Training the public to collect oral histories of our community : the OHAA Queensland Chapter’s model

In a digital age, the skills required to undertake an oral history project have changed dramatically. For community groups, this shift can be new and exciting, but can also invoke feelings of anxiety when there is a gap in the skill set. Addressing this gap is one of Oral History Association of Australia, Queensland (OHAA Qld) main activities. This paper reports on the OHAA Qld chapter’s oral history workshop program, which was radically altered in 2011.

Artful interviewing: Conducting oral history interviews for practice-led research

Recently, there has been an increased use of oral history as source material and inspiration for creative products, such as new media productions; visual art; theatre and fiction. The rise of the digital story in museum and library settings reflects a new emphasis on publishing oral histories in forms that are accessible and speak to diverse audiences. Visual artists are embracing oral history as a source of emotional, experiential and thematic authenticity (Anderson 2009 and Brown 2009). Rosemary Neill (2010) observes the rise of documentary and verbatim theatre — where the words of real people are reproduced on-stage — in Australia. Authors such as Dave Eggers (2006), M. J. Hyland (2009), Padma Viswanathan (2008) and Terry Whitebeach (2002) all acknowledge that interviews heavily inform their works of fiction. In such contexts, oral histories are not valued so much for their factual content but as sources that are at once dynamic, evolving, emotionally authentic and ambiguous. How can practice-led researchers design interviews that reflect this emphasis? In this paper, I will discuss how I developed an interview methodology for my own practice-led research project, The Artful Life Story: Oral History and Fiction. In my practice, I draw on oral histories to inform a work of fiction. I developed a methodology for eliciting sensory details and stories around place and the urban environment. I will also read an extract from ‘Evelyn on the Verandah,’ a short story based on an oral history interview with a 21 year-old woman who grew up in New Farm, which will be published in the One Book Many Brisbanes short story anthology in June this year (2010).

The effect of oral metformin on insulin sensitivity in insulin-resistant ponies

Metformin may be an effective therapeutic option for insulin-resistant (I-R) horses/ponies because, in humans, it reportedly enhances insulin sensitivity (SI) of peripheral tissues without stimulating insulin secretion. To determine the effect of metformin on insulin and glucose dynamics in I-R ponies, six ponies were studied in a cross-over design by Minimal Model analysis of a frequently-sampled intravenous glucose tolerance test (FSIGT). Metformin was administered at 15. mg/kg bodyweight (BW), orally, twice-daily, for 21. days to the metformin-treated group. The control group received a placebo. A FSIGT was conducted before and after treatment. The Minimal Model of glucose and insulin dynamics rendered indices describing SI, glucose effectiveness (Sg), acute insulin response to glucose (AIRg) and the disposition index (DI). The body condition score (BCS), BW and cresty neck score (CNS) were also assessed. There was no significant change in SI, Sg, AIRg, DI, BW, BCS or CNS in response to metformin, or over time in the control group. There were no measurable benefits of metformin on SI, consistent with recent work showing that the bioavailability of metformin in horses is poor, and chronic dosing may not achieve therapeutic blood concentrations. Alternatively, metformin may only be effective in obese ponies losing weight or with hyperglycaemia.

Orals ain’t orals : the role of prepared oral presentations in the classroom and beyond. How do instruction and feedback practices guide delivery choices?

Despite an ostensibly technology-driven society, the ability to communicate orally continues to feature as an essential ability for students at school and university, as it is for graduates in the workplace. Pedagogically, one rationale is that the need to develop effective oral communication skills is tied to life-long learning which includes successful participation in future work-related tasks. One tangible way that educators have assessed proficiency in the area of communication is through prepared oral presentations. While much of the literature uses the terms 'oral communication' and 'oral presentation' interchangeably, some writers question the role more formal presentations play in the overall development of oral communication skills. However, such formal speaking tasks continue to be a recognised assessment practice in both the secondary school and academy, and, therefore, worthy of further investigation. Adding to the discussion, this thesis explores the knowledge and skills students bring into the academy from previous educational experiences. It examines some of the teaching and assessment methods used in secondary schools to develop oral communication skills through the use of formal oral presentations. Specifically, it investigates criterion-referenced assessment sheets and how these tools are used as a form of instruction, as well as their role and effectiveness in the evaluation of student ability. The focus is on the student's perspective and includes 12 semi-structured interviews with school students. The purpose of this thesis is to explore key thematics underpinning oral communication and to identify tensions between expectations and practice. While acknowledging the breadth and depth of material available under the heading of 'communication theory', this study specifically draws on an expanded view of the rhetorical tradition to fully interrogate the assumptions supporting the practice of assessing oral presentations. Finally, this thesis recommends reconnecting with an updated understanding of rhetoric as a way of assisting in the development of expressive, articulate and discerning communicators.

Jogging alongside or bumping off? oral history and fiction in dialogue

This paper emerges from my practice-led PhD thesis investigating the ways fiction writers can enter a dialogue with the project of oral history in Australia. In this paper, I survey the current literature in order to identify the status of fiction within the practice of oral history in Australia. I argue that oral historians and fiction writers are, among other things, both concerned with understanding subjectivity. I consider how one of the specific qualities of fiction, that of character, can provide a space to explore subjectivity, and rely on my own writing practice in order to demonstrate how oral history theory can enrich fictive writings. This paper, while positioned in the field of oral history, exists within a wider debate around how the past can legitimately be represented; I argue oral historians and fiction writers can enter a dialogue around shared concerns.

Antibiotics overuse in children with upper respiratory tract infections in Saudi Arabia : risk factors and potential interventions

Background: Antibiotics misuse is currently one of the major public health issues worldwide. This misuse can lead to the development of bacterial resistance, increasing the burden of chronic diseases, rising costs of health services, and the development of side effects. Several factors may influence this pattern of overuse. Objectives:This article will review the pertinent factors contributing to the overuse of antibiotics worldwide, and to assess the intervention strategies to limit this overuse. Methods: studies about antibiotics use in children were reviewed from several electronic databases, such as MEDLINE and Pubmed. Results: Factors contributing to the overuse of antibiotics could include psychosocial factors, such as behaviors and attitudes (e.g. self-medication, over-the-counter medication, or patients/parents pressure), and demographic factors, such as socio-economic status and education level. Several intervention strategies were reported to be effective in reducing the overuse of antibiotics, such as health education, doctor-patient communication, and policies change. Multifaceted interventions were found to be the most effective in reducing the antibiotics overuse.

Could BFFB mode breath aerosol play a role in H5N1 transmission?

Recent findings concerning exhaled aerosol size distributions and the regions in the respiratory tract in which they are generated could have significant implications for human to human spread of lower respiratory tract-specific infections. Even in healthy people, measurable quantities of aerosol are routinely generated from the Lower Respiratory Tract (LRT) during breathing(1-3). We have found that there at least three modes in the exhaled aerosol size distribution of healthy adults(4) (see Figure 1). These modes each have a characteristic size and arise from different parts of the respiratory tract. The respiratory bronchioles produce aerosol during breathing, the larynx during speech and the oral cavity also during speech. The model of the resulting droplet size distribution is therefore called the Bronchial Laryngeal Oral (B.L.O.) tri-modal model of expired aerosol.

Evaluation of the cost-effectiveness of strategies claiming to reduce the risk of surgical site infections following primary total hip arthroplasty

Background Total hip arthroplasty (THA) is a commonly performed procedure and numbers are increasing with ageing populations. One of the most serious complications in THA are surgical site infections (SSIs), caused by pathogens entering the wound during the procedure. SSIs are associated with a substantial burden for health services, increased mortality and reduced functional outcomes in patients. Numerous approaches to preventing these infections exist but there is no gold standard in practice and the cost-effectiveness of alternate strategies is largely unknown. Objectives The aim of this project was to evaluate the cost-effectiveness of strategies claiming to reduce deep surgical site infections following total hip arthroplasty in Australia. The objectives were: 1. Identification of competing strategies or combinations of strategies that are clinically relevant to the control of SSI related to hip arthroplasty 2. Evidence synthesis and pooling of results to assess the volume and quality of evidence claiming to reduce the risk of SSI following total hip arthroplasty 3. Construction of an economic decision model incorporating cost and health outcomes for each of the identified strategies 4. Quantification of the effect of uncertainty in the model 5. Assessment of the value of perfect information among model parameters to inform future data collection Methods The literature relating to SSI in THA was reviewed, in particular to establish definitions of these concepts, understand mechanisms of aetiology and microbiology, risk factors, diagnosis and consequences as well as to give an overview of existing infection prevention measures. Published economic evaluations on this topic were also reviewed and limitations for Australian decision-makers identified. A Markov state-transition model was developed for the Australian context and subsequently validated by clinicians. The model was designed to capture key events related to deep SSI occurring within the first 12 months following primary THA. Relevant infection prevention measures were selected by reviewing clinical guideline recommendations combined with expert elicitation. Strategies selected for evaluation were the routine use of pre-operative antibiotic prophylaxis (AP) versus no use of antibiotic prophylaxis (No AP) or in combination with antibiotic-impregnated cement (AP & ABC) or laminar air operating rooms (AP & LOR). The best available evidence for clinical effect size and utility parameters was harvested from the medical literature using reproducible methods. Queensland hospital data were extracted to inform patients’ transitions between model health states and related costs captured in assigned treatment codes. Costs related to infection prevention were derived from reliable hospital records and expert opinion. Uncertainty of model input parameters was explored in probabilistic sensitivity analyses and scenario analyses and the value of perfect information was estimated. Results The cost-effectiveness analysis was performed from a health services perspective using a hypothetical cohort of 30,000 THA patients aged 65 years. The baseline rate of deep SSI was 0.96% within one year of a primary THA. The routine use of antibiotic prophylaxis (AP) was highly cost-effective and resulted in cost savings of over $1.6m whilst generating an extra 163 QALYs (without consideration of uncertainty). Deterministic and probabilistic analysis (considering uncertainty) identified antibiotic prophylaxis combined with antibiotic-impregnated cement (AP & ABC) to be the most cost-effective strategy. Using AP & ABC generated the highest net monetary benefit (NMB) and an incremental $3.1m NMB compared to only using antibiotic prophylaxis. There was a very low error probability that this strategy might not have the largest NMB (<5%). Not using antibiotic prophylaxis (No AP) or using both antibiotic prophylaxis combined with laminar air operating rooms (AP & LOR) resulted in worse health outcomes and higher costs. Sensitivity analyses showed that the model was sensitive to the initial cohort starting age and the additional costs of ABC but the best strategy did not change, even for extreme values. The cost-effectiveness improved for a higher proportion of cemented primary THAs and higher baseline rates of deep SSI. The value of perfect information indicated that no additional research is required to support the model conclusions. Conclusions Preventing deep SSI with antibiotic prophylaxis and antibiotic-impregnated cement has shown to improve health outcomes among hospitalised patients, save lives and enhance resource allocation. By implementing a more beneficial infection control strategy, scarce health care resources can be used more efficiently to the benefit of all members of society. The results of this project provide Australian policy makers with key information about how to efficiently manage risks of infection in THA.

More men than women make mucosal IgA antibodies to human papillomavirus type 16 (HPV-16) and HPV-18: A study of oral HPV and oral HPV antibodies in a normal healthy population

Background: We have previously shown the high prevalence of oral anti-human papillomavirus type 16 (HPV-16) antibodies in women with HPV-associated cervical neoplasia. It was postulated that the HPV antibodies were initiated after HPV antigenic stimulation at the cervix via the common mucosal immune system. The present study aimed to further evaluate the effectiveness of oral fluid testing for detecting the mucosal humoral response to HPV infection and to advance our limited understanding of the immune response to HPV. Methods: The prevalence of oral HPV infection and oral antibodies to HPV types 16, 18 and 11 was determined in a normal, healthy population of children, adolescents and adults, both male and female, attending a dental clinic. HPV types in buccal cells were determined by DNA sequencing. Oral fluid was collected from the gingival crevice of the mouth by the OraSure method. HPV-16, HPV-18 and HPV-11 antibodies in oral fluid were detected by virus-like particle-based enzyme-linked immunosorbent assay. As a reference group 44 women with cervical neoplasia were included in the study. Results: Oral HPV infection was h ighest in children (9/114, 7.9%), followed by adolescents (4/78, 5.1%), and lowest in normal adults (4/116, 3.5%). The predominant HPV type found was HPV-13 (7/22, 31.8%) followed by HPV-32 (5/22, 22.7%). The prevalence of oral antibodies to HPV-16, HPV-18 and HPV-11 was low in children and increased substantially in adolescents and normal adults. Oral HPV-16 IgA was significantly more prevalent in women with cervical neoplasia (30/44, 68.2%) than the women from the dental clinic (18/69, 26.1% P = 0.0001). Significantly more adult men than women displayed oral HPV-16 IgA (30/47 compared with 18/69, OR 5.0, 95% CI 2.09-12.1, P < 0.001) and HPV-18 IgA (17/47 compared with 13/69, OR 2.4, 95% CI 0.97-6.2, P = 0.04). Conclusion: The increased prevalence of oral HPV antibodies in adolescent individuals compared with children was attributed to the onset of sexual activity. The increased prevalence of oral anti-HPV IgA in men compared with women was noteworthy considering reportedly fewer men than women make serum antibodies, and warrants further investigation. © 2006 Marais et al; licensee BioMed Central Ltd.