Women’s perceptions of their lifestyle and quality of life several years after a diagnosis of endometrial cancer

Background Few studies have examined the long-term changes experienced by women treated for endometrial cancer. Objective The objectives of this study were to describe what women perceived important to their lifestyle and quality of life in the years following their diagnosis and to provide new insights that might inform healthcare practice. Methods This was a thematic analysis of 237 open-ended comments from Australian women diagnosed with endometrial cancer 3 to 5 years previously. Results We identified 3 main themes: (1) personal change, in which women spoke about cancer as permanently altering their lives in mostly negative but sometimes positive ways; (2) continuity of former life, which described both the minimal impact of cancer on women's lives and identities and the difficulties negotiating this within the dominant "cancer survivorship" culture; (3) social support, where women wrote about how the quality of their relationships shaped their cancer trajectory. Conclusions While typical "survivorship" issues exist for many women with endometrial cancer (eg, physical, emotional, sexual health changes), a proportion of women will not be focused on their cancer and can be encouraged to form lives and identities that are not situated within the "cancer survivorship" culture. Implications for Practice A network of support, sensitive to women's responses to having cancer, may benefit women's long-term adjustment. Regular standardized assessment of women's needs may facilitate appropriate support for those with concerns, whereas those without concerns could be reassured by health professionals that their experience is normal and shared by other people with cancer. This may encourage women to form lives that are personally meaningful.

Deriving a preference-based utility measure for cancer patients from the European Organisation for the Research and Treatment of Cancer's Quality of Life Questionnaire C30 : a confirmatory versus exploratory approach

Background Multi attribute utility instruments (MAUIs) are preference-based measures that comprise a health state classification system (HSCS) and a scoring algorithm that assigns a utility value to each health state in the HSCS. When developing a MAUI from a health-related quality of life (HRQOL) questionnaire, first a HSCS must be derived. This typically involves selecting a subset of domains and items because HRQOL questionnaires typically have too many items to be amendable to the valuation task required to develop the scoring algorithm for a MAUI. Currently, exploratory factor analysis (EFA) followed by Rasch analysis is recommended for deriving a MAUI from a HRQOL measure. Aim To determine whether confirmatory factor analysis (CFA) is more appropriate and efficient than EFA to derive a HSCS from the European Organisation for the Research and Treatment of Cancer’s core HRQOL questionnaire, Quality of Life Questionnaire (QLQ-C30), given its well-established domain structure. Methods QLQ-C30 (Version 3) data were collected from 356 patients receiving palliative radiotherapy for recurrent/metastatic cancer (various primary sites). The dimensional structure of the QLQ-C30 was tested with EFA and CFA, the latter informed by the established QLQ-C30 structure and views of both patients and clinicians on which are the most relevant items. Dimensions determined by EFA or CFA were then subjected to Rasch analysis. Results CFA results generally supported the proposed QLQ-C30 structure (comparative fit index =0.99, Tucker–Lewis index =0.99, root mean square error of approximation =0.04). EFA revealed fewer factors and some items cross-loaded on multiple factors. Further assessment of dimensionality with Rasch analysis allowed better alignment of the EFA dimensions with those detected by CFA. Conclusion CFA was more appropriate and efficient than EFA in producing clinically interpretable results for the HSCS for a proposed new cancer-specific MAUI. Our findings suggest that CFA should be recommended generally when deriving a preference-based measure from a HRQOL measure that has an established domain structure.

Speaking to the deceased child : Australian Health Professional perspectives in paediatric end-of-life care

Supporting a dying child and family surrounding the child’s death is one of the most significant and challenging roles undertaken by health professionals in paediatric end of life care. An Australian study of parent and health professional constructions of meanings around post mortem care and communication revealed the practice of health professionals speaking to a child after death. This practice conveyed respect for the personhood of the deceased child, recognised the presence of the deceased child, and assisted in involving parents in their child’s post-mortem care. Such findings illuminate an area of end of life care practice that is not often addressed. Talking to a deceased child appeared as a socially symbolic practice that may promote a continued bond between parent and child.

Hyperlinking history and illegitimate imagination : the historiographic metafictional E-novel

‘Historiographic Metafiction’ (HM) is a literary term first coined by creative writing academic Linda Hutcheon in 1988, and which refers to the postmodern practice of a fiction author inserting imagined--or illegitimate--characters into narratives that are intended to be received as authentic and historically accurate, that is, ostensibly legitimate. Such adventurous and bold authorial strategies frequently result in “novels which are both intensely self-reflexive and yet paradoxically also lay claim to historical events and personages” (Hutcheon, A Poetics 5). They can be so entertaining and engaging that the overtly intertextual, explicitly inventive work of biographical HM can even change the “hegemonic discourse of history” (Nunning 353) for, as Philippa Gregory, the author of HM novel The Other Boleyn Girl (2001), has said regarding this genre of creative writing: “Fiction is about imagined feelings and thoughts. History depends on the outer life. The novel is always about the inner life. Fiction can sometimes do more than history. It can fill the gaps” (University of Sussex). In a way, this article will be filling one of the gaps regarding HM...

Improved nutritional status is related to improved quality of life in Parkinson’s disease

Background: Quality of life is poorer in Parkinson’s disease than in other conditions and in the general population without Parkinson’s disease. Malnutrition also results in poorer quality of life. This study aimed at determining the relationship between quality of life and nutritional status. Methods: Community-dwelling people with Parkinson’s disease >18 years old were recruited. The Patient-Generated Subjective Global Assessment (PG-SGA) assessed nutritional status. The Parkinson’s Disease Questionnaire 39 (PDQ-39) measured quality of life. Phase I was cross-sectional. The malnourished in Phase I were eligible for a nutrition intervention phase, randomised into 2 groups: standard care (SC) with provision of nutrition education materials only and intervention (INT) with individualised dietetic advice and regular weekly follow-up. Data were collected at baseline, 6 weeks, and 12 weeks. Results: Phase I consisted of 120 people who completed the PDQ-39. Phase II consisted of 9 in the SC group and 10 in the INT group. In Phase I, quality of life was poorer in the malnourished, particularly for mobility and activities of daily living domains. There was a significant correlation between PG-SGA and PDQ-39 scores (Phase I, rs = 0.445, p = .000; Phase II, rs = .426, p = .002). In Phase II, no significant difference in the PDQ-39 total or sub-scores was observed between the INT and SC groups; however, there was significant improvement in the emotional well-being domain for the entire group, X2(2) = 8.84, p = .012. Conclusions: Malnourished people with Parkinson’s disease had poorer quality of life than the well-nourished, and improvements in nutritional status resulted in quality of life improvements. Attention to nutritional status is an important component of quality of life and therefore the total care of people with Parkinson’s disease.

Manuel Aires Mateus : an architecture for the art of life [曼努埃尔·艾利斯·马特乌斯：建筑，为了生活的艺术]

This text is the outcome of a conversation with Manuel Aires Mateus (Aires Mateus Arquitectos) and discusses the importance of architecture and memory in contemporary architectural productions

An acute cough-specific quality of life questionnaire for children: Development and validation

Background Patient-relevant outcome measures are essential for high-quality clinical research, and quality-of-life (QoL) tools are the current standard. Currently, there is no validated children's acute cough-specific QoL questionnaire. Objective The objective of this study was to develop and validate the Parent-proxy Children's Acute Cough-specific QoL Questionnaire (PAC-QoL). Methods Using focus groups, a 48-item PAC-QoL questionnaire was developed and later reduced to 16 items by using the clinical impact method. Parents of children with a current acute cough (<2 weeks) at enrollment completed 2 validated cough score measures, the preliminary 48-item PAC-QoL, and 3 other questionnaires (the State Trait Anxiety Inventory [STAI], the Short-Form 8-item 24-hour recall Health Survey [SF-8], and the Depression, Anxiety, and Stress 21-item Scale [DASS21]). All measures were repeated on days 3 and 14. Results The median age of the 155 children enrolled was 2.3 years (interquartile range, 1.3-4.6). Median cough duration at enrollment was 3 days (interquartile range, 2-5). The reduced 16-item scale had high internal consistency (Cronbach α = 0.95). Evidence for repeatability and criterion validity was shown by significant correlations between the domains and total PAC-QoL scores and the SF-8 (r = −0.36 and −0.51), STAI (r = −0.27 and −0.39), and DASS21 (r = −0.32 and −0.41) scales on days 0 and 3, respectively. The final PAC-QoL questionnaire was sensitive to change over time, with changes significantly relating to changes in cough score measures (P < .001). Conclusion The 16-item PAC-QoL is a reliable and valid outcome measure that assesses QoL related to childhood acute cough at a given time point and reflects changes in acute cough-specific QoL over time.

Analysing children’s persuasive texts : the use of hedging and intensification

Research Quality This is a dialogue between two Australian literacy scholars about two persuasive writing techniques that posed difficulty for the students in our research. This dialogue flows from the analysis of Year 6 writing samples from an ARC Linkage Project, URLearning (2009-2013) - the focus of the symposium. We use vivid examples of writing from students’ handwritten persuasive texts on topics that were chosen by teachers. The persuasive structure in the texts followed the Toulmin (2003) model: a thesis statement, three arguments with evidence, and a conclusion. The findings show that to realise the effective power of rhetorical persuasion, students need an expanded lexicon that does not rely on intensifiers, and which employs a greater range of advanced hedging techniques to use to their advantage. National & International Importance The study is potentially of national and international relevance, given that argumentation or persuasion is a key life skill in many professional, personal, and discourses. It is also a requirement in the International English Language Testing Systems (IELTS) tests, which are a critical gateway for tertiary studies in many English-speaking countries (Coffin, 2004). Timeliness The research is timely given the Australian Curriculum English, in which persuasive texts figure prominently from Preparatory to Year 10 (ACARA, 2014). The recommendations are also timely in the context of educational policies in other parts of the world. For example, in the United States, the Common Core Standards: English Language Arts, mandates the teaching of persuasive texts (Council of Chief State School Officers & National Governors Association, 2013) Implications for practice/policy The findings of the study have specific practical implications for teachers, who can address the persuasive writing techniques of hedging and intensification with which children need targeted support and explicit instruction. The presentation is positioned at the nexus of teacher practice to better address the national priorities of the Australian Curriculum: English (ACARA, 2014), while having implications for applied linguistics research by identifying common problems in students' persuasive writing.

Impact of high PV penetration on distribution transformer life time

Integration of rooftop photovoltaics (PVs) in residential networks at moderate penetration levels is becoming a reality in many countries including Australia. Despite the technical challenges in properly accommodating PV units, one of the major benefits is the ability of PV units to extend useful life time of distribution transformers. This effect is not quantified in the existing literature. This paper carries out an analysis into the impacts of rooftop PVs at different penetration levels on the performance of distribution transformers and residential networks. This paper presents a methodology to quantify the benefit of the distribution transformer life extension brought about by customer-owned rooftop PV units. The proposed methodology is applied to a real distribution system with various scenarios, including different penetration levels. The results show the distribution transformer loss-of-life function, as a function of the rooftop PV penetration level, is monotonically decreasing function which saturates after a certain penetration level. The best life improvements occur with transformers that are highly loaded and the presence of a significant PV installation may support the deferral of transformer upgrades.

University life and Australian homes : three case studies of international Muslim students in Brisbane

Despite a significant increase in enrolments of postgraduate international Muslim students within Australian universities, little is known about their perceptions of life within Australian homes while undertaking their studies. The aim of this study is to investigate the ways in which students’ cultural and religious traditions affect their use of domestic spaces within the homes in which they reside. The research found that participants faced some minor difficulties in achieving privacy, maintaining modesty and extending hospitality while able to perform their daily activities in Australian designed homes. The findings suggest that greater research attention needs to be given to the development of Australian home designs that are adaptable to the needs of a multicultural society. Australian society encompasses diverse cultural customs and requirements with respect to home design, and these are yet to be explored.

Domestic violence (DV) service provision and the architecture of rural life: An Australian case study

This article uses the concept of the architecture of rural life to analyse domestic violence service provision in rural Australia. What is distinctive about this architecture is that it polices the privacy of the rural family. A tight cloak of silence is carved around instances of domestic violence. Imagined threats to rural safety are seen as coming from outsiders (i.e. urban influences or Indigenous), not insiders within rural families. This article draws on key findings from a study conducted in rural New South Wales, Australia. The study interviewed 49 rural service providers working in human services and the criminal justice system. The application of architecture of rural life as a conceptual tool demonstrates challenges with service provision in a rural setting. The main results of this study found that this architecture operates as a silencing form of social control in three distinctive ways. Firstly, shame about being a victim of domestic violence encourages rural women's complicity in remaining silent. Secondly, family privacy maintains a veil of silence that accentuates rural women's social and economic dependency on men. Thirdly, community sanctions act as a deterrent to women seeking help.

Hormone and Metabolite Profiles in Nesting Green and Flatback Turtles: Turtle Species with Different Life Histories

Herbivorous turtle, Chelonia mydas, inhabiting the south China Sea and breeding in Peninsular Malaysia, and Natator depressus, a carnivorous turtle inhabiting the Great Barrier Reef and breeding at Curtis Island in Queensland, Australia, differ both in diet and life history. Analysis of plasma metabolites levels and six sex steroid hormones during the peak of their nesting season in both species showed hormonal and metabolite variations. When compared with results from other studies progesterone levels were the highest whereas dihydrotestosterone was the plasma steroid hormone present at the lowest concentration in both C. mydas and N. depressus plasma. Interestingly, oestrone was observed at relatively high concentrations in comparison to oestradiol levels recorded in previous studies suggesting that it plays a significant role in nesting turtles. Also, hormonal correlations between the studied species indicate unique physiological interactions during nesting. Pearson correlation analysis showed that in N. depressus the time of oviposition was associated with elevations in both plasma corticosterone and oestrone levels. Therefore, we conclude that corticosterone and oestrone may influence nesting behaviour and physiology in N. depressus. To summarise, these two nesting turtle species can be distinguished based on the hormonal profile of oestrone, progesterone, and testosterone using discriminant analysis.

Can we do better? Researchers' experiences with ethical review boards on projects with later life as a focus

The goal of this study was to describe researchers' experiences in submitting ethical proposals focused on older adult populations, including studies with persons with dementia, to ethical review boards. Ethical approval was granted for an online survey. Researchers were recruited via listservs and snowballing techniques. Participants included 157 persons (73% female) from Australia and the United States, with a mean age of 46 (±13). Six main issues were encountered by researchers who participated in this survey. In descending order, these included questions regarding: informed consent and information requirements (61.1%), participants' vulnerability, particularly for those with cognitive impairments (58.6%), participant burden (44.6%), data access (29.3%), adverse effects of data collection/intervention (26.8%), and study methodology (25.5%). An inductive content analysis of responses revealed a range of encounters with ethical review panels spanning positive, negative, and neutral experiences. Concerns voiced about ethical review boards included committees being overly focused on legal risk, as well as not always hearing the voice of older research participants, both potential and actual. Respondents noted inability to move forward on studies, as well as loss of researchers and participant groups from gerontological and clinical research as a result of negative interactions with ethics committees. Positive interactions with the committees reinforced researchers' need to carefully construct their research approaches with persons with dementia in particular. Suggested guidelines for committees when dealing with ethics applications involving older adults include self-reflecting on potential biases and stereotypes, and seeking further clarification and information from gerontological researchers before arriving at decisions.

The use of multimodal technologies to enhance reflective writing in teacher education

For preservice teachers new to the teaching profession, reflective practice can be a difficult process. Yet reflective writing, once mastered, has the capacity to support preservice teachers to make connections between teaching theory and professional practice, and to start to take control of their own professional learning journey. The reflective practice described in this chapter was scaffolded through a framework for writing, the use of annotated work samples and explicit teaching. This approach was enhanced through multimodal resources including written peer assessment, audio teacher feedback and a video recording of the class presentation. The video footage assisted the preservice teachers to reconcile the feedback that they received from multiple sources. This chapter describes and analyses the implementation of the PRT Pattern (Prompting Reflection using Technology). Results of this practice revealed that the multiple forms of feedback assisted the preservice teachers to analyse their performance in terms of their developing professional identity and practice.

The Scent of Ancestral Memory

Poetry expresses the physical and spiritual worlds that other kinds of writing cannot. Travelling open our minds and frees our spirit. Creative writings and meditations on life, spirit, grace and relationships, art and nature weave their way through these lyrical poems. Some poems are suitable for study in the Australian Curriculum.