Longitudinal patterns of weight in women diagnosed with breast cancer [Conference Abstract]

Introduction: Weight gain is a common concern following breast cancer and has been associated with negative health outcomes. As such, prevention of weight gain is of clinical interest. This work describes weight change between 6- and 18-months following a breast cancer diagnosis and explores the personal, treatment and behavioural characteristics associated with gains in weight. Methods: Body mass index was objectively assessed, at three-monthly intervals, on a population-based sample of women newly diagnosed with unilateral breast cancer (n=185). Changes in BMI between 6- and 18-months post-diagnosis were calculated, with gains of one or more being considered clinically detrimental to future health. Results: Approximately 60% of participants were overweight or obese at 6-months post-diagnosis. While BMI remained relatively stable across the testing period (range=27.3-27.8), 24% of participants experienced clinically relevant gains in BMI (median gains=1.9). Following adjustment for potential confounders, younger age (<45 years; Odds ratio, OR=9.8), being morbidly obese at baseline (OR=4.6) and receiving hormone therapy (OR=4.8) were characteristics associated with an increased odds (p<0.05) of gaining BMI. Other characteristics associated with gains in BMI were more extensive surgery and having a history of smoking, although these relationships were not supported statistically. In contrast, caring for younger children was associated with reduced risk of gaining BMI (OR=0.3, p=0.20). Conclusions: Clinically relevant weight gain between 6- and 18-months post-breast cancer diagnosis is an issue for one in four women, with certain subgroups being particularly susceptible. However, the majority of women diagnosed with breast cancer are overweight or obese and gains in body weight are common. Thus, interventions that address the importance of achieving and sustaining a healthy body weight, delivered to all women with breast cancer, may have greater public health impact than interventions targeting any specific breast cancer subgroup.

A qualitative investigation of sources of value in social marketing from the lens of a public health service

This paper seeks to identify the sources of value in a government health screening service. Consumers' use of such services for their won benefits demonstrates desirable behaviour and their continued use of these services indicates maintenance of the behaviour. There are also positive outcomes for society as the health of its members is improved overall through this behaviour. Individual-depth interview with 25 women who use breast cancer screening services provided by BreastScreen (BSQ) revealed five categories of sources of value. They are information sources, interaction sources, service, environment, and consumer participation. These findings provide valuable insights into the value construction of consumers and contribute towards our understanding of the value concept in social marketing.

Glycaemic load is associated with insulin resistance in older Australian women

Background: Diets with a high postprandial glycemic response may contribute to long-term development of insulin resistance and diabetes, however previous epidemiological studies are conflicting on whether glycemic index (GI) or glycemic load (GL) are dietary factors associated with the progression. Our objectives were to estimate GI and GL in a group of older women, and evaluate cross-sectional associations with insulin resistance. Subjects and Methods: Subjects were 329 Australian women aged 42-81 years participating in year three of the Longitudinal Assessment of Ageing in Women (LAW). Dietary intakes were assessed by diet history interviews and analysed using a customised GI database. Insulin resistance was defined as a homeostasis model assessment (HOMA) value of >3.99, based on fasting blood glucose and insulin concentrations. Results: GL was significantly higher in the 26 subjects who were classified as insulin resistant compared to subjects who were not (134±33 versus 114±24, P<0.001). In a logistic regression model, an increment of 15 GL units increased the odds of insulin resistance by 2.09 (95%CI 1.55, 2.80, P<0.001) independently of potential confounding variables. No significant associations were found when insulin resistance was assessed as a continuous variable. Conclusions: Results of this cross-sectional study support the concept that diets with a higher GL are associated with increased risk of insulin resistance. Further studies are required to investigate whether reducing glycemic intake, by either consuming lower GI foods and/or smaller serves of carbohydrate, can contribute to a reduction in development of insulin resistance and long-term risk of type 2 diabetes.

From Sydney and Shanghai : Australian and Chinese women writing modernism

In the 1930s and 1940s, Australian women writers published novels, poems, and short stories that pushed the boundaries of their national literary culture. From their position in the Pacific, they entered into a dialogue with a European modernism that they reworked to invigorate their own writing and to make cross-continental connections. My interest in the work of Australian women prose writers of this period stems from an appreciation of the extent of their engagement with interwar modernism (an engagement that is generally under-acknowledged) and the realization that there are commonalities of approach with the ways in which contemporaneous Chinese authors negotiated this transnational cultural traffic. China and Australia, it has been argued, share an imaginative and literal association of many centuries, and this psychic history produces a situation in which ‘Australians feel drawn towards China: they cannot leave it alone.’1 Equally, Chinese exploration of the great southern land began in the fifteenth century, prior to European contact. In recent times, the intensity of Australia’s cultural and commercial connections with Asia has led to a repositioning of the Australian sense of regionalism in general and, in particular, has activated yet another stage in the history of its relationship with China. In this context, the association of Australian and Chinese writing is instructive because the commonalities of approach and areas of interest between certain authors indicate that Australian writers were not alone in either the content or style of their response to European modernism. This recognition, in turn, advances discussions of modernism in Australia and reveals an alternative way of looking at the world from the Pacific Rim through literature. The intent is to examine selective Australian and Chinese authors who are part of this continuous history and whose writing demonstrates common thematic and stylistic features via the vector of modernism. I focus on the 1930s and 1940s because these are the decades in which Australia and China experienced wideranging conflict in the Pacific, and it is significant that war, both forthcoming and actual, features as an ominous soundtrack in the writing of Chinese and Australian women. I argue that, given the immensity of cultural difference between Australia and China, there is an especially interesting juncture in the ways in which the authors interrogate modernist practices and the challenge of modernism. The process in which writing from the Pacific Rim jointly negotiates the twin desires of engaging with European literary form and representing one’s own culture may be seen as what Jessica Berman identifies as a geomodernism, one of the ‘new possible geographies’ of modernism.2 My discussion centres on the work of the Australian women, to which the Chinese material serves as a point of reference, albeit a critical one. The Chinese writing examined here is restricted to authors who wrote at least some material in English and whose work is available in translation.

Air evacuation in war : the role of RAAF nurses undertaking air evacuation of casualties between 1943-1953

Air transportation of Australian casualties in World War II was initially carried out in air ambulances with an accompanying male medical orderly. By late 1943 with the war effort concentrated in the Pacific, Allied military authorities realised that air transport was needed to move the increasing numbers of casualties over longer distances. The Royal Australian Air Force (RAAF) became responsible for air evacuation of Australian casualties and established a formal medical air evacuation system with trained flight teams early in 1944. Specialised Medical Air Evacuation Transport Units (MAETUs) were established whose sole responsibility was undertaking air evacuations of Australian casualties from the forward operational areas back to definitive medical care. Flight teams consisting of a RAAF nursing sister (registered nurse) and a medical orderly carried out the escort duties. These personnel had been specially trained in Australia for their role. Post-WWII, the RAAF Nursing Service was demobilised with a limited number of nurses being retained for the Interim Air Force. Subsequently, those nurses were offered commissions in the Permanent Air Force. Some of the nurses who remained were air evacuation trained and carried out air evacuations both in Australia and as part of the British Commonwealth Occupation Force in Japan. With the outbreak of the Korean War in June 1950, Australia became responsible for the air evacuation of British Commonwealth casualties from Korea to Japan. With a re-organisation of the Australian forces as part of the British Commonwealth forces, RAAF nurses were posted to undertake air evacuation from Korea and back to Australia from Iwakuni, Japan. By 1952, a specialised casualty staging section was established in Seoul and staffed by RAAF nurses from Iwakuni on a rotation basis. The development of the Australian air evacuation system and the role of the flight nurses are not well documented for the period 1943-1953. The aims of this research are three fold and include documenting the origins and development of the air evacuation system from 1943-1953; analysing and documenting the RAAF nurse’s role and exploring whether any influences or lessons remain valid today. A traditional historical methodology of narrative and then analysis was used to inform the flight nurse’s role within the totality of the social system. Evidence was based on primary data sources mainly held in Defence files, the Australian War Memorial or the National Archives of Australia. Interviews with 12 ex-RAAF nurses from both WWII and the Korean War were conducted to provide information where there were gaps in the primary data and to enable exploration of the flight nurses’ role and their contributions in war of the air evacuation of casualties. Finally, this thesis highlights two lessons that remain valid today. The first is that interoperability of air evacuation systems with other nations is a force multiplier when resources are scarce or limited. Second, the pre-flight assessment of patients was essential and ensured that there were no deaths in-flight.

Comparison of multiple and novel measures of dietary glycemic carbohydrate with insulin resistant status in older women

BACKGROUND:Previous epidemiological investigations of associations between dietary glycemic intake and insulin resistance have used average daily measures of glycemic index (GI) and glycemic load (GL). We explored multiple and novel measures of dietary glycemic intake to determine which was most predictive of an association with insulin resistance.METHODS:Usual dietary intakes were assessed by diet history interview in women aged 42-81 years participating in the Longitudinal Assessment of Ageing in Women. Daily measures of dietary glycemic intake (n = 329) were carbohydrate, GI, GL, and GL per megacalorie (GL/Mcal), while meal based measures (n = 200) were breakfast, lunch and dinner GL; and a new measure, GL peak score, to represent meal peaks. Insulin resistant status was defined as a homeostasis model assessment (HOMA) value of >3.99; HOMA as a continuous variable was also investigated.RESULTS:GL, GL/Mcal, carbohydrate (all P < 0.01), GL peak score (P = 0.04) and lunch GL (P = 0.04) were positively and independently associated with insulin resistant status. Daily measures were more predictive than meal-based measures, with minimal difference between GL/Mcal, GL and carbohydrate. No significant associations were observed with HOMA as a continuous variable.CONCLUSION:A dietary pattern with high peaks of GL above the individual's average intake was a significant independent predictor of insulin resistance in this population, however the contribution was less than daily GL and carbohydrate variables. Accounting for energy intake slightly increased the predictive ability of GL, which is potentially important when examining disease risk in more diverse populations with wider variations in energy requirements.

Incorporating community history into urban redevelopment

A community history project must be relevant to each person within it so that they see themselves as part of the socio-cultural fabric of the area and feel a sense of ownership of their environment. The Mill Albion community history project is a diverse, multi-layered public history/art program that captures the social heritage of The Mill Albion and allows the community to contribute to their ongoing history. The Albion Flour Mill was built in 1930 at a time when Australia was feeling the effects of its worst economic depression and continued operations for more than 72 years. After ceasing operation in 2005 the site was left to deteriorate. The FKP Property Group purchased the land to undertake a new urban redevelopment project, drawing on the design principles of a traditional ‘village’, while valuing the importance of remembering the community that once included the Flour Mill. This paper reflects on the this project and showcases some of the culturally creative ways this community’s history was told, using methods such as digital stories, contemporary and historical photography and oral history.

The shaping of midlife women's views of health and health behaviors

The menopausal transition is a marker of aging for women and a time when health professionals urge women to prevent disease. In this research we adopted a constructivist, inductive approach in exploring how and why midlife women think about health in general, about being healthy, and about factors that influence engaging in healthy behaviors. The sample constituted 23 women who had participated in a women’s wellness program intervention trial and subsequent interviews. The women described lives of healthy eating and exercise, yet, their perceptions of health and healthy behavior at midlife contradicted that history. Midlife was associated with risk and guilt at not doing enough to be healthy. Health professionals provided a very limited frame within which to judge what is healthy. Mostly this was left up to individual women. Those who were successful framed health as “being able to do what you want to do when you want to do it.” In this article we present study findings of how meanings attached to health and being healthy were constructed through social expectations, family relationships, and life experiences.

An obsession with storytelling : conducting oral history interviews for creative writing

Anna Hirsch and Clare Dixon (2008, 190) state that creative writers’ ‘obsession with storytelling…might serve as an interdisciplinary tool for evaluating oral histories.’ This paper enters a dialogue with Hirsch and Dixon’s statement by documenting an interview methodology for a practice-led PhD project, The Artful Life Story: Oral History and Fiction, which investigates the fictionalising of oral history. ----- ----- Alistair Thomson (2007, 62) notes the interdisciplinary nature of oral history scholarship from the 1980s onwards. As a result, oral histories are being used and understood in a variety of arts-based settings. In such contexts, oral histories are not valued so much for their factual content but as sources that are at once dynamic, emotionally authentic and open to a multiplicity of interpretations. How can creative writers design and conduct interviews that reflect this emphasis? ----- ----- The paper briefly maps the growing trend of using oral histories in fiction and ethnographic novels, in order to establish the need to design interviews for arts-based contexts. I describe how I initially designed the interviews to suit the aims of my practice. Once in the field, however, I found that my original methods did not account for my experiences. I conclude with the resulting reflection and understanding that emerged from these problematic encounters, focusing on the technique of steered monologue (Scagliola 2010), sometimes referred to as the Biographic Narrative Interpretative Method (Wengraf 2001, Jones 2006).

Psychometric properties and health correlates of the Geriatric Anxiety Inventory in Australian community-residing older women

Abstract OBJECTIVE: To assess the psychometric properties and health correlates of the Geriatric Anxiety Inventory (GAI) in a cohort of Australian community-residing older women. METHOD: Cross-sectional study of a population-based cohort of women aged 60 years and over (N = 286). RESULTS: The GAI exhibited sound internal consistency and demonstrated good concurrent validity against the state half of the Spielberger State Trait Anxiety Inventory and the neuroticism domain of the NEO five-factor inventory. GAI score was significantly associated with self-reported sleep difficulties and perceived memory impairment, but not with age or cognitive function. Women with current DSM-IV Generalized Anxiety Disorder (GAD) had significantly higher GAI scores than women without such a history. In this cohort, the optimal cut-point to detect current GAD was 8/9. Although the GAI was designed to have few somatic items, women with a greater number of general medical problems or who rated their general health as worse had higher GAI scores. CONCLUSION: The GAI is a new scale designed specifically to measure anxiety in older people. In this Australian cohort of older women, the instrument had sound psychometric properties.

Queensland Business Women Stories

These projects build on the research of Klaebe and Burgess into digital story-telling, specifically variable workshop scenarios, co-creative media, participatory public history, and the development of co-creative production processes for cultural institutions. The projects represented a partnership between QUT and the State Library of Queensland. The Five Senses project focused on the distributed digital storytelling workshop model and the development of audiences for digital storytelling. The team worked with regional artists whose work had been selected for inclusion in the Five Senses exhibition at the State Library of Queensland to produce stories about their work; these works were then integrated into the physical exhibition space. The Queensland Businesswomen project produced four digital stories profiling the lives of leading Queensland businesswomen. The digital story telling workshop model was disbanded and research teams worked individually with participants to create the digital stories. Academic research and oral history interviews were conducted initially to foreground these productions. This pilot led to a larger project, Business Leaders Hall of Fame, which now has a dedicated viewing room in the SLQ sponsored by an annual silver service dinner event. With the Responses to the Apology project, which stimulated similar projects in Mt Isa and Cairns, the research team worked with Indigenous facilitators, and the participants created their digital stories with assistance from these facilitators and the QUT research team using a mix of workshop and individual meetings. The research component of the work relates to the further development of co-creative production processes for cultural institutions, involving a wide range of institutional and individual partners, while authentically representing the intensely personal perspectives of each of the primary participants. The Queensland Business Leaders Hall of Fame was a research project that included interviews with eminent Queenslanders that produced oral history interviews and digital stories about the achievements of both Queensland personalities and businesses. This model was able to test and evaluate the use of oral history and digital storytelling for learning and community heritage purposes. Interviewees include; Sir John and Valmai Pidgeon, Joseph Saragossi, Robert Bryan, Clem Jones, Jim Kennedy, Sr Angela Mary, Castelmaine Perkins, Burns and Philp, Qantas, Don Argus & Steve Irwin All digital stories, oral history interviews and transcripts were accessioned into the library collection – an international first for digital stories. Two publications in refereed journals have resulted, and the digital stories are stored in the SLQ permanent collection for the benefit of national and international scholars and the general public.

Mapping Australia's philanthropic investment in women and girls

The Australian Women Donors Network (Women Donors) partnered the Australian Centre for Philanthropy and Nonprofit Studies (ACPNS) at QUT to conduct this research. No studies exist on the size or sources of philanthropic giving in Australia directed intentionally towards the needs of women and girls. The survey aims to fill this knowledge gap and create a baseline for understanding trends and views in this area. Because the survey treads some new ground, its findings raise questions as well as giving answers. Encouragingly, 100 people from across the philanthropy spectrum completed the survey, embracing 41 individual donors and other respondents from various foundation types. Given the population difference, this response compares well with the 145 respondents to the USA-based Foundation Center’s 2009 European study (reported in 2011). The survey was designed for givers generally, not just those involved in giving to women and girls specifically. It is possible, though, that people with an interest in funding this area were more likely to participate. This potential oversampling may inflate the figures on funding women and girls to some degree. Also, because the population size of Australian philanthropists is unknown, no claims can be made that this information is generalizable to all Australian funders. Nonetheless, some patterns and themes emerge from the 100 responses.

Putting paid to prescribed roles : a new era for Australian women and philanthropy

In redefining our understanding of women’s roles in contemporary Australian philanthropy, the impact of major contextual and demographic changes, as well as changes in women’s roles, responsibilities and opportunities need to be considered. Although academic study of philanthropy and the wider third sector is increasing in Australia, literature searches have revealed little current data on the giving patterns and philanthropic drivers for contemporary Australian women, particularly emerging cohorts (one ABS survey looks at giving patterns – ABS, 2000b: 32). In contrast, there is increasing interest in the US, where it is acknowledged that more women are becoming independent holders of wealth; and that interested donors have specific needs, desires and motivations in terms of knowledge, power, marketing and response to their philanthropy (see for example, Grace 2000; McCarthy 2001; Women’s Philanthropy Institute 2002). These varied demographic, social and economic drivers, which could also be expected to encourage new cohorts of Australian women to give, will be examined within our definition of women in philanthropy, and a brief history of women’s philanthropy in Australia, in order to inform future in-depth analyses of Australian women donors.

Documentary as history, memory, dream and film

A century ago, as the Western world embarked on a period of traumatic change, the visual realism of photography and documentary film brought print and radio news to life. The vision that these new mediums threw into stark relief was one of intense social and political upheaval: the birth of modernity fired and tempered in the crucible of the Great War. As millions died in this fiery chamber and the influenza pandemic that followed, lines of empires staggered to their fall, and new geo-political boundaries were scored in the raw, red flesh of Europe. The decade of 1910 to 1919 also heralded a prolific period of artistic experimentation. It marked the beginning of the social and artistic age of modernity and, with it, the nascent beginnings of a new art form: film. We still live in the shadow of this violent, traumatic and fertile age; haunted by the ghosts of Flanders and Gallipoli and its ripples of innovation and creativity. Something happened here, but to understand how and why is not easy; for the documentary images we carry with us in our collective cultural memory have become what Baudrillard refers to as simulacra. Detached from their referents, they have become referents themselves, to underscore other, grand narratives in television and Hollywood films. The personal histories of the individuals they represent so graphically–and their hope, love and loss–are folded into a national story that serves, like war memorials and national holidays, to buttress social myths and values. And, as filmic images cross-pollinate, with each iteration offering a new catharsis, events that must have been terrifying or wondrous are abstracted. In this paper we first discuss this transformation through reference to theories of documentary and memory–this will form a conceptual framework for a subsequent discussion of the short film Anmer. Produced by the first author in 2010, Anmer is a visual essay on documentary, simulacra and the symbolic narratives of history. Its form, structure and aesthetic speak of the confluence of documentary, history, memory and dream. Located in the first decade of the twentieth century, its non-linear narratives of personal tragedy and poetic dreamscapes are an evocative reminder of the distance between intimate experience, grand narratives, and the mythologies of popular films. This transformation of documentary sources not only played out in the processes of the film’s production, but also came to form its theme.