relationship and causing them to experience dysthymia. Dysthymia is a lifelong form of depression, according to Michael E. Thase and Susan S. Lang. Then, how the symptoms of dysthymia depicted by Morgan and Clara in Colleen Hoover’s Regretting You? Employing a qualitative research approach, the researchers explore the symptoms of dysthymia, including changes in feeling, thinking, and behavior. Morgan and Clara's dysthymia evolves as they navigate the conflicts in the story, mainly due to the grief resulting from their loss. As a result, their mental and emotional health suffers greatly. This leads to the conclusion that their dysthymia exacerbates the tension in their mother-daughter relationship, making it difficult for them to communicate effectively and solve problems, all due to their enduring mild depression.

The authors analyze the potential effects of automation on the jobs of truck drivers and conclude that media accounts predicting the imminent loss of millions of truck-driving jobs are overstated. Their conclusion is based on three main factors. First, the count of truck drivers is often inflated due to a misunderstanding of the occupational classification system used in federal statistics. Second, truck drivers do more than drive, and these non-driving tasks will continue to be in demand. Third, the requirements of technology, combined with complex regulations over how trucks can operate in the United States, imply that certain segments of trucking will be easier to automate than others. Long-haul trucking (which constitutes a minority of jobs) will be much easier to automate than will short-haul trucking (or the last mile), in which the bulk of employment lies. Although technology will likely transform the status quo in the trucking industry, it does not necessarily imply the wholesale elimination of the demand for truck drivers, as conventional accounts suggest.

Introduction. The prevalence of schizophrenia in the world reaches 1.4 %, and the number of patients with negative disorders in this group is 90.0 %. Negative symptoms (NS) can be considered the main category symptoms of schizophrenia. They are described as a change in the patient’s usual behavior, which is usually caused by a decrease or lack of motivation, interest, and a violation of the emotional component. Currently five signs are considered key manifestations of schizophrenia NS: flattened affect, alogia, anhedonia, asociality and abulia. The leading manifestation of NS is a flattened affect, characteristic with the weakness of emotional reactions, emotional blunting with a decrease in the brightness of feelings, empathy, indifference to others, misunderstanding of the subtleties of human communication, formality, superficiality of interpersonal relations, low expressiveness of gestures and facial expressions, modulation of voice, posture and emotions. All these manifestations have negative social consequences. At the moment, understanding disorders of the affective sphere manifestations in patients with NS in schizophrenia is far from complete; subsequently the development of innovative treatment of this particular condition has been far too slow, being considered an unsolved problem in modern psychiatry. Therefore, the investigation of the features of the affective sphere in patients with NS in schizophrenia is relevant and requires further careful studies. The aim of the study – to determine the peculiarities of the dynamics of the clinical-psychopathological structure and the severity of affective flattening in patients with NS in schizophrenia in order to improve the diagnosis and correction of the affective sphere in schizophrenia. Materials and methods. Clinical-psychopathological, psychometric (SANS scale) and statistical research methods were used to study the dynamics of the characteristics of the affective sphere in patients with negative symptoms in schizophrenia. In total 252 patients with NS of schizophrenia took part in the investigation, including: 83 patients with a first psychotic episode; 88 patients with schizophrenia in a state of exacerbation; and 81 patients with schizophrenia in a state of remission. Results. Verification of negative violations was carried out using the SANS scale. Affective flattening or blunting prevailed in 34.67 % of patients with a first psychotic episode, in 49.18 % of patients with schizophrenia in a state of exacerbation, and in 68.21 % of patients with schizophrenia in a state of remission. The main manifestation included impoverished expressiveness of reactions and emotional sensitivity. Weakening of emotional reactions, mental coldness, indifference, monotony were also observed. On this background, many patients lost all feelings for relatives and loved ones, and showed complete indifference to themselves and their condition. It was found that the most affected components in patients with a first psychotic episode were reduced expressiveness of speech, avoidance of eye contact, subjective feeling of loss of emotions, and inadequacy of affect. In patients with schizophrenia in a state of exacerbation, intensification of affect was added to the listed symptoms, and in patients with schizophrenia in a state of remission, indicators of intensification of affect increased and symptoms of impoverished motor expressiveness, decreased spontaneous mobility, and impoverished facial expressions were added. Conclusions. The peculiarities of the dynamics of the characteristics of the affective sphere in patients with negative symptoms in schizophrenia were established: a) patients with the first psychotic episode (group I) were characterized mainly by minimal disturbances of emotional reactions and minimal manifestations of impoverished facial expressions; lack of reduced mobility; minimum and average levels of motor expression disorders; a slight level of inadequacy of affect, a subjective feeling of loss of emotions and eye contact disorders; mainly a moderate level of speech intonation deficiency; b) patients with negative symptoms of schizophrenia in an acute state (group II) were characterized mainly by mild and minimal levels of facial expression impoverishment; minimal decrease in spontaneous mobility; mainly minimal and average levels of expressive motor disorders; pronounced and severe levels of eye contact avoidance; a slight decrease in emotional reactions; moderate level of inadequacy of affect, lack of language intonations and subjective feeling of loss of emotions; c) patients with negative symptoms of schizophrenia in a remission (III group) were characterized mainly by moderate and pronounced levels of impoverishment of facial expressions, spontaneous mobility, motor expressiveness, avoidance of eye contact, reduction of emotional reactions; moderate inadequacy of affect; lack of language intonations of pronounced and severe levels; expressed subjective feeling of loss of emotions. The obtained data can be used to establish diagnostic criteria among patients with negative symptoms in schizophrenia, depending on the dynamics of the disease.

BACKGROUND: In children, injuries are the focus of attention both for the increasing incidence and necessity of pain management, and pain can be indicate the severity of injuries or serious complications that worsens the treatment results. Despite the obvious problem, information available in the literature regarding the theoretical and practical aspects of acute pain in children is often contradictory and needs to be systematized. AIM: To present current information about the epidemiology, physiology, diagnosis, and treatment of acute pain in children to pediatric orthopedic and trauma specialists. MATERIALS AND METHODS: Selective analysis and narrative review of relevant studies analyzing the epidemiology, diagnosis, and management of acute pain in children were performed. RESULTS: Although various pain assessment tools are available, the clinical assessment of acute pain in children remains challenging. The use of these tools depends on the child’s age, cognitive and communication skills, and pain location. The term oligoanalgesia has been used to describe inadequate pain relief in the emergency department. Oligoanalgesia in children has negative physiological and psychological effects, sometimes with long-term consequences, and may negatively affect their future pain experiences. Parents often underestimate their child’s pain level and have serious misunderstandings about how children express pain. The World Health Organization has developed recommendations for pain management in children. Ibuprofen and paracetamol are recommended as analgesics for mild-to-moderate pain in children aged 3 months. This choice considered extensive data on the effectiveness and safety. CONCLUSIONS: Personalized management strategies utilizing biopsychosocial approach will ensure that children are treated comprehensively according to their unique pain status.

Love is a small word that carries many meanings. In everyday life, we refer to love without considering its meaning because the meaning depends on the object to which we refer. Love in nursing is considered one of the pillars of the science of caring. However, this assumption has some misunderstandings. It is important to clarify the scope of love in a therapeutic relationship and to understand how love manifests itself. Objective: To understand the lived experience of love by mental health nurses in the therapeutic relationship in nursing. Method: The study used a qualitative methodology, phenomenology of practice established by Max van Manen, rooted in philosophy, using philosophical, philological, and human sciences methods. Experiential reports were collected from 10 mental health nurses. The understanding of the meanings and senses of the phenomenon was based on radical reflection using epoché and reduction. Results: Love shows itself as seeing the invisible; as the impossibility of non-action; as reassuring gestures; as “going the extra mile”; as being attuned; as being connected; as letting the other to emerge; as hosting the other in oneself; as a pathic experience; and as a personal cost. Conclusion: Love is a transformative ingredient of the therapeutic relationship experience. This study is a possible understanding of the phenomenon of love in the therapeutic relationship in nursing. In addition, the study is a contribution to help clarify and demystify stereotypes and trigger reflections on the everyday relationships in nursing. Therefore, it may promote understandings that make the practice of care more sensitive and closer to the world of each patient.

Abstract The class of $\ell _q$-regularized least squares (LQLS) are considered for estimating $\beta \in \mathbb{R}^p$ from its $n$ noisy linear observations $y=X\beta + w$. The performance of these schemes are studied under the high-dimensional asymptotic setting in which the dimension of the signal grows linearly with the number of measurements. In this asymptotic setting, phase transition (PT) diagrams are often used for comparing the performance of different estimators. PT specifies the minimum number of observations required by a certain estimator to recover a structured signal, e.g. a sparse one, from its noiseless linear observations. Although PT analysis is shown to provide useful information for compressed sensing, the fact that it ignores the measurement noise not only limits its applicability in many application areas, but also may lead to misunderstandings. For instance, consider a linear regression problem in which $n&gt;p$ and the signal is not exactly sparse. If the measurement noise is ignored in such systems, regularization techniques, such as LQLS, seem to be irrelevant since even the ordinary least squares (OLS) returns the exact solution. However, it is well known that if $n$ is not much larger than $p$, then the regularization techniques improve the performance of OLS. In response to this limitation of PT analysis, we consider the low-noise sensitivity analysis. We show that this analysis framework (i) reveals the advantage of LQLS over OLS, (ii) captures the difference between different LQLS estimators even when $n&gt;p$, and (iii) provides a fair comparison among different estimators in high signal-to-noise ratios. As an application of this framework, we will show that under mild conditions LASSO outperforms other LQLS even when the signal is dense. Finally, by a simple transformation, we connect our low-noise sensitivity framework to the classical asymptotic regime in which $n/p \rightarrow \infty$, and characterize how and when regularization techniques offer improvements over ordinary least squares, and which regularizer gives the most improvement when the sample size is large.

The statement of Latency in management Strategy in the Mindset of disaster or crisis managers (management) can cause misunderstanding intentionally or unintentionally in distinguishing a Disaster from a Crisis. Mitigating the consequences depends on whether the cause of the disorder is understood clearly or not! Many serious accidents such as Fukushima, Bhopal, Chernobyl and Three Mile Island show vast consequences, although different but primarily related to a similar factor, which is “Human Deficiency”. Literature shows, although leadership and top management and processes and mechanisms and good strategies are existent, yet problems remain. The fact is that there are fewer studies formulated in this field, from the crisis management strategies point of view, this is the deficiency. The article aims to shed light on the Importance and how to better understand Latency in management Strategy at Management levels, and to better say by the Core Native Human Effective Components (CNHECs) for better knowing and understanding the reality to better act based on the real management strategy in the Mindset (Based on the mind bandwidth). In addition, to understand whether ignoring ignorance is a good management strategy in time of crisis and will it buy time and be effective in not accurate managers or the other way around. Core Native Human Effective Components (CNHECs) are extracted from the Native Human Effective Components (NHECs) that are refined among different Human Effective Components (HECs) based on the literature reviewed in an article recently published by the authors of this article which can help to better understand the latency in management. These components may be generated and be shaped in the crisis managers’ minds’ bandwidth which can be used as a precautionary action to be avoided not to cause more situations that are complex through increase of resiliency and decrease of distress. As a conclusion, we understand that reality may be completely different from what could be assumed, understood and seen. It should be considered that actions are always based on the disaster and crisis Managers’ understanding. For better understanding, the reality we propose a method, Model or a taxonomy that to some extent clarifies and focuses on the statement of latency in management strategy process. This Structure, model or taxonomy shows how and through which windows (Soft, Semi Soft and Hard Spheres) we can get into it and to say how to better understand the function of latency in management strategy by special consideration of CNHECs which can help us to distinguish a crisis from a disaster. It is important to know that by a good Recognition and revealing and also by Better Understanding Core Native Human Effective Components (CNHECs), the disaster and crisis managers can Increase Resiliency and Decrease Distress especially in time of occurrences of different kinds of sudden emergencies generated from different kinds of hazards.

The clinical diagnosis of Alzheimer disease (AD) has been well established, but there is a widespread misunderstanding about the relationship between dementia (a syndrome) and AD (a cause of dementia). AD is the most common etiology that causes dementia in mid- and late life. The prototypical clinical presentation is that of a gradually worsening problem with learning new information, that is, a short-term memory deficit, accompanied by cognitive impairment in other domains, including language, spatial cognition, and executive functioning, as well as changes in personality and behavior. A key element of the diagnosis of dementia is that daily functioning is impaired. The concept of mild cognitive impairment (MCI) as the earliest symptomatic presentation of a dementing illness is now widely accepted. MCI due to AD typically presents with isolated problems with learning and memory without substantial loss of ability to function in daily life. Less common variants of AD are now recognized and include a disorder in which spatial and visual cognitive dysfunction occurs or in which word-finding problems predominate at the onset of symptoms. Although AD as a cause of dementia is the most common among etiologies, AD often co-occurs with other neurodegenerative diseases and with cerebrovascular disease. The presence of multietiology dementia in which AD is a contributor is particularly common in the eighth decade of life and beyond. Key words: Alzheimer disease, cognitive impairment, dementia, mild cognitive impairment

The clinical diagnosis of Alzheimer disease (AD) has been well established, but there is a widespread misunderstanding about the relationship between dementia (a syndrome) and AD (a cause of dementia). AD is the most common etiology that causes dementia in mid- and late life. The prototypical clinical presentation is that of a gradually worsening problem with learning new information, that is, a short-term memory deficit, accompanied by cognitive impairment in other domains, including language, spatial cognition, and executive functioning, as well as changes in personality and behavior. A key element of the diagnosis of dementia is that daily functioning is impaired. The concept of mild cognitive impairment (MCI) as the earliest symptomatic presentation of a dementing illness is now widely accepted. MCI due to AD typically presents with isolated problems with learning and memory without substantial loss of ability to function in daily life. Less common variants of AD are now recognized and include a disorder in which spatial and visual cognitive dysfunction occurs or in which word-finding problems predominate at the onset of symptoms. Although AD as a cause of dementia is the most common among etiologies, AD often co-occurs with other neurodegenerative diseases and with cerebrovascular disease. The presence of multietiology dementia in which AD is a contributor is particularly common in the eighth decade of life and beyond. Key words: Alzheimer disease, cognitive impairment, dementia, mild cognitive impairment

The clinical diagnosis of Alzheimer disease (AD) has been well established, but there is a widespread misunderstanding about the relationship between dementia (a syndrome) and AD (a cause of dementia). AD is the most common etiology that causes dementia in mid- and late life. The prototypical clinical presentation is that of a gradually worsening problem with learning new information, that is, a short-term memory deficit, accompanied by cognitive impairment in other domains, including language, spatial cognition, and executive functioning, as well as changes in personality and behavior. A key element of the diagnosis of dementia is that daily functioning is impaired. The concept of mild cognitive impairment (MCI) as the earliest symptomatic presentation of a dementing illness is now widely accepted. MCI due to AD typically presents with isolated problems with learning and memory without substantial loss of ability to function in daily life. Less common variants of AD are now recognized and include a disorder in which spatial and visual cognitive dysfunction occurs or in which word-finding problems predominate at the onset of symptoms. Although AD as a cause of dementia is the most common among etiologies, AD often co-occurs with other neurodegenerative diseases and with cerebrovascular disease. The presence of multietiology dementia in which AD is a contributor is particularly common in the eighth decade of life and beyond. Key words: Alzheimer disease, cognitive impairment, dementia, mild cognitive impairment

This study examines the types of requesting strategies that occur in the English textbook and investigate the context of the dialogues in the textbook. This research employed qualitative content analysis approach. The data were utterances, in the form of sentences, clauses or words that appears in the textbook, while the contexts of the data were the dialogues. Data were obtained through document analysis consisted of nine request strategies. The data were analyzed by determining the request strategies based on Trosborg‘s theory (1995), and context of situation theory by Holmes (2001). The result shows that there are eight strategies of requesting found within the textbook. The types that appears most frequently within the textbook is questioning ability/willingness and the slightest showing up is mild hints and suggestory formulae. A few sorts are also found such as, imperatives, demands/needs, wish, permissions, and strong hints. The data showed, understanding speech acts also means understanding how language is used and practiced or, in other words understanding the context. Thus, misunderstanding and misinterpretation can be minimized.Keywords: Requesting, Speech Act, Context of Situation, Textbook

Abu Hatim Muhammad ibn Idris al-Raziy (266h) is a leading figure in the science of hadith among the first generation (al-mutaqaddimun) especially in the al-Jarh and al-Ta'dil discipline. He made a lot of assessment and criticism on the narrators via different words and ways. The interpretation of his criticism sometimes is ambiguous, and sometimes supplemented by a clear statement and proof. This ambiguity usually happened in his assessment because of the complexity of the utterance-words, multiple uses of the structure, inconsistencies and sometimes because of the existence of contradictions. This matter may lead to confusion and misunderstanding among researchers of narrators or hadith. One of the utterances were: "Laysa bidzak al-qawiy" meaning: Not so strong. This phrase literally means the narrator is not so weak that will drop it to the level of da'if or matruk, even it seems like a mild criticism that carries higher value than: "Laysa bilqawiy" or "Laysa biqawiy" who denies the credibility of a narrator or denies it totally. However, based on preliminary observations of the author on the application of Abu Hatim when interacting with the phrase, he was seen as literally defying its use. The author also found no studies that reveal the following fundamental questions: Does Abu Hatim adopt the phrase literally or his use is across the border of the apparent understanding? Does his decision in using this phrase conflicts with other hadith scholars or in line with their assessment? Is the hypothesis that he was a stern critic (mutasyaddid) true? How accurate is his assessment in applying those terms? This study aims to reveal in detail the methodology of Abu Hatim in applying the phrase: "Laysa bidzak al-qawiy" to the narrators who have been criticized by him and compare it with the assessments of other evaluators of narrators and subsequent findings by the standards of al-Jarh and al-Ta'dil. The result is very important to understand the utterance-words of Abu Hatim, which certainly have an impact on the assessment of hadith narrators, and at the same time the assessment of hadith which is the ultimate goals of al-Jarh and al-Ta'dil.

While research into alcohol abuse is abundant, the science of how differing cultures view and respond to mild work-related alcohol consumption has been scientifically neglected. This article displays results from surveys conducted over a 7-year period and pivots around the cultural dimensions ‘Power distance’, ‘Individualism’, Indulgence’ and ‘Interpersonal trust’ which are correlated with motivators, responses and acceptance levels of mild work-related alcohol consumption. The strongest motivator for participating in mild work-related drinking was ‘To celebrate with colleagues’, which achieved significance with all cultural dimensions except power distance, which in contrast, achieved significance with the motivator ‘To bring out the real character’ of the counterpart. Power distance also correlated strongly with negative emotions regarding the refusal of a drink when offered by a senior. Altogether, 52 correlation tests were conducted of which 18 achieved significance. We believe that a better understanding of this topic will increase the likelihood of obtaining a harmonious workplace that lessens employee misunderstandings and conflict.

ABSTRACT Purpose To correlate behavioral assessment results of central auditory processing and the self-perception questionnaire after acoustically controlled auditory training. Methods The study assessed 10 individuals with a mean age of 44.5 years who had suffered mild traumatic brain injury. They underwent behavioral assessment of central auditory processing and answered the Formal Auditory Training self-perception questionnaire after the therapeutic intervention - whose questions address auditory perception, understanding orders, request to repeat statements, occurrence of misunderstandings, attention span, auditory performance in noisy environments, telephone communication, and self-esteem. Patients were asked to indicate the frequency with which the listed behaviors occurred. Results Figure-ground, sequential memory for sounds, and temporal processing correlated with improvement in following instructions, fewer requests to repeat statements, increased attention span, improved communication, and understanding on the phone and when watching TV. Conclusion Auditory closure, figure-ground, and temporal processing had improved in the assessment after the acoustically controlled auditory training, and there were fewer auditory behavior complaints.

A 28-year-old man was admitted to our psychiatric ward with severe obsessive-compulsive disorder (OCD) and comorbid depression. At intake, obsessive-compulsive symptoms were present most time of the day and were related to an intense fear of causing interpersonal misunderstandings. Various treatment attempts, including cognitive-behavioural therapy (CBT) with exposure and response prevention (ERP), selective serotonin reuptake inhibitors, clomipramine, and add-on antipsychotics were either ineffective and/or were not tolerated, and the patient’s condition worsened progressively. Following an in-depth multidisciplinary team discussion and a shared decision-making process, an off-label treatment trial with esketamine and concomitant psychotherapy was started. The patient received 10 esketamine + psychotherapy sessions over a period of about 2 months, followed by two maintenance sessions in about 3-week intervals. After this, he was discharged into regular outpatient care where he continued to receive maintenance esketamine treatment every 4–6 weeks and, independent of this, individual CBT. Following the establishment of esketamine with concurrent psychotherapy, the patient exhibited a remarkable clinical improvement. Obsessive-compulsive symptoms showed a clear and sustained response (Y-BOCS before treatment &gt;35, Y-BOCS at week 8 = 23, Y-BOCS at week 26 = 14). Paralleling this, depressive symptoms also decreased (MADRS before treatment = 47, MADRS at week 9 = 12, MADRS at week 26 = 3). At a naturalistic follow-up at week 66, obsessive-compulsive symptoms were still mild (Y-BOCS = 13), and depression was still in remission (MADRS &lt; 6). This clinical case suggests that (es)ketamine plus concomitant psychotherapy may hold promise as a therapeutic strategy for difficult-to-treat OCD and depression and its full clinical potential should be evaluated in more comprehensive future studies.

Abstract Background and aim Recently it has been recommended not to perform the Heller myotomy in Achalasia type III (Chicago classification) because of the persistence of chest pain after surgery; alternatively, POEM was proposed. This position is based on short term follow up studies. In the last 40 years our group performed the Heller-Dor operation (HD) in achalasia diagnosed according to Vantrappen and Castell PMDE classification also in the presence of chest pain (vigorous achalasia included, diffuse spasm and nutcracker esophagus excluded). In cases operated upon of HD, we investigated in the long term chest pain, inside the global surgery evaluation. Methods Between 1978 and 2020, 390 achalasia patients underwent the Heller-Dor operation. Among them, 79 preoperatively complained of chest pain (group A), 311 did not (group B). Patients were preoperatively classified and postoperatively followed up according to a timed protocol based on clinical assessment of intensity and frequency of dysphagia (D0 absent—D3 daily), GERD symptoms (RS0 absent-RS3 daily); chest pain was quantified according to the Eckardt’s scale (0 none—3 each meal). Barium swallow and endoscopy (E0: normal, E1: mild esophagitis, E2–3: erosive/ulcerative esophagitis) were performed at each planned control. A and B groups were compared. Results Groups were homogeneous according to sex (P = 0.42) and age (P = 0.51). After HD median follow-up was 10 years (IQR 4.7–12.6 years) for A, 14 years (IQR 5.6–20 years) for B (P = 0.166); at barium swallow the percentage of decrease in esophageal diameter and barium column was similar (P = 0.59 and P = 0.85, respectively) as well as the frequency of GERD symptoms and esophagitis (P = 0.27). Chest pain progressively attenuated; median Eckard score preoperatively was 3, at follow-up it was 1 (P &lt; 0.001). The clinical evaluation at the last control was significantly more favorable for A (satisfactory D0–2, RS0–2, and E1 in 95%) versus B (satisfactory in 89%) (P = 0.02). Conclusion In the long term HD achieves very satisfactory results with the decrease/disappearance of chest pain possibly present in regular achalasia. The clinical-radiological-manometric patterns of type 3 achalasia should be revised, to eliminate eventual misunderstandings.

Abstract Background Fear of childbirth (FOC) may contribute to postpartum depression, impaired maternal-infant relation, and preference for cesarean in future pregnancies. We aimed to investigate predictors of FOC and normal vaginal birth among postpartum women who had planned for a normal vaginal birth. Methods This cross-sectional study was conducted in 2019 with postpartum women during the first 24 h after the birth. A sample of 662 women, selected using a convenient sampling method, filled out the questionnaire composed of socio-demographic and obstetric questions and the Wijma Delivery-Expectancy Questionnaire (W-DEQ). We used multiple logistic regression analyses to determine predictors of FOC and normal vaginal birth. Results The percentage of women with mild (score ≤ 37), moderate (38–65), high (66–84), severe (85–99), and intense FOC (score ≥ 100) were 7.9, 19.5, 40.9, 21.1, and 10.6% respectively. Predictors of intense FOC were age < 30, primiparity, low maternal satisfaction with pregnancy, and a low level of perceived marital satisfaction. Overall, 21.8% of women gave birth by cesarean. Predictors of normal vaginal birth were birth weight < 4 kg, spontaneous onset of labor pain, mother’s age < 30, term pregnancy, having a doula, multiparity, satisfaction with husband’s support, and overall satisfaction with pregnancy. A high level of perceived marital/sexual satisfaction was a risk factor for cesarean. Mode of birth was not a predictor of postpartum FOC. Conclusions The rate of severe and intense FOC among this group of postpartum women is high. Our findings highlight modifiable factors for reducing FOC and increasing normal vaginal birth. In designing programs to increase the rate of normal vaginal birth, the following factors should be considered: limiting induced labor, encouraging women to recruit a doula to help them at labor, facilitate husband’s attendance throughout antenatal/intrapartum, and postnatal care to support his wife, and pay attention to women’s common misunderstandings about the effect of vaginal birth on marital/sexual relationship. Our findings indicate that seeking novel ways to promote marital/sexual satisfaction and helping women to have a smooth, hassle-free pregnancy may contribute to a reduction in the rate of the FOC.

A year ago, in the year 2020, the entire globe was seized by a minuscule particle known as the CORONA VIRUS. The Coronavirus, which originated in Wuhan, China, has now spread to every corner of the world, some more than others. There has been a lot of worry and fear about this disease all around the world. There are several misunderstandings and questions about this condition, and individuals are prone to believing everything they hear in the media without verifying it. COVID19, or Corona Virus Disease of 2019, is a one-of-a-kind virus that has wreaked havoc over the world and has become one of humanity's greatest threats. All the misconceptions and confusion and beliefs have led to more damage. Coronaviruses are a kind of virus that causes sickness in animals such as humans and birds. Infections of the respiratory system caused by coronaviruses have a wide range and can vary from person to person from no to mild infection which sometimes can be fatal, particularly in humans. Some cases of rhinorrhoea (which can be can be due to other viruses, particularly rhinoviruses) are not life-threatening, but more fatal strains can cause SARS, MERS, and COVID-19. In other species, the symptoms are different. There are presently no drugs available to prevent or treat human infections. Even though vaccination trials have begun and individuals are being immunized all over the world. Coronaviruses are members of the Coronaviridae family, the order Nidovirale: s, and the Orthocoronavirinae subfamily of the realm Riboviria. The World Health Organization (WHO) proclaimed the COVID-19 outbreak to be a pandemic in March 2020. Many instances of pneumonia with an unknown underlying cause have been reported in Wuhan, Hubei Province, China, since December 8, 2019. The great majority of the patients were either employees or residents of the Huanan wholesale fish market, which also sold other live animals. Severe acute respiratory infection symptoms appeared early in the course of this pneumonia, with some patients suffering from acute respiratory distress syndrome (ARDS), abrupt respiratory failure, and other devastating consequences. On January 7, the Chinese Center for Disease Control and Prevention (CDC) discovered a new coronavirus from a patient's throat swab sample, which the World Health Organization later called 2019 nCoV (WHO). This article includes various myths and their explanation about COVID vaccination. However, it has been observed that COVID-19 vaccination is completely safe.

Over the past century, many books for general readers have styled sharks as “monsters of the deep” (Steele). In recent decades, however, at least some writers have also turned to representing how sharks are seriously threatened by human activities. At a time when media coverage of shark sightings seems ever increasing in Australia, scholarship has begun to consider people’s attitudes to sharks and how these are formed, investigating the representation of sharks (Peschak; Ostrovski et al.) in films (Le Busque and Litchfield; Neff; Schwanebeck), newspaper reports (Muter et al.), and social media (Le Busque et al., “An Analysis”). My own research into representations of surfing and sharks in Australian writing (Brien) has, however, revealed that, although reporting of shark sightings and human-shark interactions are prominent in the news, and sharks function as vivid and commanding images and metaphors in art and writing (Ellis; Westbrook et al.), little scholarship has investigated their representation in Australian books published for a general readership. While recognising representations of sharks in other book-length narrative forms in Australia, including Australian fiction, poetry, and film (Ryan and Ellison), this enquiry is focussed on non-fiction books for general readers, to provide an initial review. Sampling holdings of non-fiction books in the National Library of Australia, crosschecked with Google Books, in early 2021, this investigation identified 50 Australian books for general readers that are principally about sharks, or that feature attitudes to them, published from 1911 to 2021. Although not seeking to capture all Australian non-fiction books for general readers that feature sharks, the sampling attempted to locate a wide range of representations and genres across the time frame from the earliest identified text until the time of the survey. The books located include works of natural and popular history, travel writing, memoir, biography, humour, and other long-form non-fiction for adult and younger readers, including hybrid works. A thematic analysis (Guest et al.) of the representation of sharks in these texts identified five themes that moved from understanding sharks as fishes to seeing them as monsters, then prey, and finally to endangered species needing conservation. Many books contained more than one theme, and not all examples identified have been quoted in the discussion of the themes below. Sharks as Part of the Natural Environment Drawing on oral histories passed through generations, two memoirs (Bradley et al.; Fossa) narrate Indigenous stories in which sharks play a central role. These reveal that sharks are part of both the world and a wider cosmology for Aboriginal and Torres Strait Islander people (Clua and Guiart). In these representations, sharks are integrated with, and integral to, Indigenous life, with one writer suggesting they are “creator beings, ancestors, totems. Their lifecycles reflect the seasons, the landscape and sea country. They are seen in the movement of the stars” (Allam). A series of natural history narratives focus on zoological studies of Australian sharks, describing shark species and their anatomy and physiology, as well as discussing shark genetics, behaviour, habitats, and distribution. A foundational and relatively early Australian example is Gilbert P. Whitley’s The Fishes of Australia: The Sharks, Rays, Devil-fish, and Other Primitive Fishes of Australia and New Zealand, published in 1940. Ichthyologist at the Australian Museum in Sydney from the early 1920s to 1964, Whitley authored several books which furthered scientific thought on sharks. Four editions of his Australian Sharks were published between 1983 and 1991 in English, and the book is still held in many libraries and other collections worldwide. In this text, Whitley described a wide variety of sharks, noting shared as well as individual features. Beautiful drawings contribute information on shape, colouring, markings, and other recognisable features to assist with correct identification. Although a scientist and a Fellow and then President of the Royal Zoological Society of New South Wales, Whitley recognised it was important to communicate with general readers and his books are accessible, the prose crisp and clear. Books published after this text (Aiken; Ayling; Last and Stevens; Tricas and Carwardine) share Whitley’s regard for the diversity of sharks as well as his desire to educate a general readership. By 2002, the CSIRO’s Field Guide to Australian Sharks & Rays (Daley et al.) also featured numerous striking photographs of these creatures. Titles such as Australia’s Amazing Sharks (Australian Geographic) emphasise sharks’ unique qualities, including their agility and speed in the water, sensitive sight and smell, and ability to detect changes in water pressure around them, heal rapidly, and replace their teeth. These books also emphasise the central role that sharks play in the marine ecosystem. There are also such field guides to sharks in specific parts of Australia (Allen). This attention to disseminating accurate zoological information about sharks is also evident in books written for younger readers including very young children (Berkes; Kear; Parker and Parker). In these and other similar books, sharks are imaged as a central and vital component of the ocean environment, and the narratives focus on their features and qualities as wondrous rather than monstrous. Sharks as Predatory Monsters A number of books for general readers do, however, image sharks as monsters. In 1911, in his travel narrative Peeps at Many Lands: Australia, Frank Fox describes sharks as “the most dangerous foes of man in Australia” (23) and many books have reinforced this view over the following century. This can be seen in titles that refer to sharks as dangerous predatory killers (Fox and Ruhen; Goadby; Reid; Riley; Sharpe; Taylor and Taylor). The covers of a large proportion of such books feature sharks emerging from the water, jaws wide open in explicit homage to the imaging of the monster shark in the film Jaws (Spielberg). Shark!: Killer Tales from the Dangerous Depths (Reid) is characteristic of books that portray encounters with sharks as terrifying and dramatic, using emotive language and stories that describe sharks as “the world’s most feared sea creature” (47) because they are such “highly efficient killing machines” (iv, see also 127, 129). This representation of sharks is also common in several books for younger readers (Moriarty; Rohr). Although the risk of being injured by an unprovoked shark is extremely low (Chapman; Fletcher et al.), fear of sharks is prevalent and real (Le Busque et al., “People’s Fear”) and described in a number of these texts. Several of the memoirs located describe surfers’ fear of sharks (Muirhead; Orgias), as do those of swimmers, divers, and other frequent users of the sea (Denness; de Gelder; McAloon), even if the author has never encountered a shark in the wild. In these texts, this fear of sharks is often traced to viewing Jaws, and especially to how the film’s huge, bloodthirsty great white shark persistently and determinedly attacks its human hunters. Pioneer Australian shark expert Valerie Taylor describes such great white sharks as “very big, powerful … and amazingly beautiful” but accurately notes that “revenge is not part of their thought process” (Kindle version). Two books explicitly seek to map and explain Australians’ fear of sharks. In Sharks: A History of Fear in Australia, Callum Denness charts this fear across time, beginning with his own “shark story”: a panicked, terror-filled evacuation from the sea, following the sighting of a shadow which turned out not to be a shark. Blake Chapman’s Shark Attacks: Myths, Misunderstandings and Human Fears explains commonly held fearful perceptions of sharks. Acknowledging that sharks are a “highly emotive topic”, the author of this text does not deny “the terror [that] they invoke in our psyche” but makes a case that this is “only a minor characteristic of what makes them such intriguing animals” (ix). In Death by Coconut: 50 Things More Dangerous than a Shark and Why You Shouldn’t Be Afraid of the Ocean, Ruby Ashby Orr utilises humour to educate younger readers about the real risk humans face from sharks and, as per the book’s title, why they should not be feared, listing champagne corks and falling coconuts among the many everyday activities more likely to lead to injury and death in Australia than encountering a shark. Taylor goes further in her memoir – not only describing her wonder at swimming with these creatures, but also her calm acceptance of the possibility of being injured by a shark: "if we are to be bitten, then we are to be bitten … . One must choose a life of adventure, and of mystery and discovery, but with that choice, one must also choose the attendant risks" (2019: Kindle version). Such an attitude is very rare in the books located, with even some of the most positive about these sea creatures still quite sensibly fearful of potentially dangerous encounters with them. Sharks as Prey There is a long history of sharks being fished in Australia (Clark). The killing of sharks for sport is detailed in An American Angler in Australia, which describes popular adventure writer Zane Grey’s visit to Australia and New Zealand in the 1930s to fish ‘big game’. This text includes many bloody accounts of killing sharks, which are justified with explanations about how sharks are dangerous. It is also illustrated with gruesome pictures of dead sharks. Australian fisher Alf Dean’s biography describes him as the “World’s Greatest Shark Hunter” (Thiele), this text similarly illustrated with photographs of some of the gigantic sharks he caught and killed in the second half of the twentieth century. Apart from being killed during pleasure and sport fishing, sharks are also hunted by spearfishers. Valerie Taylor and her late husband, Ron Taylor, are well known in Australia and internationally as shark experts, but they began their careers as spearfishers and shark hunters (Taylor, Ron Taylor’s), with the documentary Shark Hunters gruesomely detailing their killing of many sharks. The couple have produced several books that recount their close encounters with sharks (Taylor; Taylor, Taylor and Goadby; Taylor and Taylor), charting their movement from killers to conservationists as they learned more about the ocean and its inhabitants. Now a passionate campaigner against the past butchery she participated in, Taylor’s memoir describes her shift to a more respectful relationship with sharks, driven by her desire to understand and protect them. In Australia, the culling of sharks is supposedly carried out to ensure human safety in the ocean, although this practice has long been questioned. In 1983, for instance, Whitley noted the “indiscriminate” killing of grey nurse sharks, despite this species largely being very docile and of little threat to people (Australian Sharks, 10). This is repeated by Tony Ayling twenty-five years later who adds the information that the generally harmless grey nurse sharks have been killed to the point of extinction, as it was wrongly believed they preyed on surfers and swimmers. Shark researcher and conservationist Riley Elliott, author of Shark Man: One Kiwi Man’s Mission to Save Our Most Feared and Misunderstood Predator (2014), includes an extremely critical chapter on Western Australian shark ‘management’ through culling, summing up the problems associated with this approach: it seems to me that this cull involved no science or logic, just waste and politics. It’s sickening that the people behind this cull were the Fisheries department, which prior to this was the very department responsible for setting up the world’s best acoustic tagging system for sharks. (Kindle version, Chapter 7) Describing sharks as “misunderstood creatures”, Orr is also clear in her opposition to killing sharks to ‘protect’ swimmers noting that “each year only around 10 people are killed in shark attacks worldwide, while around 73 million sharks are killed by humans”. She adds the question and answer, “sounds unfair? Of course it is, but when an attack is all over the news and the people are baying for shark blood, it’s easy to lose perspective. But culling them? Seriously?” (back cover). The condemnation of culling is also evident in David Brooks’s recent essay on the topic in his collection of essays about animal welfare, conservation and the relationship between humans and other species, Animal Dreams. This disapproval is also evident in narratives by those who have been injured by sharks. Navy diver Paul de Gelder and surfer Glen Orgias were both bitten by sharks in Sydney in 2009 and both their memoirs detail their fear of sharks and the pain they suffered from these interactions and their lengthy recoveries. However, despite their undoubted suffering – both men lost limbs due to these encounters – they also attest to their ongoing respect for these creatures and specify a shared desire not to see them culled. Orgias, instead, charts the life story of the shark who bit him alongside his own story in his memoir, musing at the end of the book, not about himself or his injury, but about the fate of the shark he had encountered: great whites are portrayed … as pathological creatures, and as malevolent. That’s rubbish … they are graceful, mighty beasts. I respect them, and fear them … [but] the thought of them fighting, dying, in a net upsets me. I hope this great white shark doesn’t end up like that. (271–271) Several of the more recent books identified in this study acknowledge that, despite growing understanding of sharks, the popular press and many policy makers continue to advocate for shark culls, these calls especially vocal after a shark-related human death or injury (Peppin-Neff). The damage to shark species involved caused by their killing – either directly by fishing, spearing, finning, or otherwise hunting them, or inadvertently as they become caught in nets or affected by human pollution of the ocean – is discussed in many of the more recent books identified in this study. Sharks as Endangered Alongside fishing, finning, and hunting, human actions and their effects such as beach netting, pollution and habitat change are killing many sharks, to the point where many shark species are threatened. Several recent books follow Orr in noting that an estimated 100 million sharks are now killed annually across the globe and that this, as well as changes to their habitats, are driving many shark species to the status of vulnerable, threatened or towards extinction (Dulvy et al.). This is detailed in texts about biodiversity and climate change in Australia (Steffen et al.) as well as in many of the zoologically focussed books discussed above under the theme of “Sharks as part of the natural environment”. The CSIRO’s Field Guide to Australian Sharks & Rays (Daley et al.), for example, emphasises not only that several shark species are under threat (and protected) (8–9) but also that sharks are, as individuals, themselves very fragile creatures. Their skeletons are made from flexible, soft cartilage rather than bone, meaning that although they are “often thought of as being incredibly tough; in reality, they need to be handled carefully to maximise their chance of survival following capture” (9). Material on this theme is included in books for younger readers on Australia’s endangered animals (Bourke; Roc and Hawke). Shark Conservation By 1991, shark conservation in Australia and overseas was a topic of serious discussion in Sydney, with an international workshop on the subject held at Taronga Zoo and the proceedings published (Pepperell et al.). Since then, the movement to protect sharks has grown, with marine scientists, high-profile figures and other writers promoting shark conservation, especially through attempts to educate the general public about sharks. De Gelder’s memoir, for instance, describes how he now champions sharks, promoting shark conservation in his work as a public speaker. Peter Benchley, who (with Carl Gottlieb) recast his novel Jaws for the film’s screenplay, later attested to regretting his portrayal of sharks as aggressive and became a prominent spokesperson for shark conservation. In explaining his change of heart, he stated that when he wrote the novel, he was reflecting the general belief that sharks would both seek out human prey and attack boats, but he later discovered this to be untrue (Benchley, “Without Malice”). Many recent books about sharks for younger readers convey a conservation message, underscoring how, instead of fearing or killing sharks, or doing nothing, humans need to actively assist these vulnerable creatures to survive. In the children’s book series featuring Bindi Irwin and her “wildlife adventures”, there is a volume where Bindi and a friend are on a diving holiday when they find a dead shark whose fin has been removed. The book not only describes how shark finning is illegal, but also how Bindi and friend are “determined to bring the culprits to justice” (Browne). This narrative, like the other books in this series, has a dual focus; highlighting the beauty of wildlife and its value, but also how the creatures described need protection and assistance. Concluding Discussion This study was prompted by the understanding that the Earth is currently in the epoch known as the Anthropocene, a time in which humans have significantly altered, and continue to alter, the Earth by our activities (Myers), resulting in numerous species becoming threatened, endangered, or extinct. It acknowledges the pressing need for not only natural science research on these actions and their effects, but also for such scientists to publish their findings in more accessible ways (see, Paulin and Green). It specifically responds to demands for scholarship outside the relevant areas of science and conservation to encourage widespread thinking and action (Mascia et al.; Bennett et al.). As understanding public perceptions and overcoming widely held fear of sharks can facilitate their conservation (Panoch and Pearson), the way sharks are imaged is integral to their survival. The five themes identified in this study reveal vastly different ways of viewing and writing about sharks. These range from seeing sharks as nothing more than large fishes to be killed for pleasure, to viewing them as terrifying monsters, to finally understanding that they are amazing creatures who play an important role in the world’s environment and are in urgent need of conservation. This range of representation is important, for if sharks are understood as demon monsters which hunt humans, then it is much more ‘reasonable’ to not care about their future than if they are understood to be fascinating and fragile creatures suffering from their interactions with humans and our effect on the environment. Further research could conduct a textual analysis of these books. In this context, it is interesting to note that, although in 1949 C. Bede Maxwell suggested describing human deaths and injuries from sharks as “accidents” (182) and in 2013 Christopher Neff and Robert Hueter proposed using “sightings, encounters, bites, and the rare cases of fatal bites” (70) to accurately represent “the true risk posed by sharks” to humans (70), the majority of the books in this study, like mass media reports, continue to use the ubiquitous and more dramatic terminology of “shark attack”. The books identified in this analysis could also be compared with international texts to reveal and investigate global similarities and differences. While the focus of this discussion has been on non-fiction texts, a companion analysis of representation of sharks in Australian fiction, poetry, films, and other narratives could also be undertaken, in the hope that such investigations contribute to more nuanced understandings of these majestic sea creatures. 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The convergence of suburban homes and digital media and communications technologies is set to undergo a major shift as next-generation broadband infrastructures are installed. Embodied in the Australian Government’s National Broadband Network (NBN) and the delivery of fibre-optic cable to the front door of every suburban home, is an anticipated future of digital living that will transform the landscape and experience of suburban life. Drawing from our research, and from industry, policy and media documents, we map some scenarios of the NBN rollout in its early stages to show that this imaginary of seamless broadband in the suburbs and the transformation of digital homes it anticipates is challenged by local cultural and material geographies, which we describe as a politics of spectrum. The universal implementation of policy across Australia faces a considerable challenge in dealing with Australia’s physical environment. Geography has always had a major impact on communications technologies and services in Australia, and a major impetus of building a national broadband network has been to overcome the “tyranny of distance” experienced by people in many remote, regional and suburban areas. In 2009 the minister for Broadband, Communications and the Digital Economy (DBCDE), Stephen Conroy, announced that with the Government’s NBN policy “every person and business in Australia, no-matter where they are located, will have access to affordable, fast broadband at their fingertips” (Conroy). This ambition to digitally connect and include imagines the NBN as the solution to the current patchwork of connectivity and Internet speeds experienced across the country (ACCAN). Overcoming geographic difference and providing fast, universal and equitable digital access is to be realised through an open access broadband network built by the newly established NBN Co. Limited, jointly owned by the Government and the private sector at a cost estimated at $43 billion over eight years. In the main this network will depend upon fibre-optics reaching over 90% of the population, and achieving download speeds of up to 100 Mbit/s. The remaining population, mostly living in rural and remote areas, will receive wireless and satellite connections providing speeds of 12 Mbit/s (Conroy). Differential implementation in relation to comparisons of urban and remote populations is thus already embedded in the policy, yet distance is not the only characteristic of Australia’s material geographies that will shape the physical implementation of the NBN and create a varied spectrum of the experience of broadband. Instead, in this article we examine the uneven experience of broadband we may see occurring within suburban regions; places in which enhanced and collective participation in the digital economy relies upon the provision of faster transmission speeds and the delivery of fibre “the last mile” to each and every premise. The crucial platform for delivering broadband to the ’burbs is the digital home. The notion of the connected or smart or digital home has been around in different guises for a number of decades (e.g. Edwards et al.), and received wide press coverage in the 1990s (e.g. Howard). It has since been concretised in the wake of the NBN as telecommunications companies struggle to envision a viable “next step” in broadband consumption. Novel to the NBN imaginary of the digital home is a shift from thinking about the digital home in terms of consumer electronics and interoperable or automatic devices, based on shared standards or home networking, to addressing the home as a platform embedded within the economy. The digital home is imagined as an integral part of a network of digital living with seamless transitions between home, office, supermarket, school, and hospital. In the imaginary of the NBN, the digital home becomes a vital connection in the growing digital economy. Communications Patchwork, NBN Roll-Out and Infrastructure Despite this imagined future of seamless connectivity and universal integration of suburban life with the digital economy, there has been an uneven take-up of fibre connections. We argue that this suggests that the particularities of place and the materialities of geography are relevant for understanding the differential uptake of the NBN across the test sites. Furthermore, we maintain that these issues provide a useful model for understanding the ongoing process and challenges that the rollout of the NBN will face in providing even access to the imagined future of the digital home to all Australians. As of June 2011 an average of 70 per cent of homes in the five first release NBN sites have agreed to have the fibre cables installed (Grubb). However, there is a dramatic variation between these sites: in Armidale, NSW, and Willunga, SA, the percentage of properties consenting to fibre connections on their house is between 80-90 per cent; whereas in Brunswick, Victoria, and Midway Point, Tasmania, the take-up rate is closer to 50 per cent (Grubb). We suggest that these variations are created by a differential geography of connectivity that will continue to grow in significance as the NBN is rolled out to more locations around Australia. These can be seen to emerge as a consequence of localised conditions relating to, for example, installation policy, a focus on cost, and installation logistics. Another significant factor, unable to be addressed within the scope of this paper, is the integration of the NBN with each household’s domestic network of hardware devices, internal connections, software, and of course skill and interest. Installation Policy The opt-in policy of the NBN Co requires that owners of properties agree to become connected—as opposed to being automatically connected unless they opt-out. This makes getting connected a far simpler task for owner-occupiers over renters, because the latter group were required to triangulate with their landlords in order to get connected. This was considered to be a factor that impacted on the relatively low uptake of the NBN in Brunswick and Midway Point, and is reflected in media reports (Grubb) and our research: There was a bit of a problem with Midway Point, because I think it is about fifty percent of the houses here are rentals, and you needed signatures from the owners for the box to be put onto the building (anon. “Broadband in the Home” project). …a lot of people rent here, so unless their landlord filled it in they wouldn’t know (anon. “Broadband in the Home” project). The issue is exacerbated by the concentration of rental properties in particular suburbs and complicated rental arrangements mediated through agents, which prevent effective communication between the occupiers and owners of a property. In order to increase take-up in Tasmania, former State Premier, David Bartlett, successfully introduced legislation to the Tasmanian state legislature in late 2010 to make the NBN opt-out rather than opt-in. This reversed the onus of responsibility and meant that in Tasmania all houses and businesses would be automatically connected unless otherwise requested, and in order to effect this simple policy change, the government had to change trespass laws. However, other state legislatures are hesitant to follow the opt-out model (Grubb). Differentials in owner-occupied and rental properties within urban centres, combined with opt-in policies, are likely to see a continuation of the connectivity patchwork that that has thus far characterised Australian communications experience. A Focus on Cost Despite a great deal of public debate about the NBN, there is relatively little discussion of its proposed benefits. The fibre-to-the-home structure of the NBN is also subject to fierce partisan political debate between Australia’s major political parties, particularly around the form and cost of its implementation. As a consequence of this preoccupation with cost, many Australian consumers cannot see a “value proposition” in connecting, and are not convinced of the benefits of the NBN (Brown). The NBN is often reduced to an increased minimum download rate, and to increased ISP fees associated with high speeds, rather than a broader discussion of how the infrastructure can impact on commerce, education, entertainment, healthcare, and work (Barr). Moreover, this lack of balance in the discussion of costs and benefits extends in some instances to outright misunderstandings about the difference between infrastructure and service provision: …my neighbour across the road did not understand what that letter meant, and she would have to have been one of dozens if not hundreds in the exactly the same situation, who thought they were signing up for a broadband plan rather than just access to the infrastructure (anon. “Broadband in the Home” project) Lastly, the advent of the NBN in the first release areas does not override the costs of existing contracts for broadband delivered over the current copper network. Australians are often required to sign long-term contracts that prevent them from switching immediately to the new HSB infrastructure. Installation Logistics Local variations in fibre installation were evident prior to the rollout of the NBN, when the increased provision of HSB was already being used as a marketing device for greenfield (newly developed) estates in suburban Australia. In the wake of the NBN rollouts, some housing developers have begun to lay “NBN-ready” optic fibre in greenfield estates. While this is a positive development for those who a purchasing a newly-developed property, those that invest in brownfield “re-developments,” may have to pay over twice the amount for the installation of the NBN (Neales). These varying local conditions of installation are reflected in the contractual arrangements for installing the fibre, the installers’ policies for installation, and the processes of installation (Darling): They’re gonna have to do 4000 houses a day … and it was a solid six months to get about 800 houses hooked up here. So, logistically I just can’t see it happening. (anon. “Broadband in the Home” project) Finally, for those who do not take-up the free initial installation offer, for whatever reason, there will be costs to have contractors return and connect the fibre (Grubb; Neales). Spectrum Politics, Fibre in the Neighbourhood The promise that the NBN will provide fast, universal and equitable digital access realised through a fibre-optic network is challenged by the experience of first release sites such as Midway Point. As evident above, and due to a number of factors, there is a likelihood in supposedly NBN-connected places of varied connectivity in which service will range from dial-up to DSL and ADSL to fibre and wireless, all within a single location. The varied connectivity in the early NBN rollout stages suggests that the patchwork of Internet connections commonly experienced in Australian suburbs will continue rather than disappear. This varied patchwork can be understood as a politics of spectrum. Rod Tucker (13-14) emphasises that the crucial element of spectrum is its bandwidth, or information carrying capacity. In light of this the politics of spectrum reframes the key issue of access to participation in the digital economy to examine stakes of the varying quality of connection (particularly download speeds), through the available medium (wireless, copper, coaxial cable, optical fibre), connection (modem, antenna, gateway) and service type (DSL, WiFi, Satellite, FTTP). This technical emphasis follows in the wake of debates about digital inclusion (e.g., Warschauer) to re-introduce the importance of connection quality—embedded in older “digital divide” discourse—into approaches that look beyond technical infrastructure to the social conditions of their use. This is a shift that takes account of the various and intertwined socio-technical factors influencing the quality of access and use. This spectrum politics also has important implications for the Universal Service Obligation (USO). Telstra (the former Telecom) continues to have the responsibility to provide every premise in Australia with a standard telephone service, that is at least a single copper line—or equivalent service—connection. However, the creation of the NBN Co. relieves Telstra of this obligation in the areas which have coverage from the fibre network. This agreement means that Telstra will gradually shut down its ageing copper network, following the pattern of the NBN rollout and transfer customers to the newly developed broadband fibre network (Hepworth and Wilson). Consequently, every individual phone service in those areas will be required to move onto the NBN to maintain the USO. This means that premises not connected to the NBN because the owners of the property opted out—by default or by choice—are faced with an uncertain future vis-à-vis the meaning and provision of the USO because they will not have access to either copper or fibre networks. At this extreme of spectrum politics, the current policy setting may result in households that have no possibility of a broadband connection. This potential problem can be resolved by a retro-rollout, in which NBN fibre connection is installed at some point in the future to every premises regardless of whether they originally agreed or not. Currently, however, the cost of a retrospective connection is expected to be borne by the consumer: “those who decline to allow NBN Co on to their property will need to pay up to $300 to connect to the NBN at a later date” (Grubb) Smaller, often brownfield development estates also face particular difficulties in the current long-term switch of responsibilities from Telstra to the NBN Co. This is because Telstra is reluctant to install new copper networks knowing that they will soon become obsolete. Instead, “in housing estates of fewer than 100 houses, Telstra is often providing residents with wireless phones that are unable to connect to the Internet” (Thompson). Thus a limbo is created, where new residents will not have access to either copper or fibre fixed line connections. Rather, they will have to use whatever wireless Internet is available in the area. Particularly concerning is that the period of the rollout is projected to last for eight years. As a result: “Thousands of Australians—many of them in regional areas—can expect years of worse, rather than better, Internet services as the National Broadband Network rolls out across the country” (Thompson). And, given different take-up rates and costs of retro-fitting, this situation could continue for many people and for many years after the initial rollout is completed. Implications of Spectrum Politics for the Digital Home What does this uncertain and patchwork future of connectivity imply for digital living and the next-generation broadband suburb? In contrast to the imagined post-NBN geography of the seamless digital home, local material and cultural factors will still create varied levels of service. This predicament challenges the ideals of organisations such as the Digital Living Network, an industry body comprised of corporate members, “based on principles of open standards and home networking interoperability [which] will unleash a rich digital media environment of interconnected devices that enable us all to experience our favorite content and services wherever and whenever we want” (Vohringer). Such a vision of convergence takes a domestic approach to the “Internet of things” by imagining a user-friendly network of personal computing, consumer electronics, mobile technologies, utilities, and other domestic technologies. The NBN anticipates a digital home that is integrated into the digital economy as a node of production and consumption. But this future is challenged by the patchwork of connectivity. Bruno Latour famously remarked that even the most extensive and powerful networks are local at every point. Although he was speaking of actor-networks, not broadband networks, analysis of the Australian experience of high-speed broadband would do well to look beyond its national characteristics to include its local characteristics, and the constellations between them. It is at the local level, importantly, at the level of the household and suburb, that the NBN will be experienced in daily life. As we have argued here, we have reason to expect that this experience will be as disparate as the network is distributed, and we have reason to believe that local cultural and material factors such as installation policies, discussions around costs and benefits, the household’s own internal digital infrastructure, and installation logistics at the level of the house and the neighbourhood, will continue to shape a patchworked geography of media and communications experiences for digital homes. References Australian Communications Consumer Action Network (ACCAN). 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