Role of exercise in the prevention and management of lymphedema after breast cancer

Swelling or lymphedema of the limb, trunk, or breast is considered the most problematic and dreaded concern after treatment for breast cancer and has significant physical, psychological, and social ramifications. Conservative incidence estimates suggest that 20%-30% of breast cancer survivors will experience lymphedema, with the majority of cases (up to 80%) occurring within the first year after surgery. The etiology of secondary lymphedema seems to be multifactorial, with acquired abnormalities as well as preexisting conditions being contributory factors.

The role of extreme sports in lifestyle enhancement and wellness

Alternative sports are fast becoming the physical activity of choice. Participation rates are even outstripping more traditional activities such as golf. At their most extreme there is no second chance, the most likely outcome of a mismanaged error or accident is death. At this level participants enjoy activities such as B.A.S.E. (Buildings, Antennae, Space, Earth) jumping, big wave surfing, waterfall kayaking, extreme skiing, rope-free climbing and extreme mountaineering. Probably the most common explanation for participation in extreme sports is the notion that participation is just a matter of some people‟s need to take unnecessary risks. This study reports on findings that indicate a more positive experience. A phenomenological method was used via unstructured interviews with 15 extreme sports participants (ages 30 – 72 years) and other firsthand accounts. Extreme sport participants directly related their experience to personal transformations that spill over to life in general. Athletes report feelings of deep psychological wellbeing and meaningfulness. The extreme sport experience enables a participant to break through personal barriers and develop an understanding of their own resourcefulness and emotional, cognitive, physical and spiritual capabilities. Furthermore such a breakthrough also seems to trigger a change in personal philosophy or view on life. The extreme sport experience transforms a participant though not in terms of working towards an external (social or cultural) perception of identity or towards some constructed perception of an ideal self, but by touching something within.

Ecological sustainability : what role for public health education?

This article explores the notion of ecological sustainability in the context of public health education and the contribution Universities can make in creating environments that include ecologically sustainable practices. It considers the important role of environmental health in building a sustainable future for the population as a central plank of public health. It presents the evidence for the need for comprehensive approaches to ecological sustainability within the University and offers suggestions about how this can take place. It concludes by arguing that to date there is a substantial gap between the rhetoric and the reality in the University context.

The role of self-efficacy in dental patients’ brushing and flossing: Testing an extended Health Belief Model

Objective: In an effort to examine the decreasing oral health trend of Australian dental patients, the Health Belief Model (HBM) was utilised to understand the beliefs underlying brushing and flossing self-care. The HBM states that perception of severity and susceptibility to inaction and an estimate of the barriers and benefits of behavioural performance influences people’s health behaviours. Self-efficacy, confidence in one’s ability to perform oral self-care, was also examined. Methods: In dental waiting rooms, a community sample (N = 92) of dental patients completed a questionnaire assessing HBM variables and self-efficacy, as well as their performance of the oral hygiene behaviours of brushing and flossing. Results: Partial support only was found for the HBM with barriers emerging as the sole HBM factor influencing brushing and flossing behaviours. Self-efficacy significantly predicted both oral hygiene behaviours also. Conclusion: Support was found for the control factors, specifically a consideration of barriers and self-efficacy, in the context of understanding dental patients’ oral hygiene decisions. Practice implications: Dental professionals should encourage patients’ self-confidence to brush and floss at recommended levels and discuss strategies that combat barriers to performance, rather than emphasising the risks of inaction or the benefits of oral self-care.

A role mining inspired approach to representing user behaviour in ERP systems

Despite all attempts to prevent fraud, it continues to be a major threat to industry and government. Traditionally, organizations have focused on fraud prevention rather than detection, to combat fraud. In this paper we present a role mining inspired approach to represent user behaviour in Enterprise Resource Planning (ERP) systems, primarily aimed at detecting opportunities to commit fraud or potentially suspicious activities. We have adapted an approach which uses set theory to create transaction profiles based on analysis of user activity records. Based on these transaction profiles, we propose a set of (1) anomaly types to detect potentially suspicious user behaviour and (2) scenarios to identify inadequate segregation of duties in an ERP environment. In addition, we present two algorithms to construct a directed acyclic graph to represent relationships between transaction profiles. Experiments were conducted using a real dataset obtained from a teaching environment and a demonstration dataset, both using SAP R/3, presently the most predominant ERP system. The results of this empirical research demonstrate the effectiveness of the proposed approach.

Modeling and Verification of Privacy Enhancing Protocols

Privacy enhancing protocols (PEPs) are a family of protocols that allow secure exchange and management of sensitive user information. They are important in preserving users’ privacy in today’s open environment. Proof of the correctness of PEPs is necessary before they can be deployed. However, the traditional provable security approach, though well established for verifying cryptographic primitives, is not applicable to PEPs. We apply the formal method of Coloured Petri Nets (CPNs) to construct an executable specification of a representative PEP, namely the Private Information Escrow Bound to Multiple Conditions Protocol (PIEMCP). Formal semantics of the CPN specification allow us to reason about various security properties of PIEMCP using state space analysis techniques. This investigation provides us with preliminary insights for modeling and verification of PEPs in general, demonstrating the benefit of applying the CPN-based formal approach to proving the correctness of PEPs.

The moderating role of self-efficacy on the relationship between emotional exhaustion and job strain for boundary-spanning service employees

Appropriate behaviours toward customers often requires employees to suppress some genuine emotions and/or express other emotions; genuine or contrived. Managing one's emotions in this way gives rise to emotional exhaustion. This can have consequences for psychological ill health, in the form of work place strain, and ultimately employee's desire to leave. This student examines the relationships between emotional management, emotional exhaustion and turnover intentions amongst diversional therapy professionals. We find that some forms of emotional management have a significant impact on emotional exhaustion and that this predicts workplace strain. Furthermore, the deleterious effects of emotional exhaustion are mitigated somewhat for employees who have strong beliefs in their ability to provide good service, compared to employees with lower self efficacy beliefs.

The role of fluid and emotional intelligence in malingering

The purpose of the present study was to examine the role of fluid (gf), social (SI) and emotional intelligence (EI) in faking the Beck Depression Inventory (2nd ed., BDI-II). Twenty-two students and 26 non-students completed Raven’s Advanced Progressive Matrices (APM), a social insight test, the Schutte et al. self-report EI scale, and the BDI-II under honest and faking instructions. Results were consistent with a new model of successful faking, in which a participant’s original response must be manipulated into a strategic response, which must match diagnostic criteria. As hypothesised, the BDI-II could be faked, and gf was not related to faking ability. Counter to expectations, however, SI and EI were not related to faking ability. A second study explored why EI failed to facilitate faking. Forty-nine students and 50 non-students completed the EI measure, the Marlowe-Crown Scale and the Levenson et al. Psychopathy Scale. As hypothesised, EI was negatively correlated with psychopathy, but EI showed no relationship with socially desirable responding. It was concluded that in the first experiment, high-EI people did fake effectively, but high-psychopathy people (who had low EI) were also faking effectively, resulting in a distribution that showed no advantage to high EI individuals.

Bayesian latent trait modeling of migraine symptom data

Definition of disease phenotype is a necessary preliminary to research into genetic causes of a complex disease. Clinical diagnosis of migraine is currently based on diagnostic criteria developed by the International Headache Society. Previously, we examined the natural clustering of these diagnostic symptoms using latent class analysis (LCA) and found that a four-class model was preferred. However, the classes can be ordered such that all symptoms progressively intensify, suggesting that a single continuous variable representing disease severity may provide a better model. Here, we compare two models: item response theory and LCA, each constructed within a Bayesian context. A deviance information criterion is used to assess model fit. We phenotyped our population sample using these models, estimated heritability and conducted genome-wide linkage analysis using Merlin-qtl. LCA with four classes was again preferred. After transformation, phenotypic trait values derived from both models are highly correlated (correlation = 0.99) and consequently results from subsequent genetic analyses were similar. Heritability was estimated at 0.37, while multipoint linkage analysis produced genome-wide significant linkage to chromosome 7q31-q33 and suggestive linkage to chromosomes 1 and 2. We argue that such continuous measures are a powerful tool for identifying genes contributing to migraine susceptibility.

Inequalities in cardiovascular disease mortality : the role of behavioural, physiological and social risk factors

Background: While the relationship between socioeconomic disadvantage and cardiovascular disease (CVD) is well established, the role that traditional cardiovascular risk factors play in this association remains unclear. We examined the association between education attainment and CVD mortality and the extent to which behavioural, social and physiological factors explained this relationship. Methods: Adults (n=38 355) aged 40-69 years living in Melbourne, Australia were recruited in 1990-1994. Subjects with baseline CVD risk factor data ascertained through questionnaire and physical measurement were followed for an average of 9.4 years with CVD deaths verified by review of medical records and autopsy reports. Results: CVD mortality was higher for those with primary education only compared to those who had completed tertiary education, with a hazard ratio (HR) of 1.66 (95% confidence interval [CI] 1.11-2.49) after adjustment for age, country of birth and gender. Those from the lowest educated group had a more adverse cardiovascular risk factor profile compared to the highest educated group, and adjustment for these risk factors reduced the HR to 1.18 (95% CI 0.78-1.77). In analysis of individual risk factors, smoking and waist circumference explained most of the difference in CVD mortality between the highest and lowest education groups. Conclusions: Most of the excess CVD mortality in lower socioeconomic groups can be explained by known risk factors, particularly smoking and overweight. While targeting cardiovascular risk factors should not divert efforts from addressing the underlying determinants of health inequalities, it is essential that known risk factors are addressed effectively among lower socioeconomic groups.

Modeling the impact of potential vaccines on epidemics of sexually transmitted chlamydia trachomatis infection

Background. We investigated the likely impact of vaccines on the prevalence of and morbidity due to Chlamydia trachomatis (chlamydia) infections in heterosexual populations. Methods.An individual‐based mathematical model of chlamydia transmission was developed and linked to the infection course in chlamydia‐infected individuals. The model describes the impact of a vaccine through its effect on the chlamydial load required to infect susceptible individuals (the “critical load”), the load in infected individuals, and their subsequent infectiousness. The model was calibrated using behavioral, biological, and clinical data. Results.A fully protective chlamydia vaccine administered before sexual debut can theoretically eliminate chlamydia epidemics within 20 years. Partially effective vaccines can still greatly reduce the incidence of chlamydia infection. Vaccines should aim primarily to increase the critical load in susceptible individuals and secondarily to decrease the peak load and/or the duration of infection in vaccinated individuals who become infected. Vaccinating both sexes has a beneficial impact on chlamydia‐related morbidity, but targeting women is more effective than targeting men. Conclusions.Our findings can be used in laboratory settings to evaluate vaccine candidates in animal models, by regulatory bodies in the promotion of candidates for clinical trials, and by public health authorities in deciding on optimal intervention strategies.

The relationship between communication and team performance : testing moderators and identifying communication profiles in established work teams

Communication is one team process factor that has received considerable research attention in the team literature. This literature provides equivocal evidence regarding the role of communication in team performance and yet, does not provide any evidence for when communication becomes important for team performance. This research program sought to address this evidence gap by a) testing task complexity and team member diversity (race diversity, gender diversity and work value diversity) as moderators of the team communication — performance relationship; and b) testing a team communication — performance model using established teams across two different task types. The functional perspective was used as the theoretical framework for operationalizing team communication activity. The research program utilised a quasi-experimental research design with participants from a large multi-national information technology company whose Head Office was based in Sydney, Australia. Participants voluntarily completed two team building exercises (a decision making and production task), and completed two online questionnaires. In total, data were collected from 1039 individuals who constituted 203 work teams. Analysis of the data revealed a small number of significant moderation effects, not all in the expected direction. However, an interesting and unexpected finding also emerged from Study One. Large and significant correlations between communication activity ratings were found across tasks, but not within tasks. This finding suggested that teams were displaying very similar profiles of communication on each task, despite the tasks having different communication requirements. Given this finding, Study Two sought to a) determine the relative importance of task versus team effects in explaining variance in team communication measures for established teams; b) determine if established teams had reliable and discernable team communication profiles and if so, c) investigate whether team communication profiles related to task performance. Multi-level modeling and repeated measures analysis of variance (ANOVA) revealed that task type did not have an effect on team communication ratings. However, teams accounted for 24% of the total variance in communication measures. Through cluster analysis, five reliable and distinct team communication profiles were identified. Consistent with the findings of the multi-level analysis and repeated measures ANOVA, teams’ profiles were virtually identical across the decision making and production tasks. A relationship between communication profile and performance was identified for the production task, although not for the decision making task. This research responds to calls in the literature for a better understanding of when communication becomes important for team performance. The moderators tested in this research were not found to have a substantive or reliable effect on the relationship between communication and performance. However, the consistency in team communication activity suggests that established teams can be characterized by their communication profiles and further, that these communication profiles may have implications for team performance. The findings of this research provide theoretical support for the functional perspective in terms of the communication – performance relationship and further support the team development literature as an explanation for the stability in team communication profiles. This research can also assist organizations to better understand the specific types of communication activity and profiles of communication that could offer teams a performance advantage.

Modeling corneal surfaces with rational functions for high-speed videokeratoscopy data compression

High-speed videokeratoscopy is an emerging technique that enables study of the corneal surface and tear-film dynamics. Unlike its static predecessor, this new technique results in a very large amount of digital data for which storage needs become significant. We aimed to design a compression technique that would use mathematical functions to parsimoniously fit corneal surface data with a minimum number of coefficients. Since the Zernike polynomial functions that have been traditionally used for modeling corneal surfaces may not necessarily correctly represent given corneal surface data in terms of its optical performance, we introduced the concept of Zernike polynomial-based rational functions. Modeling optimality criteria were employed in terms of both the rms surface error as well as the point spread function cross-correlation. The parameters of approximations were estimated using a nonlinear least-squares procedure based on the Levenberg-Marquardt algorithm. A large number of retrospective videokeratoscopic measurements were used to evaluate the performance of the proposed rational-function-based modeling approach. The results indicate that the rational functions almost always outperform the traditional Zernike polynomial approximations with the same number of coefficients.