Frequency of CSF oligoclonal banding in multiple sclerosis increases with latitude

With the advent of MRI scanning, the value of lumbar puncture to assess oligoclonal band (OCB) status-for the diagnosis of multiple sclerosis (MS) is increasingly uncertain. One major issue is that the reported frequency of cerebrospinal fluid (CSF)-restricted oligoclonal banding for the diagnosis of MS varies considerably in different studies. In addition, the relationship between OCB positivity and disease outcome remains uncertain, as reported studies are generally too small to assess comparative disability outcomes with sufficient power. In order to further investigate variation of OCB positivity in patients with MS, we utilized MSBase, a longitudinal, Web-based collaborative MS outcomes registry following clinical cohorts in several continents and latitudes. We also assessed whether OCB positivity affects long-term disability outcome. A total of 13,242 patient records were obtained from 37 MS specialist centres in 19 different countries. OCB status was documented in 4481 (34%) patients and 80% of these were OCB positive. The presence of OCB was associated with degree of latitude (p = 0.02). Furthermore, the outcome of patients negative for CSF-specific OCB was significantly better in comparison to the OCB positive patients, as assessed by Expanded Disability Status Scale change (p < 0.001). The results of this study indicate that latitude could explain some of the inconsistencies in OCB status reported in different populations. The study confirms that OCB positivity in MS is associated with a worse long-term prognosis.

Persistence on therapy and propensity matched outcome comparison of two subcutaneous interferon beta 1a dosages for multiple sclerosis

To compare treatment persistence between two dosages of interferon β-1a in a large observational multiple sclerosis registry and assess disease outcomes of first line MS treatment at these dosages using propensity scoring to adjust for baseline imbalance in disease characteristics. Treatment discontinuations were evaluated in all patients within the MSBase registry who commenced interferon β-1a SC thrice weekly (n = 4678). Furthermore, we assessed 2-year clinical outcomes in 1220 patients treated with interferon β-1a in either dosage (22 µg or 44 µg) as their first disease modifying agent, matched on propensity score calculated from pre-treatment demographic and clinical variables. A subgroup analysis was performed on 456 matched patients who also had baseline MRI variables recorded. Overall, 4054 treatment discontinuations were recorded in 3059 patients. The patients receiving the lower interferon dosage were more likely to discontinue treatment than those with the higher dosage (25% vs. 20% annual probability of discontinuation, respectively). This was seen in discontinuations with reasons recorded as “lack of efficacy” (3.3% vs. 1.7%), “scheduled stop” (2.2% vs. 1.3%) or without the reason recorded (16.7% vs. 13.3% annual discontinuation rate, 22 µg vs. 44 µg dosage, respectively). Propensity score was determined by treating centre and disability (score without MRI parameters) or centre, sex and number of contrast-enhancing lesions (score including MRI parameters). No differences in clinical outcomes at two years (relapse rate, time relapse-free and disability) were observed between the matched patients treated with either of the interferon dosages. Treatment discontinuations were more common in interferon β-1a 22 µg SC thrice weekly. However, 2-year clinical outcomes did not differ between patients receiving the different dosages, thus replicating in a registry dataset derived from “real-world” database the results of the pivotal randomised trial. Propensity score matching effectively minimised baseline covariate imbalance between two directly compared sub-populations from a large observational registry.

Sex as a determinant of relapse incidence and progressive course of multiple sclerosis

The aim of this work was to evaluate sex differences in the incidence of multiple sclerosis relapses; assess the relationship between sex and primary progressive disease course; and compare effects of age and disease duration on relapse incidence. Annualized relapse rates were calculated using the MSBase registry. Patients with incomplete data or <1 year of follow-up were excluded. Patients with primary progressive multiple sclerosis were only included in the sex ratio analysis. Relapse incidences over 40 years of multiple sclerosis or 70 years of age were compared between females and males with Andersen-Gill and Tweedie models. Female-to-male ratios stratified by annual relapse count were evaluated across disease duration and patient age and compared between relapse-onset and primary progressive multiple sclerosis. The study cohort consisted of 11 570 eligible patients with relapse-onset and 881 patients with primary progressive multiple sclerosis. Among the relapse-onset patients (82 552 patient-years), 48 362 relapses were recorded. Relapse frequency was 17.7% higher in females compared with males. Within the initial 5 years, the female-to-male ratio increased from 2.3:1 to 3.3:1 in patients with 0 versus ≥4 relapses per year, respectively. The magnitude of this sex effect increased at longer disease duration and older age (P < 10−12). However, the female-to-male ratio in patients with relapse-onset multiple sclerosis and zero relapses in any given year was double that of the patients with primary progressive multiple sclerosis. Patient age was a more important determinant of decline in relapse incidence than disease duration (P < 10−12). Females are predisposed to higher relapse activity than males. However, this difference does not explain the markedly lower female-to-male sex ratio in primary progressive multiple sclerosis. Decline in relapse activity over time is more closely related to patient age than disease duration.

Opportunities to promote mathematical content knowledge for primary teaching

Understanding the development of pre-service teachers’ mathematical content knowledge (MCK) is important for improving primary mathematics’ teacher education. This paper reports on a case study, Rose , and her opportunities to develop MCK during the four years of her program. Program opportunities to promote MCK when planning and practicing primary teaching included: coursework experiences and responding to assessment requirements. Discussion includes the Knowledge Quartet: foundation knowledge, transformation, connection and contingency. By fourth-year, Rose demonstrated development of different categories of MCK when practicing her teaching because of her program experiences.

A framework for teachers’ knowledge of mathematical reasoning

Exploring and developing primary teachers’ understanding of mathematical reasoning was the focus of the Mathematical Reasoning Professional Learning Research Program. Twenty-four primary teachers were interviewed after engagement in the first stage of the program incorporating demonstration lessons focused on reasoning conducted in their schools. Phenomenographic analysis of interview transcripts exploring variations in primary teachers’ perceptions of mathematical reasoning revealed seven categories of description based on four dimensions of variation, establishing a framework to evaluate development in understanding of reasoning.

Primary Science Specialist Learning Program – Report of Delivery

The purpose of this report is to describe the 8 day Deakin professional learning program and to examine the outcomes of the program based on feedback from participants, using a variety of data sources within the program. This evaluation of the Deakin professional learning program for primary science specialists is conducted for formative purposes, using mainly teachers' perceptions of the 5 day Professional development with science content and pedagogy focus (day 2-4, day 6-7) and the 3 day leading change focus (day 11-13). Feedback was acted on over the period of the professional development program.

Science teacher educator partnerships with schools (STEPS): developing an interpretive framework for primary science teacher education

The STEPS Project responds to international concern about primary teachers’ lack of science knowledge and confidence to teach science, and recent questioning of the effectiveness of traditional approaches to teacher education. The project reviews and builds on established, innovative and successful practices at five universities, to develop and promote a framework supporting school‐based approaches to pre‐service teacher education. This paper will outline the processes involved in developing an Interpretive Framework, which will be a key outcome of the project. The Interpretive Framework identifies key elements to assist teacher educators in planning, implementing and sustaining school-based approaches to teacher education.

Developing effective school and university partnerships for teacher education

The use of school-university partnerships to address the theory-practice divide in teacher education has recently come to attention in international teacher education studies (e.g. Darling-Hammond, 2005; Jones & Ryan, in press). School-university partnerships are particularly important in primary science teacher education as a means to overcome limited opportunities primary pre-service teachers have to observe and practice science teaching during their Practicum. Their opportunities are limited due to a lack of practising teachers who include science in their classroom teaching or who do not feel sufficiently competent to act as science mentors. This is generally attributable to low teacher confidence and knowledge of how to teach science (Jones & Carter, 2007).

This workshop will report on a study which is exploring existing approaches to school-university partnerships in science teacher education at 5 Australian universities. Utilising a multiple case study methodology (Yin, 2009), the project has examined the experiences of establishing, maintaining and developing these partnership and explored the benefits of the partnerships for pre-service teachers, practising teachers and schools.

A key outcome of the project is the development of an “Interpretive Framework” in which partnership practices were exemplified, contextualized and summarized, documenting key phases in the development of partnership arrangements. The Framework is currently undergoing validation with Australian universities. In this paper, the authors present the Framework to an braoder audience for comment and seek to explore its relevance and transferability to school-university partnerships in an international context.

Process evaluation design and tools used in a kindergarten-based, family-involved intervention to prevent obesity in early childhood. The ToyBox-study

Process evaluation (PE) is used for the in-depth evaluation of the implementation process of health promotion programmes. The aim of the current paper was to present the PE design and tools used in the ToyBox-intervention. The PE design was based on a three-step approach, including the identification of ToyBox-specific PE elements (step 1), the development of PE tools and harmonization of procedures (step 2), and the implementation of PE using standardized protocol and tools across the intervention countries (step 3). Specifically, to evaluate the implementation of the intervention, teachers' monthly logbooks were recorded (dose delivered, fidelity, dose received); post-intervention questionnaires were completed by parents/caregivers and teachers (dose received); participation and attrition rates were recorded (recruitment, reach); and audit questionnaires and retrospective information on weather conditions were collected (physical and social environment within which the intervention was implemented). Regarding the teachers' training sessions, the researchers who performed the trainings completed evaluation forms and documented teachers' attendance after each training (dose delivered, fidelity, dose received) and teachers completed evaluation forms after each training (dose received). The PE performed in the ToyBox-intervention may contribute in the evaluation of its effectiveness, guide the revision of the intervention material and provide insights for future health promotion programmes and public health policy.

Revisionist historicism theory and practice: challenging national metanarratives

 This thesis demonstrates the interdependence of theory and practice in re-envisioning Australia’s past: the postmodern methodologies explored in the exegesis inform my fictional reassessment of history. The thesis argues for revisionist historical fiction’s legitimacy in resurrecting lost voices. It looks beyond the colonial archives to reconfigure Australia’s history in more inclusive ways.