The role of physical activity in the lives of people with lymphoedema following cancer treatment : a social constructionist study

Lymphoedema is a chronic condition predominantly affecting the limbs, although it can involve the trunk and other areas of the body. It is characterised by swelling due to excess accumulation of fluid in body tissues. Secondary lymphoedema, which arises following cancer treatment, is the more common form of lymphoedema in developed countries. At least 20% of those diagnosed with the most common cancers will develop lymphoedema. This is a concern in Australia as incidence of these cancers is increasing. Cancer survival rates are also increasing. Currently, this equates to 9 300 new cases of secondary lymphoedema diagnosed each year. Considerable physical and psychosocial impacts of lymphoedema have been reported and its subsequent impact on health-related quality of life can exacerbate other side effects of cancer treatment. Exercise following cancer treatment has been shown to significantly reduce the impact of treatment side effects, improve quality of life and physical status. While participating in exercise does not increase risk nor exacerbate existing lymphoedema, reductions in incidence of lymphoedema exacerbations and associated symptoms have been observed in women participating in regular weight lifting following breast cancer treatment. Despite these benefits, lymphoedema prevention and management advice cautions people with lymphoedema against „repetitive use. or „overuse. of their affected arm. It is possible that this advice creates a barrier to participation in physical activity; however, little is known about the relationship between physical activity and lymphoedema. In addition, the majority of studies examining the experiences of people living with lymphoedema and the impact of the condition have been predominantly conducted internationally and have focused on women following breast cancer. This study sought to explore firstly, how men and women construct their experience of living with lymphoedema following treatment for a range of cancers in the context of everyday life in Australia; and secondly, to analyse the role of physical activity in the lives of those living with lymphoedema following cancer treatment. A social constructivist grounded theory approach was taken to explore these objectives as it is acknowledged that human actions and the meanings associated with these actions are influenced by the interaction between the self and the social world. It is also acknowledged that the research process itself is a social construction between the researcher and participant. Purposive sampling techniques were used to recruit a total of 29 participants from a variety of sources. Telephone interviews and focus groups were conducted to collect data. Data were concurrently collected and analysed and analysis was conducted using the constant comparative method. The core category that developed in objective one was „sense of self‟. The self was defined by perceptions participants held of themselves and their identity prior to a lymphoedema diagnosis and changes to their perceptions and identity since diagnosis. Three conceptual categories which related to each other and to „sense of self‟ were developed through the process of coding that represented the process of how participants constructed their experiences living with secondary lymphoedema in the context of everyday life. Firstly, altered normalcy reflected the physical and psychosocial changes experienced and the effect it had on their lives. Secondly, „accidental journey‟ reflected participants‟ journey with the heath care system prior to diagnosis through to longer term management. Thirdly, renegotiating control revealed participants perceived control over lymphoedema and their ability to participate in daily activities previously enjoyed. These findings revealed the failure of the broader health system to recognise the significant and chronic nature of a lymphoedema diagnosis following cancer treatment with greater understanding, knowledge and support from health professionals being needed. The findings also reveal access to health professionals trained in lymphoedema management, a comprehensive approach encompassing both physical and psychosocial needs and provision of practical and meaningful guidelines supported by scientific evidence would contribute to improved treatment and management of the condition. The key findings for objective two were that people with lymphoedema define physical activity in different ways. Physical activity post-diagnosis was perceived as important by most for a variety of reasons ranging from everyday functioning, to physical and psychosocial health benefits. Issues relating to the impact of lymphoedema on physical activity related to the impact on peoples‟ ability to be physically active, confusion about acceptable forms of physical activity and barriers that lymphoedema presented to being physically active. A relationship between how people construct their experiences with lymphoedema and the role of physical activity was also established. The contribution of physical activity to the lives of people living with lymphoedema following cancer treatment appeared to be influenced by their sense of self as socially constructed through their experiences prior to diagnosis and following diagnosis with lymphoedema. The influence of pre-lymphoedema habits, norms and beliefs suggests the importance of effective health promotion messages to encourage physical activity among the general population and specific messages and guidelines particular to the needs of those diagnosed with lymphoedema following cancer treatment. The influence of participant.s social constructions on the lymphoedema experience highlights the importance of improving interactions between the overall health care system and patients, providing a clear treatment plan, providing evidence-based and clear advice about participation in appropriate physical activity, which in doing so will limit the physical and psychosocial effect of lymphoedema and providing comprehensive physical and psychosocial support to those living with the condition and their families. This study has contributed to a deep understanding of people.s experiences with lymphoedema following cancer treatment and the role of physical activity in the context of daily life in Australia. Findings from this study lead to recommendations for advocacy, a comprehensive approach to diagnosis, treatment and management, and specific areas for future research.

Enterprise information security policy assessment : an extended framework for metrics development utilising the goal-question-metric approach

Effective enterprise information security policy management requires review and assessment activities to ensure information security policies are aligned with business goals and objectives. As security policy management involves the elements of policy development process and the security policy as output, the context for security policy assessment requires goal-based metrics for these two elements. However, the current security management assessment methods only provide checklist types of assessment that are predefined by industry best practices and do not allow for developing specific goal-based metrics. Utilizing theories drawn from literature, this paper proposes the Enterprise Information Security Policy Assessment approach that expands on the Goal-Question-Metric (GQM) approach. The proposed assessment approach is then applied in a case scenario example to illustrate a practical application. It is shown that the proposed framework addresses the requirement for developing assessment metrics and allows for the concurrent undertaking of process-based and product-based assessment. Recommendations for further research activities include the conduct of empirical research to validate the propositions and the practical application of the proposed assessment approach in case studies to provide opportunities to introduce further enhancements to the approach.

Acculturation stress in South Sudanese refugees : impact on marital relationships

A qualitative approach was used to explore the impact of acculturation stress on the marital relationships of South Sudanese refugees settled in Brisbane, Australia. Thirteen refugees, who were currently or previously married, participated in three gender specific focus groups. The perceived causes and possible solutions of conflict were thoroughly explored. Hypothetical scenarios were used to facilitate group discussion. Major issues causing conflict between couples were identified as: the management of finances and lack of family and social support. Several other areas of acculturation stress also emerged as factors associated with marital stress. There was a dissonance regarding the adherence to cultural gender roles. Freedom provided to women in Australia caused tension between the couples. Law enforcement officers were perceived as lacking cultural understanding and misinterpreting the couple distress. Finally, limited information provided to refugees pre and post migration was considered to hinder adjustment. The participants suggested a number of practical solutions to these issues which are potentially useful in guiding future refugee settlement programs.

Understanding the use of technology in organisations : a structurational approach

Information Technology and its relationship to organisational performance has long been the interest of researchers. While there is concurrence that IT does contribute to performance, and we are efficiently expanding our knowledge on what factors cause better leveraging of IT resources in organisations, we have done little to understand how these factors interact with technology that results in improved performance. Using a structurational lens that recognises the recursive interaction between technology and people in the presence of social practices, and the norms that inform their ongoing practices, we propose an ethnographic approach to understanding the interaction between technology and resources, aiming to provide richer insight on the nature of the environment that promotes better use of IT resources. Such insights could provide the IT users with at least an initial conception of the IT usage platform that they could promote in their organisations to leverage the most from their IT resources.

Towards a Deeper Understanding of Information Technology Governance Effectiveness : A Capabilities-Based Approach

We examine the relationship between the effectiveness of IT steering committee-driven IT governance initiatives and firm’s IT management and IT infrastructure related capabilities. We test these relationships empirically by a field survey of 216 firms. Results of this study suggest that a firms’ effectiveness of IT steering committee-driven IT governance initiatives positively relate to the level of their IT-related capabilities. We also found positive relationships between IT-related capabilities and internal process-level performance, which positively relate to improvement in customer service and firm-level performance. For researchers, we demonstrate that the resourcebased theory provides a more robust explanation of the determinants of firms IT governance initiatives. This would be ideal in evaluating other IT governance initiatives effectiveness in relation to how they contribute to building performance-differentiating IT-related capabilities. For decision makers, we hope our study has reiterated the notion that IT governance is truly a coordinated effort, embracing all levels of human resources.

Power in legal education : a (new) critical and analytical approach

This article explores power within legal education scholarship. It suggests that power relations are not effectively reflected on within this scholarship, and it provokes legal educators to consider power more explicitly and effectively. It then outlines in-depth a conceptual and methodological approach based on Michel Foucault’s concept of ‘governmentality’ to assist in such an analysis. By detailing the conceptual moves required in order to research power in legal education more effectively, this article seeks to stimulate new reflection and thought about the practice and scholarship of legal education, and allow for political interventions to become more ethically sensitive and potentially more effective.

Questioning pedagogies : Hong Kong pre-service teachers' dialogic reflections on a transnational school experience

There are increasing opportunities in many countries for pre-service teachers to engage in a transnational school-based experience as part of study abroad programmes. The transformative potential of such transnational teaching experiences is recorded in research studies, often supported by data from participant surveys. However, there has been a lack of evidence investigating how shifts in professional understanding derive from such experiences. This qualitative study addresses this issue by exploring the perspectives of 16 pre-service teachers of English as a Second language from Hong Kong, who engaged in transnational teaching activities with primary school pupils in Australia, during their study abroad program. Discourse analysis of participants’ dialogues traces how they encountered conflicting Discourses of ‘student-centredness’ in the Australian classroom. Reflecting dialogically on their experiences led participants to negotiate and reframe their understandings of language teaching pedagogy and themselves as language teachers. The findings demonstrate the importance of both peer and lecturer feedback into the process of dialogic reflection and the need for more longitudinal research into the impact of transnational school-based experience in pre-service teacher education.

The traditional rationale of the arm’s length approach to transfer pricing : should the separate accounting model be maintained for modern multinational entities?

This article examines the current transfer pricing regime to consider whether it is a sound model to be applied to modern multinational entities. The arm's length price methodology is examined to enable a discussion of the arguments in favour of such a regime. The article then refutes these arguments concluding that, contrary to the very reason multinational entities exist, applying arm's length rules involves a legal fiction of imagining transactions between unrelated parties. Multinational entities exist to operate in a way that independent entities would not, which the arm's length rules fail to take into account. As such, there is clearly an air of artificiality in applying the arm's length standard. To demonstrate this artificiality with respect to modern multinational entities, multinational banks are used as an example. The article concluded that the separate entity paradigm adopted by the traditional transfer pricing regime is incongruous with the economic theory of modern multinational enterprises.

Creating successful cultural Brokers : the pros and cons of a community of practice approach in arts management education

Arts managers play a critical role in creating a strong, sustainable arts and cultural sector. They operate as brokers, creating programs, and, more critically, coordinating the relationships between artists, audiences, communities, governments and sponsors required to make these programs a success. Based on study of model developed for a subject in the Master of Creative Industries (Creative Production & Arts Management) at Queensland University of Technology (QUT), this paper examines the pros and cons of a “community of practice” approach in training arts management students to act as cultural brokers. It provides data on the effectiveness of a range of activities – including Position Papers, Case Studies, Masterclasses, and offline and online conversations – that can be used facilitate the peer-to-peer engagement by which students work together to build their cultural brokering skills in a community of practice. The data demonstrates that, whilst students appreciate this approach, educators must provide enough access to voices of authority – that is, to arts professionals – to establish a well-functioning community of practice, and ensure that more expert students do not become frustrated when they are unwittingly and unwillingly thrust into this role by less expert classmates. This is especially important in arts management, where classes are always diverse, due to the fact that most dedicated programs in Australia, as in the US, UK and Europe, are taught via small-scale programs at graduate level which accept applicants from a wide variety of arts and non-arts backgrounds.

Post-graduate health promotion students assess their information literacy

Purpose - The purpose of this paper is to examine post-graduate health promotion students’ self-perceptions of information literacy skills prior to, and after completing PILOT, an online information literacy tutorial. Design/methodology/approach – Post graduate students at Queensland University of Technology enrolled in PUP038 New Developments in Health Promotion completed a pre- and post- self-assessment questionnaire. From 2008-2011 students were required to rate their academic writing and research skills before and after completing the PILOT online information literacy tutorial. Quantitative trends and qualitative themes were analysed to establish students’ self-assessment and the effectiveness of the PILOT tutorial. Findings – The results from four years of post-graduate students’ self-assessment questionnaires provide evidence of perceived improvements in information literacy skills after completing PILOT. Some students continued to have trouble with locating quality information and analysis as well as issues surrounding referencing and plagiarism. Feedback was generally positive and students’ responses indicated they found the tutorial highly beneficial in improving their research skills. Originality/value - This paper is original because it describes post-graduate health promotion students’ self-assessment of information literacy skills over a period of four years. The literature is limited in the health promotion domain and self-assessment of post-graduate students’ information literacy skills. Keywords – Self-assessment, Post-graduate, Information literacy, Library instruction, Higher education, Health promotion, Evidence-based practice Paper Type - Research paper

International transfer pricing : the Australian approach and lessons for Canada

In response to developments in international trade and an increased focus on international transfer-pricing issues, Canada’s minister of finance announced in the 1997 budget that the Department of Finance would undertake a review of the transfer-pricing provisions in the Income Tax Act. On September 11, 1997, the Department of Finance released draft transfer-pricing legislation and Revenue Canada released revised draft Information Circular 87-2R. The legislation was subsequently amended and included in Bill C-28, which received first reading on December 10, 1997. The new rules are intended to update Canada’s international transfer-pricing practices. In particular, they attempt to harmonize the standards in the Income Tax Act with the arm’s-length principle established in the OECD’s transfer pricing guidelines. The new rules also set out contemporaneous documentation requirements in respect of cross-border related-party transactions, facilitate administration of the law by Revenue Canada, and provide for a penalty where transfer prices do not comply with the arm’s-length principle. The Australian tax authorities have similarly reviewed and updated their transfer-pricing practices. Since 1992, the Australian commissioner of taxation has issued three rulings and seven draft rulings directly relating to international transfer pricing. These rulings outline the selection and application of transfer pricing methodologies, documentation requirements, and penalties for non-compliance. The Australian Taxation Office supports the use of advance pricing agreements (APAs) and has expanded its audit strategy by conducting transfer-pricing risk assessment reviews. This article presents a detailed review of Australia’s transfer-pricing policy and practices, which address essentially the same concerns as those at which the new Canadian rules are directed. This review provides a framework for comparison of the approaches adopted in the two jurisdictions. The author concludes that although these approaches differ in some respects, ultimately they produce a similar result. Both regimes set a clear standard to be met by multinational enterprises in establishing transfer prices. Both provide for audits and penalties in the event of noncompliance. And both offer the alternative of an APA as a means of avoiding transfer-pricing disputes with Australian and Canadian tax authorities.

New maps of learning for quality art education : what pre-service teachers should learn and be able to do

It would be a rare thing to visit an early years setting or classroom in Australia that does not display examples of young children’s artworks. This practice serves to give schools a particular ‘look’, but is no guarantee of quality art education. The Australian National Review of Visual Arts Education (NRVE) (2009) has called for changes to visual art education in schools. The planned new National Curriculum includes the arts (music, dance, drama, media and visual arts) as one of the five learning areas. Research shows that it is the classroom teacher that makes the difference, and teacher education has a large part to play in reforms to art education. This paper provides an account of one foundation unit of study (Unit 1) for first year university students enrolled in a 4-year Bachelor degree program who are preparing to teach in the early years (0–8 years). To prepare pre-service teachers to meet the needs of children in the 21st century, Unit 1 blends old and new ways of seeing art, child and pedagogy. Claims for the effectiveness of this model are supported with evidence-based research, conducted over the six years of iterations and ongoing development of Unit 1.

Efficiency and productivity of Singapore’s manufacturing sector 2001-2010: An analysis using Simar and Wilson’s (2007) bootstrapped truncated approach

This paper seeks to explain the lagging productivity in Singapore’s manufacturing noted in the statements of the Economic Strategies Committee Report 2010. Two methods are employed: the Malmquist productivity to measure total factor productivity change and Simar and Wilson’s (J Econ, 136:31–64, 2007) bootstrapped truncated regression approach. In the first stage, the nonparametric data envelopment analysis is used to measure technical efficiency. To quantify the economic drivers underlying inefficiencies, the second stage employs a bootstrapped truncated regression whereby bias-corrected efficiency estimates are regressed against explanatory variables. The findings reveal that growth in total factor productivity was attributed to efficiency change with no technical progress. Most industries were technically inefficient throughout the period except for ‘Pharmaceutical Products’. Sources of efficiency were attributed to quality of worker and flexible work arrangements while incessant use of foreign workers lowered efficiency.

A practical approach for identifying expected solution performance and robustness in operations research applications

A practical approach for identifying solution robustness is proposed for situations where parameters are uncertain. The approach is based upon the interpretation of a probability density function (pdf) and the definition of three parameters that describe how significant changes in the performance of a solution are deemed to be. The pdf is constructed by interpreting the results of simulations. A minimum number of simulations are achieved by updating the mean, variance, skewness and kurtosis of the sample using computationally efficient recursive equations. When these criterions have converged then no further simulations are needed. A case study involving several no-intermediate storage flow shop scheduling problems demonstrates the effectiveness of the approach.