Cochrane review summary for cancer nursing : drug therapy for cancer-related fatigue

Cancer-related fatigue (CRF) is one of themost debilitating symptoms in patients with cancer. It is prevalent at the time of diagnosis and during and after antineoplastic treatment and in patients with advanced disease. The multifactorial and complex nature of CRF makes it challenging for health professionals to identify a clear underlying mechanism and manage this symptom effectively. Often, the management plan for CRF (whether pharmacological or nonpharmacological) can be further complicated by the coexistence of other symptoms. This systematic review1 is therefore important in informing health professionals on the effectiveness of pharmacological management for CRF.

Anna Clark (2008) History’s Children: History Wars in the Classroom. UNSW Press, Sydney, 178 pages

“History’s Children” stems from Anna Clark’s 2004 postdoctoral research into the ways in which Australian students connect with the past, and aims at bringing some classroom perspectives into the public debates about Australian history education. Although the title makes reference to the “History Wars”, there is little evidence of contestation, engagement, passion or intellectual excitement in Clark’s conclusions about what happens in history classrooms. Rather, Clark’s small focus groups with 182 high school students in 34 high schools around Australia indicate that “it got a bit dismal hearing student after student being so dismissive of Australian history” (p. 143). Apart from some enthusiasm for the study of Australians at war, a sort of resigned boredom seems to characterise what students have to say about learning Australian history, despite their acknowledgement that it is important to “know about” it.

The Early Prevention of Obesity in CHildren (EPOCH) collaboration : an individual patient data prospective meta-analysis

Background: Efforts to prevent the development of overweight and obesity have increasingly focused early in the life course as we recognise that both metabolic and behavioural patterns are often established within the first few years of life. Randomised controlled trials (RCTs) of interventions are even more powerful when, with forethought, they are synthesised into an individual patient data (IPD) prospective meta-analysis (PMA). An IPD PMA is a unique research design where several trials are identified for inclusion in an analysis before any of the individual trial results become known and the data are provided for each randomised patient. This methodology minimises the publication and selection bias often associated with a retrospective meta-analysis by allowing hypotheses, analysis methods and selection criteria to be specified a priori. Methods/Design: The Early Prevention of Obesity in CHildren (EPOCH) Collaboration was formed in 2009. The main objective of the EPOCH Collaboration is to determine if early intervention for childhood obesity impacts on body mass index (BMI) z scores at age 18-24 months. Additional research questions will focus on whether early intervention has an impact on children’s dietary quality, TV viewing time, duration of breastfeeding and parenting styles. This protocol includes the hypotheses, inclusion criteria and outcome measures to be used in the IPD PMA. The sample size of the combined dataset at final outcome assessment (approximately 1800 infants) will allow greater precision when exploring differences in the effect of early intervention with respect to pre-specified participant- and intervention-level characteristics. Discussion: Finalisation of the data collection procedures and analysis plans will be complete by the end of 2010. Data collection and analysis will occur during 2011-2012 and results should be available by 2013. Trial registration number: ACTRN12610000789066

Interest from Tertiary Educated Persons in Fostering Children with Higher Care needs under a Professional (Paid) Model Compared with General Foster Care

The number of Australian children requiring foster care due to abuse and neglect is increasing at a faster rate than suitable carers can be recruited. Currently increased numbers of foster children are presenting with higher care needs. Evidence suggests carers with a higher education could contribute to placement stability and ultimately provide more positive outcomes for this group of children. This paper explores the level of interest by tertiary educated persons toward a model of fostering for children with higher needs. Using a descriptive survey methodology, a convenience sample of 644 university undergraduate and postgraduate students within faculties of health sciences, and education, arts and social sciences was employed. Psychology students in the 17-26 year old age group showed greatest interest in a professional foster care model and this was statistically significant (p=0.002 955 CI .000-.010) when compared to other health professionals and other age groups. Education students held the highest interest in general fostering although not statistically significant. When these survey results were extrapolated to the total number of health professionals in Australia there could be 8,385 potential recruits for a model professional foster care. Focused campaigns are required to source professional as recruits to fostering with the benefit of servicing the placement needs of higher care needs children and contributing to general foster care resources.

Electronic games: A legitimate diversional therapy intervention for health care consumers?

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Cognitive behaviour therapy (CBT) for the treatment of co-occurring depression and substance use : current evidence and directions for future research

Issues and Approach: The high rates of co-occurring depression and substance use, and the negative impact of this on illness course and outcomes have been well established. Despite this, few clinical trials have examined the efficacy of cognitive behaviour therapy (CBT). This paper systematically reviews these clinical trials, with an aim of providing recommendations for how future research can develop a more robust evidence base for the treatment of these common comorbidities. Leading electronic databases, including PubMed (ISI) and PsychINFO (CSA), were searched for peer-reviewed journal articles using CBT for the treatment of co-occurring depression and substance use. Of the 55 articles identified, 12 met inclusion criteria and were included in the review. ---------- Key Findings: There is only a limited evidence for the effectiveness of CBT either alone or in combination with antidepressant medication for the treatment of co-occurring depression and substance use. While there is support for the efficacy of CBT over no treatment control conditions, there is little evidence that CBT is more efficacious than other psychotherapies. There is, however, consistent evidence of improvements in both depression and substance use outcomes, regardless of the type of treatment provided and there is growing evidence that that the effects of CBT are durable and increase over time during follow up. ---------- Conclusions. Rather than declaring the ‘dodo bird verdict’ that CBT and all other psychotherapies are equally efficacious, it would be more beneficial to develop more potent forms of CBT by identifying variables that mediate treatment outcomes.

Tyrosine monitoring in children with early and continuously treated phenylketonuria: Results of an international practice survey

Investigations into the biochemical markers associated with executive function (EF) impairment in children with early and continuously treated phenylketonuria (ECT-PKU) remain largely phenylalanine-only focused, despite experimental data showing that a high phenylalanine:tyrosine (phe:tyr) ratio is more strongly associated with EF deficit than phe alone. A high phe:tyr ratio is hypothesized to lead to a reduction in dopamine synthesis within the brain, which in turn results in the development of EF impairment. This paper provides a snapshot of current practice in the monitoring and/or treatment of tyrosine levels in children with PKU, across 12 countries from Australasia, North America and Europe. Tyrosine monitoring in this population has increased over the last 5 years, with over 80% of clinics surveyed reporting routine monitoring of tyrosine levels in infancy alongside phe levels. Twenty-five percent of clinics surveyed reported actively treating/managing tyrosine levels (with supplemental tyrosine above that contained in PKU formulas) to ensure tyrosine levels remain within normal ranges. Anecdotally, supplemental tyrosine has been reported to ameliorate symptoms of both attention deficit hyperactivity disorder and depression in this population. EF assessment of children with ECT-PKU was likewise highly variable, with 50% of clinics surveyed reporting routine assessments of intellectual function. However when function was assessed, test instruments chosen tended towards global measures of IQ prior to school entry, rather than specific assessment of EF development. Further investigation of the role of tyrosine and its relationship with phe and EF development is needed to establish whether routine tyrosine monitoring and increased supplementation is recommended.

Lost children and imaginary mothers in Sonya Hartnett's Of A Boy

In Powers of Horror, Julia Kristeva writes about lost children. These are what she calls “dejects,” who, in the psychodrama of subject formation, fail to fully absent the body of the mother, to accept the Law of the Father and the Symbolic, and subsequently to establish “clear boundaries which constitute the object-world for normal subjects.” Dejects are “strays” looking for a place to belong, a place that is bound up with the Imaginary mother of the pre-Oedipal period. Kristeva’s sketch of the deject as one who is unable to negotiate a proper path to the Symbolicis useful to a reading of Hartnett’s Of A Boy (2002),a novel that also deals with lost children and imaginary mothers. However, in its portrayal of children who are doomed to never achieve adulthood, Of A Boy enacts a haunting retrieval of the pre-Oedipal from the dark side of phallocentric representation, privileging the semiotic (Kristeva’s concept) and the maternal as necessary disruptive checks on a patriarchal Symbolic Order.

The novice researcher : interviewing young children

Being a novice researcher undertaking research interviews with young children requires understandings of the interview process. By investigating the interaction between a novice researcher undertaking her first interview and a child participant, we attend to theoretical principles, such as the competence of young children as informants, and highlight practical matters when interviewing young children. A conversation analysis approach examines the talk preceding and following a sticker task. By highlighting the conversational features of a research interview, researchers can better understand the co-constructed nature of the interview. This paper provides insights into how to prepare for the interview and manage the interview context to recognize the active participation of child participants, and the value of artifacts to promote interaction. These insights make more transparent the interactional process of a research interview and become part of the researcher’s collection of devices to manage the conduct of research interviews.

Executive function effects and numerical development in children : behavioural and ERP evidence from a numerical Stroop paradigm

Most research on numerical development in children is behavioural, focusing on accuracy and response time in different problem formats. However, Temple and Posner (1998) used ERPs and the numerical distance task with 5-year-olds to show that the development of numerical representations is difficult to disentangle from the development of the executive components of response organization and execution. Here we use the numerical Stroop paradigm (NSP) and ERPs to study possible executive interference in numerical processing tasks in 6–8-year-old children. In the NSP, the numerical magnitude of the digits is task-relevant and the physical size of the digits is task-irrelevant. We show that younger children are highly susceptible to interference from irrelevant physical information such as digit size, but that access to the numerical representation is almost as fast in young children as in adults. We argue that the developmental trajectories for executive function and numerical processing may act together to determine numerical development in young children.

Stars are made of glass : children as capable and creative communicators

This booklet is the third in the Research in Practice Series, designed to complement Belonging, being & becoming: The Early Years Learning Framework for Australia (DEEWR, 2009). It focuses on Learning Outcome 5 of the Early Years Learning Framework (EYLF): Children are effective communicators (DEEWR, 2009).

Monitoring children's progress using child portfolios

Introduces a method to early childhood professionals of observing children as they are involved in everyday play episodes, record children's development and plan for this, while utilising the knowledge and input of the key players in the partnership, parents and teachers.

The nature of caregiving in children of a parent with multiple sclerosis from multiple sources and the associations between caregiving activities and youth adjustment overtime

This study explored youth caregiving for a parent with multiple sclerosis (MS) from multiple perspectives, and examined associations between caregiving and child negative (behavioural emotional difficulties, somatisation) and positive (life satisfaction, positive affect, prosocial behaviour) adjustment outcomes overtime. A total of 88 families participated; 85 parents with MS, 55 partners and 130 children completed questionnaires at Time 1. Child caregiving was assessed by the Youth Activities of Caregiving Scale (YACS). Child and parent questionnaire data were collected at Time 1 and child data were collected 12 months later (Time 2). Factor analysis of the child and parent YACS data replicated the four factors (instrumental, social-emotional, personal-intimate, domestic-household care), all of which were psychometrically sound. The YACS factors were related to parental illness and caregiving context variables that reflected increased caregiving demands. The Time 1 instrumental and social-emotional care domains were associated with poorer Time 2 adjustment, whereas personal-intimate was related to better adjustment and domestic-household care was unrelated to adjustment. Children and their parents exhibited highest agreement on personal-intimate, instrumental and total caregiving, and least on domestic-household and social-emotional care. Findings delineate the key dimensions of young caregiving in MS and the differential links between caregiving activities and youth adjustment.

Book review : Kellett, M (2010) Rethinking children and research : attitudes in contemporary society

Rethinking Children and Research characterizes Mary Kellett’s vision as campaigner and sociologist actively working for and with children for many years. The book itself is not only visionary; it is informative, thought provoking and pragmatic. From a contemporary standpoint, the manuscript presents a detailed synopsis of the shifts in thinking about research with children and provides an appraisal of the theoretical movements that have driven a participatory research agenda. A strong theoretical approach of the combined lenses of sociologies of childhood and rights discourse is introduced early in the book. From the outset, the reader receives loud and clear, the key message of the book: that children in research should and can be included as competent members who lead research in the study of their everyday lives. The argument for a more mutual research approach is shaped throughout the book using research examples and practical suggestions on how this might be achieved. Overall, the reader is left feeling compelled to adopt such an approach.

A Mouthful of Pins : questioning constructionist therapy frameworks in theatre-making

A Mouthful of Pins constitutes the practical component (50 per cent) of a practice-led Master of Arts through the Creative Industries Faculty of Queensland University of Technology. This research reports on the attempt to create a constructionist/collaborative theatre-making process by incorporating postmodern constructs borrowed from the therapy room. The study asserts that, when applied with awareness, therapeutic frameworks can help members of the creative team . including the director, performers, writer, designers and technicians . to fulfil their artistic capacity, thereby enriching their process, their performance and their collaborative relationship with each other. For this to occur, it is imperative that the director/facilitator stay curious and aware of how they lead their creative team, with particular care around their use of language, as well as an increased awareness of the multiple stories (including the sometimes invisible social, historical, political, theatrical and leadership discourses) that surround and impact the artist.s process. This research is designed to assist students of theatre, as well as established professional practitioners, to find an alternative approach for collaboration that can result in longevity of practice, while at the same time embracing best practice for their outgoing creativity.