Determinants of rapid weight gain during infancy: Baseline results from the NOURISH randomised controlled trial.

Background: Rapid weight gain in infancy is an important predictor of obesity in later childhood. Our aim was to determine which modifiable variables are associated with rapid weight gain in early life. Methods: Subjects were healthy infants enrolled in NOURISH, a randomised, controlled trial evaluating an intervention to promote positive early feeding practices. This analysis used the birth and baseline data for NOURISH. Birthweight was collected from hospital records and infants were also weighed at baseline assessment when they were aged 4-7 months and before randomisation. Infant feeding practices and demographic variables were collected from the mother using a self administered questionnaire. Rapid weight gain was defined as an increase in weight-for-age Z-score (using WHO standards) above 0.67 SD from birth to baseline assessment, which is interpreted clinically as crossing centile lines on a growth chart. Variables associated with rapid weight gain were evaluated using a multivariable logistic regression model. Results: Complete data were available for 612 infants (88% of the total sample recruited) with a mean (SD) age of 4.3 (1.0) months at baseline assessment. After adjusting for mother's age, smoking in pregnancy, BMI, and education and infant birthweight, age, gender and introduction of solid foods, the only two modifiable factors associated with rapid weight gain to attain statistical significance were formula feeding [OR=1.72 (95%CI 1.01-2.94), P= 0.047] and feeding on schedule [OR=2.29 (95%CI 1.14-4.61), P=0.020]. Male gender and lower birthweight were non-modifiable factors associated with rapid weight gain. Conclusions: This analysis supports the contention that there is an association between formula feeding, feeding to schedule and weight gain in the first months of life. Mechanisms may include the actual content of formula milk (e.g. higher protein intake) or differences in feeding styles, such as feeding to schedule, which increase the risk of overfeeding. Trial Registration: Australian Clinical Trials Registry ACTRN12608000056392

Data modelling in the beginning school years

This paper argues for a renewed focus on statistical reasoning in the beginning school years, with opportunities for children to engage in data modelling. Some of the core components of data modelling are addressed. A selection of results from the first data modelling activity implemented during the second year (2010; second grade) of a current longitudinal study are reported. Data modelling involves investigations of meaningful phenomena, deciding what is worthy of attention (identifying complex attributes), and then progressing to organising, structuring, visualising, and representing data. Reported here are children's abilities to identify diverse and complex attributes, sort and classify data in different ways, and create and interpret models to represent their data.

Intraoperative imaging in hallux valgus surgery

Background: This prospective study investigates the use of intraoperative fluoroscopy in 28 consecutive cases undergoing hallux valgus surgery. To our knowledge there have been no studies validating the use of intraoperative fluoroscopy in hallux valgus surgery. Methods: We performed a prospective investigation of 28 consecutive cases undergoing hallux valgus surgery. Fluoroscopic images were examined intraoperatively and any significant unforseen findings documented. A comparison was made between the fluoroscopic images and weight bearing films taken 6 weeks postoperatively to examine whether the intraoperative images are an accurate representation of the standard films obtained post-operatively. We excluded those patients that went on to have an Akin osteotomy. Results: There were no unforeseen intraoperative events that were revealed by the use of fluoroscopy and no surgical modifications were made as a result of the intraoperative images. The intraoperative films were found to be a reliable representation of the postoperative weight bearing films but a small increase in the hallux valgus angle was noted at six weeks and this is thought to be due to stretching of the medial soft tissue repair. Conclusions: Intraoperative fluoroscopy is a reliable technique. This study was performed at a centre which performs approximately 100 hallux valgus operations per year and that should be taken into consideration when reviewing our findings. We conclude that there may be a role for fluoroscopy for surgeons in the early stages of the surgical learning curve and for those that infrequently perform hallux valgus surgery. We cannot however recommend that fluoroscopy be used routinely in hallux valgus surgery.

Problems with a great idea : referral by prehospital emergency services to a community-based falls-prevention service

Background and aim Falls are the leading cause of injury in older adults. Identifying people at risk before they experience a serious fall requiring hospitalisation allows an opportunity to intervene earlier and potentially reduce further falls and subsequent healthcare costs. The purpose of this project was to develop a referral pathway to a community falls-prevention team for older people who had experienced a fall attended by a paramedic service and who were not transported to hospital. It was also hypothesised that providing intervention to this group of clients would reduce future falls-related ambulance call-outs, emergency department presentations and hospital admissions. Methods An education package, referral pathway and follow-up procedures were developed. Both services had regular meetings, and work shadowing with the paramedics was also trialled to encourage more referrals. A range of demographic and other outcome measures were collected to compare people referred through the paramedic pathway and through traditional pathways. Results Internal data from the Queensland Ambulance Service indicated that there were approximately six falls per week by community-dwelling older persons in the eligible service catchment area (south west Brisbane metropolitan area) who were attended to by Queensland Ambulance Service paramedics, but not transported to hospital during the 2-year study period (2008–2009). Of the potential 638 eligible patients, only 17 (2.6%) were referred for a falls assessment. Conclusion Although this pilot programme had support from all levels of management as well as from the service providers, it did not translate into actual referrals. Several explanations are provided for these preliminary findings.

Breastfeeding self-efficacy and alternative techniques to overcome maternal or infant breastfeeding challenges : a retrospective descriptive study

Background: Breastfeeding is the internationally accepted ideal in infant feeding. Ensuring mothers and babies receive optimal benefits, in both the short and long term, is dependent upon the successful establishment of breastfeeding in the first week. Many maternal and infant challenges can occur during the establishment of breastfeeding (Lactogenesis II). There are also many methods and devices (alternative techniques) which can be used to help, but the majority do not have an evidence-base. The mother.s self-confidence (self-efficacy) can be challenged by these unexpected circumstances, but understanding of the relationship is unclear. Method: This descriptive study used mail survey (including the Breastfeeding Self-Efficacy Scale . Short Form) to obtain the mother.s reports of their self-efficacy and their breastfeeding experience during the first week following birth, as well as actual use of alternative techniques. This study included all mothers of full term healthy singleton infants from one private hospital in Brisbane who began any breastfeeding. The data collection took place from November 2008 to February 2009. Ethical approval was granted from the research site and QUT Human Research Ethics Committee. Results: A total of 128 questionnaires were returned, a response rate of 56.9%. The sample was dissimilar to the Queensland population with regard to age, income, and education level, all of which were higher in this study. The sample was similar to the Queensland population in terms of parity and marital status. The rate of use of alternative techniques was 48.3%. The mean breastfeeding self-efficacy score of those who used any alternative technique was 43.43 (SD=12.19), and for those who did not, it was 58.32 (SD=7.40). Kruskal-Wallis analysis identified that the median self efficacy score for those who used alternative techniques was significantly lower than median self efficacy scores for those who did not use alternative techniques. The reasons women used alternative techniques varied widely, and their knowledge of alternative techniques was good. Conclusion: This study is the first to document breastfeeding self-efficacy of women who used alternative techniques to support their breastfeeding goals in the first week postpartum. An individualised clinical intervention to develop women.s self-efficacy with breastfeeding is important to assist mother/infant dyads encountering challenges to breastfeeding in the first week postpartum.

Maroochydore House

The reinvention of existing housing stock to suit current and future needs within the suburban beachside context was the contextual background for this project. Adaptation, consolidation, understanding and reinterpretation of existing and potential architectural possibilities were demonstrated in this work to enhance the discussion and perceptions of value through enhancement of the existing suburban fabric.

Towards testing a new first-order decision making model for the procurement of public sector major infrastructure

Given global demand for new infrastructure, governments face substantial challenges in funding new infrastructure and simultaneously delivering Value for Money (VfM). As background to this challenge, a brief review is given of current practice in the selection of major public sector infrastructure in Australia, along with a review of the related literature concerning the Multi-Attribute Utility Approach (MAUA) and the effect of MAUA on the role of risk management in procurement selection. To contribute towards addressing the key weaknesses of MAUA, a new first-order procurement decision making model is mentioned. A brief summary is also given of the research method and hypothesis used to test and develop the new procurement model and which uses competition as the dependent variable and as a proxy for VfM. The hypothesis is given as follows: When the actual procurement mode matches the theoretical/predicted procurement mode (informed by the new procurement model), then actual competition is expected to match optimum competition (based on actual prevailing capacity vis-à-vis the theoretical/predicted procurement mode) and subject to efficient tendering. The aim of this paper is to report on progress towards testing this hypothesis in terms of an analysis of two of the four data components in the hypothesis. That is, actual procurement and actual competition across 87 road and health major public sector projects in Australia. In conclusion, it is noted that the Global Financial Crisis (GFC) has seen a significant increase in competition in public sector major road and health infrastructure and if any imperfections in procurement and/or tendering are discernible, then this would create the opportunity, through the deployment of economic principles embedded in the new procurement model and/or adjustments in tendering, to maintain some of this higher level post-GFC competition throughout the next business cycle/upturn in demand including private sector demand. Finally, the paper previews the next steps in the research with regard to collection and analysis of data concerning theoretical/predicted procurement and optimum competition.

Converting theory to practice : university-school collaboration on devising strategies for mentoring pedagogical knowledge

There appears no shortage of theorists for preservice teacher education; however many ideas are abandoned without practical applications. Indeed, it can take years for theories to materialise into practice, if they materialise at all. The quality of preservice teacher education is central for enhancing an education system, and mentors’ roles can assist to shape preservice teachers’ development within the school context. Yet mentoring can be haphazard without being underpinned by a theoretical framework. A mentoring model (personal attributes, system requirements, pedagogical knowledge, modelling, and feedback) has emerged from research and the literature to guide mentors’ practices. This qualitative study investigates mentors’ pedagogical knowledge as one factor crucial to the mentoring process. More specifically, this study involves a questionnaire and audio-recorded focus group meetings with experienced mentors (n=14) who deliberated on devising practical applications for mentoring pedagogical knowledge. Findings revealed that these experienced mentors pinpointed practical applications around a mentor’s role for providing pedagogical knowledge to the mentee. These strategies were varied and demonstrated that any one mentoring practice may be approached from a number of different angles. Nevertheless, there were core mentoring practices in pedagogical knowledge such as showing the mentee how to plan for teaching, articulating classroom management approaches, and talking about how to connect learning to assessment. Mentors may require education on current mentoring practices with practical strategies that are linked to theoretical underpinnings.

Educational change and youth voice: Informing school action on cyberbullying

Change is a regular part of school life. Educational innovations are constantly being implements in order to benefit students, improve outcomes and meet the obligations and accountability demands of governments. Rapid social and technological change has occurred within and around schools during the past 15 or more years, impacting upon curricula and pedagogies. Simultaneously, there has been a trend towards incorporating youth voice, where young people share in the decisions that will impact on their school experiences (Mitra, 2008a, 2004). Most recently, with the advent of the first National Australian Curriculum (McGaw, 2010), there is an imposed curriculum change, which reflects the growing global trend towards centralised control over what students learn in school (Zhao, 2011) and highlights that schools have to respond to change from all levels. Spears (in press) also notes that parents are raising children in an increasingly wireless world which is far removed from the one in which they were raised. Educators are teaching in schools that are vastly different technologically from those they knew as children and adolescents, or even those in which they were teaching a decade ago. Children born in 1995, the year when the Internet was first commercialised, are 16 years old in 2011 and, whilst parents may have embraced technological advances in their own adult working or social lives, they are yet to fathom fully what it means for their children and their relationships: to be educated and to socialise in the midst of mobile social media. Young people have greater access to more information than at any time past and move seamlessly between online and offline environments, often referring to them as ‘the same life’ (Spears, Kofoed, Bartolo, Palermiti and Castabile, in press). Along with these changes has come the transformation of traditional forms of bullying to cyberbullying, amid the public perception that bullying generally is becoming worse in schools.

Falls in Parkinson’s disease : evidence for altered stepping strategies on compliant surfaces

Background: Real-world environments comprise surfaces of different textures, densities and gradients, which can threaten postural stability and increase falls risk. However, there has been limited research that has examined how walking on compliant surfaces influences gait and postural stability in older people and PD patients. Methods: PD patients (n = 49) and age-matched controls (n = 32) were assessed using three dimensional motion analysis during self-paced walking on both firm and foam walkways. Falls were recorded prospectively over 12 months using daily falls calendars. Results: Walking on a foam surface influenced the temporospatial characteristics for all groups, but PD fallers adopted very different joint kinematics compared with controls. PD fallers also demonstrated reduced toe clearance and had increased mediolateral head motion(relative to walking velocity) compared with control participants. Conclusions: Postural control deficits in PD fallers may impair their capacity to attenuate surface-related perturbations and control head motion. The risk of falling for PD patients may be increased on less stable surfaces.

The effect of simulated astigmatic refractive error on reading performance

Background: Few studies have specifically investigated the functional effects of uncorrected astigmatism on measures of reading fluency. This information is important to provide evidence for the development of clinical guidelines for the correction of astigmatism. Methods: Participants included 30 visually normal, young adults (mean age 21.7 ± 3.4 years). Distance and near visual acuity and reading fluency were assessed with optimal spectacle correction (baseline) and for two levels of astigmatism, 1.00DC and 2.00DC, at two axes (90° and 180°) to induce both against-the-rule (ATR) and with-the-rule (WTR) astigmatism. Reading and eye movement fluency were assessed using standardized clinical measures including the test of Discrete Reading Rate (DRR), the Developmental Eye Movement (DEM) test and by recording eye movement patterns with the Visagraph (III) during reading for comprehension. Results: Both distance and near acuity were significantly decreased compared to baseline for all of the astigmatic lens conditions (p < 0.001). Reading speed with the DRR for N16 print size was significantly reduced for the 2.00DC ATR condition (a reduction of 10%), while for smaller text sizes reading speed was reduced by up to 24% for the 1.00DC ATR and 2.00DC condition in both axis directions (p<0.05). For the DEM, sub-test completion speeds were significantly impaired, with the 2.00DC condition affecting both vertical and horizontal times and the 1.00DC ATR condition affecting only horizontal times (p<0.05). Visagraph reading eye movements were not significantly affected by the induced astigmatism. Conclusions: Induced astigmatism impaired performance on selected tests of reading fluency, with ATR astigmatism having significantly greater effects on performance than did WTR, even for relatively small amounts of astigmatic blur of 1.00DC. These findings have implications for the minimal prescribing criteria for astigmatic refractive errors.

Philosophy, behaviour disorders, and the school

The recent exponential rise in the number of behaviour disorders has been the focus of a wide range of commentaries, ranging from the pedagogic and the administrative, to the sociological, and even the legal. This book will be the first to apply, in a systematic and thorough manner, the ideas of the foundational discipline of philosophy. A number of philosophical tools are applied here, tools arising through the medium of the traditional philosophical debates, such as those concerning governance, truth, logic, ethics, free-will, law and language. Each forms a separate chapter, but together they constitute a comprehensive, rigorous and original insight into what is now an important set of concerns for all those interested in the governance of children. The intention is threefold: first, to demonstrate the utility, accessibility and effectiveness of philosophical ideas within this important academic area. Philosophy does not have to be regarded an arcane and esoteric discipline, with only limited contemporary application, far from it. Second, the book offers a new set of approaches and ideas for both researchers and practitioners within education, a field is in danger of continually using the same ideas, to endlessly repeat the same conclusions. Third, the book offers a viable alternative to the dominant psychological model which increasingly employs pathology as its central rationale for conduct. The book would not only be of interest to mainstream educators, and to those students and academics interested in philosophy, and more specifically, the application of philosophical ideas to educational issues, it would also be an appropriate text for courses on education and difference, and due to the breadth of the philosophical issues addressed, courses on applied philosophy.

Data modeling in elementary and middle school classes : a shared experience

This paper argues for a renewed focus on statistical reasoning in the elementary school years, with opportunities for children to engage in data modeling. Data modeling involves investigations of meaningful phenomena, deciding what is worthy of attention, and then progressing to organizing, structuring, visualizing, and representing data. Reported here are some findings from a two-part activity (Baxter Brown’s Picnic and Planning a Picnic) implemented at the end of the second year of a current three-year longitudinal study (grade levels 1-3). Planning a Picnic was also implemented in a grade 7 class to provide an opportunity for the different age groups to share their products. Addressed here are the grade 2 children’s predictions for missing data in Baxter Brown’s Picnic, the questions posed and representations created by both grade levels in Planning a Picnic, and the metarepresentational competence displayed in the grade levels’ sharing of their products for Planning a Picnic.

An evaluation of the pattern and structure mathematics awareness program in the early school years

This paper reports a 2-year longitudinal study on the effectiveness of the Pattern and Structure Mathematical Awareness Program (PASMAP) on students’ mathematical development. The study involved 316 Kindergarten students in 17 classes from four schools in Sydney and Brisbane. The development of the PASA assessment interview and scale are presented. The intervention program provided explicit instruction in mathematical pattern and structure that enhanced the development of students’ spatial structuring, multiplicative reasoning, and emergent generalisations. This paper presents the initial findings of the impact of the PASMAP and illustrates students’ structural development.

Perceived gender differences in STEM learning in the middle school

Women are underrepresented in science, technology, engineering and mathematics (STEM) university coursework, reflecting long-standing gender issues that have existed in core middle-school STEM subject areas. Using data from a survey and written responses, we report on findings following the introduction of engineering education in middle school classes across three schools (grade level 7, n=122). The engineering experiences fused science, technology and mathematics concepts. The survey revealed higher percentages for girls than boys in 13 of the 24 items; however there were six items with a 20% difference in their perceptions about learning in STEM. For instance, despite girls recording that they have been provided equal or more opportunities than boys in STEM, they believed they do not do as well as boys (80% boys, 48% girls) or want to seek a career in STEM (39% boys, 17% girls). The written responses revealed gender differences across a number of themes in the students’ responses, including resources, group work, the nature and type of learning experiences, content knowledge, and teachers’ instructional style. Exposing students to STEM education facilitates an awareness of their learning and may assist girls to consider studying STEM subjects or STEM careers.