The child of uncertain sex: 17 years of experience

Objective: To review the common clinical presentations, investigations and final diagnosis of children presenting with genital ambiguity. Methodology: Retrospective search of the Royal Children's Hospital, Brisbane, Australia, medical records and personal medical database of one of the authors (MJT) between 1982 and 1999. Results: Fifty-one children aged 0.1-;14 (mean 3.9) years were identified. Twenty-two cases had a 46XX karyotype, and commonly presented with an enlarged phallus (77.2%), urogenital sinus (63.6%) and labioscrotal fold(s) (40.9%). Congenital adrenal hyperplasia (CAH) was the most common final diagnosis (72.7%) . Twenty-nine cases of genital ambiguity had a 46XY karyotype and commonly presented with palpable gonad(s) (75.8%), undescended testes (51.7%), penoscrotal hypospadias (51.7%) and a small phallus (41.3%). Androgen insensitivity and gonadal dysgenesis were the commonest final diagnosis both occurring at a frequency of 17.2%. Conclusions: The results emphasize the importance of CAH as the most common diagnosis in 46XX cases presenting with ambiguous genitalia. Those with 46XY had a wider range of diagnoses. Despite thorough investigation, 23.5% had no definite final diagnosis made.

Applicability of experience from laboratory reactors with biological phosphorus removal in full-scale plants

Enhanced biological phosphorus removal (EBPR) has been used at many wastewater treatment plants all over the world for many years. In this study a full-scale sludge with good EBPR was tested with P-release batch tests and combined FISH/MAR (fluorescence in situ hybridisation and microautoradiography). Proposed models of PAOs and GAOs (polyphosphate- and glycogen-accumulating organisms) and microbial methods suggested from studies of laboratory reactors were found to be applicable also on sludge from full-scale plants. Dependency of pH and the uptake of both acetate and propionate were studied and used for calculations for verifying the models and results from microbial methods. All rates found from the batch tests with acetate were higher than in the batch tests with propionate, which was explained by the finding that only those parts of the bacterial community that were able to take up acetate anaerobically were able to take up propionate anaerobically.

Relationships between quality of experience and participation in diverse performance settingshttp://espace.library.uq.edu.au/workflow/edit_metadata.php?id=382160&wfs_id=778

The flow concept describes a model of enjoyment that has relevance for understanding participation and experience across a wide range of activities (Csikszentmihalyi, 1997). The basic premise of the flow concept is that when challenges and skills are simultaneously balanced and extending the individual, a state of total absorption can occur. Research by Jackson and colleagues has examined the utility of the flow concept to understanding participation and performance in sport settings. Recently, Jackson and Eklund have examined flow in a range of performance settings: sport, exercise, dance, creative and performing arts, and music. In this paper, we present descriptive and construct validity data on how participants in these activities experienced flow, as assessed by the recently revised flow scales: The Dispositional Flow Scale-2 (DFS-2) and Flow State Scale-2 (FSS-2) (Jackson & Eklund, 2002). The fmdings will be discussed in relation to the utility of the flow concept to understanding participation across performance settings.

Experience as a moderator of the media equation: the impact of flattery and praise

This study extends previous media equation research, which showed that the effects of flattery from a computer can produce the same general effects as flattery from humans. Specifically, the study explored the potential moderating effect of experience on the impact of flattery from a computer. One hundred and fifty-eight students from the University of Queensland voluntarily participated in the study. Participants interacted with a computer and were exposed to one of three kinds of feedback: praise (sincere praise), flattery (insincere praise), or control (generic feedback). Questionnaire measures assessing participants' affective state. attitudes and opinions were taken. Participants of high experience, but not low experience, displayed a media equation pattern of results, reacting to flattery from a computer in a manner congruent with peoples' reactions to flattery from other humans. High experience participants tended to believe that the computer spoke the truth, experienced more positive affect as a result of flattery, and judged the computer's performance more favourably. These findings are interpreted in light of previous research and the implications for software design in fields such as entertainment and education are considered. (C) 2004 Elsevier Ltd. All rights reserved.

Experience as a moderator of involvement and satisfaction on brand loyalty in a business-to-business setting 02-314R

This paper examines the relative influence of two key antecedents of brand loyalty-satisfaction and involvement and the moderating role of experience, using a sample of business buyers. The central argument of this paper is that the strength of the effect of these variables on attitudinal brand loyalty will vary with the level of customer experience with purchasing the service. Building on previous research which examined low-risk, customer product settings [Kim, J., Lim, J.S., & Bhargava, M. (1998). The role of affect in attitude formation: A classical conditioning approach. Journal of the Academy of Marketing Science 26 (2): pp. 143-152; Shiv, B., & Fedorikhin, A. (1999). Heart and mind in conflict: The interplay of affect and cognition in consumer decision-making. Journal of Consumer Research 26: 278], this study shows that for a high-risk setting, involvement with the service category will be more dominant in its influence on brand loyalty than satisfaction with the preferred brand. Furthermore, it was found that experience moderated the influence of involvement and satisfaction on attitudinal brand loyalty for a high-risk business-to-business service. This study provides new insights into the theory and practice of buyer behavior and business-to-business brands. Crown Copyright (C) 2004 Published by Elsevier Inc. All rights reserved.

Destination image, romance and place experience - an application of intimacy theory in tourism

In some forms of tourism, and perhaps particularly in the case of special interest tourism, it can be argued that tourism encounters are service relationships with emotional attachment through the special interest focus and a level of enduring involvement on the part of participants. This involvement is two-fold. First, an interest with the activity; second, a sharing with like-minded people in a social world that extends from home to tourist destination and return. Intimacies in tourism can thus be interpreted through the model of the relationship cycle that comprises the stages A. Aquaintance, B, Buildup, C, Continuation and D, Dissolution. The paper builds upon this concept by utilising ideas of other-centred and self-centredness in personal relationships, and extends the concept of other-centredness to host environments. It also suggests that, in the academic literature about place, location may be secondary in that the quality of experience is primarily determined by the intimacies that exist between people at that place, especially that existing between visitors. © 2004 Published by Elsevier Ltd.

Experience-induced preference for oviposition repellents derived from a non-host plant by a specialist herbivore

Foraging adults of phytophagous insects are attracted by host-plant volatiles and supposedly repelled by volatiles from non-host plants. In behavioural control of pest insects, chemicals derived from non-host plants applied to crops are expected to repel searching adults and thereby reduce egg laying. How experience by searching adults of non-host volatiles affects their subsequent searching and oviposition behaviour has been rarely tested. In laboratory experiments, we examined the effect of experience of a non-host-plant extract on the oviposition behaviour of the diamondback moth (DBM), Plutella xylostella, a specialist herbivore of cruciferous plants. Naive ovipositing DBM females were repelled by an extract of dried leaves of Chrysanthemum morifolium, a non-host plant of DBM, but experienced females were not repelled. Instead they were attracted by host plants treated with the non-host-plant extract and laid a higher proportion of eggs on treated than on untreated host plants. Such behavioural changes induced by experience could lead to host-plant range expansion in phytophagous insects and play an important role in determining outcome for pest management of some behavioural manipulation methods.

A naturalistic study of the word frequency effect in episodic recognition

In order to separate the effects of experience from other characteristics of word frequency (e.g., orthographic distinctiveness), computer science and psychology students rated their experience with computer science technical items and nontechnical items from a wide range of word frequencies prior to being tested for recognition memory of the rated items. For nontechnical items, there was a curvilinear relationship between recognition accuracy and word frequency for both groups of students. The usual superiority of low-frequency words was demonstrated and high-frequency words were recognized least well. For technical items, a similar curvilinear relationship was evident for the psychology students, but for the computer science students, recognition accuracy was inversely related to word frequency. The ratings data showed that subjective experience rather than background word frequency was the better predictor of recognition accuracy.

Clinical supervision in four mental health professions: A review of the evidence

This paper examines a range of theoretical issues and the empirical evidence relating to clinical supervision in four mental health professions, namely clinical psychology, occupational therapy, social work, and speech pathology. Despite the widespread acceptance of the value of supervision among practitioners and the large quantity of literature on the topic, there is very little empirical evidence in this area. It is not clear whether supervision actually produces a change in clinician behaviour, nor whether it produces benefits in terms of client outcomes. To date, there is insufficient evidence to demonstrate which styles of supervision are most beneficial for particular types of staff, in terms of their level of experience or learning style. The data suggest that directive forms of supervision, rather than unstructured approaches, are preferred by relatively inexperienced practitioners, and that experienced clinicians also value direct supervision methods when learning new skills or dealing with complex or crisis situations. The available evidence suggests that supervisors typically receive little training in supervision methods. However, to date, we have little information to guide us as to the most effective ways of training supervisors. While acknowledging the urgent need for research, the paper concludes that supervision is likely to form a valuable component of professional development for mental health professionals.

The competence of mental health occupational therapists

This research sought to investigate the self-perceived competence of mental health occupational therapists in Queensland. The research is a post-hoc analysis of survey results that formed part of the 1995 Professional Development Strategy for Adult Mental Health Services for the Queensland Health Mental Health Unit. A sample of 55 occupational therapists was compared with other professionals in relation to both general self-efficacy and efficacy in specific competencies. The devised scale for measuring self-efficacy was found to have a high level of internal reliability. The results indicated that the general self-perceived competence of occupational therapists for the whole sample was comparable to that of other professional groups, but that in the community-based sample it was significantly higher than that of social workers or nurses. In addition, occupational therapists in community settings had significantly higher general self-perceived competence than occupational therapists in hospital locations. Greater length of experience in mental health was strongly predictive of higher levels of competence for occupational therapists than for other professionals. The results suggest that occupational therapists have adapted well to the demands of multidisciplinary community practice. The possible reasons for these results, and the implications for competency-based recruitment and training, are presented.