No-one learns in a quiet classroom

OBJECTIVE: To assess the value of an introductory sailing program, Buoyed Up, as an intervention strategy to improve the well-being of children at risk of isolation due to economic, cultural and social factors. DESIGN AND METHODS: Data was collected using a mixed method approach and involved primary school children (n=89) drawing and writing about their school and sailing experiences and a focus group and interviews with primary school teachers (n= 6). RESULTS: Most children appear to be happy attending school (78.2%) however, most were passive in content (67.3%) and even those who included their friends (21.8%) drew them sitting or standing. All children drew a picture of themselves actively sailing (100%) and most were happy to be involved in the program (83% of boys and 72% of girls). Most children included a sentence expressing their like for sailing (83% of boys and 72% of girls), which was particularly evident in pictures that reflected the technicalities of sailing. Teachers found children who participated in the program developed a sense of identity and belonging with a group, developed confidence and resilience to cope with challenges and were more engaged in the classroom. CONCLUSION: Children at risk of social exclusion due to economic, social and cultural adversity can be supported to stay in school through unique and targeted programs which can be linked to the curriculum.

Maintaining quality in a school of nursing [abstract]

Three years ago, the School of Nursing (Victoria) obtained ISO 9001 accreditation. This has resulted in a number of initiatives and benefits for the School as well as changes in the workload and administrative responsibilities of the author. The latter changes include responsibility for the `quality management system' that has been established. The ISO series of quality management originated in the industrial sector in Britain. In order for the system to be acceptable and applicable in a human service industry, it was modified to meet the specific needs. These modifications had to be consistent with the ISO framework as well as addressing the needs of the School. The system requires that official and documented policies be in place and performance standards set and maintained. It also requires that customer complaints be heard and addressed. Other features of the system include the monitoring of preferred suppliers of service, documentation of professional education, staff development and the regular audtiting of procedures. Accreditation has brought to the faculty, students and the university quality accreditation to a standard recognized internationally, particularly throughout Europe and Asia. Students and staff benefit because procedures are clearly outlined, recognized and adhered to.(AU)

Teaching a masters unit using four different modes of delivery [abstract]

Over the last two years, the need for flexibility in delivery of courses to post-graduate students enrolled at the Australian Catholic University became pressing. Factors which contributed to this realization included the relatively small numbers of students enrolled over the five campuses of the University and the fact that these students resided thousands of kilometers apart. At the same time, the University decided to enter the world market for on-line education and targeted particular Faculty courses. The Master of Nursing Leadership, conducted by the Faculty of Health Sciences, was one such course. For lectures who teach units in these programmes, this created new opportunities for creativity in teaching. Over the last two years, I have taught four units in the Master of Nursing programme. One unit (Leadership in Nursing Practice) has been taught in four different modes: face to face, video conference, telephone conference and on-line. This has required a high degree of innovation with a number of different strategies being employed for each of the modes. The strategies employed depended on their suitability for the particular mode. These included the development of communication, through the sending of overheads via e-mail, and a telephone protcol. Students also learnt incidental skills such as how to manage a telephone and a video conference, as well as managing the technology. (AU)

Diabetes mellitus after GDM

The impact of factors that influence diabetes mellitus (DM) and impaired glucose tolerance (IGT) incidence rates among former gestation diabetes mellitus (GDM) patients undermine attempts at interstudy comparisons. The recommended diagnostic standards for GDM by oral glucose tolerance tests (OGTT) are the O'Sullivan and Mahan criteria and the World Health Organization (WHO) criteria for IGT, which result in prevalence rates of 2.5 and 7.2 percent, respectively, when applied to 752 unselected pregnant women. In applying the O'Sullivan and Mahan criteria, the current open-ended definition of GDM without rules either to exclude overt diabetes uncovered by pregnancy or to require a return to a normal OGTT after pregnancy is shown to be a major source of differences in subsequent incidence rates of diabetes. For subsequent nonpregnant diagnosis, the differences between WHO and National Diabetes Data Group criteria and the allowable modifications within each of the diagnostic standards all result in different incidence rates of diabetes. Review of 12 worldwide studies of diabetes among former GDM patients and control subjects, the excess risk of diabetes among GDM patients was 18 percent in Copenhagen and 30.9 percent in Boston, MA. The potential impact of varying observation periods within studies was seen when the application of an actuarial method added a further 50 percent to the Boston incidence rates of both GDM patients and control subjects. Although the variability in diabetes incidence rates is wide, there is broad general agreement on the predictive nature of gestational blood glucose levels. (AU)

Agricultural practices affect arthritis

It has been suggested that boron deficiency in food may be a cause of some arthritis (Newnham 1979). Epidemiological studies were done to try to ascertain why some countries have more or less arthritis than other countries. Jamaica, Mauritius, Fiji and Israel were visited with a view to ascertaining the boron levels of locally consumed food as it was suspected that excessive use of soluble chemical fertilizers had damaged the soils of the sugar producing lands. Food grown on these soils were found to have low boron level. By contrast the food consumed in Isreal had high boron concentrations associated with a low incidence of arthritis. South African work has shown that people who eat mostly maize have more arthritis when eating processed maize grown with fertilizer. Brief references is made to the role of boron in human diets. There are bound to be geographical differences in dietary boron, but even in the USA levels have dropped considerably in 50 years. Arthritis is increasing, especially juvenile arthritis. The increased use of fertilizers and genetic selection of plants has led to a wide range of changes in the quality of foodstuffs and their nutrient content. The identification of the parallel loss of boron may reflect vital changes in trace elements and other nutrients (AU)

Diet and mortality from malignant disease in 32 countries

W.H.O. mortality figures for 26 different types of malignant disease taken from 32 countries were correlated with data on the composition of the diet, as well as with certain indices reflecting aspects of general development, for those of the 32 countries for which they were available. For a majority of tumors the results were negative, but most showed a strong association with dietary factors. These included a positive correlation with the national consumption of fats and oils, total calories, and sugar, and a negative correlation with cereal consumption. For malignant tumours the rectum, breast, prostate, skin, nervous system, and bladder, and for leukaemia, lymphosarcoma and multiple myeloma, the probability of this association occurring by chance was less than 1 in 1,000. In seven cases the relationship with dietary factors was of a similar order to that of arteriosclerotic and degenerative heart disease. For all of the 18 separate types associated with diet, the correlation was higher than with the indices of general development,i.e., gross national product, newsprint consumption, percentage of the population engaged in agricultue and infant mortality. (AU)

Comparative radiology of the proximal gastro-intestinal tract in Jamaica

A study of the radiological appearances and pathological features of a series of 17 cases of hypertrophic pyloric stenosis of the adult revealed several interesting features. It was shown that the generally accepted radiological description of smooth, severe and regular narrowing and elongation of the pyloric canal is only present in a proportion of cases. The radiological picture is very variable and many cases presented with an irregular pyloric canal and antrum with only moderate degree of narrowing or of pyloric stenosis. The classical pathological changes are said to be those of hypertrophy and hyperplasia of the circular muscle of the pyloric canal and adjacent part of the antrum. The use of special staining techniques revealed varying amounts of fibrous tissue in the hypertrophied smooth muscle in every case, a feature only briefly referred to in one or two previous communications. The presence of fibrous tissue is compatible with the theory that hypertrophic pyloric stenosis of the adult is secondary to pyloric channel ulcer and further evidence is presented in support of this. In a significant proportion of cases, the pyloric muscle hypertrophy is complicated by the presence of a benign ulcer on the lesser curvature of the stomach. The significance of this is also discussed

Carcinoma of the oesophagus: comparison of two radiological series from Jamaica and Western Australia

Two radiological series of carcinoma of the oesophagus from Kingston, Jamaica, and Perth, Western Australia, are compared. The populations of these two cities show marked differences in race, alcohol consumption and diet, all factors which are thought to play a part in the causation of carcinoma of the oesophagus. In spite of these diffeences the age distribution, sex ratio, automatical distribution and extent of involvement of the oesophagus by this tumour showed marked similarity in these two radiological series. This suggests that the behaviour of carcinoma of the oesophagus is not modified by differences in race or environment in Jamaica and Western Australia. (Summary)

WHO collaborative study on the sero-epidemiology of rubella

Under the auspices of WHO an investigation was made by 9 laboratories in different parts of the world on the distribution of rubella antibodies in girls and women of child-bearing age. In the first part of the study the objective was to determine the reliability and reproducibility of the tests employed. It was found that there was no significant differences in the variability of the titres obtained by repeatedly testing the same sera in one laboratory. In the second part of the study sera were obtained from girls in schools and women attending clinics and health centres. They were not taken from random samples of the populations. In most of the studies the pattern of development of antibody was similar. About half the persons had antibody at 6-8 years of age and 80 percent-87 percent at 17-22 years of age, the percentage remaining relatively constant thereafter. The island populations of Trinidad and Jamaica and a rural area of Japan were, however, found to have significantly fewer women with antibodies than urban areas in Europe or the Americas.(AU)