Postoperative pain relief using intermittent intrapleural analgesia following thoracoscopic anterior correction for progressive adolescent idiopathic scoliosis

Background Thoracoscopic anterior scoliosis instrumentation is a safe and viable surgical option for corrective fusion of progressive adolescent idiopathic scoliosis (AIS) and has been performed at our centre on 205 patients since 2000. However, there is a paucity of literature reporting on or examining optimum methods of analgesia following this type of surgery. A retrospective study was designed to present the authors’ technique for delivering intermittent local anaesthetic boluses via an intrapleural catheter following thoracoscopic scoliosis surgery; report the pain levels that may be expected and any adverse effects associated with the use of intrapleural analgesia, as part of a combined postoperative analgesia regime. Methods Records for 32 patients who underwent thoracoscopic anterior correction for AIS were reviewed. All patients received an intrapleural catheter inserted during surgery, in addition to patient-controlled opiate analgesia and oral analgesia. After surgery, patients received a bolus of 0.25% bupivacaine every four hours via the intrapleural catheter. Patient’s perceptions of their pain control was measured using the visual analogue pain scale scores which were recorded before and after local anaesthetic administration and the quantity and time of day that any other analgesia was taken, were also recorded. Results 28 female and four male patients (mean age 14.5 ± 1.5 years) had a total of 230 boluses of local anaesthetic administered in the 96 hour period following surgery. Pain scores significantly decreased following the administration of a bolus (p < 0.0001), with the mean pain score decreasing from 3.66 to 1.83. The quantity of opiates via patient-controlled analgesia after surgery decreased steadily between successive 24 hours intervals after an initial increase in the second 24 hour period when patients were mobilised. One intrapleural catheter required early removal due to leakage; there were no other associated complications with the intermittent intrapleural analgesia method. Conclusions Local anaesthetic administration via an intrapleural catheter is a safe and effective method of analgesia following thoracoscopic anterior scoliosis correction. Post-operative pain following anterior thoracic scoliosis surgery can be reduced to ‘mild’ levels by combined analgesia regimes. Keywords: Adolescent idiopathic scoliosis; Thoracoscopic anterior spinal fusion; Anterior fusion; Intrapleural analgesia; Endoscopic anterior surgery; Pain relief; Scoliosis surgery

Standing brave in the face of rapid curriculum change : EAL/D teachers speak about critical literacy and its place in senior English teaching

Critical literacy (CL) has been the subject of much debate in the Australian public and education arenas since 2002. Recently, this debate has dissipated as literacy education agendas and attendant policies shift to embrace more hybrid models and approaches to the teaching of senior English. This paper/presentation reports on the views expressed by four teachers of senior English about critical literacy and it’s relevance to students who are from culturally and linguistically diverse backgrounds who are learning English while undertaking senior studies in high school. Teachers’ understandings of critical literacy are important, esp. given the emphasis on Critical and Creative Thinking and Literacy as two of the General Capabilities underpinning the Australian national curriculum. Using critical discourse analysis, data from four specialist ESL teachers in two different schools were analysed for the ways in which these teachers construct critical literacy. While all four teachers indicated significant commitment to critical literacy as an approach to English language teaching, the understandings they articulated varied from providing forms of access to powerful genres, to rationalist approaches to interrogating text, to a type of ‘critical-aesthetic’ analysis of text construction. Implications are also discussed.

Workplace information literacy : cultivation strategies for 'working smarter' in 21st century libraries

This paper presents a hybrid framework of Swedish cultural practices and Australian grounded theory for organizational development and suggests practical strategies for 'working smarter' in 21st Century libraries. Toward that end, reflective evidence-based practices are offered to incrementally build organizational capacity for asking good questions, selecting authoritative sources, evaluating multiple perspectives, organizing emerging insights, and communicating them to inform, educate, and influence. In addition, to ensure the robust information exchange necessary to collective workplace learning, leadership traits are proposed for ensuring inclusive communication, decision making, and planning processes. These findings emerge from action research projects conducted from 2003 to 2008 in two North American libraries.

Systems thinking : an approach for advancing workplace information literacy

As the importance of information literacy has gained increased recognition, so too have academic library professionals intensified their efforts to champion, activate, and advance these capabilities in others. To date, however, little attention has focused on advancing these essential competencies amongst practitioner advocates.This paper helps redress the paucity of professional literature on the topic of workplace information literacy among library professionals.

CUOL – "See You Online" : teaching strategies for digital literacy practices in the English curriculum

Literacy educator Kathy Mills, observes that creating multimodal and digital texts is an essential part of the national English curriculum in Australia. Here, she presents five practical and engaging ways to transform conventional writing tasks in a digital world.

Yarning circles in the literacy classroom

This article explains how the speaking and listening practice of yarning circles can be used in the literacy classroom. The article opens with an account of a live enactment of yarning circles with elementary students in a mainstream classroom in Australia. It explains the purpose and origin of yarning circles in Indigenous communities, and provides steps for establishing and implementing the practice in classrooms.

Socio-Spatial Approaches To Literacy Studies: Rethinking the Social Constitution and Politics of Space

Literacy studies have begun to examine the spatial dimension of literacy practices in a way that foregrounds space, and that considers space as constitutive to human relations and practices. This chapter provides an introduction to spatial literacy research, providing a guide to key theorists, themes, and studies that have shaped historical and new developments in spatial approaches to literacy practice and pedagogy. It begins by reconceptualising socio-spatial approaches to literacy research and defines terms. Intersections with related social theories are examined, with an emphasis on critical approaches and the politics of space. It clarifies the relationship between socio-spatial and socio-cultural paradigms, revisiting the spatial in seminal socio-cultural research. It covers new ground,including networks, flows, and deterritorialisation of literacy practice. The chapter concludes with challenges and recommendations for future language research and educational practice.

How to improve pupils' literacy? A cost-effectiveness analysis of a French educational project

The Action Lecture program is an innovative teaching method run in some nursery and primary schools in Paris and designed to improve pupils’ literacy. We report the results of an evaluation of this program. We describe the experimental protocol that was built to estimate the program’s impact on several types of indicators. Data were processed following a Differences-in-Differences (DID) method. Then we use the estimation of the impact on academic achievement to conduct a cost-effectiveness analysis and take a reduction of the class size program as a benchmark. The results are positive for the Action Lecture program.

Diversifying Information Literacy Research : An Informed Learning Perspective

This article uses the idea of informed learning, an interpretation of information literacy that focuses on people’s information experiences rather than their skills or attributes, to analyse the character of using information to learn in diverse communities and settings, including digital, faith, indigenous and ethnic communities. While researchers of information behaviour or information seeking and use have investi- AU :2 gated people’s information worlds in diverse contexts, this work is still at its earliest stages in the information literacy domain. To date, information literacy research has largely occurred in what might be considered mainstream educational and workplace contexts, with some emerging work in community settings. These have been mostly in academic libraries, schools and government workplaces. What does information literacy look like beyond these environments? How might we understand the experience of effective information use in a range of community settings, from the perspective of empirical research and other sources? The article concludes by commenting on the significance of diversifying the range of information experience contexts,for information literacy research and professional practice.

Developing media production skills for literacy in a primary school classroom : digital materials, embodied knowledge and material contexts

This chapter investigates the relationship between technical and operational skills and the development of conceptual knowledge and literacy in Media Arts learning. It argues that there is a relationship between the stories, expressions and ideas that students aim to produce with communications media, and their ability to realise these in material form through technical processes in specific material contexts. Our claim is that there is a relationship between the technical and the operational, along with material relations and the development of conceptual knowledge and literacy in media arts learning. We place more emphasis on the material aspects of literacy than is usually the case in socio-cultural accounts of media literacy. We provide examples from a current project to demonstrate that it is just as important to address the material as it is the discursive and conceptual when considering how students develop media literacy in classroom spaces.

Aboriginal and Torres Strait Islander people in Australia, education and health literacy

Health literacy is a vital tool to build health knowledge and enable empowerment in health decision making at a community and individual level. There are different views of what constitutes health literacy with the most inclusive addressing broadly the skills and competencies required “to seek out, comprehend, evaluate, and use health information and concepts to make informed choices, reduce health risks, and increase quality of life” (Zarcadoolas 2005). Poor health literacy has been shown to impact health seeking behaviour, access and awareness to preventive health.

Segmental torso masses and gravity-induced coronal plane joint moments in adolescent idiopathic scoliosis

Introduction: Calculating segmental (vertebral level-by-level) torso masses in Adolescent Idiopathic Scoliosis (AIS) patients allows the gravitational loading on the scoliotic spine during relaxed standing to be estimated. This study used supine CT scans of AIS patients to measure segmental torso masses and explored the joint moments in the coronal plane, particularly at the apex of a scoliotic major curve. Methods: Existing low dose CT data from the Paediatric Spine Research Group was used to calculate vertebral level-by-level torso masses and joint moments occurring in the spine for a group of 20 female AIS patients with right sided thoracic curves. The mean age was 15.0 ± 2.7 years and all curves were classified Lenke Type 1 with a mean Cobb angle 52 ± 5.9°. Image processing software, ImageJ (v1.45 NIH USA) was used to create reformatted coronal plane images, reconstruct vertebral level-by-level torso segments and subsequently measure the torso volume corresponding to each vertebral level. Segment mass was then determined by assuming a tissue density of 1.04x103 kg/m3. Body segment masses for the head, neck and arms were taken from published anthropometric data (Winter 2009). Intervertebral joint moments in the coronal plane at each vertebral level were found from the position of the centroid of the segment masses relative to the joint centres with the segmental body mass data. Results and Discussion: The magnitude of the torso masses from T1-L5 increased inferiorly, with a 150% increase in mean segmental torso mass from 0.6kg at T1 to 1.5kg at L5. The magnitudes of the calculated coronal plane joint moments during relaxed standing were typically 5-7 Nm at the apex of the curve, with the highest apex joint torque of 7Nm. The CT scans were performed in the supine position and curve magnitudes are known to be 7-10° smaller than those measured in standing, due to the absence of gravity acting on the spine. Hence, it can be expected that the moments produced by gravity in the standing individual will be greater than those calculated here.

Australian adolescent perceptions of parental support: Can it predict self-esteem among high and low SES groups?

Aims Physical activity has been shown to increase adolescent self-esteem. The aim of this investigation was to assess adolescent perceptions of parental support for physical activity endeavours, and its relationship with self-esteem among high and low SES groups. Methods Perceptions of parental support, and Rosenberg’s self-esteem (1965) were derived from the Children’s Physical Activity Correlates questionnaire, with scores ranging from 1 (lowest) to 4 (highest). Independent sample t-tests were conducted and Levene’s test indicated homogenous group variance, while Pearson’s r was employed to assess relationships between perceptions of parental support, and self-esteem. Results Overall, 111 (89%) and 64 (55%) high and low SES participants had complete data and were included in the analysis. The high SES differed for self-esteem (M = 3.39, SE = .05) from the low SES group (M = 2.75, SE = .08), t (173) = 6.82, p < .05, with a medium effect size (ES) r = .46. The high SES group scored higher for perceptions of parental support (M = 2.95, SE = .06) than the low SES group (M = 2.71, SE = .07), t (173) = 2.58, p < .05, with a low ES r = .04. Self-esteem was significantly correlated with parental support in both high (r = .34) and low (r = .47) SES groups. Conclusion Results indicate that perceptions of parental support may be a stronger indicator of self-esteem for low, than for high SES adolescents. Future physical activity strategies to promote self-esteem should involve parents as active facilitators.

Discovering how scientific literacy has been positioned in the new Australian curriculum : science

Through the use of critical discourse analysis, this thesis investigated the perceived importance of scientific literacy in the new Australian Curriculum: Science. It was found that scientific literacy was ambiguous, and that the document did not provide detailed scope for intentional teaching for scientific literacy. To overcome this, recommendations on how to intentionally teach for scientific literacy were provided, so that Australian Science teachers can focus on improving scientific literacy outcomes for all students within this new curriculum.

Workplace experiences of information literacy

The idea of information literacy, broadly deÞned as the ability to recognise information needs and identify, evaluate and use information e¤ectively, has been of growing concern in the education sectors for a number of years; whilst in the workplace, employers and managers have perhaps attended more to the need for computer and information technology skill. New descriptions of information literacy, that may be of value to the business sector, are now beginning to appear as a result of qualitative research into how professional employees experience the e¤ective use of information. This paper summarises the outcomes of an investigation into the experience of information literacy amongst various types of professionals; and explores the possible di¤erences and interrelations between individual and organisational information literacy suggested by these outcomes. Seven di¤erent ways of experiencing information literacy were identiÞed. These experiences are closely related to important workplace processes such as environmental scanning, information management, corporate memory, and research and development; conÞrming that information literacy should be considered a signiÞcant part of the character of learning organisations as well as being a key characteristic of the organisationÕs employees. Implications of individual and organisational information literacy for beginning and continuing professional education are explored.