Health outcomes of adults 3 months after injury

Background: Injury is a leading cause of preventable mortality and morbidity in Australia and the world. Despite this there is little research examining the health related quality of life of adults following general trauma. Methods: A prospective cohort design was used to study adults who presented to hospital following injury. Data regarding injury and demographic details was collected through the routine operation of the Queensland Trauma Registry (QTR). In addition, the short form 36 (SF-36) was mailed to patients approximately 3 months following injury. Results: Participants included 339 injured patients who were hospitalised for ≥24 h in March-June 2003. A secondary group of 145 patients completed the SF-36, but did not have QTR data collected due to hospitalisation being <24 h. Both groups of participants reported significantly lower scores on all subscales of the SF-36 when compared to Australian norms. Conclusions: Health related quality of life of injured survivors is markedly reduced 3 months after injury. Ongoing treatment and support is necessary to improve these health outcomes.

Long-term outcomes of seriously injured children : a study using the Child Health Questionnaire

Objective: To assess the health-related quality of life (HRQoL) in children 1-2 years after they had sustained an injury. Methods: Parents of all children who were identified by the Queensland Trauma Registry during their admission to either of the two paediatric specialty hospitals in Brisbane, Australia, for the treatment of an injury, were invited to participate in this study. Parents who consented to participation received a copy of the Child Health Questionnaire (CHQ) that required them to provide information regarding their child’s HRQoL following injury. The CHQ scores for the study respondents were compared with those of the Australian norms. This study was approved by the relevant ethics committees. Results: Two hundred and forty-one completed questionnaires were returned. The majority of cases were male (65%) and there was even representation across all age groups. The majority of injuries were considered to be minor (81%) and were predominantly the result of falls and cycling accidents causing mainly fractures and intracranial injury. On the majority of subscales of the CHQ, study participants recorded scores that were statistically significantly below those of the Australian norms. None of the relevant variables collected by the Queensland Trauma Registry were found to predict scores on the CHQ in this study (for those children hospitalized for >24 h). Conclusion: Injured children are worse off than their Australian counterparts in terms of HRQoL even up to 2 years following an injury. Further research needs to be undertaken to identify factors that predict lower HRQoL in order to reduce the burden of injury on children and their families.

Aligning school reform and teacher education reform in the middle years : an Australian case study

This paper discusses the development of a new Bachelor of Education (Middle Years of Schooling) at The University of Queensland, Australia. The middle years of schooling have increasingly been the focus of education reform initiatives in Australia, but this has not been accompanied by significant increases in the number of teacher education institutions offering specialised middle schooling-level teacher preparation programmes. Considering the rapidly changing social and economic context and the emergent state of middle schooling in Australia, the programme represented a conceptual and practical opportunity and challenge for The University of Queensland team. Working collaboratively, the team sought to design a teacher education preservice programme that was both responsive and generative: that is, responsive to local school contexts and to current education research and reform at national and international levels; and generative of cutting-edge theories and practices associated with middle schooling, teachers' work, and teacher education. This paper focuses on one component of the Middle Years of Schooling Teacher Education programme at The University of Queensland; namely, the practicum. We first present the underlying principles of the practicum programme and then examine "dilemmas" that emerged early in the practicum. These issues and tensions were associated with the ideals of "middle years" philosophy and the pragmatics of school reform associated with that approach. Within this context, we explore what it means to be both responsive and generative, and describe how we as teacher educators negotiated the extremes these terms implied.

Crimes against morality

The purpose of this chapter is to discuss the relationship between crime and morality, with a specific focus on crimes against morality. While we argue that all crimes have a general moral basis, condemned as wrong or bad and proscribed by society, there is a specific group of offences in modern democratic nations labelled crimes against morality. Included within this group are offences related to prostitution, pornography and homosexuality. What do these crimes have in common? Most clearly they tend to have a sexual basis and are often argued to do sexual harm, in both a moral and /or psychological sense, as well as physically. Conversely they are often argued to be victimless crimes, especially when the acts occur between consenting adults. Finally they are considered essentially private acts but they often occur, and are regulated, in the public domain. Most importantly, each of these crimes against morality has only relatively recently (ie in the past 150 years) become identified and regulated by the state as a criminal offence.

Rethinking Prostitution : feminism, sex and the self

Prostitution is a difficult issue, particularly for feminists. Are prostitutes victims of exploitation or the most honest of women? Are clients perverts or just acting instinctively? Should prostitution be eliminated or supported? This book examines these contemporary questions and offers a way of thinking about the issues, which does not rely on these inappropriate and often ineffectual options. Repositioning the institution and its main players outside the confines of the prostitution debate offers new and exciting ways of thinking and acting for all those interested in moving this discussion into the twenty-first century.

The impact of child sexual abuse on victims/survivors: Exploring posttraumatic outcomes as a function of childhood sexual abuse

There is sparse systematic examination of the potential for growth as well as distress that may occur for some adult survivors of childhood sexual abuse. The presented study explored posttraumatic growth and its relationship with negative posttrauma outcomes within the specific population of survivors of childhood sexual abuse (N = 40). Results showed that 95% of the participants experienced clinically significant post-traumatic stress disorder symptomatology related to their childhood sexual abuse. In conjunction with these high levels of negative symptoms, the population evidenced posttraumatic growth levels that were comparable to other trauma samples. This research has clinical relevance in terms of adding to the knowledge base on sexual abuse and the usefulness of this knowledge in therapeutic interventions and relationships.

Working in groups

This chapter is a condensation of a guide written by the chapter authors for both university teachers and students (Fowler et al., 2006). All page references given in this chapter are to this guide, unless otherwise stated. University students often work in groups. It may be a formal group (i.e. one that has been formed for a group presentation, writing a report, or completing a project) or an informal group (i.e. some students have decided to form a study group or undertake research together). Whether formal or informal, this chapter aims to make working in groups easier for you. Health care professionals also often work in groups. Yes, working in groups will extend well beyond your time at university. In fact, the skills and abilities to work effectively in groups are some of the most sought-after attributes in health care professionals. It seems obvious, then, that taking the opportunity to develop and enhance your skills and abilities for working in groups is a wise choice.

Obesity in pregnancy : outcomes and economics

Maternal obesity is an important aspect of reproductive care. It is the commonest risk factor for maternal mortality in developed countries and is also associated with a wide spectrum of adverse pregnancy outcomes. Maternal obesity may have longer-term implications for the health of the mother and infant, which in turn will have economic implications. Efforts to prevent, manage and treat obesity in pregnancy will be costly, but may pay dividends from reduced future economic costs, and subsequent improvements to maternal and infant health. Decision-makers working in this area of health services should understand whether the problem can be reduced, at what cost; and then, what cost savings and health benefits will accrue in the future from a reduction of the problem.

Geological control of physiography in Southeast Queensland: A multi-scale analysis using GIS

The study reported here, constitutes a full review of the major geological events that have influenced the morphological development of the southeast Queensland region. Most importantly, it provides evidence that the region’s physiography continues to be geologically ‘active’ and although earthquakes are presently few and of low magnitude, many past events and tectonic regimes continue to be strongly influential over drainage, morphology and topography. Southeast Queensland is typified by highland terrain of metasedimentary and igneous rocks that are parallel and close to younger, lowland coastal terrain. The region is currently situated in a passive margin tectonic setting that is now under compressive stress, although in the past, the region was subject to alternating extensional and compressive regimes. As part of the investigation, the effects of many past geological events upon landscape morphology have been assessed at multiple scales using features such as the location and orientation of drainage channels, topography, faults, fractures, scarps, cleavage, volcanic centres and deposits, and recent earthquake activity. A number of hypotheses for local geological evolution are proposed and discussed. This study has also utilised a geographic information system (GIS) approach that successfully amalgamates the various types and scales of datasets used. A new method of stream ordination has been developed and is used to compare the orientation of channels of similar orders with rock fabric, in a topologically controlled approach that other ordering systems are unable to achieve. Stream pattern analysis has been performed and the results provide evidence that many drainage systems in southeast Queensland are controlled by known geological structures and by past geological events. The results conclude that drainage at a fine scale is controlled by cleavage, joints and faults, and at a broader scale, large river valleys, such as those of the Brisbane River and North Pine River, closely follow the location of faults. These rivers appear to have become entrenched by differential weathering along these planes of weakness. Significantly, stream pattern analysis has also identified some ‘anomalous’ drainage that suggests the orientations of these watercourses are geologically controlled, but by unknown causes. To the north of Brisbane, a ‘coastal drainage divide’ has been recognized and is described here. The divide crosses several lithological units of different age, continues parallel to the coast and prevents drainage from the highlands flowing directly to the coast for its entire length. Diversion of low order streams away from the divide may be evidence that a more recent process may be the driving force. Although there is no conclusive evidence for this at present, it is postulated that the divide may have been generated by uplift or doming associated with mid-Cenozoic volcanism or a blind thrust at depth. Also north of Brisbane, on the D’Aguilar Range, an elevated valley (the ‘Kilcoy Gap’) has been identified that may have once drained towards the coast and now displays reversed drainage that may have resulted from uplift along the coastal drainage divide and of the D’Aguilar blocks. An assessment of the distribution and intensity of recent earthquakes in the region indicates that activity may be associated with ancient faults. However, recent movement on these faults during these events would have been unlikely, given that earthquakes in the region are characteristically of low magnitude. There is, however, evidence that compressive stress is building and being released periodically and ancient faults may be a likely place for this stress to be released. The relationship between ancient fault systems and the Tweed Shield Volcano has also been discussed and it is suggested here that the volcanic activity was associated with renewed faulting on the Great Moreton Fault System during the Cenozoic. The geomorphology and drainage patterns of southeast Queensland have been compared with expected morphological characteristics found at passive and other tectonic settings, both in Australia and globally. Of note are the comparisons with the East Brazilian Highlands, the Gulf of Mexico and the Blue Ridge Escarpment, for example. In conclusion, the results of the study clearly show that, although the region is described as a passive margin, its complex, past geological history and present compressive stress regime provide a more intricate and varied landscape than would be expected along typical passive continental margins. The literature review provides background to the subject and discusses previous work and methods, whilst the findings are presented in three peer-reviewed, published papers. The methods, hypotheses, suggestions and evidence are discussed at length in the final chapter.

Poly-immunoglobulin receptor-mediated transport of IgA into the male genital tract is important for clearance of chlamydia muridarum infection

Problem: Chlamydia trachomatis is the most common sexually transmitted infection worldwide. While infection in females requires a Th1 response for clearance, such a response in males may disrupt the immune privileged nature of the male reproductive tract, potentially contributing to infertility. Method of study: We investigated the role of IgA in protection against an intrapenile Chlamydia muridarum infection of C57BL/6 and pIgR−/− mice. Results: Here, we show that the poly immunoglobulin receptor is the main pathway for IgA transport into the male reproductive tract. The high levels of IgA seen in prostatic fluid of wild-type mice correlate with reduction in chlamydial infection both in vitro and in vivo. Conclusion: These findings indicate that a Chlamydia vaccine that induces neutralizing IgA in the prostate will aid in the protection against infection in males.

Spun from four horizons : re-writing the Sydney Harbour Bridge

The Sydney Harbour Bridge provides an imaginative space that is revisited by Australian writers in particular ways. In this space novelists, poets, and cultural historians negotiate questions of emotional and psychological transformation as well as reflect on social and environmental change in the city of Sydney. The writerly tensions that mark these accounts often alter, or query, representations of the Bridge as a symbol of material progress and demonstrate a complex creative engagement with the Bridge. This discussion of ‘the Bridge’ focuses on the work of four authors, Eleanor Dark, P.R. Stephensen, Peter Carey and Vicki Hastrich and includes a range of other fictional and non-fictional accounts of ‘Bridge-writing.’ The ideas proffered are framed by a theorising of space, especially referencing the work of Michel de Certeau, whose writing on the spatial ambiguity of a bridge is important to the examination of the diverse ways in which Australian writers have engaged with the imaginative potential and almost mythic resonance of the Sydney Harbour Bridge.

Patterns of engagement in workplace learning amongst employees from social sectors

Continuous learning and development has become increasingly important in the information age. However, employees with limited formal education in lower status occupations may be disadvantaged in their opportunities for development, as their jobs tend to require more limited knowledge and skills. In mature age, such workers may be subject to cumulative disadvantage with respect to work related learning and development, as well as negative stereotyping. This thesis concerns work related learning and development from a lifespan development psychology perspective. Development across the lifespan is grounded in biocultural co-constructivism. That is, the reciprocal influences of the individual and environment produce change in the individual. Existing theories and models of adaptive development attempt to explain how developmental resources are allocated across the lifespan. These included the Meta- theory of Selective Optimisation with Compensation, Dual Process Model of Self Regulation, and Developmental Regulation via Optimisation and Primary and Secondary Control. These models were integrated to create the Model of Adaptive Development for Work Related Learning. The Learning and Development Survey (LDS) was constructed to measure the hypothesised processes of adaptive development for work related learning, which were individual goal selection, individual goal engagement, individual goal disengagement, organisational opportunities (selection and engagement), and organisational constraints. Data collection was undertaken in two phases: the pilot study and the main study. The objective of the pilot study was to test the LDS on a target population of 112 employees from a local government organisation. Exploratory factor analysis reduced the pilot version of the survey to 38 items encompassing eight constructs which covered the processes of the model of adaptive development for work related learning. In the main study, the Revised Learning and Development Survey (R-LDS) was administered to another group of 137 employees from the local government organisation, as well as 110 employees from a private healthcare organisation. The purpose of the main study was to validate the R-LDS on two different groups to provide evidence of stability, and compare survey scores according to age and occupational status to determine construct validity. Findings from the main study indicated that only four constructs of the R-LDS were stable, which were organisational opportunities – selection, individual goal engagement, organisational constraints – disengagement and organisational opportunities – engagement. In addition, MANOVA studies revealed that the demographic variables affected organisational opportunities and constraints in the workplace, although individual goal engagement was not influenced by age. The findings from the pilot and main study partially supported the model of adaptive development for work related learning. Given that only four factors displayed adequate reliability in terms of internal consistency and stability, the findings suggest that individual goal selection and individual goal disengagement are less relevant to work related learning and development. Some recent research which emerged during the course of the current study has suggested that individual goal selection and individual goal disengagement are more relevant when goal achievement is impeded by biological constraints such as ageing. However, correlations between the retained factors support the model of adaptive development for work related learning, and represent the role of biocultural co-constructivism in development. Individual goal engagement was positively correlated with both opportunity factors (selection and engagement), while organisational constraints – disengagement was negatively correlated with organisational opportunities – selection. Demographic findings indicated that higher occupational status was associated with more opportunities for development. Age was associated with fewer opportunities or greater constraints for development, especially for lower status workers.