A boarding school outbreak of pertussis in adolescents : value of laboratory diagnostic methods

Culture for Bordetella pertussis (B. pertussis) is the traditional gold standard for laboratory diagnosis of pertussis but is insensitive, especially later in the course of illness and in vaccinated persons. Interpretation of serology is limited by the lack of an appropriate reference standard. An outbreak of pertussis in a crowded boarding-school dormitory allowed evaluation of laboratory correlates of infection. Questionnaires, serum samples and throat swabs were collected from members of the exposed group. Serum samples from unexposed controls of a similar age group were used for comparison. B. pertussis PCR was performed on throat swabs, and sera were tested for IgA antibodies against whole-cell (WC) B. pertussis antigen and IgG antibodies to pertussis toxin (PT). The Centers for Disease Control and Prevention definition for pertussis was used to define clinical cases. We evaluated the use of a previously published cut-off for PT IgG of 125 EIA units (EU)/ml. Completed questionnaires were obtained from 115 students, of whom 85 (74%) reported coughing symptoms, including 32 (28%) who met the clinical case definition for pertussis. B. pertussis was detected by PCR in 17 (15%) and WC IgA in 22 (19%) students; neither correlated with symptoms, but dormitory of residence strongly predicted PCR status. The mean PT IgG geometric mean concentration, in this situation of high pertussis exposure, correlated with severity of symptoms and was significantly higher in both symptomatic and asymptomatic children exposed during the outbreak (P<0·001) than in control children. A cut-off for PT IgG of 125 EU/ml was too high in an outbreak situation to be sensitive enough to identify pertussis cases. A case of pertussis in a crowded boarding-school dormitory resulted rapidly in an outbreak. Serology and PCR were useful in identifying the outbreak and commencing disease control measures. The use of serology has mostly been evaluated in community serosurveys, where it is not possible to determine if immunity reflects vaccination, asymptomatic disease or symptomatic disease. This outbreak gave us the opportunity to evaluate the value of serology and PCR in the presence of confirmed exposure to pertussis.

The educative value of values

There appears to be increasing interest among certain educational institutions to include values as a prominent feature of their practice (Buckley & Erricker, 2004). One recent example is the Victorian Curriculum Assessment Authority (VCAA) who released a discussion paper earlier this year, which indicates that values are to play a much greater role in government schools. However, endeavouring to promote values as common standards can be criticised to be problematic in our pluralist society, because not all values are necessarily valuable.

This paper reviews the VCAA paper and attempts to respond to Nietzsche’s (1998) challenge to question the value of our values, by offering guidance as to how the educative value of values might be determined. Such an examination is expected to identify a potential tension between a particular civic education and that of a more philosophic and universally educative perspective. In order to do this, a differentiation between a value (noun) as ‘objective fact’ and value (verb) as a ‘subjective relation’ is made. This paper will adopt an existential perspective by drawing upon consequentialism, intentionality and the works of Kierkegaard and Dewey, to argue that emphasis should be placed on the subjective aspects of educative valuing without fostering an objective/subjective divide.

The educative value of Dewey's religious attitude for spirituality

John Dewey's 'religious attitude' has great potential for the educative development of children's spirituality. This is because it enables their spiritual understandings to become more intelligently composed - not just in a cognitive or hyper-rational sense, but as a way of being. This paper provides an outline of Dewey's approach, which is described as being democratic, inquiry based, and 'scientific'. Such an approach therefore offers a contrast to other more epistemologically focused curricula which attempt to educate a person's spirituality. In order to make the case for the potential educative value of such an attitude, a brief review of Dewey's approach to education shall be offered, in which the notions of inquiry, democracy, and 'science' shall be highlighted to make the case that such attributes might be necessary for spiritual education if the United Nations Educational and Scientific Organization's goal of attaining world peace is to ever become possible.

Improving the value of the national curriculum through ethics and the religious

Ethics and religion are currently being considered for inclusion into Australia's national curriculum. This paper argues that such a consideration ought to be founded upon an education for democracy, where students are encouraged to become critical inquirers. It is also contended here that an engagement with ethics and the religious has a lot of potential for enhancing the educative value of our national curriculum because currently ACARA lacks any aspirational purposes for education and is merely focused upon the technical concerns regarding teaching and learning.

Cross-cultural adaption of the Health Educaiton Impact Questionnaire: experimental study showed expert committee, not back-translation, added value

Objectives
To assess the contribution of back-translation and expert committee to the content and psychometric properties of a translated multidimensional questionnaire.

Study Design and Setting
Recommendations for questionnaire translation include back-translation and expert committee, but their contribution to measurement properties is unknown. Four English to French translations of the Health Education Impact Questionnaire were generated with and without committee or back-translation. Face validity, acceptability, and structural properties were compared after random assignment to people with rheumatoid arthritis (N = 1,168), chronic renal failure (N = 2,368), and diabetes (N = 538). For face validity, 15 bilingual people compared translations quality with the original. Psychometric properties were examined using confirmatory factor analysis (metric and scalar invariance) and item response theory.

Results
Qualitatively, there were five types of translation errors: style, intensity, frequency/time frame, breadth, and meaning. Bilingual assessors ranked best the translations with committee (P = 0.0026). All translations had good structural properties (root mean square error of approximation <0.05; comparative fit index [CFI], ≥0.899; and Tucker–Lewis index, ≥0.889). Full measurement invariance was observed between translations (ΔCFI ≤ 0.01) with metric invariance between translations and original (lowest ΔCFI = 0.022 between fully constrained models and models with free intercepts). Item characteristic curve analyses revealed no significant differences.

Conclusion
This is the first experimental evidence that back-translation has moderate impact, whereas expert committee helps to ensure accurate content.

Resolving the theory of planned behaviour's ‘expectancy-value muddle’ using dimensional salience

The theory of planned behaviour is one of the most widely used models of decision-making in the health literature. Unfortunately, the primary method for assessing the theory's belief-based expectancy-value models results in statistically uninterpretable findings, giving rise to what has become known as the ‘expectancy-value muddle’. Moreover, existing methods for resolving this muddle are associated with various conceptual or practical limitations. This study addresses these issues by identifying and evaluating a parsimonious method for resolving the expectancy-value muddle. Three hundred and nine Australian residents aged 18–24 years rated the expectancy and value of 18 beliefs about posthumous organ donation. Participants also nominated their five most salient beliefs using a dimensional salience approach. Salient beliefs were perceived as being more likely to eventuate than non-salient beliefs, indicating that salient beliefs could be used to signify the expectancy component. The expectancy-value term was therefore represented by summing the value ratings of salient beliefs, an approach that predicted attitude (adjusted R 2 = 0.21) and intention (adjusted R 2 = 0.21). These findings suggest that the dimensional salience approach is a useful method for overcoming the expectancy-value muddle in applied research settings.

Resolving the value of the dingo in ecological restoration

There is global interest in restoring populations of apex predators, both to conserve them and to harness their ecological services. In Australia, reintroduction of dingoes (Canis dingo) has been proposed to help restore degraded rangelands. This proposal is based on theories and the results of studies suggesting that dingoes can suppress populations of prey (especially medium- and large-sized herbivores) and invasive predators such as red foxes (Vulpes vulpes) and feral cats (Felis catus) that prey on threatened native species. However, the idea of dingo reintroduction has met opposition, especially from scientists who query the dingo's positive effects for some species or in some environments. Here, we ask 'what is a feasible experimental design for assessing the role of dingoes in ecological restoration?' We outline and propose a dingo reintroduction experiment-one that draws upon the existing dingo-proof fence-and identify an area suitable for this (Sturt National Park, western New South Wales). Although challenging, this initiative would test whether dingoes can help restore Australia's rangeland biodiversity, and potentially provide proof-of-concept for apex predator reintroductions globally.

Price divergence from fundamental value and the value relevance of accounting information

By employing two alternative measures of fundamental value, we reexamine the value relevance of accounting information over time. Consistent with some recent studies, we do not find evidence on the temporal decline in R 2s of conventional value-relevance regressions when the stock price is replaced by these measures as the dependent variable. Further, our results show that the divergence between fundamental value and the prevailing stock price (a) increases over time and (b) is associated with measures of noise trading and other arbitrage risks and costs. Additional analyses also reveal that proxies measuring the extent of noise trading increase over time. Overall, we do not find evidence that there is a loss over time in the value relevance of accounting information with respect to fundamental value. More importantly, we show that measures of price divergence are associated with noise trading as well as other arbitrage costs and risks (such as transaction costs and information uncertainty) that prohibit market prices from converging to fundamental values.