Patients with terminal cancer who use alternative therapies: their beliefs and practices

This paper examines the extent to which patients who have been diagnosed as having terminal cancer choose to use non-medical therapies. In particular it is concerned with the illness behaviour of patients who are receiving conventional cytotoxic drug and radiation treatments, who also decide to use a wide range of ‘alternative’ medications and therapies. The paper discusses the findings of a study of 152 patients with metastatic cancer that examined the extent to which they used alternative cancer therapies, as well as the beliefs and attitudes they have about their cancer, its treatment, and the practitioners providing that treatment. Four groups of users of alternative therapies, who differ according to their commitment to and the type of therapies they use, were identified. Results of logistic regression analyses indicate that those using alternative therapies were different in range of social attitudes. These differences were primarily their greater reported ‘will to live’ and desire for control over treatment decisions, and the differing beliefs they hold about their disease.

The confidence of speech-language pathology students regarding communicating with people with aphasia

Background Aphasia is an acquired language disorder that can present a significant barrier to patient involvement in healthcare decisions. Speech-language pathologists (SLPs) are viewed as experts in the field of communication. However, many SLP students do not receive practical training in techniques to communicate with people with aphasia (PWA) until they encounter PWA during clinical education placements. Methods This study investigated the confidence and knowledge of SLP students in communicating with PWA prior to clinical placements using a customised questionnaire. Confidence in communicating with people with aphasia was assessed using a 100-point visual analogue scale. Linear, and logistic, regressions were used to examine the association between confidence and age, as well as confidence and course type (graduate-entry masters or undergraduate), respectively. Knowledge of strategies to assist communication with PWA was examined by asking respondents to list specific strategies that could assist communication with PWA. Results SLP students were not confident with the prospect of communicating with PWA; reporting a median 29-points (inter-quartile range 17–47) on the visual analogue confidence scale. Only, four (8.2%) of respondents rated their confidence greater than 55 (out of 100). Regression analyses indicated no relationship existed between confidence and students‘ age (p = 0.31, r-squared = 0.02), or confidence and course type (p = 0.22, pseudo r-squared = 0.03). Students displayed limited knowledge about communication strategies. Thematic analysis of strategies revealed four overarching themes; Physical, Verbal Communication, Visual Information and Environmental Changes. While most students identified potential use of resources (such as images and written information), fewer students identified strategies to alter their verbal communication (such as reduced speech rate). Conclusions SLP students who had received aphasia related theoretical coursework, but not commenced clinical placements with PWA, were not confident in their ability to communicate with PWA. Students may benefit from an educational intervention or curriculum modification to incorporate practical training in effective strategies to communicate with PWA, before they encounter PWA in clinical settings. Ensuring students have confidence and knowledge of potential communication strategies to assist communication with PWA may allow them to focus their learning experiences in more specific clinical domains, such as clinical reasoning, rather than building foundation interpersonal communication skills.

Factors influencing research engagement : research interest, confidence and experience in an Australian speech-language pathology workforce

Background Recent initiatives within an Australia public healthcare service have seen a focus on increasing the research capacity of their workforce. One of the key initiatives involves encouraging clinicians to be research generators rather than solely research consumers. As a result, baseline data of current research capacity are essential to determine whether initiatives encouraging clinicians to undertake research have been effective. Speech pathologists have previously been shown to be interested in conducting research within their clinical role; therefore they are well positioned to benefit from such initiatives. The present study examined the current research interest, confidence and experience of speech language pathologists (SLPs) in a public healthcare workforce, as well as factors that predicted clinician research engagement. Methods Data were collected via an online survey emailed to an estimated 330 SLPs working within Queensland, Australia. The survey consisted of 30 questions relating to current levels of interest, confidence and experience performing specific research tasks, as well as how frequently SLPs had performed these tasks in the last 5 years. Results Although 158 SLPs responded to the survey, complete data were available for only 137. Respondents were more confident and experienced with basic research tasks (e.g., finding literature) and less confident and experienced with complex research tasks (e.g., analysing and interpreting results, publishing results). For most tasks, SLPs displayed higher levels of interest in the task than confidence and experience. Research engagement was predicted by highest qualification obtained, current job classification level and overall interest in research. Conclusions Respondents generally reported levels of interest in research higher than their confidence and experience, with many respondents reporting limited experience in most research tasks. Therefore SLPs have potential to benefit from research capacity building activities to increase their research skills in order to meet organisational research engagement objectives. However, these findings must be interpreted with the caveats that a relatively low response rate occurred and participants were recruited from a single state-wide health service, and therefore may not be representative of the wider SLP workforce.

Feeding attitudes, practices and traditional dietary beliefs of Chinese mothers with young children in Australia : a mixed methods study

Background and Objectives Obesity and some dietary related diseases are emerging health problems among Chinese immigrants and their children in developed countries. These health problems are closely linked to eating habits, which are established in the early years of life. Young children’s eating habits are likely to persist into later childhood and youth. Family environment and parental feeding practices have a strong effect on young children’s eating habits. Little information is available on the early feeding practices of Chinese mothers in Australia. The aim of this study was to understand the dietary beliefs, feeding attitudes and practices of Chinese mothers with young children who were recent immigrants to Australia. Methods Using a sequential explanatory design, this mixed methods study consisted of two distinct phases. Phase 1 (quantitative): 254 Chinese immigrant mothers of children aged 12 to 59 months completed a cross-sectional survey. The psychometric properties and factor structure of a Chinese version of the Child Feeding Questionnaire (CFQ, by Birch et al. 2001) were assessed and used to measure specific maternal feeding attitudes and controlling feeding practices. Other questions were developed from the literature and used to explore maternal traditional dietary beliefs and feeding practices related to their beliefs, perceptions of picky eating in children and a range of socioeconomic and acculturation factors. Phase 2 (qualitative): 21 mothers took part in a follow-up telephone interview to assist in explaining and interpreting some significant findings obtained in the first phase. Results Chinese mothers held strong traditional dietary beliefs and fed their children according to these beliefs. However, children’s consumption of non-core foods was high. Both traditional Chinese and Australian style foods were consumed by their children. Confirmatory factor analysis revealed that the original 7-factor model of the CFQ provided an acceptable fit to the data with minor modification. However, an alternative model with eight constructs in which two items related to using food rewards were separated from the original restriction construct, not only provided an acceptable fit to the data, but also improved the conceptual clarity of the constructs. The latter model included 24 items loading onto the following eight constructs: restriction, pressure to eat, monitoring, use of food rewards, perceived responsibility, perception of own weight, perception of child’s weight, and concern about child becoming overweight. The internal consistency of the constructs was acceptable or desirable (Cronbach’s α = .60 - .93). Mothers reported low levels of concern about their child overeating or becoming overweight, but high levels of controlling feeding practices: restriction, monitoring, pressure to eat and use of food rewards. More than one quarter of mothers misinterpreted their child’s weight status (based on mothers’ self-reported data). In addition, mothers’ controlling feeding practices independently predicted half of the variance and explained 16% of the variance in child weight status: pressuring the child to eat was negatively associated with child weight status (β = -0.30, p < .01) and using food rewards was positively associated with child weight status (β = 0.20, p < .05) after adjusting for maternal and child covariates. Monitoring and restriction were not associated with child weight status. Mothers’ perceptions of their child’s weight were positively associated with child weight status (β = 0.33, p < .01). Moreover, mothers reported that they mostly decided what (65%) and how much (80%) food their child ate. Mothers who decided what food their child ate were more likely to monitor (β = -0.17, p < .05) and restrict (β = -0.17, p < .05) their child’s food consumption. Mothers who let their child decide how much food their child ate were less likely to pressure their child to eat (β = -0.38, p < .01) and use food rewards (β = -0.24, p < .01). Mothers’ perceptions of picky eating behaviour were positively associated with their use of pressure (β = 0.21, p < .01) and negatively associated with monitoring (β = -0.16, p < .05) and perceptions of their child’s weight status (β = -0.13, p < .05). Qualitative data showed that pressuring to eat, monitoring and restriction of the child’s food consumption were common practices among these mothers. However, mothers stated that their motivation for monitoring and restricting was to ensure the child’s general health. Mothers’ understandings of picky eating behaviour in their children were consistent with the literature and they reported multiple feeding strategies to deal with it. Conclusion Chinese immigrant mothers demonstrated strong traditional dietary beliefs, a low level of concern for child weight, misperceptions of child weight status, and a high overall level of control in child feeding in this study. The Chinese version of the CFQ, which consists of eight constructs and distinguishes between the constructs using food rewards and restriction, is an appropriate instrument to assess feeding attitudes and controlling feeding practices among Chinese immigrant mothers of young children in Australia. Mothers’ feeding attitudes and practices were associated with children’s weight status and mothers’ perceptions of picky eating behaviour in children after adjusting for a range of socio-demographic maternal and child characteristics. Monitoring and restriction of children’s food consumption according to food selection may be positive feeding practices, whereas pressuring to eat and using food rewards appeared to be negative feeding practices in this study. In addition, the results suggest that these young children have high exposure to energy-dense, nutrient-poor food. There is a need to develop and implement nutrition interventions to improve maternal feeding practices and the dietary quality among children of Chinese immigrant mothers in Australia.

Outdoor worker sun protection project : a comprehensive applied research project to demonstrate the effectiveness of sun protection measures which influence high risk outdoor workers in Queensland to adopt sun safe behaviour practices 2010 – 2013

The QUT Outdoor Worker Sun Protection (OWSP) project undertook a comprehensive applied health promotion project to demonstrate the effectiveness of sun protection measures which influence high risk outdoor workers in Queensland to adopt sun safe behaviours. The three year project (2010-2013) was driven by two key concepts: 1) The hierarchy of control, which is used to address risks in the workplace, advocates for six control measures that need to be considered in order of priority (refer to Section 3.4.2); and 2) the Ottawa Charter which recommends five action means to achieve health promotion (refer to Section 2.1). The project framework was underpinned by a participatory action research approach that valued peoples’ input, took advantage of existing skills and resources, and stimulated innovation (refer to Section 4.2). Fourteen workplaces (small and large) with a majority outdoor workforce were recruited across regional Queensland (Darling Downs, Northwest, Mackay and Cairns) from four industries types: 1) building and construction, 2) rural and farming, 3) local government, and 4) public sector. A workplace champion was identified at each workplace and was supported (through resource provision, regular contact and site visits) over a 14 to 18 month intervention period to make sun safety a priority in their workplace. Employees and employers were independently assessed for pre- and postintervention sun protection behaviours. As part of the intervention, an individualised sun safety action plan was developed in conjunction with each workplace to guide changes across six key strategy areas including: 1) Policy (e.g., adopt sun safety practices during all company events); 2) Structural and environmental (e.g., shade on worksites; eliminate or minimise reflective surfaces); 3) Personal protective equipment (PPE) (e.g., trial different types of sunscreens, or wide-brimmed hats); 4) Education and awareness (e.g., include sun safety in inductions and toolbox talks; send reminder emails or text messages to workers);5) Role modelling (e.g., by managers, supervisors, workplace champions and mentors); and 6) Skin examinations (e.g., allow time off work for skin checks). The participatory action process revealed that there was no “one size fits all” approach to sun safety in the workplace; a comprehensive, tailored approach was fundamental. This included providing workplaces with information, resources, skills, know how, incentives and practical help. For example, workplaces engaged in farming complete differing seasonal tasks across the year and needed to prepare for optimal sun safety of their workers during less labour intensive times. In some construction workplaces, long pants were considered a trip hazard and could not be used as part of a PPE strategy. Culture change was difficult to achieve and workplace champions needed guidance on the steps to facilitate this (e.g., influencing leaders through peer support, mentoring and role modelling). With the assistance of the project team the majority of workplaces were able to successfully implement the sun safety strategies contained within their action plans, up skilling them in the evidence for sun safety, how to overcome barriers, how to negotiate with all relevant parties and assess success. The most important enablers to the implementation of a successful action plan were a pro-active workplace champion, strong employee engagement, supportive management, the use of highly visual educational resources, and external support (provided by the project team through regular contact either directly through phone calls or indirectly through emails and e-newsletters). Identified barriers included a lack of time, the multiple roles of workplace champions, (especially among smaller workplaces), competing issues leading to a lack of priority for sun safety, the culture of outdoor workers, and costs or budgeting constraints. The level of sun safety awareness, knowledge, and sun protective behaviours reported by the workers increased between pre-and post-intervention. Of the nine sun protective behaviours that were assessed, the largest changes reported included a 26% increase in workers who “usually or always” wore a broad-brimmed hat, a 20% increase in the use of natural shade, a 19% increase in workers wearing long-sleeved collared shirts, and a 16% increase in workers wearing long trousers.

An investigation of moderation practices within a faculty of education

Moderation of student assessment is a critical component of teaching and learning in contemporary universities. In higher education, moderation is usually governed by university-wide policies and practices. However, in Australia, moderation processes will now be guided by the new national university accreditation authority, Tertiary Education Quality and Standards Agency (TEQSA). In light of this reform, the purpose of this qualitative study was to identify and analyse current moderation practices operating within a faculty of education at a large urban university in eastern Australia.

Re-contextualising and re-theorising cultural values in teacher education practices : a Samoan standpoint

This thesis explores the significance of Samoan cultural values in teacher education practices. The study examines the coexistence of traditional Samoan cultural values alongside values that have resulted through the influence of missionaries, colonisation, post-colonialism and globalisation.

Review : "English language education across Greater China" by A. Feng

I have formally learned English from Year Four till the completion of my undergraduate study in China. Because of this personal history, I was keen to review this book and revisit English education in China. The list of contributors to the book includes Anwei Feng (editor) and his colleagues, who play an insider role in English language practice, research, and policy-making in ‘Greater China’. ‘Greater China’ according to Feng, can be defined as geographically close, demographically Chinese-dominated, and culturally, economically, and socio-politically interrelated countries and territories where Chinese is either the mother tongue or used as an official language.

The role of HRM practices in building intellectual capital in knowledge-based teams

In this paper, we investigate the ways HRM systems support development of intellectual capital in teams in three case studies of knowledge-intensive firms (KIFs) in Denmark. By focusing on team composition and structure, findings build on the rapidly growing body of literature on HRM’s role in supporting intellectual capital development. Specifically, we make a theoretical contribution to this literature by identifying three distinct ways KIFs develop intellectual capital: 1) through HRM development systems that build relationship-centric team-based intellectual capital by targeting development of social capital; 2) through HRM employee relations systems that build human-centric team based intellectual capital by targeting human capital; 3) through a balanced approach to HRM that builds polycentric team-based intellectual capital through focusing on all aspects of intellectual capital. The findings also have managerial implications regarding the need to align team composition and structure, HRM systems, and intellectual capital focus to support development of team-based intellectual capital.

Improving the ability of guarantors to make a real choice : lenders' practices in taking third party guarantees

This article considers recent cases on guarantees of business loans to identify the lending practices that led the court to set aside the guarantee as against the creditor on the basis that the creditor had engaged in unconscionable conduct. It also explores the role of industry codes of practice in preventing unconscionable conduct, including whether there is a correlation between commitment to an industry code and higher standards of lending practices; whether compliance with an industry code would have produced different outcomes in the cases considered; and whether lenders need to do more than comply with an industry code to ensure their practices are fair and reasonable.

Heritage language for Chinese Australians : negotiating 'Chineseness' and, capitalising on resources in the lived world

The ethnic identity and commitment of Heritage Language Learners play salient roles in Heritage Language learning process. The mutually constitutive effect amongst Heritage Language Learner's ethnic identity, commitment, and Heritage Language proficiency has been well documented in social psychological and poststructuralist literatures. Both social psychological and poststructural schools offer meaningful insights into particular contexts but receive critiques from other contexts. In addition, the two schools largely oppose each other. This study uses Bourdieu's sociological triad of habitus, capital, and field to reconcile the two schools through the examination of Chinese Heritage Language Learners in Australia, an idiosyncratic social, cultural, and historical context for these learners. Specifically, this study investigates how young Chinese Australian adults (18-35 in age) negotiate their 'Chineseness' and capitalise on resources through Chinese Heritage Language learning in the lived world. The study adopts an explanatory mixed methods design to combine the quantitative approach with the qualitative approach. The initial quantitative phase addresses the first research question: Is Chinese Heritage Language proficiency of young Chinese Australian adults influenced by their investment of capital, the strength of their habitus of 'Chineseness', or both? The subsequent qualitative phase addresses the second research question: How do young Chinese Australian adults understand their Chinese Heritage Language learning in relation to (potential) profits produced by this linguistic capital in given fields? The initial quantitative phase applies Structural Equation Modelling to analyse the data from an online survey with 230 respondents. Findings indicate the statistically significant positive contribution made by the habitus of 'Chineseness' and by investment of capital to Chinese Heritage Language proficiency (r = .71 and r = .86 respectively). Subsequent multiple regression analysis demonstrates that 62% of the variance of Chinese Heritage Language proficiency can be accounted for by the joint contribution of 'Chineseness' and 'capital'. The qualitative phase of the study uses multiple interviews with five participants. It reveals that Chinese Heritage Language offers meaningful benefits for participants in the forms of capital production and habitus capture or recapture. Findings from the two phases talk to each other in terms of the inherent entanglement amongst habitus of 'Chineseness', investment of capital, and Chinese Heritage Language proficiency. The study offers important contributions. Theoretically, by virtue of Bourdieu's signature concepts of habitus, capital, and field, the study provides answers to questions that both social psychological and poststructuralist theories have long been struggling to answer. Methodologically, the position of 'pluralism' talks back to Bourdieu's theory and forwards to the mixed methods design. Particularly, the study makes a methodological breakthrough: A set of instruments was developed and validated to quantify Bourdieu's key concepts of capital and habitus within certain social fields. Practically, understanding Chinese Australians' heterogeneity and the potential drivers behind Chinese Heritage Language learning contributes to the growing interest in Chinese Australians' contemporary life experiences and helps to better accommodate linguistically diverse Chinese Heritage Language Learners in Chinese language courses. In addition, this study is very timely. It resonates with the recently released Australia in the Asian Century White Paper: Chinese Australians, with sound knowledge of Chinese culture and language obtained through negotiating their 'Chineseness' and capitalising on diverse resources for learning, will help to serve Australia's economic, social, and political needs in unique ways.

Using a Capability Maturity Model to build on the generational approach to student engagement practices

The generational approach to conceptualising first year student learning behaviour has made a useful contribution to understanding student engagement. It has an explicit focus on student behaviour and we suggest that a capability maturity model interpretation may provide a complementary extension of that understanding as it builds on the generational approach by allowing an assessment of institutional capability to initiate, plan, manage, evaluate and review institutional student engagement practices. The development of a Student Engagement, Success and Retention Maturity Model (SESR-MM) is discussed along with its application in an Australian higher education institution. In this case study, the model identified first, second and third generation approaches and in addition achieved a ‘complementary extension’ of the generational approach, building on it by identifying additional practices not normally considered within the generational concept and indicating the capability of the institution to provide and implement the practices.

Faster than the speed of print : reconciling ‘big data’ social media analysis and academic scholarship

The promise of ‘big data’ has generated a significant deal of interest in the development of new approaches to research in the humanities and social sciences, as well as a range of important critical interventions which warn of an unquestioned rush to ‘big data’. Drawing on the experiences made in developing innovative ‘big data’ approaches to social media research, this paper examines some of the repercussions for the scholarly research and publication practices of those researchers who do pursue the path of ‘big data’–centric investigation in their work. As researchers import the tools and methods of highly quantitative, statistical analysis from the ‘hard’ sciences into computational, digital humanities research, must they also subscribe to the language and assumptions underlying such ‘scientificity’? If so, how does this affect the choices made in gathering, processing, analysing, and disseminating the outcomes of digital humanities research? In particular, is there a need to rethink the forms and formats of publishing scholarly work in order to enable the rigorous scrutiny and replicability of research outcomes?

The health information practices of people living with chronic health conditions: Implications for health literacy

The reduction of the health literacy concept to a functional relationship with text, does not acknowledge the range of information sources that people draw from in order to make informed decision about their health and treatment. Drawing from two studies that explored how people with two different but complex and life-threatening chronic health conditions, chronic kidney disease and HIV, a socio-cultural understanding of the practise of health literacy is described. Health information is experienced by patients as a chronic health condition landscape, and develops from three information sources; namely epistemic, social and corporeal sources. Participants in both studies used activities that involved orienting, sharing and creating information to map this landscape which was used to inform their decision-making. These findings challenge the traditional conceptions of health literacy and suggest an approach that views the landscape of chronic illness as being socially, physically and contextually constructed. This approach necessitates a recasting of health literacy away from a sole interest in skills and towards understanding how information practices facilitate people becoming health literate.