Quality of life in restless legs syndrome: A systematic review of clinical trials and a critical review of instruments

Restless legs syndrome (RLS) is a neurological movement disorder characterized by sensory symptoms and motor disturbances. While the underlying cause remains unknown, it is suggested that 20–25% of people with RLS are affected seriously enough to require pharmacological treatment. Dopamine agonists (DAs) are the most common treatment and act by increasing the low levels of dopamine to which RLS is often attributed. A growing literature highlights the debilitating and distressing nature of this condition from the patient's perspective. While sleep problems are most commonly reported, the impact of RLS on quality of life (QOL) is wide ranging, affecting relationships with partners, sex life, family life, social life, leisure activities, friendships, everyday activities, concentration, travel, career/work, sleep, and health.

We conducted a systematic review of clinical trials in which DAs have been evaluated in terms of RLS-specific QOL, i.e. their impact on the QOL of people with RLS, and critically reviewed the development history and measurement properties of RLS-specific QOL instruments.

A systematic search using terms synonymous with RLS, DAs and QOL was conducted using Scopus software, which includes MEDLINE, PsycINFO, EMBASE, and CINAHL. Our search covered publications from 2000 (prior to which RLS-specific QOL measures did not exist) to August 2009. Trials were included in our review if they evaluated DAs for the treatment of adults with RLS and reported evaluation using an RLS-specific QOL measure. We also ran citation searches to identify papers reporting the development history and measurement properties of the identified RLS-specific QOL instruments.

Three measures of RLS-specific QOL have been developed in recent years and are reviewed here: the Restless Legs Syndrome Quality of Life (RLSQOL) questionnaire, the Restless Legs Syndrome Quality of Life Instrument (RLS-QLI), and the Quality of Life Restless Legs Syndrome (QOL-RLS) measure. Critical review indicates that each has limitations (particularly in terms of published developmental history and content validity). Eleven trials of DAs were identified that included assessment of RLS-specific QOL (nine using the RLSQOL and two using the QOL-RLS). In all studies, significant improvements in RLS-specific QOL were observed, although these were mostly short term (12 weeks) and large placebo effects were also noted.

In people with RLS, the use of DAs has been shown to improve RLS-specific QOL. Longer-term, large-scale studies may be needed to confirm these findings and demonstrate statistically significant improvements in RLS-specific QOL at lower doses. Further development of the RLS-specific QOL measures is needed to ensure that the full impact of RLS (and the full benefit of new treatments) on aspects of life identified as important to individuals is captured in future studies.

Expanding the horizons of accounting education : incorporating social and critical perspectives

This paper examines a case of accounting education change in the context of increased interest in ethical, social, and environmental accountability, presenting a reflexive case study of a new university accounting subject incorporating social and critical perspectives. Foundational pedagogical principles and key aspects of curriculum are outlined. The pedagogy draws on the integration of humanistic and formative education (principally based on Gramscian and Freirean approaches) and deep and elaborative learning. Two key aspects of curriculum and pedagogy are analysed. First, a curriculum based on a broad conception of accounting and accountability as power-laden social processes, drawing on a range of research literature. Second, the adoption of an authentic, supportive, and collegial team teaching approach. Students’ feedback relating to identified issues is presented. The paper contributes to the renewal of the social and ethical worth of accounting education, concluding that deep accounting educational change encompasses both the content and practice of classroom activity and changes in the self-consciousness of staff and students.

Maternal vitamin D in pregnancy may influence not only offspring bone mass but other aspects of musculoskeletal health and adiposity

Osteoporotic fractures, falls and obesity are major health problems in developed nations. Evidence suggests that there are antenatal factors predisposing to these conditions. Data are emerging from Australia and elsewhere to suggest that maternal vitamin D status in pregnancy affects intrauterine skeletal mineralisation and skeletal growth together with muscle development and adiposity. Given that low levels of vitamin D have been documented in many urbanised populations, including those in countries with abundant sunlight, an important issue for public health is whether maternal vitamin D insufficiency during pregnancy has adverse effects on offspring health. The developing fetus may be exposed to low levels of vitamin D during critical phases of development as a result of maternal hypovitaminosis D. We hypothesise that this may have adverse effects on offspring musculoskeletal health and other aspects of body composition. Further research focused on the implications of poor gestational vitamin D nutrition is warranted as these developmental effects are likely to have a sustained influence on health during childhood and in adult life. We suggest that there is a clear rationale for randomised clinical trials to assess the potential benefits and harmful effects of vitamin D supplementation during pregnancy.

Designing online role plays with a focus on story development to support engagement and critical learning for higher education students

Online role plays, as they are designed for use in higher education in Australia and internationally, are active and authentic learning activities (Wills, Leigh & Ip, 2011). In online role plays, students take a character role in developing a story that serves as a metaphor for real-life experience in order to develop a potentially wide range of subject-related and generic learning outcomes. The characteristics of these stories are rarely considered as factors in the design―and success―of these activities. The unspoken cultural assumptions, norms and rules in the stories that impact on the meanings students make from their experiences are also rarely scrutinised in the online role play literature. This paper presents findings from a case study of an asynchronous text-based online role play involving politics and journalism students from three Australian universities. The findings highlight the centrality of students’ collaborative story-building activity to their engagement and learning, including their development of critical perspectives. The study underlines the importance of certain aspects of the role play's design to support students' story-building activity.

A critical evaluation and comparison of two formative measures of system quality using criterion variables

Evaluating the validity of formative variables has presented ongoing challenges for researchers. In this paper we use global criterion measures to compare and critically evaluate two alternative formative measures of System Quality. One model is based on the ISO-9126 software quality standard, and the other is based on a leading information systems research model. We find that despite both models having a strong provenance, many of the items appear to be non-significant in our study. We examine the implications of this by evaluating the quality of the criterion variables we used, and the performance of PLS when evaluating formative models with a large number of items. We find that our respondents had difficulty distinguishing between global criterion variables measuring different aspects of overall System Quality. Also, because formative indicators “compete with one another” in PLS, it may be difficult to develop a set of measures which are all significant for a complex formative construct with a broad scope and a large number of items. Overall, we suggest that there is cautious evidence that both sets of measures are valid and largely equivalent, although questions still remain about the measures, the use of criterion variables, and the use of PLS for this type of model evaluation.

A critical pedagogy of embodied education : learning to become an activist

Unlike any current publication on social purpose education, this book explores the differences and similarities between two groups of activists: lifelong activists who have been engaged in campaigns and socials movements over many years and circumstantial activists, those protestors who come to activism due to a series of life circumstances. Using empirical research conducted in Australia, Tracey Ollis outlines the pedagogy of activism and the process of learning to become an activist.

Temporal patterning of competitive emotions : a critical review

An interactional model of stress that integrates current research on competitive affects and emphasizes the temporal dimensions of the stress process is forwarded. The literature reveals that the study of athletes' affective responses to competition has been narrowly focused on pre-competitive anxiety. Equivocal findings on temporal patterning of competitive anxiety suggest that a fundamental change in the empirical approach is needed because the current conceptualization of anxiety and other complex emotions is imprecise. The analysis of secondary emotions as patterns of discrete basic emotions, as suggested by differential emotions theorists, is proposed for consideration in future research. In this view, competitive anxiety is considered as a set of patterns of emotions rather than a unitary affect. The adoption of this approach could result in better operationalization of competitive anxiety as well as other secondary performance-related emotions. We propose that research on competitive affects should follow two parallel lines. The first should focus on the description of complex emotional states that reflect the idiosyncratic emotional experience and vocabulary of the athlete. The second should examine the sets of basic emotions experienced throughout competition, and focus on individual differences and factors determining those differences. The integration of the two approaches could lead to a better understanding of whether, how and why individuals differ in the interpretation of specific secondary emotions and their effect on performance. Moreover, it would permit the analysis of intra-individual variations in labelling secondary emotions with respect to different competitive contexts and temporal aspects.

Critical evaluation of the nursery role hypothesis for seagrass meadows

The vast majority of published papers concerning seagrass meadows contain statements to the effect that seagrass beds serve as important nurseries for many species. We reviewed more than 200 papers that were relevant to the nursery role hypothesis. We used both vote counting and meta-analytic techniques to evaluate whether the body of previous studies that report seagrass meadows to be nursery grounds actually contain data that support this proposition. We restricted our analyses to papers that compared seagrass beds to other habitats, and examined data on a variety of well-studied species concerning their density, growth, survival and migration to adult habitat. Within this group of papers, we considered potential factors that could influence the nursery function (e.g. location, or laboratory vs field studies). We also evaluated case histories of well-documented large-scale seagrass losses on the nursery function. Major results were consistent with the expectations that abundance, growth and survival were greater in seagrass than in unstructured habitats. Abundance data also suggested that seagrass beds in the Northern Hemisphere might be more important as nursery areas than those in the Southern Hemisphere. Surprisingly, few significant differences existed in abundance, growth or survival when seagrass meadows were compared to other structured habitats, such as oyster or cobble reefs, or macroalgal beds. Nor were there decreases in harvests of commercially important species that could clearly be attributed to significant seagrass declines in 3 well-studied areas. However, there were decreased abundances of juveniles of commercially important species in these areas, suggesting a strong link between seagrass abundance and those of juvenile finfish and shellfish. One important implication of these results is that structure per se, rather than the type of structure, appears to be an important determinant of nursery value. Clearly, more rigorous studies that test all aspects of the nursery role hypothesis are clearly needed for seagrass meadows as well as other structured habitats. The results of such studies will allow better decisions to be made concerning the conservation and restoration of marine habitats.

Quantitative studies of student self-assessment in higher education: a critical analysis of findings

Student self-assessment occurs when learners make judgements about aspects of their own performance. This paper focuses on one aspect of quantitative self-assessments: the comparison of student-generated marks with those generated by teachers. Studies including such comparisons in the context of higher education courses are reviewed and the following questions are addressed: (i) do students tend to over- or under-rate themselves vis-á-vis teachers?, (ii) do students of different abilities have the same tendencies?, (iii) do students in different kinds or levels of course tend to under- or over-rate themselves?, (iv) do students improve their ability to rate themselves over time or with practice?, (v) are the same tendencies evident when self-marks are used for formal assessment purposes?, and (vi) are there gender differences in self-rating? The paper also discusses methodological issues in studies of this type and makes recommendations concerning the analysis and presentation of information.

Treatment of textile wastewater with membrane bioreactor: a critical review

Membrane bioreactor (MBR) technology has been used widely for various industrial wastewater treatments due to its distinct advantages over conventional bioreactors. Treatment of textile wastewater using MBR has been investigated as a simple, reliable and cost-effective process with a significant removal of contaminants. However, a major drawback in the operation of MBR is membrane fouling, which leads to the decline in permeate flux and therefore requires membrane cleaning. This eventually decreases the lifespan of the membrane. In this paper, the application of aerobic and anaerobic MBR for textile wastewater treatment as well as fouling and control of fouling in MBR processes have been reviewed. It has been found that long sludge retention time increases the degradation of pollutants by allowing slow growing microorganisms to establish but also contributes to membrane fouling. Further research aspects of MBR for textile wastewater treatment are also considered for sustainable operations of the process.

A survey on mechanisms and critical parameters on solidification of selective laser melting during fabrication of Ti-6Al-4V prosthetic acetabular cup

Additive Manufacturing (AM) includes a range of approaches that correlate with computer aided design (CAD) and manufacturing by fabrication via precise layers and is a promising method for the production of medical tools. In this study, different aspects and mechanisms of solidification for curved surfaces based on equilibrium at curved interfaces, Monge patch, interfacial and Gibbs energy will be discussed. Also, the effect of capillarity, geometry, substrate temperature, cooling rate and scanning parameters in the solidification of a prosthetic acetabular cup (PAC) using selective laser melting (SLM) is analysed. The contributions of this work are analysing solidification and effective factors in this process to produce parts with a higher quality and mechanical properties such as strength, strain, porosity, relative density and hardness. Results indicate that due to the surface to volume (S/V) ratio, and the increasing effect of the radius on Monge patch, thermal stresses and surface forces are more prevalent on outer surfaces. Moreover, solidification and mechanical properties are related to capillarity, geometry, substrate temperature, cooling rate, scanning power and speed. The results also indicate the interaction of solute diffusion and heat transfer with interatomic forces in large S/V ratio and at small scales tend to improve solidification.