Life impact of ankle fractures : qualitative analysis of patient and clinician experiences

Background: Ankle fractures are one of the more commonly occurring forms of trauma managed by orthopaedic teams worldwide. The impacts of these injuries are not restricted to pain and disability caused at the time of the incident, but may also result in long term physical, psychological, and social consequences. There are currently no ankle fracture specific patient-reported outcome measures with a robust content foundation. This investigation aimed to develop a thematic conceptual framework of life impacts following ankle fracture from the experiences of people who have suffered ankle fractures as well as the health professionals who treat them. Methods: A qualitative investigation was undertaken using in-depth semi-structured interviews with people (n=12) who had previously sustained an ankle fracture (patients) and health professionals (n=6) that treat people with ankle fractures. Interviews were audio-recorded and transcribed. Each phrase was individually coded and grouped in categories and aligned under emerging themes by two independent researchers. Results: Saturation occurred after 10 in-depth patient interviews. Time since injury for patients ranged from 6 weeks to more than 2 years. Experience of health professionals ranged from 1 year to 16 years working with people with ankle fractures. Health professionals included an Orthopaedic surgeon (1), physiotherapists (3), a podiatrist (1) and an occupational therapist (1). The emerging framework derived from patient data included eight themes (Physical, Psychological, Daily Living, Social, Occupational and Domestic, Financial, Aesthetic and Medication Taking). Health professional responses did not reveal any additional themes, but tended to focus on physical and occupational themes. Conclusions: The nature of life impact following ankle fractures can extend beyond short term pain and discomfort into many areas of life. The findings from this research have provided an empirically derived framework from which a condition-specific patient-reported outcome measure can be developed.

Weight stigma in maternity care : women's experiences and care providers' attitudes

Background: Weight stigma is pervasive in Western society and in healthcare settings, and has a negative impact on victims’ psychological and physical health. In the context of an increasing focus on the management of overweight and obese women during and after pregnancy in research and clinical practice, the current studies aimed to examine the presence of weight stigma in maternity care. Addressing previous limitations in the weight stigma literature, this paper quantitatively explores the presence of weight stigma from both patient and care provider perspectives. Methods: Study One investigated associations between pre-pregnancy body mass index (BMI) and experiences of maternity care from a state-wide, self-reported survey of 627 Australian women who gave birth in 2009. Study Two involved administration of an online survey to 248 Australian pre-service medical and maternity care providers, to investigate their perceptions of, and attitudes towards, providing care for pregnant patients of differing body sizes. Both studies used linear regression analyses. Results: Women with a higher BMI were more likely to report negative experiences of care during pregnancy and after birth, compared to lower weight women. Pre-service maternity care providers perceived overweight and obese women as having poorer self-management behaviours, and reported less positive attitudes towards caring for overweight or obese pregnant women, than normal weight pregnant women. Even care providers who reported few weight-stigmatising attitudes responded less positively to overweight and obese pregnant women. Conclusions: Overall, these results provide preliminary evidence that weight stigma is present in maternity care settings in Australia. They suggest a need for further research into the nature and consequences of weight stigma in maternity care, and for the inclusion of strategies to recognise and combat weight stigma in maternity care professionals’ training.

Elaborated intrusion theory : a cognitive-emotional theory of food craving

A clear understanding of the cognitive-emotional processes underpinning desires to overconsume foods and adopt sedentary lifestyles can inform the development of more effective interventions to promote healthy eating and physical activity. The Elaborated Intrusion Theory of Desires offers a framework that can help in this endeavor through its emphases on the roles of intrusive thoughts and elaboration of multisensory imagery. There is now substantial evidence that tasks that compete for limited working memory resources with food-related imagery can reduce desires to eat that food, and that positive imagery can promote functional behavior. Meditation mindfulness can also short-circuit elaboration of dysfunctional cognition. Functional Decision Making is an approach that applies laboratory-based research on desire, to provide a motivational intervention to establish and entrench behavior changes, so healthy eating and physical activity become everyday habits.

Indian students at QUT : expectations and experiences

India currently ranks among the top source countries for the Australian education industry and therefore, a better understanding of the concerns and challenges confronted by Indian students is essential. This study was undertaken to assess the needs and expectations of Indian students enrolled at Queensland University of Technology (QUT) that would inform the formulation of strategies to provide superior service to the current and future cohorts of students coming from India. Data collection was undertaken through surveys and focus group meetings. The findings reveal the acute need for more effective dissemination of information prior to the students commencing their programs on both academic and non-academic aspects of university life as well as the resources and support available at QUT. Usage of English in an academic setting, career related services, accommodation, and networking opportunities were identified as some of the key areas of concern by the participants.

Pre-service teachers' pedagogical relationships and experiences of embedding Indigenous Australian knowledge in teaching practicum

This paper argues from the standpoint that embedding Indigenous knowledge and perspectives in Australian curricula occurs within a space of tension, ‘the cultural interface’ (Nakata, 2002), in negotiation and contestation with other dominant knowledge systems. In this interface, Indigenous knowledge (IK) is in a state of constancy and flux, invisible and simultaneously pronounced depending on the teaching and learning contexts. More often than not, IK competes for validity and is vexed by questions of racial and cultural authenticity, and therefore struggles to be located centrally in educational systems, curricula and pedagogies. Interrogating normative western notions of what constitutes authentic or legitimate knowledge is critical to teaching Indigenous studies and embedding IK. The inclusion (and exclusion) of IK at the interface is central to developing curriculum that allows teachers to test and prod, create new knowledge and teaching approaches. From this perspective, we explore Indigenous Australian pre-service teachers’ experiences of pedagogical relationships within the teaching habitus of Australian classrooms. Our study is engaged with the strategic transgressions of praxis. We contend that tensions that participant Indigenous Australian pre-service teachers experience mirror the broader (and unresolved) political status of Indigenous people and thus where and why IK is strategically deployed as ‘new’ or ‘old knowledge within Australian liberal democratic systems of curriculum and schooling. It is significant to discuss the formation and transformation of the pedagogical cultural identity of the teaching profession within which Indigenous and non-Indigenous pre-service teachers are employed.

Preservice teachers’ perceptions of their middle schooling teacher preparation : a sample of the Australian context

Reviews into teacher education and reform measures, such as implementing professional standards for teachers, are designed to raise the quality of education. Such reviews and reforms also target preservice teachers; hence universities examine their teacher education programs to address these issues, including developing programs that are current with the literature. Over the past fifteen years, concerns have arisen about Australian early adolescents and their disengagement from the schooling system, their “at risk” behaviour and their need for social, emotional and academic support. These concerns have prompted a middle schooling movement in Australia with the literature recognising a need for specialised middle school teachers. As a result, various universities have responded by developing courses specifically designed to graduate teachers who possess the theoretical and pedagogical knowledge for engaging early adolescent learners. This mixed-method study analysed the responses of preservice teachers from three universities across two states in Australia near the completion of their middle years teacher preparation program. The three aims of the study were to: (1) investigate final-year preservice teachers’ perceptions of their confidence to teach in the middle years of schooling; (2) analyse the experiences included in their teacher preparation course that made them feel confident; and (3) describe strategies for enhancing middle schooling teacher education preparation. Data were gathered from final-year preservice teachers (n=142) using a survey that was developed in response to middle schooling literature and the Professional Standards for Queensland Teachers (Queensland College of Teachers, 2006). A questionnaire collected extended information about the participants’ (n=142) experiences that made them feel confident. It also gathered information about strategies for enhancing middle years teacher preparation. One-to-one, 45-minute interviews (n=10) were conducted to elicit in-depth responses aligned with the research aims. Quantitative results indicated that the majority of preservice teachers (n=142) claimed confidence associated with survey items relating to creating a positive classroom environment (range: 70-97%), developing positive relationships for teaching (71-98%), pedagogical knowledge for teaching (72-95%), and implementation of teaching (70-91%). Qualitative findings suggested that the experiences that assisted them to be confident for teaching were practicum and associated field studies coursework, a positive mentor teacher, specifically designed middle years subjects, the pedagogical approaches of university staff, and other real-world experiences such as volunteering in schools and participating in professional development alongside their mentors. This study demonstrated that universities presenting middle years teacher preparation need to consider: the quality of the practicum experience; the suitability of mentor teachers; the significance and practicalities of middle years subjects; university lecturers’ modelling of pedagogical practices; and the inclusion of real-world learning experiences. Although the findings of this study provided evidence as to how preservice teacher confidence for teaching has been influenced by their middle schooling teacher preparation, further research is required to investigate how confidence translates into practice within their first years of teaching.

Exploring the effect of companion robots on emotional expression in older people with dementia : a pilot randomized controlled trial

This pilot study aimed to compare the effect of companion robots (PARO) to participation in an interactive reading group on emotions in people living with moderate to severe dementia in a residential care setting. A randomized crossover design, with PARO and reading control groups, was used. Eighteen residents with mid- to late-stage dementia from one aged care facility in Queensland, Australia, were recruited. Participants were assessed three times using the Quality of Life in Alzheimer’s Disease, Rating Anxiety in Dementia, Apathy Evaluation, Geriatric Depression, and Revised Algase Wandering Scales. PARO had a moderate to large positive influence on participants’ quality of life compared to the reading group. The PARO intervention group had higher pleasure scores when compared to the reading group. Findings suggest PARO may be useful as a treatment option for people with dementia; however, the need for a larger trial was identified.

Information practices of teen content creators : the intersection of action and experiences a grounded theory study

What are the information practices of teen content creators? In the United States over two thirds of teens have participated in creating and sharing content in online communities that are developed for the purpose of allowing users to be producers of content. This study investigates how teens participating in digital participatory communities find and use information as well as how they experience the information. From this investigation emerged a model of their information practices while creating and sharing content such as film-making, visual art work, story telling, music, programming, and web site design in digital participatory communities. The research uses grounded theory methodology in a social constructionist framework to investigate the research problem: what are the information practices of teen content creators? Data was gathered through semi-structured interviews and observation of teen’s digital communities. Analysis occurred concurrently with data collection, and the principle of constant comparison was applied in analysis. As findings were constructed from the data, additional data was collected until a substantive theory was constructed and no new information emerged from data collection. The theory that was constructed from the data describes five information practices of teen content creators. The five information practices are learning community, negotiating aesthetic, negotiating control, negotiating capacity, and representing knowledge. In describing the five information practices there are three necessary descriptive components, the community of practice, the experiences of information and the information actions. The experiences of information include information as participation, inspiration, collaboration, process, and artifact. Information actions include activities that occur in the categories of gathering, thinking and creating. The experiences of information and information actions intersect in the information practices, which are situated within the specific community of practice, such as a digital participatory community. Finally, the information practices interact and build upon one another and this is represented in a graphic model and explanation.

Remove, rehabilitate, return? The use and effectiveness of behaviour schools in New South Wales, Australia

Research indicates that enrolments in separate special educational settings for students with disruptive behaviour have increased in a number of educational jurisdictions internationally. Recent analysis of school enrolment data has identified a similar increase in the New South Wales (NSW) government school sector; however, questions have been raised as to their use and effectiveness. To situate the NSW experiment with behaviour schools in a broader context, the paper begins with a review of the international research literature. This is followed by a discussion of the NSW experience with the aim of identifying parallels and gaps in the research. The paper concludes by outlining important questions and directions for research to better understand and improve the educational experiences and outcomes of disruptive disaffected students in Australia’s largest school system.

Existential place-making : the dialogical realms of design for dwelling with disability

The world of disability is often neglected or taken for granted in able-bodied society. Apart from the challenge that disability is a social construct (Linton, 1998, 2006; Longmore, 2003; Thompson, 1997) there is an impact on the people with disability that they either feel left out or they don’t belong in the larger community. The able-bodied community is also left with very little knowledge or no sensitivity towards people with disability. These internal whirlpools do not contribute to any community only to create larger gaps and higher differences between the groups of people. Peace (2010) claims that disability is something imposed on to a person on top of a physical impairment. Nord (2008) advocates that while environmental barriers and social attitudes are crucial aspects of a person’s experience, they can indeed disable a person. The study reported high-lights what is home for people with disability and their family members. The way the person with disability and family members without disability share the same home and nurture personal relationships with each other demands greater attention. This research sheds light on the intricate relationships that exists between the family members including person with disability and their built environment. These existential connections provide a holistic viewpoint and the glimpse into the lived experiences of homes for people with disability and their care-givers. Concepts of universal design or barrier free design have not been successful (Connell and Sanford, 1999) in revealing in-depth the nature of place-making for people with disability and their care-givers. Such studies fail to incorporate the holistic needs of individuals with disability and their family members in terms of their bodily, visceral, emotional, social, psycho-social, intuitive, spiritual and temporal needs, to name a few (Franz, Bitner, 2010). This paper reports on some preliminary findings on phenomena of dwelling for people with different kinds of disability and their care-givers sharing the same home from an interior design perspective.

Relationship between emotional climate and the fluency of classroom interactions

This study examined emotional climate in relation to the teaching and learning of grade 7 science. A multi-method and multi-theoretic approach used sociocultural frameworks as a foundation for interpretive research, conversation analysis, prosody analysis, and studies of nonverbal conduct. Emotional climate varied continuously throughout a lesson. Dialogues occurred and afforded learning when interactions between the teacher and students were fluent and included humour and collective effervescence. Emotional climate was negatively valenced when the teacher and/or students endeavoured to establish and maintain power by restricting others’ participation to spectator roles. The teacher’s endeavours to maintain and establish control over students were potentially detrimental to teaching and learning, teachers and learners. This type of teaching gradually evolved into a form we referred to as cranky teaching, whereby the teacher and her students showed signs of frustration and the enacted teaching and learning roles lacked fluency. The methods we pioneered in the present study might be helpful for other teachers who wish to participate in research on their classes to ascertain what works and should be strengthened, and identify practices and rituals that are deleterious and in need of change.

Comparison of self-reported driving behaviours and experiences of immediate-uptake and delayed-uptake licence holders

The objective of this paper was to explore experiences of ‘immediate-uptake’ (intermediate licensure at age 17-18 years, n = 928) and ‘delayed-uptake’ (intermediate licensure at age 19-20 years, n = 158) driver’s licence holders in the Australian state of Queensland. In Queensland, the graduated driver licence program applies to all novices irrespective of age. Drivers who obtained a Provisional 1 (intermediate) (P1) licence completed a survey exploring pre-Licence and Learner experiences, including the Behaviour of Young Novice Drivers Scale (BYNDS). Six months later, 351 drivers from this sample (n = 300 immediate-uptake) completed a survey exploring P1 driving. Delayed-uptake Learners reported significantly more difficulty gaining driving practice, which appeared to be associated with significantly greater engagement in unsupervised driving during the Learner period. Whilst a larger proportion of delayed-uptake novices, particularly males, reported the use of more active punishment avoidance strategies (avoiding Police, talking themselves out of a ticket) in the P1 phase, there was no significant difference in the BYNDS scores in the Learner and P1 phases according to licence-uptake category. Delayed-uptake novices report more difficulty meeting GDL requirements and place themselves at increased risk by driving unsupervised during the Learner licence phase. Additional efforts such as mentoring programs which can support the delayed-uptake Learner in meeting their GDL obligations merit further consideration to allow this novice group to gain the full benefits of the GDL program and to reduce their risk of harm in the short-term.

Working with refugee survivors of torture and trauma : an opportunity for vicarious posttraumatic growth

Clinical work with people who have survived trauma carries a risk of vicarious traumatisation for the service provider, but also the potential for vicarious posttraumatic growth. Despite growing interest in this area, the effects of working with survivors of refugee-related trauma have remained relatively unexplored. The aim of the current study was to examine the lived experiences of people working on a daily basis with survivors of torture and trauma who had sought refuge in Australia. Seventeen clinical, administrative, and managerial staff from a not-for-profit organisation participated in a semi-structured interview that was later analysed using interpretive phenomenological analysis. Analysis of the data demonstrated that the entire sample reported symptoms of vicarious trauma (e.g., strong emotional reactions, intrusive images, shattering of existing beliefs) as well as vicarious posttraumatic growth (e.g., forming new relationships, increased self-understanding, greater appreciation of life). Moreover, effortful meaning making processes appeared to facilitate such positive changes. Reduction in the risks associated with this work, enhancement of clinician well-being, and improvement of therapeutic outcomes is a shared responsibility of the organisation and clinician. Without negating the distress of trauma work, clinicians are encouraged to more deeply consider the unique positive outcomes that supporting survivors can provide.

Skill development and social inclusion via peer assisted learning in first-year higher education : an evaluation of student experiences across two law units

Because professions seek graduates who can 'collaborate, share skills and knowledge, and communicate' (Kruck and Reif, 2001, p 37), it is important that university graduates are not equipped solely with the content knowledge of their discipline, but also with prospective employment skills. Furthermore, when students 'interact more in positive ways with their teachers and peers, they gain more in terms of essential skills and competencies, such as critical thinking, problem~solving [and] effective communication' (NSSE, 2000, p 2)./n this way, peer assisted fellowing has the potential to enhance students' professional development, and provide the social inclusion and engagement necessary for effective learning. This session describes two peer assisted learning models embedded within first year QUT Faculty of Law units. Through a partnership between teaching staff, student mentors and mentees, the models aim to facilitate student socialisation whilst supplementing understanding of substantive law with the development of academic and work·related skills. Mentor and mentee perceptions, and program implications, are considered.

Studying in Cuba, returning home to work : experiences of graduates from the English-speaking Caribbean

Cuba’s higher education scholarship program has received little attention in the literature on education and development. In this chapter, I discuss themes that emerge from my interviews with graduates from English-speaking Caribbean countries who studied in Cuba, as well as Cuban educators, on the nature of their academic programs and their subsequent careers. This facilitates exploration of a number of questions, including the following: 1. How, in the perceptions of scholarship students and graduates, have they experienced the philosophy of combing study, practical work, and research in the tertiary education curriculum in Cuban universities? 2. What impact does studying in Cuba appear to have on graduates after they return to their home countries? 3. How does the experience of the graduates throw light on the relationship between tertiary education and national development?