Exercise for health : a breast cancer recovery program - quality of life benefits [Conference Abstract]

Introduction: Five-year survival from breast cancer in Australia is 87%. Hence, ensuring a good quality of life (QOL) has become a focal point of cancer research and clinical interest. Exercise during and after treatment has been identified as a potential strategy to optimise QOL of women diagnosed with breast cancer.----- Methods: Exercise for Health is a randomised controlled trial of an eight-month, exercise intervention delivered by Exercise Physiologists. An objective of this study was to assess the impact of the exercise program during and following treatment on QOL. Queensland women diagnosed with unilateral breast cancer in 2006/07 were eligible to participate. Those living in urban-Brisbane (n=194) were allocated to either the face-to-face exercise group, the telephone exercise group, or the usual-care group, and those living in rural Queensland (n=143) were allocated to the telephone exercise group or the usual-care group. QOL, as assessed by the Functional Assessment of Cancer Therapy-Breast (FACT-B+4) questionnaire, was measured at 4-6 weeks (pre-intervention), 6 months (mid-intervention) and 12 months (three months post-intervention) post-surgery.----- Results: Significant (P<0.01) increases in QOL were observed between pre-intervention and three months post-intervention 12 months post-surgery for all women. Women in the exercise groups experienced greater mean positive changes in QOL during this time (+10 points) compared with the usual-care groups (+5 to +7 points) after adjusting for baseline QOL. Although all groups experienced an overall increase in QOL, approximately 20% of urban and rural women in the usual-care groups reported a decline in QOL, compared with 10% of women in the exercise groups.----- Conclusions: This work highlights the potential importance of participating in physical activity to optimise QOL following a diagnosis of breast cancer. Results suggest that the telephone may be an effective medium for delivering exercise counselling to newly diagnosed breast cancer patients.

The prognostic significance of quality of life following breast cancer [Conference Abstract]

Introduction: Evidence suggests a positive association between quality of life (QOL). and overall survival(OS). among metastatic breast cancer (BC). patients, although the relationship in early-stage BC is unclear. This work examines the association between QOL and OS following a diagnosis of early-stage BC. ----- Methods: A population-based sample of Queensland women (n=287). with early-stage, invasive, unilateral BC, were prospectively observed for a median of 6.6 years. QOL was assessed at six and 18 months post-diagnosis using the Functional Assessment of Cancer Therapy, Breast FACT-B+4. questionnaire. Raw scores for the FACT-B+4 scales were computed and individuals were categorised according to whether QOL declined, remained stable or improved over time. OS was measured from the date of diagnosis to the date of death or was censored at the date of last follow-up. Risk ratios (RR) and 95% confidence intervals (CI). for the association between QOL and OS were obtained using Cox proportional hazards survival models adjusted for confounding characteristics. ----- Results: A total of 27 (9.4%). women died during the follow-up period. Three baseline QOL scales (emotional, general and overall QOL) were significantly associated with OS, with RRs ranging between 0.89 95% CI: 0.81, 0.98; P=0.01. and 0.98 (95% CI: 0.96, 0.99; P=0.03),indicating a 2%-11% reduced risk of death for every one unit increase in QOL. When QOL was categorised according to changes between six and 18 months post-diagnosis, analyses showed that for those who experienced declines in functional and physical QOL, risk of death increased by two- (95% CI: 1.43, 12.52; P<0.01) and four-fold (95% CI: 1.15, 7.19; P=0.02), respectively. Conclusions: This work indicates that specific QOL scales at six months post-diagnosis, and changes in certain QOL scales over the subsequent 12-month period (as measured by the FACT-B+4), are associated with overall survival in women with early-stage breast cancer.

Young people, imagination and re-engagement in the middle years

This article reports on the first stage of a study that uses Young People as Researchers methodology to investigate the phenomenon of middle-year student disengagement. The study obtains student perspectives on the meanings of engagement and disengagement using a variety of innovative research methods. The first stage of the study focused on a two-day workshop giving students and teachers an overview of the project and providing training and experience in conducting research in their schools. The process employed by the study provides spaces and resources for critical thinking and encourages imaginative responses to the real life problems confronting the students and their peers and affecting their educational engagement. This article describes ways in which engagement is viewed both theoretically and through the empirical work of the student researchers, and how various applications of ‘disciplined imagination’ connect with methods of investigating and understanding engagement.

The effectiveness of product placement within the immersive environment

This research investigates the impact of participants’ involvement on evaluation of virtual product placement within immersive environments. An exploratory student was conducted and face-to-face, semi structured interviews were used in this research. That sample consisted of active and current Second Life users in the age group of 20-50 years old and from a range of different occupations. Results of the qualitative study indicate that high involvement with the product and deep immersion within Second Life both lead to higher perceptions of product placement effectiveness and enhanced virtual experience. A model developed from the qualitative study is presented and future research is discussed.

Enhancing Student Learning in Large Undergraduate Clasees by Using Audio-visual Case Studies

Critical skills such as identifying and appreciating issues that confront firms engaging in international business, and the ability to undertake creative decision-making, are considered fundamental to the study of International Business. It has been argued that using audio-visual case studies can help develop such skills. However, this is difficult due to a lack of Australian case studies. This paper reviews the literature outlining the advantages believed to result from the use of audio-visual case studies, describes a project implemented in a large cohort of students studying International Business, reports on a pilot evaluation of the project, and outlines the findings and conclusions of the survey.

Serious playground : using Second Life to engage high school students in urban planning

Virtual world platforms such as Second Life have been successfully used in educational contexts to motivate and engage learners. This article reports on an exploratory workshop involving a group of high school students using Second Life for an urban planning project. Young people are traditionally an under-represented demographic when it comes to participating in urban planning and decision making processes. The research team developed activities that combined technology with a constructivist approach to learning. Real world experiences and purposes ensured that the workshop enabled students to see the relevance of their learning. Our design also ensured that play remained an important part of the learning. By conceiving of the workshop as a ‘serious playground’ we investigated the ludic potential of learning in a virtual world.

Sampling perceptions; testing reality : an evidence-based approach to measurably improve information literacy and student research skills

Do commencing students possess the level of information literacy (IL) knowledge and skills they need to succeed at university? What impact does embedding IL within the engineering and design curriculum have? This paper reports on the self-perception versus the reality of IL knowledge and skills, across a large cohort of first year built environment and engineering students. Acting on the findings of this evaluation, the authors (a team of academic librarians) developed an intensive IL skills program which was integrated into a faculty wide unit. Perceptions, knowledge and skills were re-evaluated at the end of the semester to determine if embedded IL education made a difference. Findings reveal that both the perception and reality of IL skills were significantly and measurably improved.

What about me? Avoiding fatigue and gaining personal time in the work to leisure transition in work-life balance initiatives

Fatigue and overwork are problems experienced by numerous employees in many industry sectors. Focusing on improving work-life balance can frame the ‘problem’ of long work hours to resolve working time duration issues. Flexible work options through re-organising working time arrangements is key to developing an organisational response for delivering work-life balance and usually involves changing the internal structure of work time. This study examines the effect of compressed long weekly working hours and the consequent ‘long break’ on work-life balance. Using Spillover theory and Border theory, this research considers organisational and personal determinants of overwork and fatigue. It concludes compressed long work hours with a long break provide better work-life balance. Further, a long break allows gaining ‘personal time’ and overcoming fatigue.

International students using online information resources to learn

This qualitative study views international students as information-using learners, through an information literacy lens. Focusing on the experiences of 25 international students at two Australian universities, the study investigates how international students use online information resources to learn, and identifies associated information literacy learning needs. An expanded critical incident approach provided the methodological framework for the study. Building on critical incident technique, this approach integrated a variety of concepts and research strategies. The investigation centred on real-life critical incidents experienced by the international students whilst using online resources for assignment purposes. Data collection involved semi-structured interviews and an observed online resource-using task. Inductive data analysis and interpretation enabled the creation of a multifaceted word picture of international students using online resources and a set of critical findings about their information literacy learning needs. The study’s key findings reveal: • the complexity of the international students’ experience of using online information resources to learn, which involves an interplay of their interactions with online resources, their affective and reflective responses to using them, and the cultural and linguistic dimensions of their information use. • the array of strengths as well as challenges that the international students experience in their information use and learning. • an apparent information literacy imbalance between the international students’ more developed information skills and less developed critical and strategic approaches to using information • the need for enhanced information literacy education that responds to international students’ identified information literacy needs. Responding to the findings, the study proposes an inclusive informed learning approach to support reflective information use and inclusive information literacy learning in culturally diverse higher education environments.

Challenging endoscopy reprocessing guidelines: a prospective study investigating the safe shelf life of flexible endoscopes in a tertiary gastroenterology unit.

Professional prac− tice guidelines for endoscope reprocessing re− commend reprocessing endoscopes between each case and proper storage following repro− cessing after the last case of the list. There is lim− ited empirical evidence to support the efficacy of endoscope reprocessing prior to use in the first case of the day; however, internationally, many guidelines continue to recommend this practice. The aim of this study is to estimate a safe shelf life for flexible endoscopes in a high−turnover gastroenterology unit. Materials and methods: In a prospective obser− vational study, all flexible endoscopes in active service during the 3−week study period were mi− crobiologically sampled prior to reprocessing be− fore the first case of the day (n = 200). The main outcome variables were culture status, organism cultured, and shelf life. Results: Among the total number of useable samples (n = 194), the overall contamination rate was 15.5 %, with a pathogenic contamination rate of 0.5 %. Mean time between last case one day and reprocessing before the first case on the next day (that is, shelf life) was 37.62 h (SD 36.47). Median shelf life was 18.8 h (range 5.27± 165.35 h). The most frequently identified organ− ism was coagulase−negative Staphylococcus, an environmental nonpathogenic organism. Conclusions: When processed according to es− tablished guidelines, flexible endoscopes remain free from pathogenic organisms between last case and next day first case use. Significant re− ductions in the expenditure of time and resources on reprocessing endoscopes have the potential to reduce the restraints experienced by high−turnover endoscopy units and improve ser− vice delivery.

Creating and enabling opportunities for increased student participation in experience based learning in professional practice

This paper explores models for enabling increased participation in experience based learning in legal professional practice. Legal placements as part of “for-credit” units offer students the opportunity to develop their professional skills in practice, reflect on their learning and job performance and take responsibility for their career development and planning. In short, work integrated learning (WIL) in law supports students in making the transition from university to practice. Despite its importance, WIL has traditionally taken place in practical legal training courses (after graduation) rather than during undergraduate law courses. Undergraduate WIL in Australian law schools has generally been limited to legal clinics which require intensive academic supervision, partnerships with community legal organisations and government funding. This paper will propose two models of WIL for undergraduate law which may overcome many of the challenges to engaging in WIL in law (which are consistent with those identified generally by the WIL Report). The first is a virtual law placement in which students use technology to complete a real world project in a virtual workplace under the guidance of a workplace supervisor. The second enables students to complete placements in private legal firms, government legal offices, or community legal centres under the supervision of a legal practitioner. The units complement each other by a) creating and enabling placement opportunities for students who may not otherwise have been able to participate in work placement by reason of family responsibilities, financial constraints, visa restrictions, distance etc; and b) enabling students to capitalise on existing work experience. This paper will report on the pilot offering of the units in 2008, the evaluation of the models and changes implemented in 2009. It will conclude that this multi-pronged approach can be successful in creating opportunities for, and overcoming barriers to participation in experiential learning in legal professional practice.

What determines the health-related quality of life among regional and rural breast cancer survivors?

Objective: To assess the health-related quality of life (HRQoL) of regional and rural breast cancer survivors at 12 months post-diagnosis and to identify correlates of HRQoL. Methods: 323 (202 regional and 121 rural) Queensland women diagnosed with unilateral breast cancer in 2006/2007 participated in a population-based, cross-sectional study. HRQoL was measured using the Functional Assessment of Cancer Therapy, Breast plus arm morbidity (FACT-B+4) self-administered questionnaire. Results: In age-adjusted analyses, mean HRQoL scores of regional breast cancer survivors were comparable to their rural counterparts 12 months post-diagnosis (122.9, 95% CI: 119.8, 126.0 vs. 123.7, 95% CI: 119.7, 127.8; p>0.05). Irrespective of residence, younger (<50 years) women reported lower HRQoL than older (50+ years) women (113.5, 95% CI: 109.3, 117.8 vs. 128.2, 95%CI: 125.1, 131.2; p<0.05). Those women who received chemotherapy, reported two complications post-surgery, had poorer upper-body function than most, reported more stress, reduced coping, who were socially isolated, had no confidante for social-emotional support, had unmet healthcare needs, and low health self-efficacy reported lower HRQoL scores. Together, these factors explained 66% of the variance in overall HRQoL. The pattern of results remained similar for younger and older age groups. Conclusions and Implications: The results underscore the importance of supporting and promoting regional and rural breast cancer programs that are designed to improve physical functioning, reduce stress and provide psychosocial support following diagnosis. Further, the information can be used by general practitioners and other allied health professionals for identifying women at risk of poorer HRQoL.

Age-related differences in exercise and quality of life among breast cancer survivors

Purpose: Physical activity has become a focus of cancer recovery research as it has the potential to reduce treatment-related burden and optimize health-related quality of life (HRQoL). However, the potential for physical activity to influence recovery may be age-dependent. This paper describes physical activity levels and HRQoL among younger and older women after surgery for breast cancer and explores the correlates of physical inactivity. Methods: A population-based sample of breast cancer patients diagnosed in South-East Queensland, Australia, (n=287) were assessed once every three months, from 6 to 18 months post-surgery. The Functional Assessment of Cancer Therapy-Breast questionnaire (FACTB+4) and items from the Behavioral Risk Factor Surveillance System (BRFSS) questionnaire were used to measure HRQoL and physical activity, respectively. Physical activity was assigned metabolic equivalent task (MET) values, and categorized as < 3, 3 to 17.9 and 18+ MET-hours/weeks. Descriptive statistics, generalized linear models with age stratification (<50 years versus 50+ years), and logistic regression were used for analyses (p=0.05, two-tailed). Results: Younger women who engaged in 3 or more MET-hours/week of physical activity reported a higher HRQoL at 18 months compared to their more sedentary counterparts (p<0.05). Older women reported similar HRQoL irrespective of activity level and consistently reported clinically higher HRQoL than younger women. Increasing age, being overweight or obese, and restricting use of the treated side at six months post-surgery increased the likelihood of sedentary behavior (OR>3, p<0.05). Conclusions: Age influences the potential to observe HRQoL benefits related to physical activity participation. These results also provide relevant information for the design of exercise interventions for breast cancer survivors and highlights that some groups of women are at greater risk of long-term sedentary behavior.

Redefining the student-teacher relationship through online sharing activities

The student-teacher relationship should be a critical factor for successful teaching and learning in design education. In tradition, the relationship is defined as a master-apprentice, so design teachers’ visual assessment capability and technical standards significantly affect students’ quality of learning and achievements. However, there are some negative aspects of the master-apprentice relationship in design education that it may restrict student experiences to cultural diversity and interdisciplinary learning through various interactions with other students. A visual design subject was designed to adapt a new learning method that is to share students’ work and assessment through an asynchronous communication tool. This method was expected to reduce the negative aspects of the master-apprentice relationship and enhance peer-to-peer interactions and individualistic collaboration. A survey with two types of student groups in terms of their levels of participation was conducted to evaluate student experiences to this method. The outcomes implicate that online peer assessment is helpful to reduce the negative aspects of master-apprentice relation and can be useful for achieving the ultimate purpose of design education.