The role of informal networks in providing effective work opportunities for people with an intellectual disability

Being in paid employment is socially valued, and is linked to health, financial security and time use. Issues arising from a lack of occupational choice and control, and from diminished role partnerships are particularly problematic in the lives of people with an intellectual disability. Informal support networks are shown to influence work opportunities for people without disabilities, but their impact on the work experiences of people with disability has not been thoroughly explored. The experience of 'work' and preparation for work was explored with a group of four people with an intellectual disability (the participants) and the key members of their informal support networks (network members) in New South Wales, Australia. Network members and participants were interviewed and participant observations of work and other activities were undertaken. Data analysis included open, conceptual and thematic coding. Data analysis software assisted in managing the large datasets across multiple team members. The insight and actions of network members created and sustained the employment and support opportunities that effectively matched the needs and interests of the participants. Recommendations for future research are outlined.

Eat, pray, loathe : women’s travel memoir as moving metaphysical journey or narcissistic new-age babble?

This paper considers the contentious space between self-affirmation and selfpreoccupation in Elizabeth Gilbert’s popular travel memoir, Eat, Pray, Love. Following the surveillance of the female confessant, the female traveller has recently come under close scrutiny and public suspicion. She is accused of walking a fine line between critical self-insight and obsessive selfimportance and her travel narratives are branded as accounts of navel gazing that are less concerned with what is seen than with who is doing the seeing. In reading these themes against the backdrop of women’s travel, the possibility arises that the culture of narcissism is increasingly read as a female discursive practice, concerned with authorship, privacy and the subjectivity of truth. The novel, which has been praised by some as ‘the ultimate guide to balanced living’ and dismissed by others as ‘self-serving junk’, poses questions about the requisites in Western culture for being a female traveller and for telling a story that focuses primarily on the self.

Included by design : a case for regulation for accessible housing in Australia

Accessible housing is a scarce yet much needed commodity in Australia. A national agreement between industry and advocacy groups to a voluntary approach, called the Livable Design program, aims to provide access features in all new housing by 2020. Through a range of awareness raising initiatives, the program is anticipating increased supply by builders and increased demand by home-buyers. However the people who need accessible housing are the least likely and least able to buy it at the point of new sale and average homebuyers do not consider access features as a priority. This approach has not been successful overseas or in Australia in the past. Regulation with incentives supported by education and awareness has provided the best results, yet, regulation typically comes with controversy and resistance from the housing industry. A study is planned to identify how effective the Livable Design program is likely to be, what is likely to hinder it and why regulation is likely to be needed.

The sun gives without ever receiving

YEAR: 2010 ROLE: Artist FORMAT: Miniature 3D Sculpture produced in resin using 3D printing technologies. WITH: International Touring Show ‘Inside Out’ WHAT: A miniature sculpture that contributes towards my ongoing explorations into how our collective ability to sustain (the future) is as much a cultural problematic as it is an economic or technological one. OVERVIEW: The curatorial brief was for each curated artist was to design a piece in CAD suitable for 3D resin printing - The object should be entirely generated through 3D visualisation and modelling tools and should be machined and shipped within the dimensions of 6cm x 6cm x 6cm. My design for this brief was influenced by recent research I had conducted in Mildura in the Sunraysia irrigated region of NW Victoria. Each name set within the work is an Australian soldier/settler – who, on returning from the ‘Great War’ was duly awarded a ‘block’ in Australia’s new inland irrigated settlements - with the explicit task of clearing it to plant and reap. Through their concerted and well-intentioned efforts, these workers began to profoundly re-shape Australia’s marginal country - inadvertently presaging the bleak future faced today by many of Australia’s inland lands and river systems. Furthermore, through that time's predominant colonial conception of ‘terra nullius’ (this land is unoccupied and therefore free to be claimed) they each played a small but formative part in building the profound cultural divide between land and peoples that still haunts Australia today. THE EXHIBITION: Inside Out is a compelling international touring exhibition featuring forty-six miniature sculptures produced in resin using 3D printing technologies. Developments in virtual computer visualisation and integrated digital technologies are giving contemporary makers new insight and opportunities to create objects and forms which were previously impossible to produce or difficult to envisage. The exhibition is the result of collaboration between the Art Technology Coalition, the University of Technology Sydney and RMIT University in Australia along with De Montfort University, Manchester Metropolitan University and Dartington College of Arts at University College Falmouth in the United Kingdom.

A randomized trial of a telephone-delivered exercise intervention for non-urban dwelling women newly diagnosed with breast cancer : exercise for health

Physical activity is important following breast cancer. Trials of non-face-to-face interventions are needed to assist in reaching women living outside major metropolitan areas. This study seeks to evaluate the feasibility and effectiveness of a telephone-delivered, mixed aerobic and resistance exercise intervention for non-urban Australian women with breast cancer. A randomized controlled trial comparing an 8-month intervention delivered by exercise physiologists (n = 73) to usual care (n = 70). Sixty-one percent recruitment rate and 96% retention at 12 months; 79% of women in the intervention group received at least 75% of calls; odds (OR, 95% CI) of meeting intervention targets favored the intervention group for resistance training (OR 3.2; 1.2, 8.9) and aerobic (OR 2.1; 0.8, 5.5) activity. Given the limited availability of physical activity programs for non-urban women with breast cancer, results provide strong support for feasibility and modest support for the efficacy of telephone-delivered interventions.

The role of cultural beliefs in contributing to risky road use behaviour in Pakistan

Background Pakistan has the highest population rate of road fatalities in South Asia (25.3 fatalities per 100,000 people: Global Status Report on Road Safety, WHO 2009). Along with road environment and vehicle factors, human factors make a substantial contribution to traffic safety in Pakistan. Beliefs about road crash causation and prevention have been demonstrated to contribute to risky road use behaviour and resistance to preventive measures in a handful of other developing countries, but has not been explored in Pakistan. In particular, fatalism (whether based on religion, other cultural beliefs or experience) has been highlighted as a barrier to achieving changes in attitudes and behaviour. Aims The research reported here aimed (i) to explore perceptions of road crash causation among policy makers, police officers, professional drivers and car drivers in Pakistan; (ii) to identify how cultural and religious beliefs influence road use behaviour in Pakistan; and (iii) to understand how fatalistic beliefs may work as obstacles to road safety interventions. Methods In-depth interviews were conducted by the primary author (mostly in Urdu) in Lahore, Rawalpindi and Islamabad with 12 professional drivers (taxi, bus and truck), 4 car drivers, 6 police officers, 4 policy makers and 2 religious orators. All but two were Muslim, two were female, and they were drawn from a wide range of ages (24 to 60) and educational backgrounds. The interviews were taped and transcribed, then translated into English and analysed for themes related to the aims. Results Fatalism emerged as a pervasive belief utilised to justify risky road use behaviour and to resist messages about preventive measures. There was a strong religious underpinning to the statement of fatalistic beliefs (this reflects popular conceptions of Islam rather than scholarly interpretations), but also an overlap with superstitious beliefs which have longer-standing roots in Pakistani culture. These beliefs were not limited to people of poor educational background or position. A particular issue which was explored in more detail was the way in which these beliefs and their interpretation within Pakistani society contributed to poor police reporting of crashes. Discussion and conclusions The pervasive nature of fatalistic beliefs in Pakistan affects road user behaviour by supporting continued risk taking behaviour on the road, and by interfering with public health messages about behaviours which would reduce the risk of traffic crashes. The widespread influence of these beliefs on the ways that people respond to traffic crashes and the death of family members contribute to low crash reporting rates and to a system which is difficult to change. The promotion of an evidence-based approach to road user behaviour is recommended, along with improved professional education for police and policy makers.

The effect of exercise on sleep quality in heart failure

Purpose The primary objective of this study was to examine the effect of exercise on subjective sleep quality in heart failure patients. Methods This study used a randomised, controlled trial design with blinded end-point analysis. Participants were randomly assigned to a 12-week programme of education and self-management support (control) or to the same programme with the addition of a tailored physical activity programme designed and supervised by an exercise specialist (intervention). The intervention consisted of 1 hour of aerobic and resistance exercise twice a week. Participants included 108 patients referred to three hospital heart failure services in Queensland, Australia. Results Patients who participated in supervised exercise classes showed significant improvement in subjective sleep quality, sleep latency, sleep disturbance and global sleep quality scores after 12 weeks of supervised hospital based exercise. Secondary analysis showed that improvements in sleep quality were correlated with improvements in geriatric depression score (p=0.00) and exercise performance (p=0.03). General linear models were used to examine whether the changes in sleep quality following intervention occurred independently of changes in depression, exercise performance and weight. Separate models adjusting for each covariate were performed. Results suggest that exercise significantly improved sleep quality independent of changes in depression, exercise performance and weight. Conclusion This study supports the hypothesis that a 12 week program of aerobic and resistance exercise improves subjective sleep quality in patients with heart failure. This is the first randomised controlled trial to examine the role of exercise in the improvement of sleep quality for patients with this disease. While this study establishes exercise as a therapy for poor sleep quality, further research is needed to investigate exercise as a treatment for other parameters of sleep in this population. Study investigators plan to undertake a more in-depth examination within the next 12 months

More is not necessarily better. A biomechanical study on distal screw numbers in volar locking distal radius plates

INTRODUCTION: Currently available volar locking plates for the treatment of distal radius fractures incorporate at least two distal screw rows for fixation of the metaphyseal fragment and have a variable-angle locking mechanism which allows placement of the screws in various directions There is, however no evidence that these plates translate into better outcomes or have superior biomechanical properties to first generation plates, which had a single distal screw row and fixed-angle locking. The aim of our biomechanical study was to compare fixed-angle single-row plates with variable-angle multi-row plates to clarify the optimal number of locking screws. MATERIALS AND METHODS: Five different plate-screw combinations of three different manufacturers were tested, each group consisting of five synthetic fourth generation distal radius bones. An AO type C2 fracture was created and the fractures were plated according to each manufacturer's recommendations. The specimens then underwent cyclic and load-to-failure testing. An optical motion analysis system was used to detect displacement of fragments. RESULTS: No significant differences were detected after cyclic loading as well as after load-to-failure testing, neither in regard to axial deformation, implant rigidity or maximum displacement. The fixed-angle single-row plate showed the highest pre-test rigidity, least increase in post-testing rigidity and highest load-to-failure rigidity and least radial shortening. The radial shortening of plates with two distal screw rows was 3.1 and 4.3 times higher, respectively, than that of the fixed-angle single-row plate. CONCLUSION: The results of our study indicate that two distal screw rows do not add to construct rigidity and resistance against loss of reduction. Well conducted clinical studies based on the findings of biomechanical studies are necessary to determine the optimal number of screws necessary to achieve reproducibly good results in the treatment of distal radius fractures.

Tranquility falls

“Tranquility Falls” depicts a computer-generated waterfall set to sentimental stock music. As the water gushes, text borrowed from a popular talk show host’s self-help advice fade in and out graphically down the screen. As the animated phrases increase in tempo, the sounds of the waterfall begin to overwhelm the tender music. By creating overtly fabricated sensations of inspiration and awe, the work questions how and where we experience contemplation, wonderment and guidance in a contemporary context. “Tranquility Falls” contributes to studies in the field of contemporary art. It is particularly concerned with representations of spirituality and nature. These have been important themes in art practice for some time. For example, artists such as Olafur Eliasson and James Turrell have created artificial insertions in nature in order to question contemporary experiences of the natural environment. Other artists such as Nam Jun Paik have more directly addressed the changing relationship between spirituality and popular culture. Using a practice-led research methodology, “Tranquility Falls” extends these creative inquiries. By presenting an overtly synthetic but strangely evocative pun on a ‘fountain of knowledge’, it questions whether we are informed less by traditional engagements with organised religions and natural wonder, and instead, increasingly reliant on the mechanisms of popular culture for moments of insight and reflection. “Tranquility Falls” has been exhibited internationally at LA Louver Gallery, Venice, California in 2013 and nationally with GBK as part of Art Month Sydney, also in 2013. It has been critically reviewed in The Los Angeles Times.

Permeability of high-performance concrete incorporating presoaked lightweight aggregates for internal curing

This paper presents an experimental study on the effect of presoaked lightweight aggregates (LWAs) for internal curing on water permeability, water absorption and resistance of concrete to chloride-ion penetration in comparison with those of a control concrete and a concrete with shrinkage reducing admixture (SRA) of similar water/cement ratios (w/c). In general, the concretes with LWA particles had initial water absorption, sorptivity and water permeability similar to or lower than those of the control concrete and the concrete with SRA. The charges passed, chloride migration coefficient and chloride diffusion coefficient of such concretes were in the same order as those of the control concrete and the concrete with SRA. However, the incorporation of the LWAs for internal curing reduced unit weight, compressive strength and elastic modulus of the concrete. Comparing the LWAs of different sizes for internal curing, finer particles were more efficient in reducing the shrinkage and generally resulted in less reduction in the unit weight, compressive strength, and elastic modulus. However, the increase in the more porous crushed LW particles in concrete seems to increase the penetration of chloride ions in the concrete. The concrete with SRA had initial water absorption, sorptivity, water permeability and resistance to chloride ion penetration comparable with those of the control concrete. The use of SRA in concrete does not affect the elastic modulus of the concrete, except for a minor influence on the compressive strength of the concrete.

High-strength high-performance lightweight concrete : a review (Invited)

In the last two decades, there are developments that lead to greater understanding on how and why lightweight concretes (LWC) may achieve similar or higher performance than their normal weight counterparts. The present paper reviews some of these aspects beginning with basic properties such as unit weight, compressive strength and specific strength (strength/ unit weight). Stability and workability of LWC is discussed from rheological perspective. The volumetric stability of LWC in terms of shrinkage and creep are presented with some recent published data. Transport properties of the LWC in terms of sorptivity, water permeability and resistance to chloride-ion penetration are reviewed in comparison with normal weight concrete. Fire resistance of LWC and some current measures used to improve the resistance are discussed. With continual research and development, the performance of LWC is being enhanced to provide new opportunities for practical applications.

The effect of exercise training on sleep quality in heart failure

Background: Heart failure is a serious condition estimated to affect 1.5-2.0% of the Australian population with a point prevalence of approximately 1% in people aged 50-59 years, 10% in people aged 65 years or more and over 50% in people aged 85 years or over (National Heart Foundation of Australian and the Cardiac Society of Australia and New Zealand, 2006). Sleep disturbances are a common complaint of persons with heart failure. Disturbances of sleep can worsen heart failure symptoms, impair independence, reduce quality of life and lead to increased health care utilisation in patients with heart failure. Previous studies have identified exercise as a possible treatment for poor sleep in patients without cardiac disease however there is limited evidence of the effect of this form of treatment in heart failure. Aim: The primary objective of this study was to examine the effect of a supervised, hospital-based exercise training programme on subjective sleep quality in heart failure patients. Secondary objectives were to examine the association between changes in sleep quality and changes in depression, exercise performance and body mass index. Methods: The sample for the study was recruited from metropolitan and regional heart failure services across Brisbane, Queensland. Patients with a recent heart failure related hospital admission who met study inclusion criteria were recruited. Participants were screened by specialist heart failure exercise staff at each site to ensure exercise safety prior to study enrolment. Demographic data, medical history, medications, Pittsburgh Sleep Quality Index score, Geriatric Depression Score, exercise performance (six minute walk test), weight and height were collected at Baseline. Pittsburgh Sleep Quality Index score, Geriatric Depression Score, exercise performance and weight were repeated at 3 months. One hundred and six patients admitted to hospital with heart failure were randomly allocated to a 3-month disease-based management programme of education and self-management support including standard exercise advice (Control) or to the same disease management programme as the Control group with the addition of a tailored physical activity program (Intervention). The intervention consisted of 1 hour of aerobic and resistance exercise twice a week. Programs were designed and supervised by an exercise specialist. The main outcome measure was achievement of a clinically significant change (.3 points) in global Pittsburgh Sleep Quality score. Results: Intervention group participants reported significantly greater clinical improvement in global sleep quality than Control (p=0.016). These patients also exhibited significant improvements in component sleep disturbance (p=0.004), component sleep quality (p=0.015) and global sleep quality (p=0.032) after 3 months of supervised exercise intervention. Improvements in sleep quality correlated with improvements in depression (p<0.001) and six minute walk distance (p=0.04). When study results were examined categorically, with subjects classified as either "poor" or "good" sleepers, subjects in the Control group were significantly more likely to report "poor" sleep at 3 months (p=0.039) while Intervention participants were likely to report "good" sleep at this time (p=0.08). Conclusion: Three months of supervised, hospital based, aerobic and resistance exercise training improved subjective sleep quality in patients with heart failure. This is the first randomised controlled trial to examine the role of aerobic and resistance exercise training in the improvement of sleep quality for patients with this disease. While this study establishes exercise as a therapy for poor sleep quality, further research is needed to investigate the effect of exercise training on objective parameters of sleep in this population.

Reflection as a dialogic strategy for developing a professional identity

The benefits of reflective practice have been well established in the literature (Rogers, 2001), as have models to embed reflective thinking in higher education curriculum (Ryan and Ryan, 2012). Reflection is commonly envisaged as a textual practice, through which students ‘reflect in and on action’ (Schön 1983), and articulate their experiences, learning and outcomes in written portfolios, journals, or blogs. While such approaches to individual written reflection are undoubtedly beneficial for deepening insight and self-criticality, reflection can also provide other benefits when approached as a collaborative, oral activity. This poster presents a dialogic model of reflective practice that affords the opportunity for developing presentation skills, critique, community and professional identity formation. This dialogic approach to reflection is illustrated by a first year subject (‘KIB101 Visual Communication’ at QUT), in which students apply visual theory (presented in lectures) to communication and graphic design problems in the studio. In regular (fortnightly) presentations, they critically reflect upon their work in progress by aligning it with the concepts, design principles and professional language of the lectures. This iterative process facilitates responsive peer feedback, similarly couched in the formal terms of the discipline. This ‘mirrored reflection’ not only provides opportunities to incrementally improve, it also sets designs in a theoretical frame; provides the opportunity for comparative analysis (to see design principles applied by peers in different ways); to practice formal design language and presentation techniques of the discipline and; because peer critique is framed as an act of generosity; it affords the development of a supportive community of practice. In these ways, dialogic reflection helps students develop a professional voice and identity from first year. Evidence of impact is provided by quantitative and qualitative student feedback over several years, as well as institutional feedback and recognition.

Genetic susceptibility to complex traits : moving towards informed analysis of whole-genome screens

Susceptibility to complex traits, by definition, involves aetiological polymorphisms at multiple genetic loci combined with variable contributions by environmental factors. However, the approaches taken to identifying genetic loci implicated in susceptibility to complex traits frequently overlooks the compounding contribution of multiple loci in favour of highlighting a single gene solely responsible for predisposition. It is only in a small minority of cases that this has resulted in clear disease heritability associated with polymorphisms in a single gene. More often, this approach has led to an accumulation of single-gene associations with minor contributions to disease susceptibility. As the genomic era advances and genome-wide screens become higher in resolution and throughput, the need for simultaneous consideration of multiple loci is becoming more important. With special reference to non-Hodgkin’s lymphoma (NHL), this chapter will overview the current progress made in elucidating genetic polymorphisms associated with disease susceptibility. We also present novel data from a high-resolution single nucleotide polymorphism (SNP) microarray screen for susceptibility loci that are involved in NHL. Using an ‘informed approach’, the findings are highlighted within the context of cellular pathways, and provide insight and new ideas for methods of analysis for genome-wide screens for susceptibility.

Training for performance : insights from molecular biology

In this commentary the authors discuss the molecular basis of the training adaptation and review the role of several key signaling proteins important in the adaptation to endurance and resistance training.