Minimum important difference between patients with rheumatoid arthritis : the patient's perspective

OBJECTIVE: To determine the point at which differences in clinical assessment scores on physical ability, pain and overall condition are sufficiently large to correspond to a subjective perception of a meaningful difference from the perspective of the patient. METHODS: Forty patients with a diagnosis of rheumatoid arthritis participated in an evening of clinical assessment and one-on-one conversations with each other regarding their arthritic condition. The assessments included tender and swollen joint counts, clinician and patient global assessments, participant assessment of pain and the Health Assessment Questionnaire (HAQ) on physical ability. After each conversation, participants rated themselves relative to their conversational partner on physical ability, pain and overall condition. These subjective comparative ratings were compared to the differences of the individual clinical assessments. RESULTS: In total there were 120 conversations. Generally participants judged themselves as less disabled than others. They rated themselves as "somewhat better" than their conversation partner when they had a (mean) 7% better score on the HAQ, 6% less pain, and 9% better global assessment. In contrast, they rated themselves as "somewhat worse" when they had a (mean) 16% worse score on the HAQ, 16% more pain, and 29% worse global assessment. CONCLUSIONS: Patients view clinically important differences in an asymmetric manner. These results can provide guidance in interpreting results and planning clinical trials.

Attitudes and expectations of technologies to manage high risk wandering and elopement in persons with dementia : an Australian perspective

Wandering is aimless and repetitive locomotion that may expose persons with dementia (PWD) to elopement, getting lost and death. This study is an Australian replication of a US study. Cross-disciplinary consensus- based analysis was applied to data from five focus groups (N =47: cognitively intact LTC residents (5), carers of PWD (11), home care workers (13) allied health professionals and health-focused engineers (7) and RNs (11). Groups received briefing about wandering monitoring and elopement management systems. Consistent with US attitudes, participants in all groups agreed on what a wandering technology should do, how it should do it, and necessary technical specifications. Within each group participants raised the need for a continuum of care for PWD and the imperative for early recognition of potentially dangerous wandering and getting lost when they occur. Global Positioning System elopement management was the preferred option. Interestingly, the prospective value of GPS to recover a lost or eloped wanderer far outweighed privacy concerns, as in the US. A pervasive theme was that technologies need to augment, but cannot replace, attentive, compassionate caregiver presence. A significant theme raised only by Australian carers of PWD was the potential for development of implantable GPS technologies and the need for public debate about attendant ethical issues. Given that 60% or more of over 200,000 Australians and 4.5 million Americans with dementia will develop wandering, there is a pressing need to develop effective locator systems that may delay institutionalization, help allay carer concern and enhance PWD safety.

Chinese fashion designers in Shanghai : identifying a fresh perspective about their role in the world order of fashion

Shanghai possesses an apt legacy, once referred to as “Paris of the East”. Municipal aspirations for Shanghai to assume a position among the great fashion cities of the world have been integrated in the recent re-shaping of this modern city into a role model for Chinese creative enterprise yet China is still known primarily as centre of clothing production. Increasingly however, “Made in China” is being replaced by “Created in China” drawing attention to two distinct consumer markets for Chinese designers. Fashion designers who have entered the global fashion system for education or by showing their collections have generally adopted a design aesthetic that aligns with Western markets, allowing little competitive advantage. In contrast, Chinese designers who rest their attention on the domestic Chinese market find a disparate, highly competitive marketplace. The pillars of authenticity that for foreign fashion brands extend far into their cultural and creative histories, often for many decades in the case of Louis Vuitton, Hermes and Christian Dior do not yet exist in China in this era of rapid globalisation. Here, the cultural bedrock allows these same pillars to extend only thirty years or so into the past reaching the moments when Deng Xiaoping granted China’s creative entrepreneurs passage. To this end, interviews with fashion designers in Shanghai have been undertaken during the last twelve months for a PhD dissertation. Production of culture theory has been used to identify working methods, practices of production and the social and cultural milieu necessary for designers to achieve viability. Preliminary findings indicate that some fashion designers have adopted an as-yet unexplored strategy of business and brand development with a distinct Chinese aesthetic at its core, in contrast to the clichéd cultural iconography often viewed by Western viewers as representative of Chinese creativity.

Chinese fashion designers in Shanghai : a new perspective about their role in the construction of a fashion city

Shanghai possesses an apt legacy, once referred to as ‘Paris of the East’. Municipal aspirations for Shanghai to assume a position among the great fashion cities of the world have been integrated in the recent re-shaping of this modern city into a role model for Chinese creative enterprise yet China is still known primarily as centre of clothing production. Increasingly however, ‘Made in China’ is being replaced by ‘Created in China’ drawing attention to two distinct consumer markets for Chinese designers. Fashion designers who have entered the global fashion system for education or by showing their collections have generally adopted a design aesthetic that aligns with Western markets, allowing little competitive advantage. In contrast, Chinese designers who rest their attention on the domestic Chinese market find a disparate, highly competitive marketplace. The pillars of authenticity that for foreign fashion brands extend far into their cultural and creative histories, often for many decades in the case of Louis Vuitton, Hermes and Christian Dior do not yet exist in China in this era of rapid globalisation. Here, the cultural bedrock allows these same pillars to extend only thirty years or so into the past reaching the moments when Deng Xiaoping granted China’s creative entrepreneurs passage. To this end, interviews with fashion designers in Shanghai have been undertaken during the last twelve months for a PhD dissertation. Production of culture theory has been used to identify working methods, practices of production and the social and cultural milieu necessary for designers to achieve viability. Preliminary findings indicate that some fashion designers have adopted an as-yet unexplored strategy of business and brand development with a distinct Chinese aesthetic at its core, in contrast to the clichéd cultural iconography often viewed by Western viewers as representative of Chinese creativity. The development of this aesthetic is similar to the development of the Scandinavian design ethos that emerged during the 1950s.

Responding to the 5Rs : an alternate perspective of Slowmation

This paper is a response to Hoban and Neilsen's (2010) Five Rs model for understanding how learners engage with slowmation. An alternative model (the Learning MMAEPER Model) that builds on the 5Rs model is explained in terms of its use in secondary science preservice teacher education. To probe into the surface and deep learning that can occur during the creation of a slowmation, the learning and relearning model is explored in terms of learning elements. This model can assist teachers to monitor the learning of their students and direct them to a deeper understanding of science concepts.

Gender bias in schooling : the case for Bhutan

Differing parental considerations for girls and boys in households are a primary cause of the gender gap in school enrolment and educational attainment in developing countries, particularly in Sub-Saharan Africa and South Asia. While a number of studies have focused on the inequality of educational opportunities in South Asia, little is known about Bhutan. This study uses recent household expenditure data from the Bhutan Living Standard Survey to evaluate the gender gap in the allocation of resources for schooling. The findings, based on cross-sectional as well as household fixed-effect approaches, suggest that girls are less likely to enrol in school but are not allocated fewer resources once they are enrolled.

Making sense of mental illness as a full human experience : Perspective of illness and recovery held by people with a mental illness living in the community.

Recovery is a highly contextualized concept amid divergent interpretations and unique experiences. There is substantial current interest in building evidence about recovery from mental illness in order to inform best practice founded in the ways people find to live productive and meaningful lives. This paper presents some accounts related to recovery and illness expressed by eight people through a Participatory Action Research project. The research facilitated entry to the subjective experiences of living in the community as an artist with a mental illness. The people in the research shared an integrated understanding of illness, recovery and identity. Their understanding provided insight into mental illness as an inseparable aspect of who they were. Further, specific issue was raised of recovery as a clinical term with a requirement to meet distinct conventions of recovery. This paper emphasizes that being ill and being well, for the person with a mental illness, is a dynamic and complex development not easily explained or transformed into uniform process or outcomes. Attempts to establish an integral or consensual approach to recovery has, to date, disregarded mental illness as a full human experience. This paper argues that broader frameworks for thinking and responding to the dynamic processes of mental illness and recovery are needed and require acknowledgment of competing and contradictory ideas.

Feminist criminologies’ contribution to understandings of sex, gender, and crime

This chapter provides an overview of the contribution of feminist criminologies to understandings of the complex intersections between sex, gender and crime. Dozens of scholars and activists have participated in these debates over the past four decades. For our contribution to this handbook, we interviewed ten distinguished scholars whose contributions are recognized internationally. Through the commentary provided by these scholars, this chapter examines some of the distinctive contributions of feminism to our knowledge about sex, gender, and crime, as well as some of the challenges it continues to face in the field of criminology. We conclude that feminist work within criminology continues to face a number of lingering challenges, most notably in relation to the struggle to maintain relevance in a world where concerns about gender inequality are marginalized and considered as historical relics not contemporary issues; where there are on-going tensions around the best strategies for change, as well as difficulties in challenging distorted representations of female crime and violence; and where a backlash, anti-feminist politics seeks to discredit explanations that draw a link between sex, gender, and crime. This chapter critically reviews these lingering challenges—locating feminist approaches (of which there are many) at the centre and not the periphery of advancing knowledge about gender, sex, and crime.

Outcomes following inpatient rehabilitation : a seven year perspective

Introduction: Improving physical and cognitive functioning is a key objective of multi-disciplinary inpatient geriatric rehabilitation. Outcomes relevant to minimum functional ability required for older adults to successfully participate in the community have been reported. However, there has been little investigation reporting outcomes of older inpatients receiving multi-disciplinary rehabilitation being discharged home from geriatric rehabilitation units. This study aims to investigate characteristics and physical and cognitive outcomes of this cohort. Method: The Princess Alexandra Hospital Geriatric and Rehabilitation Unit is the largest rehabilitation unit in Queensland. Multidisciplinary health professionals enter admission and discharge functional and clinical outcomes along with demographic information into a purpose designed database for all patients. Data collected between 2005 and 2011 was analysed using descriptive statistics. Results: During the seven-year period, 4120 patients were admitted for rehabilitation; 2126 (52%) were female, mean age of 74 years (Standard Deviation 14). Primary reasons for admission were for reconditioning post medical illness or surgical admission (n = 1285, 31%), and 30% (n = 1233) admitted for orthopaedic reasons. Of these orthopaedic admissions, 6.6% (n = 82) were for elective surgery, and 46% (n = 565) were for fractured neck-of-femurs. 76% (n = 3130) of patients were discharged home, 13% (n = 552) to residential care facilities and 10% (n = 430) were discharged to an alternative hospital setting or passed away during their admission. Mean length of stay was 44 days (SD 39) Preliminary analysis of FIM outcomes shows a mean motor score of 53 (SD = 19) on admission which significantly improved to 71 (SD = 18) by discharge. There was no change on FIM cognitive score (28 (SD7) vs 29 (SD 6). Conclusion: Geriatric patients have significant functional limitations even on discharge from inpatient rehabilitation; though overall cognition is relatively intact. Orthopaedic conditions and general deconditioning from medical/surgical admissions are the main reasons for admission. The majority of people receiving rehabilitation are discharged home.

Queer theory, media studies and editorial processes in queer student media

Australian queer (GLBTIQ) university student activist media is an important site of self-representation. Community media is a significant site for the development of queer identity, community and a key part of queer politics. This paper reviews my research into queer student media, which is grounded in a queer theoretical perspective. Rob Cover argues that queer theoretical approaches that study media products fail to consider the material contexts that contribute to their construction. I use an ethnographic approach to examine how editors construct queer identity and community in queer student media. My research contributes to queer media scholarship by addressing the gap that Cover identifies, and to the rich scholarship on negotiations of queer community.

The Corio Oval Tribe : a prosopographical perspective of the Geelong Football Club in the nineteenth century

This article analyses the occupational and class status of Geelong footballers in the nineteenth century via the methodology of prosopography. Prosopography is an empirical group biography approach to historical research. The article argues that during the period 1859-78 Geelong's playing group was largely derived from the squattocracy and urban middle class. In the later period 1878-96 the Geelong club recruited more widely from the working class, as in keeping with the increased participation of this class in football from the late 1870s. It can be argued that this more diverse group helped establish Geelong as a footballing power.

Towards improving public understanding of judgement practice in standards-referenced assessment : an Australian perspective

Internationally there has been a move towards standards-referenced assessment with countries such as Australia developing a National Curriculum and Achievement Standards, New Zealand adopting National Standards for literacy and numeracy that involve schools making and reporting judgements about the reading, writing and mathematics achievement of children up to Year 8 (the end of primary school) and in Canada, classroom assessment standards aimed at the improvement of assessment practice of K-12 education are being formulated. Standards-driven reform has major implications for teachers’ work. The consequences of adopting a standards-driven approach to educational change by systems are often under-estimated with the unintended effects not fully understood by either the policy writers, and the public, including parents. It is for these reasons that the contention developed in this article relates to the teacher’s role, which it is argued remains central to policy focused on the improvement of the quality of education and educational standards.

Organizational culture and willingness to share knowledge : a competing values perspective in Australian context

A considerable amount of research has confirmed the relationship between organizational culture and knowledge sharing behaviours. However, less research has been conducted on the impact of project sub-cultures in relation to the sharing of knowledge between projects, particularly in project based organizations (PBOs). The unique structures and contexts characterized by PBOs indicate the need to investigate further the impact of cultures present within PBOs and their effect on knowledge sharing. We report on a rich case study of four large Australian-based PBOs whereby the cultural values of these large organizations were seen to impact significantly on whether project teams were more or less likely to improve inter-project knowledge sharing. Furthermore, this research demonstrates the utility of using Cameron and Quinn's (2005) Competing Values Framework to evaluate culture in the context of PBOs