Relationships between preventive activities, psychosocial factors and recurrence of venous leg ulcers : a prospective study

Aim To identify relationships between preventive activities, psychosocial factors and leg ulcer recurrence in patients with chronic venous leg ulcers. Background Chronic venous leg ulcers are slow to heal and frequently recur, resulting in years of suffering and intensive use of health care resources. Methods A prospective longitudinal study was undertaken with a sample of 80 patients with a venous leg ulcer recruited when their ulcer healed. Data were collected from 2006–2009 from medical records on demographics, medical history and ulcer history; and from self-report questionnaires on physical activity, nutrition, preventive activities and psychosocial measures. Follow-up data were collected via questionnaires every three months for 12 months after healing. Median time to recurrence was calculated using the Kaplan-Meier method. A Cox proportional-hazards regression model was used to adjust for potential confounders and determine effects of preventive strategies and psychosocial factors on recurrence. Results: There were 35 recurrences in a sample of 80 participants. Median time to recurrence was 27 weeks. After adjustment for potential confounders, a Cox proportional hazards regression model found that at least an hour/day of leg elevation, six or more days/week in Class 2 (20–25mmHg) or 3 (30–40mmHg) compression hosiery, higher social support scale scores and higher General Self-Efficacy scores remained significantly associated (p<0.05) with a lower risk of recurrence, while male gender and a history of DVT remained significant risk factors for recurrence. Conclusion Results indicate that leg elevation, compression hosiery, high levels of self-efficacy and strong social support will help prevent recurrence.

Profiling off-road motorcycle and all-terrain riders in Queensland, Australia

The current research aimed to profile off-road riders to identify specific sub-groups in relation to their risk-related behaviours and perceptions. A total of 235 adults from the Australian state of Queensland who had ridden a motorcycle or ATV off-road in the last 12 months were recruited. A cluster analysis was applied to the survey data. Two distinct clusters of riders were identified, which corresponded with the self-report of injury from an off-road riding crash in the prior 12 months. The injured cluster had a significantly higher mean risk propensity and use of safety equipment, though did not differ on self-reported risk taking. The injured cluster as a whole included a higher percentage of males, was younger, and rode more often for recreational or competitive purposes than the non-crash involved cluster. The results indicate that the crash cluster may be both more aware of the potential risks of riding and more willing to ride in a riskier manner.

Development and pilot test of a peer-support based Cardiac-Diabetes Self-Management program : a study protocol

Background: People with cardiac disease and type 2 diabetes have higher hospital readmission rates (22%)compared to those without diabetes (6%). Self-management is an effective approach to achieve better health outcomes; however there is a lack of specifically designed programs for patients with these dual conditions. This project aims to extend the development and pilot test of a Cardiac-Diabetes Self-Management Program incorporating user-friendly technologies and the preparation of lay personnel to provide follow-up support. Methods/Design: A randomised controlled trial will be used to explore the feasibility and acceptability of the Cardiac-Diabetes Self-Management Program incorporating DVD case studies and trained peers to provide follow-up support by telephone and text-messaging. A total of 30 cardiac patients with type 2 diabetes will be randomised, either to the usual care group, or to the intervention group. Participants in the intervention group will received the Cardiac-Diabetes Self-Management Program in addition to their usual care. The intervention consists of three faceto- face sessions as well as telephone and text-messaging follow up. The face-to-face sessions will be provided by a trained Research Nurse, commencing in the Coronary Care Unit, and continuing after discharge by trained peers. Peers will follow up patients for up to one month after discharge using text messages and telephone support. Data collection will be conducted at baseline (Time 1) and at one month (Time 2). The primary outcomes include self-efficacy, self-care behaviour and knowledge, measured by well established reliable tools. Discussion: This paper presents the study protocol of a randomised controlled trial to pilot evaluates a Cardiac- Diabetes Self-Management program, and the feasibility of incorporating peers in the follow-ups. Results of this study will provide directions for using such mode in delivering a self-management program for patients with both cardiac condition and diabetes. Furthermore, it will provide valuable information of refinement of the intervention program.

Does sea-level rise have an impact on saltwater intrusion?

Climate change effects are expected to substantially raise the average sea level. It is widely assumed that this raise will have a severe adverse impact on saltwater intrusion processes in coastal aquifers. In this study we hypothesize that a natural mechanism, identified as the “lifting process” has the potential to mitigate or in some cases completely reverse the adverse intrusion effects induced by sea-level rise. A detailed numerical study using the MODFLOW-family computer code SEAWAT, was completed to test this hypothesis and to understand the effects of this lifting process in both confined and unconfined systems. Our conceptual simulation results show that if the ambient recharge remains constant, the sea-level rise will have no long-term impact (i.e., it will not affect the steady-state salt wedge) on confined aquifers. Our transient confined flow simulations show a self-reversal mechanism where the wedge which will initially intrude into the formation due to the sea-level rise would be naturally driven back to the original position. In unconfined systems, the lifting process would have a lesser influence due to changes in the value of effective transmissivity. A detailed sensitivity analysis was also completed to understand the sensitivity of this self-reversal effect to various aquifer parameters.

A trial of the distribution of chlamydia self-collection postal specimen kits from Australian community pharmacies

We explored the feasibility of community pharmacies for the distribution of chlamydia specimen self-collection kits, which featured a transport medium allowing postage of urine specimens in Australia. Eligible clients were requested to complete a code-matched risk-screening questionnaire in the pharmacy, and the derived risk scores were compared to the test results from the corresponding specimen. Four Queensland pharmacies distributed 156 kits, while 44 questionnaires and 18 specimens were received.

Adam Smith's Dinner

The Future of Financial Regulation is an edited collection of papers presented at a major conference at the University of Glasgow in Spring 2009. It draws together a variety of different perspectives on the international financial crisis which began in August 2007 and later turned into a more widespread economic crisis following the collapse of Lehman Brothers in the Autumn of 2008. Spring 2009 was in many respects the nadir since valuations in financial markets had reached their low point and crisis management rather than regulatory reform was the main focus of attention. The conference and book were deliberately framed as an attempt to re-focus attention from the former to the latter. The first part of the book focuses on the context of the crisis, discussing the general characteristics of financial crises and the specific influences that were at work during this time. The second part focuses more specifically on regulatory techniques and practices implicated in the crisis, noting in particular an over-reliance on the capacity of regulators and financial institutions to manage risk and on the capacity of markets to self-correct. The third part focuses on the role of governance and ethics in the crisis and in particular the need for a common ethical framework to underpin governance practices and to provide greater clarity in the design of accountability mechanisms. The final part focuses on the trajectory of regulatory reform, noting the considerable potential for change as a result of the role of the state in the rescue and recuperation of the financial system and stressing the need for fundamental re-appraisal of business and regulatory models. This informative book will be of interest to financial regulators and theorists, commercial and financial law practitioners, and academics involved in the law and economics of regulation.

An examination of the relationship between emotional intelligence, leadership style and perceived leadership outcomes in Australian educational institutions

In the field of leadership studies transformational leadership theory (e.g., Bass, 1985; Avolio, Bass, & Jung, 1995) has received much attention from researchers in recent years (Hughes, Ginnet, & Curphy, 2009; Hunt, 1999). Many previous studies have found that transformational leadership is related to positive outcomes such as the satisfaction, motivation and performance of followers in organisations (Judge & Piccolo, 2004; Lowe, Kroeck, & Sivasubramaniam, 1996), including in educational institutions (Chin, 2007; Leithwoood & Jantzi, 2005). Hence, it is important to explore constructs that may predict leadership style in order to identify potential transformational leaders in leadership assessment and selection procedures. Several researchers have proposed that emotional intelligence (EI) is one construct that may account for hitherto unexplained variance in transformational leadership (Mayer, 2001; Watkin, 2000). Different models of EI exist (e.g., Goleman, 1995, 2001; Bar-On, 1997; Mayer & Salovey, 1997) but momentum is growing for the Mayer and Salovey (1997) model to be considered the most useful (Ashkanasy & Daus, 2005; Daus & Ashkanasy, 2005). Studies in non-educational settings claim to have found that EI is a useful predictor of leadership style and leader effectiveness (Harms & Crede, 2010; Mills, 2009) but there is a paucity of studies which have examined the Mayer and Salovey (1997) model of EI in educational settings. Furthermore, other predictor variables have rarely been controlled in previous studies and only self-ratings of leadership behaviours, rather than multiple ratings, have usually been obtained. Therefore, more research is required in educational settings to answer the question: to what extent is the Mayer and Salovey (1997) model of EI a useful predictor of leadership style and leadership outcomes? This project, set in Australian educational institutions, was designed to move research in the field forward by: using valid and reliable instruments, controlling for other predictors, obtaining an adequately sized sample of real leaders as participants and obtaining multiple ratings of leadership behaviours. Other variables commonly used to predict leadership behaviours (personality factors and general mental ability) were assessed and controlled in the project. Additionally, integrity was included as another potential predictor of leadership behaviours as it has previously been found to be related to transformational leadership (Parry & Proctor-Thomson, 2002). Multiple ratings of leadership behaviours were obtained from each leader and their supervisors, peers and followers. The following valid and reliable psychological tests were used to operationalise the variables of interest: leadership styles and perceived leadership outcomes (Multifactor Leadership Questionnaire, Avolio et al., 1995), EI (Mayer–Salovey–Caruso Emotional Intelligence Test, Mayer, Salovey, & Caruso, 2002), personality factors (The Big Five Inventory, John, Donahue, & Kentle, 1991), general mental ability (Wonderlic Personnel Test-Quicktest, Wonderlic, 2003) and integrity (Integrity Express, Vangent, 2002). A Pilot Study (N = 25 leaders and 75 raters) made a preliminary examination of the relationship between the variables included in the project. Total EI, the experiential area, and the managing emotions and perceiving emotions branches of EI, were found to be related to transformational leadership which indicated that further research was warranted. In the Main Study, 144 leaders and 432 raters were recruited as participants to assess the discriminant validity of the instruments and examine the usefulness of EI as a predictor of leadership style and perceived leadership outcomes. Scores for each leadership scale across the four rating levels (leaders, supervisors, peers and followers) were aggregated with the exception of the management-by-exception active scale of transactional leadership which had an inadequate level of interrater agreement. In the descriptive and measurement component of the Main Study, the instruments were found to demonstrate adequate discriminant validity. The impact of role and gender on leadership style and EI were also examined, and females were found to be more transformational as leaders than males. Females also engaged in more contingent reward (transactional leadership) behaviours than males, whilst males engaged in more passive/avoidant leadership behaviours than females. In the inferential component of the Main Study, multiple regression procedures were used to examine the usefulness of EI as a predictor of leadership style and perceived leadership outcomes. None of the EI branches were found to be related to transformational leadership or the perceived leadership outcomes variables included in the study. Openness, emotional stability (the inverse of neuroticism) and general mental ability (inversely) each predicted a small amount of variance in transformational leadership. Passive/avoidant leadership was inversely predicted by the understanding emotions branch of EI. Overall, EI was not found to be a useful predictor of leadership style and leadership outcomes in the Main Study of this project. Implications for researchers and human resource practitioners are discussed.

Revisioning the self : self-portraiture as educator professional development

This paper focuses on a series of self-portraits I created between 2003 and 2009. Each portrait holds a series of layered images that the final layer conceals. As I created the self-portraits I also created written thinking in the form of a research journal. This a/r/tographic (Irwin & Springgay, 2008) research activity investigates the acquiring and accruing of visual art teaching knowledges and practices. I use as a premise, an opinion that the information acquired on an Education Degree slowly fades over time so, what is ‘information’ becomes ‘memory’. Memory is eventually what informs teaching, if further professional development is not undertaken.

The potential of critical race theory in decolonizing university curricula

This paper critiques our experiences as non-Indigenous Australian educators of working with numerous embedding Indigenous perspectives curricular projects at an Australian university. Reporting on these project outcomes alone, while useful in identifying limitations, does not illustrate ways in which future embedding and decolonising projects can persist and evolve. Deeper analysis is required of the ways in which Indigenous knowledge and perspectives are perceived, and what ‘embedding’ IK in university curricula truly means to various educational stakeholders. To achieve a deeper analysis and propose ways to invigorate the continuing decolonisation of Australian university curricula, this paper critically interrogates the methodology and conceptualisation of Indigenous knowledge in embedding Indigenous perspectives (EIP) in the university curriculum using tenets of critical race theory. Accordingly, we conduct this analysis from the standpoint that EIP should not subscribe to the luxury of independence of scholarship from politics and activism. The learning objective is to create a space to legitimise politics in the intellectual / academic realm (Dei, 2008, p. 10). We conclude by arguing that critical race theory’s emancipatory, future and action-oriented goals for curricula (Dei, 2008) would enhance effective and sustainable embedding initiatives, and ultimately, preventing such initiatives from returning to the status quo (McLaughlin & Whatman, 2008).

Self-defence against terrorism in the post 9/11 world

In 1986 the then United States Secretary of State George Shultz asserted that: It is absurd to argue that international law prohibits us from capturing terrorists in international waters or airspace; from attacking them on the soil of other nations, even for the purpose of rescuing hostages; or from using force against states that support, train and harbor terrorists or guerrillas. At that time the United States’ claim of a right to use military force in self-defence against terrorism2 received little support from other states.3 The predominant view then was that terrorist attacks committed by private or non-state actors were a form of criminal activity to be combated through domestic and international criminal justice mechanisms. The notion that such terrorist acts should be treated as ‘armed attacks’ triggering a victim state’s right of self-defence was not accepted by the majority of states. To suggest, as Shultz had done, that a state not directly responsible for terrorist acts could have its territorial integrity violated by military action targeting terrorists located within that state, was a controversial proposition in 1986. However, some fifteen years later, when the United States and a coalition of allies launched a military campaign in Afghanistan following the 11 September 2001 (hereafter ‘9/11’) terrorist attacks, there was virtually unanimous international support for the use of force.

Researching employment relations : a self-reflexive analysis of a multi-method, school-based project

Drawing on primary data and adjunct material, this article adopts a critical self-reflexive approach to a three-year, Australian Research Council-funded projectthat explored themes around 'employment citizenship'for high school students in Queensland. The article addresses three overlapping areas that reflect some of the central dilemmas and challenges arising through the project- consent in the context of research ethics, questionnaire administration in schools, and focus group research practice. It contributes to the broader methodological literature addressing research with young people by canvassing pragmatic suggestions for future school-based research, and research addressing adolescent employment.

Tailoring Consumer Resources to Enhance Self-Care in Chronic Heart Failure

Background Chronic heart failure (CHF) is associated with high hospitalisation and mortality rates and debilitating symptoms. In an effort to reduce hospitalisations and improve symptoms individuals must be supported in managing their condition. Patients who can effectively self-manage their symptoms through lifestyle modification and adherence to complex medication regimens will experience less hospitalisations and other adverse events. Aim The purpose of this paper is to explain how providing evidence-based information, using patient education resources, can support self-care. Discussion Self-care relates to the activities that individuals engage in relation to health seeking behaviours. Supporting self-care practices through tailored and relevant information can provide patients with resources and advice on strategies to manage their condition. Evidence-based approaches to improve adherence to self-care practices in patients with heart failure are not often reported. Low health literacy can result in poor understanding of the information about CHF and is related to adverse health outcomes. Also a lack of knowledge can lead to non-adherence with self-care practices such as following fluid restriction, low sodium diet and daily weighing routines. However these issues need to be addressed to improve self-management skills. Outcome Recently the Heart Foundation CHF consumer resource was updated based on evidence-based national clinical guidelines. The aim of this resource is to help consumers improve understanding of the disease, reduce uncertainty and anxiety about what to do when symptoms appear, encourage discussions with local doctors, and build confidence in self-care management. Conclusion Evidence-based CHF patient education resources promote self-care practices and early detection of symptom change that may reduce hospitalisations and improve the quality of life for people with CHF.