Do mass media campaigns capture and describe the experience of stroke symptoms?

Introduction: In 2006, the National Stroke Foundation of Australia launched the FAST (Face, Arm, Speech)/ Signs of Stroke (SOS) (5 symptom categories) campaigns designed to improve public awareness of stroke symptoms and the sense of urgency to present to hospital. However, there is little published review of how well such campaigns capture and describe the experience of stroke. This study aims to examine the awareness, content and language of the FAST/SOS campaigns by those experiencing stroke symptoms.
Methods: Interviews were conducted with either the stroke patient or a witness (incapacitated patients) whilst an inpatient at Box Hill or Maroondah Hospitals between August 2006 through April 2008. They were asked to describe awareness of campaigns, symptoms experienced (recorded verbatim and coded into campaign symptom categories) and to evaluate the descriptions of “Signs of Stroke” against their own experience (exact, somewhat, or not at all).
Results: Of 239 eligible stroke cases, 167 (70%) were interviewed (100 patients and 67 witnesses). Few (n= 20, 12%) were aware of the FAST campaign and only 16% recalled all three symptoms. Most recalled that it was “something” to do with the face, however facial droop (n=6) was less commonly experienced compared to speech impairments (n=16) and arm drift (n=13). FAST symptoms detected 84% (patients 77% and witnesses 94%) and SOS symptoms 100% of stroke patients. Patients not describing a FAST symptom (n=27) described: arm or hand numbness; hand incoordination; leg impairments; vision disturbances; or collapse. Approximately, half of patients and witnesses thought the SOS descriptions of the most commonly detected symptoms (arm/leg/face weakness or paralysis or numbness and speech impairments) exactly described the experience. Common language used to describe symptoms were: incoordination of hands or limbs; sudden difficulty walking; drooped/dropped face or mouth; slurred or loss of speech; pins and needles or tingling.
Conclusion: Both campaigns identified symptoms most commonly detected in those experiencing and reacting to symptoms. Both campaigns could portray symptoms more realistically using common descriptors without impacting on the simplicity of the messages

Learning to be a teacher - examining the role of self-as-researcher in a phenomenological study

Many qualitative studies position the researcher as either an impartial observer or as an active participant in any given gathering of humanistic data. This paper presents the researcher in a different paradigm and emphasises the importance of the researcher's story being told as well as those of the participants. The paper presents the research of a doctoral study that used a phenomenological framework and adopted a narrative inquiry approach. Narrative inquiry was used as it recognised that particular research interests often have their genesis in the researcher’s own experience and background. This study focused on how you can explore the role of self-as-researcher in order to be open to listen and report on the findings of those who we study.

Cost-effectiveness of a post-splenectomy registry for prevention of sepsis in the asplenic

Background: Overwhelming, sometimes fatal infections represent a lifelong risk after surgical removal of the spleen, or in patients who develop hyposplenism as a consequence of illnesses. This risk may be reduced by all or a combination of vaccination, antibiotic prophylaxis and education. We aimed to determine if a registry approach to delivering these interventions would be cost effective using our own experience and published data.
Method: The decision model compared a cohort of 1,000 people covered by a registry to a cohort of 1,000 people with no registry. The impact of the registry was assessed in terms of achieved rates of vaccination, chemoprophylaxis and education, consequent outcomes of overwhelming post-splenectomy infection (OPSI) and mortality (years of life lived). The cost-effectiveness of the registry compared with no registry was estimated in terms of additional cost per case of OPSI avoided and as additional cost per life year gained.
Results: In the first two years, the additional cost of the registry was $152,611 per case of OPSI avoided or $205,931 per life year gained. After this initial registration period the costeffectiveness improves over time, such that over the cohort lifetime a post-splenectomy register is associated with an additional cost of $105,159 per case of OPSI avoided or $16,113 per life year gained.
Conclusion: A registry-based approach is likely to prove cost effective in terms of mortality and rates of OPSI avoided.

Unfree associations : inside psychoanalytic institutes

In an age of managed care and new biological therapies for mental illness, psychoanalysis is generally seen as a 'profession on the ropes' whose hour is up. What went wrong? While external factors have played their part in the fall of psychoanalysis, psychoanalysts have generally disregarded their own crucial role in creating this decline. This thesis examines this role as played out through their own institutions, the freestanding psychoanalytic institutes. Freud was an explorer but he also codified his ideas. His work has been taken as an inspiration to explore without presuppositions but also as Holy Writ. Psychoanalysis deals with emotions and excites passions. Like religion, psychoanalysis asks big questions, and, like religion, is easily influenced and seduced by dogmatic answers to these difficult questions. Psychoanalytic institutes have been notable as closed shops. Their solid walls have kept them sealed off and mysterious to the outside world, including the mental health professions and the academy. Authoritarian cliques, power struggles and intrigues have predominated inside the institutes. Institute life has been secret, the subject of rumour rather than knowledge. Insiders often know little about of other institutes (unless they are involved in site visits to particular institutes). Sometimes, insiders have a limited view of their own institutions because they see them through the vantage points of their own experience and that of some close colleagues. I have interviewed central participants of the dramas of the histories of some key psychoanalytic institutes in the US. For the first time, this thesis recounts the intricate inside history of these organizations. The thesis reveals the detailed inner political histories of arguably the four most important and varied psychoanalytic institutes affiliated with the APsaA. The New York Psychoanalytic Institute was the first and for decades the prestigious institute which set the model for many others. It became pre-eminent on a world scale with the immigration of leading European analysts fleeing the Nazis. The Boston Psychoanalytic Society and Institute, the Chicago Psychoanalytic Institute and the Los Angeles Psychoanalytic Society and Institute are quite varied in their organization and histories. The cultures are often quite different yet many of the problems will be found to be similar at base. I first examine the detailed political history of the New York Psychoanalytic Institute which provides a quintessential example of analytic anointment in practice, together with its pitfalls. I then examine a split that occurred in the Boston Psychoanalytic Society and Institute, which demonstrates some of the tensions and ambiguities that seem inherent in psychoanalytic organizations, especially where society and institute are part of the same institution. I move on to investigate a very different history in the Chicago Psychoanalytic Institute, which is quite differently organized: in Chicago, the institute with a lay Board of Trustees is quite separate from the society, and has for most of its history been headed by a powerful director. Then I look at the very complex history of the Los Angeles Psychoanalytic Society and Institute which in the 1970s came very close to being closed down by the APsaA. The Los Angeles Institute history is especially colourful and informative, given the introduction of Kleinian and object relations ideas into the institute and the reactions to them. These histories provide dramatic insights into what psychoanalysts and their institutions have contributed to what has gone wrong with psychoanalysis from the basis of a critique. A major aspect of the problem, in my view, is that a basically humanistic discipline has conceived and touted itself as a positivist science while organizing itself institutionally as a religion. I argue that psychoanalysts approach psychoanalysis with an inappropriate paradigm, 'as if it were a science. Their systemic misconception of their own discipline, and the resultant, widespread creation of what Christopher Bollas calls a 'false expertise' contributes to their present-day decline. I argue that qualification from an institute assumes the transmission of a body of knowledge which has not really been established as knowledge. This presumed knowledge is then transmitted by means of anointment reminiscent of the Bible. There is no unified body of knowledge within the psychoanalytic field nor is there a unified practice that can be readily empirically tested. Therefore, by default, psychoanalytic education has become a process of anointment, transmission through a subjective process akin to consecration. The large gap between the small knowledge base of psychoanalysis and the high level of 'pretend' knowledge which is inculcated during training and upon which qualification is based entrench conditions which themselves make real knowledge in this complex field more and more difficult to attain. This argument has implications not only for psychoanalysis but for many other professions where knowledge and qualification have unrealistic and inappropriate bases.

Master planned estates : parish or panacea?

Master planned estates in Australia emerge from two major directions: one aims to address the inadequacies of 1970s suburbanisation and the other comes from governments and developers seeking to realise alternatives. The very idea of master planning has a longer history, one that arguably dates back to 19th-century Utopian Socialism and Baron Haussmann's redesign of Paris, which involved a large-scale, comprehensive alternative vision realised by a sanctioned authority. Master planning thereby partakes of both utopianism and authoritarianism. These associations have infused the discussion and construction of Australian master planned estates rendering them both pariah and panacea. But research and my own experience suggests that they are far more panaceas than pariahs.

Japanese lesson study : teacher professional development through communities of inquiry

Japanese Lesson Study has come under increasing attention from educators in the West and throughout South-East Asia since it was revealed outside Japan through the release of the TIMSS Video Study. In this paper we argue that Japanese Lesson Study provides a model for large scale, sustainable professional development. In particular, we draw on our own experience of Japanese Lesson Study and the research literature to describe its characteristic features and examine some of the cultural assumptions that underpin its implementation.

Meaningful mathematics in the middle years

This paper describes an action research project that investigated issues concerning the teaching and learning of numeracy in the middle years. Building on research concerning the middle years of schooling, and their own experience of teaching mathematics in years 5 - 8, a group of teachers, drawn from four schools, trialed strategies intended to improve the engagement, attitudes and outcomes of their students in mathematics. The group recommended at the end of the study that mathematics needs to be meaningful for young adolescents. The concept of meaningful mathematics is explored through a description of the actions and findings of the teachers participating in this project.

A unified formalism for landmark based representation of maps and navigation plans

We present a unified formalism for representing maps and using them for constructing plans of navigation for an autonomous agent. The foundation of this work lies in addressing key questions that an agent is confronted with when navigating. That is, besides the main task of how to reach the intended destination from the current position, the agent faces other questions like: where am I? what landmarks can I see? where is my destination relative to me and the landmarks I am seeing? Fundamental to this representation is the use of visual landmarks, which are used as pivotal points in the landscape being described. Further, in the representation of spatial information and navigation there are three different viewpoints: first, the localized representation from the viewpoint of a sighted, mobile agent; second, the static representation seen by the map-maker; and third, the view of an external agent giving directions on the basis of his own experience/knowledge. The major contribution of this map model and the associated navigation method lies in the framework which unifies these three different points of view. This unification enables the agent to make no distinction in terms of following implicit instructions contained in a map and the directions given by external agents.

Exploring a recently developed census population model of the diversity of the sixteen psychological types in Australia

It is important for practitioners to know about the distribution of the sixteen psychological types in the country in which they operate. For instance: Are more females with Feeling preferences found in particular occupational categories? Can you make valid distinctions on the basis of the types found in sales workers compared with other categories? What are the differences in the Australian distribution of psychological types compared with the UK and USA? Participants in this workshop will be encouraged to make connections between their own experience of the diversity of types and a recently developed Australian Census Population Type Table which for the first time approaches a national probability sample. We will explore the patterns of type distribution in Australia, and compare the data with national population Type Tables developed in the UK and the USA.

Illness in old age is part of an individual's fate and must be approached with acceptance

Older members of the Greek community see aging and the ill health that may accompany it as an inevitable part of life. They associate illness very closely with God’s will, and largely believe their state of health is an aspect of fate and / or luck that they do not have control over and must simply accept. This paper, based on research conducted in Melbourne, Australia, describes the way in which the experience of old age is understood in the worldview of this group. The words fate and luck (τύχη = tyche; γραφτό = graphto) are often used by older Greeks to characterize their situation. Luck, to this group, is not random. The term (τύχη) was used in classical times to refer to a kind of minor deity that controlled the fortune of the Greek city states, and an element of this idea of intention remains today. In the modern context, luck comes from God, and for this group, is part of γραφτό, or destiny, something that is written. In its usual usage in Greek, γραφτό refers to something that must happen to a person because it is predetermined and cannot not occur. The meaning that these older Greek individuals give to the word luck in the modern world is manifested in their acceptance of the problems of aging and their approach to coping with their own experience.

Witness recall across repeated interviews in a case of repeated abuse.

In this illustrative case study we examine the three forensic interviews of a girl who experienced repeated sexual abuse from ages 7 to 11. She disclosed the abuse after watching a serialized television show that contained a storyline similar to her own experience. This triggered an investigation that ended in successful prosecution of the offender. Because this case involved abuse that was repeated on a weekly basis for 4 years we thus investigated the degree to which the child's narrative reflected specific episodes or generic accounts, and both the interviewer's and child's attempts to elicit and provide, respectively, specific details across the 3 interviews collected in a 1 month period. Across the 3 interviews, the child's account was largely generic, yet on a number of occasions she provided details specific to individual incidents (episodic leads) that could have been probed further. As predicted: earlier interviews were characterized more by episodic than generic prompts and the reverse was true for the third interview; the child often responded using the same style of language (episodic or generic) as the interviewer; and open questions yielded narrative information. We discuss the importance of adopting children's words to specify occurrences, and the potential benefits of permitting generic recall in investigative interviews on children's ability to provide episodic leads. Despite the fact that the testimony was characterized by generic information about what usually happened, rather than specific episodic details about individual occurrences, this case resulted in successful prosecution.

Material damage: expanded cinema

Over a 35 year career de Bruyn’s bracing and immersive work has investigated legacies of trauma anddisplacement, dealing with the residue of the white Australia policy and his own experience ofchildhood migration to Australia from Holland.In recent years de Bruyn has presented his hand drawn 16mm animation films as performances, withde Bruyn manipulating the images live, and accompanying them with a live vocal soundtrack. returnsto Auckland to deliver an expanded cinema performance for 16mm projectors and voice.

In the circle of white stones: moving through seasons with nomads of Eastern Tibet

This narrative of subsistence on the Tibetan plateau describes the life-worlds of people in a region traditionally known as Kham who move with their yaks from pasture to pasture, depending on the milk production of their herd for sustenance. Gillian Tan's story, based on her own experience of living through seasonal cycles with the people of Dora Karmo between 2006 and 2013, examines the community's powerful relationship with a Buddhist lama and their interactions with external agents of change. In showing how they perceive their environment and dwell in their world, Tan conveys a spare beauty that honors the stillness and rhythms of nomadic life.

(Re)examining identities: working with diversity in the pre-service teaching experience

Australia, like the United States (US) and the United Kingdom (UK), continues to experience a mismatch between the cultural backgrounds and socio-economic class of teachers and those of the students they work with. This article reports on a study that explored how a group of Australian teacher-education students understand their own ethnic and socio-economic class identities and how they work with students of ethnic and class backgrounds different from their own. Analysis of data from interviews and focus groups with the student-teachers is presented to highlight how they make sense of difference and how they take up the challenges of teaching for diversity. The paper raises issues and concerns regarding how diversity and difference might be addressed in teacher education.

In their own words : a qualitative study of the reasons Australian university students plagiarise

The ways in which universities and individual academics attempt to deter and respond to student plagiarism may be based on untested assumptions about particular or primary reasons for this behaviour. Using a series of group interviews, this qualitative study gathered the views of 56 Australian university students on the possible reasons for plagiarism within their institution. The results indicate a wide and disparate range of possible contributing reasons for plagiarism, including: institutional admission criteria; student understanding of plagiarism; poor academic skills; a range of teaching and learning factors; personality factors; and external pressures. These findings are compared with other findings about reasons for student plagiarism in Australasia. The implications of these findings are considered for universities and individual academics seeking to better engage with their students to minimize or marginalize plagiarism.