Risk of second cancer after lymphohematopoietic neoplasm

People living with lymphohematopoietic neoplasms (LHNs) are known to have increased risks of second cancer; however, the incidence of second cancers after LHNs has not been studied extensively in Australia. The Australian Cancer Database was used to analyze site-specific risk of second primary cancer after LHNs in 127,707 patients diagnosed between 1983 and 2005. Standardized incidence ratios (SIRs) were calculated using population rates. Overall, patients with an LHN had nearly twice the risk of developing a second cancer compared to the Australian population. Among 40,321 patients with non-Hodgkin's lymphoma (NHL), there was over a fourfold significant increase in melanoma, Kaposi sarcoma, cancer of the lip, connective tissue and peripheral nerves, eye, thyroid, Hodgkin's disease (HD) and myeloid leukemia. Among 6,396 patients with HD, there was over a fourfold significant increase in melanoma, Kaposi sarcoma, cancer of the lip, oral cavity and pharynx, female breast, uterine cervix, testis, thyroid, NHL and myeloid leukemia. Among the 33,025 patients with lymphoid and myeloid leukemia, significant excess were seen for cancers of the lip, eye, connective tissue and peripheral nerves, NHL and HD. Among the 13,856 patients with plasma cell tumors, there was over fourfold significant increase for melanoma, cancer of the connective tissue and peripheral nerves and myeloid leukemia. Our findings provide evidence of an increased risk of cancer, particularly ultraviolet radiation- and immunosuppression-related cancers, after an LHN in Australia. Copyright © 2010 UICC.

Bouncing back : the role of design in facilitating students to understand and deal with adversity

After state-wide flooding and a category-5 tropical cyclone, three-quarters of the state of Queensland was declared a disaster zone in early 2011. This deluge of adversity had a significant impact on university students, a few weeks prior to the start of the academic semester. The purpose of this paper is to examine the role that design plays in facilitating students to understand and respond to, adversity. The participants of this study were second and fourth year architectural design students at a large Australian University, in Queensland. As a part of their core architectural design studies, students were required to provide architectural responses to the recent catastrophic events in Queensland. Qualitative data was obtained through student surveys, work design work submitted by students and a survey of guests who attending an exhibition of the student work. The results of this research showed that the students produced more than just the required set of architectural drawings, process journals and models, but also recognition of the important role that the affective dimension of the flooding event and the design process played in helping them to both understand and respond to, adversity. They held the ‘real world’ experience and practical aspect of the assessment in higher regard than their typical focus on aesthetics and the making of iconic design. Perhaps most importantly, the students recognised that this process allowed them to have a voice, and a means to respond to adversity through the powerful language of design.

Butterpaper, sweat & tears : the affective dimension of engaging students during the architectural critique

Considering how dominant a feature of architectural education the critique has been, and continues to be, little has been written about the affective dimension of engaging students during this key final stage of the design or documentation process. For most students, the critique is unlike any previous educational or life experience that they have ever confronted, and the abrupt change in the instructor’s role, from tutor to judge, can be disconcerting at a time when the student is feeling their most vulnerable. The fact that the period immediately leading up to the critique habitually entails not only a focused and sustained effort, but also sleepless nights of intensive work, further exacerbates this. The purpose of this paper is to recognise the affective phenomena influencing student engagement, during the critique. The participants of this research were second to fourth year architecture students at a major Australian university. Following the implementation of trials in alternative modes of critique in architectural design and technology studios, qualitative data was obtained from students, through questionnaires and interviews. Six indicators of engagement were investigated through this research: motivation and agency, transactional engagement with staff, transactional engagement with students, institutional support, active citizenship, and non-institutional support. This research confirms that affective phenomena play a significant role in the events of the critique; the relationship between instructor and student influences student engagement, as does the choreography and spatial planning of the critique environment; and these factors ultimately have an impact on the depth of student learning.

Assessing students in senior science: an analysis of questions in contextualised chemistry exams

This study explores the development of a coding system for analysing test questions in two context-based chemistry exams. We describe our unique analytical procedures before contrasting the data from both tests. Our findings indicate that when a new curriculum is developed such as a context-based curriculum, teachers are required to combine the previously separate domains of context and concept to develop contextualised assessment. We argue that constructing contextualised assessment items requires teachers to view concepts and context as interconnected rather than as separate entities that may polarise scientific endeavour. Implications for practice, curriculum and assessment-development in context-based courses are proposed.

Drinking and driving in Vietnam : perceptions and risk

Road traffic injuries are a major global public health problem but continue to receive inadequate attention. Alcohol influences both risk and consequence of road traffic injury but the scale of the problem is not well understood in many countries. In Vietnam, economic development has brought a substantial increase in the number of registered motorcycles as well as alcohol consumption. Traffic injury is among the leading causes of death in Vietnam but there is little local information regarding alcohol related traffic injuries. The primary goal of this study is to explore the drinking and driving patterns of males and their perceptions towards drink-driving and to determine the relationship between alcohol consumption and road traffic injuries. Furthermore, this thesis aims to present the situation analysis for choosing priority actions to reduce drinking and driving in Vietnam. The study is a combination of two cross-sectional surveys and a pilot study. The pilot study, involving 224 traffic injured patients, was conducted to test the tools and the feasibility of approach methods. In the first survey, male patrons (n=464) were randomly selected at seven restaurants. Face-to-face interviews were conducted when patrons just arrived and breath tests were collected when they were about to leave the restaurant. In the second survey, male patients admitted to hospital following a traffic injury (n=480, of which 414 were motorcycle or bicycle riders) were interviewed and their blood alcohol concentration (BAC) measured by breathalyzer. The results show broadly similar patterns of drinking and driving among male patrons and male traffic injured patients with a high frequency of drinking and drink-driving reported among the majority of the two groups. A high proportion of male patrons were leaving restaurants with a BAC over the legal limit. Factors that significantly associate with the number of drinks and BAC were age, hazardous drinking, frequency of drink-driving in the past year, self-estimated number of drinks consumed to drive legally, perceived family’s disapproval of drink-driving, and perceived legal risk and physical risk. The proportion of patrons and patients with BAC above the legal limit of 0.05 were 86.7% and 60.4% respectively, which was much higher than found in previous studies. In addition, both groups had a high prevalence of BAC over 0.15g/100ml (39.7% of patrons and 45.6% patients), a level that can seriously affect driving capacity. Results from the case-crossover analysis for patients indicate a dose-response relationship between alcohol consumption and the risk of traffic injury. The risk of traffic injury increased when alcohol was consumed before driving and there was a more than 13 fold increase when six or more drinks were consumed. Regarding perceptions towards drinking and driving, findings corroborate the low awareness among males in Vietnam, with a majority of respondents holding a low knowledge of safe and legally permissible alcohol use, and a low perceived risk of drinking and driving. The results also indicate a huge gap in prevention skills in terms of planning ahead or using alternative transport to avoid drink-driving and a perception by patrons and patients of a low rate of disapproval of drink-driving from peers and family. Findings in this study have considerable implications for national policy, injury prevention, clinical practice, reporting systems, and for further research. The low rate of compliance with existing laws and a generally low perceived legal risk toward drink-driving in this study call for the strengthening of enforcement along with mass media campaigns and news coverage in order to decrease the widespread perception of impunity and thereby, to reduce the level of drink-driving. In addition, no significant difference was found in this study on risk of traffic injuries between car drivers and motorcycle drivers. The current inconsistency between legal BAC for drivers of motorcycles, compared to cars, thus needs addressing. Furthermore, as drinking was found to be very common, rather than solely targeting drink-driving, it is important to call for a more strategic and comprehensive approach to alcohol policy in Viet Nam. This study also has considerable implications for clinical practice in terms of screening and brief interventions. Our study suggests that the short form of the AUDIT (AUDIT-C) screening tool is appropriate for use in busy emergency departments. The high proportion of traffic injured patients with evidence of alcohol abuse or hazardous drinking suggests that brief interventions by alcohol and drug counselors in emergency departments are a sensible option to addressing this important problem. The significance of this study is in the combination of the systematic collection of breath test and use of case-crossover design to estimate the risk of traffic injuries after alcohol consumption. The results provide convincing evidence to policy makers, health authorities and the media to help raise community awareness and policy advocacy toward the drinkdriving problem in Vietnam. The findings suggest an urgent need for a multi-sectoral approach to curtail drink-driving in Vietnam, especially programs to raise community awareness and effective legal enforcement. Furthermore, serving as a situation analysis, the thesis should inform the formulation of interventions designed to curtail drinking and driving in Vietnam and other developing countries.

Interactive peer-based learning in a comparative case study : what do students gain?

As English increasingly becomes one of the most commonly spoken languages in the world today for a variety of economic, social and cultural reasons, education is impacted by globalisation, the internationalisation of universities and the diversity of learners in classrooms. The challenge for educators is to find more effective ways of teaching English language so that students are better able to create meaning and communicate in the target language as well as to transform knowledge and understanding into relevant skills for a rapidly changing world. This research focuses broadly on English language education underpinned by social constructivist principles informing communicative language teaching and in particular, interactive peer learning approaches. An intervention of interactive peer-based learning in two case study contexts of English as Foreign Language (EFL) undergraduates in a Turkish university and English as Second Language (ESL) undergraduates in an Australian university investigates what students gain from the intervention. Methodology utilising qualitative data gathered from student reflective logs, focus group interviews and researcher field notes emphasises student voice. The cross case comparative study indicates that interactive peer-based learning enhances a range of learning outcomes for both cohorts including engagement, communicative competence, diagnostic feedback as well as assisting development of inclusive social relationships, civic skills, confidence and self efficacy. The learning outcomes facilitate better adaptation to a new learning environment and culture. An iterative instructional matrix tool is a useful product of the research for first year university experiences, teacher training, raising awareness of diversity, building learning communities, and differentiating the curriculum. The study demonstrates that English language learners can experience positive impact through peer-based learning and thus holds an influential key for Australian universities and higher education.

Preliminary development of a sewerage infrastructure buffer assessment tool for engineering risk and strategic land use planning

Urban expansion continues to encroach on once isolated sewerage infrastructure. In this context,legislation and guidelines provide limited direction to the amenity allocation of appropriate buffer distances for land use planners and infrastructure providers. Topography, wind speed and direction,temperature, humidity, existing land uses and vegetation profiles are some of the factors that require investigation in analytically determining a basis for buffer separations. This paper discusses the compilation and analysis of six years of Logan sewerage odour complaint data. Graphically,relationships between the complaints, topographical features and meteorological data are presented. Application of a buffer sizing process could assist planners and infrastructure designers alike, whilst automatically providing extra green spaces. Establishing a justifiable criterion for buffer zone allocations can only assist in promoting manageable growth for healthier and more sustainable communities.

Perceptions of online learning in an Australian university : Malaysian students' perspectives

Several researchers have reported that cultural and language differences can affect online interactions and communications between students from different cultural backgrounds. Other researchers have asserted that online learning is a tool that can improve teaching and learning skills, but, its effectiveness depends on how the tool is used. Therefore, this study aims to investigate the kinds of challenges encountered by the international students and how they actually cope with online learning. To date little research exists on the perceptions of online learning environments by international Asian students, in particular Malaysian students who study in Australian Universities; hence this study aims to fill this gap. A mixed-method approach was used to collect quantitative and qualitative data using a modified Online Learning Environment Survey (OLES) instrument and focus group interviews. The sample comprised 76 international students from a university in Brisbane. Thirty-five domestic Australian students were included for comparison. Contrary to assumptions from previous research, the findings revealed that there were few differences between the international Asian students from Malaysia and Australian students with regard to their perceptions of online learning. Another cogent finding that emerged was that online learning was most effective when included within blended learning environments. The students clearly indicated that when learning in a blended environment, it was imperative that appropriate features are blended in and customised to suit the particular needs of international students. The study results indicated that the university could improve the quality of the blended online learning environment by: 1) establishing and maintaining a sense of learning community; 2) enhancing the self motivation of students; and 3) professional development of lecturers/tutors, unit coordinators and learning support personnel. Feedback from focus group interviews, highlighted the students‘ frustration with a lack of cooperative learning, strategies and skills which were expected of them by their lecturers/tutors in order to work productively in groups. They indicated a strong desire for lecturers/tutors to provide them prior training in these strategies and skills. The students identified four ways to optimise learning opportunities in cross-cultural spaces. These were: 1) providing preparatory and ongoing workshops focusing on the dispositions and roles of students within student-centred online learning environments; 2) providing preparatory and ongoing workshops on collaborative group learning strategies and skills; 3) providing workshops familiarising students with Australian culture and language; and 4) providing workshops on strategies for addressing technical problems. Students also indicated a strong desire for professional development of lecturers/tutors focused on: 1) teacher attributes, 2) ways to culturally sensitive curricula, and 3) collaborative learning and cooperative working strategies and skills, and 4) designing flexible program structures. Recommendations from this study will be useful to Australian universities where Asian international students from Malaysia study in blended learning environments. An induction program (online skills, collaborative and teamwork skills, study expectations plus familiarisation with Australian culture) for overseas students at the commencement of their studies; a cultural awareness program for lecturers (cultural sensitivity, ways to communicate and a better understanding of Asian educational systems), upskilling of lecturers‘ ability to structure their teaching online and to apply strong theoretical underpinnings when designing learning activities such as discussion forums, and consistency with regards to how content is located and displayed in a learning management system like Blackboard. Through addressing the research questions in this study, the researcher hopes to contribute to and advance the domain of knowledge related to online learning, and to better understand how international Malaysian students‘ perceive online learning environments. These findings have theoretical and pragmatic significance.

Connecting online with external students : do we really know how to?

Students are often time poor and find it difficult to manage their time in relation to study and other external factors including work. Online study is no exception to this and in many cases where the student is studying in an online only environment, they are also working in full time employment. Higher Education institutions are now offering an abundance of courses online to attract more under-graduate and post-graduate students. It is in this sense that there is an ever-increasing need to understand the student of today and find ways to connect with them and support them in their studies. This paper will report on a small-scale case study of an undergraduate online-only group of first year education students and their associated online experiences in developing a sense of community whilst interacting with a learning management system and its associated tools. Further the paper will explore the mis-conceptions that are widely held by course designers and lecturers involved with online courses.

Engaging middle school students in context-based science : One teacher's approach

In Australia, there is a crisis in science education with students becoming disengaged with canonical science in the middle years of schooling. One recent initiative that aims to improve student interest and motivation without diminishing conceptual understanding is the context-based approach. Contextual units that connect the canonical science with the students’ real world of their local community have been used in the senior years but are new in the middle years. This ethnographic study explored the learning transactions that occurred in one 9th grade science class studying an Environmental Science unit for 11 weeks. Data were derived from field notes, audio and video recorded conversations, interviews, student journals and classroom documents with a particular focus on two selected groups of students. Data were analysed qualitatively through coding for emergent themes. This paper presents an outline of the program and discussion of three assertions derived from the preliminary analysis of the data. Firstly, an integrated, coherent sequence of learning experiences that included weekly visits to a creek adjacent to the school enabled the teacher to contextualise the science in the students’ local community. Secondly, content was predominantly taught on a need-to-know basis and thirdly, the lesson sequence aligned with a model for context-based teaching. Research, teaching and policy implications of these results for promoting the context-based teaching of science in the middle years are discussed.

Marginalised students and insider knowledge

One of the claims made for valuing the voices of marginalised students is that an insider perspective can be revealed on student issues and the ways in which education policies and systems impact on them. This chapter examines the ways in which participants in an Australian ‘students-as-researchers’ (SaR) project were able to raise knowledge of and address, to some extent, long-standing issues of racism in their schools. The SaR project has operated in more than thirty schools for periods of one to five years. Based on a participatory action research model, groups of secondary school students from schools serving socio-economically disadvantaged communities have worked with nominated teachers and university researchers to identify and research local issues relating to low academic outcomes and to develop and enact responses to the identified concerns. The voices of marginalised students quoted in this chapter illustrate that important insider knowledge can be revealed through the SaR process. Where student views have been acknowledged and acted on by the schools, significant change to student-teacher relationships and school culture has been achieved; the participants have been personally empowered and academic improvements across the schools have been noted. For such change to occur, however, a culture of mutual respect must be created in which teachers and school administrators value students’ views and are open to the possibility of unfavourable criticism.

Development and evaluation of the Clinician Suicide Risk Assessment Checklist

This paper describes the development and evaluation of a new instrument - the Clinician Suicide Risk Assessment Checklist (CSRAC). The instrument assesses the clinician's competency in three areas: clinical interviewing, assessment of specific suicide risk factors, and formulating a management plan. A draft checklist was constructed by integrating information from 1) literature review 2) expert clinician focus group and 3) consultation with experts. It was utilised in a simulated clinical scenario with clinician trainees and a trained actor in order to test for inter-rater agreement. Agreement was calculated and the checklist was re-drafted with the aim of maximising agreement. A second phase of simulated clinical scenarios was then conducted and inter-rater agreement was calculated for the revised checklist. In the first phase of the study, 18 of 35 items had inadequate inter-rater agreement (60%>), while in the second phase, using the revised version, only 3 of 39 items failed to achieve adequate inter-rater agreement. Further evidence of reliability and validity are required. Continued development of the CSRAC will be necessary before it can be utilised to assess the effectiveness of risk assessment training programs.

A review of the acculturation experiences of international students

Universities in Western countries host a substantial number of international students. These students bring a range of benefits to the host country and in return the students gain higher education. However, the choice to study overseas in Western countries may present many challenges for the international student including the experience of acculturative stress and difficulties with adjustment to the environment of the host country. The present paper provides a review of current acculturation models as applied to international students. Given that these models have typically been empirically tested on migrant and refugee populations only, the review aims to determine the extent to which these models characterise the acculturation experience of international students. Literature pertaining to salient variables from acculturation models was explored including acculturative stressors encountered frequently by international students (e.g., language barriers, educational difficulties, loneliness, discrimination, and practical problems associated with changing environments). Further discussed was the subsequent impact of social support and coping strategies on acculturative stress experienced by international students, and the psychological and sociocultural adaptation of this student group. This review found that the international student literature provides support for some aspects of the acculturation models discussed, however, further investigation of these models is needed to determine their accuracy in describing the acculturation of international students. Additionally, prominent acculturation models portray the host society as an important factor influencing international students’ acculturation, which suggests the need for future intervention.

Developing a social justice framework to ensure good practice in higher education

The concept of student engagement is a key factor in student achievement and retention and Australasian universities have a range of initiatives aimed at monitoring and intervening with students who are at risk of disengaging. Given the aspirations about widening participation, it is absolutely critical that these initiatives are designed to enable success for all students, particularly those for whom social and cultural disadvantage have been a barrier. Consequently, these types of initiatives must be consistent with the concept of social justice and a set of principles would provide this philosophical foundation for the sector. An Australian Learning and Teaching Council (ALTC) project that involves ten Australasian universities, is designing of a suite of resources for the sector which will include: (1) a set of principles for good practice in MSLE, (2) a good practice guide for the design and implementation of institutional MSLE policy and practice, and (3) a collection of resources for and exemplars of good practice to be taken up by the sector. This workshop session will provide an opportunity for participants to examine the draft set of principles and to discuss their potential value for the participants’ institutional contexts. Australian Learning and Teaching Council Competitive Grant CG10-1730 2010-2012: Good practice for safeguarding student learning engagement in higher education institutions.

Understanding the coping strategies of international students : a qualitative approach

International students encounter a range of additional challenges as a part of their tertiary study experience. A qualitative approach was used to understand the challenges faced by international students, coping strategies that promoted their personal resilience and advice they have for future international students. Twenty-two international students from an Australian university participated in four focus groups. The challenges identified by students included adjustment, social isolation, English language skills, academic difficulties, unmet expectations, employment, culture shock and psychological distress. Participants shared their own personal experiences and strategies used by them to cope and identified strategies that future students could use prior to leaving their home country and whilst in Australia to improve their adjustment. Uses of international student stories in prevention interventions are discussed.