The prognostic significance of quality of life following breast cancer [Conference Abstract]

Introduction: Evidence suggests a positive association between quality of life (QOL). and overall survival(OS). among metastatic breast cancer (BC). patients, although the relationship in early-stage BC is unclear. This work examines the association between QOL and OS following a diagnosis of early-stage BC. ----- Methods: A population-based sample of Queensland women (n=287). with early-stage, invasive, unilateral BC, were prospectively observed for a median of 6.6 years. QOL was assessed at six and 18 months post-diagnosis using the Functional Assessment of Cancer Therapy, Breast FACT-B+4. questionnaire. Raw scores for the FACT-B+4 scales were computed and individuals were categorised according to whether QOL declined, remained stable or improved over time. OS was measured from the date of diagnosis to the date of death or was censored at the date of last follow-up. Risk ratios (RR) and 95% confidence intervals (CI). for the association between QOL and OS were obtained using Cox proportional hazards survival models adjusted for confounding characteristics. ----- Results: A total of 27 (9.4%). women died during the follow-up period. Three baseline QOL scales (emotional, general and overall QOL) were significantly associated with OS, with RRs ranging between 0.89 95% CI: 0.81, 0.98; P=0.01. and 0.98 (95% CI: 0.96, 0.99; P=0.03),indicating a 2%-11% reduced risk of death for every one unit increase in QOL. When QOL was categorised according to changes between six and 18 months post-diagnosis, analyses showed that for those who experienced declines in functional and physical QOL, risk of death increased by two- (95% CI: 1.43, 12.52; P<0.01) and four-fold (95% CI: 1.15, 7.19; P=0.02), respectively. Conclusions: This work indicates that specific QOL scales at six months post-diagnosis, and changes in certain QOL scales over the subsequent 12-month period (as measured by the FACT-B+4), are associated with overall survival in women with early-stage breast cancer.

Third space in cyberspace : Indigenous youth, new technologies and literacies

This chapter analyses the affordances and constraints of an online literacy program designed for Indigenous Australian youth through a partnership between the Indigenous community, university staff and local schools. The after-school program sought to build on the cultural resources and experiences of the young people through a dialogic process of planning, negotiating, implementing, reflecting, and renegotiating the program with participants and a range of stakeholders. In the majority of cases, students presented themselves as part of pervasive global popular cultures, often hot-linking their webpages to pop icons and local sports stars. Elders regarded their competency as a potential cultural tool and community resource.

Longitudinal patterns of weight in women diagnosed with breast cancer [Conference Abstract]

Introduction: Weight gain is a common concern following breast cancer and has been associated with negative health outcomes. As such, prevention of weight gain is of clinical interest. This work describes weight change between 6- and 18-months following a breast cancer diagnosis and explores the personal, treatment and behavioural characteristics associated with gains in weight. Methods: Body mass index was objectively assessed, at three-monthly intervals, on a population-based sample of women newly diagnosed with unilateral breast cancer (n=185). Changes in BMI between 6- and 18-months post-diagnosis were calculated, with gains of one or more being considered clinically detrimental to future health. Results: Approximately 60% of participants were overweight or obese at 6-months post-diagnosis. While BMI remained relatively stable across the testing period (range=27.3-27.8), 24% of participants experienced clinically relevant gains in BMI (median gains=1.9). Following adjustment for potential confounders, younger age (<45 years; Odds ratio, OR=9.8), being morbidly obese at baseline (OR=4.6) and receiving hormone therapy (OR=4.8) were characteristics associated with an increased odds (p<0.05) of gaining BMI. Other characteristics associated with gains in BMI were more extensive surgery and having a history of smoking, although these relationships were not supported statistically. In contrast, caring for younger children was associated with reduced risk of gaining BMI (OR=0.3, p=0.20). Conclusions: Clinically relevant weight gain between 6- and 18-months post-breast cancer diagnosis is an issue for one in four women, with certain subgroups being particularly susceptible. However, the majority of women diagnosed with breast cancer are overweight or obese and gains in body weight are common. Thus, interventions that address the importance of achieving and sustaining a healthy body weight, delivered to all women with breast cancer, may have greater public health impact than interventions targeting any specific breast cancer subgroup.

Youth cultures, style and education

If our only sources of information were the newspapers and the television, the available evidence would suggest that youth is a terrible problem. Not only would we be convinced that most crime is committed by the social category of youth, but that young people are running out of control, that the streets are no longer safe, that all manner of standards are dropping, that the schools are in chaos, and that, as a consequence of these facts, society faces ruin. Fortunately, there is a considerable body of academic literature which rebuts these assertions, and via a more rigorous and objective analysis of society, it has sought to explain the practices, cultures and circumstances through and by which contemporary youth is formed.

Youth, femininity and self-shaping

The arguments in this paper concerned the manner in which young people learn to construct specific types of relationships with themselves. The analysis of this self-making is accomplished by applying Foucault’s four-part model of self-formation, to an examination of the role of manuals such as young women’s magazines in the shaping of various aspects of the ‘youthful self’. The intention has been to provide a set of tools for approaching the issue of young women's magazines which avoids some of the problems associated with critical theory - a paradigm which translates such magazines almost exclusively in terms of social control.

Youth, Sex, and Government

For nearly twenty-five years, the field of youth studies has employed the same conceptual tools to explain the conduct of young people, tools that inexorably lead to the same recurrent conclusions-youth equals resistance, youth equals alienation, youth equals problem. This book offers a way out of this theoretical Groundhog Day. Starting with the familiar notion of youth subcultures, but also addressing topics such as young women's magazines, 'at risk' youth, anorexia nervosa, and HIV/AIDS programs, this book examines the way in which youth is produced as both a governmental object and a set of practices of the self. Employing the ideas of Foucault, Rose and Mauss, this new approach attempts to reinvigorate what is an important-yet slumbering-area of research.

Youth, personhood and 'practices of the self'

In contrast to most previous research in the field, this paper argues that the concept of 'youth' is best understood as an example of the governmental formation of a specific type of person. It is constructed at the intersection of a variety of diverse problematisations, being produced by the processes of individuation/ normalisation and the regulation of relations of time. Within programs such as those pertinent to the management of sex, an array of technologies structure the practices by which individuals pattern their own conduct - thereby fashioning a kind of habitus. This forms part of a general strategy of enrolling the objects of these programs in their own self-reformation. Consequently, `youth' can be understood as `the doing of specific types of work on the self'. By utilising this framework, the paper not only seeks to identify and better understand some of the sexual subjectivities associated with the construction of youth, it also seeks to offer some new directions for research in the area.

Shaping the 'at-risk' youth : risk, governmentality and the Finn Report

The category of the `at-risk youth' currently underpins a good deal of youth policy, and in particular, education policy. Primarily, the category is centred around a range of programmes associated with the need for state intervention, intervention which largely occurs `at a distance' within domains such as the school and the family. While it is argued that in some ways, the `at-risk youth' simply replaces older characterisations used in the policing of the young, it will also be argued that the preventative policies associated with `risk' are constituted in terms of factors rather than individuals; that prevention is no longer primarily based upon personal expertise, but rather upon the gathering and collation of statistical knowledge which identifies `risks' within given populations; and that `risk' permits a greater number of young people to be brought into the field of regulatory strategies. Importantly, the category of the `at-risk youth' underpins crucial sections of policy documents such as the Finn Report (into credentialling/ education and vocational competency). In this case, youth is deemed to be `at-risk' of not making the transition to adulthood successfully. It will be argued that not only is the Finn Report significant in the administrative and cultural shaping of the category of `youth', but also by employing the notion of `risk', the Report puts in place yet another element of an effective network of governmental intelligibility covering the young. Finally, it will be argued that young women, as a specific example of a `risk' group (vis-a-vis obtaining certain types of employment), require particular forms of intervention, primarily through changing the vocational aspirations of their parents.

Rethinking youth cultures : the case of the 'Gothics'

This paper has argued that subcultural social formations, such as the Gothics, did not evolve as resistance to a dominant culture. Instead, they are a response to the governmental construction of youth as an object of knowledge—the by-product of particular forms of government, generated by specific power/knowledge relations. Accordingly, attempts to account for the phenomenon of ‘subcultures’ should begin, not with notions of a shared, resistant class/generational consciousness, but rather with detailed investigations of specific forms of government, such as those involving conventions and customs within the fashion and music industries, the distribution of technologies of marketing and consumption, the adoption of various techniques of self-shaping, the prevalence of different journalistic practices, routines of policing, and so on. ‘Subcultural style’ is not an expression of relationship between a given social class, its material conditions and its economic and cultural aspirations. Rather, it constitutes the construction of particular habitus, shaped by fashion and leisure activities, through which certain youthful personae are given their form.

Alternative schooling programs for at risk youth : three case studies

This thesis develops a critical realist explanatory critique of alternative schooling programs for youth at risk taking place at three case study sites. Throughout the thesis the author pursues the question, \Are alternative provisions of schooling working academically and socially for youth at risk?. The academic lens targets literacy learning and associated pedagogies. Social outcomes are posited as positive social behaviours and continued engagement in learning. A four phased analysis, drawing on critical realism, interpretive and subject specific theories is used to elicit explanations for the research question. An overall framework is a critical realist methodology as set out by Danermark, Ekstrom, Jakobsen and Karlsson (2002, p. 129). Consequently phase one describes the phenomena of alternative schooling programs taking place at three case study sites. This is reported first as staff narratives that are resolved into imaginable historical causal components of \generative events., \prior schooling structures., \models of alternative schooling., \purpose., \individual agency., and \relations with linked community organisations.. Then transcendental questions are posed about each component using retroduction to uncover structures, underlying mechanisms and powers, and individual agency. In the second phase the researcher uses modified grounded theory methodology to theoretically redescribe causal categories related to a \needed different teaching and administrative approach. that emerged from the previous critique. A transcendental question is then applied to this redescription. The research phenomena are again theoretically redescribed in the third phase, this time using three theoretically based constructs associated with literacy and literacy pedagogies; the NRS, the 4 Resources Model, and Productive Pedagogies. This redescription is again questioned in terms of its core or \necessary. components. The fourth phase makes an explanatory critique by comparing and critiquing all previous explanations, recontextualising them in a wider macro reality of alternative schooling. Through this critical realist explanatory critiquing process, a response emerges not only to whether alternative provisions of schooling are working, but also how they are working, and how they are not working, with realistically based implications for future improvement.

A re-assessment of the debate over sex education

The intention of this paper is to call into question the apparent dichotomy between left and right wing positions concerning the implementation of sex education in Queensland Schools. By adopting a more historicised approach, it is suggested that these positions are part of dual and supplementary strategies which work through specific problematisations associated with youth. Accordingly, the emphasis should be shifted from generalised depictions of the adolescent/youth to more focused accounts, questioning how teaching children to manage their sex became a governmental imperative.

Youth, Sport and the Social Inclusion Agenda

The purpose of this paper is to assess aspects of the British Government's attempts to use sporting participation as a vehicle to re-integrate socially disadvantaged, excluded and 'at-risk' youth into mainstream society. A number of organisations, policy-makers, commentators, and practitioners with a stake in the 'sport and social inclusion agenda' were interviewed. General agreement was found on a number of points: that the field was overly crowded with policies, programmes and initiatives; that the field worked in a 'bottom-up' way, with the most significant factor determining success being effective local workers with good networks and cultural access; that the dichotomising rhetoric of inclusion/exclusion was counter-productive; that the notion of the 'at-risk youth' was problematic and unhelpful; and that they all now dealt with a marketplace, where 'clients' had to be enrolled in their own reformation. There was also disagreement on a number of points: that policy acts as a relatively accurate template for practice, as opposed to the argument that it was simply regarded as a cluster of suggestions for practice; that policy was exceptionally piecemeal in its formulation and application, as opposed to regarding policy as necessarily targeted and dispersed; and that the inclusion agenda was largely politically driven and transitory, as opposed to the optimistic view that it had become ingrained in local practice. Finally, the paper examines some issues that are the most likely points of contribution by researchers in the area: that more research needs to be done on the processes of identity formation associated with participation in sport; that more effective programme evaluation needs to be done for such forms of governmental intervention to work properly; and that the relationship between different kinds of physical activity and social and personal change needs to be more thoroughly theorised.

There is no relationship : service provider staff on how LGBT young people experience policing

There has been an extended engagement with how young people experience policing, with a focus on the intersection between policing and indigeneity, ethnicity, gender, and social class. Interestingly, sexuality and/or gender diversity has been almost completely overlooked, both nationally and internationally. This paper reports on LGBT youth service providers’ accounts about police and LGBT young people interactions. It overviews the outcomes of semi-structured interviews with key LGBT youth service providers in different regions of Brisbane, Queensland. As the first qualitative engagement with these issues from the perspective of service providers, it highlights not only how LGBT young people experience policing, but also how service providers need to ‘work the system’ of policing to produce the best outcomes for LGBT young people.