Measurement of the economic impact of visual impairment from age-related macular degeneration in Australia

The purpose of this report was to: (i) outline the potential value of health economic studies into age-related macular degeneration (AMD); (ii) provide an overview of health economic studies pertinent to AMD; and (iii) outline the basic frame work of cost-of-illness studies (a useful first step in applying economic methods). The detection and management of sensory loss in the elderly plays a key role in the Australian Government's Healthy Ageing Strategy. Age-related macular degeneration is currently the leading cause of blindness in elderly Australians. Although a large proportion of AMD cases remain untreatable, the introduction of photo­dynamic therapy provides a relatively expensive and possibly cost-effective innovation for others. Antioxidant therapy has also been proven effective in reducing progression of early to late disease. The discipline of economics can contribute to an understanding of AMD prevention and treatment through: (i) describing the current burden of disease; (ii) predicting the changes in the burden of disease over time, and (iii) evaluating the efficiency of different interventions. Cost-of-illness studies have been performed in many fields of medicine. Little work, however, has been done on describing the economic impact from AMD. A number of different economic evaluation methods can be used in judging the efficiency of possible interventions to reduce the disease burden of AMD. Although complementary in nature, each has specific uses and limitations. Studies of the economic impact of eye diseases are both feasible and necessary for informed health care decision-making.

The impact of test medium on use of visual analogue scales

Objectives: Visual analog scales are frequently used as a means of allowing participants to rate symptoms during clinical trials. The accuracy and reproducibility of these scales play an important role in determining the experimental value of the data they provide. This study was initiated to compare the data collected using paper- and computer-based (Tablet PC) analog scales to better understand the variability in data provided by a visual analog scale.

Methods: Thirty participants rated ocular comfort, redness, and clarity of vision (right and left eyes) on a nondemarcated horizontal line on both paper and a Tablet PC. Measurements were taken in the morning between the hours of 8:30 and 10:30 am and again the same day between 2:30 and 4:30 pm.

Results: The mean difference between the measures recorded in the morning for the 2 media was 2.6 ± 0.9 (confidence intervals, 2 standard errors of the differences) units on a 100 unit scale, with the Tablet PC having the higher mean measure. The limits of agreement (2 standard deviations of the differences) was 9.4 units. Comparing the difference of the differences (1.0 ± 1.3) between the 2 methods of measure (morning vs. afternoon) the visual analog scales on the Tablet PC seemed to have good reproducibility of agreement in comparison with the paper version.

Conclusions: Discrepancy analysis yielded no significant difference and slight bias between paper- and computer-based analog scales. Repeatability of measures using the Tablet PC was also demonstrated. These results suggest that the choice of medium does not significantly influence the outcome for subjective analog scales.

Peer groups, power and pedagogy : the limits of an educational paradigm of separation

In contrast to the plethora of literature that suggests that the increasing gulf between teachers and young people is due to the shifting interests and expectations of young people, the focus of this paper is on the roles teachers play in this relationship. Provoking interest is a concern that some of the assumptions that underpin 'mainstream' pedagogic theory and practice might actually contribute, albeit unwittingly, to hardening rather than softening the communication divide. Drawing on an incident that took place between a group of 7–8 year old males in a primary school setting, the authors reveal the limits of a teaching paradigm that encourages teachers to adopt authoritative positions from which to separate and individualise student behaviour. In theoretical terms, they argue that the application of this paradigm asserts an exaggerated notion of agency to individuals in the construction of identity. In practical terms it promotes processes that individualise behaviour as a way of dealing with miscreance. Together these manifest themselves as a 'pedagogy of separation'. The process of building more productive pedagogic relationships, it is concluded, needs to begin with teachers better recognising and engaging with the collective investments of young people.

Floating lives : cultural citizenship and the limits of diaspora

Cultural citizenship may, in the simplest terms, be taken to mean a certain 'fit' or compatibility between the cultural attributes of an individual or group and those of the society in which they live. It is a complex concept, taking in rights, responsibilities and competencies as well as the more intangible issues of identity and belonging which have been the subject of intense debates within cultural studies in the last decade. In the case of diasporic or transnational peoples, it is further complicated by the fact of their multiple and unstable cultural and/or civic allegiances (to home and host nations in the first instance, but frequently also to the cultural space of diaspora itself).

This essay examines recent life stories by Chinese Australians: Clara Law's film Floating Life (1996) and two novellas by Liu Guande and Huangfu Jun, published together in English under the title Bitter Peaches and Plums (1995). Focusing on the diversity of experience evoked by notions of cultural belonging, it argues against the prevalent tendency within diaspora studies to engage in a rhetoric of cultural essentialism. The literatures of diaspora deserve to be read as documents of unique and complex cultural experiences rather than mere illustrations of archetypes

The limits of medicine and the social consequences for sufferers of chronic fatigue syndrome

Chronic fatigue syndrome (CFS) appears to be made up of several clusters of illness categories acting alone or in tandem to cause the decline of health through; fatigue/exhaustion, sensitivity/allergies, pain, general muscle and joint pains, cognitive impairment and gastrointestinal problems. This study investigated how patients interpret, evaluate and respond to the complex and varied symptoms of chronic fatigue syndrome. Data were collected from persons with CFS using a survey (n=90) and an interview (n=45). The researchers investigated how chronic fatigue syndrome is diagnosed by medical practitioners, how the label of CFS is determined and the social consequences for the patient. The results confirm the limited ability of the biomedical paradigm to diagnose adequately and treat effectively 'socially constructed' and medically ambiguous illnesses like CFS. In the absence of a legitimated regime of medical treatment for CFS, a range of often expensive treatments are employed by CFS sufferers, from formal use of pharmaceutical drugs through to 'alternative' therapies, including herbal, vitamin, homeopathic, esoteric meditative techniques, spiritual healing and general counselling are taken in no particular order.

Extrusion limits of magnesium alloys

Magnesium alloys are generally found to be slower to extrude than aluminum alloys; however, limited quantitative comparisons of the actual operating windows have been published. In this work, the extrusion limits are determined for a series of commercial magnesium alloys (M1, ZM21, AZ31, AZ61, and ZK60). These are compared with the limits established for aluminum alloy AA6063. The maximum extrusion speed of alloy M1 is shown to be similar to AA6063. Alloys ZM21, AZ31, ZK60, and AZ61 exhibit maximum extrusion speeds 44, 18, 4, and 3 pct, respectively, of the maximum measured for AA6063. For AZ31, the maximum extrusion speed is increased by 22 pct after homogenization and by 64 pct for repeat extrusions. The variation in the extrusion limits with changing alloy content is rationalized in terms of differences in the hot working flow stress and solidus temperature.

Expanding the extrusion limits of wrought magnesium alloys

Consumption of wrought magnesium products wax reduced by half between 1971 and the 1990s. To increase the use of wrought magnesium, several challenges must be overcome: its formability at room temperature is lower than steel or aluminum; its productivity is lower than steel or aluminum; and extruded magnesium exhibits a marked anisotropy of yield when comparing tension and compression. This article describes research on the rapid evaluation of the extrusion behavior of wrought magnesium alloys. The work aims to establish a methodology for rapid prototyping of alloys and to assess the effects of aluminum on the behavior of AZ-series magnesium alloys.

Risky business: health education and the limits of risk discourse

The paper explores the ways in which risk operates as a powerful discourse that shapes what health education teachers said about and what they did in their classroom practices. The paper draws on a qualitative study that seeks to explore the dominant and contesting discourses within health education.

The outer limits of read-ability

This is a 20-minute presentation that involves 3 simultaneous 16mm film projections and live performance of sound poetry, which addresses issues of traumatic effect and affect. The Outer Limits of Read-ability extends the concerns of my earlier film, entitled Traum A Dream (Australia, 2003), into the immediacy of the performance situation. Traum A Dream has been described as “a representation of traumatised space, depicting a person who is consumed by a body of pain in which slowly something is remembered.” The Outer Limits of Read-ability enlists the strategies of experimental film, direct cinema, and punk, while invoking Artaud's notions of “cruel performance”