A study of post diagnosis breast cancer concerns for women living in rural and remote Queensland. Part I : Personal concerns

The findings presented in this paper are part of a research project designed to provide a preliminary indication of the support needs of postdiagnosis women with breast cancer in remote and isolated areas in Queensland. This discussion will present data that focuses on the women’s expressed personal concerns. For participants in this research a diagnosis of breast cancer involves a confrontation with their own mortality and the possibility of a reduced life span. This is a definite life crisis, creating shock and needing considerable adjustment. Along with these generic issues the participants also articulated significant issues in relation to their experience as women in a rural setting. These concerns centred around worries about how their partner and families cope during their absences for treatment, the additional burden on the family of having to cope with running the property or farm during the participant’s absence or illness, added financial strain brought about by the cost of travel for treatment, maintenance of properties during absences, and problems created by time off from properties or self-employment. These findings accord with other reports of health and welfare services for rural Australian and the generic literature on psycho-oncology studies of breast cancer.

Designing a continuum of quality external cause of injury information in Queensland : from ambulance to hospital

This study is the first to employ an epidemiological framework to evaluate the ‘fit-for-purpose’ of ICD-10-AM external cause of injury codes, ambulance and hospital clinical documentation for injury surveillance. Importantly, this thesis develops an evidence-based platform to guide future improvements in routine data collections used to inform the design of effective injury prevention strategies. Quantification of the impact of ambulance clinical records on the overall information quality of Queensland hospital morbidity data collections for injury causal information is a unique and notable contribution of this study.

Urinary biomolecular indicators of exercise-induced over exertion injury

Poor health and injury represent major obstacles to the future economic security of Australia. The national economic cost of work-related injury is estimated at $57.5 billion p/a. Since exposure to high physical demands is a major risk factor for musculoskeletal injury, monitoring and managing such physical activity levels in workers is a potentially important injury prevention strategy. Current injury monitoring practices are inadequate for the provision of clinically valuable information about the tissue specific responses to physical exertion. Injury of various soft tissue structures can manifest over time through accumulation of micro-trauma. Such micro-trauma has a propensity to increase the risk of acute injuries to soft-tissue structures such as muscle or tendon. As such, the capacity to monitor biomarkers that result from the disruption of these tissues offers a means of assisting the pre-emptive management of subclinical injury prior to acute failure or for evaluation of recovery processes. Here we have adopted an in-vivo exercise induced muscle damage model allowing the application of laboratory controlled conditions to assist in uncovering biochemical indicators associated with soft-tissue trauma and recovery. Importantly, urine was utilised as the diagnostic medium since it is non-invasive to collect, more acceptable to workers and less costly to employers. Moreover, it is our hypothesis that exercise induced tissue degradation products enter the circulation and are subsequently filtered by the kidney and pass through to the urine. To test this hypothesis a range of metabolomic and proteomic discovery-phase techniques were used, along with targeted approaches. Several small molecules relating to tissue damage were identified along with a series of skeletal muscle-specific protein fragments resulting from exercise induced soft-tissue damage. Each of the potential biomolecular markers appeared to be temporally present within urine. Moreover, the regulation of abundance seemed to be associated with functional recovery following the injury. This discovery may have important clinical applications for monitoring of a variety of inflammatory myopathies as well as novel applications in monitoring of the musculoskeletal health status of workers, professional athletes and/or military personnel to reduce the onset of potentially debilitating musculoskeletal injuries within these professions.

Communicating personal amnesty : a model for health promotion in an Australian disability context

Currently pathological and illness-centric policy surrounds the evaluation of the health status of a person experiencing disability. In this research partnerships were built between disability service providers, community development organizations and disability arts organizations to build a translational evaluative methodology prior to implementation of an arts-based workshop that was embedded in a strengths-based approach to health and well-being. The model consisted of three foci: participation in a pre-designed drama-based workshop program; individualized assessment and evaluation of changing health status; and longitudinal analysis of participants changing health status in their public lives following the culmination of the workshop series. Participants (n = 15) were recruited through disability service providers and disability arts organizations to complete a 13-week workshop series and public performance. The study developed accumulative qualitative analysis tools and member-checking methods specific to the communication systems used by individual participants. Principle findings included increased confidence for verbal and non-verbal communicators; increased personal drive, ambition and goal-setting; increased arts-based skills including professional engagements as artists; demonstrated skills in communicating perceptions of health status to private and public spheres. Tangential positive observations were evident in the changing recreational, vocational and educational activities participants engaged with pre- and post- the workshop series; participants advocating for autonomous accommodation and health provision and changes in the disability service staff's culture. The research is an example of translational health methodologies in disability studies.

The remediation of the personal photograph and the politics of self-representation in digital storytelling

Over the past couple of decades, the cultural field formerly known as ‘domestic’, and later ‘personal’ photography has been remediated and transformed as part of the social web, with its convergence of personal expression, interpersonal communication, and online social networks (most recently via platforms like Flickr, Facebook and Twitter). Meanwhile, the Digital Storytelling movement (involving the workshop-based production of short autobiographical videos) from its beginnings in the mid 1990s relied heavily on the narrative power of the personal photograph, often sourced from family albums, and later from online archives. This paper addresses the new issues arising for the politics of self-representation and personal photography in the era of social media, focusing particularly on the consequences of online image-sharing. It discusses in detail the practices of selection, curation, manipulation and editing of personal photographic images among a group of activist-oriented queer digital storytellers who have in common a stated desire to share their personal stories in pursuit of social change, and whose stories often aim to address both intimate and antagonistic publics.

Metrological performances of a diffusion charger particle counter for personal monitoring

Airborne particles have been shown to be associated with a wide range of adverse health effects, which has led to a recent increase in medical research to gain better insight into their health effects. However, accurate evaluation of the exposure-dose-response relationship is highly dependent on the ability to track actual exposure levels of people to airborne particles. This is quite a complex task, particularly in relation to submicrometer and ultrafine particles, which can vary quite significantly in terms of particle surface area and number concentrations. Therefore, suitable monitors that can be worn for measuring personal exposure to these particles are needed. This paper presents an evaluation of the metrological performance of six diffusion charger sensors, NanoTracer (Philips Aerasense) monitors, when measuring particle number and surface area concentrations, as well as particle number distribution mean when compared to reference instruments. Tests in the laboratory (by generating monodisperse and polydisperse aerosols) and in the field (using natural ambient particles) were designed to evaluate the response of these devices under both steady-state and dynamics conditions. Results showed that the NanoTracers performed well when measuring steady state aerosols, however they strongly underestimated actual concentrations during dynamic response testing. The field experiments also showed that, when the majority of the particles were smaller than 20 nm, which occurs during particle formation events in the atmosphere, the NanoTracer underestimated number concentration quite significantly. Even though the NanoTracer can be used for personal monitoring of exposure to ultrafine particles, it also has limitations which need to be considered in order to provide meaningful results.

Personal exposure to ultrafine particles : the influence of time-activity patterns

Exposure to ultrafine particles (UFPs) is deemed to be a major risk affecting human health. Therefore, airborne particle studies were performed in the recent years to evaluate the most critical micro-environments, as well as identifying the main UFP sources. Nonetheless, in order to properly evaluate the UFP exposure, personal monitoring is required as the only way to relate particle exposure levels to the activities performed and micro-environments visited. To this purpose, in the present work, the results of experimental analysis aimed at showing the effect of the time-activity patterns on UFP personal exposure are reported. In particular, 24 non-smoking couples (12 during winter and summer time, respectively), comprised of a man who worked full-time and a woman who was a homemaker, were analyzed using personal particle counter and GPS monitors. Each couple was investigated for a 48-h period, during which they also filled out a diary reporting the daily activities performed. Time activity patterns, particle number concentration exposure and the related dose received by the participants, in terms of particle alveolar-deposited surface area, were measured. The average exposure to particle number concentration was higher for women during both summer and winter (Summer: women 1.8×104 part. cm-3; men 9.2×103 part. cm-3; Winter: women 2.9×104 part. cm-3; men 1.3×104 part. cm-3), which was likely due to the time spent undertaking cooking activities. Staying indoors after cooking also led to higher alveolar-deposited surface area dose for both women and men during the winter time (9.12×102 and 6.33×102 mm2, respectively), when indoor ventilation was greatly reduced. The effect of cooking activities was also detected in terms of women’s dose intensity (dose per unit time), being 8.6 and 6.6 in winter and summer, respectively. On the contrary, the highest dose intensity activity for men was time spent using transportation (2.8 in both winter and summer).

Developing targets and strategies for school-based injury prevention programs to reduce alcohol associated transport risks

Background There is considerable and ongoing debate about the role and effectiveness of school-based injury prevention programs in reducing students’ later involvement in alcohol associated transport injuries. Most relevant literature is concerned with pre-driving and licensing programs for middle age range adolescents (15-17 years). This research team is concerned with prevention at an earlier stage by targeting interventions to young adolescents (13-14 years). There is strong evidence that young adolescents who engage in unsafe and illegal alcohol associated transport risks are significantly likely to incur serious related injuries in longitudinal follow up. For example, a state-wide representative sample of male adolescents (mean age 14.5 years) who reported being passengers of drink drivers were significantly more likely to have incurred a hospitalised injury related to traffic events at a 20 year follow up. Aim This paper reports on first aid training integrated with peer protection and school connectedness within the Skills for Preventing Injury in Youth (SPIY) program. A component of the intervention is concerned with providing strategies to reduce the likelihood of being a passenger of a drink driver and effectiveness is followed up at six months post-intervention. Method In early 2012 the study was undertaken in 35 high schools throughout Queensland that were randomly assigned to intervention and control conditions. A total of 2,521 Year 9 students (mean age 13.5years, 43% male) completed surveys prior to the intervention. Results Of these students 316 (13.7%) reported having ridden in a car with someone who has been drinking. This is a traffic safety behaviour that is particularly relevant to a peer protection intervention and the findings of the six month follow up will be reported. Discussion and conclusions This research will provide evidence as to whether this approach to the introduction of first aid skills within a school-based health education curriculum has traffic safety implications.

Postdiagnosis personal growth in an Australian population of parents raising children with developmental disability

Background Parenting a child with a developmental disability presents a variety of long-term physical and emotional challenges. When exploring parent wellbeing, the disability field is dominated by a deficit model despite parents reportedly demonstrating coping and resilience. The current study is embedded in a salutogenic theory (Antonovsky, 1979) and explores the potential for parents of children diagnosed with a developmental disability to undergo positive changes. Method Participants were 6 fathers and 27 mothers who completed measures of distress and posttraumatic growth. Results Compared with a number of other Australian samples, participants reported significantly higher levels of posttraumatic growth. Reports of growth did not negate reports of distress. Results also indicated that constructs of distress and growth were independent. Conclusions The research has important implications for disability support services, reminding providers to be cognisant of the potential for growth, as well as distress, thereby permitting an atmosphere conducive to exploring such outcomes.

The effects of risk factors and protective factors on influencing engagement in risky behaviours and injury experiences for high-risk adolescents

High-risk adolescents are most vulnerable to the negative outcomes of risk taking behaviour, such as injury. It has been theorised by Jessor (1987) that adolescent risk behaviours (e.g. violence, alcohol use) can be predicted by assessing the risk factors (e.g. peer models for violence) and protective factors (e.g. school connectedness) in a young person’s life. The aim of this research is to examine the influence of risk factors and protective factors on the proneness of high-risk adolescents to engage in risky behaviour. 2,521 Grade 9 students (13-14 years of age) from 35 schools in Queensland, Australia participated in this study. The findings examine the influence of risk factors and protective factors on self-reported risky behaviour and injury experiences for adolescents who have been categorized as high-risk. Thereby, providing insight that may be used to target preventive interventions aimed at high-risk adolescents.

ACE research vignette 026 : Do Entrepreneurs’ Personal Networks Influence Small Firm Performance?

This series of research vignettes is aimed at sharing current and interesting research findings from our team of international Entrepreneurship researchers. This vignette, written by Dr. Rene Bakker, examines the evidence on the effects of a entrepreneurs’ personal networks on small firm performance, and the factors that moderate this relationship.

Exploring expedition research methodology : a personal reflection

Research into the human dynamics of expeditions is a potentially rewarding and fruitful area of study. However, the complex nature of expedition work presents the researcher with numerous challenges. This paper presents a personal reflection on the challenges linked to determining appropriate methodological processes for a study into expedition teamwork. Previous expedition research is outlined and reviewed for appropriateness. Some alternative methodological theories are described and limitations highlighted. Lastly the actual data gathering and analysis processes are detailed. The aim being to show that what happened in the field inevitably dictated how methodological processes were adapted. Essentially the paper describes a personal journey into research. A journey that sparked numerous personal insights in the science of human dynamics and expeditions and one that I hope will add to the development of expedition research in general.

Development of school connectedness as a component of an injury prevention program for early adolescents

The current program of research addresses the need for multi-level programs to target the major increase in injury rates that occurs throughout adolescence. Specifically, it involves the investigation of school connectedness as a protective factor for adolescent injury, and the development of school connectedness as a component of an injury prevention program. To date, school-based risk taking and injury prevention has frequently been limited to addressing adolescents' knowledge and attitudes to risk behaviours, and has largely overlooked the importance of the wider school social context as a protective factor in adolescent development. Additionally, school connectedness has been primarily studied in terms of its impact on student achievement, wellbeing and risk taking behaviour, and research has not yet addressed possible links with injury. Further, school connectedness intervention programs have targeted risk taking behaviours without evaluating their potential impact on injury outcomes. This is the first reported research to develop strategies to increase school connectedness as part of a school-based injury prevention program. The research program was conceptualised as three distinct stages. The development of these research stages was informed by a comprehensive review of the literature on adolescent risk taking, injury and school-based prevention, as well as on school connectedness and its importance in adolescence. A review of the school connectedness literature indicated that students' connectedness is largely influenced by relationships within the school context including with teachers and other school staff, and is therefore a potentially modifiable factor that may be targeted in school-based programs. Overall, the literature shows school connectedness to be a key protective factor in adolescent development. This review established a foundation from which the current program of research was designed. The first stage of the research involved an empirical investigation of the relationship between adolescent risk taking-related injuries and school connectedness. Stage one incorporated two studies. The first involved the development of a measure of adolescent injury, the Extended Adolescent Injury Checklist (E-AIC), for use in the current research as well as in future school-based studies and program evaluation. The results of this study also highlighted the extent of the problem of risk-related injury in adolescence. The second study in Stage one examined the relationship between students' reports of school connectedness, risk taking behaviour and risk taking-related injuries on the E-AIC. The results of this study showed significant relationships between increased school connectedness and reduced reported engagement in transport and violence risk taking, and fewer associated injuries. This study therefore suggested the potential for school-based injury prevention programs to incorporate strategies targeting increased adolescent connectedness to school. The second stage of this research involved the compilation of an evidence base to inform the design of a school connectedness intervention. Stage two also incorporated two studies. The first study in Stage two involved a systematic review of programs that have targeted school connectedness for reduced risk taking and injury. The results of this study revealed that interventions targeting school connectedness can be effective in reducing adolescent risk taking behaviour, and also provided an evidence base for the design of the current school connectedness intervention. The second study in Stage two examined teachers' understanding and perceptions of school connectedness. This qualitative study indicated that teachers consider students' connectedness to be an important factor that relates to their risk taking behaviour; and also provided directions and content for the intervention design stage. The third stage of this research built upon the findings of each of the previous studies, and involved the design, implementation and evaluation of a school connectedness intervention as a component of an adolescent injury prevention program, Skills for Preventing Injury in Youth (SPIY). This connectedness intervention was designed as a professional development workshop for teachers of 13 to 14 year old adolescents, and was developed as a complementary component to the curriculum-based SPIY program. The SPIY connectedness component was implemented and evaluated using process and six-month impact evaluation methodologies. The results of this study revealed that teachers saw value in the program and made use of the strategies presented, and that program school students' self-reported violence risk behaviour was reduced at six-month follow-up. Despite these promising findings, the results of this study did not demonstrate a significant impact of the program on change in students' connectedness to school, relative to comparison schools. The positive impact on self-reported violence risk behaviour was however replicated in additional analyses comparing students participating in the connectedness version of SPIY with students participating in an earlier curriculumonly version of the program. This finding indicated that the connectedness component has additional benefits relating to reduction in violence risks, over and above a curriculum-only version of the program. This research was the first reported to address the relationship between school connectedness and adolescent injury outcomes, and to develop school connectedness as a component of an adolescent injury prevention program. Overall, the results of this program of research have demonstrated the importance of incorporating strategies targeting the wider school social context, including school connectedness, in adolescent injury prevention programs. This research has important implications for future research and practice in adolescent injury prevention.

A new era : personal technology challenges educational technology

As we race towards a new era, rapid change of conventional models has become the norm. Just as technology has etched itself to the core of society, the sheer quantity of student devices connecting to university networks presents a sector wide challenge coinciding almost perfectly with many universities creating technology rich learning spaces. New fears include future proofing. It is not just a matter of technology becoming outdated. In seeking to accommodate the teaching styles and experience of staff across diverse faculties, is this technology simply too vanilla to meet their needs as they become increasingly skilled and inspired by technology’s potential? Through the early findings of a study into staff use of technology within Queensland University of Technology's next generation collaborative learning spaces, this paper explores whether the answers lie in a model presented by students equipping themselves with the tools they need to learn in the 21st century.

Injury severity of pedestrian crashes in Singapore

Singapore is a highly urbanized city-state country where walking is an important mode of travel. Pedestrians form about 25% of road fatalities every year, making them one of the most vulnerable road user groups in Singapore. Engineering measures like provision of overhead pedestrian crossings and raised zebra crossings tend to address pedestrian safety in general, but there may be occasions where pedestrians are particularly vulnerable so that targeted interventions are more appropriate. The objective of this study is to identify factors and situations that affect the injury severity of pedestrians involved in traffic crashes. Six years of crash data from 2003 to 2008 containing around four thousands pedestrian crashes at roadway segments were analyzed. Injury severity of pedestrians—recorded as slight injury, major injury and fatal—were modeled as a function of roadway characteristics, traffic features, environmental factors and pedestrian demographics by an ordered probit model. Results suggest that the injury severity of pedestrians involved in crashes during night time is higher indicating that pedestrian visibility during night is a key issue in pedestrian safety. The likelihood of fatal or serious injuries is higher for crashes on roads with high speed limit, center and median lane of multi-lane roads, school zones, roads with two-way divided traffic type, and when pedestrians cross the roads. Elderly pedestrians appear to be involved in fatal and serious injury crashes more when they attempt to cross the road without using nearby crossing facilities. Specific countermeasures are recommended based on the findings of this study.