Primary brain tumor patients’ supportive care needs and multidisciplinary rehabilitation, community and psychosocial support services: Awareness, referral and utilization

Primary brain tumors are associated with significant physical, cognitive and psychosocial changes. Although treatment guidelines recommend offering multidisciplinary rehabilitation and support services to address patients’ residual deficits, the extent to which patients access such services is unclear. This study aimed to assess patients’ supportive care needs early after diagnosis, and quantify service awareness, referral and utilization. A population-based sample of 40 adults recently diagnosed with primary brain tumors was recruited through the Queensland Cancer Registry, representing 18.9% of the eligible population of 203 patients. Patients or carer proxies completed surveys of supportive care needs at baseline (approximately three months after diagnosis) and three months later. Descriptive statistics summarized needs and service utilization, and linear regression identified predictors of service use. Unmet supportive care needs were highest at baseline for all domains, and highest for the physical and psychological needs domains at each time point. At follow-up, participants reported awareness of, referral to, and use of 32 informational, support, health professional or practical services. All or almost all participants were aware of at least one informational (100%), health professional (100%), support (97%) or practical service (94%). Participants were most commonly aware of speech therapists (97%), physiotherapists (94%) and diagnostic information from the internet (88%). Clinician referrals were most commonly made to physiotherapists (53%), speech therapists (50%) and diagnostic information booklets (44%), and accordingly, participants most commonly used physiotherapists (56%), diagnostic information booklets (47%), diagnostic information from the internet (47%), and speech therapists (43%). Comparatively low referral to and use of psychosocial services may limit patients’ abilities to cope with their condition and the changes they experience.

Fostering cultural awareness in pre-service teacher education : an experiment in Asia literacy capacity building in an Australian university

This paper presents the findings of a small pilot study conducted with a group of final year pre-service teachers studying a secondary social science curriculum method unit in an Australian university. One of the study’s research objectives aimed at identifying how students responded to efforts to embed intercultural understanding through Studies of Asia in their final curriculum method unit. The unit was designed and taught by the researcher on the assumption that beginning social science teachers need to be empowered with pedagogical skills and new dispositions to deal with value laden emerging regional and global concerns in their Australian secondary school classrooms. This pilot study’s research methodology was located within the qualitative framework of a participatory action research model whereby the lecturer who designed, coordinated and taught the unit was also the researcher. Its scope was limited to one semester with volunteer students. The pilot study sought to investigate responses to several issues, and this paper reports on pre-service teacher reflections on the content, pedagogy and learning they experienced in their weekly sessions with specific reference to cultural understanding, Studies of Asia and the development of Asia literacy. It also reports on pre-service teacher reflections about their own evolving capacity as beginning teachers. The findings indicate that pre-service teachers valued the opportunity to engage with learning experiences which enhanced their conceptual understandings about culture whilst also extending their pedagogical and content knowledge.

English language study abroad program : an investigation of Hong Kong pre-service teachers’ experiences of a language immersion program

There has been minimal research focused on short-term study abroad language immersion programs, in particular, with home-stay families. The importance of authentic intercultural experience is increasingly clear and was acknowledged as central to the process of language learning (Liddicoat, 2004). In Hong Kong, education programs for pre-service language teachers have significantly emphasised language and intercultural training through short-term study abroad, and these short overseas language immersion courses have become a compulsory component for teacher training (Bodycott & Crew, 2001) in the last decade. This study aims to investigate eight Hong Kong pre-service teachers’ and their home-stay families’ experiences of a short-term (two months) language immersion program in Australia. The focus is on listening to commentaries concerning the development of communicative competence, intercultural competence and professional growth during the out-of-class study abroad experience. The conceptual framework adopted in this study views language and intercultural learning from social constructivist perspectives. Central to this framing is the notion that the internalisation of higher mental functions involves the transfer from the inter-psychological to the intra-psychological plane, that is, a progression process from the socially supported to individually controlled performance. From this perspective, language serves as a way to communicate about, and in relation to, actions and experience. Three research questions were addressed and studied through qualitative methodology. 1. How do the pre-service teachers and their home-stay families perceive the out-of-class component of the program in terms of opportunities for the development of language proficiency and communicative competence? 2. How do the pre-service teachers and their home-stay families perceive the out-of-class component of the program in terms of the development of intercultural competence? 3. How do the pre-service teachers and home-stay families perceive the outof- class component of the program in terms of teachers’ professional growth? Data were generated from multiple data collection methods and analysed through thematic analysis from both a “bottom up” and “top down” approach. The study showed that the pre-service teachers perceived that the immersion program influenced, to varying degrees, their language proficiency, communication and intercultural awareness, as well as their self-awareness and professional growth. These pre-service teachers believed that effective language learning centres on active engagement in the target language community. A mismatch between the views and evaluations of the two groups – the pre-service teachers and the home-stay family members – provides some evidence of misalignments in terms of expectations and perceptions of each other’s roles and responsibilities. The study has highlighted challenges encountered, and provided suggestions for ways of meeting these challenges. The inclusion in the study of the home-stay families’ perceptions and commentaries provided insights, which can inform program development. There is clearly further work to be done in terms of predeparture orientation and preparation, not only for the main participants themselves, the students, but also for the host families.

Evaluation of the Type I child car restraints fitting service in WA

Child passenger injury remains a major road safety issue despite advances in biomechanical understanding and child restraint design. In Australia, one intervention with parents to encourage universal and consistent use of the most appropriate restraint as well as draw their attention to critical aspects of installation is the RoadWise Type 1 Child Car Restraints Fitting Service, WA. A mixed methods evaluation of this service was conducted in early 2010. Evaluation results suggest that it has been effective in ensuring good quality training of child restraint fitters. In addition, stakeholder and user satisfaction with the Service is high, with participants agreeing that the Service is valuable to the community, and fitters regarding the training course, materials and post-training support as effective. However, a continuing issue for interventions of this type is whether the parents who need them perceive this need. Evidence from the evaluation suggests that only about 25% of parents who could benefit from the Service actually use it. This may be partly due to parental perceptions that such services are not necessary or relevant to them, or to overconfidence about the ease of installing restraints correctly. Thus there is scope for improving awareness of the Service amongst groups most likely to benefit from it (e.g. new parents) and for alerting parents to the importance of correct installation and getting their self-installed restraints checked. Efforts to inform and influence parents should begin when their children are very young, preferably at or prior to birth and/or before the parent installs the first restraint.

Protecting Vulnerable Young People in Cyberspace from Sexual Abuse: Raising Awareness and Responding Globally

This paper explores the danger that young people may be exposed to when using the Internet. The first part sets out the context by considering new developments in UK and international legislation and then explores educational moves to protect children. Focus is upon findings from research undertaken on behalf of the London Metropolitan Police Service in evaluating the Safer Surfing programme designed to enable young people’s safe Internet use. In the final part of this paper it is argued that more must however be done internationally both to protect children online and to curb the growing trade in indecent child images.

Risk-taking, harm and help-seeking : reported by young people in treatment at a youth alcohol and drug counselling service

Regarded as a normative component of development, risk-taking by young people is a well-researched subject, and some risk-taking behaviours, such as substance use, are particularly well covered because of their potential to adversely affect health and wellbeing. What has remained unclear is the extent of young people's risk-taking while engaged in alcohol and other drug (AOD) treatment, their awareness of the related harms of risk-taking behaviours, and their prior help-seeking for these harms - information which may have a significant impact on the quality and relevance of the care they receive. This paper reports the findings from a brief pilot study exploring those factors in a clinical sample of young people engaged in ongoing AOD counselling.

Queensland police service : an evaluation of HealthStart 2012

The HS program consists of a voluntary health screening and personalised feedback (via a website) which incorporates physical measurements, psychological stress assessment and blood tests. The following report describes the results of a research project that evaluated the effectiveness of the QPS-HS program and examines the health benefits it offers its participants. This report has three main areas that correspond to the research questions and includes three primary aims: 1.Review the literature pertaining to the health, social and economic value of wellness programs in workplaces. In particular, we reviewed policing worksites and other safety sensitive workplaces, to understand best-practice wellness programming and return on investment, in terms of value to employees, social value to the community, and economic value to employers; 2.Evaluate health outcomes of participants in the HS program, including physical measurements, such as blood tests and psychological well-being. These measures were to form an outcome evaluation and assess the effectiveness of the HS program in positively impacting physical and psychological health of HS participants; and 3.Assess employee awareness and perceptions of the HS program for a process evaluation.

Emergency Health Services (EHS) : demand and service delivery models. monograph 3 : patients’ reasons and perceptions

Executive Summary Emergency health is a critical component of Australia’s health system and emergency departments (EDs) are increasingly congested from growing demand and blocked access to inpatient beds. The Emergency Health Services Queensland (EHSQ) study aims to identify the factors driving increased demand for emergency health and to evaluate strategies which may safely reduce the future demand growth. This monograph addresses the perspectives of users of both ambulance services and EDs. The research reported here aimed to identify the perspectives of users of emergency health services, both ambulance services and public hospital Emergency Departments and to identify the factors that they took into consideration when exercising their choice of location for acute health care. A cross-sectional survey design was used involving a survey of patients or their carers presenting to the EDs of a stratified sample of eight hospitals. A specific purpose questionnaire was developed based on a novel theoretical model which had been derived from analysis of the literature (Monograph 1). Two survey versions were developed: one for adult patients (self-complete); and one for children (to be completed by parents/guardians). The questionnaires measured perceptions of social support, health status, illness severity, self-efficacy; beliefs and attitudes towards ED and ambulance services; reasons for using these services, and actions taken prior to the service request. The survey was conducted at a stratified sample of eight hospitals representing major cities (four), inner regional (two) and outer regional and remote (two). Due to practical limitations, data were collected for ambulance and ED users within hospital EDs, while patients were waiting for or under treatment. A sample size quota was determined for each ED based on their 2009/10 presentation volumes. The data collection was conducted by four members of the research team and a group of eight interviewers between March and May 2011 (corresponding to autumn season). Of the total of 1608 patients in all eight emergency departments the interviewers were able to approach 1361 (85%) patients and seek their consent to participate in the study. In total, 911 valid surveys were available for analysis (response rate= 67%). These studies demonstrate that patients elected to attend hospital EDs in a considered fashion after weighing up alternatives and there is no evidence of deliberate or ill-informed misuse. • Patients attending ED have high levels of social support and self-efficacy that speak to the considered and purposeful nature of the exercise of choice. • About one third of patients have new conditions while two thirds have chronic illnesses • More than half the attendees (53.1%) had consulted a healthcare professional prior to making the decision. • The decision to seek urgent care at an ED was mostly constructed around the patient’s perception of the urgency and severity of their illness, reinforced by a strong perception that the hospital ED was the correct location for them (better specialised staff, better care for my condition, other options not as suitable). • 33% of the respondent held private hospital insurance but nevertheless attended a public hospital ED. Similarly patients exercised considered and rational judgements in their choice to seek help from the ambulance service. • The decision to call for ambulance assistance was based on a strong perception about the severity of the illness (too severe to use other means of transport) and that other options were not considered appropriate. • The decision also appeared influenced by a perception that the ambulance provided appropriate access to the ED which was considered most appropriate for their particular condition (too severe to go elsewhere, all facilities in one spot, better specialised and better care). • In 43.8% of cases a health care professional advised use of the ambulance. • Only a small number of people perceived that ambulance should be freely available regardless of severity or appropriateness. These findings confirm a growing understanding that the choice of professional emergency health care services is not made lightly but rather made by reasonable people exercising a judgement which is influenced by public awareness of the risks of acute health and which is most often informed by health professionals. It is also made on the basis of a rational weighing up of alternatives and a deliberate and considered choice to seek assistance from a service which the patient perceived was most appropriate to their needs at that time. These findings add weight to dispensing with public perceptions that ED and ambulance congestion is a result of inappropriate choice by patients. The challenge for health services is to better understand the patient’s needs and to design and validate services that meet those needs. The failure of our health system to do so should not be grounds for blaming the patient, claiming inappropriate patient choices.

Reframing Conceptions of Contemporary Literacy Capabilities in Pre-Service Primary Teacher Education

This chapter describes the challenges of integrating new technologies with literacy education in pre-service primary teacher education in Australia. The authors describe the policy context and regulatory mechanisms controlling pre-service education, including a national set of professional standards for graduate teachers, a new national curriculum for school students, the introduction of high stakes national assessment for school students, and the looming threat of decontextualized back-to-the-basics professional entry tests for aspiring teachers. The chapter includes three case studies of the authors’ pedagogical practices that attempt to reframe conceptions of the literacy capabilities of pre-service teachers to reflect the complex and sophisticated requirements of teachers in contemporary schooling. The authors conclude the chapter with a discussion of the implications of these case studies as they illustrate the ways that pre-service teachers can be scaffolded and supported to develop creative capacity and critical awareness of the kinds of literacies required in the digital age despite restrictive regimes.

Toward Self-Organising Service Communities

This paper discusses a framework in which catalog service communities are built, linked for interaction, and constantly monitored and adapted over time. A catalog service community (represented as a peer node in a peer-to-peer network) in our system can be viewed as domain specific data integration mediators representing the domain knowledge and the registry information. The query routing among communities is performed to identify a set of data sources that are relevant to answering a given query. The system monitors the interactions between the communities to discover patterns that may lead to restructuring of the network (e.g., irrelevant peers removed, new relationships created, etc.).