Development, implementation and evaluation of a cancer survivor self-management care plan

Aim There is a growing population of people with cancer who experience physiological and psychological effects that persist long after treatment is complete. Interventions that enhance survivors’ self-management abilities might help offset these effects. The aim of this pilot study was to develop, implement and evaluate interventions tailored to assist patients to manage post-treatment health issues effectively. Method In this pre-post intervention cohort study, participants were recruited on completion of cancer treatment. Participants recruited preimplementation, who received usual care, comprised the control group. Participants recruited later formed the intervention group. In the intervention group, the Cancer Care Coordinator developed an individualised, structured Cancer Survivor Self-management Care Plan. Participants were interviewed on completion of treatment (baseline) and at three months. Assessments concerned health needs (CaSUN), self-efficacy in adjusting and coping with cancer and health-related quality of life (FACIT-B or FACT-C). The impact of the intervention was determined by independent t-tests of change scores. Results The intervention (n = 32) and control groups (n = 35) were comparable on demographic and clinical characteristics. Sample mean age was 54 + 10 years. Cancer diagnoses were breast (82%) and colorectal (18%). Statistically significant differences (p < 0.05) indicated improvement in the intervention group for: (a) functional well-being, from the FACIT, (Control: M = −0.69, SE = 0.91; Intervention: M = 3.04, SE = 1.13); and (b) self-efficacy in maintaining social relationships, (Control: M = −0.333, SE = 0.33; Intervention: M = 0.621, SE = 0.27). No significant differences were found in health needs, other subscales of quality of life, the extent and number of strategies used in coping and adjusting to cancer and in other domains of self-efficacy. Conclusions While the results should be interpreted with caution, due to the non-randomised nature of the study and the small sample size, they indicate the potential benefits of tailored self-management interventions warrant further investigation in this context.

What is plan B? Using Foucault’s archaeology to enhance policy analysis

Many governments in western democracies conduct the work of leading their societies forward through policy generation and implementation. Despite government attempts at extensive negotiation, collaboration and debate, the general populace in these same countries frequently express feelings of disempowerment and undue pressure to be compliant, often leading to disengagement. Here we outline Plan B: a process for examining how policies that emerge from good intentions are frequently interpreted as burdensome or irrelevant by those on whom they have an impact. Using a case study of professional standards for teachers in Australia, we describe how we distilled Foucault’s notions of archaeology into a research approach centring on the creation of ‘polyhedrons of intelligibility’ as an alternative approach by which both policy makers and those affected by their policies may understand how their respective causes are supported and adversely affected.

Discomfort glare in open plan green buildings

This study presents the largest-known, investigation on discomfort glare with 493 surveys collected from five green buildings in Brisbane, Australia. The study was conducted on full-time employees, working under their everyday lighting conditions, all of whom had no affiliation with the research institution. The survey consisted of a specially tailored questionnaire to assess potential factors relating to discomfort glare. Luminance maps extracted from high dynamic range (HDR) images were used to capture the luminous environment of the occupants. Occupants who experienced glare on their monitor and/or electric glare were excluded from analysis leaving 419 available surveys. Occupants were more sensitive to glare than any of the tested indices accounted for. A new index, the UGP was developed to take into account the scope of results in the investigation. The index is based on a linear transformation of the UGR to calculate a probability of disturbed persons. However all glare indices had some correlation to discomfort, and statistically there was no difference between the DGI, UGR and CGI. The UGP broadly reflects the demographics of the working population in Australia and the new index is applicable to open plan green buildings.

New suburbs in the making? Locating master planned estates in a comparative analysis of suburbs in South-East Queensland

In urban scholarship Master Planned Estates (MPEs) are viewed as illustrative of broader changes to the urban environment and characterised as homogenous, affluent enclaves where community life is largely orchestrated by the developer. Yet no study has fully considered if, and to what extent, MPEs can be distinguished from other suburb types in terms of their residential composition and their levels of sociability and community attachment. In this article, we empirically test if MPEs are different from ‘conventional’ suburbs by examining them structurally in terms of their demographic and socio-economic characteristics, as well as in terms of their key community social processes. Using data from a 2008 study of 148 suburbs across Brisbane, Australia (which includes data from two MPEs), we undertake a comparative analysis of suburbs and examine the density of neighbour networks, residents' reports of place attachment and cohesion and neighbourly contact in MPEs compared to other residential suburbs. Our findings suggest that MPEs are not distinct in terms of their degree of homogeneity and socio-economic characteristics, but that connections among residents are lower than other suburbs despite—or perhaps because of—the active interventions of the developer.

Predicting the likelihood of QA failure using treatment plan accuracy metrics

This study used automated data processing techniques to calculate a set of novel treatment plan accuracy metrics, and investigate their usefulness as predictors of quality assurance (QA) success and failure. 151 beams from 23 prostate and cranial IMRT treatment plans were used in this study. These plans had been evaluated before treatment using measurements with a diode array system. The TADA software suite was adapted to allow automatic batch calculation of several proposed plan accuracy metrics, including mean field area, small-aperture, off-axis and closed-leaf factors. All of these results were compared the gamma pass rates from the QA measurements and correlations were investigated. The mean field area factor provided a threshold field size (5 cm2, equivalent to a 2.2 x 2.2 cm2 square field), below which all beams failed the QA tests. The small aperture score provided a useful predictor of plan failure, when averaged over all beams, despite being weakly correlated with gamma pass rates for individual beams. By contrast, the closed leaf and off-axis factors provided information about the geometric arrangement of the beam segments but were not useful for distinguishing between plans that passed and failed QA. This study has provided some simple tests for plan accuracy, which may help minimise time spent on QA assessments of treatments that are unlikely to pass.

Certified pseudonyms colligated with master secret key

A pseudonym provides anonymity by protecting the identity of a legitimate user. A user with a pseudonym can interact with an unknown entity and be confident that his/her identity is secret even if the other entity is dishonest. In this work, we present a system that allows users to create pseudonyms from a trusted master public-secret key pair. The proposed system is based on the intractability of factoring and finding square roots of a quadratic residue modulo a composite number, where the composite number is a product of two large primes. Our proposal is different from previously published pseudonym systems, as in addition to standard notion of protecting privacy of an user, our system offers colligation between seemingly independent pseudonyms. This new property when combined with a trusted platform that stores a master secret key is extremely beneficial to an user as it offers a convenient way to generate a large number of pseudonyms using relatively small storage.

Treatment plan complexity metrics for predicting IMRT pre-treatment quality assurance results

The planning of IMRT treatments requires a compromise between dose conformity (complexity) and deliverability. This study investigates established and novel treatment complexity metrics for 122 IMRT beams from prostate treatment plans. The Treatment and Dose Assessor software was used to extract the necessary data from exported treatment plan files and calculate the metrics. For most of the metrics, there was strong overlap between the calculated values for plans that passed and failed their quality assurance (QA) tests. However, statistically significant variation between plans that passed and failed QA measurements was found for the established modulation index and for a novel metric describing the proportion of small apertures in each beam. The ‘small aperture score’ provided threshold values which successfully distinguished deliverable treatment plans from plans that did not pass QA, with a low false negative rate.

Prostate radiotherapy treatment plan quality : effects of hip prostheses

Introduction This study aimed to examine the geometric and dosimetric results when radiotherapy treatment plans are designed for prostate cancer patients with hip prostheses. Methods Ten EBRT treatment plans for localised prostate cancer, in the presence of hip prostheses, were analysed and compared with a reference set of 196 treatment plans for localised prostate cancer in patients without prostheses. Crowe et al.’s TADA code [1] was used to extract treatment plan parameters and evaluate doses to target volumes and critical structures against recommended goals [2] and constraints [3, 4]. Results The need to avoid transmitting the radiation beam through the hip prostheses limited the range of gantry angles available for use in both the rotational (VMAT) and the non-rotational (3DCRT and IMRT) radiotherapy treatments. This geometric limitation (exemplified in the VMAT data shown in Fig. 1) reduced the overall quality of the treatment plans for patients with prostheses compared to the reference plans. All plans with prostheses failed the PTV dose homogeneity requirement [2], whereas only 4 % of the plans without prostheses failed this test. Several treatment plans for patients with hip prostheses also failed the QUANTEC requirements that less than 50 % of the rectum receive 50 Gy and less than 35 % of the rectum receive 60 Gy to keep the grade 3 toxicity rate below 10 % [3], or the Hansen and Roach requirement that less than 25 % of the bladder receive 75 Gy [4]. Discussion and conclusions The results of this study exemplify the difficulty of designing prostate radiotherapy treatment plans, where beams provide adequate doses to targeted tissues while avoiding nearby organs at risk, when the presence of hip prostheses limits the available treatment geometries. This work provides qualitative evidence of the compromised dose distributions that can result, in such cases.

The 1989 Comprehensive Plan of Action (CPA) and refugee policy in Southeast Asia : twenty years forward what has changed?

In 2012, the only South East Asian countries that have ratified the 1951 Convention relating to the Status of Refugees and the 1967 Protocol Relating to the Status of Refugees (hereafter referred to as the 1951 Convention and 1967 Protocol) is Philippines (signed 1954), Cambodia (signed 1995) and Timor Leste (signed 2001). Countries such as Indonesia, Malaysia and Thailand have annual asylum seeking populations from Myanmar, South Asia and Middle East, that are estimated to be at 15 000-20 000 per country (UNHCR 2012). The lack of a permanent and formal asylum processing process in these countries means that that asylum-seeking populations in the region are reliant on the local offices of the United Nations High Commission for Refugees based in the region to process their claims. These offices rely upon the good will of these governments to have a presence near detection camps and in capital cities to process claims of those who manage to reach the UNHCR representative office. The only burden sharing mechanism within the region primarily exists under the Bali Process on People Smuggling, Trafficking in Persons and Related Transnational Crime (the Bali Process), introduced in 2002. The Bali Process refers to an informal cooperative agreement amongst the states from the Asia-Pacific region, with Australia and Indonesia as the co-chairs, which discusses its namesake: primarily anti-people smuggling activities and migration protocols. There is no provision within this process to discuss the development of national asylum seeking legislation, processes for domestic processing of asylum claims or burden sharing in contrast to other regions such as Africa and South America (i.e. 2009 African Union Convention for the Protection and Assistance of the Internally Displaced, 1969 African Union Convention Governing the Specific Aspects of Refugee Problems in Africa and 1984 Cartagena Declaration on Refugees [Americas]) (PEF 2010: 19).

New laws for off the plan contracts in Queensland

The Land Sales Act 1984 regulates “off the plan” sales in Queensland in conjunction with several provisions in the Body Corporate and Community Management Act 1997. Together the Acts regulate sales in both unit developments and housing estates. From 2010 to 2013 the Queensland Government undertook a comprehensive review of the Land Sales Act 1984 to identify opportunities to modernise and improve the legislation. Significant changes were recommended by the Review to align the Land Sales Act 1984 (LSA) with current surveying and conveyancing practice and to overcome a number of practical issues faced by developers under the current legislation. A significant outcome of the review is the removal of provisions related to off the plan community title sales from the LSA to the Body Corporate and Community Management Act 1997 (BCCMA) and the Building Units and Group Titles Act 1980 (BUGTA). This article examines the Land Sales and Other Legislation Amendment Act 2014 due to commence in November 2014.

Reframe : QUT's Evaluation Framework 2014 Communications Plan

2014 is the year for embedding the Reframe: QUT’s Evaluation Framework as core business within the University, with the following providing an outline of the Learning and Teaching Unit’s (LTU) planned activities to support this implementation. LTU is continuing its commitment to intensive support and engagement with the academic and teaching focused community within QUT. The Academic Quality and Standards team have extended the existing communication and dissemination activities into a comprehensive communication plan for 2014, with major initiatives defined within this document. It should be noted that these activities are aligned to the discussions from the 2013 Integrated Management of Feedback (IMF) Steering Group and as endorsed by the University Learning and Teaching Committee at their meeting in February, 2014.

Conservation communication camp : come with ideas, leave with a plan

IUCN´s core work involves generating knowledge and tools to influence policy and practice for nature conservation. Whilst it appears that we are collectively making progress in some areas, we acknowledge the need to improve our communication processes and practices to ´move to action´ in this regard. We need to extend the influence of the science and the knowledge beyond the documents to achieve effective impact and action. The training course will focus on the process of getting the conservation messages out to a wider audience. This interactive and participatory training course will develop the skills and knowledge needed to communicate effective conservation messages for a range of IUCN internal and external audiences. The course will cover: • what is communication for conservation? • the communication planning process (developing your communication objectives) • identifying and understanding your target audiences • developing your conservation message • choosing your communication media and • evaluating the effectiveness of your communication strategies. A unique feature of the training course will be the use of Web 2.0 tools in innovative conservation communications e.g. use of social media in concept branding and social marketing. In the spirit of the Forum´s objective of ´Sharing know how´, each participant will bring a current conservation issue to the training course and will leave with their own communication plan. Potentially, the training course adopts a cross-thematic approach as the issues addressed could be drawn from any of the IUCN´s program themes. Primarily though, the training course´s best fit is with the ´Valuing and Conserving Biodiversity´ theme since it will provide concrete and pragmatic solutions to enhancing the implementation of conservation measures through participatory planning and capacity building.

Foundations for the future : A long-term plan for Australian ecosystem science

Abstract: Australia’s ecosystems are the basis of our current and future prosperity, and our national well-being.A strong and sustainable Australian ecosystem science enterprise is vital for understanding and securing these ecosystems in the face of current and future challenges. This Plan defines the vision and key directions for a national ecosystem science capability that will enable Australia to understand and effectively manage its ecosystems for decades to come.The Plan’s underlying theme is that excellent science supports a range of activities, including public engagement, that enable us to understand and maintain healthy ecosystems.Those healthy ecosystems are the cornerstone of our social and economic well-being.The vision guiding the development of this Plan is that in 20 years’ time the status of Australian ecosystems and how they change will be widely reported and understood, and the prosperity and well-being they provide will be secure. To enable this, Australia’s national ecosystem science capability will be coordinated, collaborative and connected.The Plan is based on an extensive set of collaboratively generated proposals from national town hall meetings that also formthe basis for its implementation. Some directions within the Plan are for the Australian ecosystem science community itself to implement, others will involve the users of ecosystem science and the groups that fund ecosystem science.We identify six equal priority areas for action to achieve our vision: (i) delivering maximum impact for Australia: enhancing relationships between scientists and end-users; (ii) supporting long-termresearch; (iii) enabling ecosystem surveillance; (iv) making the most of data resources; (v) inspiring a generation: empowering the public with knowledge and opportunities; (vi) facilitating coordination, collaboration and leadership. This shared vision will enable us to consolidate our current successes, overcome remaining barriers and establish the foundations to ensure Australian ecosystem science delivers for the future needs of Australia..

Southern New England Social and Community Plan 2009 - Covering Local Government Authorities: Armidale Dumaresq, Guyra, Uralla and Walcha

The Southern New England (SNE) Social and Community Plan is a guide to collaborative, integrated planning involving the three spheres of government, the community and commercial sectors. The Plan is based on social justice principles such as: • Equity - fairness in resource distribution, particularly for those most in need • Access - fairer access for everyone to the economic resources and services essential to meeting their basic needs and improving their quality of life • Rights - recognition and promotion of civil rights • Participation - better opportunities for genuine participation and consultation about decisions affecting people's lives. The Plan is also aimed at improving the accountability of decision-makers, and should help the councils, in conjunction with their communities meet the state government's social justice commitments. Preparation of a social and community plan is required at least every five years, and as with most councils, Armidale Dumaresq Council (ADC) has produced two already, one in 1999 and one in 2004, following the amalgamation of the former Armidale City and Dumaresq Shire Councils in 2000. Those Councils formerly prepared their own Plans in 1999, based on shared consultancy work on a community profile. This is the first joint Southern New England Plan, featuring Armidale Dumaresq, Walcha, Uralla and Guyra Councils. This Social Plan has aimed to identify and address the needs of the local community by: • describing who makes up the community • summarising key priority issues • assessing the effectiveness of any previous plans • recommending strategic ways for council and other government and non-government agencies to met community needs.