Effects and feasibility of a multi-disciplinary orientation program for newly registered cancer patients : design of a randomised controlled trial

Background Diagnosis and treatment of cancer can contribute to psychological distress and anxiety amongst patients. Evidence indicates that information giving can be beneficial in reducing patient anxiety, so oncology specific information may have a major impact on this patient group. This study investigates the effects of an orientation program on levels of anxiety and self-efficacy amongst newly registered cancer patients who are about to undergo chemotherapy and/or radiation therapy in the cancer care centre of a large tertiary Australian hospital. Methods The concept of interventions for orienting new cancer patients needs revisiting due to the dynamic health care system. Historically, most orientation programs at this cancer centre were conducted by one nurse. A randomised controlled trial has been designed to test the effectiveness of an orientation program with bundled interventions; a face-to-face program which includes introduction to the hospital facilities, introduction to the multi-disciplinary team and an overview of treatment side effects and self care strategies. The aim is to orientate patients to the cancer centre and to meet the health care team. We hypothesize that patients who receive this orientation will experience lower levels of anxiety and distress, and a higher level of self-efficacy. Discussion An orientation program is a common health care service provided by cancer care centres for new cancer patients. Such programs aim to give information to patients at the beginning of their encounter at a cancer care centre. It is clear in the literature that interventions that aim to improve self-efficacy in patients may demonstrate potential improvement in health outcomes. Yet, evidence on the effects of orientation programs for cancer patients on self-efficacy remains scarce, particularly with respect to the use of multidisciplinary team members. This paper presents the design of a randomised controlled trial that will evaluate the effects and feasibility of a multidisciplinary orientation program for new cancer patients.

Library technician course recognition : meeting the challenge of a distributed national education program

This paper looks at the challenges presented for the Australian Library and Information Association by its role as the professional association responsible for ensuring the quality of Australian library technician graduates. There is a particular focus on the issue of course recognition, where the Association's role is complicated by the need to work alongside the national quality assurance processes that have been established by the relevant technical education authorities. The paper describes the history of course recognition in Australia; examines the relationship between course recognition and other quality measures; and describes the process the Association has undertaken recently to ensure appropriate professional scrutiny in a changing environment of accountability.

Exercise for health : a breast cancer recovery program - quality of life benefits [Conference Abstract]

Introduction: Five-year survival from breast cancer in Australia is 87%. Hence, ensuring a good quality of life (QOL) has become a focal point of cancer research and clinical interest. Exercise during and after treatment has been identified as a potential strategy to optimise QOL of women diagnosed with breast cancer.----- Methods: Exercise for Health is a randomised controlled trial of an eight-month, exercise intervention delivered by Exercise Physiologists. An objective of this study was to assess the impact of the exercise program during and following treatment on QOL. Queensland women diagnosed with unilateral breast cancer in 2006/07 were eligible to participate. Those living in urban-Brisbane (n=194) were allocated to either the face-to-face exercise group, the telephone exercise group, or the usual-care group, and those living in rural Queensland (n=143) were allocated to the telephone exercise group or the usual-care group. QOL, as assessed by the Functional Assessment of Cancer Therapy-Breast (FACT-B+4) questionnaire, was measured at 4-6 weeks (pre-intervention), 6 months (mid-intervention) and 12 months (three months post-intervention) post-surgery.----- Results: Significant (P<0.01) increases in QOL were observed between pre-intervention and three months post-intervention 12 months post-surgery for all women. Women in the exercise groups experienced greater mean positive changes in QOL during this time (+10 points) compared with the usual-care groups (+5 to +7 points) after adjusting for baseline QOL. Although all groups experienced an overall increase in QOL, approximately 20% of urban and rural women in the usual-care groups reported a decline in QOL, compared with 10% of women in the exercise groups.----- Conclusions: This work highlights the potential importance of participating in physical activity to optimise QOL following a diagnosis of breast cancer. Results suggest that the telephone may be an effective medium for delivering exercise counselling to newly diagnosed breast cancer patients.

Learning to drive with cognitive impairment : the experience of young ADHD diagnosed drivers and their parent supervisors

A subset of novice drivers exhibit executive function impairments which may adversely impact on the learn-to-drive period and subsequent driving experience, potentially explaining their overrepresentation in traffic offences and crashes. This paper presents the results of a qualitative analysis of a small series of in-depth semi-structured interviews undertaken individually with affected young drivers (n = 7) and each of their parent supervisors (n = 6). Young drivers were selected on the basis of their ADHD diagnosis, as a sample particularly affected by executive function impairments. Standardised rating scale measures confirmed the currency of the young drivers’ ADHD symptoms and executive function impairment. Results are discussed in terms of common experiences of the young affected drivers and those of their parents as supervising drivers of the learn-to-drive process and subsequent driving behaviour. Key themes included difficulties that were related to core executive function impairments symptomatic of ADHD. Themes also included common emotions that the young drivers associated with driving, with particular types of impact on their driving behaviour. Common strategies that were used by both the young driver and their parent during this learning process and their perceived effectiveness are also discussed. Those that were perceived to be most effective tended to focus on reducing the cognitive load for the young driver when introducing new information and skills.

The Innovation Management Program (IMP) : a holistic approach to managing change in knowledge based firms

Innovation Management (IM) in most knowledge based firms is used on an adhoc basis where senior managers use this term to leverage competitive edge without understanding its true meaning and how its robust application in organisation impacts organisational performance. There have been attempts in the manufacturing industry to harness the innovative potential of the business and apprehend its use as a point of difference to improve financial and non financial outcomes. However further work is required to innovatively extrapolate the lessons learnt to introduce incremental and/or radical innovation to knowledge based firms. An international structural engineering firm has been proactive in exploring and implementing this idea and has forged an alliance with the Queensland University of Technology to start the Innovation Management Program (IMP). The aim was to develop a permanent and sustainable program with which innovation can be woven through the fabric of the organisation. There was an intention to reinforce the firms’ vision and reinvigorate ideas and create new options that help in its realisation. This paper outlines the need for innovation in knowledge based firms and how this consulting engineering firm reacted to this exigency. The development of the Innovation Management Program, its different themes (and associated projects) and how they integrate to form a holistic model is also discussed. The model is designed around the need of providing professional qualification improvement opportunities for staff, setting-up organised, structured & easily accessible knowledge repositories to capture tacit and explicit knowledge and implement efficient project management strategies with a view to enhance client satisfaction. A Delphi type workshop is used to confirm the themes and projects. Some of the individual projects and their expected outcomes are also discussed. A questionnaire and interviews were used to collect data to select appropriate candidates responsible for leading these projects. Following an in-depth analysis of preliminary research results, some recommendations on the selection process will also be presented.

Choreographing research : supervising the dancing thesis

The dancing doctorate is an interrogative endeavour which can but nurture the art form and forge a beneficial dynamism between those who seek and those who assess the emerging knowledges of dance’. (Vincs, 2009) From 2006-2008 three dance academics from Perth, Brisbane and Melbourne undertook a research project entitled Dancing between Diversity and Consistency: Refining Assessment in Postgraduate Degrees in Dance, funded by the ALTC Priority Projects Program. Although assessment rather than supervision was the primary focus of this research, interviews with 40 examiner/supervisors, 7 research deans and 32 candidates across Australia and across the creative arts, primarily in dance, provide an insight into what might be considered best practice in preparing students for higher research degrees, and the challenges that embodied and experiential knowledges present for supervision. The study also gained the industry perspectives of dance professionals in a series of national forums in 5 cities, based around the value of higher degrees in dance. The qualitative data gathered from these two primary sources was coded and analysed using the NVivo system. Further perspectives were drawn from international consultant and dance researcher Susan Melrose, as well as recent publications in the field. Dance is a young addition to academia and consequently there tends to be a close liaison between the academy and the industry, with a relational fluidity that is both beneficial and problematic. This partially explains why dance research higher degrees are predominantly practice-led (or multi-modal, referring to those theses where practice comprises the substantial examinable component). As a physical, embodied art form, dance engages with the contested territory of legitimising alternative forms of knowledge that do not sit comfortably with accepted norms of research. In supporting research students engaged with dance practice, supervisors traverse the tricky terrain of balancing university academic requirements with studies that are emergent, not only in the practice and attendant theory but in their methodologies and open-ended outcomes; and in an art form in which originality and new knowledge also arises from collaborative creative processes. Formal supervisor accreditation through training is now mandatory in most Australian universities, but it tends to be generic and not address supervisory specificity. This paper offers the kind of alternative proposed by Edwards (2002) that improving postgraduate supervision will be effective if supervisors are empowered to generate their own standards and share best practice; in this case, in ways appropriate to the needs of their discipline and alternative modes of thesis presentation. In order to frame the qualities and processes conducive to this goal, this paper will draw on both the experiences of interviewees and on philosophical premises which underpin the research findings of our study. These include the ongoing challenge of dissolving the binary oppositions of theory and practice, especially in creative arts practice where theory resides in and emerges from the doing as much as in articulating reflection about the doing through what Melrose (2003) terms ‘mixed mode disciplinary practices’. In guiding practitioners through research higher degrees, how do supervisors deal with not only different forms of knowledge but indeed differing modes of knowledge? How can they navigate tensions that occur between the ‘incompatible competencies’ (Candlin, 2000) of the ‘spectating’ academic experts with their ‘irrepressible drive ... to inscribe, interpret, and hence to practise temporal closure’, and practitioner experts who create emergent works of ‘residual unfinishedness’ (Melrose 2006) which are not only embodied but ephemeral, as in the case of live performance?

Barriers and facilitators of a designated driver program

The general aim of designated driver programs is to reduce the level of drink driving by encouraging potential drivers to travel with a driver who has abstained from (or at least limited) consuming alcohol. Designated driver programs are quite widespread around the world, however a limited number have been rigorously evaluated. This paper reports the qualitative results from an evaluation of a designated driver program known as ‘Skipper’, in a provincial city in Queensland. Focus groups were conducted with 108 individuals from the intervention area. These focus groups aimed to assess the barriers and facilitators to the programs’ effectiveness by obtaining information about the patrons’ views on various aspects of the program, as well as designated driver and travelling after drinking more generally. A brief questionnaire was also given to participants in order to present responses in terms of the participants’ characteristics. Results suggest general support for the designated driver concept and the ‘Skipper’ program specifically. Facilitating factors reported by participants included the media coverage highlighting the risks associated with drink driving and the social acceptability of choosing not to drink. However, there was also some suggestion that the impact of the program was mainly to encourage those who already engage in designated driver behaviour to continue doing so, rather than encouraging the uptake of the behaviour among potential new users. Some of the suggested barriers to this kind of behaviour change include: social pressure to drink; alcohol dependency; and a failure to plan ahead.

Historical and Personal Perspectives on the Fall of the Berlin Wall, 1989: address to 20th anniversary forums.

The story of the fall of the Berlin Wall was an aspect of the “imagination gap” that we had to wrestle with as journalists covering the collapse of the Eastern Bloc in Europe. It was scarcely possible to believe what you found yourself reporting, and that work became a two-track process. On one hand a mass social movement was dictating the pace and direction of events; on the other, the institutional business of politics as usual, to provide a framework for all the change that was happening, had to be managed – and reported on. In later analyseds we could see, that crisis in the Soviet Union led to the crisis over the Berlin Wall; and from the fall of the Wall, came Germany’s reunification, and with that also, formation of the European Union as it is today. The government of the Federal Republic of Germany convinced its neighbours that a reunited Germany, within an expanded EU, would be a very acceptable “European Germany” -- not the leader of a “German Europe”. It committed itself financially, supporting the new Euro currency. The former communist states of Eastern Europe demanded to join and expand the EU; in order to remove themselves from the Soviet Union, enjoy human rights, and share in Western prosperity. So today, following on from the events of 1989, the European Union is an amalgam of 27 member countries, with close to 500 million citizens and accounting for 30 % of world Gross National Product.

Applying Stafford and Warr’s Reconceptualization of Deterrence Theory to drug driving : can it predict those likely to offend?

In December 2007, random roadside drug testing commenced in Queensland, Australia. Subsequently, the aim of this study was to explore the preliminary impact of Queensland’s drug driving legislation and enforcement techniques by applying Stafford and Warr’s [Stafford, M. C., & Warr, M. (1993). A reconceptualization of general and specific deterrence. Journal of Research in Crime and Delinquency, 30, 123-135] reconceptualization of deterrence theory. Completing a comprehensive drug driving questionnaire were 899 members of the public, university students, and individuals referred to a drug diversion program. Of note was that approximately a fifth of participants reported drug driving in the past six months. Additionally, the analysis indicated that punishment avoidance and vicarious punishment avoidance were predictors of the propensity to drug drive in the future. In contrast, there were indications that knowing of others apprehended for drug driving was not a sufficient deterrent. Sustained testing and publicity of the legislation and countermeasure appears needed to increase the deterrent impact for drug driving.

Assessment by interview and portfolio in a Graduate School Program

Assessment plays an integral role in teaching and learning in Higher Education and teachers have a strong interest in debates and commentaries on assessment as and for learning. In a one-year graduate entry teacher preparation program, the temptation is to emphasize assessment in an attempt to ensure students “cover” everything as part of a robust preparation for the profession. The risk is that, for students, assessment drives curriculum, and time spent in the completion of assignments is no guarantee of either effective learning or authentic preparation for teaching. Interviews as assessment provide an opportunity for a learning experience as well as an authentic task, since students will shortly be interviewing for employment in a “real world” situation. This paper reports on a project experimenting with interview panels as authentic assessment with pre-service early childhood teachers. At the end of their first semester of study, students enrolled in the Graduate Diploma of Education program at the Queensland University of Technology in Australia were required to participate in a panel interview where they were graded by a panel made up of three faculty staff and one undergraduate student enrolled in the four-year Bachelor of Education program. Students and panel members completed a questionnaire on their experience after the interview. Results indicated that both students and staff valued the experience and felt it was authentic. Results are discussed in terms of how the assessment interview and portfolio presentation supports graduating students in their preparation for employment interviews, and how this authentic assessment task has benefits for both students and teaching staff.

Novel educational training program for community pharmacists

There is little evidence that workshops alone have a lasting impact on the day-to-day practice of participants. The current paper examined a strategy to increase generalization and maintenance of skills in the natural environment using pseudo-patients and immediate performance feedback to reinforce skills acquisition. A random half of pharmacies (N=30) took part in workshop training aimed at optimizing consumers' use of nonprescription analgesic products. Pharmacies in the training group also received performance feedback on their adherence to the recommended protocol. Feedback occurred immediately after a pseudo-patient visit in which confederates posed as purchasers of analgesics, and combined positive and corrective elements. Trained pharmacists were significantly more accurate at identifying people who misused the medication (P<0.001). The trained pharmacists were more likely than controls to use open-ended questions (P<0.001), assess readiness to change problematic use (P <0.001), and to deliver a brief intervention that was tailored to the person's commitment to alter his/her usage (P <0.001). Participants responded to the feedback positively. Results were consistent with the hypothesis that when workshop is combined with on-site performance feedback, it enhances practitioners' adherence to protocols in the natural setting.

Dual-process action of exercise on appetite control : increase in orexigenic drive but improvement in meal-induced satiety

Background: Exercise could contribute to weight loss by altering the sensitivity of the appetite regulatory system. Objective: The aim of this study was to assess the effects of 12 wk of mandatory exercise on appetite control. Design: Fifty-eight overweight and obese men and women [mean (±SD) body mass index (in kg/m2) = 31.8 ± 4.5, age = 39.6 ± 9.8 y, and maximal oxygen intake = 29.1 ± 5.7 mL · kg–1 · min–1] completed 12 wk of supervised exercise in the laboratory. The exercise sessions were designed to expend 2500 kcal/wk. Subjective appetite sensations and the satiating efficiency of a fixed breakfast were compared at baseline (week 0) and at week 12. An Electronic Appetite Rating System was used to measure subjective appetite sensations immediately before and after the fixed breakfast in the immediate postprandial period and across the whole day. The satiety quotient of the breakfast was determined by calculating the change in appetite scores relative to the breakfast's energy content. Results: Despite large variability, there was a significant reduction in mean body weight (3.2 ± 3.6 kg), fat mass (3.2 ± 2.2 kg), and waist circumference (5.0 ± 3.2 cm) after 12 wk. The analysis showed that a reduction in body weight and body composition was accompanied by an increase in fasting hunger and in average hunger across the day (P < 0.0001). Paradoxically, the immediate and delayed satiety quotient of the breakfast also increased significantly (P < 0.05). Conclusions: These data show that the effect of exercise on appetite regulation involves at least 2 processes: an increase in the overall (orexigenic) drive to eat and a concomitant increase in the satiating efficiency of a fixed meal.

Translation of addictions science into practice : update and future directions.

Recent advances in the understanding of the genetic, neurochemical, behavioral and cultural underpinnings of addiction have led to rapid advances in the understanding of addiction as a disease. In fact, advances in basic science and the development of new pharmacological and behavioral therapies associated with them are appearing faster than can be assimilated not only by clinical researchers but practitioners and policy makers as well. Translation of science-based addictions knowledge into improved prevention, assessment and treatment, and communication of these changes to researchers and practitioners are significant challenges to the field. The general aim of this book is to summarize current and potential linkages between advances in addiction science and innovations in clinical practice. Whilst this book is primarily focused on translation, it also encompasses some scientific advances that are relevant to dissemination, and the book is itself a tool for disseminating innovative thinking. The goal is to generate interest in application opportunities from both recent research and theoretical advances.

Learning to program : from pear-shaped to pairs

The consistently high failure rate in Queensland University of Technology’s introductory programming subject reflects a similar dilemma facing other universities worldwide. Experiments were conducted to quantify the effectiveness of collaborative learning on introductory level programming students over a number of semesters, replicating previous studies in this area. A selection of workshops in the introductory programming subject required students to problem-solve and program in pairs, mimicking the eXtreme Programming concept of pair programming. The failure rate for the subject fell from what had been an average of 30% since 2003 (with a high of 41% in 2006), to just 5% for those students who worked consistently in pairs.

Histology challenge : an interactive program for 1st year students

Our students come from diverse backgrounds. They need flexibility in their learning, and opportunities to review aspects of curriculum they are less confident with. An online teaching and learning programme called the Histology Challenge has been developed to supplement learning experiences offered in several first year anatomy and anatomy & physiology units at QUT. The programme is designed to be integrated with the existing Blackboard sites. The Histology Challenge emphasises the foundation concept that a complex system, such as the human body, can be better understood by examining its simpler components. The tutorial allows students to examine the cells and tissues which ultimately determine structural and functional properties of body organs. The program is interactive, asking students to make decisions and choices, demonstrating an integrated understanding of systemic and cellular aspects. It provides users with the ability to progress at their own pace and to test their understanding and knowledge. For the developer the learning activity can be easily controlled and modified via the use of text files. There are several key elements of this programme, designed to promote specific aspects of student learning. Minimum text is used, instead there is a strong emphasis on instructive artwork and original, high quality histology images presented within a framework that reinforces learning and promotes problem solving skills.