Correlates of student satisfaction with study modes

Research into the outcomes for students of different study modes has generally concluded that there is ‘no significant difference’ between outcomes for students studying face-to-face and for those studying by a variety of distance or flexible means. As the shift towards CIT-based and independent learning for oncampus students accelerates, it is important to establish how student outcomes are affected. This paper reports on a survey of the experiences and satisfaction of oncampus students with different learning environments and compares the satisfaction of those students who have experienced both on- and off-campus study. These comparisons were made based on students’ employment status and their reasons for studying off-campus. The findings revealed that students were significantly less satisfied with their off-campus than on-campus experience regardless of their work status. Further, the results indicate an association between students’ satisfaction with off-campus study and their reasons for studying off-campus. Given the evidence provided in this paper in support of face-to-face learning environments for ‘conventional’ on-campus students, both academics and administrators have an interest in ensuring that it remains central to the higher education experience of current and future students.

Self-perceived quality of life of children and adolescents with physical disabilities in Hong Kong

Although illnesses and diseases are thought to adversely affect quality of life (QoL), whether children who have physical disabilities (PD) from a young age adapt to the effect of developmental disabilities has rarely been investigated. This study attempted to assess the subjective wellbeing, and examine the correlation between objective and subjective QoL, of children with PD. Using a self-reported non-disease-specific questionnaire, the QoL of 72 young persons (13.5 ± 2.0 years) with PD was contrasted with those who do not have disabilities (n = 510; age-matched). MANOVA analyses revealed that the PD group had lower objective QoL score (63.0 ± 7.4 vs. 66.8 ± 5.7, p < 0.001) but the two groups were not significantly different in subjective QoL score (70.9 ± 11.4 vs. 69.6 ± 13.6, p = 0.466). No correlation was found between objective and subjective QoL in the PD group (r ranged from 0.06 to 0.19), while weak to medium correlations (r ranged from 0.03 to 0.41) were observed for the controls. The apparent detachment of subjective feeling and objective circumstances in the PD group may reflect adjustment to developmental disabilities.

Continuity of care and general wellbeing of patients with comorbidities requiring joint replacement

Aim. The aim of this paper is to examine the continuity of care and general wellbeing of patients with comorbidities undergoing elective total hip or knee joint replacement.
Background. Advances in medical science and improved lifestyles have reduced mortality rates in most Western countries. As a result, there is an ageing population with a concomitant growth in the number of people who are living with multiple chronic illnesses, commonly referred to as comorbidities. These patients often require acute care services, creating a blend of acute and chronic illness needs. For example, joint replacement surgery is frequently performed to improve impaired mobility associated with osteoarthritis.
Method. A purposive sample of twenty participants with multiple comorbidities who required joint replacement surgery was recruited to obtain survey, interview and medical record audit data. Data were collected during 2004 and 2005.
Findings. Comorbidity care was poorly co-ordinated prior to having surgery, during the acute care stay and following surgery and primarily entailed prescribed medicines. The main focus in acute care was patient throughput following joint replacement surgery according to a prescribed clinical pathway. General wellbeing was less than optimal: participants reported pain, fatigue, insomnia and alterations in urinary elimination as the chief sources of discomfort during the course of the study.
Conclusion. Continuity of care of comorbidities was lacking. Comorbidities affected patient general wellbeing and delayed recovery from surgery. Acute care, clinical pathways and the specialisation of medicine and nursing subordinated the general problem of patients with comorbidities. Systems designed to integrate and co-ordinate chronic illness care had limited application in the acute care setting. A multidisciplinary, holistic approach is required. Recommendations for further research conclude this paper.

How well does the gudjonsson suggestibility scale for children, version 2 predict the recall of false details among children with and without intellectual disabilities?

Purpose. This study explored the effectiveness of the Gudjonsson Suggestibility Scale for Children, version 2 in predicting the tendency of older school-aged children (with and without intellectual disabilities) to generate errors in an independent suggestibility paradigm.

Method. Sixty-nine children with an intellectual disability (aged 9-14 years) and 50 mainstream children matched for chronological age participated in a 30-minute magic show that was staged at their school. Three days later, the children participated in a separate biasing interview that provided seven true and seven false details about the magic show. The following day, the children participated in a second interview where they were required to recall the magic show in their own words and answer a series of cued-recall questions. Between 1 and 2 weeks later, the children were administered the Gudjonsson Suggestibility Scale-2 (GSS-2).

Results. While there was no significant association between performance on the GSS-2 and the independent suggestibility paradigm for the children with an intellectual disability, the chronological age-matched children's yield scores predicted their reporting of both false-new details and false-interviewer suggestions for the independent event.

Conclusion. When predicting children's recall of false details, the GSS-2 appears to be more useful with mainstream school-aged children compared with children who have an intellectual disability.

Issues concerning the on-going care of patients with comorbidities in acute care and post-discharge in Australia: a literature review

Issues concerning the on-going care of patients with comorbidities in acute care and post-discharge in Australia: a literature review

Background. Advances in medical science and improved lifestyles have reduced mortality rates in Australia and most western countries. This has resulted in an ageing population with a concomitant growth in the number of people who are living with chronic illnesses. Indeed a significant number of younger people experience more than one chronic illness. Large numbers of these may require repeated admissions to hospital for acute or episodic care that is superimposed upon the needs of their chronic conditions.

Aim. To explore the issues that circumscribe the complexities of caring for people with concurrent chronic illnesses, or comorbidities, in the acute care setting and postdischarge.

Methods. A literature review to examine the issues that impact upon the provision of comprehensive care to patients with comorbidities in the acute care setting and postdischarge.

Findings. Few studies have investigated this subject. From an Australian perspective, it is evident that the structure of the current health care environment has made it difficult to meet the needs of patients with comorbidities in the acute care setting and postdischarge. This is of major concern for nurses attempting to provide comprehensive care to an increasingly prevalent group of chronically ill people.

Conclusion. Further research is necessary to explore how episodic care is integrated into the on-going management of patients with comorbidities and how nurse clinicians can better use an episode of acute illness as an opportunity to review their overall management.

You Shall Have No Other Gods Before Me: Covenant in Faith and History

In this paper I have attempted to explore "covenant" in faith and history, as it extends throughout the entire framework of the Bible and the entire history of the people who produced it. With such a monstrous topic, a comprehensive analysis of the material could take a lifetime to do it justice. Therefore, I have taken a very specific approach to the material in order to investigate the evolution of covenant from the Hebrew Bible (Old Testament) to the Christian Scriptures (New Testament). I have made every effort to approach this thesis as a text-based, non-doctrinal discussion. However, having my own religious convictions, it has, at times, been difficult to recognize and escape my biases. Nevertheless, I am confident that this final product is, for the most part, objective and free from dogmatism. Of course, I have brought my own perspective and understanding to the material, which may be different from the reader's, so there may be matters of interpretation on which we differ, but c 'est fa vie in the world of religious dialogue. The structure of this paper is symmetrical: Part I examines the traditions of the Torah and the Prophets; Part II, the Gospels and Paul's letters. I have balanced the Old Testament against the New Testament (the Torah against the Gospels; the Prophets against Paul) in order to give approximately equal weight to the two traditions, and establish a sense of parallelism in the structure of my overall work. A word should also be said about three matters of style. First, instead of the customary Christian designation of time as B.C. or A.D., I have opted to use the more modem B.C.E. (Before the Common Era) and C.E. (Common Era) notations. This more recent system is less traditional; however, more acceptable in academic and, certainly, more appropriate for a non-doctrinal discussion. Second, in the body of this paper I have chosen to highlight several texts using a variety of colors. This highlighting serves (1) to call the reader's attention to specific passages, and (2) to compare the language and imagery of similar texts. All highlighting has been added to the texts at my own discretion. Finally, the divine name, traditionally vocalized as "Yahweh," is a verbal form of the Hebrew "to be," and means, approximately, "I am who I am." This name was considered too holy to pronounce by the ancient Israelites, and, the word adonai ("My LORD") was used in its stead. In respect of this tradition, I have left the divine name in its original Hebrew form. Accordingly, should be read as "the LORD" throughout this paper. All Hebrew and Greek translations, where they occur, are my own. The Greek translations are based on the New Revised Standard Version (NRSV) of the Bible.

Close, but still too far: the experience of Australian people with cancer commuting from a regional to a capital city for radiotherapy treatment

This paper reports the findings of a study undertaken in November 2001 on the experiences of 17 rural people from the regional city of Toowoomba who had been diagnosed with cancer and were required to travel to the capital city of Queensland (Brisbane) for radiotherapy. The interviews were tape recorded; the recordings were transcribed verbatim and analysed for emergent themes and subthemes, following verification by the participants that the transcription was a true record of their experience. The major themes that arose from the study were (1) the burden of travel; (2) the difficulties of living in accommodation that is not one's own home; (3) the financial burden caused by the need to relocate or travel to and from Brisbane; (4) the lack of closeness to family and friends; (5) and feelings of being a burden on others. The findings suggest that at a time of stress, an increasing burden is placed on cancer clients and their families if they are required to travel for radiotherapy. Health professionals who read the results of this study should be aware of the isolation of rural people who have to live in an unfamiliar environment at a time of great stress. Support mechanisms should be put into place in these referral centres to deal with these stressors.

Improving the quality of life for patients' with co-morbidities requiring acute care

Reduced mortality rates in the Western world have created an increase in people with co-morbidities who have the potential to require acute care hospital services. These patients' chronic conditions often require complex needs that may not always be met by an acute care focus. This has created a precedent for nurses concerned with the holistic care and quality of life for these patients. This paper aims to describe the experiences of patients with co-morbidities who were admitted to hospital with an acute illness. This exploratory descriptive design selected patients in acute care who had more than one co-morbidity for approximately five years. Data was obtained from a purposive sample of twelve patients within two weeks of being discharged home using a semi-structured interview approach. Data analysis was conducted utilising Nvivo software to process the Colaizzi [1978] method. The theme clusters revealed a lack of continuity and co-ordinated care of the patients' co-morbidities during the acute admission and in discharge planning. It was seen that combinations of chronic conditions and treatments affected these patients' experience of acute care and thereafter, where conceptualisations of co-morbidity failed to accurately capture the underlying health care needs of these patients. These findings have implications for a comprehensive and considered approach to these patients' health care needs and quality of life whilst developing an improved understanding of co-morbidity for nursing. Recommendations for further research conclude this paper.

The Victorian living with possums policy : a review

Possums in urban areas can cause problems for residents when they live in the roof cavity of homes. The Victorian Living With Possums policy was implemented by the Department of Natural Resources and Environment (DNRE) in 1997 to address the ineffective, illegal and inhumane nature of possum management practices. Human-possum conflicts in urban areas can be difficult to resolve, and it is therefore important that the Living With Possums policy is effectively reaching the community and other stakeholders (e.g. vets, local councils).

This study represents Stage 1 of a two-part research project that aims to examine community awareness of and compliance with the policy and relevant legislation. A pilot questionnaire was designed and distributed to a sample of individuals who have recently hired possum traps from local councils or private organisations within metropolitan Melbourne. Preliminary findings indicate that although there is some level of awareness about the Living with Possums policy, there is evidence of non-compliance and a lack of understanding about the detailed policy guidelines. In Stage 2 of this project, questionnaires will be distributed to a larger sample of individuals who are experiencing conflicts with possums in order to examine just how widespread this lack of compliance and awareness is.

Being resilient as described by people who experience mental illness

Aim: The purpose of this research was to explore resilience as described by consumers of mental health services in Australia who have experienced mental illness.

Background: Most qualitative research pertaining to resilience has focused on child and adolescent groups. In relation to the Australian context there appears to be a paucity of qualitative studies on resilience and the experience of mental illness.

Method: The study utilized a phenomenological approach elucidated by Colaizzi as the philosophical underpinnings of the study. In keeping with Colaizzi’s (1978) approach to inquiry, information was gathered through in-depth, semi-structured individual interviews. Information analysis utilised Colaizzi’s (1978) original seven-step approach with the inclusion of two additional steps, making this study’s analysis a nine step process.

Findings: Emergent themes explicated from participant transcripts follow: Universality, Acceptance, Naming and knowing, Faith, Hope, Being the fool and, Striking a balance, Having meaning and meaningful relationships, and ‘Just doing it’. The emergent conceptualisation which encapsulated the themes was; Viewing life from the ridge with eyes wide open. - choosing to walk through the darkness all the while knowing the risks and dangers ahead and making a decision for life amid ever-present hardships.

Conclusion: The findings of this study suggest being resilient can be learnt and therefore, should be a fundamental consideration in guiding therapeutic interventions within the context of clinical practice.

Stroke statistics

This publication is the latest edition of a series of statistical compendia and supplements that document the burden of cardiovascular disease in the United Kingdom. This series of publications, published by the British Heart Foundation, usually focuses on coronary heart disease, but Stroke Statistics is jointly published by the British Heart Foundation and The Stroke Association and focuses on the important and substantial burden of stroke in the United Kingdom.

Stroke Statistics is designed for policy makers, health professionals, medical researchers and anyone else with an interest in stroke or cardiovascular disease. It aims to provide the most recent statistics related to the burden of stroke and to document the geographic, social and ethnic inequalities in the experience of stroke.

Stroke Statistics is divided into five chapters. Chapter 1 documents trends and patterns in stroke mortality and premature mortality. Chapter 2 reports on the morbidity burden of stroke, both in terms of prevalence (the rate of people who have had a stroke in the past) and incidence (the rate of first ever strokes). Chapter 3 describes the burden of stroke on the National Health Service, in terms of drug therapy, hospitalisations and surgical procedures. Chapter 4 provides estimates of the prevalence of risk factors for stroke, broken down by age, sex, socioeconomic status and ethnicity. Details about Government targets to tackle the risk factor status of the population are also provided where available. Chapter 5 provides new estimates, calculated specifically for Stroke Statistics, of the economic cost of stroke to the National Health Service and to the United Kingdom economy.

Domestic violence : perpetrator programs in Western Australia

This symposium explores policy, organisational, practice, and research issues in the delivery of legally mandated programs for men who have acted violently in their intimate relationships. It will draw on the findings of a collaborative project between corrections and a number of non-government agencies contracted to provide services. The paper will provide an overview of some of the systemic and policy issues that impact upon on program delivery and evaluation issues, and the experiences of female partners of men attending programs.

Sex-specific developmental plasticity in response to yolk corticosterone in an oviparous lizard

Corticosterone exposure during prenatal development as a result of maternal upregulation of circulating hormone levels has been shown to have effects on offspring development in mammals. Corticosterone has also been documented in egg yolk in oviparous vertebrates, but the extent to which this influences phenotypic development is less studied. We show that maternal corticosterone is transferred to egg yolk in an oviparous lizard (the mallee dragon, Ctenophorus fordi Storr), with significant variation among clutches in hormone levels. Experimental elevation of yolk corticosterone did not affect hatching success, incubation period or offspring sex ratio. However, corticosterone did have a sex-specific effect on skeletal growth during embryonic development. Male embryos exposed to relatively high levels of corticosterone were smaller on average than control males at hatching whereas females from hormone-treated eggs were larger on average than control females. The data thus suggest that males are not just more sensitive to the detrimental effects of corticosterone but rather that the sexes may have opposite responses to corticosterone during development. Positive selection on body size at hatching for both sexes in this species further suggests that increased corticosterone in egg yolk may have sex-specific fitness consequences, with potential implications for sex allocation and the evolution of hormone-mediated maternal effects.

Aggressive tax planning : differentiating those playing the game from those who don't

The study reported in this paper examined a group of Australian taxpayers who have expressed a preference for a creative and aggressive tax agent. The study attempted to understand how high-risk taxpayers and high-risk practitioners form their partnerships by examining aggressive taxpayers' attitudes and perceptions of the Australian tax system. Data were taken from 2040 Australian taxpayers who had responded to a national survey on tax issues. Results from a series of independent sample t-tests revealed that there are a number of important differences between 'aggressive' and 'non-aggressive' taxpayers. Finally, a logistic regression analysis was used to determine which variables most effectively differentiated aggressive taxpayers from non-aggressive taxpayers. The findings are discussed in a regulatory context and possible solutions for how tax authorities might deal with this high-risk group of taxpayer are suggested.

Meaning of home : a comparison of the meaning of home as identified by samples of Victorians with, and without, an intellectual disability

This phenomenological study of the meaning of home from the perspectives of people with and without an intellectual disability sought to identify, (a) any common ‘essence’ of meaning held by and, (b) the nature of any differences of perception between, the groups. Purposive samples of 18 people with an intellectual disability and 21 non-disabled people were surveyed using a semi-structured interview to ascertain their experiences of home and 'non-homes'. Inductive analysis of the data revealed a shared understanding of the meaning of home at a fundamental level. This shared meaning of home was found to comprise: the ability to exert control over an area; having a personalised space; feeling content with the living situation; a sense of familiarity with the setting; a set of behaviours and routines usually only enacted when at home; common names and uses for rooms; socialising at home with others; the importance of a positive social atmosphere in the home; and, recognition of places as non-homes because they lacked one or more of these attributes. Further analysis revealed the essence of home is its experience as the place where stress is most reduced or minimised for the individual. The study demonstrates that the concept of stress is superordinate to previously identified concepts considered fundamental to home such as privacy, control and non-homes. Major differences between the two samples were largely differences of degree with people who have an intellectual disability reporting the same fundamental attributes of home as people who do not have an intellectual disability, but in a less elaborated form. Principal among these differences of degree was the notion of control over the home and its derivative elements which encompassed the whole dwelling including its setting for people without an intellectual disability but was very restricted for people with an intellectual disability being largely confined to the person's bedroom. Socialising in or from the home was also very limited for people with an intellectual disability in comparison with that experienced by non-disabled informants with the former group conveying an impression of leading significantly socially isolated lives at home. The major implications of this study are related to the meaning of home per se, to residential service provision to people with an intellectual disability, and to future research.