Feasibility of conducting a palliative care randomized controlled trial in children with advanced cancer: assessment of the PediQUEST study

Pediatric palliative care randomized controlled trials (PPC-RCTs) are uncommon.

Australian PLT practitioners’ engagements with scholarship of teaching and learning

 Drawing on Bourdieu’s reflexive sociology and Certeau’s heterological science to investigate individual and extra-individual dimensions of Australian PLT practitioners’ engagements with scholarship of teaching and learning, this thesis identified obstacles and opportunities for recognition of professional legal education and training as emergent professional practice in law and education.

Predicting female depression across puberty : a two-nation longitudinal study

Objective: To prospectively examine the relation between pubertal stage and the onset and course of depressive symptoms.

Method: The design was a three-wave longitudinal study of health and social development using statewide community samples in Washington, United States, and Victoria, Australia. Approximately 5,769 students initially ages 10 to 15 years were assessed for depressive symptoms with the Short Mood and Feelings Questionnaire. Pubertal status was assessed using a self-report version of the Pubertal Development Scale.

Results: Advancing pubertal stage carried higher risks for depressive symptoms in female subjects in all of the three study waves. The pubertal rise in female depressive symptoms was due to both higher risk for incident cases and an even greater effect on risks for persistence of depressive symptoms. Report of poor emotional control 12 months earlier carried a twofold higher risk for incident depressive symptoms and largely explained the pubertal rise in female incident cases. High family conflict and severity of bullying also predicted persistence of depressive symptoms. Preexisting depressive symptoms were not associated with later increases in the rate of pubertal transition.

Conclusions: Advancing pubertal stage carries risks for both the onset and persistence of depressive symptoms in females. Social adversity around puberty predicts the persistence of symptoms but does not account for a pubertal rise in female depression. A report of poor emotional control may be a useful marker of girls at risk for depressive symptoms and as a target for preventive intervention.

Reliability and validity of the Melbourne edge test and high/low contrast visual acuity chart

Purpose. The purposes of the study were to investigate the test-retest reliability and the validity of new versions of the Melbourne Edge Test (MET) and the High/Low Contrast Visual Acuity (H/LCVA) chart and to investigate the agreement between the original and new versions.

Methods. The MET original photographic version, MET new light box version, H/LCVA Chart original photographic version, H/LCVA Chart new printed version, and the Pelli-Robson chart were administered twice to one eye of 22 subjects with low vision and 20 soft contact lenses wearers.

Results. For the low vision group, the test-retest 95% limits of agreement were ±5.2 dB for the MET new light box version and ±0.39 logarithm of the minimum angle of resolution (logMAR) for the LCVA component of the H/LCVA new printed version. For the soft contact lens group, the test-retest 95% limits of agreement were ±2.1 dB for the MET new light box version and ± 0.26 logMAR for the LCVA component of the H/LCVA new printed version. Moderate to high correlations were obtained between contrast sensitivity tests, thus providing evidence of validity. Scores obtained for the new test versions were significantly higher than the original versions (p < 0.01).

Conclusions. Of all the tests administered, the MET original photographic version and the Pelli-Robson Chart had the highest test-retest reliability for the low vision group. For the soft contact lens group, the H/LCVA original version (low contrast letters, 18% Weber) and the Pelli-Robson Chart had the highest reliability.

The development and validation of the impact of multiple sclerosis scale and the symptoms of multiple sclerosis scale

Objective

To develop and validate the Impact of Multiple Sclerosis Scale (IMSS) and the Symptoms of Multiple Sclerosis Scale (SMSS) using the Extended Disability Status Scale (EDSS) for construct validity.
Design

Panel design involving test-retest over 4 months.
Setting

A mailed survey.
Participants

Volunteers with a diagnosis of multiple sclerosis (MS) recruited from an MS support service in Australia: 193 people (mean age, 39y) and 150 people participated at time 1 and time 2, respectively.
Interventions

Not applicable.
Main Outcome Measures

Principal components analyses, the Cronbach α, and descriptive statistics for the 2 scales; correlations for construct validity with the EDSS and retest; and confirmatory factor analysis to test the stability of IMSS and SMSS components over time.
Results

The IMSS yielded 5 independent and reliable components; the SMSS yielded 3 components; both component structures were stable over time. These scales showed convergent validity with the EDSS.
Conclusions

The IMSS and SMSS are psychometrically sound scales suitable for clinical and research purposes to assess the symptoms and impact of MS.

Puberty and the onset of substance use and abuse

Objective: Substance abuse remains one of the major threats to adolescent health in Western cultures. The study aim was to ascertain the extent of association between pubertal development and early adolescent substance use.

Methods: The design was a cross-sectional survey of 10- to 15-year-old subjects in the states of Washington, United States, and Victoria, Australia. Participants were 5769 students in grades 5, 7, and 9, drawn as a 2-stage cluster sample in each state, and the questionnaire was completed in the school classrooms. The main outcomes of the study were lifetime substance use (tobacco use, having been drunk, or cannabis use), recent substance use (tobacco, alcohol, or cannabis use in the previous month), and substance abuse (daily smoking, any binge drinking, drinking at least weekly, or cannabis use at least weekly).

Results: The odds of lifetime substance use were almost twofold higher (odds ratio [OR]: 1.7; 95% confidence interval [CI]: 1.4–2.1) in midpuberty (Tanner stage III) and were threefold higher (OR: 3.1; 95% CI: 2.4–4.2) in late puberty (Tanner stage IV/V), after adjustment for age and school grade level. Recent substance use was moderately higher (OR: 1.4; 95% CI: 1.0–1.9) in midpuberty and more than twofold higher (OR: 2.3; 95% CI: 1.7–3.3) in late puberty. The odds of substance abuse were twofold higher (OR: 2.0; 95% CI: 1.2–3.2) in midpuberty and more than threefold higher (OR: 3.5; 95% CI: 2.2–5.4) in late puberty. Reporting most friends as substance users was more likely in the later stages of pubertal development, a relationship that accounted in part for the association found between later pubertal stage and substance abuse.

Conclusions: Pubertal stage was associated with higher rates of substance use and abuse independent of age and school grade level. Early maturers had higher levels of substance use because they entered the risk period at an earlier point than did late maturers. The study findings support prevention strategies and policies that decrease recreational substance use within the peer social group in the early teens.

Joint range of motion limitations in children and young adults with spinal muscular atrophy

Objectives
To elicit descriptive data about limited joint range of motion (ROM) in subjects with type II or III spinal muscular atrophy (SMA) and to examine the relation between the number of motions with limited range and both age and functional ability.
Design
Descriptive cross-sectional study.
Setting
Neurologic pediatric outpatient clinic at a hospital in Taiwan.
Participants
Twenty-seven subjects with SMA type II (mean age, 9.8±6.5y) and 17 with SMA type III (mean age, 12.2±8.7y).
Intervention
Measurement with transparent goniometers of joint ROM bilaterally of the shoulder, elbow, wrist, hip, knee, and ankle.
Main outcome measures
The proportion of participants with each ROM limitation compared with all participants with the same SMA type, age distribution of the participants with each ROM limitation, mean range loss of each motion limitation, and the contracture index (risk index of joint contracture).
Results
Eighty-nine percent of the participants with SMA type II experienced knee extension limitation. Approximately 50% of the participants with both types of SMA had ankle dorsiflexion limitation. The motions of knee and hip extension and ankle dorsiflexion also had a relatively high contracture index. The number of motions with limited range positively correlated (P<.001) with age and upper-extremity functional grade (the higher the functional grade, the poorer the functional ability) for SMA type II.
Conclusions
We found varying degrees of joint ROM limitation. Certain motions were noted to be high risks for the development of contractures. This risk was higher mostly in younger children.

Quality-of-life measurement in patients undergoing radiation therapy for head and neck cancer: a Hong Kong experience

The aims of this study are (1) to establish a reliable and valid quality-of-life (QOL) questionnaire for Chinese patients with head and neck (H&N) cancer who are treated with radiation therapy and (2) to evaluate the impact of the immediate side effects of treatment on the QOL of these patients. The 39-item "Quality of Life Radiation Therapy Instrument with Head and Neck Companion Module" (QOL-RTI/H&N) was translated into Chinese. In the reliability evaluation phase (study module 1), the questionnaire was administered twice to 56 H&N cancer patients, 7 days apart, during the second and third week of radiation therapy. In the validity evaluation phase (study module 2), 138 patients completed the QOL-RTI/H&N before starting and at the end of radiation therapy. Sixty-nine of these 138 patients also completed the QOL-RTI/H&N during the second week of their radiation therapy, at the same time as completing the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) questionnaire. Cronbach alpha coefficients were 0.88 for the general-tool QOL-RTI and 0.90 for the H&N subscale. Test-retest reliability was satisfactory with intraclass correlation coefficients of 0.89 for the general-tool QOL-RTI and 0.75 for the H&N subscale. The instrument can discriminate between patients with stage I or II disease and those with stage III or IV disease (P < .05). Concurrent validity was established by the good agreement with the FACT-H&N (r = 0.86, P < .001). A highly significant deterioration was in the QOL from the baseline to the end of treatment (mean difference for general tool = 1.95, P < .001; mean difference for H&N subscale = 4.85, P < .001). The Chinese QOL-RTI/H&N is a reliable and valid tool for determining the QOL in H&N cancer patients receiving radiation therapy. The immediate side effects of treatment had a significantly negative impact on the patients' QOL. The impact was relatively large for the functional and treatment-site aspects.

Critical perspectives on refugee policy in Australia : proceedings of the Refugee Rights Symposium hosted by the Institute for Citizenship and Globalisation, Faculty of Arts, Deakin University, December 5, 2002

Keynote addresses: What next for Australia's refugee policy? / Peter Mares -- One year after Tampa: refugees, deportees and TPVs / Chris Sidoti -- Academic papers: The tension of re-other-ing bodies / Snezana Dabic -- Acting for asylum: the nexus of pro-refugee activism in Melbourne / Helen Hintjens & Alison Jarman -- Biopolitics and the 'problem' of the refugee / Matthew Holt -- Temporary protection of refugees: Australian policy and international comparison / Fethi Mansouri & Michael Leach --The not-so-special benefit and non-mutual obligation: refugees on a TPV and income support arrangements / Greg Marston -- Family separation: Somali women in Melbourne / Celia McMichael & Malyun Ahmed -- Embodying exile: protest, performance, trauma and effect in the formation of East Timorese refugee identities / Amanda Wise -- Personal and Community Sector Perspectives -- A personal experience of the TPV policy / Mueen Al-Breihi -- A city of refuge?: protecting the social and cultural rights of refugees in Brisbane / Renae Mann -- Temporary protection visas, recovery from trauma and personal identity / Helen Martin -- All I ask for is protection: young people seeking asylum in Australia / Samira Mohamed.

Economic reforms, cultural policy : opportunities and challenges to the arts and culture in Vietnam in the age of globalization

The author investigates social change in Vietnam in the late 1980s-2000s, a transition from a subsidized economy to a market-oriented economy. The author discusses the influences of socioeconomic changes on the operation of the performing arts sector through analyzing changes in cultural policies, opportunities, and challenges confronted by performing arts organizations. The new cultural policy allows arts organizations, arts managers, and artists more opportunities to develop a greater degree of autonomy and more freedom in performing, programming and other artistic activities. The author believes that open policies will motivate Vietnam to develop its own national identity and to participate in cultural exchange with other parts of the world. However, under the impact of global culture, global economics, cuts in state funding, and rapid technological development, the performing arts sector has faced challenges in terms of financial viability, audience development, and balance between commercialization and artistic creativity. The author suggests that privatization should be implemented depending on the art form. Consideration should be given by the Vietnamese government to implementing appropriate funding policies and schemes, as state funding still forms a significant part of public companies' incomes.

I'm here to save you : a case study of the arts and managerialism in Australia

Managerialism has been adopted with alacrity by Australian government agencies across multiple sectors. A few studies of managerialism in concept and practice have been undertaken in some public sectors. Here we challenge the appropriateness and effectiveness of new managerialism generally, and for the arts in particular, through an analysis of conflict between an artistic director, the general manager(s), and the board of directors in a community arts organization. We outline the implications of the implementation of managerialism for the organization generally and the implications specifically for the workplace rights of some of the artistic and administrative staff. We call for further research into the appropriateness of management theory and practice for the arts, and we seek new ways of managing our cultural capital.