The validation of an Australian sign language instrument for outcome measurement of adults in mental health settings

Objective: There are currently no adult mental health outcome measures that have been translated into Australian sign language (Auslan). Without a valid and reliable Auslan outcome measure, empirical research into the efficacy of mental health interventions for sign language users is unattainable. To address this research problem the Outcome Rating Scale (ORS), a measure of general functioning, was translated into Auslan and recorded on to digital video disk for use in clinical settings. The purpose of the present study was therefore to examine the reliability, validity and acceptability of an Auslan version of the ORS (ORS-Auslan).
Method: The ORS-Auslan was administered to 44 deaf people who use Auslan as their first language and who identify as members of a deaf community (termed ‘Deaf’ people) on their first presentation to a mental health or counselling facility and to 55 Deaf people in the general community. The community sample also completed an Auslan version of the Depression Anxiety Stress Scale-21 (DASS-21).
Results: t-Tests indicated significant differences between the mean scores for the clinical and community sample. Internal consistency was acceptable given the low number of items in the ORS-Auslan. Construct validity was established by significant correlations between total scores on the DASS-21-Auslan and ORS-Auslan. Acceptability of ORS-Auslan was evident in the completion rate of 93% compared with 63% for DASS-21-Auslan.
Conclusions: This is the only Auslan outcome measure available that can be used across a wide variety of mental health and clinical settings. The ORS-Auslan provides mental health clinicians with a reliable and valid, brief measure of general functioning that can significantly distinguish between clinical and non-clinical presentations for members of the Deaf community.

English for a new millennium : leading change

Book overview: This book came about as a result of The Australian Government Summer School for Teachers program that was announced as part of the 2007-08 Budget Package: Realising Our Potential. The Summer School brought together over 200 academics, teachers and education department officials for a smorgasbord of keynote presentations, workshops and social events that is unlikely to be repeated in this country. English for a New Millennium gives every English teacher an opportunity to share in the richness of that experience. It includes contributions from Catherine Beavis, Ray Misson, Elizabeth Webby, Gabriel Matters and Clare Bradford.

Patterns of treatment of external genital warts in Australian sexual health clinics

Background: External genital warts are a common sexually transmitted viral disease. We describe the patterns of treatment for initial presentations of external genital warts (EGWs) in Australian sexual health centers.
Methods: This was a retrospective audit of 489 case notes from consecutive individuals who presented with a new diagnosis of EGWs to 1 of 5 major sexual health clinics in Australia. Eligibility criteria were consecutive patients aged 18 to 45 years inclusively, presenting with first ever episode of EGWs from January 1, 2004. Exclusion criteria were patients who were immunocompromised, including HIV infection, or enrollment in a treatment study for EGWs.
Results: The median age at presentation of women was 23.2 years and of men 26.8 years. One quarter (n = 127) of patients had another sexually transmitted infection diagnosed at presentation. Nearly half of the patients (n = 224) presented only once for treatment. Most often, patients were treated with a monotherapy (n = 382/489; 78%), usually cryotherapy (257; 53%). Staff applied treatment in 361 (74%) cases. There was wide variation across sites, possibly reflecting local policies and budgets. We found no difference in wart resolution (n = 292; 60%) by initial treatment chosen.
Conclusions: The diagnosis and treatment of genital warts constitute a sizable proportion of clinical visits to the audited sexual health services and require a large input of staff time to manage, including the application of topical treatments. Our results help complete the picture of the burden of EGWs on Australian sexual health centers before the introduction of the HPV vaccine.

A measurement framework for international entrepreneurship policy research : from impossible index to malleable matrix

The Global Entrepreneurship Monitor (GEM), a multifaceted, multinational research programme now in its seventh year of field operation, currently dominates the field of international entrepreneurship policy research but faces a crisis of credibility. Despite having created and continuing to develop a very rich database capable of addressing many of the complexities requisite for understanding entrepreneurship at the national and international levels of analysis, GEM has chosen to disguise the depths of its potential research and policy utility through a misnamed quest for unobtainable simplicity at the centre of the project and a disorganised variety of report presentations at the periphery. Subsequent to a review of the entrepreneurial definitional literature and a resolution of its many themes into six components of entrepreneurial activity, based on Penrose's (1959/1995) articulation of the practical meaning of 'entrepreneurial services', this paper suggests that a 'malleable matrix' approach can provide a practical measurement framework capable of reporting national entrepreneurial activity in a structure that is comprehensive without being overwhelming.

Borderline personality disorder - an overview for emergency clinicians

The diagnosis of borderline personality disorder frequently underlies self-harm and suicidal presentations to the emergency department. Borderline pathology combined with high levels of comorbidity, stigma, and treatment uncertainty, increase the challenges of caring for someone with this diagnosis in an emergency setting. Attributes such as black-and-white thinking and splitting may compromise an already precarious situation. The maintenance of safety requires prioritisation and necessitates a practical and respectful approach, which avoids notions of attention-seeking behaviour. Clinical assessment should distinguish between self-harm and suicide attempts where possible and take into account acute on chronic risk. The emergency clinician will need to consider the degree of containment required in the emergency department and is encouraged to maintain transparency and honesty with the client regarding treatment decisions. If hospitalisation needs to be considered, clinicians should take into account immediate therapeutic benefit versus the counter-therapeutic risk of dependency and regression. Overall, it is reasonable for clinicians to aim for clients to return to their pre-crisis level of functioning, and beneficial for clinicians to approach this client group with therapeutic optimism.

Assessing the risk of suicide at triage

Mental health related presentations to Australian emergency departments are steadily increasing. There is a growing incidence of depression, substance abuse, and other mental illnesses in the Australian population. Mental health problems will contribute 15% of the total world disease burden by 2020. Triage nurses are pivotal to the early detection and management of mental health problems.

The rapid assessment of mental health presentations at triage requires skill, knowledge, experience and confidence. One of the more complex aspects of triage is suicide risk assessment.

Critical intellectual resources for praxis in physical education teacher education : the limits to rationality

This study focuses on the way four student-teachers engage with critical social discourses in a year-long physical education unit. The student-teachers were encouraged to examine and (re)construct their pedagogy through their interactions with critical discourses. Drawing on their personal theories and actions, the study examines the extent to which critical intellectual resources can provide pedagogical frames of reference that are 'practical and non-ideal'. Using a critical ethnographic methodology the students' interactions with critical social discourses are diagnosed across three levels. The first level is the case study presentations of each student's engagement with the critical intellectual resources and the extent to which they were able to understand and implement them. The second level involves an interpretation of the individual cases that is informed by Brian Fay's (1987) metatheoretical reconstruction of the critical social sciences. In the third stage of diagnosis the study focuses on retheorising critical aspirations for praxis pedagogy in physical education. Critical scholars within the physical education arena argue that critical praxis represents a pedagogy based on a 'world view' of the potential for agents to engage in a rational reordering of their qualitative existence. The essence of their claim is that critical discourses have the potential to facilitate a mode of praxis through which physical education teachers might better recognise, understand, critique and transform their values and practices. However, there is broad recognition that the translation of social-critical discourses into a pedagogic context is highly problematic. Interpretation of the study is provided by Fay's (1987) 'limits to change' thesis which recognises that critical aspirations must ultimately be adopted and implemented by real people in real settings. As a diagnostic frame of reference, Fay insists that a 'complete' critical theory [of physical education] be simultaneously scientific, critical, practical and non-ideal. In seeking to temper the "e; over-rationalistic"e; tendency of the critical project he recognises the historical, embedded, embodied and traditional nature of human existence Criticisms of critical theories of education traverse a number of philosophic perspectives. Recent post-structural criticisms of truth regimes, knowledge-power differentials, rationality and agency have seriously destabilised modernist justifications of the critical agenda. Critical theories of physical education have not been absolved of such criticism. A prominent element of this study is its promotion of a dialectical relationship between agency and structure to extend critical conceptualisations of physical education pedagogy. Through the mediation of structural determinism and self-determination this research proffers a means of practically advancing a critical praxis in physical education. The conclusion of this thesis outlines some broad recommendations pertaining to the introduction of social critical discourses in physical education teacher education.

Descriptive epidemiology of Australian football injuries presenting to sports medicine clinics

Sports injury prevention has been the focus of a number of recent public health initiatives due to the acknowledgement that sports injuries are a significant public health problem in Australia Whilst Australian football is one of the most popular participation sports in the country, only very limited data is available about football injuries The majority of sports injury data available for this sport is from hospital emergency departments and elite-level injury surveillance Overall there is a paucity of data from treatment settings other than hospitals In particular, there is a lack of information about the injuries sustained by community-level, junior and recreational Australian football participants. One good potential source of football injury data is sports medicine clinics. Analysis of injury presentations to sports medicine clinics was undertaken to provide a detailed description of the epidemiology of Australian football injuries that present to this treatment setting and to determine the implications for injury prevention in this sport. In addition, the data from sports medicine clinics was compared with existing sources of Australian football injury data to determine how representative sports medicine clinic data is of other football injury data sources and to provide recommendations for future injury surveillance n Australian football. The results contained in this thesis show that Australian football is the sport most associated with injury presentation at sports medicine clinics. The majority of injured Australian football players presenting to sports medicine clinics are community-level or junior participants which suggests that sports medicine clinics are a good source of information on the injuries sustained by sub-elite football participants. Competition is the most common context in which Australian football players presenting to sports medicine clinics are injured. The major causes of injuries to Australian football players are being struck by another player, collisions and overuse. Injuries to Australian football players predominantly involve the lower limb. Adult players, players who stopped participating immediately after noticing their injury and players with overuse injuries are the most likely to sustain a more severe injury (i.e. more than four weeks before a full return to football participation and a moderate/significant amount of treatment expected). The least experienced players (five or less years of participation) are more likely to require a significant amount of treatment than the more experienced players. The prevention of lower limb injuries, injuries caused by body contact and injuries caused by overuse should be a priority for injury prevention research in Australian football due to the predominance of these injury types in the pattern of Australian football injuries Additionally, adult players, as a group, should be a focus of injury prevention activities in Australian football due to the association between age and injury severity. Overall, the pattern of Australian football injuries presenting to sports medicine clinics appears to be different than reported by club-based and hospital emergency department injury surveillance activities. However, detailed comparison of sports medicine clinic Australian football data with other sources of Australian football injury data is difficult due to the variable methods of collecting and reporting injury information used by hospital emergency department and club-based injury surveillance activities. The development of a standardised method for collecting and reporting injury data in Australian football is strongly recommended to overcome the existing limitations of data collection in this sport. In summary, sports medicine clinics provide a rich source of Australian football injury data, especially from the community and junior levels of participation. The inclusion of sports medicine clinic data provides a broader epidemiological picture of Australian football injuries. This broader understanding of the pattern of Australian football injuries provides a better basis for the development of injury prevention measures in this sport.

Preparing for flexible delivery in industry : learners and their workplaces

This thesis examines the learning preferences and learning strategies of apprentices, and the contexts within which they learn in their workplaces. Since the end of the 1980s Australian vocational education and training (VET) structures and processes have undergone radical change in attempts to develop skills in the workforce that will ensure enterprise, national, and international competitiveness. A major strategy in the national reforms has been the encouragement of flexible delivery as a means through which workplace-based learning can be accessed by a larger number of workers in ways that are cost-efficient, and that reduce the amount of time that workers spend away from their jobs. Although flexible delivery has been championed by governments and industry alike, there has been little attempt to identify the preparedness of either learners or their workplaces for the demands of flexible learning. The thesis examines the economic context for these changes to VET, and also examines the literature available on workplace learning. Additionally, the thesis examines the conceptualisations of flexible delivery that are available in the literature, pointing to the possibility that the wide range of meanings associated with the term ‘flexible delivery’ may result in quite different practices and expectations. The thesis also examines the literature on independent learning and self-directed learning, and explores the concept of ‘client-focused’ flexible delivery. The study of learner preferences uses data collected from apprentices over a period of some years, in the four occupational areas commanding the highest number of apprentices in Australia. These occupational areas are Metals and Machining, Building, Electrical, and Hairdressing. These data on learning preferences are collected using the commercially available Canfield Learning Styles Inventory (CLSI). The data from the sample of 389 apprentices are analysed statistically through analyses of variance, and indicate that variables such as age, gender, and occupational area are related to learning preferences. Apprentices are shown by this analysis to prefer structured programs of instruction that are instructor-led, and to not have a high preference for independent learning or the development of their own learning goals. Additionally, they are shown to have very low preferences for learning through reading, preferring instead to learn through direct hands-on experience. While these characteristics are largely common among the four occupational groups, the Hairdressing apprentices are shown to have a slightly higher preference for independent learning and goal setting. Females are shown to have a higher preference than males for learning qualitative material through reading. Interestingly, the younger apprentices are shown to have a higher preference than the older ones for self-directed learning. Some possibilities for that finding are discussed. The research also shows that the learning preferences displayed by different groups of apprentices in any one program are much the same over time, providing some confidence that data generated from one group of apprentices can be used to make instructional decisions for future groups in the same program. The data are also factor analysed to indicate three major factors underlying apprentice learning preferences. The first factor indicates a Verbal–Non-verbal preference factor, with apprentices clearly preferring to learn through non-verbal means. A second factor is described as Structure–Content, with apprentices showing a preference for learning from structured programs in a structured environment. A third factor, Self-directed–Social preference, indicates apprentices preferring to learn through socially mediated presentations and contexts rather than through more independent forms of learning. Qualitative data are also generated through interviewing eight apprentices, and focusing on the learning strategies they employ while constructing knowledge in the workplace. That component of the research uses a modification of the Marland, Patching and Putt (1992a, 1992b) stimulated recall technique, and a set of learning strategies derived from the work of O’Malley and Chamot (1990) and Billett (1996a). The eight apprentices are drawn from the Metals and Machining, Electrical, and Hairdressing trades. The findings indicate that the learning strategies most often used by apprentices in the workplace are those associated with the construction of knowledge that is structured and provided by the instructor or learning program, and those that include social mediation of learning. Additionally, the strategies associated with demonstration and hands-on practice are most favoured. The qualitative data are confirmatory of the quantitative data. The research also indicates, through the apprentice interviews, that support for apprentice’s learning in their workplace is typically unplanned and haphazard. Their experience was sometimes characterised by a reluctance on the part of the workplace to acknowledge learning needs such as trialling and practice of new knowledge, or pro-actively seeking understanding from other more skilled workers. The learning preferences and learning strategies findings for apprentices, coupled with the findings of typically poor or unplanned support in the workplace, indicate that effective flexible delivery of training to apprentices in the workplace provides a number of challenges. These challenges, it is argued, demand strategies to be developed and implemented to prepare both learners and workplaces for effective engagement with flexible delivery. Using as a theoretical framework Kember’s (1995) two-dimensional model of open learning for adults, the thesis integrates the findings into a proposed two-dimensional model of learner and workplace preparedness for flexible delivery. The model provides for a Learner Development Space, a Workplace Development Space, and a Strategy Space. Within the Learner Development Space, focuses for the development of learner preparedness are identified in terms of self-directed learning, skills developments, and effective participation in a community of practice. Focuses for workplace development identified in the Workplace Development Space are those associated with development of training policies, training structures, and trainer skills and abilities. The Strategy Space then provides detail of seventy-nine specific strategies developed to enhance learner and workplace preparedness within each of the focuses identified.

Assessing the strain experienced by managers and professional Australian footballers using an augmented job strain model

Generic models of job stress, such as the Job Strain Model (JSM), have recently been criticised for focusing on a small number of general work characteristics while ignoring those that are occupation-specific (Sparks & Cooper, 1999). However this criticism is based on limited research that has not examined the relative influence of all three dimensions of the JSM - job demand, job control and social support - and job-specific stressors. The JSM is the most commonly used model underpinning large-scale occupational stress research (Fox, Dwyer, & Ganster, 1993) and is regarded as the most influential model in the research on the psycho-social work environment, stress and disease in recent times (Kristensen, 1995). This thesis addresses the lack of information on the relative influence of the JSM and job-specific stressors by assessing the capacity of an augmented JSM to predict the strain experienced by managers and professional Australian footballers. The augmented JSM consisted of job-specific stressors in addition to the generic components of the model. Managers and professional Australian footballers represent two very different occupational groups. While the day-today roles of a manager include planning, organising, monitoring and controlling (Carroll & Gillen, 1987), the working life of a professional Australian footballer revolves around preparing for and playing football (Shanahan, 1998). It was expected that the large differences in the work undertaken by managers and professional Australian footballers would maximise the opportunities for identifying job-specific stressors and measuring the extent that these vary from one group to the next. The large disparity between managers and professional footballers was also used to assess the cross-occupational versatility of the JSM when it had been augmented by job-specific stressors. This thesis consisted of three major studies. Study One involved a survey of Australian managers, while studies Two and Three focused on professional Australian footballers. The latter group was under-represented in the literature, and as a result of the lack of information on the stressors commonly experienced by this group, an in-depth qualitative study was undertaken in Study Two. The results from Study Two then informed the survey of professional footballers that was conducted in Study Three. Contrary to previous research examining the relative influence of generic and job-specific stressors, the results only provided moderate support for augmenting the JSM with job-specific stressors. Instead of supporting the versatility of the augmented JSM, the overall findings reinforced the broad relevance of the original JSM. Of the four health outcomes measured in Studies One and Three, there was only one - the psychological health of professional Australian footballers - where the proportion of total variance explained by job-specific stressors exceeded 13%. Despite the generally strong performance of the JSM across the two occupational groups, the importance of demand, control and support diminished when examining the less conventional occupation of professional football. The generic model was too narrow to capture the highly specific work characteristics that are important for this occupational group and, as a result, the job-specific stressors explained significantly more of the strain over and above that already provided by the generic model. These findings indicate that when investigating the stressors experienced by conventional occupational groups such as managers, the large amount resources required to identify job-specific stressors are unlikely to be cost-effective. In contrast, the influence of the more situation specific stressors is significantly greater in unconventional occupations and thus the benefits of identifying these non-generic stressors are more likely to outweigh the costs. Studies One and Three identified strong connections between job-specific stressors and important characteristics of the occupation being studied. These connections were consistent with previous research and suggest that before attempting to identify job-specific stressors, researchers need to first become familiar with the nature and context of the occupation. The final issue addressed in this thesis was the role of work and non-work support. The findings indicate that the support provided by supervisors and colleagues was a significant predictor of wellbeing for both managers and professional footballers. In contrast, the level of explained strain accounted for by non-work support was not significant. These results indicate that when developing strategies to protect and enhance employee well-being, particular attention should be given to monitoring and, where necessary, boosting the effectiveness of work-based support. The findings from this thesis have been fed back to the management and sporting communities via conference presentations and peer-reviewed journals (refer pp 220-221). All three studies have been presented at national and international conferences and, overall, were well received by participants. Similarly, the methods, results and major findings arising from Studies One and Two have been critiqued by anonymous reviewers from two international journals. These papers have been accepted for publication in 2001 and 2002 and feedback from the reviewers indicates that the findings represent a significant and unique contribution to the literature. The results of Study Three are currently under review by a sports psychology journal.

A view of community building from the inside

This presentations explores to what happens when a group of people "do" community building. Whilst it is notable that state and national governments are supporting concepts like "social capital" critics argue that this a means to coopt and contain social unrest.

Issues arising from the implementation of a comprehensive assessment approach in a large, multi-modal Bachelor of Commerce unit

Recent literature in higher education argues university assessment has been too narrow and hasn’t adequately reflected the quality, breadth and depth of students’ learning. Research shows students often prioritise and learn what they need to know for formal, graded assessment and disregard other academic content seen as less relevant to those requirements. The predominance of essays and examinations has therefore tended to constrain learning. The case for a more comprehensive approach has been clearly articulated. So what happens when staff take up the unique challenge of designing fair and uniform assessment for a large, core, multi-modal, multi-campus unit offered nationally and internationally?

When developing an undergraduate Bachelor of Commerce unit at Deakin University, staff considered the most appropriate ways to assess a range of conceptual understandings and communication skills. This resulted in the mapping and adoption of a comprehensive approach incorporating teacher, peer, and self-assessment aspects, individual and group work, oral and written presentations, and the use of portfolios and journals. Particular practices were adopted to control workloads, ensure fairness in marking, and overcome some problems generally associated with group work. When implementing the approach, practical issues arose that demanded adjustments. This paper details the approach taken, outlines research activities, and discusses the practical implications of issues that arose.