Re-examining the evidence in radiation dermatitis management literature : an overview and a critical appraisal of systematic reviews

Purpose: To provide an overview and a critical appraisal of systematic reviews (SRs) of published interventions for the prevention/management of radiation dermatitis. Methods and Materials: We searched Medline, CINAHL, Embase, and the Cochrane Library. We also manually searched through individual reference lists of potentially eligible articles and a number of key journals in the topic area. Two authors screened all potential articles and included eligible SRs. Two authors critically appraised and extracted key findings from the included reviews using AMSTAR (the measurement tool for “assessment of multiple systematic reviews”). Results: Of 1837 potential titles, 6 SRs were included. A number of interventions have been reported to be potentially beneficial for managing radiation dermatitis. Interventions evaluated in these reviews included skin care advice, steroidal/nonsteroidal topical agents, systemic therapies, modes of radiation delivery, and dressings. However, all the included SRs reported that there is insufficient evidence supporting any single effective intervention. The methodological quality of the included studies varied, and methodological shortfalls in these reviews might create biases to the overall results or recommendations for clinical practice. Conclusions: An up-to-date high-quality SR in the prevention/management of radiation dermatitis is needed to guide practice and direction for future research. We recommend that clinicians or guideline developers critically evaluate the information of SRs in their decision making.

Epidermal growth factor receptors and cyclooxygenase-2 in the pathogenesis of non-small cell lung cancer : potential targets for chemoprevention and systemic therapy

The epidermal growth factor receptor (EGFR) is part of a family of plasma membrane receptor tyrosine kinases that control many important cellular functions, from growth and proliferation to cell death. Cyclooxygenase (COX)-2 is an enzyme which catalyses the conversion of arachidonic acid to prostagladins and thromboxane. It is induced by various inflammatory stimuli, including the pro-inflammatory cytokines, Interleukin (IL)-1β, Tumour Necrosis Factor (TNF)-α and IL-2. Both EGFR and COX-2 are over-expressed in non-small cell lung cancer (NSCLC) and have been implicated in the early stages of tumourigenesis. This paper considers their roles in the development and progression of lung cancer, their potential interactions, and reviews the recent progress in cancer therapies that are directed toward these targets. An increasing body of evidence suggests that selective inhibitors of both EGFR and COX-2 are potential therapeutic agents for the treatment of NSCLC, in the adjuvant, metastatic and chemopreventative settings. © 2002 Elsevier Science Ireland Ltd. All rights reserved.

Systemic racism: the hidden barrier to educational success for Indigenous school students

Explanations for poor educational experiences and results for Australian Indigenous school students have, to a great extent, focused on intended or conscious acts or omissions. This paper adopts an analysis based on the legislation prohibiting indirect racial discrimination. Using the elements of the legislation and case law it argues that apparently benign and race-neutral policies and practices may unwittingly be having an adverse impact on Indigenous students' education. These practices or policies include the building blocks of learning, a Eurocentric school culture. Standard English as the language of assessment, legislation to limit schools' legal liability, and teachers' promotions.

In Pursuit of Excellence : A Policy Driven Systemic Initiative to Embed Gifted Education

Embedding gifted education practices requires major professional development strategies supported by transparent, credible and enforceable policy. This paper describes an analysis of a state-wide initiative involving the establishment of a series of schools tasked to develop and disseminate gifted education principles. The authors have been involved with this initiative at a number of levels over a ten-year period. Their involvement culminated in a commissioned review of the program. Extensive qualitative data were purposively collected from all stakeholders and the effectiveness of the initiative is examined from a theoretical framework of policy development and excellence. The findings summarised in this proposal, indicate the achievement of excellence at a systemic level was constrained by lack of vision, leadership and commitment to long term achievements of excellence. At a local level evidence exists that excellence can be manifested when there is synchronicity of vision, purpose, decisions, and actions.

Strains as Mediators between Job Characteristics and Work-Related Outcomes in Police Officers

The relationship between job characteristics (e.g., job demands, social support) and work-related outcomes (e.g., turnover intentions, job performance) is assumed to be mediated by strains (e.g., work-related well-being, psychological strain). However, evidence suggests this association will be stronger for work-related strains than broader measures of overall psychological well-being. The primary aim of this study was to identify whether work and non-work related strains differ significantly in their ability to mediate between job characteristics and work-related outcomes. Perceptions of job characteristics, strain, turnover intentions and job performance were collected via a self-report survey from 2,588 Australian police officers. All job characteristics (job demands, job control, supervisor support and colleague support) were significant predictors of both job performance and turnover intentions, with the exception of job demands, which was not a significant predictor of turnover intentions. Both work and non-work related strains were significant predictors of turnover intentions and job performance. Strains were collectively significant in mediating between job characteristics and work-related outcomes, except in the case of job demands and job performance. The indirect effects of job characteristics on work-related outcomes were primarily through officers’ work-related enthusiasm. The relative importance of work-related enthusiasm in mediating between job characteristics and work-related outcomes offers some support for previous research suggesting stronger associations between work-related constructs. Future research should examine whether there are substantial differences in the explanatory power of work-related enthusiasm and a popular related construct, work engagement.

The failure of Australian legislation on indirect discrimination to detect the systemic racism which prevents Aboriginal people from fully participating in the workforce

Government figures put the current indigenous unemployment rate at around 23%, 3 times the unemployment rate for other Australians. This thesis aims to assess whether Australian indirect discrimination legislation can provide a remedy for one of the causes of indigenous unemployment - the systemic discrimination which can result from the mere operation of established procedures of recruitment and hiring. The impact of those practices on indigenous people is examined in the context of an analysis of anti-discrimination legislation and cases from all Australian jurisdictions from the time of the passing of the Racial Discrimination Act by the Commonwealth in 1975 to the present. The thesis finds a number of reasons why the legislation fails to provide equality of opportunity for indigenous people seeking to enter the workforce. In nearly all jurisdictions it is obscurely drafted, used mainly by educated middle class white women, and provides remedies which tend to be compensatory damages rather than change to recruitment policy. White dominance of the legal process has produced legislative and judicial definitions of "race" and "Aboriginality" which focus on biology rather than cultural difference. In the commissions and tribunals complaints of racial discrimination are often rejected on the grounds of being "vexatious" or "frivolous", not reaching the required standard of proof, or not showing a causal connection between race and the conduct complained of. In all jurisdictions the cornerstone of liability is whether a particular employment term, condition or practice is reasonable. The thesis evaluates the approaches taken by appellate courts, including the High Court, and concludes that there is a trend towards an interpretation of reasonableness which favours employer arguments such as economic rationalism, the maintenance of good industrial relations, managerial prerogative to hire and fire, and the protection of majority rights. The thesis recommends that separate, clearly drafted legislation should be passed to address indigenous disadvantage and that indigenous people should be involved in all stages of the process.

“I smile when I’m angry!” an examination of emotional dissonance among police officers

With the growth of service industry occupations, managing emotions at work has increased as a topic of interest among scholars and practitioners in organisational behaviour and human resource management(Grandey, 2000). Emotional dissonance occurs when there is discrepancy between organisational sanctioned emotions and actual emotions of employees(Zapf, Vogt, Seifert, Mertini, & Isic, 1999). This discrepancy can be associated with significant levels of psychological ill-health (Zapf, Seifert, Schmutte, Mertini, & Holz, 2001). Policing is consistently ranked among the top five stressful/high-risk occupations (e.g. Coman, Evans, Stanley, & Burrows, 1991). Police officers act as the front-line contact when dealing directly with community members; they are expected to be social workers, teachers, role models, and counsellors. Operational police officers are often required to suppress their actual emotions during their work, in order to perform their job to formally designated procedures and standards.

Charities, civil society and the charity law reviews on the island of Ireland

This article considers the opportunity, presented by the coincidence of simultaneous charity law reviews in the two jurisdictions on the island of Ireland, for an adjustment of charity law frameworks to maximise appropriate and effective charitable activity within each jurisdiction,while also facilitating the coordination of some such activity between both. It examines the nature of civil society and charity law, and the relationship between them. The article argues that a creative legislative response to this opportunity could address themes of social inclusion common to both jurisdictions and thereby contribute to the consolidation of civil society on this island.

The role of social capital in reducing negative health outcomes among police officers

This paper investigates the role of social capital on the reduction of short and long run negative health effects associated with stress, as well as indicators of burnout among police officers. Despite the large volume of research on either social capital or the health effects of stress, the interaction of these factors remains an underexplored topic. In this empirical analysis we aim to reduce such a shortcoming focusing on a highly stressful and emotionally draining work environment, namely law enforcement agents who perform as an essential part of maintaining modern society. Using a multivariate regression analysis focusing on three different proxies of health and three proxies for social capital conducting also several robustness checks, we find strong evidence that increased levels of social capital is highly correlated with better health outcomes. Additionally we observe that while social capital at work is very important, social capital in the home environment and work-life balance are even more important. From a policy perspective, our findings suggest that work and stress programs should actively encourage employees to build stronger social networks as well as incorporate better working/home life arrangements.