Responsiveness of the Effective Consumer Scale (EC-17)

Objective. The Effective Consumer Scale (EC-17) comprises 17 items measuring the main skills and behaviors people need to effectively manage their healthcare. We tested the responsiveness of the EC-17. Methods. Participants, in 2 waves of a 6-week Arthritis Self-Management Program (ASMP) from Arthritis Ireland, received a questionnaire at the first and last week of the weekly ASMP. The questionnaire included the EC-17 and 10 other measures for arthritis. Deficits, mean change, and standard deviations were calculated at baseline and Week 6. The EC-17 scores were compared to the Arthritis Self-Efficacy (ASE) and Patient Activation Measure (PAM) scales. Results were presented at OMERACT 9. Results. There is some overlap between the EC-17 and the ASE and PAM; however, most items of greatest deficit in the EC-17 are not covered by those scales. In 327 participants representing both intervention waves (2006 and 2007), the EC-17 was more efficient than the ASE but less efficient than the PAM for detecting improvements after the ASMP, and was moderately correlated with the PAM. Conclusion. The EC-17 appears to measure different skills and attributes than the ASE and PAM. Discussions with participants at OMERACT 9 agreed that it is worthwhile to measure the skills and attributes of an effective consumer, and supported the development of an intervention (such as proposed online decision aids) that would include education in the categories in the EC-17.

Aromatherapy for treatment of postoperative nausea and vomiting

Background: Postoperative nausea and vomiting is a common and unpleasant phenomenon and current therapies are not always effective for all patients. Aromatherapy has been suggested as a possible addition to the available treatment strategies. Objectives: This review sought to establish what effect the use of aromatherapy has on the severity and duration of established postoperative nausea and vomiting and whether aromatherapy can be used with safety and clinical effectiveness comparable to standard pharmacological treatments. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 3); MEDLINE; EMBASE; CINAHL; CAM on PubMed; Meditext; LILACS database; and ISI Web of Science as well as grey literature sources and the reference lists of retrieved articles. We conducted database searches up to August 2011. Selection criteria: We included all randomized controlled trials (RCTs) and controlled clinical trials (CCTs) where aromatherapy was used to treat postoperative nausea and vomiting. Interventions were all types of aromatherapy. Aromatherapy was defined as the inhalation of the vapours of any substance for the purposes of a therapeutic benefit. Primary outcomes were the severity and duration of postoperative nausea and vomiting. Secondary outcomes were adverse reactions, use of rescue anti-emetics and patient satisfaction with treatment. Data collection and analysis: Two review authors assessed risk of bias in the included studies and extracted data. As all outcomes analysed were dichotomous, we used a fixed-effects model and calculated relative risk (RR) with associated 95% confidence interval (95% CI). Results: The nine included studies comprised six RCTs and three CCTs with a total of 402 participants. The mean age and range data for all participants were not reported for all studies. The method of randomization in four of the six included RCTs was explicitly stated and adequate. Incomplete reporting of data affected the completeness of the analysis. Compared with placebo, isopropyl alcohol vapour inhalation was effective in reducing the proportion of participants requiring rescue anti-emetics (RR 0.30, 95%CI 0.09 to 1.00, P = 0.05). However, compared with standard anti-emetic treatment, isopropyl alcohol was not effective in reducing the proportion of participants requiring rescue anti-emetics (RR 0.66 95%CI 0.39 to 1.13, P = 0.13) except when the data from a possibly confounded study were included (RR 0.66, 95% CI 0.45 to 0.98, P = 0.04). Where studies reported data on patient satisfaction with aromatherapy, there were no statistically significant differences between the groups (RR 1.12, 95%CI 0.62 to 2.03, P = 0.71). Authors' conclusions: Isopropyl alcohol was more effective than saline placebo for reducing postoperative nausea and vomiting but less effective than standard anti-emetic drugs. There is currently no reliable evidence for the use of peppermint oil.

A Survey-based Study of Knowledge of Alzheimer's Disease among Health Care Staff

Background Continued aging of the population is expected to be accompanied by substantial increases in the number of people with dementia and in the number of health care staff required to care for them. Adequate knowledge about dementia among health care staff is important to the quality of care delivered to this vulnerable population. The purpose of this study was to assess knowledge about dementia across a range of health care staff in a regional health service district. Methods Knowledge levels were investigated via the validated 30-item Alzheimer's Disease Knowledge Scale (ADKS). All health service district staff with e-mail access were invited to participate in an online survey. Knowledge levels were compared across demographic categories, professional groups, and by whether the respondent had any professional or personal experience caring for someone with dementia. The effect of dementia-specific training or education on knowledge level was also evaluated. Results A diverse staff group (N = 360), in terms of age, professional group (nursing, medicine, allied health, support staff) and work setting from a regional health service in Queensland, Australia responded. Overall knowledge about Alzheimer's disease was of a generally moderate level with significant differences being observed by professional group and whether the respondent had any professional or personal experience caring for someone with dementia. Knowledge was lower for some of the specific content domains of the ADKS, especially those that were more medically-oriented, such as 'risk factors' and 'course of the disease.' Knowledge was higher for those who had experienced dementia-specific training, such as attendance at a series of relevant workshops. Conclusions Specific deficits in dementia knowledge were identified among Australian health care staff, and the results suggest dementia-specific training might improve knowledge. As one piece of an overall plan to improve health care delivery to people with dementia, this research supports the role of introducing systematic dementia-specific education or training.

Assessment of lifetime cumulative sun exposure using a self-administered questionnaire : reliability of two approaches

Few studies have evaluated the reliability of lifetime sun exposure estimated from inquiring about the number of hours people spent outdoors in a given period on a typical weekday or weekend day (the time-based approach). Some investigations have suggested that women have a particularly difficult task in estimating time outdoors in adulthood due to their family and occupational roles. We hypothesized that people might gain additional memory cues and estimate lifetime hours spent outdoors more reliably if asked about time spent outdoors according to specific activities (an activity-based approach). Using self-administered, mailed questionnaires, test-retest responses to time-based and to activity-based approaches were evaluated in 124 volunteer radiologic technologist participants from the United States: 64 females and 60 males 48 to 80 years of age. Intraclass correlation coefficients (ICC) were used to evaluate the test-retest reliability of average number of hours spent outdoors in the summer estimated for each approach. We tested the differences between the two ICCs, corresponding to each approach, using a t test with the variance of the difference estimated by the jackknife method. During childhood and adolescence, the two approaches gave similar ICCs for average numbers of hours spent outdoors in the summer. By contrast, compared with the time-based approach, the activity-based approach showed significantly higher ICCs during adult ages (0.69 versus 0.43, P = 0.003) and over the lifetime (0.69 versus 0.52, P = 0.05); the higher ICCs for the activity-based questionnaire were primarily derived from the results for females. Research is needed to further improve the activity-based questionnaire approach for long-term sun exposure assessment. (Cancer Epidemiol Biomarkers Prev 2009;18(2):464–71)

Epidemiology

The aim of this chapter is to provide you with a basic understanding of epidemiology, and to introduce you to some of the epidemiological concepts and methods used by researchers and practitioners working in public health. It is hoped that you will recognise how the principles and practice of epidemiology help to provide information and insights that can be used to achieve better health outcomes for all. Epidemiology is fundamental to preventive medicine and public health policy. Rather than examine health and illness on an individual level, as clinicians do, epidemiologists focus on communities and population health issues. The word epidemiology is derived from the Greek epi (on, upon), demos (the people) and logos (the study of). Epidemiology, then, is the study of that which falls upon the people. Its aims are to describe health-related states or events, and through systematic examination of the available information, attempt to determine their causes. The ultimate goal is to contribute to prevention of disease and disability and to delay mortality. The primary question of epidemiology is: why do certain diseases affect particular population groups? Drawing upon statistics, the social and behavioural sciences, the biological sciences and medicine, epidemiologists collect and interpret information to assist in the prevention of new cases of disease, eradicate existing disease and prolong the lives of people who have disease.

Transition to school of diverse learners

This thesis examines the approaches taken by early years teachers in supporting the inclusive school transition of diverse learners. A Thesis by Publication format has been employed, where instead of traditional thesis chapters, scholarly journal articles are presented in an ordered sequence in two sections. The first set of journal articles establishes a synthesis of approaches to diversity and inclusion and to transition to school, in order to set a clear theoretical position arising from the literature. The second set of journal articles reports empirical evidence from three school sites on diversity, inclusion and transition to school, discussed in relation to both the first set of papers and to additional literature. The relationship between these articles, and the methodology used for the theoretical papers, is outlined in linking summaries of the challenges the papers seek to address.

Vibrational spectroscopic studies of wool

Fourier transfonn (FT) Raman, Raman microspectroscopy and Fourier transform infrared (FTIR) spectroscopy have been used for the structural analysis and characterisation of untreated and chemically treated wool fibres. For FT -Raman spectroscopy novel methods of sample presentation have been developed and optimised for the analysis of wool. No significant fluorescence was observed and the spectra could be obtained routinely. The stability of wool keratin to the laser source was investigated and the visual and spectroscopic signs of sample damage were established. Wool keratin was found to be extremely robust with no signs of sample degradation observed for laser powers of up to 600 m W and for exposure times of up to seven and half hours. Due to improvements in band resolution and signal-to-noise ratio, several previously unobserved spectral features have become apparent. The assignment of the Raman active vibrational modes of wool have been reviewed and updated to include these features. The infrared spectroscopic techniques of attenuated total reflectance (ATR) and photoacoustic (P A) have been used to examine shrinkproofed and mothproofed wool samples. Shrinkproofing is an oxidative chemical treatment used to selectively modifY the surface of a wool fibre. Mothproofing is a chemical treatment applied to wool for the prevention of insect attack. The ability of PAS and A TR to vary the penetration depth by varying certain instrumental parameters was used to obtain spectra of the near surface regions of these chemically treated samples. These spectra were compared with those taken with a greater penetration depth, which therefore represent more of the bulk wool sample. The PA and ATR spectra demonstrated that oxidation was restricted to the near-surface layer of wool. Extensive curve fitting of ATR spectra of untreated wool indicated that cuticle was composed of a mixed protein conformation, but was predominately that of an a.-helix. The cortex was proposed to be a mixture of both a.helical and ~-pleated sheet protein conformations. These findings were supported by PAS depth profiling results. Raman microspectroscopy was used in an extensive investigation of the molecular structure of the wool fibre. This included determining the orientation of certain functional groups within the wool fibre and the symmetry of particular vibrations. The orientation ofbonds within the wool fibre was investigated by orientating the wool fibre axis parallel and then perpendicular to the plane of polarisation of the electric vector of the incident radiation. It was experimentally determined that the majority of C=O and N-H bonds of the peptide bond of wool lie parallel to the fibre axis. Additionally, a number of the important vibrations associated with the a-helix were also found to lie parallel to the fibre axis. Further investigation into the molecular structure of wool involved determining what effect stretching the wool fibre had on bond orientation. Raman spectra of stretched and unstretched wool fibres indicated that extension altered the orientation ofthe aromatic rings, the CH2 and CH3 groups of the amino acids. Curve fitting results revealed that extension resulted in significant destruction of the a-helix structure a substantial increase in the P-pleated sheet structure. Finally, depolarisation ratios were calculated for Raman spectra. The vibrations associated with the aromatic rings of amino acids had very low ratios which indicated that the vibrations were highly symmetrical.

The theatre programme : a public discourse at a staging of Maxwell Anderson's "Anne of the Thousand Days"

The term ’public discourses’ describes a range of texts or signifiers that inform the conditions of audience reception. Public discourses include myriad written, visual, spatial, auditory and sensory texts experienced by an audience at a particular theatrical event. Ric Knowles first introduced this term in his recent work Reading the Material Theatre. Whereas Knowles was interested in how public discourses modified the conditions of reception, my broader research is to explore how these public discourses become texts in themselves. This paper will discuss one public discourse, the theatre programme, as it related to a staging of Maxwell Anderson’s Anne of the Thousand Days at the Brisbane Powerhouse in June 2006. The significance of the programme was explored at symposiums held after the performances. Audiences generally view programmes before a performance and after a performance and its significance as a written text changes. The program became a sign vehicle that worked to expound and explicate the meaning of the play for the audience. This public discourse became a significant written text contributing to the textual whole of the theatrical event.

Stripping Sight Bare : Alison Jones’ ‘Portraits by Proxy’

In this paper I analyse UK artist Alison Jones’ sonic interventions Portrait of the Artist by Proxy (2008), Voyeurism by Proxy (2008) and Art, Lies and Audio Tapes (2009). In Portrait of the Artist by Proxy, Jones – who, due to deteriorating vision, has not seen her reflection in a mirror in years – asks and trusts participants to audio-describe her own image back to her. In Voyeurism by Proxy, Jones asks participants to audio-describe erotic drawings by Gustav Klimt. In Art, Lies and Audio Tapes, Jones asks participants to audio-describe other artworks, such as W.F. Yeames’ And When Did You Last see Your Father?. In these portraits by proxy, Jones opens her image, and other images, to interpretation. In doing so, Jones draws attention to the way sight is privileged as a mode of access to fixed, fundamental truths in Western culture – a mode assumed to be untainted by filters that skew perception of the object. “In a culture where vision is by far the dominant sense,” Jones says, “and as a visual artist with a visual impairment, I am reliant on audio-description …Inevitably, there are limitations imposed by language, time and the interpreter’s background knowledge of the subject viewed, as well as their personal bias of what is deemed important to impart in their description” . In these works, Jones strips these background knowledges, biases and assumptions bare. She reveals different perceptions, as well as tendencies or censor, edit or exaggerate descriptions. In this paper, I investigate how, by revealing unconscious biases, Jones’ works renders herself and her participants vulnerable to a change of perception. I also examine how Jones’ later editing of the audio-descriptions allows her to show the instabilities of sight, and, in Portrait of the Artist by Proxy, to reclaim authorship of her own image.