Nutrition screening and risk factors prior to chemotherapy in cancer patients 65 years and older

Background The largest proportion of cancer patients are aged 65 years and over. Increasing age is also associated with nutritional risk and multi-morbidities—factors which complicate the cancer treatment decision-making process in older patients. Objectives To determine whether malnutrition risk and Body Mass Index (BMI) are associated with key oncogeriatric variables as potential predictors of chemotherapy outcomes in geriatric oncology patients with solid tumours. Methods In this longitudinal study, geriatric oncology patients (aged ≥65 years) received a Comprehensive Geriatric Assessment (CGA) for baseline data collection prior to the commencement of chemotherapy treatment. Malnutrition risk was assessed using the Malnutrition Screening Tool (MST) and BMI was calculated using anthropometric data. Nutritional risk was compared with other variables collected as part of standard CGA. Associations were determined by chi-square tests and correlations. Results Over half of the 175 geriatric oncology patients were at risk of malnutrition (53.1%) according to MST. BMI ranged from 15.5–50.9kg/m2, with 35.4% of the cohort overweight when compared to geriatric cutoffs. Malnutrition risk was more prevalent in those who were underweight (70%) although many overweight participants presented as at risk (34%). Malnutrition risk was associated with a diagnosis of colorectal or lung cancer (p=0.001), dependence in activities of daily living (p=0.015) and impaired cognition (p=0.049). Malnutrition risk was positively associated with vulnerability to intensive cancer therapy (rho=0.16, p=0.038). Larger BMI was associated with a greater number of multi-morbidities (rho =.27, p=0.001. Conclusions Malnutrition risk is prevalent among geriatric patients undergoing chemotherapy, is more common in colorectal and lung cancer diagnoses, is associated with impaired functionality and cognition and negatively influences ability to complete planned intensive chemotherapy.

Passenger experience at airports : An activity-centred approach

This project has provided a new understanding of the passenger experience in Australian international airport departure terminals. A novel understanding of the passenger experience developed by observing the activities passengers carried out on their day of travel, and interviewing passengers and staff members. The development of the Taxonomy of Passenger Activities (TOPA) has been an important outcome of this research. It provides a new understanding of the airport passenger experience at departure. The Taxonomy of Passenger Activities identifies the activities that improve the experience of passengers and the processing efficiency of the airport terminal.

Challenging the female underperformance hypothesis

Purpose – The question of whether female-owned firms underperform male-owned firms has triggered much research and discussion. Klapper and Parker's review concluded that the majority of prior research suggests that female-owned firms underperform relative to male-owned firms. However, using performance measures that control for size and risk (and after controlling for demographic differences such as industry, experience and hours worked) Robb and Watson found no gender performance difference in their sample of newly established US firms. The aim of this study, therefore, is to replicate Robb and Watson's study to determine whether their findings can be generalized to another geographical location, Australia. Design/methodology/approach – The authors test the female underperformance hypothesis using data from the CAUSEE project, a panel study which follows young firms over four years. They use three outcome variables: survival rates, return on assets and the Sharpe ratio. Findings – Consistent with Robb and Watson the results indicate that female-owned firms do not underperform male-owned firms. Originality/value – While replication studies are rare in entrepreneurship, they are an important tool for accumulating generalizable knowledge. The results suggest that while female-owned firms differ from male-owned firms in terms of many control variables (such as industry, owners' previous experience and hours worked) they are no less successful. This outcome should help dispel the female underperformance myth; which if left unchallenged could result in inappropriate policy decisions and, more importantly, could discourage women from establishing new ventures.

Incongruence between self-reported and observed senior physical education teaching styles : an analysis using Mosston and Ashworth’s spectrum

Pedagogical styles, methods, models, practices or strategies are valued for what they claim they can achieve. In recent times curriculum documents and governments have called for a range of teaching approaches to meet the variety of learner differences and allow students to make more independent decision making in physical education (Hardy and Mawer, 1999). One well known system of categorizing teaching styles is the Mosston and Ashworth’s Spectrum of Teaching Styles (2002). In Queensland, prior to 2005, no research had been conducted on the teaching styles used by teachers of Physical Education. However, many teachers self-reported that they employed a variety of teaching styles depending on the aims and content of the material to be taught (Cothran, et al., 2005). This research, for the first time, collected teacher’s self-reported use of teaching styles and through observations verify the styles that were being used to teach Senior Physical Education in Queensland. More specifically the aims of the research were to determine: a) What teaching styles teachers of Senior Physical Education in Queensland believe they use? i) Were they using a range of teaching styles? ii) Were teachers of Senior Physical Education in Queensland using teaching styles that the Queensland Senior Physical Education Syllabus (2004) required? b) If Mosston and Ashworth’s (2002) Spectrum of Teaching Styles were used to categorise styles observed during the teaching of Senior Physical Education did the styles being used provide opportunities for evaluating as described by the Queensland Senior Physical Education Syllabus (2004)? The research was conducted in two phases. Part A involved use of a questionnaire to determine the teaching styles Queensland teachers of Senior Physical Education reported using and how often they reported using them. The questionnaire was administered to 110 teachers throughout Queensland. The sample was determined from 346 schools teaching Senior Physical Education (in 2006) across the state of Queensland, Australia. 286 questionnaires were sent to 77 non-randomised schools. There were 66 male and 44 female respondents in the sample. A wide range of teaching styles were reportedly used by teachers of Senior Physical Education with Practice Style-Style B, Command Style-Style A and Divergent Discovery Style-Style H, the most reportedly used. The Self-Teaching Style-Style K was reportedly used the least by teachers involved in this study. From the respondents a group of teachers were identified to form the participants for Part B. Part B of the study involved observation of a group of volunteer participants (from those who had completed the questionnaire) who displayed many of the ‘typical’ characteristics, and a cross-section of backgrounds, of teachers of Senior Physical Education in Queensland. In the case of this study, the criteria used to select the group of teachers to be observed teaching were, teaching experience (number of years: 0-4, 5-10 and 11 years and over), gender, geographical location of schools (focused on Brisbane and near area for travel/access purposes), profile of the students at schools (girls, boys or co-educational), nature of school (Government or Private) and the physical activities being taught in a school (activities to reflect all the areas of physical activity outlined within the syllabus). A total of 27 questionnaire respondents from Part A indicated that they were willing to be observed teaching practical lessons. The respondents who volunteered to be involved in Part B of the study came from different regions across the state of Queensland and was not confined to the Brisbane metropolitan area or large cities. From the group of people who volunteered for Part B four came from outside Brisbane and 23 from the Brisbane area. The final observation group of nine participants included eight teachers from the Brisbane area and one from a rural area. The characteristics of the final group included three females and six males from private and public schools with a range of teaching experience in years and a range of physical activities. Four year 12 and five year 11 teachers and their classes were videoed on three occasions as they progressed through an eight – nine week unit of work. This resulted in 24 hours 48 minutes and 20 seconds (or 4465 observations) of video teaching data which was subsequently coded by several researchers (99% interobserver reliability) to determine the teaching styles employed by the participants. This research indicated that, based on Mosston and Ashworth’s (2002) Spectrum of Teaching Styles, teachers of Senior Physical Education in Queensland used predominantly one style to teach 27 observed lessons. This is in sharp contrast to the variety of styles 110 teachers self- reportedly used and in spite of the Queensland Senior Physical Education Syllabus (2004) suggesting a range of specific styles be used. These results are discussed in the context of the Queensland Senior Physical Education Syllabus (2004), teacher knowledge of teaching styles and high-stakes curriculum and external pressures such as national testing and the publication of data from schools in tabloid newspapers. The data and findings in this research provide a rationale for improving teacher knowledge regarding teaching styles and the need for a clear definition of terminology in syllabus documents. Careful examination of the effects that the publishing of school data may have on teaching styles is advised. This research not only collected teacher’s perceptions of the teaching styles they believed they used it also verified these claims through direct observations of the teachers while teaching. These findings are relevant to syllabus writers, teacher educators, policy makers within education and teachers.

Knowledge is not power, but it’s a start : what young people know about their rights and obligations in employment

Scholarship addressing the employment concerns of school age workers has identified a number of areas of vulnerability. Prominent among these is that young workers have insufficient knowledge of their rights in employment, yet the extent of this knowledge has not previously been quantified. This study explores areas of strength and deficit in awareness of employment rights and obligations in a sample of 892 young people in Australian high schools. The findings demonstrate that, despite part-time work being a majority experience for school students, young Australians know relatively little of their employment rights. The conclusions underscore the need for education strategies that inform young people prior to and in the very early stages of their working lives.

The evolving emotional experience with portable interactive devices

Emotions play a significant role in people’s lives, including interactions with portable devices. The research aimed to understand the evolving emotional experience between people and portable interactive devices (PIDs). Activity Theory was the theoretical framework used to contextualise the research approach and findings. Two longitudinal experiments were conducted investigating emotional experiences with PIDs over six months. Experiment 1 focused on media / entertainment PIDs while Experiment 2 focused on medical / health PIDs. Mixed research methods consisting of diaries, interviews and codiscovery sessions were used to collect data. Results identified that more social interactions were experienced with media PIDs than medical PIDs. Different Task Categories, and their emotional responses, were also revealed including Features, Functional, Mediation and Auxiliary Categories. Functional and Mediation categories were characterised as overall positive while Features and Auxiliary Categories were characterised as overall negative. Further, the consequences of Negative Personal and Social interactions on the overall emotional experience were determined. For media PIDs, Negative Social experiences adversely impacted the evolving emotional experience. For medical PIDs, both Negative Social and Negative Personal experiences adversely impacted the evolving emotional experience. As a result of the findings the Designing for Evolving Emotional Experience framework was developed, outlining principles to promote positive, and avoid negative, emotional experiences with PIDs. Contributions to knowledge from the research include methodological contributions, advancing understanding of emotional experiences with PIDs, expanding the taxonomy of emotional interactions with PIDs and broadening emotion design theory and principles. The thesis concludes with an outline of implications to design research, design and related fields, future research potentials, as well as the positive contributions to designing for meaningful and enjoyable experiences in everyday life.

TrainRoulette : promoting situated in-train social interaction between passengers

Travelling by public transport is usually regarded as boring and uninteresting. Refraining from talking to the stranger next to you may be due to limitations that are self-imposed and further corroborated by social expectations and cultural norms that govern behaviour in public space. Our design research into passenger interactions on board of urban commuter trains has informed the development of the TrainRoulette prototype – a mobile app for situated, real-time chats between train passengers. We study the impact of our design intervention on shaping perceptions of the train journey experience. Moreover, we are interested in the implications of such ICT-mediated interactions within train journeys for stimulating social offline interactions and new forms of passenger engagement.

The SCOOT experience : games in place : collaborative interventions in socio-spatial practices

The principal focus of this thesis is the representation of a significant creative practice in relation to the design and installation of the Location-Based Game, SCOOT. This project demonstrates new understandings relating to the contingencies and potentials for transferring positive aspects of digital gameplay to everyday physical environments in an effort to reveal hidden histories and revitalise peoples’ interactions with their local urban spaces.

Risk factors for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory : a matched case-control study

Background: Side effects of the medications used for procedural sedation and analgesia in the cardiac catheterisation laboratory are known to cause impaired respiratory function. Impaired respiratory function poses considerable risk to patient safety as it can lead to inadequate oxygenation. Having knowledge about the conditions that predict impaired respiratory function prior to the procedure would enable nurses to identify at-risk patients and selectively implement intensive respiratory monitoring. This would reduce the possibility of inadequate oxygenation occurring. Aim: To identify pre-procedure risk factors for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory. Design: Retrospective matched case–control. Methods: 21 cases of impaired respiratory function were identified and matched to 113 controls from a consecutive cohort of patients over 18 years of age. Conditional logistic regression was used to identify risk factors for impaired respiratory function. Results: With each additional indicator of acute illness, case patients were nearly two times more likely than their controls to experience impaired respiratory function (OR 1.78; 95% CI 1.19–2.67; p = 0.005). Indicators of acute illness included emergency admission, being transferred from a critical care unit for the procedure or requiring respiratory or haemodynamic support in the lead up to the procedure. Conclusion: Several factors that predict the likelihood of impaired respiratory function were identified. The results from this study could be used to inform prospective studies investigating the effectiveness of interventions for impaired respiratory function during nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory.

Toward an in-depth understanding of cardiovascular interventional nursing : a qualitative study into nursing within the cardiac catheterisation laboratory setting

Introduction: Nursing in the cardiac catheterisation laboratory (CCL) varies globally in terms of scope and deployment. In the US, all allied staff are cross-trained into all CCL roles. The Australian and New Zealand experience has legislative frameworks that reserves specific functions to nurses. Yet, the nursing role within the CCL is poorly researched and defined. Aim: This study sought to gain deeper understanding of the perceived role of CCL nurses in Australia and New Zealand. Method: A descriptive qualitative study using semi-structured in-depth interviews was used. A cross-sectional sample of 23 senior clinical nurses or nursing managers representing 16 CCLs across Australia and New Zealand was obtained. Data were digitally recorded and transcribed verbatim prior to analysis by three researchers. Results: Five major themes emerged from the data. These themes were: 1. The CCL is a unique environment; 2. CCL nursing is a unique and advanced cardiac nursing discipline; 3. The recruitment attributes for CCL nurses are advanced; 4. Education needs to be standardised; and 5. The evidence to support practice is poor. Discussion: The CCL environment is a dynamic, deeply interdisciplinary setting with CCL nursing seen to be a unique advanced practice role. Yet the time has come for a scope of practice, educational standards, guidelines and competencies was expressed by the participants. Conclusion: Nursing in the CCL is an advanced practice role working within a complex interdisciplinary environment. Further work is required to define the role of CCL nurses together with the evidence-base for their practice.

Social Media Sites as Online Information Grounds : An exploratory study of the ways in which Information Technology (IT) professionals experience social media

Social media tools are often the result of innovations in Information Technology and developed by IT professionals and innovators. Nevertheless, IT professionals, many of whom are responsible for designing and building social media technologies, have not been investigated on how they themselves use or experience social media for professional purposes. This study will use Information Grounds Theory (Pettigrew, 1998) as a framework to study IT professionals’ experience in using social media for professional purposes. Information grounds facilitates the opportunistic discovery of information within social settings created temporarily at a place where people gather for a specific purpose (e.g., doctors’ waiting rooms, office tea rooms etc.), but the social atmosphere stimulates spontaneous sharing of information (Pettigrew, 1999). This study proposes that social media has the qualities that make it a rich information grounds; people participate from separate “places” in cyberspace in a synchronous manner in real-time, making it almost as dynamic and unplanned as physical information grounds. There is limited research on how social media platforms are perceived as a “place,” (a place to go to, a place to gather, or a place to be seen in) that is comparable to physical spaces. There is also no empirical study on how IT professionals use or “experience” social media. The data for this study is being collected through a study of IT professionals who currently use Twitter. A digital ethnography approach is being taken wherein the researcher uses online observations and “follows” the participants online and observes their behaviours and interactions on social media. Next, a sub-set of participants will be interviewed on their experiences with and within social media and how social media compares with traditional methods of information grounds, information communication, and collaborative environments. An Evolved Grounded Theory (Glaser, 1992) approach will be used to analyse tweets data and interviews and to map the findings against the Information Ground Theory. Findings from this study will provide foundational understanding of IT professionals’ experiences within social media, and can help both professionals and researchers understand this fast-evolving method of communications.

Differences in the symptom experience of older versus younger oncology outpatients : a cross-sectional study

Background: Mortality rates for cancer are decreasing in patients under 60 and increasing in those over 60 years of age. The reasons for these differences in mortality rates remain poorly understood. One explanation may be that older patients received substandard treatment because of concerns about adverse effects. Given the paucity of research on the multiple dimensions of the symptom experience in older oncology patients, the purpose of this study was to evaluate for differences in ratings of symptom occurrence, severity, frequency, and distress between younger (< 60 years) and older ( ≥ 60 years) adults undergoing cancer treatment. We hypothesized that older patients would have significantly lower ratings on four symptom dimensions. Methods: Data from two studies in the United States and one study in Australia were combined to conduct this analysis. All three studies used the MSAS to evaluate the occurrence, severity, frequency, and distress of 32 symptoms. Results: Data from 593 oncology outpatients receiving active treatment for their cancer (i.e., 44.4% were < 60 years and 55.6% were ≥ 60 years of age) were evaluated. Of the 32 MSAS symptoms, after controlling for significant covariates, older patients reported significantly lower occurrence rates for 15 (46.9%) symptoms, lower severity ratings for 6 (18.9%) symptoms, lower frequency ratings for 4 (12.5%) symptoms, and lower distress ratings for 14 (43.8%) symptoms. Conclusions: This study is the first to evaluate for differences in multiple dimensions of symptom experience in older oncology patients. For almost 50% of the MSAS symptoms, older patients reported significantly lower occurrence rates. While fewer age-related differences were found in ratings of symptom severity, frequency, and distress, a similar pattern was found across all three dimensions. Future research needs to focus on a detailed evaluation of patient and clinical characteristics (i.e., type and dose of treatment) that explain the differences in symptom experience identified in this study.

Factors influencing research engagement : research interest, confidence and experience in an Australian speech-language pathology workforce

Background Recent initiatives within an Australia public healthcare service have seen a focus on increasing the research capacity of their workforce. One of the key initiatives involves encouraging clinicians to be research generators rather than solely research consumers. As a result, baseline data of current research capacity are essential to determine whether initiatives encouraging clinicians to undertake research have been effective. Speech pathologists have previously been shown to be interested in conducting research within their clinical role; therefore they are well positioned to benefit from such initiatives. The present study examined the current research interest, confidence and experience of speech language pathologists (SLPs) in a public healthcare workforce, as well as factors that predicted clinician research engagement. Methods Data were collected via an online survey emailed to an estimated 330 SLPs working within Queensland, Australia. The survey consisted of 30 questions relating to current levels of interest, confidence and experience performing specific research tasks, as well as how frequently SLPs had performed these tasks in the last 5 years. Results Although 158 SLPs responded to the survey, complete data were available for only 137. Respondents were more confident and experienced with basic research tasks (e.g., finding literature) and less confident and experienced with complex research tasks (e.g., analysing and interpreting results, publishing results). For most tasks, SLPs displayed higher levels of interest in the task than confidence and experience. Research engagement was predicted by highest qualification obtained, current job classification level and overall interest in research. Conclusions Respondents generally reported levels of interest in research higher than their confidence and experience, with many respondents reporting limited experience in most research tasks. Therefore SLPs have potential to benefit from research capacity building activities to increase their research skills in order to meet organisational research engagement objectives. However, these findings must be interpreted with the caveats that a relatively low response rate occurred and participants were recruited from a single state-wide health service, and therefore may not be representative of the wider SLP workforce.

Hybrid placemaking in the library : designing digital technology to enhance users’ on-site experience

This paper presents research findings and design strategies that illustrate how digital technology can be applied as a tool for hybrid placemaking in ways that would not be possible in purely digital or physical space. Digital technology has revolutionised the way people learn and gather new information. This trend has challenged the role of the library as a physical place, as well as the interplay of digital and physical aspects of the library. The paper provides an overview of how the penetration of digital technology into everyday life has affected the library as a place, both as designed by place makers, and, as perceived by library users. It then identifies a gap in current library research about the use of digital technology as a tool for placemaking, and reports results from a study of Gelatine – a custom built user check-in system that displays real-time user information on a set of public screens. Gelatine and its evaluation at The Edge, at State Library of Queensland illustrates how combining affordances of social, spatial and digital space can improve the connected learning experience among on-site visitors. Future design strategies involving gamifying the user experience in libraries are described based on Gelatine’s infrastructure. The presented design ideas and concepts are relevant for managers and designers of libraries as well as other informal, social learning environments.