Communication ethics in public health

As new diseases and medical conditions emerge, new community groups appear in the public health arena as consumer advocates or lobby groups seeking to affect policy or to represent ‘communities’ formed around these new diseases and conditions. The role of these groups in public health, their political status, and the extent to which they are actually representative are highly problematic for public health. These new constellations of social groups and activities challenge traditional ideas about public health decision-making and demand a rethinking of the constituency and limits of public health. Using discourse theory, symbolic interactionism, and ethological theory, the authors examine one case, exploring the perspectives of various communities on hepatitis C, and explore some issues that this raises for public health.

Book review: Leaky Bodies and Boundaries. Feminism, Post-modernism and (Bio)ethics. Shildrick, M. (1997)

This thoughtful book is a much needed contribution to feminist ethics that is brimming with detailed and insightful analyses of the positioning of women in contemporary health care and particularly in relation to new reproductive technologies (NRTs). The clearly written and structured chapters provide accessible points to modern ethics, post-modernism, and feminist ethics. Margrit Shildrick takes on these areas with authority and vigour, building an argument for women to enter the relations of reproduction on terms more expressive of feminine desire...

Hepatitis C and policy implementation : ethics as a dialogic process for resource allocation

Hepatitis C, which was first identified in 1988, has become an important issue for public health as epidemiological and clinical evidence has emerged. These disciplines have highlighted the extent of infection and its medical consequences. Now, governments at both the state and federal levels are sifting through this evidence and are attempting to create structures to deal with the problem of hepatitis C. These structures have generally taken the form of expert committees and working parties organised from established medical, scientific and public health bodies...

A prospective longitudinal survey of fatigue self-management behaviors in patients with advanced cancer

Background: Fatigue is a distressing symptom experienced by approximately 74-88% of patients with advanced cancer. Although there have been advances in managing fatigue with the use of a range of pharmacologic and non-pharmacologic strategies, fatigue is not well-managed in patients with advanced cancer. Objectives: For patients with advanced cancer, the aims of the study were to examine the self-management (SM) behaviours associated with fatigue; the perceived effectiveness of these SM behaviours, and the socio-demographic and clinical factors influencing the effectiveness of these SM behaviours. Methodology: A prospective longitudinal study was undertaken with 152 patients with metastatic breast, lung, colorectal and prostate cancer experiencing fatigue (>3/10) over a two month period. SM behaviours associated with fatigue, medical/demographic characteristics, social support, depression, anxiety, self-efficacy and other symptoms were assessed. Results: Findings indicate that on most fatigue severity measures, levels of fatigue increased slightly over time. On average, participants used nine fatigue SM behaviours at each time point. Participants reported that the most effective SM behaviours were ‘pacing their activities during the day’, ‘planning activities to make the most of energy’, ‘taking short sleeps’, ‘doing things that distract them from their fatigue’, and ‘doing things to improve sleep at night’. Factors associated with the increased effectiveness of fatigue SM behaviours included higher self-efficacy, higher education level, lower levels of depressive symptoms, and lower functional status. These results can be used to inform the design of future interventions to support the use of effective fatigue SM behaviours in this population.

Incongruence between self-reported and observed senior physical education teaching styles : an analysis using Mosston and Ashworth’s spectrum

Pedagogical styles, methods, models, practices or strategies are valued for what they claim they can achieve. In recent times curriculum documents and governments have called for a range of teaching approaches to meet the variety of learner differences and allow students to make more independent decision making in physical education (Hardy and Mawer, 1999). One well known system of categorizing teaching styles is the Mosston and Ashworth’s Spectrum of Teaching Styles (2002). In Queensland, prior to 2005, no research had been conducted on the teaching styles used by teachers of Physical Education. However, many teachers self-reported that they employed a variety of teaching styles depending on the aims and content of the material to be taught (Cothran, et al., 2005). This research, for the first time, collected teacher’s self-reported use of teaching styles and through observations verify the styles that were being used to teach Senior Physical Education in Queensland. More specifically the aims of the research were to determine: a) What teaching styles teachers of Senior Physical Education in Queensland believe they use? i) Were they using a range of teaching styles? ii) Were teachers of Senior Physical Education in Queensland using teaching styles that the Queensland Senior Physical Education Syllabus (2004) required? b) If Mosston and Ashworth’s (2002) Spectrum of Teaching Styles were used to categorise styles observed during the teaching of Senior Physical Education did the styles being used provide opportunities for evaluating as described by the Queensland Senior Physical Education Syllabus (2004)? The research was conducted in two phases. Part A involved use of a questionnaire to determine the teaching styles Queensland teachers of Senior Physical Education reported using and how often they reported using them. The questionnaire was administered to 110 teachers throughout Queensland. The sample was determined from 346 schools teaching Senior Physical Education (in 2006) across the state of Queensland, Australia. 286 questionnaires were sent to 77 non-randomised schools. There were 66 male and 44 female respondents in the sample. A wide range of teaching styles were reportedly used by teachers of Senior Physical Education with Practice Style-Style B, Command Style-Style A and Divergent Discovery Style-Style H, the most reportedly used. The Self-Teaching Style-Style K was reportedly used the least by teachers involved in this study. From the respondents a group of teachers were identified to form the participants for Part B. Part B of the study involved observation of a group of volunteer participants (from those who had completed the questionnaire) who displayed many of the ‘typical’ characteristics, and a cross-section of backgrounds, of teachers of Senior Physical Education in Queensland. In the case of this study, the criteria used to select the group of teachers to be observed teaching were, teaching experience (number of years: 0-4, 5-10 and 11 years and over), gender, geographical location of schools (focused on Brisbane and near area for travel/access purposes), profile of the students at schools (girls, boys or co-educational), nature of school (Government or Private) and the physical activities being taught in a school (activities to reflect all the areas of physical activity outlined within the syllabus). A total of 27 questionnaire respondents from Part A indicated that they were willing to be observed teaching practical lessons. The respondents who volunteered to be involved in Part B of the study came from different regions across the state of Queensland and was not confined to the Brisbane metropolitan area or large cities. From the group of people who volunteered for Part B four came from outside Brisbane and 23 from the Brisbane area. The final observation group of nine participants included eight teachers from the Brisbane area and one from a rural area. The characteristics of the final group included three females and six males from private and public schools with a range of teaching experience in years and a range of physical activities. Four year 12 and five year 11 teachers and their classes were videoed on three occasions as they progressed through an eight – nine week unit of work. This resulted in 24 hours 48 minutes and 20 seconds (or 4465 observations) of video teaching data which was subsequently coded by several researchers (99% interobserver reliability) to determine the teaching styles employed by the participants. This research indicated that, based on Mosston and Ashworth’s (2002) Spectrum of Teaching Styles, teachers of Senior Physical Education in Queensland used predominantly one style to teach 27 observed lessons. This is in sharp contrast to the variety of styles 110 teachers self- reportedly used and in spite of the Queensland Senior Physical Education Syllabus (2004) suggesting a range of specific styles be used. These results are discussed in the context of the Queensland Senior Physical Education Syllabus (2004), teacher knowledge of teaching styles and high-stakes curriculum and external pressures such as national testing and the publication of data from schools in tabloid newspapers. The data and findings in this research provide a rationale for improving teacher knowledge regarding teaching styles and the need for a clear definition of terminology in syllabus documents. Careful examination of the effects that the publishing of school data may have on teaching styles is advised. This research not only collected teacher’s perceptions of the teaching styles they believed they used it also verified these claims through direct observations of the teachers while teaching. These findings are relevant to syllabus writers, teacher educators, policy makers within education and teachers.

Pleading - self-incrimination and penalty privileges

In Anderson v Australian Securities and Investments Commission [2012] QCA 301 the Queensland Court of Appeal allowed an appeal from the decision of the primary judge (ASIC v Managed Investments Ltd No 3 [2012] QSC 74. The Court of Appeal was satisfied that the defendants’ non-compliance with the pleading rules in the Uniform Civil Procedure Rules 1999 (Qld) was justified by the claims to privilege against self-incrimination or exposure to a penalty.

Carnivore : an investigation into the ways that serial killers in the Silence of the Lambs, American Psycho and Darkly Dreaming Dexter are representative of consumers

Serial killers are among the most popular and enduring character types in contemporary culture. In this exegesis I investigate one of the reasons for this popularity by examining the representational relationships between serial killers and serial consumers. I initially establish that all monsters, whether they are vampires, werewolves or serial killers, emerge from cultural anxieties and signify the anxiety which gave them birth. I go on to identify that the cultural anxiety at play with serial killers is consumerism and in doing so, I identify two key parallels between the serial killer and the consumer, namely a sense of lack and a desire for transformation. I then examine the ways in which the serial killer is representative of the consumer in three exemplar texts, The Silence of the Lambs by Thomas Harris, American Psycho by Bret Easton Ellis and Darkly Dreaming Dexter by Jeff Lindsay. I go on to self-reflexively examine the creation of my novel Carnivore, the accompanying draft of which has been influenced by both the exemplar texts and the findings of the exegesis.

Implementing the self-management threshold learning outcome in Australian legal curricula : insights from self-determination theory

In 2010, six Threshold Learning Outcomes (TLOs) for law were developed by the Australian Learning and Teaching Council's Discipline Scholars: Law. The final of these outcomes, TLO 6, concerns self-management. This thesis examines strategies for implementing self-management in Australian legal education by first contextualising the development of TLO 6 in light of other relevant national and international developments in higher education, and secondly, analysing this learning outcome through the lens of Self-Determination Theory (SDT), an influential branch of educational psychology. It is argued that the central concept of autonomous self-regulation in SDT provides insights into factors that are relevant to law students’ capacities for long-term self-management, which is reinforced by analysis of the literature on law students’ distress. Accordingly, curriculum design that supports students’ autonomy may simultaneously promote students’ self-management capacities. The discussion of theoretical and practical perspectives on autonomy supportive curriculum design in this thesis thus illuminates potential pedagogical approaches for the implementation of TLO 6 in Australian legal curricula.

Determinants of uptake of whole-body skin self-examination in older men

Early detection through whole-body Skin Self-Examination (wbSSE) may decrease mortality from melanoma. Using the Health Action Process Approach (HAPA) or Health Belief Model (HBM) we aimed to assess determinants of uptake of wbSSE in 410 men 50 years of older who participated in the control group of a randomized trial. Overall, the HAPA was a significantly better predictor of wbSSE compared to the HBM (p < .001). The construct of self-efficacy in the HBM was a significant predictor of future wbSSE (p = .001), while neither perceived threat (p = .584) nor outcome expectations (p = .220) were. In contrast, self-efficacy, perceived threat, and outcome expectations predicted intention to perform SSE, which predicted behavior (p = .015). The HAPA construct volitional self-efficacy was also associated with wbSSE (p = .046). The use of the HAPA model for future SSE interventions for this population is warranted.

Development and validation of a new self-report instrument for measuring sedentary behaviors and light-intensity physical activity in adults

Background Low levels of physical activity and high levels of sedentary behavior (SB) are major public health concerns. This study was designed to develop and validate the 7-day Sedentary (S) and Light Intensity Physical Activity (LIPA) Log (7-day SLIPA Log), a self-report measure of specific daily behaviors. Method To develop the log, 62 specific SB and LIPA behaviors were chosen from the Compendium of Physical Activities. Face-to-face interviews were conducted with 32 sedentary volunteers to identify domains and behaviors of SB and LIPA. To validate the log, a further 22 sedentary adults were recruited to wear the GT3X for 7 consecutive days and nights. Results Pearson correlations (r) between the 7-day SLIPA Log and GT3X were significant for sedentary (r =.86, p < 0.001), for LIPA (r =.80, p < 0.001). Lying and sitting postures were positively correlated with GT3X output (r =.60 and r =.64, p < 0.001, respectively). No significant correlation was found for standing posture (r =.14, p = 0.53).The kappa values between the 7-day SLIPA Log and GT3X variables ranged from 0.09–0.61, indicating poor to good agreement. Conclusion The 7-day SLIPA Log is a valid self-report measure of SB and LIPA in specific behavioral domains.

Enhanced skin self-examination : a novel approach to skin cancer monitoring and follow-up

Advances in mobile telephone technology and available dermoscopic attachments for mobile telephones have created a unique opportunity for consumer-initiated mobile teledermoscopy. At least 2 companies market a dermoscope attachment for an iPhone (Apple), forming a mobile teledermoscope. These devices and the corresponding software applications (apps) enable (1) lesion magnification (at least ×20) and visualization with polarized light; (2) photographic documentation using the telephone camera; (3) lesion measurement (ruler); (4) adding of image and lesion details; and (5) e-mail data to a teledermatologist for review. For lesion assessment, the asymmetry-color (AC) rule has 94% sensitivity and 62 specificity for melanoma identification by consumers [1]. Thus, consumers can be educated to recognize asymmetry and color patterns in suspect lesions. However, we know little about consumers' use of mobile teledermoscopy for lesion assessment.

Ethics and social networking sites : a disclosive analysis of Facebook

Purpose – This paper aims to provide insights into the moral values embodied by a popular social networking site (SNS), Facebook. Design/methodology/approach – This study is based upon qualitative fieldwork, involving participant observation, conducted over a two-year period. The authors adopt the position that technology as well as humans has a moral character in order to disclose ethical concerns that are not transparent to users of the site. Findings – Much research on the ethics of information systems has focused on the way that people deploy particular technologies, and the consequences arising, with a view to making policy recommendations and ethical interventions. By focusing on technology as a moral actor with reach across and beyond the internet, the authors reveal the complex and diffuse nature of ethical responsibility and the consequent implications for governance of SNS. Research limitations/implications – The authors situate their research in a body of work known as disclosive ethics, and argue for an ongoing process of evaluating SNS to reveal their moral importance. Along with that of other authors in the genre, this work is largely descriptive, but the paper engages with prior research by Brey and Introna to highlight the scope for theory development. Practical implications – Governance measures that require the developers of social networking sites to revise their designs fail to address the diffuse nature of ethical responsibility in this case. Such technologies need to be opened up to scrutiny on a regular basis to increase public awareness of the issues and thereby disclose concerns to a wider audience. The authors suggest that there is value in studying the development and use of these technologies in their infancy, or if established, in the experiences of novice users. Furthermore, flash points in technological trajectories can prove useful sites of investigation. Originality/value – Existing research on social networking sites either fails to address ethical concerns head on or adopts a tool view of the technologies so that the focus is on the ethical behaviour of users. The authors focus upon the agency, and hence the moral character, of technology to show both the possibilities for, and limitations of, ethical interventions in such cases.

Exploring the ethical implications of the late discovery of adoptive and donor-insemination offspring status

Some children adopted under the now discredited period of closed adoption were never told of their adoptive status until it was revealed to them in adulthood. Yet to date, this ‘late-discovery’ experience has received little research attention. Now a new generation of ‘late discoverers’ is emerging as a result of (heterosexual couple) donor insemination (DI) practices. This study of 25 late-discovery participants of either adoptive or (heterosexual couple) DI offspring status reveals ethical concerns particular to the lateness of discovery. Most of the participants were Australian, with the remainder from the UK, USA and Canada. All were asked to give an ‘open’ account of their experience, with four themes or suggestions provided on request. These accounts were added to those available in relevant publications. The analysis employed a hermeneutic phenomenological methodology and all accounts were analysed using an ethical perspective developed by Walker (2006, 2007). The main themes that emerged were: disrupted personal autonomy, betrayal of deep levels of trust and feelings of injustice and diminished self-worth. The lack of recognition of concerns particular to late discovery has resulted in late discoverers (i) feeling unable to regain a sense of personal control, (ii) significantly disrupted relationships with those closest to them and others, including community and institutions, and (iii) feelings of diminished value and self-worth.

Career-path analysis using optimal matching and self-organizing maps

This paper is devoted to the analysis of career paths and employability. The state-of-the-art on this topic is rather poor in methodologies. Some authors propose distances well adapted to the data, but are limiting their analysis to hierarchical clustering. Other authors apply sophisticated methods, but only after paying the price of transforming the categorical data into continuous, via a factorial analysis. The latter approach has an important drawback since it makes a linear assumption on the data. We propose a new methodology, inspired from biology and adapted to career paths, combining optimal matching and self-organizing maps. A complete study on real-life data will illustrate our proposal.

The relationship between children's emotional and cognitive self-regulation at 2 to 3 years and prosocial behavior in the early years of school

This study used data from Growing Up in Australia: The Longitudinal Study of Australian Children (LSAC) to investigate how parent report of children’s emotional and cognitive regulation at age 2-3 years was associated with teacher ratings of children’s prosocial behaviors in the early years of school. A sample of 2,392 children was drawn from the LSAC Birth Cohort for the analyses. The analyses used structural equation modeling to estimate parameters of the relationships between key variables. Within the model, estimates of mother-reported emotional and cognitive regulation at age 2 to 3 years were significantly associated with teacher-reported prosocial behavior at 6 to 7 years. Emotional regulation was a slightly stronger indicator of prosocial behavior than cognitive regulation. Being female and from a family with a higher socioeconomic position were also associated with higher levels of prosocial behavior. Results are discussed in relation to the role of early childhood teachers in fostering children’s self-regulatory behaviors and in providing environments in which empathic and prosocial behaviors are modeled, guided, and scaffolded so that foundations are laid for caring behaviors to be understood and internalized by children.