Journal articles on the topic 'Kaduna State Rehabilitation Board'

Purpose: This paper focused on livelihood vulnerability induced by climatic variability amongst farming households in Kaduna state, Nigeria. Methodology: The research used a sample population of 400 using Taro Yamane formula which represents about 0.05% of the population of the three selected local government areas and it purposively targeted farming households heads (FHHH) in one of each of the three eco-climatic zones in the state. Kagarko, BirninGwari and Makarfi local government areas were based on their eco-climatic location and rurality to represent humid, sub-humid and dry sub humid zones of the state respectively. A multi stage sampling technique was further adopted in which farming districts and villages were selected for the administration of 400 structured questionnaires proportionately distributed proportionately to the three local government areas. The Department for International Development (DFID) sustainable livelihoods framework was adopted in the design of the structured questionnaires. Coefficient of Variation (CV %) was deployed to determine the variability of rainfall and temperature of the three eco-climatic zones of the past thirty six years (1981-2016) which was employed into the Micah Hahn’s Livelihood Vulnerability Index model.The results show that Kagarko (humid) had a CV% of 105.43 of rainfall, 9.06 CV% of maximum temperature and CV% of 17.63 in minimum temperature. BirninGwari (sub-humid) had a CV% of 119.64 in rainfall, CV% of 14.17 in maximum temperature and CV% of 15.92 in minimum temperature while Makarfi (dry sub-humid) had a CV% of 124.71 in rainfall, CV% of 9.72 in maximum temperature and 16.29 CV% in minimum temperature. The livelihood vulnerability index (LVI) of Kagarko was calculated to be 0.35, Makarfi and BirninGwari were calculated to be 0.36 respectively and vulnerability spider diagrams were used to capture and compare results. On a vulnerability scale of 0-1, the three eco-climatic zones were found to be very vulnerable to climatic variability. The paper has proved the applicability of Co-efficient of Variation (CV %) into the LVI model which is a departure from previous users who have consistently deployed Mean Standard Deviation into the model. Results: This study will serve as a spring board to meet the Sustainable Development Goals (SDGs) targets on vulnerable communities in Kaduna state. It is discovered that farmers in Makarfi and BirninGwari, even though in different eco-climatic zones of sub-humid and dry sub humid zones respectively, share equal level of livelihood vulnerability index of 0.36 while Kagarko area which is in humid zone, is having 0.35. These indicated that all the areas are within the very vulnerable values on a vulnerability scale of 0-1. The vulnerability levels of the study area can be attributed to weak Natural, Financial and Physical capitals. Recommendations: The paper recommended Integrated Farmers’ Livelihoods Support Strategy (IFLISS) so as to build the resilience of farming households’ livelihood capitals and reduce vulnerability levels.

Tourism is not just a lucrative sector but the fastest growing industry in the world. Many people travel miles to satisfy their pleasure apatite at any destination where satisfaction can be met. But some destinations are flooded while some are scanty. There are many approaches to investigate this and many studies had been done. But despite all these, each destination is unique in terms of its components and attractions combination, this form the basis for this study. The aim of this study is to analyze tourism destination components in Zaria Kaduna State of Nigeria. Tourists’ opinions were sampled through questionnaire at various strategic centers to cover all tourism elements at the destination. Data collected were analyzed using Importance Performance Analysis technique (IPA). The results prove attraction to be the primary destination component i.e. main attractant, while accommodation and accessibility as secondary attractants (Facilitators) in the destination. The outcomes suggest major shortcomings that are traced to poor advertisement, insecurity in the destination e.t.c. The study established the state of the attractiveness of Zaria as a tourist destination, what components and elements are attractive and are not and the factors that influence these. In line with these, the study proposes recommendation that the local tourism board needs to be rejuvenated in other to enhance the local tourism industries to improve its attractiveness among others.

AbstractThe re-enactment of religious preaching board laws to regulate religious preaching in some states of Northern Nigeria generated debates between Government on the one hand and religious/human rights groups on the other. This research examines the Preaching Board Laws of Kano, Borno and Kaduna States in Northern Nigeria through the prism of the Nigerian Constitution and other democratic norms that relate to the right to freedom of religion in all democratic orders. It applies argumentative methodology to raise and analyse the following questions: how reasonable and justifiable are these religious preaching board laws in a democratic Nigeria?; what gave rise to the enactment of these laws in the states under study?; what judicial review mechanism would be employed to determine their reasonableness and justifiability in a democracy?; how do they accord with the freedom of religion clause in the Constitution of the Federal Republic of Nigeria? The research establishes that some of the provisions of these laws are inconsistent with the provisions of the Nigerian Constitution and, by extension, international freedom of religion norms operating in all democratic orders. Second, Nigerian courts have not developed suitable balancing mechanisms for resolving conflicts between the right of the state to regulate and citizens’ right to freedom of religion otherwise called the two competing rights, in the light of which the research calls for the amendment of the laws to accord with the provisions of the Constitution and international freedom of religion norms acceptable in all democracies. The paper further recommends a harmonised proportionality test or judicial standard of review based on Nigeria’s religion-state relations and local experience for the use of courts, legislators and administrative agents coming face to face with this type of conflict in their official capacity.

On June 30,2006, Secretary of State Condoleezza Rice rescinded die United States designation of Libya as a state sponsor of terrorism. Her action ended nearly twenty-seven years of Libya’s pariah status in American law and rhetoric.The road to the rehabilitation of Libya was a long one in more than a temporal sense. During the 1980s, the country was widely perceived as the world’s strongest supporter of terrorism.The United States in particular saw Libya under the leadership of Muammar el-Qaddafi as a “rogue state” posing a serious threat to U.S. national security interests.This fear was confirmed by Libya’s destruction of Pan Am Flight 103 in 1988. A bomb placed by Libyan agents on board the aircraft en route to New York detonated over Lockerbie, Scodand, resulting in the deaths of 270 civilians, including 189 Americans. It was perhaps the single worst act of terrorism against the United States until the carnage of September 11, 2001.

Abstract Purpose Geriatric rehabilitation provides effective multidisciplinary treatment for older people who show symptoms of relevant and potentially reversible functional decline. The aim of this study is to provide an overview on structures of geriatric rehabilitation across Europe. Methods All European Geriatric Medicine Society (EuGMS) Full board members, each representing one member state of the society, were asked to complete an online questionnaire about the current structure of geriatric rehabilitation in their country. Results Thirty-one out of 33 EuGMS Full Board members participated in this questionnaire. Geriatric rehabilitation was officially recognized in 65% (20/31) of participating countries while 29% (9/31) had no geriatric rehabilitation services in their country. In countries with geriatric rehabilitation, the number of available beds varied widely (0–70/100,000 inhabitants). Average length of stay varied from 7 to 65 days. The estimated mean age of the patients in geriatric rehabilitation was 80 years, with most patients being older than 70 years. Six countries had no specified lower age limit and no country had an upper age limit. 42% (13/31) of countries reported having national or local guidelines and 35% (11/31) had a benchmarking or audit system established. Most participants responded positively about the prospects for improvement in the field. Conclusion We observed major differences among EuGMS member countries with regard to the availability of geriatric rehabilitation and how it was organized. Despite various barriers in most countries, future improvement in geriatric rehabilitation services is anticipated.

Purpose This purpose of this paper is to describe methamphetamine relapse risk, examine the relationship between factors in the dynamic model of relapse and methamphetamine relapse risk. Design/methodology/approach A total of 165 clients from the Substance Rehabilitation Center of National Narcotics Board in West Java, Indonesia were recruited. The research instruments included a demographic characteristic questionnaire and eight different tests: Drug Taking Confidence Questionnaire; Stimulant Effect Expectancy Questionnaire; Stage of Change Readiness and Treatment Eagerness Scale version 8.0 for Drug; Coping Strategies Inventory Short Form; Positive Affect and Negative Affect Schedule; Desire for Speed Questionnaire; Social Support Questionnaire; and the Stimulant Relapse Risk Scale. Descriptive statistics were used to analyze the data. Pearson’s product moment correlation was used to test the relationship among variables. Findings Clients (63 percent) were at a moderate level of methamphetamine relapse risk (mean=56.33, SD=10.54). Outcome expectancy, positive emotional state, negative emotional state and craving were positive and had a significant correlation with relapse risk (r=0.261, r=0.380, r=0.370, r=0.509, p<0.01, respectively). Self-efficacy was negative and had a significant correlation with relapse risk (r=−0.316, p<0.01). Motivation, coping and social support had no correlation with relapse risk. Originality/value Two-thirds of the clients in a rehabilitation center have a tendency to relapse following treatment. Nursing intervention for early detection of methamphetamine relapse risk during treatment by using standardized instruments should be implemented.

BackgroundDirect access to physical therapist services is permitted by law in the majority of states and across all practice settings. Ohio enacted such legislation in 2004; however, it was unknown how direct access had affected actual clinical practice.ObjectivesThe purpose of this study was to describe physical therapist and physical therapist practice environment factors that affect direct access practice.DesignA 2-phase, mixed-method descriptive study was conducted.MethodsIn the first phase, focus group interviews with 32 purposively selected physical therapists were completed, which resulted in 8 themes for an electronically distributed questionnaire. In the second phase, survey questionnaires were distributed to physical therapists with an e-mail address on file with the Ohio licensing board. An adjusted return rate of 23% was achieved. Data were analyzed for descriptive statistics. A constant comparative method assessed open-ended questions for common themes and patterns.ResultsThirty-one percent of the respondents reported using direct access in physical therapist practice; however, 80% reported they would practice direct access if provided the opportunity. Physical therapists who practiced direct access were more likely to be in practice 6 years or more and hold advanced degrees beyond the entry level, were American Physical Therapy Association members, and had supportive management and organizational practice policies. The direct access physical therapist practice was generally a locally owned suburban private practice or a school-based clinic that saw approximately 6% to 10% of its patients by direct access. The majority of patients treated were adults with musculoskeletal or neuromuscular impairments.LimitationsNonresponse from e-mail may be associated with sample frame bias.ConclusionsImplementation of a direct access physical therapist practice model is evident in Ohio. Factors related to reimbursement and organizational policy appear to impede the process.

Inclusion, the philosophy of placing all children with disabilities in regular education settings, is easily the most discussed and controversial education reform issue since the 1975 passage of PL 94-142, Education of Handicapped Children Act (EHA). However, inclusion is never mentioned in the original EHA or the updated PL 101-476, Individuals with Disabilities Education Act (IDEA) (e.g., Sherrill, 1994; Stein, 1994). What is discussed in IDEA as well as Section 504 of the Rehabilitation Act of 1973 is the “continuum of least restrictive environments” (LRE). The purpose of this paper is to (a) review United States federal laws regarding inclusion and LRE, most notably IDEA and Section 504 of the Rehabilitation Act of 1973; (b) review recent U.S. court cases regarding inclusion and LRE including three landmark cases: Roncker v. Walter (Ohio) (1983), Daniel R.R. v. State Board of Education (Texas) (1989), and Sacramento Unified School District, Board of Education v. Rachel H. (California) (1994); and (c) apply these federal laws and court decisions to physical education placement.

Background: Anterior cruciate ligament (ACL) graft conditioning protocols to decrease postoperative increases in anterior tibial translation and pivot-shift instability have not been established. Purpose: To determine what ACL graft conditioning protocols should be performed at surgery to decrease postoperative graft elongation after ACL reconstruction. Study Design: Controlled laboratory study. Methods: A 6 degrees of freedom robotic simulator evaluated 3 ACL graft constructs in 7 cadaver knees for a total of 19 graft specimens. Knees were tested before and after ACL sectioning and after ACL graft conditioning protocols before reconstruction. The ACL grafts consisted of a 6-strand semitendinosus-gracilis TightRope, bone–patellar tendon–bone TightRope, and bone–patellar tendon–bone with interference screws. Two graft conditioning protocols were used: (1) graft board tensioning (20 minutes, 80 N) and (2) cyclic conditioning (5°-120° of flexion, 90-N anterior tibial load) after graft reconstruction to determine the number of cycles needed to obtain a steady state with no graft elongation. After conditioning, the grafts were cycled a second time under anterior-posterior loading (100 N, 25° of flexion) and under pivot-shift loading (100 N anterior, 5-N·m internal rotation, 7 N·m valgus) to verify that the ACL flexion-extension conditioning protocol was effective. Results: Graft board tensioning did not produce a steady-state graft. Major increases in anterior tibial translation occurred in the flexion-extension graft-loading protocol at 25° of flexion (mean ± SD: semitendinosus-gracilis TightRope, 3.4 ± 1.1 mm; bone–patellar tendon–bone TightRope, 3.2 ± 1.0 mm; bone–patellar tendon–bone with interference screws, 2.4 ± 1.5 mm). The second method of graft conditioning (40 cycles, 5°-120° of flexion, 90-N anterior load) produced a stable conditioned state for all grafts, as the anterior translations of the anterior-posterior and pivot-shift cycles were statistically equivalent ( P < .05, 1-20 cycles). Conclusion: ACL graft board conditioning protocols are not effective, leading to deleterious ACL graft elongations after reconstruction. A secondary ACL graft conditioning protocol of 40 flexion-extension cycles under 90-N graft loading was required for a well-conditioned graft, preventing further elongation and restoring normal anterior-posterior and pivot-shift translations. Clinical Relevance: There is a combined need for graft board tensioning and robust cyclic ACL graft loading before final graft fixation to restore knee stability.

A framework for inspection, rehabilitation, and replacement of corrugated steel culvert pipes (CSCP) is developed. It is expected to lead to developing a culvert information management system (CIMS), wherein justification and need are based on recent Governmental Accounting Standards Board (GASB) requirements. The CIMS will assist in evaluating infrastructure assets and facilitate comparing present costs of preserving infrastructure. Benefits include long-term savings from adopting optimized preventive maintenance strategies. CSCP condition states are used to express the extent of deterioration. Rehabilitation options and recommendations are given for deteriorated CSCPs. These options will be incorporated into the proposed CIMS, which uses survival probabilities based on the CSCP condition state during the previous year. Survival probabilities within Condition States 1, 2, and 3 are computed on the basis of corrosion research data. However, implementing the proposed CIMS requires field data for CSCPs or laboratory tests that mimic field conditions. The proposed CIMS can analyze decisions to inspect, rehabilitate and replace, or do nothing at both project and network levels. At the project level, inspection or rehabilitation and replacement costs are compared with failure risks and costs. At the network level, associated costs are optimized to meet the annual maintenance budget by prioritizing CSCPs needing inspection and rehabilitation and replacement. The proposed CIMS can also be used to estimate the required annual budgetary allocation for a stipulated planning horizon and to maintain or improve the aggregate condition state of the CSCP network or to maintain or improve the total highway CSCP network asset value, thereby meeting GASB 34 requirements. The optimum sequential path in the annual decision-making process may then be determined using a combination of operations research tools.

Knee injuries are among the most common health problems in the world. They not only affect people who practice sports, but also those who lead a rather sedentary life. Factors such as age, weight, working and leisure activities can affect the health of the knees, causing disorders such as inflammation, edema, deterioration of cartilage and osteoarthritis. Although for the diagnosis and treatment of the various pathologies it is always advisable to contact orthopedists and specialized structures, it would often be useful to monitor the state of health of the knees in order to evaluate the healing (or worsening) process and the effects of sport/motion activities or rehabilitation. In this perspective, a portable knee health monitoring system was developed to be used at home or in gyms and sports environments in general. Besides requiring a simple custom front end, the system relies on a PC audio board capable of a sampling rate of 192 kHz to perform bioimpedance measurements at frequencies in excess of 50 kHz. A simple numerical calibration procedure allows to obtain high accuracy while maintaining low hardware complexity. The software developed for the operation of the system is freely available to any researcher willing to experiment with the bioimpedance measurement approach we propose, ensuring the conditions of portability and low complexity. Primary (intracellular and extracellular resistances and cell membrane capacitance) and secondary (real and imaginary parts of the total impedance) bioimpedance parameters can be obtained and analyzed through direct measurements with reference to an equivalent circuit model. The functionality of the system has been tested on nine subjects with different well-known health conditions, providing encouraging results in terms of the ability to correlate bioimpedance measurements to the health status of the knees. If proper clinical trials were to confirm our preliminary results, a system such as the one we propose could be used for fast and frequent monitoring of knee joints, thus possibly reducing the frequency at which complex and expensive medical exams, sometimes involving long waiting lists, must be performed.

Background: It is important to measure the functional capabilities of a prosthesis in order to make informed decisions when prescribing a limb. Objectives: To measure the functional of a range of commercial single degree of freedom hands to act as baseline comparisons for the newer multi-axis hands. Study Design: Form-board and self-timed tasks. Method: Repeated measures with a single subject using a validated assessment tool. The test measured the function of three conventional, single axis, powered hands, controlled by five different myocontroller formats. One transcarpal device was also tested. Results: When controlled by the same type of two channel myoelectric controllers (proportional voluntary opening, voluntary closing) the overall functional scores were similar for all similar types of hand, with a maximum score of 94 out of 100. The smaller transcarpel hand had a score of 84. Only when a more limited single channel three state controller was used was the score much lower (81). Conclusion: All of the hands were of a similar design and were set in a precision grip, but the precision grip did not achieve the highest individual grip score. Additionally, while the Southampton Hand Assessment Procedure (SHAP) score is dependent on the speed of execution of the task, the speed of the prosthesis did not have as great an impact on the score as the other variables. Clinical relevance This study provides comparative data between similar designs of commercial hands. This will allow clinicians to be better informed when they prescribe a device for a user.

Background: Prescribing opioids has become a challenge. The US Drug Enforcement Agency (DEA) and Centers for Disease Control and Prevention (CDC) have become more involved, culminating in the March 2016 release of the CDC’s “Guidelines for Prescribing Opioids for Chronic Pain.” Objectives: Given the new guidelines, we wanted to see if there have been any changes in the numbers, demographics, physician risk factors, charges, and sanctions involving the DEA against physicians who prescribe opioids, when compared to a previous DEA database review from 1998 to 2006. Study Design: This study involved an analysis of the DEA database from 2004 to 2017. Setting: The review was conducted at the Henry Ford Health System Division of Pain Medicine. Method: After institutional review board approval at Henry Ford Health System, an analysis of the DEA database of criminal prosecutions of physician registrants from 2004-2017 was performed. The database was reviewed for demographic information such as age, gender, type of degree (doctor of medicine [MD] or doctor of osteopathic medicine [DO]), years of practice, state, charges, and outcome of prosecution (probation, sentencing, and length of sentencing). An internet-based search was performed on each registrant to obtain demographic data on specialty, years of practice, type of medical school (US vs foreign), board certification, and type of employment (private vs employed). Results: Between 2004 and 2017, Pain Medicine (PM) had the highest percentage of in-specialty action at 0.11% (n = 5). There was an average of 18 prosecutions per year vs 14 in the previous review. Demographic risk factors for prosecution demonstrated the significance of the type of degree (MD vs. DO), gender, type of employment (private vs. employed), and board certification status for rates of prosecution. Having a DO degree and being male were associated with significantly higher risk as well as being in private practice and not having board certification (P < .001). In terms of type of criminal charges as a percent of cases, possession with intent to distribute (n = 90) was most prevalent, representing 52.3% of charges, with new charges being prescribing without medical purpose outside the usual course of practice (n = 71) representing 41.3% of charges. Comparison of US graduates (MD/DO) vs. foreign graduates showed higher rates of DEA action for foreign graduates but this was of borderline significance (P = .072). Limitations: State-by-state comparisons could not be made. Specialty type was sometimes selfreported, and information on all opioid prosecutions could not be obtained. The previous study by Goldenbaum et al included data beyond DEA prosecution, so direct comparisons may be limited. Conclusion: The overall risk of DEA action as a percentage of total physicians is small but not insignificant. The overall rates of DEA prosecution have increased. New risk factors include type of degree (DO vs. MD) and being in private practice with a subtle trend toward foreign graduates at higher risk. With the trend toward less prescribing by previously high-risk specialties such as Family Medicine, there has been an increase in the relative risk of DEA action for specialties treating patients with pain such as PM, Physical Medicine and Rehabilitation, neurology, and neurosurgery bearing the brunt of prosecutions. New, more subtle charges have been added involving interpretation of the medical purpose of opioids and standard of care for their use. Key words: Certification, CDC, criminal, DEA, opioid, prescribing, prosecution, sanctions

Context California is currently the only state that does not regulate who can and cannot call themselves athletic trainers (ATs). Therefore, previous national or state-specific investigations may not have provided an accurate representation of AT availability at the secondary school level in California. Similarly, it is unknown whether the factors that influence AT availability in California, such as socioeconomic status, are similar to or different from those identified in previous studies. Objective To describe the availability of ATs certified by the Board of Certification in California secondary schools and to examine potential factors influencing access to AT services in California secondary schools. Design Cross-sectional study. Setting Online survey. Patients or Other Participants Representatives of 1270 California high schools. Main Outcome Measure(s) Officials from member schools completed the 2017–2018 California Interscholastic Federation Participation Census. Respondents provided information regarding school type, student and student-athlete enrollment, whether the school had ATs on staff, and whether the ATs were certified by the Board of Certification. The socioeconomic status of public and charter schools was determined using the percentage of students eligible for free or reduced-price lunch. Results More than half (54.6%) of schools reported that they either did not employ ATs (47.6%) or employed unqualified health personnel (UHP) in the role of AT (7.0%). Nearly 30% of student-athletes in California participated in athletics at a school that did not employ ATs (n = 191 626, 28.9%) and 8% of student-athletes participated at a school that employed UHP in the role of AT (n = 54 361, 8.2%). Schools that reported employing ATs had a lower proportion of students eligible for free or reduced-price lunch than schools that did not employ ATs and schools that employed UHP (both P values &lt; .001). Conclusions With ongoing legislative efforts to obtain regulation of ATs in California, secondary school administrators are encouraged to hire ATs with the proper certification to enhance the patient care provided to student-athletes and improve health outcomes.

This case provides a comprehensive account of the origin, foundation, growth, managerial and operational problems, labor relationship, decline in performance, change of ownership, and the initiatives taken by the new management team to revive the company. Mangalore was an initiative by Karnataka State Government in India. Originally, MCFL was conceived as a private sector organization. Eventually it was converted to a state-owned public sector undertaking. There was no accountability for the senior managers in managing the plant. Often, they had to make a trade off between their loyalty to the elected representatives and the prosperity of MCFL. Invariably, the operating officers who were usually drawn from Indian Administrative Services chose to neglect the commercial prospects of MCFL. Erratic power supply and hostile labor situation (as a consequence of inappropriate labor policies) led to frequent shut down of the plant. Consequently, the financial health of the plant deteriorated. The precarious financial position made MCFL a candidate for either closure or for sale. The Indian Government, in an attempt to revive the plant, put MCFL through two rehabilitation packages supported by its Board and its financial institutions. Eventually, MCFL was sold to UB Group in 1990. The Chairman Mr. Mallya nominated a team from UB group to manage and revive MCFL. As of 2002, MCFL is a profit-generating organization. The management has to decide, how MCFL should grow from now onwards.

Purpose – The purpose of this paper is to evaluate the effectiveness of a brief, Cognitive Behaviour Therapy-based group intervention in anger management with male offenders. All participants were the subject of a stipulation to attend the programme under a probation order, and were at the time of the study being managed in the community. Design/methodology/approach – Totally, 105 offenders attended the anger management programme, which was delivered by the Probation Board for Northern Ireland (PBNI), between 2008 and 2010 across a range of centres, representing most regions of the province. Prior to treatment, the offenders completed two measures: The State Trait Anger Expression Inventory (STAXI), and the Stages of Change Scales (SCS). Both these measures were also completed at the end of the programme of treatment. Findings – It was found that the programme significantly reduced the expression of anger as well as state and trait anger among offenders referred to the programme as measured by the STAXI. Both the action and maintenance subscales of the SCS were significant predictors of improvement in anger expression. The action subscale was shown to be a valuable predictor of readiness for change amongst the offenders. Originality/value – Assessing an offender’s readiness to change may enhance selection for specific rehabilitation programs thus reducing drop-out rates leading to a more efficient use of resources. This study demonstrates that those participants who were found to be more ready for change, benefited most from the intervention programme.

The last decade has seen significant advances in research on haptics and haptic interfaces. Device performance has improved, and the many commercial devices now available at reasonable prices indicate how haptic research will grow and new applications involving haptics will touch all aspects of daily life. Sophisticated systems require research beyond physical devices, such as modeling the physical properties of virtual objects, human physiology, and haptic evaluation. This special issue focuses on state-of-the-art design and development of haptic interfaces and explores potential applications of this technology and related issues such as tactile display, haptic rendering, physiology, and evaluation methodologies. The 15 papers were selected after a rigorous peer review from around the world and include diverse topics such as haptic device design and technology, tactile display and tactile sensing, collaborative multiuser haptic environments, haptic cognition, haptic rendering, tele-existence and multimodal interaction, and medical and rehabilitation applications. We thank the Editorial Board of JRM Journal for making this special issue possible. We also thank the authors for contributing their fine work and revising their papers for this issue, and extend our thanks and appreciation to the reviewers for their constructive comments and suggestions.

Abstract Introduction According to the American Burn Association, Burn Awareness Week is an annual event that provides an “opportunity for organizations to mobilize burn, fire and life safety educators to unite in sharing a common burn awareness and prevention message in our communities.” In 2018, due to alarming data indicating that a high volume of our children’s burn admissions was a result of scald burns, we recognized the need to participate in our first Burn Awareness Week and involve our community stakeholders. Methods Analysis of our data from the 2017 trauma registry determined that 61% of pediatric burn admits were scald burns and most were &lt; 6 years old. Geo-mapping identified at risk areas by ethnicity and zip-codes. Our Burn Awareness Week messaging was designed based on this information. We predominantly targeted English and Spanish speaking families with the goal of increasing awareness of the prevalence and prevention of scald burns and evidence-based first aid treatment. Most materials created were bilingual and included an interactive burn awareness quiz with rewards, firefighter coloring books, bilingual first aid magnets, and t-shirts displaying the scald awareness message, “Hot Liquids Burn Like Fire.” Bilingual story board testimonials of real patients were displayed. Multimedia platforms provided public service announcements in English and Spanish. Results More than 1500 people attended the booth during the 5-day event. We designed and implemented our first Burn Awareness Week with participation from community stake-holders. A post-event survey identified that the interactive burn awareness quiz, first aid magnets, t-shirts, and story boards were most effective in delivering our message and well-received by the community. This event served as a catalyst to continue burn awareness and education with clinics and interdepartmental units. In addition, a community hospital requested our materials and information. During our event, one of our community stakeholders successfully secured a proclamation for Burn Awareness Week from our state Governor. Conclusions Burn Awareness Week enabled our institution and our community to get involved in addressing an identified pressing public health issue. We created a template for our future participation in Burn Awareness Week based on generated data that allows us to target demographic locations with specific burn related issues within our community. Applicability of Research to Practice Scald burns is the most common burn injury in young children admitted at our hospital. A collaborative event between our hospital and community stake-holders provided burn awareness and prevention education to our community to help reduce such injuries in the future.

IntroductionPatients with systemic inflammatory diseases such as rheumatoid arthritis (RA) have an increased risk of cardiovascular disease (CVD) above the baseline risk attributable to traditional CVD risk factors seen in the general population. Exercise in cardiac rehabilitation (CR) is designed specifically for high-risk primary prevention and those with established CVD. Even though the European League Against Rheumatism guidelines state that exercise is safe for individuals with RA and exercise can reduce CVD risk, patients with RA rarely participate in CR. Thus, little is known about CR’s impact on inflammatory and CVD risk in the RA population. The purpose of this trial is to determine the feasibility of a 12-week CR programme for patients with RA and whether it decreases CVD risk without exacerbating RA.Methods and analysisThis is a randomised controlled trial whereby 60 participants with RA will be recruited and randomly assigned to either standard of care (SOC) treatment or SOC plus a 12-week CR programme (60 min of education plus two 60 min aerobic exercise sessions/week). Exercise will be performed at 60%–80% of heart rate reserve. Outcome measures (Framingham Risk Score, resting heart rate, blood pressure, blood lipids, markers of systemic inflammation (ie, interleukin (IL) 6 and tumour necrosis factor-α (TNF-α), Clinical Disease Assessment Index, Disease Activity Score-28, physical activity levels and peak cardiorespiratory fitness) will be assessed preintervention (week-0), postintervention (week-13) and 6 months postintervention.Ethics and disseminationEthical approval was obtained from the Nova Scotia Health Authority Research Ethics Board. Results will be submitted for publication in an appropriate peer-reviewed journal.Trial registration numberNCT01534871; Pre-results

IntroductionThis randomised controlled trial (RCT) examines treadmill walking exercise training effects on learning and memory performance, hippocampal volume, and hippocampal resting-state functional connectivity in persons with multiple sclerosis (MS) who have objective impairments in learning new information.Methods and analysisForty fully ambulatory persons with MS who demonstrate objective learning and memory impairments will be randomly assigned into either the intervention or active control study conditions. The intervention condition involves supervised, progressive treadmill walking exercise training three times per week for a 3-month period. The active control condition involves supervised, progressive low-intensity resistive exercise that will be delivered at the same frequency as the intervention condition. The primary outcome will involve composite performance on neuropsychological learning and memory tests, and the secondary outcomes involve MRI measures of hippocampal volume and resting-state functional connectivity administered before and after the 3-month study period. Outcomes will be administered by treatment-blinded assessors using alternate test forms to minimise practice effects, and MRI data processing will be performed by blinded data analysts.Ethics and disseminationThis study has been approved by a university institutional review board. The primary results will be disseminated via peer-reviewed publications and the final data will be made available to third parties in applicable data repositories. If successful, the results from this study will eventually inform subsequent RCTs for developing physical rehabilitation interventions (ie, treadmill walking exercise training) for improving learning and memory and its relationship with hippocampal outcomes in larger samples of cognitively impaired persons with MS. The results from this early-phase RCT will further lay preliminary groundwork for ultimately providing clinicians and patients with guidelines for better using chronic treadmill walking exercise for improving cognition and brain health. This approach is paramount as learning and memory impairment is common, burdensome and poorly managed in MS.Trial registration numberNCT03319771; Pre-results.

AbstractAccording to Islamic Financial Service Board (IFSB), Sukuk are certificates that represent the holders’ proportionate ownership in an undivided part of underlying asset where the holder assumes all right and obligations to such asset. The emergence of Sukuk in Islamic capital markets is a significant development that provides alternative funding avenue for corporate entities, government and financial institutions. Despite the tremendous growth of Sukuk finance globally, the phenomenon is relatively new in Nigeria, though the regulator, Securities and Exchange Commission (SEC) has issued guidelines for the operation and placing of Sukuk in the country, apart from Osun State Government that has listed its Sukuk and the recent FGN Sukuk issuance, evidence shows that, none within the corporate and financial bodies had listed any Sukuk in Nigeria. It is against this backdrop that this paper aims at assessing the role of Sukuk financing in nation building with special reference to the recent Sukuk issuance by the Federal Government for the rehabilitation of Federal roads across the six geo-political zones of the Country. The researchers adopted analytical and descriptive approaches in this study. The main findings of the paper have shown that despite the novelty of Sukuk finance to Nigerian context, it has incalculable impact on nation building. It also revealed that Ṣukūk have many economic benefits and potentialities to Nigerian economy in terms of economic growth, financial inclusion, diversification, Liquidity Control and infrastructural financing, among others.

Abstract STUDY QUESTION Is the presence or absence of certain vaginal bacteria associated with failure or success to become pregnant after an in vitro fertilization (IVF) or IVF with intracytoplasmic sperm injection (IVF-ICSI) treatment? SUMMARY ANSWER Microbiome profiling with the use of interspace profiling (IS-pro) technique enables stratification of the chance of becoming pregnant prior to the start of an IVF or IVF-ICSI treatment. WHAT IS KNOWN ALREADY Live-birth rates for an IVF or IVF-ICSI treatment vary between 25 and 35% per cycle and it is difficult to predict who will or will not get pregnant after embryo transfer (ET). Recently, it was suggested that the composition of the vaginal microbiota prior to treatment might predict pregnancy outcome. Analysis of the vaginal microbiome prior to treatment might, therefore, offer an opportunity to improve the success rate of IVF or IVF-ICSI. STUDY DESIGN, SIZE, DURATION In a prospective cohort study, 303 women (age, 20–42 years) undergoing IVF or IVF-ICSI treatment in the Netherlands were included between June 2015 and March 2016. PARTICIPANTS/MATERIALS, SETTING, METHODS Study subjects provided a vaginal sample before the start of the IVF or IVF-ICSI procedure. The vaginal microbiota composition was determined using the IS-pro technique. IS-pro is a eubacterial technique based on the detection and categorization of the length of the 16S–23S rRNA gene interspace region. Microbiome profiles were assigned to community state types based on the dominant bacterial species. The predictive accuracy of the microbiome profiles for IVF and IVF-ICSI outcome of fresh ET was evaluated by a combined prediction model based on a small number of bacterial species. From this cohort, a model was built to predict outcome of fertility treatment. This model was externally validated in a cohort of 50 women who were undergoing IVF or IVF-ICSI treatment between March 2018 and May 2018 in the Dutch division of the MVZ VivaNeo Kinderwunschzentrum Düsseldorf, Germany. MAIN RESULTS AND THE ROLE OF CHANCE In total, the vaginal microbiota of 192 women who underwent a fresh ET could be analysed. Women with a low percentage of Lactobacillus in their vaginal sample were less likely to have a successful embryo implantation. The prediction model identified a subgroup of women (17.7%, n = 34) who had a low chance to become pregnant following fresh ET. This failure was correctly predicted in 32 out of 34 women based on the vaginal microbiota composition, resulting in a predictive accuracy of 94% (sensitivity, 26%; specificity, 97%). Additionally, the degree of dominance of Lactobacillus crispatus was an important factor in predicting pregnancy. Women who had a favourable profile as well as <60% L. crispatus had a high chance of pregnancy: more than half of these women (50 out of 95) became pregnant. In the external validation cohort, none of the women who had a negative prediction (low chance of pregnancy) became pregnant. LIMITATIONS, REASONS FOR CAUTION Because our study uses a well-defined study population, the results will be limited to the IVF or IVF-ICSI population. Whether these results can be extrapolated to the general population trying to achieve pregnancy without ART cannot be determined from these data. WIDER IMPLICATIONS OF THE FINDINGS Our results indicate that vaginal microbiome profiling using the IS-pro technique enables stratification of the chance of becoming pregnant prior to the start of an IVF or IVF-ICSI treatment. Knowledge of their vaginal microbiota may enable couples to make a more balanced decision regarding timing and continuation of their IVF or IVF-ICSI treatment cycles. STUDY FUNDING/COMPETING INTEREST(S) This study was financed by NGI Pre-Seed 2014–2016, RedMedTech Discovery Fund 2014–2017, STW Valorisation grant 1 2014–2015, STW Take-off early phase trajectory 2015–2016 and Eurostars VALBIOME grant (reference number: 8884). The employer of W.J.S.S.C. has in collaboration with ARTPred acquired a MIND subsidy to cover part of the costs of this collaboration project. The following grants are received but not used to finance this study: grants from Innovatie Prestatie Contract, MIT Haalbaarheid, other from Dutch R&D tax credit WBSO, RedMedTech Discovery Fund, (J.D.d.J.). Grants from Ferring (J.S.E.L., K.F., C.B.L. and J.M.J.S.S.), Merck Serono (K.F. and C.B.L.), Dutch Heart Foundation (J.S.E.L.), Metagenics Inc. (J.S.E.L.), GoodLife (K.F.), Guerbet (C.B.L.). R.K. is employed by ARTPred B.V. during her PhD at Erasmus Medical Centre (MC). S.A.M. has a 100% University appointment. I.S.P.H.M.S., S.A.M. and A.E.B. are co-owners of IS-Diagnostics Ltd. J.D.d.J. is co-owner of ARTPred B.V., from which he reports personal fees. P.H.M.S. reports non-financial support from ARTPred B.V. P.H.M.S., J.D.d.J. and A.E.B. have obtained patents `Microbial population analysis’ (9506109) and `Microbial population analysis’ (20170159108), both licenced to ARTPred B.V. J.D.d.J. and A.E.B. report patent applications `Method and kit for predicting the outcome of an assisted reproductive technology procedure’ (392EPP0) and patent `Method and kit for altering the outcome of an assisted reproductive technology procedure’ by ARTPred. W.J.S.S.C. received personal consultancy and educational fees from Goodlife Fertility B.V. J.S.E.L. reports personal consultancy fees from ARTPred B.V., Titus Health B.V., Danone, Euroscreen and Roche during the conduct of the study. J.S.E.L. and N.G.M.B. are co-applicants on an Erasmus MC patent (New method and kit for prediction success of in vitro fertilization) licenced to ARTPred B.V. F.J.M.B. reports personal fees from Advisory Board Ferring, Advisory Board Merck Serono, Advisory Board Gedeon Richter and personal fees from Educational activities for Ferring, outside the submitted work. K.F. reports personal fees from Ferring (commercial sponsor) and personal fees from GoodLife (commercial sponsor). C.B.L. received speakers’ fee from Ferring. J.M.J.S.S. reports personal fees and other from Merck Serono and personal fees from Ferring, unrelated to the submitted paper. The other authors declare that they have no competing interests. TRIAL REGISTRATION NUMBER ISRCTN83157250. Registered 17 August 2018. Retrospectively registered.

Abstract STUDY QUESTION Is the combined use of fluorescence lifetime imaging microscopy (FLIM)-based metabolic imaging and second harmonic generation (SHG) spindle imaging a feasible and safe approach for noninvasive embryo assessment? SUMMARY ANSWER Metabolic imaging can sensitively detect meaningful metabolic changes in embryos, SHG produces high-quality images of spindles and the methods do not significantly impair embryo viability. WHAT IS KNOWN ALREADY Proper metabolism is essential for embryo viability. Metabolic imaging is a well-tested method for measuring metabolism of cells and tissues, but it is unclear if it is sensitive enough and safe enough for use in embryo assessment. STUDY DESIGN, SIZE, DURATION This study consisted of time-course experiments and control versus treatment experiments. We monitored the metabolism of 25 mouse oocytes with a noninvasive metabolic imaging system while exposing them to oxamate (cytoplasmic lactate dehydrogenase inhibitor) and rotenone (mitochondrial oxidative phosphorylation inhibitor) in series. Mouse embryos (n = 39) were measured every 2 h from the one-cell stage to blastocyst in order to characterize metabolic changes occurring during pre-implantation development. To assess the safety of FLIM illumination, n = 144 illuminated embryos were implanted into n = 12 mice, and n = 108 nonilluminated embryos were implanted into n = 9 mice. PARTICIPANTS/MATERIALS, SETTING, METHODS Experiments were performed in mouse embryos and oocytes. Samples were monitored with noninvasive, FLIM-based metabolic imaging of nicotinamide adenine dinucleotide (NADH) and flavin adenine dinucleotide (FAD) autofluorescence. Between NADH cytoplasm, NADH mitochondria and FAD mitochondria, a single metabolic measurement produces up to 12 quantitative parameters for characterizing the metabolic state of an embryo. For safety experiments, live birth rates and pup weights (mean ± SEM) were used as endpoints. For all test conditions, the level of significance was set at P &lt; 0.05. MAIN RESULTS AND THE ROLE OF CHANCE Measured FLIM parameters were highly sensitive to metabolic changes due to both metabolic perturbations and embryo development. For oocytes, metabolic parameter values were compared before and after exposure to oxamate and rotenone. The metabolic measurements provided a basis for complete separation of the data sets. For embryos, metabolic parameter values were compared between the first division and morula stages, morula and blastocyst and first division and blastocyst. The metabolic measurements again completely separated the data sets. Exposure of embryos to excessive illumination dosages (24 measurements) had no significant effect on live birth rate (5.1 ± 0.94 pups/mouse for illuminated group; 5.7 ± 1.74 pups/mouse for control group) or pup weights (1.88 ± 0.10 g for illuminated group; 1.89 ± 0.11 g for control group). LIMITATIONS, REASONS FOR CAUTION The study was performed using a mouse model, so conclusions concerning sensitivity and safety may not generalize to human embryos. A limitation of the live birth data is also that although cages were routinely monitored, we could not preclude that some runt pups may have been eaten. WIDER IMPLICATIONS OF THE FINDINGS Promising proof-of-concept results demonstrate that FLIM with SHG provide detailed biological information that may be valuable for the assessment of embryo and oocyte quality. Live birth experiments support the method’s safety, arguing for further studies of the clinical utility of these techniques. STUDY FUNDING/COMPETING INTEREST(S) Supported by the Blavatnik Biomedical Accelerator Grant at Harvard University and by the Harvard Catalyst/The Harvard Clinical and Translational Science Center (National Institutes of Health Award UL1 TR001102), by NSF grants DMR-0820484 and PFI-TT-1827309 and by NIH grant R01HD092550-01. T.S. was supported by a National Science Foundation Postdoctoral Research Fellowship in Biology grant (1308878). S.F. and S.A. were supported by NSF MRSEC DMR-1420382. Becker and Hickl GmbH sponsored the research with the loaning of equipment for FLIM. T.S. and D.N. are cofounders and shareholders of LuminOva, Inc., and co-hold patents (US20150346100A1 and US20170039415A1) for metabolic imaging methods. D.S. is on the scientific advisory board for Cooper Surgical and has stock options with LuminOva, Inc.

Object A dural tear resulting in a cerebrospinal fluid (CSF) leak is a well-known risk of lumbar spinal procedures. The authors hypothesized that the incidence of CSF leakage is higher in cases involving repeated operations and those in which the surgeon performing the surgery is less experienced; however, they postulated that the overall outcome of the patient would not be adversely affected by a dural tear. Methods An institutional review board–approved protocol at Louisiana State University Health Sciences Center, Shreveport, was initiated in August 2003 to allow prospective comparison of data obtained in patients in whom a CSF leak occurred (Group A) and those in whom no CSF leak occurred (Group B) during lumbar surgery. Basic demographic information, descriptive findings regarding the tear, history of other surgeries, hospital length of stay (LOS), and immediate disposition at the time of discharge were compared between the two groups. Seventy-seven patients were eligible for this study. One patient refused to participate. In 12 (15.8%) of 76 patients CSF leakage developed. In three patients the presence of a tear was questioned, and the patients were clinically treated as if a tear were present. The patients in Group A were older than those in Group B (59.8 ± 16.9 and 49.4 ± 13.6 years of age, respectively; p = 0.02, Fisher exact test). In terms of those with a history of surgery, there was no significant difference between patients with and patients without a CSF leak (three [25%] of 12 patients [Group A] compared with 28 [43.8%] of 64 patients [Group B]; p = 0.34, two-sample t-test). In the 12 patients with dural tears, nine (75%) were caused by a resident-in-training, and the Kerrison punch was the instrument most often being used at the time (55%). This is significantly greater than 50% at the 5% level (p = 0.044, binomial test). The authors were able to repair the tear primarily with suture in all but one patient, whose tear was along the nerve root sleeve. In all cases fibrin glue and a muscle/fat graft were used to cover the tear, and all patients were assigned to bed rest from 24 to 48 hours after the operation. In Group A one patient required rehabilitation at discharge. The LOS in Group A was greater than that in Group B (median 5 days compared with 3 days), but no additional complication was noted. Conclusions The incidence of CSF leakage was 16% in 76 patients, and there were no other complications. Older patient age and higher level of the surgeon’s training were factors contributing to the incidence, but the history of surgery was not.

Jules M Rothstein, clinician, researcher, educator, author, and speaker, entered into the field of physical therapy in 1975 following graduation from the Department of Physical Therapy at New York University. He completed his Master of Arts Degree in Kinesiology in 1979 and his Doctor of Philosophy in Physical Therapy in 1983, also at New York University. During his training, he worked as Staff Physical Therapist at Peninsula Hospital Center in Queens, as Research Fellow with the Arthritis Foundation, and in private practice in Cedarhurst, New York. From 1977 to 1980, Dr Rothstein was Adjunct Instructor in the Department of Physical Therapy at New York University. From 1980 to 1983, he was Instructor and Coordinator of Clinical Research and Training Programs at Washington University School of Medicine, and from 1984 to 1990, he was Associate Professor at the Medical College of Virginia. A tenured professor at the University of Illinois at Chicago since 1990, Dr Rothstein also served as Head of the Department of Physical Therapy at the University of Illinois at Chicago and as Chief of Physical Therapy Services at the University of Illinois Hospital in Chicago until 1999. During that period, the department obtained more than $6 million in research funding and received APTA's 1997 Minority Initiative Award for consistently recruiting and maintaining ethnic and racial diversity among its students. He continues to serve as Professor in the Department of Physical Therapy and remains active in all areas of physical therapy, practice, research, and service. Dr Rothstein's expertise in measurement and research design has been used by many professionals—across disciplines—in the allied health community. He is in great demand as an invited guest speaker, having given professional presentations and keynote speeches on the topic of rehabilitation sciences at numerous national and international forums, including Sweden, Denmark, Iceland, Japan, and Saudi Arabia. He has also served as a consultant and visiting professor in South Africa, the Netherlands, and Poland. Dr Rothstein has made extensive contributions to the physical therapy profession's body of knowledge, including the publication of more than 60 refereed articles and abstracts. In 1985, he edited the text Measurement in Physical Therapy. He chaired the APTA Task Force on Standards for Measurement in Physical Therapy that produced the first APTA Standards for Tests and Measurements in Physical Therapy Practice in 1993. As part of that task force, he co-authored the Primer on Measurement: An Introductory Guide to Measurements Issues. Since 1989, Dr Rothstein has served as Editor of Physical Therapy and has been appointed to that position for three 5-year terms by the APTA Board of Directors. Dr Rothstein is a Catherine Worthingham Fellow of the American Physical Therapy Association. He is the recipient of numerous awards, including the Golden Pen Award, the Outstanding Service Award for Research, the Outstanding Service Award for Continuing Education, and the Outstanding Therapist Award in the State of Illinois. [Rothstein JM. Thirty-Second Mary McMillan Lecture: Journeys beyond the horizon. Phys Ther. 2001;81:1817–1829.]

Perfect vision for the path ahead? As I write this editorial it seems that once again, we stand on the threshold of yet another significant date. The fortieth anniversary of ISCPES and also that of this journal, that has been the voice of the society’s contribution over that period, has been and gone. This time it is 2020 that looms on the near horizon. It is a date that has long been synonymous with perfect vision. Many may perhaps see this as somewhat ironic, given the themes surrounding change and the directions it has taken, that have been addressed previously in these pages. Perfect vision and the clarity it can bring seem a far cry away from the turbulent world to which we seem to be becoming accustomed. So many of the divisions that we are facing today seem to be internal in nature and far different from the largely: nation against nation; system against system strife, we can remember from the cold war era. The US, for example, seems to be a nation perpetually at war with itself. Democrats v Republicans, deplorables v elites - however you want to label the warring sides - we can construct a number of divisions which seem to put 50% of Americans implacably opposed to the other 50%. In the UK, it has been the divide around the referendum to leave the European Union – the so-called Brexit debate. Nationally the division was 52% to 48% in favour of leaving. Yet the data can be reanalysed in, it seems, countless ways to show the splits within a supposedly ‘United’ Kingdom. Scotland v England, London and the South East v the English regions, young v old are just some of the examples. Similar splits seem to be increasing within many societies. Hong Kong has recently been the focus of world interest We have watched this erstwhile model of an apparently successful and dynamic compromise between two ‘diverse’ systems, appear to tear itself apart on our television screens. Iran, Brazil, Venezuela are just three further examples of longstanding national communities where internal divisions have bubbled to the surface in recent times. These internal divisions frequently have no simple and single fault line. In bygone times, social class, poverty, religion and ethnicity were simple universal indicators of division. Today ways of dividing people have become far more complex and often multi-dimensional. Social media has become a means to amplify and repeat messages that have originated from those who have a ‘gripe’ based in identity politics or who wish to signal to all and sundry how extremely ‘virtuous’ and progressive they are. The new technologies have proved effective for the distribution of information but remarkably unsuccessful in the promotion of communication. This has been exemplified by the emergence and exploitation of Greta Thunberg a sixteen-year-old from Sweden as a spokesperson for the ‘Extinction Rebellion’ climate change lobby. It is a movement that has consciously eschewed debate and discussion in favour of action. Consequently, by excluding learning from its operation, it is cutting itself off from the possibility of finding out what beneficial change will look like and therefore finding a way by which to achieve it. Put simply, it has predetermined its desired goal and defined the problem in inflexible terms. It has ignored a basic tenet of effective problem solving, namely that the key lies in the way you actually frame the problem. Unfortunately, the movement has adopted the polarised labelling strategies that place all humans into the category of either ‘believers’ or ‘deniers’. This fails to acknowledge and deal with the depth and complexity of the problem and the range of our possible responses to it. We are all the losers when problems, particularly given their potential significance, become addressed in such a way. How and where can human behaviour learn to rise above the limits of the processes we see being followed all around us? If leadership is to come, it must surely come from and through a process of education. All of us must assume some responsibility here – and certainly not abdicate it to elite and powerful groups. In other words, we all have a moral duty to educate ourselves to the best of our ability. An important part of the process we follow should be to remain sceptical of the limits of human knowledge. In addition, we need to be committed to applying tests of truth and integrity to the information we access and manage. This is why we form and support learned societies such as ISCPES. Their duty is to test, debate and promote ideas and concepts so that truth and understanding might emerge from sharing and exploring information, while at the same time applying the criteria developed by the wisdom and experience of those who have gone before. And so, we come to the processes of change and disruption as we are currently experiencing them at International Sports Studies. Throughout our history we have followed the traditional model of a scholarly journal. That is, our reason for existence is to provide a scholarly forum for colleagues who wish to contribute to and develop understanding within the professional and academic field of Comparative Physical Education and Sport. As the means of doing this, we encourage academics and professionals in our field to submit articles which are blind reviewed by experts. They then advise the editor on their quality and suitability for publication. As part of our responsibility we particularly encourage qualified authors from non-English speaking backgrounds to publish with us, as a means of providing a truly international forum for ideas and development. Where possible the editorial team works with contributors to assist them with this process. We have now taken a step further by publishing the abstracts in Portuguese, Spanish and Chinese on the website, in order to spread the work of our contributors more widely. Consistent with international changes in labelling and focus over the years, the title of the society’s journal was changed from the Journal of Comparative Physical Education and Sport to International Sports Studies in 1989. However, our aim has remained to advance understanding and communication between members of the global community who share a professional, personal or scholarly interest in the state and development of physical education and sport around the world. In line with the traditional model, the services of our editorial and reviewing teams are provided ex gratia and the costs of publication are met by reader and library subscriptions. We have always offered a traditional printed version but have, in recent years, developed an online version - also as a subscription. Over the last few years we have moved to online editorial support. From 2020 will be adopting the practice of making articles available online immediately following their acceptance. This will reduce the wait time experienced by authors in their work becoming generally available to the academic community. Readers will no doubt be aware of the current and recent turbulence within academic publishing generally. There has been a massive increase in the university sector globally. As a result, there has been an increasing number of academics who both want to and need to publish, for the sake of advancement in their careers. A number of organisations have seen this as providing a business opportunity. Consequently, many academics now receive daily emails soliciting their contributions to various journals and books. University libraries are finding their budgets stretched and while they have been, up until now, the major funders of scholarly journals through their subscriptions, they have been forced to limit their lists and become much more selective in their choices. For these reasons, open access has provided a different and attractive funding model. In this model, the costs of publication are effectively transferred to the authors rather than the readers. This works well for those authors who may have the financial support to pursue this option, as well as for readers. However, it does raise a question as to the processes of quality control. The question arises because when the writer becomes the paying customer in the transaction, then the interests of the merchant (the publisher) can become more aligned to ensuring the author gets published rather than guaranteeing the reader some degree of quality control over the product they are receiving. A further confounding factor in the scenario we face, is the issue of how quality is judged. Universities have today become businesses and are being run with philosophies similar to those of any business in the commercial world. Thus, they have ‘bought into’ a series of key performance indicators which are used to compare institutions one with another. These are then added up together to produce summative scores by which universities can be compared and ranked. There are those of us that believe that such a process belittles and diminishes the institutions and the role they play in our societies. Nonetheless it has become a game with which the majority appear to have fallen in line, seeing it as a necessary part of the need to market themselves. As a result, very many institutions now pay their chief executives (formerly Vice-Chancellors) very highly, in order to for them to optimise the chosen metrics. It is a similar process of course with academic journals. So it is, that various measures are used to categorise and rank journals and provide some simplistic measure of ‘quality’. Certain fields and methodologies are inherently privileged in these processes, for example the medical and natural sciences. As far as we are concerned, we address a very significant element in our society – physical education and sport - and we address it from a critical but eclectic perspective. We believe that this provides a significant service to our global community. However, we need to be realistic in acknowledging the limited and restricted nature of that community. Sport Science has become dominated by physiology, data analytics, injury and rehabilitation. Courses and staff studying the phenomenon of sport and physical education through the humanities and social sciences, seem to be rarer and rarer. This is to the great detriment of the wellbeing and development of the phenomenon itself. We would like to believe that we can make an important difference in this space. So how do we address the question of quality? Primarily through following our advertised processes and the integrity and competence of those involved. We believe in these and will stick with them. However, we appreciate that burying our heads in the sand and remaining ‘king of the dinosaurs’ does not provide a viable way forward. Therefore, in our search for continuing strategy and clear vision in 2020, we will be exploring ways of signalling our quality better, while at the same time remaining true to our principles and beliefs. In conclusion we are advising you, as our readers, that changes may be expected as we, of necessity, adapt to our changing environment while seeking sustainability. Exactly what they will be, we are not certain at the time of going to press. We believe that there is a place, even a demand for our contribution and we are committed to both maintaining its standard and improving its accessibility. Comments and advice from within and outside of our community are welcome and we remain appreciative, as always, of the immense contribution of our international review board members and our supportive and innovative publisher. So, to the contributors to our current volume. Once again, we would point with some pride to the range of articles and topics provided. Together, they provide an interesting and relevant overview of some pertinent current issues in sport and physical education, addressed from the perspectives of different areas across the globe. Firstly, Pill and Agnew provide an update to current pedagogical practices in physical education and sport, through their scoping review of findings related to the use of small-sided games in teaching and coaching. They provide an overview of the empirical research, available between 2006 and 2016, and conclude that the strategy provides a useful means of achieving a number of specific objectives. From Belgium, Van Gestel explores the recent development of elite Thai boxing in that country. He draws on Elias’ (1986) notion of ‘sportization’ which describes the processes by which various play like activities have become transformed into modern sport. Thai boxing provides an interesting example as one of a number of high-risk combat sports, which inhabit an ambiguous area between the international sports community and more marginalised combat activities which can be brutal in nature. Van Gestel expertly draws out some of the complexities involved in concluding that the sport has experienced some of the processes of sportization, but in this particular case they have been ‘slight’ in impact rather than full-blown. Abdolmaleki, Heidari, Zakizadeh XXABSTRACT De Bosscher look at a topic of considerable contemporary interest – the management of a high-performance sport system. In this case their example is the Iranian national system and their focus is on the management of some of the resources involved. Given that the key to success in high performance sport systems would appear to lie in the ability to access and implement some of the latest and most effective technological information intellectual capital would seem to be a critical component of the total value of a competitive high performance sport system Using a model developed by a Swedish capital services company Skandia to model intangible assets in a service based organisation, Abdolmaleki and his associates have argued for the contribution of human, relational and structural capital to provide an understanding of the current place of intellectual capital in the operations of the Iranian Ministry of Sport and Youth. An understanding of the factors contributing to the development of these assets, contributes to the successful operation of any organisation in such a highly competitive and fast changing environment. Finally, from Singapore, Chung, Sufri and Wang report on some of the exciting developments in school based physical education that have occurred over the last decade. In particular they identify the increase in the placement of qualified physical education teachers as indicative of the progress that has been made. They draw on Foucault’s strategy of ‘archaeological analysis’ for an explanation of how these developments came to be successfully put in place. Their arguments strongly reinforce the importance of understanding the social and political context in order to achieve successful innovation and development. May I commend the work of our colleagues to you and wish you all the best in the attempt to achieve greater clarity of vision for 2020!

The impacts of parenting styles on adolescent’s antisocial behaviors have been established; but the emotional status of the parents and its relationship with the parenting style is yet to be exploited. The purpose of this study is to examine the relationship between the parenting style and emotional maturity of parents. The sample consisted of two hundred and thirty two (232) participants that reside in the Kaduna metropolis of Kaduna state, Nigeria. Participants completed the validated subscale Parenting Styles and Emotional Maturity questionnaires. The scoring was done according to the scoring key in the respective manual of the questionnaire and the results were statistically analyzed and interpreted. The results indicated that there is a significant gender difference in the dimensions of emotional maturity and parenting styles. Females are more emotionally matured (t=2.480, p≤0.05*) and are more authoritative (t=2.344, p≤0.05*) and more involved (t=2.698, p≤0.01**) than male in parenting style practices. Also emotional maturity shows significant correlations with authoritarian (p≤0.000**), permissive (p≤0.000**) and uninvolved (p≤0.000**) not with authoritative style in this study. Certain personality and social differences have been suggested to explain why these differences may emerge. It is recommended that a well-designed counseling and rehabilitation programs be organized for couples and parents so as to help them gain the knowledge and emotional maturity necessary to support their parenting style. Presently, there’s paucity of studies exploring these gender based differences in emotional maturity and parenting style of both parents and the degree of similarities and differences when compared with single parents in Nigeria, and Kaduna state in particular, this is an important area that deserves further investigation.

This research titled: “Effect of Learning Simile on Essay Writing Skills of SSI Arabic Secondary Students in Kaduna State, Nigeria,” tried to unravel the subject matter. The research problem emanated from the weaknesses experienced by the researchers in the essay writing of the students in the course of their teaching at secondary levels. Thus, they formulated a research question with the aim of answering it through the usage of the experimental method. As such, they grouped their students into two: experimental and Control group, in which each of the groups consisted of ninety (90) students. The experimental group was taught simile using particular treatment, while the control group was taught conventionally. Consequently, it was vividly clear that those exposed to special treatment performed better than their counterpart in essay writing. Thus, the researchers recommend that: Teachers should give serious attention to the use of special treatment in the course of teaching rhetorics, as this would enhance their performance in writing skills. The National Board for Arabic and Islamic Studies (NBAIS) was also advised to consider what will improve the teaching/learning of rhetorics in the course of their curriculum development and implementation.

<p>This article aimed at findings the impact of body language used by Arabic teacher on developing language performance of Arabic students. To justify the objectives of the article, the researchers stated one question and attempt was made to answer it. Senior Arabic Schools II in Kaduna State were used as a population of the study, quasi-experimental design was used for the research purposes. The sample of 80 students was drown from the population. They were further subdivided into two experimental group with (40) and control group (40) students, purposive sampling technique was employed in the sampling. The researchers designed questions derived from Arabic Grammar, Arabic liteary texts and Rhetorics to test the performance of the students. The results show that there is positive effect of body language used by Arabic teacher on developing language performance. Based on the research finding, the researchers recommend that Arabic teachers in Senior Arabic schools should use body language appropriately in order to develop students’ language performance. Also, National Board for Arabic and Islamic Studies, should train the Arabic teachers on the body language skills and the ways in which these skills can be used appropriately used during teaching.</p>

The following study builds upon prior research on rehabilitation counseling salary surveys completed by the American Counseling Association (ACA), the Commission on Rehabilitation Counselor Certification (CRCC), the International Association of Rehabilitation Professionals (IARP), and the American Board of Vocational Experts (ABVE). The present study examines the current state of salary distribution within the private sector of rehabilitation counseling by combining the data sets from the IARP and ABVE participants into one large sample for regression analyses. The survey was created by building on the existing ACA and CRCC salary surveys in the counseling field and refined with the assistance of a Delphi panel of 10 nationally known rehabilitation counselors with an average of 31 years clinical experience. The survey participants included 524 members of IARP and ABVE who completed the identical online survey to provide the data to examine the average annual earnings, demographics, and participants who experienced disabilities during their career within the two national organizations. Results found that gender, education level, practice setting, licensure status, and years in practice were statistically significant.

In August-September 1996, personnel from Prewitt and Associates, Inc., conducted a cultural resources survey of ca. 725 acres of the former Leander Rehabilitation Center. The project area lies adjacent to U.S. Highway 183 and FM 620 in southern Williamson County, Texas. The survey resulted in additional documentation of one previously recorded prehistoric archeological site (41 WM452), the identification and recording of four historic archeological sites (41WM892, 41WM893, 41WM896, and 41WM897), and reconnaissance-level documentation of 45 historic buildings and structures. Site 41WM452 is an extensive upland lithic scatter and lithic procurement site which lacks subsurface deposits, features, and datable materials. Site 41WM892 is a wood-chopper camp that contains a number of rock alignments and limited artifact deposits dating to the first decade of the twentieth century. Site 41WM893 is a remnant of a railroad spur used during the 1937-1941 construction of Marshall Ford Dam (now Mansfield Dam). Site 41WM896 contains a small number of features and sparse artifact deposits associated with the 1937-1945 Rhodes farmstead. Site 41WM897 is an isolated historic well with unknown associations. None of these archeological sites contains important information, and it is recommended that they be considered not eligible for listing in the National Register of Historic Places or for designation as State Archeological Landmarks. The 45 buildings and structures, at 36 locations, are associated with the former State Dairy and Hog Farm. This farm was established in 1942, expanded after 1945, and reached its peak years of production as a hog farm between 1950 and the late 1960s, Created to serve the needs of the State Board of Control and the State Hospital, the facility is significant for its success in food production for eleemosynary institutions in Austin and throughout Texas, as well as for its role in the application of modern psychiatric treatment based on the therapeutic value of manual labor. Among the surveyed resources are dwellings, an office and warehouse building, a dormitory, a variety of agricultural buildings and structures, and infrastructural elements, all built between 1943 and 1955. Twenty-one of the 45 surveyed resources are recommended as being eligible for listing in the National Register of Historic Places under Criteria A and C as Contributing resources in a historic district and for designation as State Archeological Landmarks.

HUMAN HEALTH Open Journal Systems ipv6 ready Journal Help User Username Password Remember me Notifications View Subscribe Language Select Language Journal Content Search Search Scope Browse By Issue By Author By Title Other Journals Categories Font Size Make font size smaller Make font size default Make font size larger Home About Login Register Search Current Archives Announcements Editorial Board Home > No 1 (2019) > Odinets FACTOR STRUCTURE OF FUNCTIONAL PARAMETERS OF WOMEN WITH POST-MASTECTOMY SYNDROME WITH DIFFERENT LEVELS OF FUNCTIONAL STATE OF THE CARDIOVASCULAR SYSTEM Tetiana Odinets Abstract Modern approaches used in breast cancer treatment resulted in increasing survival rates. However, significant adverse events such as сardiotoxicity and cardiovascular complications remain high. A lot of women experienced fatigue, arrhythmias, heart failure, ischemic heart disease, and pulmonary side effects induced by breast cancer treatment. The objective: to determine the features of the factor structure of functional parameters in women with postmastectomy syndrome with different levels of functional state of the cardiovascular system. Methods: analysis of sources of literature and empirical data; rheography, spirography, analysis of heart rate variability; anthropometry; mathematical statistics methods. Results. a developed method for estimating the level of functional state of the cardiovascular system of women with postmastectomy syndrome based on age and objective indicators of central hemodynamics: heart rate, minute blood volume and left ventricular work, as well as their significant contribution to overall predicted level. Based on the values of the determined parameters and coefficients of multiple regression, criteria of levels of functional state of the cardiovascular system of patients with postmastectomy syndrome are determined. The proposed method allows to carry out rapid monitoring and with a high degree of probability to assess the functional state of the cardiovascular system of the patients with postmastectomy syndrome, as well as to determine the effectiveness of therapeutic, rehabilitation measures and make adjustments to the program of rehabilitation. Defined factors of the direction of the rehabilitation process with the integral account of the predicted level of the functional state of the cardiovascular system are in the manuscript. It has been identified that the hemodynamic factor has covered 22.37% of the dispersion in women with the low level of functional state, 21.24% – with the lower-than-average level, 22.06 – with the average level; expiratory – 17.15%, 16.74% and 17.48; vegetative – 11.21%, 13.29% and 12.97% at corresponding levels at outpatient rehabilitation stage. Conclusions. obtained results are the basis for choosing priority means of physical rehabilitation during developing a program for the rehabilitation of women with postmastectomy syndrome with various levels of the functional state of the cardiovascular system.

The case documents the evolution of an eye care hospital promoted by a not-for profit organization located in Mandvi, Surat, close to the tribal community of Gujarat state, India. In a short span of five years (as of 2016), the trust has evolved as a community hospital. The value proposition of the trust is a portfolio of activities, which includes awareness by education, prevention of eye care diseases through eye screening camps, treatment, and rehabilitation on need basis and addressing direct and indirect healthcare needs of the community. The managerial challenge before the board of trustees is to carefully balance (a) The purpose for which the trust was created, (b) the gap between the ground realities and the need in the relevant tribal community (c) the accomplishments of the eye hospital so far.

Abstract This study investigated changes in plasma fibrinogen metabolism and changes in coagulation in severely burned adults. Ten patients (27 ± 3 years; 91 ± 6 kg) with 51 ± 3% TBSA were consented and enrolled into an institutional review board–approved prospective study. On the study day, stable isotope infusion of 1-13C-phenylalanine and d5-phenylalanine was performed to quantify fibrinogen production and consumption. During the infusion, vital signs were recorded and blood samples were drawn every hour. Coagulation was measured by thromboelastograph (TEG). Ten normal healthy volunteers (37 ± 7 years; 74 ± 4 kg) were included as the control group. Burned adults had elevated heart rates (120 ± 2 vs 73 ± 5 [control] beats/minute), respiration rates (23 ± 2 vs 15 ± 1 breaths/minute), plasma glucose (127 ± 10 vs 89 ± 2 mg/dl), and fibrinogen levels (613 ± 35 vs 239 ± 17 mg/dl); and decreased albumin (1.3 ± 0.2 vs 3.7 ± 0.1 g/dl) and total protein (4.4 ± 0.2 vs 6.8 ± 0.1 g/dl, all P < .05). Fibrinogen breakdown was elevated in the burn group (2.3 ± 0.4 vs. 1.0 ± 0.3 µmol/kg/minute); and fibrinogen synthesis was further enhanced in the burn group (4.4 ± 0.7 vs 0.7 ± 0.2 µmol/kg/minute, both P < .05). Clotting speed (TEG-alpha) and clot strength (TEG-MA) were increased in the burn group (62 ± 4 vs 50 ± 4°, and 76 ± 2 vs 56 ± 2 mm, respectively, both P < .05). Fibrinolysis of TEG-LY60 was accelerated in the burn group (16 ± 6 vs 3 ± 1) and so was the increase in D-dimer level in the burn group (4.5 ± 0.4 vs 1.9 ± 0.3 mg/l, both P < .05). The hypercoagulable state postburn is in part a result of increased fibrinogen synthesis, over and above increased fibrinogen breakdown.

Background and Purpose: Very few large scale multicentric stroke clinical trials have been done in India. The Indian Council of Medical Research funded INSTRuCT (Indian Stroke Clinical Trial Network) as a task force project with the objectives to establish a state-of-the-art stroke clinical trial network and to conduct pharmacological and nonpharmacological stroke clinical trials relevant to the nation and globally. The purpose of the article is to enumerate the structure of multicentric stroke network, with emphasis on its scope, challenges and expectations in India. Methods: Multiple expert group meetings were conducted by Indian Council of Medical Research to understand the scope of network to perform stroke clinical trials in the country. Established stroke centers with annual volume of 200 patients with stroke with prior experience of conducting clinical trials were included. Central coordinating center, standard operating procedures, data and safety monitoring board were formed. Discussion: In first phase, 2 trials were initiated namely, SPRINT (Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India) and Ayurveda treatment in the rehabilitation of patients with ischemic stroke in India (RESTORE [Rehabilitation of Ischemic stroke Patients in India: A Randomized controlled trial]). In second phase, 4 trials have been approved. SPRINT trial was the first to be initiated. SPRINT trial randomized first patient on April 28, 2018; recruited 3048 patients with an average of 128.5 per month so far. The first follow-up was completed on May 27, 2019. RESTORE trial randomized first patient on May 22, 2019; recruited 49 patients with an average of 3.7 per month so far. The first follow-up was completed on August 30, 2019. Conclusions: In next 5 years, INSTRuCT will be able to complete high-quality large scale stroke trials which are relevant globally. REGISTRATION: URL: http://www.ctri.nic.in/ ; Unique Identifier: CTRI/2017/05/008507.

Abstract Objective Quality of life (QOL) is a broad-ranging concept affecting an individual’s physical health, psychological state, social relationships, and relationship to their environment. Although the role of psychometrists in clinical neuropsychology is integral to the delivery of services, little is known about their QOL. The current study assessed psychometrists’ workload and aspects related to work QOL (e.g., physical and emotional exhaustion, social and work satisfaction). Method Psychometrists (N = 164) from 38 states completed a nationally distributed survey. Participants averaged eight years of experience, ~29% completed board certification, and worked primarily in general hospitals (~36%), academic medical centers (~21%), private practice (~15%), veterans/military hospitals (~13%), and rehabilitation hospitals (~12%). Results Respondents saw 5.6±2.4 (Mean±Standard Deviation) patients and spent 18.8±6.9 and 9.4±4.9 hours administering and scoring, respectively, per week. Although the majority of respondents felt satisfied with their work QOL, approximately 49% experienced emotional exhaustion, 42% experienced burnout, and 62% reported that fatigue interfered with work, family, or social life. Correlational analyses found a significant relationship between QOL variables and professional activities, particularly with time spent scoring. Additionally, patient load, time spent administering/scoring, and QOL factors varied depending on work setting. Conclusion The current study provides a novel characterization of psychometrists’ QOL. Specifically, the prevalence of emotional exhaustion and fatigue appears to be higher than in the general working population in the United States. In addition, these findings highlight the current variability of job responsibilities and QOL across work settings. Ongoing advocacy and practice adjustments for this field are indicated.

Abstract Background Whole-body vibration training (WBV) performed on a vibration platform can significantly improve physical performance in patients with chronic obstructive pulmonary disease. It has been suggested that an important mechanism of this improvement is based on an improvement in balance. Therefore, the aim of this study was to investigate the effects of WBV compared to conventional balance training. Methods 48 patients with severe COPD (FEV1: 37 ± 7%predicted) and low exercise performance (6 min walk distance (6MWD): 55 ± 10%predicted) were included in this randomized controlled trial during a 3 week inpatient pulmonary rehabilitation. All patients completed a standardized endurance and strength training program. Additionally, patients performed 4 different balance exercises 3x/week for 2 sets of 1 min each, either on a vibration platform (Galileo) at varying frequencies (5–26 Hz) (WBV) or on a conventional balance board (BAL). The primary outcome parameter was the change in balance performance during a semi tandem stance with closed eyes assessed on a force measurement platform. Muscular power during a countermovement jump, the 6MWD, and 4 m gait speed test (4MGST) were secondary outcomes. Non-parametric tests were used for statistical analyses. Results Static balance performance improved significantly more (p = 0.032) in favor of WBV (path length during semi-tandem stand: − 168 ± 231 mm vs. + 1 ± 234 mm). Muscular power also increased significantly more (p = 0.001) in the WBV group (+ 2.3 ± 2.5 W/kg vs. − 0.1 ± 2.0 W/kg). 6MWD improved to a similar extent in both groups (WBV: 48 ± 46 m, p < 0.001 vs. BAL: 38 ± 32 m; p < 0.001) whereas the 4MGST increased significantly only in the WBV-group (0.08 ± 0.14 m/s2, p = 0.018 vs. 0.01 ± 0.11 m/s2, p = 0.71). Conclusions WBV can improve balance performance and muscular power significantly more compared to conventional balance training. Trial registration: Clinical-Trials registration number: NCT03157986; date of registration: May 17, 2017. https://clinicaltrials.gov/ct2/results?cond=&term=NCT03157986&cntry=&state=&city=&dist =

The development of OpenFES hardware presented in this paper involved a closed-loop functional electrical stimulation (FES) system that could be assembled from off-the-shelf parts in India. The state-of-the-art biosignal-based control strategies could be evaluated in a clinical research setting using the familiar development environment of MATLAB/SIMULINK (The Mathworks). This hardware was developed primarily for a rehabilitation research center where students from an engineering and medical school could use it as a testbed for clinical research. It is envisioned that the design of a working prototype would be available after thorough testing at http://robo4rehab.wikispaces.com/OpenFES so that it can be further enhanced in an open-source setting. The command source selected for modulating/triggering the electrical stimulation was electromyogram (EMG), which is the recording of the bioelectrical signal generated at the cell membrane of contracting muscle fibers. The FES controller was implemented in an xPC target (The Mathworks) real-time kernel, running on a single board computer where the stimulation pattern, i.e., the temporal pattern of current pulses, was computed online based on the surface EMG patterns. The stimulation parameters were passed to a dsPIC33F microcontroller (Microchip, India) driven voltage controlled current source (VCCS) via a universal asynchronous receiver/transmitter (UART). The VCCS consisted of a coupled transconductance amplifier in series with precharged capacitors. The biphasic stimulation waveform was obtained with an analog switch that switched to reverse the polarity of the surface electrodes. The input stage for surface EMG consisted of an instrumentation amplifier with an anti-aliasing filter made of switched-capacitor (recording capacitor) banks. The dry surface EMG electrodes had buffer op-amps to provide high input impedance. A dsPIC33F microcontroller (Microchip, India) in the input/output (I/O) stage coordinated the switching of the stimulating capacitors with the recording capacitors in order to reject the stimulation artifact. The control software ran on the xPC target and delivered the stimulation parameters via UART to the dsPIC33F microcontroller (Microchip, India). The controller specifications are as follows: (1) Communications: xPC target is a battery powered stand-alone FES controller, communicating with the slave microprocessor in the input/output stages via UART. (2) FES controller: PC/104 single board computer (Advantech Co., PCM-3355) running xPC target kernel (The Mathworks). (3) PC/104 CPU: 366 MHz ×86 (AMD Geode processor). (4) Display: LCD (1024×768 at 18 bpp TFT) or CRT (1024×768 at 24 noninterlaced). (5) Stimulation pulse-width range: 1–255 ms. (6) Stimulation amplitude range: 0–100 mA (16 bit analog output with voltage controlled current source). (7) Stimulation frequency range: up to 30 Hz. (8) I/O channels (Sensoray, model 526): 4 AO (16 bit), 8 DIO, and 8 AI (16 bit). (9) Channel offset: 1000 Hz. (10) Analog to digital conversion for EMG: 16 bit. (11) Maximum signal amplitude: about 10 mV (peak to peak). (12) Minimum signal amplitude: about 1 mV (peak to peak), i.e., the noise floor should preferably be lower. (13) Signal to noise ratio.

Introduction This year, 2008, marks the tenth anniversary of the portable MP3 player. MPMan F10, the first such device to utilise the MP3-encoding format, was launched in March 1998 (Smith). However it was not until April 2003 when Apple Inc launched the iPod that the market began the massive growth that has made the devices almost ubiquitous in everyday life. In 2006 iPods were rated as more popular than beer amongst college students in the United States, according to Student Monitor. Beer had only previously surpassed in popularity once before, in 1997, by the Internet (Zeff). This year will also see the launch in Australia of the latest offering in this line of products – the iPhone – which incorporates the popular MP3 player in an advanced mobile phone. The iPhone features a touch-sensitive flat screen that serves as the interface for its operating system. While the design is striking, it also generates accessibility problems. There are obvious implications for those with vision impairments when there are no physical markers to point towards the phone’s functions (Crichton). This article critically examines the promise of Internet-based digital technology to open up the world to people with disabilities, and the parallel danger that the social construction of disability in the digital environment will simply come to mirror pre-existing analogue discrimination. This paper explores how technologies and innovations designed to improve access by the disabled actually enhance access for all users. The first part of the paper focuses on ‘Web 2.0’ and digital access for people with disability, particularly those with vision impairment. The online software that drives the iPod and iPhone and exclusively delivers content to these devices is iTunes. While iTunes seems on the surface to provide enormous opportunity for the vision impaired to access a broad selection of audio content, its design actually works to inhibit access to the platform for this group. Apple promotes the use of iTunes in educational settings through the iTunes U channel, and this potentially excludes those who have difficulty with access to the technology. Critically, it is these excluded people who, potentially, could benefit the most from the new technology. We consider the difficulty experienced by users of screen readers and braille tablets in relation to iTunes and highlight the potential problems for universities who seek to utilise iTunes U. In the second part of the paper we reframe disability accessibility as a principle of universal access and design and outline how changes made to assist users with disability can enhance the learning experience of all students using the Lectopia lecture recording and distribution system as an example. The third section of the paper situates these digital developments within the continuum of disability theory deploying Finkelstein’s three stages of disability development. The focus then shifts to the potential of online virtual worlds such as Second Life to act as a place where the promise of technology to mediate for disability might be realised. Goggin and Newell suggest that the Internet will not be fully accessible until disability is considered a cultural identity in the same way that class, gender and sexuality are. This article argues that accessibility must be addressed through the context of design and shared open standards for digital platforms. Web 2.0 and Accessibility The World Wide Web based its successful development on a set of common standards that worked across different software and operating systems. This interoperability held out great opportunity for the implementation of enabling software for those with disability, particularly sight and hearing impairments. The increasing sophistication and diversification of online content has confounded this initial promise. Websites have become more complex, particularly with the rise of ‘Web 2.0’ and the associated trends in coding and website design. This has aggravated attempts to mediate this content for a disabled audience through software (Zajicek). As Wood notes, ‘these days many computers are used principally to access the Internet – and there is no telling what a blind person will encounter there’. As the content requiring translation – either from text into audio or onto a braille tablet, or from audio into text captions – become less standardised and more complex, it becomes both harder for software to act as a translator, and harder to navigate this media once translated. This is particularly the case when links are generated ‘on the fly’ for each view of a website and where images replace words as hyperlinks. These problems can trace their origin to before the development of the World Wide Web. Reihing, addressing another Apple product in 1987 notes: The Apple Macintosh is particularly hard to use because it depends heavily on graphics. Some word processors ‘paint’ pictures of letters on the screen instead of using standard computer codes, and speech or braille devices can’t cope (in Goggin and Newell). Web 2.0 sites loaded with Ajax and other forms of Java scripting present a particular challenge for translation software (Zajicek). iTunes, an iconic Web 2.0 application, is a further step away from easily translated content as proprietary software that while operating though the Internet, does not conform to Web standards. Many translation software packages are unable to read the iTunes software at all or are limited and only able to read part of the page, but not enough of it to use the program (Furendal). As websites utilising ‘Web 2.0’ technology increase in popularity they become less attractive to users who are visually impaired, particularly because the dynamic elements can not be accessed using screen readers provided with the operating system (Bigham, Prince and Ladner). While at one level this presents an inability for a user with a disability to engage with the popular software, it also meant that universities seeking to use iTunes U to deliver content were excluding these students. To Apple’s credit they have taken some of these access concerns on board with the recent release of both the Apple operating system and iTunes, to better enable Apple’s own access software to translate the iTunes screen for blind users. However this also illustrates the problems with this type of software operating outside of nominated standards as there are still serious problems with access to iTunes on Microsoft’s dominant Windows operating system (Furendal). While Widows provides its own integrated screen reading software, the company acknowledges that this is not sufficiently powerful for regular use by disabled users who will need to use more specialised programs (Wood). The recent upgrade of the standard Windows operating system from XP to Vista seems to have abandoned the previous stipulation that there was a keyboard shortcut for each operation the system performed – a key requirement for those unable to use a visual interface on the screen to ‘point and click’ with a mouse (Wood). Other factors, such as the push towards iTunes U, explored in the next section, explain the importance of digital accessibility for everyone, not just the disabled as this technology becomes ubiquitous. The use of Lectopia in higher education demonstrates the value of flexibility of delivery to the whole student population, inclusive of the disabled. iPods and Higher Education iTunes is the enabling software supporting the iPod and iPhone. As well as commercial content, iTunes also acts as a distribution medium for other content that is free to use. It allows individuals or organisations to record and publish audio and video files – podcasts and vodcasts – that can be automatically downloaded from the Internet and onto individual computers and iPods as they become available. Significantly this technology has provided opportunities for educational use. iTunes U has been developed by Apple to facilitate the delivery of content from universities through the service. While Apple has acknowledged that this is, in part, a deliberate effort to drive the uptake of iTunes (Udell), there are particular opportunities for the distribution of information through this channel afforded by the technology. Duke University in the United States was an early adopter, distributing iPods to each of its first-year students for educational use as early as 2004 (Dean). A recent study of students at The University of Western Australia (UWA) by Williams and Fardon found that students who listen to lectures through portable media players such as iPods (the ‘Pod’ in iPod stands for ‘portable on demand’) have a higher attendance rate at lectures than those who do not. In 1998, the same year that the first portable MP3 player was being launched, the Lectopia (or iLecture) lecture recording and distribution system was introduced in Australia at UWA to enable students with disabilities better access to lecture materials. While there have been significant criticisms of this platform (Brabazon), the broad uptake and popularity of this technology, both at UWA and at many universities across Australia, demonstrates how changes made to assist disability can potentially help the broader community. This underpins the concept of ‘universal design’ where consideration given to people with disability also improves the lives of people without disability. A report by the Australian Human Rights and Equal Opportunity Commission, examined the accessibility of digital technology. Disability issues, such as access to digital content, were reframed as universal design issues: Disability accessibility issues are more accurately perceived in many cases as universal access issues, such that appropriate design for access by people with disabilities will improve accessibility and usability for … the community more generally. The idea of universal access was integral to Tim Berners-Lee’s original conception of the Web – however the platform has developed into a more complex and less ordered environment that can stray from agreed standards (Edwards, "Stop"). iTunes comes with its own accessibility issues. Furendal demonstrated that its design has added utility for some impairments notably dyslexia and colour blindness. However, as noted above, iTunes is highly problematic for those with other vision impairment particularly the blind. It is an example of the condition noted by Regan: There exists a false perception among designers that accessibility represents a restriction on creativity. There are few examples that exist in the world that can dissuade designers of this notion. While there are no technical reasons for this division between accessibility and design, the notion exists just the same. The invisibility of this issue confirms that while an awareness of differing abilities can assist all users, this blinkered approach to diverse visual acuities is not only blocking social justice imperatives but future marketing opportunities. The iPhone is notable for problems associated with use by people with disabilities, particularly people with hearing (Keizer) and vision impairments (Crichton). In colder climates the fact that the screen would not be activated by a gloved hand has also been a problem, its design reflects bias against not just the physically impaired. Design decisions reflect the socially constructed nature of disability where disability is related to how humans have chosen to construct the world (Finkelstein ,"To Deny"). Disability Theory and Technology Nora Groce conducted an anthropological study of Martha’s Vineyard in the United States. During the nineteenth century the island had an unusually high incidence of deafness. In response to this everyone on the island was able to communicate in sign language, regardless of the hearing capability, as a standard mode of communication. As a result the impairment of deafness did not become a disability in relation to communication. Society on the island was constructed to be inclusive without regard to a person’s hearing ability. Finkelstein (Attitudes) identified three stages of disability ‘creation’ to suggest disability (as it is defined socially) can be eradicated through technology. He is confident that the third phase, which he argues has been occurring in conjunction with the information age, will offset many of the prejudicial attitudes established during the second phase that he characterised as the industrial era. Digital technologies are often presented as a way to eradicate disability as it is socially constructed. Discussions around the Web and the benefits for people with disability usually centre on accessibility and social interaction. Digital documents on the Internet enable people with disability greater access than physical spaces, such as libraries, especially for the visually impaired who are able to make use of screen readers. There are more than 38 million blind people who utilise screen reading technology to access the Web (Bigham, Prince and Ladner). A visually impaired person is able to access digital texts whereas traditional, analogue, books remain inaccessible. The Web also allows people with disability to interact with others in a way that is not usually possible in general society. In a similar fashion to arguments that the Web is both gender and race neutral, people with disability need not identify as disabled in online spaces and can instead be judged on their personality first. In this way disability is not always a factor in the social encounter. These arguments however fail to address several factors integral to the social construction of disability. While the idea that a visually impaired person can access books electronically, in conjunction with a screen reader, sounds like a disability-free utopia, this is not always the case as ‘digital’ does not always mean ‘accessible’. Often digital documents will be in an image format that cannot be read by the user’s screen reader and will need to be converted and corrected by a sighted person. Sapey found that people with disabilities are excluded from informational occupations. Computer programming positions were fourth least likely of the 58 occupations examined to employ disabled people. As Rehing observed in 1987, it is a fantasy to think that accessibility for blind people simply means turning on a computer (Rehing in Goggin and Newell). Although it may sound empowering for people with disability to interact in an environment where they can live out an identity different from the rhythm of their daily patterns, the reality serves to decrease the visibility of disability in society. Further, the Internet may not be accessible for people with disability as a social environment in the first place. AbilityNet’s State of the eNation Web Accessibility Report: Social Networking Sites found a number of social networking sites including the popular MySpace and Facebook are inaccessible to users with a number of different disabilities, particularly those with a visual impairment such as blindness or a cognitive disability like dyslexia. This study noted the use of ‘Captcha’ – ‘Completely Automated Public Turing test to tell Computers and Humans Apart’ – technology designed to differentiate between a person signing up for an account and an automated computer process. This system presents an image of a word deliberately blurred and disfigured so that it cannot be readily identified by a computer, which can only be translated by a human user. This presents an obstacle to people with a visual impairment, particularly those relying on transcription software that will, by design, not be able to read the image, as well as those with dyslexia who may also have trouble translating the image on the screen. Virtual Worlds and New Possibilities The development of complex online virtual worlds such as Second Life presents their own set of challenges for access, for example, the use of Captcha. However they also afford opportunity. With over a million residents, there is a diversity of creativity. People are using Second Life to try on different identities or campaign for causes relevant in the real world. For example, Simon Stevens (Simon Walsh in SL), runs the nightclub Wheelies in the virtual world and continues to use a wheelchair and helmet in SL – similar to his real-life self: I personally changed Second Life’s attitude toward disability when I set up ‘Wheelies’, its first disability nightclub. This was one of those daft ideas which grew and grew and… has remained a central point for disability issues within Second Life. Many new Disabled users make contact with me for advice and wheelies has helped some of them ‘come out’ and use a wheelchair (Carter). Able-bodied people are also becoming involved in raising disability awareness through Second Life, for example Fez Richardson is developing applications for use in Second Life so that the non-disabled can experience the effects of impairment in this virtual realm (Cassidy) Tertiary Institutions are embracing the potential of Second Life, utilising the world as a virtual classroom. Bates argues that Second Life provides a learning environment free of physical barriers that has the potential to provide an enriched learning experience for all students regardless of whether they have a disability. While Second Life might be a good environment for those with mobility impairment there are still potential access problems for the vision and hearing impaired. However, Second Life has recently become open source and is actively making changes to aid accessibility for the visually impaired including an audible system where leaves rustle to denote a tree is nearby, and text to speech software (Sierra). Conclusion Goggin and Newell observe that new technology is a prominent component of social, cultural and political changes with the potential to mitigate for disability. The uneven interface of the virtual and the analogue, as demonstrated by the implementation and operation of iTunes, indicates that this mitigation is far from an inevitable consequence of this development. However James Edwards, author of the Brothercake blog, is optimistic that technology does have an important role in decreasing disability in wider society, in line with Finkelstein’s third phase: Technology is the last, best hope for accessibility. It's not like the physical world, where there are good, tangible reasons why some things can never be accessible. A person who's blind will never be able to drive a car manually; someone in a wheelchair will never be able to climb the steps of an ancient stone cathedral. Technology is not like the physical world – technology can take any shape. Technology is our slave, and we can make it do what we want. With technology there are no good reasons, only excuses (Edwards, "Technology"). Internet-based technologies have the potential to open up the world to people with disabilities, and are often presented as a way to eradicate disability as it is socially constructed. While Finkelstein believes new technologies characteristic of the information age will offset many of the prejudicial attitudes established during the industrial revolution, where technology was established around able-bodied norms, the examples of the iPhone and Captcha illustrate that digital technology is often constructed in the same social world that people with disability are routinely disabled by. The Lectopia system on the other hand enables students with disabilities to access lecture materials and highlights the concept of universal access, the original ideology underpinning design of the Web. Lectopia has been widely utilised by many different types of students, not just the disabled, who are seeking flexibility. While we should be optimistic, we must also be aware as noted by Goggin and Newell the Internet cannot be fully accessible until disability is considered a cultural identity in the same way that class, gender and sexuality are. Accessibility is a universal design issue that potentially benefits both those with a disability and the wider community. References AbilityNet Web Accessibility Team. State of the eNation Web Accessibility Reports: Social Networking Sites. AbilityNet. January 2008. 12 Apr. 2008 ‹http://www.abilitynet.org.uk/docs/enation/2008SocialNetworkingSites.pdf›. Bates, Jacqueline. "Disability and Access in Virtual Worlds." Paper presented at Alternative Format Conference, LaTrobe University, Melbourne, 21–23 Jan. 2008. Bigham, Jeffrey P., Craig M. Prince, and Richard E. Ladner . "WebAnywhere: A Screen Reader On-the-Go." Paper presented at 17th International World Wide Web Conference, Beijing, 21–22 April 2008. 29 Apr. 2008 ‹http://webinsight.cs.washington.edu/papers/webanywhere-html/›. Brabazon, Tara. "Socrates in Earpods: The iPodification of Education." Fast Capitalism 2.1, (July 2006). 8 June 2008 ‹http://www.uta.edu/huma/agger/fastcapitalism/2_1/brabazon.htm›. Carter, Paul. "Virtually the Same." Disability Now (May 2007). Cassidy, Margaret. "Flying with Disability in Second Life." Eureka Street 18.1 (10 Jan. 2008): 22-24. 15 June 2007 ‹http://www.eurekastreet.com.au/article.aspx?aeid=4849›. Crichton, Paul. "More on the iPhone…" Access 2.0. BBC.co.uk 22 Jan. 2007. 12 Apr. 2008 ‹http://www.bbc.co.uk/blogs/access20/2007/01/more_on_the_iphone.shtml›. Dean, Katie. "Duke Gives iPods to Freshmen." Wired Magazine (20 July 2004). 29 Apr. 2008 ‹http://www.wired.com/entertainment/music/news/2004/07/64282›. Edwards, James. "Stop Using Ajax!" Brothercake (24 April 2008). 1 May 2008 ‹http://dev.opera.com/articles/view/stop-using-ajax›. –––. "Technology Is the Last, Best Hope for Accessibility." Brothercake 13 Mar. 2007. 1 May 2008 ‹http://www.brothercake.com/site/resources/reference/hope›. Finkelstein, Victor. "To Deny or Not to Deny Disability." Magic Carpet 27.1 (1975): 31-38. 1 May 2008 ‹http://www.independentliving.org/docs1/finkelstein.html›. –––. Attitudes and Disabled People: Issues for Discussion. Geneva: World Rehabilitation Fund, 1980. 1 May 2008 ‹http://www.leeds.ac.uk/disability-studies/archiveuk/finkelstein/attitudes.pdf›. Furendal, David. "Downloading Music and Videos from the Internet: A Study of the Accessibility of The Pirate Bay and iTunes store." Presentation at Uneå University, 24 Jan. 2007. 13 Apr. 2008 ‹http://www.david.furendal.com/Accessibility.aspx›. Groce, Nora E. Everyone Here Spoke Sign Language: Hereditary Deafness on Martha's Vineyard. Cambridge, MA: Harvard University, 1985. Goggin, Gerard, and Christopher Newell. Digital Disability: The Social Construction of Disability in New Media. Oxford: Rowman & Littlefield, 2003. Human Rights and Equal Opportunities Commission. Accessibility of Electronic Commerce and New Service and Information Technologies for Older Australians and People with a Disability. 31 March 2000. 30 Apr. 2008 ‹http://www.hreoc.gov.au/disability_rights/inquiries/ecom/ecomrep.htm#BM2_1›. Keizer, Gregg. "Hearing Loss Group Complains to FCC about iPhone." Computerworld (20 Sep. 2007). 12 Apr. 2008 ‹http://www.computerworld.com/action/article.do?command=viewArticleBasic&articleId=9037999›. Regan, Bob. "Accessibility and Design: A Failure of the Imagination." ACM International Conference Proceedings Series 63: Proceedings of The 2004 International Cross-disciplinary Workshop on Web Accessibility (W4A). 29–37. Sapey, Bob. "Disablement in the Information Age." Disability and Society 15.4 (June 2000): 619–637. Sierra. "IBM Project: Second Life Accessible for Blind People." Techpin (24 Sep. 2007). 3 May 2008 ‹http://www.techpin.com/ibm-project-second-life-accessible-for-blind-people/›. Smith, Tony. "Ten Years Old: The World’s First MP3 Player." Register Hardware (10 Mar. 2008). 12 Apr. 2008 ‹http://www.reghardware.co.uk/2008/03/10/ft_first_mp3_player/›. Udell, Jon. "The iTunes U Agenda." InfoWorld (22 Feb. 2006). 13 Apr. 2008 ‹http://weblog.infoworld.com/udell/2006/02/22.html›. Williams, Jocasta, and Michael Fardon. "Perpetual Connectivity: Lecture Recordings and Portable Media Players." Proceedings from Ascilite, Singapore, 2–5 Dec. 2007. 1084–1092. Wood, Lamont. "Blind Users Still Struggle with 'Maddening' Computing Obstacles." Computerworld (16 Apr. 2008). 27 Apr. 2008 ‹http://www.computerworld.com/action/article.do?command=viewArticleBasic&articleId=9077118&source=NLT_AM&nlid=1›. Zajicek, Mary. "Web 2.0: Hype or Happiness?" Paper presented at International Cross-Disciplinary Conference on Web Accessibility, Banff, Canada, 2–9 May 2007. 12 Apr. 2008 ‹http://www.w4a.info/2007/prog/k2-zajicek.pdf›. Zeff, Robbin. "Universal Design across the Curriculum." New Directions for Higher Education 137 (Spring 2007): 27–44.

In the last months of his life, 86-year-old Albert Facey became a best-selling author and revered cultural figure following the publication of his autobiography, A Fortunate Life. Released on Anzac Day 1981, it was praised for its “plain, unembellished, utterly sincere and un-self-pitying account of the privations of childhood and youth” (Semmler) and “extremely powerful description of Gallipoli” (Dutton 16). Within weeks, critic Nancy Keesing declared it an “Enduring Classic.” Within six months, it was announced as the winner of two prestigious non-fiction awards, with judges acknowledging Facey’s “extraordinary memory” and “ability to describe scenes and characters with great precision” (“NBC” 4). A Fortunate Life also transformed the fortunes of its publisher. Founded in 1976 as an independent, not-for-profit publishing house, Fremantle Arts Centre Press (FACP) might have been expected, given the Australian average, to survive for just a few years. Former managing editor Ray Coffey attributes the Press’s ongoing viability, in no small measure, to Facey’s success (King 29). Along with Wendy Jenkins, Coffey edited Facey’s manuscript through to publication; only five months after its release, with demand outstripping the capabilities, FACP licensed Penguin to take over the book’s production and distribution. Adaptations soon followed. In 1984, Kerry Packer’s PBL launched a prospectus for a mini-series, which raised a record $6.3 million (PBL 7–8). Aired in 1986 with a high-rating documentary called The Facey Phenomenon, the series became the most watched television event of the year (Lucas). Syndication of chapters to national and regional newspapers, stage and radio productions, audio- and e-books, abridged editions for young readers, and inclusion on secondary school curricula extended the range and influence of Facey’s life writing. Recently, an option was taken out for a new television series (Fraser).A hundred reprints and two million readers on from initial publication, A Fortunate Life continues to rate among the most appreciated Australian books of all time. Commenting on a reader survey in 2012, writer and critic Marieke Hardy enthused, “I really loved it [. . .] I felt like I was seeing a part of my country and my country’s history through a very human voice . . .” (First Tuesday Book Club). Registering a transformed reading, Hardy’s reference to Australian “history” is unproblematically juxtaposed with amused delight in an autobiography that invents and embellishes: not believing “half” of what Facey wrote, she insists he was foremost a yarn spinner. While the work’s status as a witness account has become less authoritative over time, it seems appreciation of the author’s imagination and literary skill has increased (Williamson). A Fortunate Life has been read more commonly as an uncomplicated, first-hand account, such that editor Wendy Jenkins felt it necessary to refute as an “utter mirage” that memoir is “transferred to the page by an act of perfect dictation.” Sidonie Smith and Julia Watson argue of life narratives that some “autobiographical claims [. . .] can be verified or discounted by recourse to documentation outside the text. But autobiographical truth is a different matter” (16). With increased access to archives, especially digitised personnel records, historians have asserted that key elements of Facey’s autobiography are incorrect or “fabricated” (Roberts), including his enlistment in 1914 and participation in the Gallipoli Landing on 25 April 1915. We have researched various sources relevant to Facey’s early years and war service, including hard-copy medical and repatriation records released in 2012, and find A Fortunate Life in a range of ways deviates from “documentation outside of the text,” revealing intriguing, layered storytelling. We agree with Smith and Watson that “autobiographical acts” are “anything but simple or transparent” (63). As “symbolic interactions in the world,” they are “culturally and historically specific” and “engaged in an argument about identity” (63). Inevitably, they are also “fractured by the play of meaning” (63). Our approach, therefore, includes textual analysis of Facey’s drafts alongside the published narrative and his medical records. We do not privilege institutional records as impartial but rather interpret them in terms of their hierarchies and organisation of knowledge. This leads us to speculate on alternative readings of A Fortunate Life as an illness narrative that variously resists and subscribes to dominant cultural plots, tropes, and attitudes. Facey set about writing in earnest in the 1970s and generated (at least) three handwritten drafts, along with a typescript based on the third draft. FACP produced its own working copy from the typescript. Our comparison of the drafts offers insights into the production of Facey’s final text and the otherwise “hidden” roles of editors as transformers and enablers (Munro 1). The notion that a working man with basic literacy could produce a highly readable book in part explains Facey’s enduring appeal. His grandson and literary executor, John Rose, observed in early interviews that Facey was a “natural storyteller” who had related details of his life at every opportunity over a period of more than six decades (McLeod). Jenkins points out that Facey belonged to a vivid oral culture within which he “told and retold stories to himself and others,” so that they eventually “rubbed down into the lines and shapes that would so memorably underpin the extended memoir that became A Fortunate Life.” A mystique was thereby established that “time” was Albert Facey’s “first editor” (Jenkins). The publisher expressly aimed to retain Facey’s voice, content, and meaning, though editing included much correcting of grammar and punctuation, eradication of internal inconsistencies and anomalies, and structural reorganisation into six sections and 68 chapters. We find across Facey’s drafts a broadly similar chronology detailing childhood abandonment, life-threatening incidents, youthful resourcefulness, physical prowess, and participation in the Gallipoli Landing. However, there are also shifts and changed details, including varying descriptions of childhood abuse at a place called Cave Rock; the introduction of (incompatible accounts of) interstate boxing tours in drafts two and three which replace shearing activities in Draft One; divergent tales of Facey as a world-standard athlete, league footballer, expert marksman, and powerful swimmer; and changing stories of enlistment and war service (see Murphy and Nile, “Wounded”; “Naked”).Jenkins edited those sections concerned with childhood and youth, while Coffey attended to Facey’s war and post-war life. Drawing on C.E.W. Bean’s official war history, Coffey introduced specificity to the draft’s otherwise vague descriptions of battle and amended errors, such as Facey’s claim to have witnessed Lord Kitchener on the beach at Gallipoli. Importantly, Coffey suggested the now famous title, “A Fortunate Life,” and encouraged the author to alter the ending. When asked to suggest a title, Facey offered “Cave Rock” (Interview)—the site of his violent abuse and humiliation as a boy. Draft One concluded with Facey’s repatriation from the war and marriage in 1916 (106); Draft Two with a brief account of continuing post-war illness and ultimate defeat: “My war injuries caught up with me again” (107). The submitted typescript concludes: “I have often thought that going to War has caused my life to be wasted” (Typescript 206). This ending differs dramatically from the redemptive vision of the published narrative: “I have lived a very good life, it has been very rich and full. I have been very fortunate and I am thrilled by it when I look back” (412).In The Wounded Storyteller, Arthur Frank argues that literary markets exist for stories of “narrative wreckage” (196) that are redeemed by reconciliation, resistance, recovery, or rehabilitation, which is precisely the shape of Facey’s published life story and a source of its popularity. Musing on his post-war experiences in A Fortunate Life, Facey focuses on his ability to transform the material world around him: “I liked the challenge of building up a place from nothing and making a success where another fellow had failed” (409). If Facey’s challenge was building up something from nothing, something he could set to work on and improve, his life-writing might reasonably be regarded as a part of this broader project and desire for transformation, so that editorial interventions helped him realise this purpose. Facey’s narrative was produced within a specific zeitgeist, which historian Joy Damousi notes was signalled by publication in 1974 of Bill Gammage’s influential, multiply-reprinted study of front-line soldiers, The Broken Years, which drew on the letters and diaries of a thousand Great War veterans, and also the release in 1981 of Peter Weir’s film Gallipoli, for which Gammage was the historical advisor. The story of Australia’s war now conceptualised fallen soldiers as “innocent victims” (Damousi 101), while survivors were left to “compose” memories consistent with their sacrifice (Thomson 237–54). Viewing Facey’s drafts reminds us that life narratives are works of imagination, that the past is not fixed and memory is created in the present. Facey’s autobiographical efforts and those of his publisher to improve the work’s intelligibility and relevance together constitute an attempt to “objectify the self—to present it as a knowable object—through a narrative that re-structures [. . .] the self as history and conclusions” (Foster 10). Yet, such histories almost invariably leave “a crucial gap” or “censored chapter.” Dennis Foster argues that conceiving of narration as confession, rather than expression, “allows us to see the pathos of the simultaneous pursuit and evasion of meaning” (10); we believe a significant lacuna in Facey’s life writing is intimated by its various transformations.In a defining episode, A Fortunate Life proposes that Facey was taken from Gallipoli on 19 August 1915 due to wounding that day from a shell blast that caused sandbags to fall on him, crush his leg, and hurt him “badly inside,” and a bullet to the shoulder (348). The typescript, however, includes an additional but narratively irreconcilable date of 28 June for the same wounding. The later date, 19 August, was settled on for publication despite the author’s compelling claim for the earlier one: “I had been blown up by a shell and some 7 or 8 sandbags had fallen on top of me, the day was the 28th of June 1915, how I remembered this date, it was the day my brother Roy had been killed by a shell burst.” He adds: “I was very ill for about six weeks after the incident but never reported it to our Battalion doctor because I was afraid he would send me away” (Typescript 205). This account accords with Facey’s first draft and his medical records but is inconsistent with other parts of the typescript that depict an uninjured Facey taking a leading role in fierce fighting throughout July and August. It appears, furthermore, that Facey was not badly wounded at any time. His war service record indicates that he was removed from Gallipoli due to “heart troubles” (Repatriation), which he also claims in his first draft. Facey’s editors did not have ready access to military files in Canberra, while medical files were not released until 2012. There existed, therefore, virtually no opportunity to corroborate the author’s version of events, while the official war history and the records of the State Library of Western Australia, which were consulted, contain no reference to Facey or his war service (Interview). As a consequence, the editors were almost entirely dependent on narrative logic and clarifications by an author whose eyesight and memory had deteriorated to such an extent he was unable to read his amended text. A Fortunate Life depicts men with “nerve sickness” who were not permitted to “stay at the Front because they would be upsetting to the others, especially those who were inclined that way themselves” (350). By cross referencing the draft manuscripts against medical records, we can now perceive that Facey was regarded as one of those nerve cases. According to Facey’s published account, his wounds “baffled” doctors in Egypt and Fremantle (353). His medical records reveal that in September 1915, while hospitalised in Egypt, his “palpitations” were diagnosed as “Tachycardia” triggered by war-induced neuroses that began on 28 June. This suggests that Facey endured seven weeks in the field in this condition, with the implication being that his debility worsened, resulting in his hospitalisation. A diagnosis of “debility,” “nerves,” and “strain” placed Facey in a medical category of “Special Invalids” (Butler 541). Major A.W. Campbell noted in the Medical Journal of Australia in 1916 that the war was creating “many cases of little understood nervous and mental affections, not only where a definite wound has been received, but in many cases where nothing of the sort appears” (323). Enlisted doctors were either physicians or surgeons and sometimes both. None had any experience of trauma on the scale of the First World War. In 1915, Campbell was one of only two Australian doctors with any pre-war experience of “mental diseases” (Lindstrom 30). On staff at the Australian Base Hospital at Heliopolis throughout the Gallipoli campaign, he claimed that at times nerve cases “almost monopolised” the wards under his charge (319). Bearing out Facey’s description, Campbell also reported that affected men “received no sympathy” and, as “carriers of psychic contagion,” were treated as a “source of danger” to themselves and others (323). Credentialed by royal colleges in London and coming under British command, Australian medical teams followed the practice of classifying men presenting “nervous or mental symptoms” as “battle casualties” only if they had also been wounded by “enemy action” (Loughran 106). By contrast, functional disability, with no accompanying physical wounds, was treated as unmanly and a “hysterical” reaction to the pressures of war. Mental debility was something to be feared in the trenches and diagnosis almost invariably invoked charges of predisposition or malingering (Tyquin 148–49). This shifted responsibility (and blame) from the war to the individual. Even as late as the 1950s, medical notes referred to Facey’s condition as being “constitutional” (Repatriation).Facey’s narrative demonstrates awareness of how harshly sufferers were treated. We believe that he defended himself against this with stories of physical injury that his doctors never fully accepted and that he may have experienced conversion disorder, where irreconcilable experience finds somatic expression. His medical diagnosis in 1915 and later life writing establish a causal link with the explosion and his partial burial on 28 June, consistent with opinion at the time that linked concussive blasts with destabilisation of the nervous system (Eager 422). Facey was also badly shaken by exposure to the violence and abjection of war, including hand-to-hand combat and retrieving for burial shattered and often decomposed bodies, and, in particular, by the death of his brother Roy, whose body was blown to pieces on 28 June. (A second brother, Joseph, was killed by multiple bayonet wounds while Facey was convalescing in Egypt.) Such experiences cast a different light on Facey’s observation of men suffering nerves on board the hospital ship: “I have seen men doze off into a light sleep and suddenly jump up shouting, ‘Here they come! Quick! Thousands of them. We’re doomed!’” (350). Facey had escaped the danger of death by explosion or bayonet but at a cost, and the war haunted him for the rest of his days. On disembarkation at Fremantle on 20 November 1915, he was admitted to hospital where he remained on and off for several months. Forty-one other sick and wounded disembarked with him (HMAT). Around one third, experiencing nerve-related illness, had been sent home for rest; while none returned to the war, some of the physically wounded did (War Service Records). During this time, Facey continued to present with “frequent attacks of palpitation and giddiness,” was often “short winded,” and had “heart trouble” (Repatriation). He was discharged from the army in June 1916 but, his drafts suggest, his war never really ended. He began a new life as a wounded Anzac. His dependent and often fractious relationship with the Repatriation Department ended only with his death 66 years later. Historian Marina Larsson persuasively argues that repatriated sick and wounded servicemen from the First World War represented a displaced presence at home. Many led liminal lives of “disenfranchised grief” (80). Stephen Garton observes a distinctive Australian use of repatriation to describe “all policies involved in returning, discharging, pensioning, assisting and training returned men and women, and continuing to assist them throughout their lives” (74). Its primary definition invokes coming home but to repatriate also implies banishment from a place that is not home, so that Facey was in this sense expelled from Gallipoli and, by extension, excluded from the myth of Anzac. Unlike his two brothers, he would not join history as one of the glorious dead; his name would appear on no roll of honour. Return home is not equivalent to restoration of his prior state and identity, for baggage from the other place perpetually weighs. Furthermore, failure to regain health and independence strains hospitality and gratitude for the soldier’s service to King and country. This might be exacerbated where there is no evident or visible injury, creating suspicion of resistance, cowardice, or malingering. Over 26 assessments between 1916 and 1958, when Facey was granted a full war pension, the Repatriation Department observed him as a “neuropathic personality” exhibiting “paroxysmal tachycardia” and “neurocirculatory asthenia.” In 1954, doctors wrote, “We consider the condition is a real handicap and hindrance to his getting employment.” They noted that after “attacks,” Facey had a “busted depressed feeling,” but continued to find “no underlying myocardial disease” (Repatriation) and no validity in Facey’s claims that he had been seriously physically wounded in the war (though A Fortunate Life suggests a happier outcome, where an independent medical panel finally locates the cause of his ongoing illness—rupture of his spleen in the war—which results in an increased war pension). Facey’s condition was, at times, a source of frustration for the doctors and, we suspect, disappointment and shame to him, though this appeared to reduce on both sides when the Repatriation Department began easing proof of disability from the 1950s (Thomson 287), and the Department of Veteran’s Affairs was created in 1976. This had the effect of shifting public and media scrutiny back onto a system that had until then deprived some “innocent victims of the compensation that was their due” (Garton 249). Such changes anticipated the introduction of Post-Traumatic Shock Disorder (PTSD) to the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 1980. Revisions to the DSM established a “genealogy of trauma” and “panic disorders” (100, 33), so that diagnoses such as “neuropathic personality” (Echterling, Field, and Stewart 192) and “soldier’s heart,” that is, disorders considered “neurotic,” were “retrospectively reinterpreted” as a form of PTSD. However, Alberti points out that, despite such developments, war-related trauma continues to be contested (80). We propose that Albert Facey spent his adult life troubled by a sense of regret and failure because of his removal from Gallipoli and that he attempted to compensate through storytelling, which included his being an original Anzac and seriously wounded in action. By writing, Facey could shore up his rectitude, work ethic, and sense of loyalty to other servicemen, which became necessary, we believe, because repatriation doctors (and probably others) had doubted him. In 1927 and again in 1933, an examining doctor concluded: “The existence of a disability depends entirely on his own unsupported statements” (Repatriation). We argue that Facey’s Gallipoli experiences transformed his life. By his own account, he enlisted for war as a physically robust and supremely athletic young man and returned nine months later to life-long anxiety and ill-health. Publication transformed him into a national sage, earning him, in his final months, the credibility, empathy, and affirmation he had long sought. Exploring different accounts of Facey, in the shape of his drafts and institutional records, gives rise to new interpretations. In this context, we believe it is time for a new edition of A Fortunate Life that recognises it as a complex testimonial narrative and theorises Facey’s deployment of national legends and motifs in relation to his “wounded storytelling” as well as to shifting cultural and medical conceptualisations and treatments of shame and trauma. ReferencesAlberti, Fay Bound. Matters of the Heart: History, Medicine, and Emotions. Oxford: Oxford UP, 2010. Butler, A.G. Official History of the Australian Medical Services 1814-1918: Vol I Gallipoli, Palestine and New Guinea. Canberra: Australian War Memorial, 1930.Campbell, A.W. “Remarks on Some Neuroses and Psychoses in War.” Medical Journal of Australia 15 April (1916): 319–23.Damousi, Joy. “Why Do We Get So Emotional about Anzac.” What’s Wrong with Anzac. Ed. Marilyn Lake and Henry Reynolds. Sydney: UNSWP, 2015. 94–109.Dutton, Geoffrey. “Fremantle Arts Centre Press Publicity.” Australian Book Review May (1981): 16.Eager, R. “War Neuroses Occurring in Cases with a Definitive History of Shell Shock.” British Medical Journal 13 Apr. 1918): 422–25.Echterling, L.G., Thomas A. Field, and Anne L. Stewart. “Evolution of PTSD in the DSM.” Future Directions in Post-Traumatic Stress Disorder: Prevention, Diagnosis, and Treatment. Ed. Marilyn P. Safir and Helene S. Wallach. New York: Springer, 2015. 189–212.Facey, A.B. A Fortunate Life. 1981. Ringwood: Penguin, 2005.———. Drafts 1–3. University of Western Australia, Special Collections.———. Transcript. University of Western Australia, Special Collections.First Tuesday Book Club. ABC Splash. 4 Dec. 2012. <http://splash.abc.net.au/home#!/media/1454096/http&>.Foster, Dennis. Confession and Complicity in Narrative. Cambridge: Cambridge UP, 1987.Frank, Arthur. The Wounded Storyteller. London: U of Chicago P, 1995.Fraser, Jane. “CEO Says.” Fremantle Press. 7 July 2015. <https://www.fremantlepress.com.au/c/news/3747-ceo-says-9>.Garton, Stephen. The Cost of War: Australians Return. Melbourne: Oxford UP, 1994.HMAT Aeneas. “Report of Passengers for the Port of Fremantle from Ports Beyond the Commonwealth.” 20 Nov. 1915. <http://recordsearch.naa.gov.au/SearchNRetrieve/Interface/ViewImage.aspx?B=9870708&S=1>.“Interview with Ray Coffey.” Personal interview. 6 May 2016. Follow-up correspondence. 12 May 2016.Jenkins, Wendy. “Tales from the Backlist: A Fortunate Life Turns 30.” Fremantle Press, 14 April 2011. <https://www.fremantlepress.com.au/c/bookclubs/574-tales-from-the-backlist-a-fortunate-life-turns-30>.Keesing, Nancy. ‘An Enduring Classic.’ Australian Book Review (May 1981). FACP Press Clippings. Fremantle. n. pag.King, Noel. “‘I Can’t Go On … I’ll Go On’: Interview with Ray Coffey, Fremantle Arts Centre Press, 22 Dec. 2004; 24 May 2006.” Westerly 51 (2006): 31–54.Larsson, Marina. “A Disenfranchised Grief: Post War Death and Memorialisation in Australia after the First World War.” Australian Historical Studies 40.1 (2009): 79–95.Lindstrom, Richard. “The Australian Experience of Psychological Casualties in War: 1915-1939.” PhD dissertation. Victoria University, Feb. 1997.Loughran, Tracey. “Shell Shock, Trauma, and the First World War: The Making of a Diagnosis and its Histories.” Journal of the History of Medical and Allied Sciences 67.1 (2012): 99–119.Lucas, Anne. “Curator’s Notes.” A Fortunate Life. Australian Screen. <http://aso.gov.au/titles/tv/a-fortunate-life/notes/>.McLeod, Steve. “My Fortunate Life with Grandad.” Western Magazine Dec. (1983): 8.Munro, Craig. Under Cover: Adventures in the Art of Editing. Brunswick: Scribe, 2015.Murphy, Ffion, and Richard Nile. “The Naked Anzac: Exposure and Concealment in A.B. Facey’s A Fortunate Life.” Southerly 75.3 (2015): 219–37.———. “Wounded Storyteller: Revisiting Albert Facey’s Fortunate Life.” Westerly 60.2 (2015): 87–100.“NBC Book Awards.” Australian Book Review Oct. (1981): 1–4.PBL. Prospectus: A Fortunate Life, the Extraordinary Life of an Ordinary Bloke. 1–8.Repatriation Records. Albert Facey. National Archives of Australia.Roberts, Chris. “Turkish Machine Guns at the Landing.” Wartime: Official Magazine of the Australian War Memorial 50 (2010). <https://www.awm.gov.au/wartime/50/roberts_machinegun/>.Semmler, Clement. “The Way We Were before the Good Life.” Courier Mail 10 Oct. 1981. FACP Press Clippings. Fremantle. n. pag.Smith, Sidonie, and Julia Watson. Reading Autobiography: A Guide for Interpreting Life Narratives. 2001. 2nd ed. U of Minnesota P, 2010.Thomson, Alistair. Anzac Memories: Living with the Legend. 1994. 2nd ed. Melbourne: Monash UP, 2013. Tyquin, Michael. Gallipoli, the Medical War: The Australian Army Services in the Dardanelles Campaign of 1915. Kensington: UNSWP, 1993.War Service Records. National Archives of Australia. <http://recordsearch.naa.gov.au/NameSearch/Interface/NameSearchForm.aspx>.Williamson, Geordie. “A Fortunate Life.” Copyright Agency. <http://readingaustralia.com.au/essays/a-fortunate-life/>.

There have been a number of Australian memoirs written by adoptees over the last twenty years—Robert Dessaix’s A Mother’s Disgrace, Suzanne Chick’s Searching for Charmian, Tom Frame’s Binding Ties:An Experience of Adoption and Reunion in Australia, for example—as well as international adoptee narratives by Betty Jean Lifton, Florence Fisher, and A. M. Homes amongst others. These works form a component of the small but growing field of adoption life writing that includes works by “all members of the adoption triad” (Hipchen and Deans 163): adoptive parents, birthparents, and adoptees. As the broad genre of memoir becomes more theorised and mapped, many sub-genres are emerging (Brien). My own adoptee story (which I am currently composing) could be a further sub-categorisation of the adoptee memoir, that of “late discovery adoptees” (Perl and Markham), those who are either told, or find out, about their adoption in adulthood. When this is part of a life story, secrets and silences are prominent, and digging into these requires using whatever resources can be found. These include cookbooks, recipes written by hand, and the scraps of paper shoved between pages. There are two cookbooks from my adoptive mother’s belongings that I have kept. One of them is titled Miss Tuxford’s Modern Cookery for the Middle Classes: Hints on Modern Gas Stove Cooking, and this was published around 1937 in England. It’s difficult to date this book exactly, as there is no date in my copy, but one of the advertisements (for Bird’s Custard, I think; the page is partly obscured by an Orange Nut Loaf recipe from a Willow baking pan that has been glued onto the page) is headed with a date range of 1837 to 1937. It has that smell of long ago that lingers strongly even now, out of the protective custody of my mother’s storage. Or should I say, out of the range of my adoptive father’s garbage dump zeal. He loved throwing things away, but these were often things that I saw as valuable, or at least of sentimental value, worth keeping for the memories they evoked. Maybe my father didn’t want to remember. My mother was brimming with memories, I discovered after her death, but she did not reveal them during her life. At least, not to me, making objects like these cookbooks precious in my reconstruction of the lives I know so little about, as well as in the grieving process (Gibson).Miss Tuxford (“Diplomée Board of Education, Gold Medallist, etc”) produced numerous editions of her book. My mother’s is now fragile, loose at the spine and browned with age. There are occasional stains showing that the bread and cakes section got the most use, with the pages for main meals of meat and vegetables relatively clean. The author divided her recipes into the main chapters of Soups (lentil, kidney, sheep’s head broth), Sauces (white, espagnol, mushroom), Fish (“It is important that all fish is fresh when cooked” (23)), Meats (roasted, boiled, stuffed; roast rabbit, boiled turkey, scotch collop), Vegetables (creamed beetroot, economical salad dressing, potatoes baked in their skins), Puddings and Sweets (suet pastry, Yorkshire pudding, chocolate tarts, ginger cream), Bread and Cakes (household bread, raspberry sandwich cake, sultana scones, peanut fancies), Icings and Fillings, Invalid Cookery (beef tea, nourishing lemonade, Virol pudding), Jams, Sweetmeats and Pickles (red currant jelly, piccalilli) and Miscellaneous Dishes including Meatless Recipes (cheese omelette, mock white fish, mock duck, mock goose, vegetarian mincemeat). At the back, Miss Tuxford includes sections on gas cooking hints, “specimen household dinners” (206), and household hints. There is then a “Table of Foods in Season” (208–10) taking the reader through the months and the various meats and vegetables available at those times. There is a useful index and finally an advertisement for an oven cleaner on the last page (which is glued to the back cover). There are food and cookery advertisements throughout the book, but my favourite is the one inside the front cover, for Hartley’s jam, featuring two photographs of a little boy. The first shows him looking serious, and slightly anxious, the second wide-eyed and smiling, eager for his jam. The text tells mothers that “there’s nothing like plenty of bread and Hartley’s for a growing boy” (inside front cover). I love the simple appeal to making your little boy happy that is contained within this tiny narrative. Did my mother and father eat this jam when they were small? By 1937, my mother was twenty-one, not yet married, living with her mother in Weston-super-Mare. She was learning secretarial skills—I have her certificate of proficiency in Pitman’s shorthand—and I think she and my father had met by then. Perhaps she thought about when she would be giving her own children Hartley’s jam, or something else prepared from Miss Tuxford’s recipes, like the Christmas puddings, shortbread, or chocolate cake. She would not have imagined that no children would arrive, that twenty-five years of marriage would pass before she held her own baby, and this would be one who was born to another woman. In the one other cookbook I have kept, there are several recipes cut out from newspapers, and a few typed or handwritten recipes hidden within the pages. This is The Main Cookery Book, in its August 1944 reprint, which was written and compiled by Marguerite K. Gompertz and the “Staff of the Main Research Kitchen”. My mother wrote her name and the date she obtained the cookbook (31 January 1945) on the first blank page. She had been married just over five years, and my father may, or may not, have still been in the Royal Air Force. I have only a sketchy knowledge of my adoptive parents. My mother was born in Newent, Gloucestershire, and my father in Bromley, Kent; they were both born during the first world war. My father served as a navigator in the Royal Air Force in the second world war in the 1940s, received head and psychological injuries and was invalided out before the war ended. He spent some time in rehabilitation, there being letters from him to my mother detailing his stay in one hospital in the 1950s. Their life seemed to become less and less secure as the years passed, more chaotic, restless, and unsettled. By the time I came into their lives, they were both nearly fifty, and moving from place to place. Perhaps this is one reason why I have no memory of my mother cooking. I cannot picture her consulting these cookbooks, or anything more modern, or even cutting out the recipes from newspapers and magazines, because I do not remember seeing her do it. She did not talk to me about cooking, we didn’t cook together, and I do not remember her teaching me anything about food or its preparation. This is a gap in my memory that is puzzling. There is evidence—the books and additional paper recipes and stains on the pages—that my mother was involved in the world of the kitchen. This suggests she handled meats, vegetables, and flours, kneaded, chopped, mashed, baked, and boiled all manners of foods. But I cannot remember her doing any of it. I think the cooking must have been a part of her life before me, when she lived in England, her home country, which she loved, and when she still had hope that children would come. It must have then been apparent that her husband was going to need support and care after the war, and I can imagine she came to realise that any dreams she had would need rearranging.What I do remember is that our meals were prepared by my father, and contained no spices, onions, or garlic because he suffered frequently from indigestion and said these ingredients made it worse. He was a big-chested man with small hips who worried he was too heavy and so put himself on diets every other week. For my father, dieting meant not eating anything, which tended to lead to binges on chocolate or cheese or whatever he could grab easily from the fridge.Meals at night followed a pattern. On Sundays we ate roast chicken with vegetables as a treat, then finished it over the next days as a cold accompaniment with salad. Other meals would feature fish fingers, mince, ham, or a cold luncheon meat with either salad or boiled vegetables. Sometimes we would have a tin of peaches in juice or ice cream, or both. No cookbooks were consulted to prepare these meals.What was my mother doing while my father cooked? She must have been in the kitchen too, probably contributing, but I don’t see her there. By the time we came back to Australia permanently in 1974, my father’s working life had come to an end, and he took over the household cookery for something to do, as well as sewing his own clothes, and repairing his own car. He once hoisted the engine out of a Morris Minor with the help of a young mechanic, a rope, and the branch of a poinciana tree. I have three rugs that he wove before I was born, and he made furniture as well. My mother also sewed, and made my school uniforms and other clothes as well as her own skirts and blouses, jackets and pants. Unfortunately, she was fond of crimplene, which came in bright primary colours and smelled of petrol, but didn’t require ironing and dried quickly on the washing line. It didn’t exactly hang on your body, but rather took it over, imposing itself with its shapelessness. The handwritten recipe for salad cream shown on the pink paper is not in my mother’s hand but my father’s. Her correction can be seen to the word “gelatine” at the bottom; she has replaced it with “c’flour” which I assume means cornflour. This recipe actually makes me a liar, because it shows my father writing about using pepper, paprika, and tumeric to make a food item, when I have already said he used no spices. When I knew him, and ate his food, he didn’t. But he had another life for forty-seven years before my birth, and these recipes with their stains and scribbles help me to begin making a picture of both his life, and my mother’s. So much of them is a complete mystery to me, but these scraps of belongings help me inch along in my thinking about them, who they were, and what they meant to me (Turkle).The Main Cookery Book has a similar structure to Miss Tuxford’s, with some variations, like the chapter titled Réchauffés, which deals with dishes using already cooked foodstuffs that only then require reheating, and a chapter on home-made wines. There are also notes at the end of the book on topics such as gas ovens and methods of cooking (boiling, steaming, simmering, and so on). What really interests me about this book are the clippings inserted by my mother, although the printed pages themselves seem relatively clean and uncooked upon. There is a recipe for pickles and chutneys torn from a newspaper, and when I look on the other side I find a context: a note about Charlie Chaplin and the House of Representatives’s Un-American Activities Committee starting its investigations into the influence of Communists on Hollywood. I wonder if my parents talked about these events, or if they went to see Charlie Chaplin’s films. My mother’s diaries from the 1940s include her references to movies—Shirley Temple in Kiss and Tell, Bing Crosby in Road to Utopia—as well as day to day activities and visits to, and from, family and friends, her sinus infections and colds, getting “shock[ed] from paraffin lamp”, food rationing. If my father kept diaries during his earlier years, nothing of them survives. I remember his determined shredding of documents after my mother’s death, and his fear of discovery, that his life’s secrets would be revealed. He did not tell me I had been adopted until I was twenty-three, and rarely spoke of it afterwards. My mother never mentioned it. I look at the recipe for lemon curd. Did my mother ever make this? Did she use margarine instead of butter? We used margarine on sandwiches, as butter was too hard to spread. Once again, I turn over this clipping to read the news, and find no date but an announcement of an exhibition of work by Marc Chagall at the Tate Gallery, the funeral of Sir Geoffrey Fison (who I discover from The Peerage website died in 1948, unmarried, a Baronet and decorated soldier), and a memorial service for Dr. Duncan Campbell Scott, the Canadian poet and prose writer, during which the Poet Laureate of the time, John Masefield, gave the address. And there was also a note about the latest wills, including that of a reverend who left an estate valued at over £50 000. My maternal adoptive grandmother, who lived in Weston-super-Mare across the road from the beach, and with whom we stayed for several months in 1974, left most of her worldly belongings to my mother and nothing to her son. He seems to have been cut out from her life after she separated from her husband, and her children’s father, sometime in the 1920s. Apparently, my uncle followed his father out to Australia, and his mother never forgave him, refusing to have anything more to do with her son for the rest of her life, not even to see her grandchildren. When I knew her in that brief period in 1974, she was already approaching eighty and showing signs of dementia. But I do remember dancing the Charleston with her in the kitchen, and her helping me bathe my ragdoll Pollyanna in a tub in the garden. The only food I remember at her stone house was afternoon tea with lots of different, exotic cakes, particularly one called Neopolitan, with swirls of red and brown through the moist sponge. My grandmother had a long narrow garden filled with flowers and a greenhouse with tomatoes; she loved that garden, and spent a lot of time nurturing it.My father and his mother-in-law were not each other’s favourite person, and this coloured my mother’s relationship with her, too. We were poor for many years, and the only reason we were able to go to England was because of the generosity of my grandmother, who paid for our airfares. I think my father searched for work while we were there, but whether he was successful or not I do not know. We returned to Australia and I went into grade four at the end of 1974, an outsider of sorts, and bemused by the syllabus, because I had moved around so much. I went to eight different primary schools and two high schools, eventually obtaining a scholarship to a private girls’ school for the last four years. My father was intent on me becoming a doctor, and so my life was largely study, which is another reason why I took little notice of what went on in the kitchen and what appeared on the dining table. I would come home from school and my parents would start meal preparation almost straight away, so we sat down to dinner at about four o’clock during the week, and I started the night’s study at five. I usually worked through until about ten, and then read a novel for a little while before sleep. Every parcel of time was accounted for, and nothing was wasted. This schedule continued throughout those four years of high school, with my father berating me if I didn’t do well at an exam, but also being proud when I did. In grades eight, nine, and ten, I studied home economics, and remember being offered a zucchini to taste because I had never seen one before. I also remember making Greek biscuits of some sort for an exam, and the sieve giving out while I was sifting a large quantity of flour. We learned to cook simple meals of meats and vegetables, and to prepare a full breakfast. We also baked cakes but, when my sponges remained flat, I realised that my strengths might lay elsewhere. This probably also contributed to my lack of interest in cooking. Domestic pursuits were not encouraged at home, although my mother did teach me to sew and knit, resulting in skewed attempts at a shirt dress and a white blouse, and a wildly coloured knitted shoulder bag that I actually liked but which embarrassed my father. There were no such lessons in cakemaking or biscuit baking or any of the recipes from Miss Tuxford. By this time, my mother bought such treats from the supermarket.This other life, this previous life of my parents, a life far away in time and place, was completely unknown to me before my mother’s death. I saw little of them after the revelation of my adoption, not because of this knowledge I then had, but because of my father’s controlling behaviour. I discovered that the rest of my adoptive family, who I hardly knew apart from my maternal grandmother, had always known. It would have been difficult, after all, for my parents to keep such a secret from them. Because of this life of constant moving, my estrangement from my family, and our lack of friends and connections with other people, there was a gap in my experience. As a child, I only knew one grandmother, and only for a relatively brief period of time. I have no grandfatherly memories, and none either of aunts and uncles, only a few fleeting images of a cousin here and there. It was difficult to form friendships as a child when we were only in a place for a limited time. We were always moving on, and left everything behind, to start again in a new suburb, state, country. Continuity and stability were not our trademarks, for reasons that are only slowly making themselves known to me: my father’s mental health problems, his difficult personality, our lack of money, the need to keep my adoption secret.What was that need? From where did it spring? My father always seemed to be a secretive person, an intensely private man, one who had things to hide, and seemed to suffer many mistakes and mishaps and misfortune. At the end, after my mother’s death, we spent two years with each other as he became frailer and moved into a nursing home. It was a truce formed out of necessity, as there was no one else to care for him, so thoroughly had he alienated his family; he had no friends, certainly not in Australia, and only the doctor and helping professionals to talk to most days. My father’s brother John had died some years before, and the whereabouts of his other sibling Gordon were unknown. I discovered that he had died three years previously. Nieces had not heard from my father for decades. My mother’s niece revealed that my mother and she had never met. There is a letter from my mother’s father in the 1960s, probably just before he died, remarking that he would like a photograph of her as they hadn’t seen each other for forty years. None of this was talked about when my mother was alive. It was as if I was somehow separate from their stories, from their history, that it was not suitable for my ears, or that once I came into their lives they wanted to make a new life altogether. At that time, all of their past was stored away. Even my very origins, my tiny past life, were unspoken, and made into a secret. The trouble with secrets, however, is that they hang around, peek out of boxes, lurk in the corners of sentences, and threaten to be revealed by the questions of puzzled strangers, or mistakenly released by knowledgeable relatives. Adoptee memoirs like mine seek to go into those hidden storage boxes and the corners and pages of sources like these seemingly innocent old cookbooks, in the quest to bring these secrets to light. Like Miss Tuxford’s cookbook, with its stains and smudges, or the Main Cookery Book with its pages full of clippings, the revelation of such secrets threaten to tell stories that contradict the official version. ReferencesBrien, Donna Lee. “Pathways into an ‘Elaborate Ecosystem’: Ways of Categorising the Food Memoir”. TEXT (October 2011). 12 Jun. 2013 ‹http://www.textjournal.com.au/oct11/brien.htm›.Chick, Suzanne. Searching for Charmian. Sydney: Picador, 1995.Dessaix, Robert. A Mother’s Disgrace. Sydney: Angus & Robertson, 1994.Fisher, Florence. The Search for Anna Fisher. New York: Arthur Fields, 1973.Frame, Tom. Binding Ties: An Experience of Adoption and Reunion in Australia. Alexandria: Hale & Iremonger, 1999.Gibson, Margaret. Objects of the Dead: Mourning and Memory in Everyday Life. Carlton, Victoria: Melbourne U P, 2008. Gompertz, Marguerite K., and the Staff of the Main Research Kitchen. The Main Cookery Book. 52nd. ed. London: R. & A. Main, 1944. Hipchen, Emily, and Jill Deans. “Introduction. Adoption Life Writing: Origins and Other Ghosts”. a/b: Auto/Biography Studies 18.2 (2003): 163–70. Special Issue on Adoption.Homes, A. M. The Mistress’s Daughter: A Memoir. London: Granta, 2007.Kiss and Tell. Dir. By Richard Wallace. Columbia Pictures, 1945.Lifton, Betty Jean. Twice Born: Memoirs of An Adopted Daughter. Middlesex, England: Penguin, 1977.Lundy, Darryl, comp. The Peerage: A Genealogical Survey of the Peerage of Britain as well as the Royal Families of Europe. 30 May 2013 ‹http://www.thepeerage.com/p40969.htm#i409684›Perl, Lynne and Shirin Markham. Why Wasn’t I Told? Making Sense of the Late Discovery of Adoption. Bondi: Post Adoption Resource Centre/Benevolent Society of NSW, 1999.Road to Utopia. Dir. By Hal Walker. Paramount, 1946.Turkle, Sherry, ed. Evocative Objects: Things We Think With. Cambridge, Massachusetts: MIT P, 2011. Tuxford, Miss H. H. Miss Tuxford’s Modern Cookery for the Middle Classes: Hints on Modern Gas Stove Cooking. London: John Heywood, c.1937.