Weekly cisplatin concurrently with radiotherapy in head and neck squamous cell cancer : a retrospective analysis of a tertiary institute experience

Radiotherapy combined with three weekly 100 mg/m2 of cisplatin is the accepted standard of care in head and neck squamous cell carcinoma. However, this regimen is associated with severe toxicities with devastating effects on patients. Alternative protocols like weekly 40 mg/m2 have been used in an attempt to reduce toxicities. The main objective of the present study is to identify the dose intensities and toxicities of weekly cisplatin in patients treated in a tertiary centre over a 12 month period. Included patients had squamous cell carcinoma arising in the oral cavity, oropharynx, larynx, or hypopharynx. Patients were excluded if they had nasopharyngeal squamous cell carcinoma, distant metastasis or if they had prior treatment for head and neck cancer excluding neck dissection. During the study period, 52 patients met the inclusion criteria and their data were retrospectively obtained from the patients' database of St James hospital, Dublin. The median age of the study cohort was 54 years (range 33-73). Of the patients, 40 (76.9 %) were male and 12 (20.1 %) were female. The primary tumour sites were as follows: oral cavity and oropharynx in 38 (73 %), larynx in 10 (19 %), and hypopharynx in 4 (8 %). In total, 33 (63.5 %) patients had stage IV disease, while 19 (36.5 %) had stage III disease. Treatment was definitive in 35 (67 %) patients and adjuvant in 17 (35 %). Full-dose radiotherapy was achieved in 50 (96 %) patients. Only 22 (42.3 %) patients completed the intended six cycles of chemotherapy. Cumulative dose of 200 mg/m2 or more was reached in 37 (71 %) patients. The acute adverse effects included grades 3 and 4 mucositis, which occurred in 22 (43.3 %) and 6 patients (12 %), respectively. Grade 3 and 4 neutropenia occurred in six (11.5 %) and three (5.7 %) patients, respectively. The only other haematological toxicity was grade 3 anaemia in 20 (38.4 %) patients. There was no grade 3 or 4 renal toxicity among the study cohort, although grade 2 was observed in six (11.5 %) patients. Death occurred in one patient due to neutropenic septicaemia. In conclusion, weekly cisplatin is associated with moderate to severe toxicities and might lead to suboptimal chemotherapy delivery. More prospective clinical studies are required to determine the optimal chemoradiation regimen in head and neck squamous cell carcinoma.

The schooling experience of six adolescent boys who have been diagnosed with Attention Deficit/ Hyperactivity Disorder (AD/HD)

This thesis explored the experience of schooling of six adolescent boys diagnosed with AD/HD from the perspectives of the boys, their mothers and their teachers. The study utilised social constructionism as the theoretical orientation and an explanatory theory of AD/HD, the Dynamic Developmental Theory (DDT) of AD/HD as a framework. Findings included the importance of making and managing friendships for young people with AD/HD, the importance of being informed about AD/HD as well classroom strategies that support the learning of students for teachers, and the apparent role that medication in concert with an engaging classroom environment can play in the successful schooling of boys with AD/HD.

Born in another country : women's experience of labour and birth in Queensland, Australia

Background Women born outside Australia make up more than a fifth of the Queensland birthing population and like migrants in other parts of the world face the challenges of cultural dislocation and possible language barriers. Recognising that labour and birth are major life events the aim was to investigate the experiences of these women in comparison to native-born English speaking women. Methods Secondary analysis of data from a population based survey of women who had recently birthed in Queensland. Self-reported clinical outcomes and quality of interpersonal care of 481 women born outside Australia who spoke a language other than English at home were compared with those of 5569 Australian born women speaking only English. Results After adjustment for demographic factors and type of birthing facility, women born in another country were less likely to be induced, but more likely to have constant electronic fetal monitoring (EFM), to give birth lying on their back or side, and to have an episiotomy. Most women felt that they were treated as an individual and with kindness and respect. However, women born outside Australia were less likely to report being looked after ‘very well’ during labour and birth and to be more critical of some aspects of care. Conclusion In comparing the labour and birth experiences of women born outside the country who spoke another language with native-born English speaking women, the present study presents a largely positive picture. However, there were some marked differences in both clinical and interpersonal aspects of care.

Accounting for forests in Fiji : the experience of Future Forests (Fiji) Limited

"in a world which is experiencing unprecedented deforestation and widespread global environmental threats there is something intuitively right about planting a tree" (Future Forests (Fiji) Limited) The above quote demonstrates that even in the wake of global environmental crisis that hope still remains and that humans can still control their destiny. This opportunity to effect positive environmental change is one of the main aims of the South Pacific Stock Exchange’s (SPSE) most recent publicly listed company: Future Forest (Fiji) Limited. Incorporated in 2004 and listed on SPSE in 2011, the company is Fiji’s first large-scale commercial hardwood forest plantation and nursery. Future Forest (FF) is the only company listed on the SPSE with biological assets or “living assets.” The accounting standard for biological assets is IAS 41: Agriculture. This standard prescribes the use of fair value as the basis of valuation. While a more relevant method of valuation, the application of fair value accounting can be more costly and burdensome for companies in developing economies (White 2008). In line with the journal’s theme of agriculture, this article explores the issues, challenges and potential benefits involved in applying fair value accounting for biological assets in a developing economy such as Fiji using the case of Future Forest (Fiji) Limited.

Psychosocial and communication variables involved in mediating the individual experience of older adults following a severe weather event

The recent floods in south-east Queensland have focused policy, academic and community attention on the challenges associated with severe weather events (SWE), specifically pre-disaster preparation, disaster-response and post-disaster community resilience. Financially, the cost of SWE was $9 billion in the 2011 Australian Federal Budget (Swan 2011); psychologically and emotionally, the impact on individual mental health and community wellbeing is also significant but more difficult to quantify. However, recent estimates suggest that as many as one in five will subsequently experience major emotional distress (Bonanno et al. 2010). With climate change predicted to increase the frequency and intensity of a wide range of SWE in Australia (Garnaut 2011; The Climate Institute 2011), there is an urgent and critical need to ensure that the unique psychological and social needs of more vulnerable community members - such as older residents - are better understood and integrated into disaster preparedness and response policy, planning and protocols. Navigating the complex dynamics of SWE can be particularly challenging for older adults and their disaster experience is frequently magnified by a wide array of cumulative and interactive stressors, which intertwine to make them uniquely vulnerable to significant short and long-term adverse effects. This current article provides a brief introduction to the current literature in this area and highlights a gap in the research relating to communication tools during and after severe weather events.

Medieval knights amid the gum-trees : the experience of European heritage tourism in south-east Queensland, Australia

This paper is interested in the way in which the heritage of another place, time, and culture is repurposed for popular consumption in an experience economy, as well as the way in which the visitors experience their own past and the past of others. We trace the processes of engagement, education and nostalgia that occur when the European heritage is presented in a postcolonial context and an Australian environment. The information presented includes the results of qualitative and quantitative research conducted at the Abbey Museum over the December-Jan. period of 2012-13.

Primary schools and the delivery of relationships and sexuality education : the experience of Queensland teachers

Primary school provides an appropriate opportunity for children to commence comprehensive relationships and sexuality education (RSE), yet many primary school teachers avoid teaching this subject area. In the absence of teacher confidence and competence, schools have often relied on health promotion professionals, external agencies and/or one-off issue related presentations rather than cohesive, systematic and meaningful health education. This study examines the implementation of a ten-lesson pilot RSE unit of work and accompanying assessment task in two primary schools in South-East Queensland, Australia. Drawing predominantly from qualitative data, this research explores the experiences of primary school teachers as they engage with RSE curriculum resources and content delivery. The results show that the provision of a high quality RSE curriculum resource grounded in contemporary educational principles and practices enables teachers to feel more confident to deliver RSE and minimises potential barriers such as parental objections and fear of mishandling sensitive content.

Prior storm experience moderates water surge perception and risk

Background How accurately do people perceive extreme water speeds and how does their perception affect perceived risk? Prior research has focused on the characteristics of moving water that can reduce human stability or balance. The current research presents the first experiment on people's perceptions of risk and moving water at different speeds and depths. Methods Using a randomized within-person 2 (water depth: 0.45, 0.90 m) ×3 (water speed: 0.4, 0.8, 1.2 m/s) experiment, we immersed 76 people in moving water and asked them to estimate water speed and the risk they felt. Results Multilevel modeling showed that people increasingly overestimated water speeds as actual water speeds increased or as water depth increased. Water speed perceptions mediated the direct positive relationship between actual water speeds and perceptions of risk; the faster the moving water, the greater the perceived risk. Participants' prior experience with rip currents and tropical cyclones moderated the strength of the actual–perceived water speed relationship; consequently, mediation was stronger for people who had experienced no rip currents or fewer storms. Conclusions These findings provide a clearer understanding of water speed and risk perception, which may help communicate the risks associated with anticipated floods and tropical cyclones.

Designing for Awareness: An Experience-focused HCI Perspective

Within Human-Computer Interaction (HCI) and Computer Supported Cooperative Work (CSCW) research, the notion of technologically-mediated awareness is often used for allowing relevant people to maintain a mental model of activities, behaviors and status information about each other so that they can organize and coordinate work or other joint activities. The initial conceptions of awareness focused largely on improving productivity and efficiency within work environments. With new social, cultural and commercial needs and the emergence of novel computing technologies, the focus of technologically-mediated awareness has extended from work environments to people’s everyday interactions. Hence, the scope of awareness has extended from conveying work related activities to people’s emotions, love, social status and other broad range of aspects. This trend of conceptualizing HCI design is termed as experience-focused HCI. In my PhD dissertation, designing for awareness, I have reported on how we, as HCI researchers, can design awareness systems from experience-focused HCI perspective that follow the trend of conveying awareness beyond the task-based, instrumental and productive needs. Within the overall aim to design for awareness, my research advocates ethnomethodologically-informed approaches for conceptualizing and designing for awareness. In this sense, awareness is not a predefined phenomenon but something that is situated and particular to a given environment. I have used this approach in two design cases of developing interactive systems that support awareness beyond task-based aspects in work environments. In both the cases, I have followed a complete design cycle: collecting an in-situ understanding of an environment, developing implications for a new technology, implementing a prototype technology to studying the use of the technology in its natural settings.

Medium and mode : relationships between visual experience and perception in an installation arts practice

Working primarily within the natural landscape, this practice-led research project explored connections between the artist's visual and perceptual experience of a journey or place while simultaneously emphasizing the capacity for digital media to create a perceptual dissonance. By exploring concepts of time, viewpoint, duration of sequences and the manipulation of traditional constructs of stop-frame animation, the practical work created a cognitive awareness of the elements of the journey through optical sensations. The work allowed an opportunity to reflect on the nature of visual experience and its mediation through images. The project recontextualized the selected mediums of still photography, animation and projection within contemporary display modes of multiple screen installations by analysing relationships between the experienced and the perceived. The resulting works added to current discourse on the interstices between still and moving imagery in a digital world.

Wasting Time? Art, Science and New Experience. Examining the Artwork, Know more (House of Commons)

Today the future is travelling rapidly towards us, shaped by all that which we have historically thrown into it. Much of what we have designed for our world over the ages, and much of what we continue to embrace in the pursuit of mainstream economic, cultural and social imperatives, embodies unacknowledged ‘time debts’. Every decision we make today has the potential to ‘give time to’, or take ‘time away’ from that future. This idea that ‘everything‘ inherently embodies ‘future time left’ is underlined by design futurist Tony Fry when he describes how we so often ‘waste’ or ‘take away’ ‘future time’. “In our endeavours to sustain ourselves in the short term we collectively act in destructive ways towards the very things we and all other beings fundamentally depend upon”

Airports of the future : improving operation, security and experience

The final report for the ARC project "Airports of the Future". It contains the findings and recommendations provided by the various teams to the industry partners.

Experience as meaning : some underlying concepts and implications for design

As the current computing systems move from desktop and work settings into our everyday lives (e.g. mobile and ubiquitous systems) a growing interest is seen for designing interactive systems with experiential support. Some conceptual work already exists that tries to analyze and understand users? experience with interactive systems but in practice this is still not frequently used. Drawing on the concepts from the domain of art, this paper introduces a way to conceptualize users? experience as the meanings or interpretations they construct during their interaction with or through the interactive systems. We consequently apply this conceptualization in a design project where we use it at an early concept design stage for designing aware technologies in care-taking situations.

Rich evaluations of entertainment experience: bridging the interpretational gap

This paper reports a qualitative study of evaluating the ?experience? supported by a state-of-the-art interactive television application. Internet Protocol Television (IPTV) system is a new technology in the ever-growing industry of interactive entertainment. Focusing on the users? interpretations, we applied a set of rich evaluation strategies to collect data about users? experiences with the IPTV. The results show implications about how the users constructed complex and reflective understandings about the system. The evaluation suite helped us gather information about users? aspirations, expectations, and intellectual and emotional states of their understandings. The results also imply a strong support for taking into account the non-technical values of human-technology interaction.

Experiencing-in-the-world : using pragmatist philosophy to design for aesthetic experience

With the growing use of personal and ubiquitous computing technology, an increase is seen in utilizing aesthetic aspects for designing interactive systems. The use of aesthetic interpretations, however, has differed in different applications, often lacking a coherent and holistic meaning of aesthetics. In this paper we provide an account on aesthetics, utilizing the pragmatist perspective, which can be used as a framework to design for aesthetic experience in interactive systems. We discuss seven major themes of aesthetic experience. Using our framework we discuss two design examples. In the first example ? Panorama, the framework is used to inform the design process and making design decisions for supporting aesthetic social awareness in an academic work environment. In the second example ? Virtual Dancer, the framework is used to analyze the aesthetics of an entertainment experience and to elicit further improvements. In the end we discuss the role of aesthetics in the design of interactive systems.