The impact of pain on the quality of life of people with multiple sclerosis: A community survey

The purpose of this study was to examine the impact of pain on functioning across multiple quality of life (QOL) domains among individuals with multiple sclerosis (MS). A total of 219 people were recruited from a regional MS society membership database to serve as the community-based study sample. All participants completed a questionnaire containing items about their demographic and clinical characteristics, validated measures of QOL and MS-related disability, and a question on whether or not they had experienced clinically significant pain in the preceding 2 weeks. Respondents who reported pain then completed an in-person structured pain interview assessing pain characteristics (intensity, quality, location, extent, and duration). Comparisons between participants with and without MS-related pain demonstrated that pain prevalence and intensity were strongly correlated with QOL: physical health, psychological health, level of independence, and global QOL were more likely to be impaired among people with MS when pain was present, and the extent of impairment was associated with the intensity of pain. Moreover, these relationships remained significant even after statistically controlling for multiple demographic and clinical covariates associated with self-reported QOL. These findings suggest that for people with MS, pain is an important source of distress and disability beyond that caused by neurologic impairments.

Sharing knowledge at work : macro, social and relational individual influences on individual behavior

The impact of relations between an organization and its workers and the relations among workers on individual knowledge generation and sharing practices has not, to date, been addressed in an integrated way. This paper discusses the findings of a study analyzing issues at macro, locally-constructed and micro levels in a public sector organization, to identify and integrate the complex sets of mediators. Key factors were found to include (a) the contested nature of the process of knowledge construction, (b) the worker’s experience of the organization’s internal environment, (c) how the organization is understood to value knowledge sharing, (d) relations with colleagues, and (e) the perceived outcomes of knowledge sharing behaviors. Implications for practice are discussed.

Cipher cities

Cipher Cities was a practice-led research project developed in 3 stages between 2005 and 2007 resulting in the creation of a unique online community, ‘Cipher Cities’, that provides simple authoring tools and processes for individuals and groups to create their own mobile events and event journals, build community profile and participate in other online community activities. Cipher Cities was created to revitalise peoples relationship to everyday places by giving them the opportunity and motivation to create and share complex digital stories in simple and engaging ways. To do so we developed new design processes and methods for both the research team and the end user to appropriate web and mobile technologies. To do so we collaborated with ethnographers, designers and ICT researchers and developers. In teams we ran a series of workshops in a wide variety of cities in Australia to refine an engagement process and to test a series of iteratively developed prototypes to refine the systems that supported community motivation and collaboration. The result of the research is 2 fold: 1. a sophisticated prototype for researchers and designers to further experiment with community engagement methodologies using existing and emerging communications technologies. 2. A ‘human dimensions matrix’. This matrix assists in the identification and modification of place based interventions in the social, technical, spatial, cultural, pedagogical conditions of any given community. This matrix has now become an essential part of a number of subsequent projects and assists design collaborators to successfully conceptualise, generate and evaluate interactive experiences. the research team employed practice-led action research methodologies that involved a collaborative effort across the fields of interaction design and social science, in particular ethnography, in order to: 1. seek, contest, refine a design methodology that would maximise the successful application of a dynamic system to create new kinds of interactions between people, places and artefacts’. 2. To design and deploy an application that intervenes in place-based and mobile technologies and offers people simple interfaces to create and share digital stories. Cipher Cities was awarded 3 separate CRC competitive grants (over $270,000 in total) to assist 3 stages of research covering the development of the Ethnographic Design Methodologies, the development of the tools, and the testing and refinement of both the engagement models and technologies. The resulting methodologies and tools are in the process of being commercialised by the Australasian CRC for Interaction Design.

The NOURISH randomised control trial : positive feeding practices and food preferences in early childhood - a primary prevention program for childhood obesity

Background Primary prevention of childhood overweight is an international priority. In Australia 20-25% of 2-8 year olds are already overweight. These children are at substantially increased the risk of becoming overweight adults, with attendant increased risk of morbidity and mortality. Early feeding practices determine infant exposure to food (type, amount, frequency) and include responses (eg coercion) to infant feeding behaviour (eg. food refusal). There is correlational evidence linking parenting style and early feeding practices to child eating behaviour and weight status. A focus on early feeding is consistent with the national focus on early childhood as the foundation for life-long health and well being. The NOURISH trial aims to implement and evaluate a community-based intervention to promote early feeding practices that will foster healthy food preferences and intake and preserve the innate capacity to self-regulate food intake in young children. Methods/Design This randomised controlled trial (RCT) aims to recruit 820 first-time mothers and their healthy term infants. A consecutive sample of eligible mothers will be approached postnatally at major maternity hospitals in Brisbane and Adelaide. Initial consent will be for re-contact for full enrolment when the infants are 4-7 months old. Individual mother- infant dyads will be randomised to usual care or the intervention. The intervention will provide anticipatory guidance via two modules of six fortnightly parent education and peer support group sessions, each followed by six months of regular maintenance contact. The modules will commence when the infants are aged 4-7 and 13-16 months to coincide with establishment of solid feeding, and autonomy and independence, respectively. Outcome measures will be assessed at baseline, with follow up at nine and 18 months. These will include infant intake (type and amount of foods), food preferences, feeding behaviour and growth and self-reported maternal feeding practices and parenting practices and efficacy. Covariates will include sociodemographics, infant feeding mode and temperament, maternal weight status and weight concern and child care exposure. Discussion Despite the strong rationale to focus on parents’ early feeding practices as a key determinant of child food preferences, intake and self-regulatory capacity, prospective longitudinal and intervention studies are rare. This trial will be amongst to provide Level II evidence regarding the impact of an intervention (commencing prior to age 12 months) on children’s eating patterns and behaviours. Trial Registration: ACTRN12608000056392

Suicide and community psychiatric care

A preliminary survey of 34 suicides among patients attending community services for the chronically mentally ill revealed a rate of 520 per 100,000 admitted. In contrast to earlier hospital surveys, no risk variables were identified for patients dying by suicide. Thirty-four percent of suicides occurred within one week of the last treatment and 59% within 3 months of service entry. It appears that early and intensive follow-up may be necessary to prevent suicide among patients receiving community psychiatric care.

At work or play : a comparison of private property vehicle crashes with those occurring on public roads in north Queensland.

Objective: To define characteristics of vehicle crashes occurring on rural private property in north Queensland with an exploration of associated risk factors. Design: Descriptive analysis of private property crash data collected by the Rural and Remote Road Safety Study. Setting: Rural and remote north Queensland. Participants: A total of 305 vehicle controllers aged 16 years or over hospitalised at Atherton, Cairns, Mount Isa or Townsville for at least 24 hours as a result of a vehicle crash. Main outcome measure: A structured questionnaire completed by participants covering crash details, lifestyle and demographic characteristics, driving history, medical history, alcohol and drug use and attitudes to road use. Results: Overall, 27.9% of interviewees crashed on private property, with the highest proportion of private road crashes occurring in the North West Statistical Division (45%). Risk factors shown to be associated with private property crashes included male sex, riding off-road motorcycle or all-terrain vehicle, first-time driving at that site, lack of licence for vehicle type, recreational use and not wearing a helmet or seatbelt. Conclusions: Considerable trauma results from vehicle crashes on rural private property. These crashes are not included in most crash data sets, which are limited to public road crashes. Legislation and regulations applicable to private property vehicle use are largely focused on workplace health and safety, yet work-related crashes represent a minority of private property crashes in north Queensland.

A participative education program to reduce speeding in a group of work-related drivers

A number of intervention approaches have been developed to improve work-related driving safety. However, past interventions have been limited in that they have been data-driven, and have not been developed within a theoretical framework. The aim of this study is to present a theory-driven intervention. Based on the methodology developed by Ludwig and Geller (1991), this study evaluates the effectiveness of a participative education intervention on a group of work-related drivers (n = 28; experimental group n = 19, control n = 9). The results support the effectiveness of the intervention in reducing speeding over a six month period, while a non significant increase was found in the control group. The results of this study have important implications for organisations developing theory-driven interventions designed to improve work-related driving behaviour.

Growing demand for emergency health services in Queensland, Australia

Introduction: The demand for emergency health services (EHS), both in the prehospital (ambulance) and hospital (emergency departments) settings, is growing rapidly in Australia. Broader health system changes have reduced available health infrastructure, particularly hospital beds, resulting in reduced access to and congestion of the EHS as demonstrated by longer waiting times and ambulance “ramping”. Ambulance ramping occurring when patients have a prolonged wait on the emergency vehicle due to the unavailability of hospital beds. This presentation will outline the trends in EHS demand in Queensland compared with the rest of Australia and factors that appear to be contributing to the growth in demand. Methods: Secondary analysis was conducted using data from publicly available sources. Data from the Queensland Ambulance Service and Queensland Health Emergency Department Information System (EDIS) also were analyzed. Results: The demand for ambulance services and emergency departments has been increasing at 8% and 4% per year over the last decade, respectively; while accessible hospital beds have reduced by almost 10% contributing to the emergency department congestion and possibly contributing to the prehospital demand. While the increase in the proportion of the elderly population seems to explain a great deal of the demand for EHS, other factors also influence this growth including patient characteristics, institutional and societal factors, economic, EHS arrangements, and clinical factors. Conclusions: Overcrowding of facilities that provide EHS are causing considerable community concern. This overcrowding is caused by the growing demand and reduced access. The causes of this growing demand are complex, and require further detailed analysis in order to quantify and qualify these causes in order to provide a resilient foundation of evidence for future policy direction.

FIA : an open foresic integration architecture for composing digital evidence

The analysis and value of digital evidence in an investigation has been the domain of discourse in the digital forensic community for several years. While many works have considered different approaches to model digital evidence, a comprehensive understanding of the process of merging different evidence items recovered during a forensic analysis is still a distant dream. With the advent of modern technologies, pro-active measures are integral to keeping abreast of all forms of cyber crimes and attacks. This paper motivates the need to formalize the process of analyzing digital evidence from multiple sources simultaneously. In this paper, we present the forensic integration architecture (FIA) which provides a framework for abstracting the evidence source and storage format information from digital evidence and explores the concept of integrating evidence information from multiple sources. The FIA architecture identifies evidence information from multiple sources that enables an investigator to build theories to reconstruct the past. FIA is hierarchically composed of multiple layers and adopts a technology independent approach. FIA is also open and extensible making it simple to adapt to technological changes. We present a case study using a hypothetical car theft case to demonstrate the concepts and illustrate the value it brings into the field.

The role of land use and psycho-social factors in high density residents' work travel mode choices : implications for sustainable transport policy

Imperatives to improve the sustainability of cities often hinge upon plans to increase urban residential density to facilitate greater reliance on sustainable forms of transport and minimise car use. However there is ongoing debate about whether high residential density land use in isolation results in sustainable transport outcomes. Findings from surveys with residents of inner-urban high density dwellings in Brisbane, Australia, suggest that solo car travel accounts for the greatest modal share of typical work journeys and attitudes toward dwelling and neighbourhood transport-related features, residential sorting factors and socio-demographics, alongside land use such as public transport availability, are significantly associated with work travel mode choice. We discuss the implications of our findings for transport policy and management including encouraging relatively sustainable intermodal forms of transport for work journeys.

Debate on statutory control of the surveying profession in Queensland : 1907 to 1975

This article was written in 1997. After a 2009 review the content was left mostly unchanged - apart from this re-written abstract, restructured headings and a table of contents. The article deals directly with professional registration of surveyors; but it also relates to government procurement of professional services. The issues include public service and professional ethics; setting of professional fees; quality assurance; official corruption; and professional recruitment, education and training. Debate on the Land Surveyors Act 1908 (Qld) and its amendments to 1916 occurred at a time when industrial unrest of the 1890s and common market principles of the new Commonwealth were fresh in peoples’ minds. Industrial issues led to a constitutional crisis in the Queensland’s then bicameral legislature and frustrated a first attempt to pass a Surveyors Bill in 1907. The Bill was re-introduced in 1908 after fresh elections and Kidston’s return as state premier. Co-ordinated immigration and land settlement polices of the colonies were discontinued when the Commonwealth gained power over immigration in 1901. Concerns shifted to protecting jobs from foreign competition. Debate on 1974 amendments to the Act reflected concerns about skill shortages and professional accreditation. However, in times of economic downturn, a so-called ‘chronic shortage of surveyors’ could rapidly degenerate into oversupply and unemployment. Theorists championed a naïve ‘capture theory’ where the professions captured governments to create legislative barriers to entry to the professions. Supposedly, this allowed rent-seeking and monopoly profits through lack of competition. However, historical evidence suggests that governments have been capable of capturing and exploiting surveyors. More enlightened institutional arrangements are needed if the community is to receive benefits commensurate with sizable co-investments of public and private resources in developing human capital.

The city is connections : Seoul as an urban network

With the rise of ubiquitous computing in recent years, concepts of spatiality have become a significant topic of discussion in design and development of multimedia systems. This article investigates spatial practices at the intersection of youth, technology, and urban space in Seoul, and examines what the author calls ‘transyouth’: in the South Korean context, these people are between the ages of 18 and 24, situated on the delicate border between digital natives and immigrants in Prensky’s (2001) terms. In the first section, the article sets out the technosocial environment of contemporary Seoul. This is followed by a discussion of social networking processes derived from semi-structured interviews conducted in 2007-8 with Seoul transyouth about their ‘lived experiences of the city.’ Interviewees reported how they interact to play, work, and live with and within the city’s unique environment. The article develops a theme of how technosocial convergence (re)creates urban environments and argues for a need to consider such user-driven spatial recreation in designing cities as (ubiquitous) urban networks in recognition of its changing technosocial contours of connections. This is explored in three spaces of different scales: Cyworld as an online social networking space; cocoon housing – a form of individual residential space which is growing rapidly in many Korean cities – as a private living space; and u-City (ubiquitous City) as the future macro-space of Seoul.

A learning community approach to doctoral education in the social sciences

The paper reports on the findings of a community learning approach to doctoral education involving scholarly writing groups (SWGs) which was developed and implemented in the context of a higher degree research programme within the social sciences in an Australian university. The research evaluated the impact of the teaching intervention on students' perceptions of the community learning experience, their knowledge of scholarly writing and their attitudes towards writing. The findings are suggestive of the advantages of community approaches to learning in higher degree research education as a supplement to independent supervision. The SWGs were associated with improvements in both participants' knowledge of scholarly writing and their attitudes towards writing. However, a variety of characteristics of doctoral education are potential impediments to the creation of ongoing and regular interactions in learning communities such as SWGs. The paper concludes that a flexible approach to the recognition and enhancement of community approaches to learning is required to acknowledge the complex and diverse context of contemporary doctoral education.