Parent and child experiences of childhood cancer : an interpretative phenomenological analysis approach

A diagnosis of cancer represents a significant crisis for the child and their family. As the treatment for childhood cancer has improved dramatically over the past three decades, most children diagnosed with cancer today survive this illness. However, it is still an illness which severely disrupts the lifestyle and typical functioning of the family unit. Most treatments for cancer involve lengthy hospital stays, the endurance of painful procedures and harsh side effects. Research has confirmed that to manage and adapt to such a crisis, families must undertake measures which assist their adjustment. Variables such as level of family support, quality of parents’ marital relationship, coping of other family members, lack of other concurrent stresses and open communication within the family have been identified as influences on how well families adjust to a diagnosis of childhood cancer. Theoretical frameworks such as the Resiliency Model of Family Adjustment and Adaptation (McCubbin and McCubbin, 1993, 1996) and the Stress and Coping Model by Lazarus and Folkman (1984) have been used to explain how families and individuals adapt to crises or adverse circumstances. Developmental theories have also been posed to account for how children come to understand and learn about the concept of illness. However more descriptive information about how families and children in particular, experience and manage a diagnosis of cancer is still needed. There are still many unanswered questions surrounding how a child adapts to, understands and makes meaning from having a life-threatening illness. As a result, developing an understanding of the impact that such a serious illness has on the child and their family is crucial. A new approach to examining childhood illness such as cancer is currently underway which allows for a greater understanding of the experience of childhood cancer to be achieved. This new approach invites a phenomenological method to investigate the perspectives of those affected by childhood cancer. In the current study 9 families in which there was a diagnosis of childhood cancer were interviewed twice over a 12 month period. Using the qualitative methodology of Interpretative Phenomenological Analysis (IPA) a semi-structured interview was used to explicate the experience of childhood cancer from both the parent and child’s perspectives. A number of quantitative measures were also administered to gather specific information on the demographics of the sample population. The results of this study revealed a number of pertinent areas which need to be considered when treating such families. More importantly experiences were explicated which revealed vital phenomena that needs to be added to extend current theoretical frameworks. Parents identified the time of the diagnosis as the hardest part of their entire experience. Parents experienced an internal struggle when they were forced to come to the realization that they were not able to help their child get well. Families demonstrated an enormous ability to develop a new lifestyle which accommodated the needs of the sick child, as the sick child became the focus of their lives. Regarding the children, many of them accepted their diagnosis without complaint or question, and they were able to recognise and appreciate the support they received. Physical pain was definitely a component of the children’s experience however the emotional strain of loss of peer contact seemed just as severe. Changes over time were also noted as both parental and child experiences were often pertinent to the stage of treatment the child had reached. The approach used in this study allowed for rich and intimate detail about a sensitive issue to be revealed. Such an approach also allowed for the experience of childhood cancer on parents and the children to be more fully realised. Only now can a comprehensive and sensitive medical and psychosocial approach to the child and family be developed. For example, families may benefit from extra support at the time of diagnosis as this was identified as one of the most difficult periods. Parents may also require counselling support in coming to terms with their lack of ability to help their child heal. Given the ease at which children accepted their diagnosis, we need to question whether children are more receptive to adversity. Yet the emotional struggle children battled as a result of their illness also needs to be addressed.

Social adaptation of children with mild intellectual disability : effects of partial integration within primary school classes

Examined the social adaptation of 32 children in grades 3–6 with mild intellectual disability: 13 Ss were partially integrated into regular primary school classes and 19 Ss were full-time in separate classes. Sociometric status was assessed using best friend and play rating measures. Consistent with previous research, children with intellectual disability were less socially accepted than were a matched group of 32 children with no learning disabilities. Children in partially integrated classes received more play nominations than those in separate classes, but had no greater acceptance as a best friend. On teachers' reports, disabled children had higher levels of inappropriate social behaviours, but there was no significant difference in appropriate behaviours. Self-assessments by integrated children were more negative than those by children in separate classes, and their peer-relationship satisfaction was lower. Ratings by disabled children of their satisfaction with peer relationships were associated with ratings of appropriate social skills by themselves and their teachers, and with self-ratings of negative behaviour. The study confirmed that partial integration can have negative consequences for children with an intellectual disability.

Volcanic sulphate and Arctic dust plumes over the North Atlantic Ocean

High time resolution aerosol mass spectrometry measurements were conducted during a field campaign at Mace Head Research Station, Ireland, in June 2007. Observations on one particular day of the campaign clearly indicated advection of aerosol from volcanoes and desert plains in Iceland which could be traced with NOAA Hysplit air mass back trajectories and satellite images. In conjunction with this event, elevated levels of sulphate and light absorbing particles were encountered at Mace Head. While sulphate concentration was continuously increasing, nitrate levels remained low indicating no significant contribution from anthropogenic pollutants. Sulphate concentration increased about 3.8 g/m3 in comparison with the background conditions. Corresponding sulphur flux from volcanic emissions was estimated to about 0.3 TgS/yr, suggesting that a large amount of sulphur released from Icelandic volcanoes may be distributed over distances larger than 1000 km. Overall, our results corroborate that transport of volcanogenic sulphate and dust particles can significantly change the chemical composition, size distribution, and optical properties of aerosol over the North Atlantic Ocean and should be considered accordingly by regional climate models.

Under great pressure, a diamond is being formed: The SBS over time

This article observes a paradox in the recent history of the Special Broadcasting Service. It is argued that, in contrast to the Australian Broadcasting Corporation, the role and general direction of SBS were not extensively debated as part of the ‘culture wars’ that occurred during the years of the Howard government. While that made SBS a less fraught space during that period, it may now be a factor in the comparative lack of support being given by the Rudd Labor government to SBS in comparison with the ABC, as some of the ‘special’ status of SBS has been blunted by its drift towards more mainstream programming and a mixed economy of commercial advertising, as well as government funding.

"There's no way in hell I would pull up" : Deterrent and other effects of vehicle impoundment laws for hooning

Traffic law enforcement is based on deterrence principles, whereby drivers control their behaviour in order to avoid an undesirable sanction. For “hooning”-related driving behaviours in Queensland, the driver’s vehicle can be impounded for 48 hours, 3 months, or permanently depending on the number of previous hooning offences. It is assumed that the threat of losing something of value, their vehicle, will discourage drivers from hooning. While official data shows that the rate of repeat offending is low, an in-depth understanding of the deterrent effects of these laws should involve qualitative research with targeted drivers. A sample of 22 drivers who reported engaging in hooning behaviours participated in focus group discussions about the vehicle impoundment laws as applied to hooning offences in Queensland. The findings suggested that deterrence theory alone cannot fully explain hooning behaviour, as participants reported hooning frequently, and intended to continue doing so, despite reporting that it is likely that they will be caught, and perceiving the vehicle impoundment laws to be extremely severe. The punishment avoidance aspect of deterrence theory appears important, as well as factors over and above legal issues, particularly social influences. A concerning finding was drivers’ willingness to flee from police in order to avoid losing their vehicle permanently for a third offence, despite acknowledging risks to their own safety and that of others. This paper discusses the study findings in terms of the implications for future research directions, enforcement practices and policy development for hooning and other traffic offences for which vehicle impoundment is applied.

Tip-over injuries in children under 5 years of age in Queensland 1999-2008

Furniture and appliance related injuries in children under 5 years of age accounts for an estimated 180 emergency presentations annually in Queensland. Injuries occur when children push or pull items over, climb and fall off furniture, or climb and tip the item over. Children under 2 years of age tend to injure themselves by pulling items over onto themselves Children over 2 years of age are more likely to be injured after climbing the item and either falling off or tipping the item over onto themselves. Tip over injuries (where the item falls over and injures the child) in children under 5 years of age account for an estimated 115 emergency presentations annually in Queensland. The item most commonly associated with a tip over injury is a television (with or without the cabinet) Prevention requires better design and selection of furniture with inherent stability coupled with mechanisms to install or fix less stable items

Introduction of a short writing task to measure and develop academic literacy in first year health undergraduates

This paper describes an initiative in the Faculty of Health at the Queensland University of Technology, Australia, where a short writing task was introduced to first year undergraduates in four courses including Public Health, Nursing, Social Work and Human Services, and Human Movement Studies. Over 1,000 students were involved in the trial. The task was assessed using an adaptation of the MASUS Procedure (Measuring the Academic Skills of University Students) (Webb & Bonanno, 1994). Feedback to the students including MASUS scores then enabled students to be directed to developmental workshops targeting their academic literacy needs. Students who achieved below the benchmark score were required to attend academic writing workshops in order to obtain the same summative 10% that was obtained by those who had achieved above the benchmark score. The trial was very informative, in terms of determining task appropriateness and timing, student feedback, student use of support, and student perceptions of the task and follow-up workshops. What we learned from the trial will be presented with a view to further refinement of this initiative.

Relationship over time between psychological distress and physical activity in colorectal cancer survivors

Purpose Increased physical activity in colorectal cancer patients is related to improved recurrence free and overall survival. Psychological distress after cancer may place patients at risk of reduced physical activity; but paradoxically also act as a motivator for positive lifestyle change. The relationship between psychological distress and physical activity after cancer over time has not been described. Methods A prospective survey of 1966 (57% response) colorectal cancer survivors assessed the psychological distress variables of anxiety, depression, somatisation, cancer threat appraisal as predictors of physical activity five, 12, 24 and 36 months post-diagnosis 978 respondents had valid data for all time points. Results Higher somatisation was associated with greater physical inactivity (Relative risk ratio (RRR) =1.12; 95% CI=[1.1, 1.2]) and insufficient physical activity (RRR=1.05; [0.90, 1.0]). Respondents with a more positive appraisal of their cancer were significantly (p=0.031) less likely to be inactive (RRR=0.95; [0.90, 1.0]) or insufficiently active (RRR=0.96). Fatigued and obese respondents and current smokers were more inactive. Respondents whose somatisation increased between two time periods were less likely to increase their physical activity over the same period (p<0.001). Respondents with higher anxiety at one time period were less likely to have increased their activity at the next assessment (p=0.004). There was no association between depression and physical activity. Conclusions Cancer survivors who experience somatisation and anxiety are at greater risk of physical inactivity. The lack of a clear relationship between higher psychological distress and increasing physical activity argues against distress as a motivator to exercise in these patients.

Introduction : the global flow of creative ideas

In the era of late modernism, various pressures play a decisive role in shaping the texture and meaning of the world around us. Population, work, transportation, new technologies of information and communication, lifestyle cultures and other forces are increasingly mobile, and this in turn helps make for a new set of public and personal surroundings. Social life everywhere now appears to share more and more in an international (if not a global) order, even if inequality and stratification remain common inside territories and across territories. Still, the perception is that a particular cultural life is increasingly universal. More and more consumers come to share in its practices and products, with those products becoming more and more homogeneous. This standardization argument finds much support in the apparent internationalization of many elements of media, entertainment, leisure and lifestyle cultures, with cultural conglomerates determined to maximize their global market reach. Once upon a time, in order to understand the economic, political and cultural forces affecting citizens and society, it was mostly deemed sufficient to look within the boundaries of the nation-state. Over the past two decades, these same pressures of globalization have impacted on critical research, highlighting the methodological need to adopt an optic that is more cross-border and transcultural as a means of gaining greater understanding of cultural life.

Unsupervised speaker adaptation for telephone call transcription

The use of the PC and Internet for placing telephone calls will present new opportunities to capture vast amounts of un-transcribed speech for a particular speaker. This paper investigates how to best exploit this data for speaker-dependent speech recognition. Supervised and unsupervised experiments in acoustic model and language model adaptation are presented. Using one hour of automatically transcribed speech per speaker with a word error rate of 36.0%, unsupervised adaptation resulted in an absolute gain of 6.3%, equivalent to 70% of the gain from the supervised case, with additional adaptation data likely to yield further improvements. LM adaptation experiments suggested that although there seems to be a small degree of speaker idiolect, adaptation to the speaker alone, without considering the topic of the conversation, is in itself unlikely to improve transcription accuracy.

Treadmill adaptation and verification of self-selected walking speed : a protocol for children

The term self-selected (i.e., individual or comfortable walking pace or speed) is commonly used in the literature (Frost, Dowling, Bar-Or, & Dyson, 1997; Jeng, Liao, Lai, & Hou, 1997; Wergel-Kolmert & Wohlfart, 1999; Maltais, Bar-Or, Pienynowski, & Galea, 2003; Browning & Kram, 2005; Browning, Baker, Herron, & Kram, 2006; Hills, Byrne, Wearing, & Armstrong, 2006) and is identified as the most efficient walking speed, with increased efficiency defined by lower oxygen uptake (VO^sub 2^) per unit mechanical work (Hoyt & Taylor, 1981; Taylor, Heglund, & Maloiy, 1982; Hreljac, 1993). [...] assessing individual and group differences in metabolic energy expenditure using oxygen uptake requires individuals to be comfortable with, and able to accommodate to, the equipment.

Adaptation to global warming by changing internal loads of buildings

Global warming can have a significant impact on the building thermal environment and energy performance. Because greenhouse gas concentrations are still continuing to increase, this warming process will continue and may accelerate. Adaptation to global warming is therefore emerging as one of the key requirements for buildings. This requires all the existing and new buildings not only to perform and operate satisfactorily in the new environment but also to satisfy the environmental performance criteria of sustainability. Through a parametric study using the building simulation technique, this paper investigates the adaptation potential of changing the building internal load densities to the future global warming. Case studies for office buildings in major Australian capital cities are presented. Based on the results of parametric study, possible adaptation strategies are also proposed and evaluated.