Knowledge, attitudes and self-care practices related to sun protection among secondary students in Australia

The aim of this research was to ascertain changes in sun-related knowledge, attitudes and self-care practices among Australian secondary school students between 1993 and 1996. Two cross-sectional surveys of sun-related attitudes, beliefs and behavior of young people aged 12–17 years of age, were conducted in 1993 and 1996. Over 80% of adolescents at both time periods knew about the issues related to skin cancer prevention, frequency of burning and burning on cloudy days. Adolescent attitudes had shifted positively in the areas of staying inside in 1996 [relative risk (RR): 1.13; 95% confidence interval (CI): 1.09–1.17] and staying under shade in 1996 (RR: 1.16; 95% CI: 1.13–1.18). Desire for a moderate or dark tan was lower in 1996 (45%) than in 1993 (50%). Respondents reported that they were less likely to wear brief clothing to get a suntan in 1996 (RR: 0.81; 95% CI: 0.78–0.84) and were significantly more likely to stay in the shade in 1996 (RR: 1.19; 95% CI: 1.16–1.23). We conclude that there has been a shift in attitudes towards use of shade and avoidance of unnecessary exposure, and away from use of sunscreens and sunglasses. The results suggest that adolescents may be more ready to accept structural changes that move desired activities out of the sun.

Using CAI to teach chemistry in secondary schools in Thailand

Participatory action research is used by six Thai chemistry teachers being supported to become more 'computer literate' and to develop understandings about the effectiveness of ways of using a chemistry CAI package to support student learning. The study demonstrates a gradual change in their ideas and attitudes to the use of computers in teaching.

Using polyatomic primary ions to probe an amino acid and a nucleic base in water ice

In this study on pure water ice, we show that protonated water species [H₂O]_nH⁺ are more prevalent than (H₂O)_n⁺ ions after bombardment by Au+ monoatomic and Au₃⁺ and C₆₀⁺ polyatomic projectiles. This data also reveals significant differences in water cluster yields under bombardment by these three projectiles. The amino acid alanine and the nucleic base adenine in solution have been studied and have been shown to have an effect on the water cluster ion yields observed using an Au₃⁺ ion beam.

Maternal transfer of mercury to the developing embryo/fetus : is there a safe level?

Mercury (Hg) exposure is ubiquitous in modern society via vaccines, fish/crustacea, dental amalgam, food, water, and the atmosphere. This article examines Hg exposure in the context of primary exposure to pregnant women and secondary exposure experienced by their unborn babies. Babies in utero are particularly at risk of higher Hg exposure than adults (on a dose/weight basis through maternal Hg transfer via the placenta), and are more susceptible to adverse effects from mercury and its biologically active compounds. It is, therefore, critical that regulatory advisories around maximum safe Hg exposures account for pregnant women and secondary exposure that children in utero experience. This study focused on standardized embryonic and fetal Hg exposures via primary exposure to the pregnant mother of two common Hg sources (dietary fish and parenteral vaccines). Data demonstrated that Hg exposures, particularly during the first trimester of pregnancy, at well-established dose/weight ratios produced severe damage to humans including death. In light of research suggestive of a mercuric risk factor for childhood conditions such as tic disorders, cerebral palsy, and autism, it is essential that Hg advisories account for secondary prenatal human exposures.

Carrying weapons and intent to harm among Victorian secondary school students in 1999 and 2009

Objective: 

Empowering primary care to tackle the obesity epidemic: the Counterweight Programme

Subjects: Obese patients (body mass index greater than or equal to30 kg/m2) or BMIgreater than or equal to28 kg/m2 with obesity-related comorbidities in 80 general practices.

Intervention: The model consists of four phases: (1) audit and project development, (2) practice training and support, (3) nurse-led patient intervention, and (4) evaluation. The intervention programme used evidence-based pathways, which included strategies to empower clinicians and patients. Weight Management Advisers who are specialist obesity dietitians facilitated programme implementation.

Main outcome measures: Proportion of practices trained and recruiting patients, and weight change at 12 months.

Results: By March 2004, 58 of the 62 (93.5%) intervention practices had been trained, 47 (75.8%) practices were active in implementing the model and 1549 patients had been recruited. At 12 months, 33% of patients achieved a clinically meaningful weight loss of 5% or more. A total of 49% of patients were classed as 'completers' in that they attended the requisite number of appointments in 3, 6 and 12 months. 'Completers' achieved more successful weight loss with 40% achieving a weight loss of 5% or more at 12 months.

Conclusion: The Counterweight programme provides a promising model to improve the management of obesity in primary care.

Sponsorship: Educational grant-in-aid from Roche Products Ltd.

Effect of a telephone-delivered coronary heart disease secondary prevention program (ProActive Heart) on quality of life and health behaviours: primary outcomes of a randomised controlled trial

Background Participation in coronary heart disease secondary prevention programs is low. Innovative programs to meet this treatment gap are required.

Purpose To aim of this study is to describe the effectiveness of a telephone-delivered secondary prevention program for myocardial infarction patients.

Methods Four hundred and thirty adult myocardial infarction patients in Brisbane, Australia were randomised to a 6-month secondary prevention program or usual care. Primary outcomes were health-related quality of life (Short Form-36) and physical activity (Active Australia Survey).

Results Significant intervention effects were observed for health-related quality of life on the mental component summary score (p = 0.02), and the social functioning (p = 0.04) and role-emotional (p = 0.03) subscales, compared with usual care. Intervention participants were also more likely to meet recommended levels of physical activity (p = 0.02), body mass index (p = 0.05), vegetable intake (p = 0.04) and alcohol consumption (p = 0.05).

Conclusions Telephone-delivered secondary prevention programs can significantly improve health outcomes and could meet the treatment gap for myocardial infarction patients.

A longitudinal study of risk and protective factors associated with successful transition to secondary school in youth with ADHD: prospective cohort study protocol

BACKGROUND: Attention-Deficit/Hyperactivity Disorder (ADHD) has a significant impact on child and adolescent development, especially in relation to school functioning and academic outcomes. Despite the transition to high school being a potentially critical period for children with ADHD, most research in this period has focused on academic outcomes. This study aims to extend previous research by describing academic, school engagement, behaviour and social-emotional outcomes for young people with ADHD in the first and third years of high school and to identify risk and protective factors predictive of differing outcomes across these four domains. METHODS AND DESIGN: The Moving Up study is a longitudinal, prospective cohort study of children with ADHD as they transition and adjust to high school (age 12-15 years). Data are collected through direct assessment and child, parent and teacher surveys. The primary outcome is academic achievement, obtained by linking to standardised test results. Secondary outcomes include measures of behaviour, ADHD symptoms, school engagement (attitudes and attendance), and social and emotional functioning, including depressive symptoms. The mean performance of the study cohort on each outcome measure will be compared to the population mean for same aged children, using t-tests. Risk and protective factors to be examined using multiple regression include a child, family and school factors know to impact academic and school functioning. DISCUSSION: The Moving up study is the first Australian study prospectively designed to measure a broad range of student outcomes for children with ADHD during the high school transition period. Examining both current (cross sectional) and earlier childhood (longitudinal) factors gives us the potential to learn more about risk and protective factors associated with school functioning in young people with ADHD. The richness and depth of this information could lead to more targeted and effective interventions that may alter academic and wellbeing trajectories for young people at risk of poor outcomes. The study is approved by The Royal Children's Hospital Melbourne Human Research Ethics Committee (33206). Findings will be disseminated through peer-reviewed journals and conference presentations.

HealthMap: a cluster randomised trial of interactive health plans and self-management support to prevent coronary heart disease in people with HIV

BACKGROUND: The leading causes of morbidity and mortality for people in high-income countries living with HIV are now non-AIDS malignancies, cardiovascular disease and other non-communicable diseases associated with ageing. This protocol describes the trial of HealthMap, a model of care for people with HIV (PWHIV) that includes use of an interactive shared health record and self-management support. The aims of the HealthMap trial are to evaluate engagement of PWHIV and healthcare providers with the model, and its effectiveness for reducing coronary heart disease risk, enhancing self-management, and improving mental health and quality of life of PWHIV.

METHODS/DESIGN: The study is a two-arm cluster randomised trial involving HIV clinical sites in several states in Australia. Doctors will be randomised to the HealthMap model (immediate arm) or to proceed with usual care (deferred arm). People with HIV whose doctors are randomised to the immediate arm receive 1) new opportunities to discuss their health status and goals with their HIV doctor using a HealthMap shared health record; 2) access to their own health record from home; 3) access to health coaching delivered by telephone and online; and 4) access to a peer moderated online group chat programme. Data will be collected from participating PWHIV (n = 710) at baseline, 6 months, and 12 months and from participating doctors (n = 60) at baseline and 12 months. The control arm will be offered the HealthMap intervention at the end of the trial. The primary study outcomes, measured at 12 months, are 1) 10-year risk of non-fatal acute myocardial infarction or coronary heart disease death as estimated by a Framingham Heart Study risk equation; and 2) Positive and Active Engagement in Life Scale from the Health Education Impact Questionnaire (heiQ).

DISCUSSION: The study will determine the viability and utility of a novel technology-supported model of care for maintaining the health and wellbeing of people with HIV. If shown to be effective, the HealthMap model may provide a generalisable, scalable and sustainable system for supporting the care needs of people with HIV, addressing issues of equity of access.

Patient engagement and coaching for health: the PEACH study- a cluster randomised controlled trial using the telephone to coach people with type 2 diabetes to engage with their GPs to improve diabetes care: a study protocol.

Background
The PEACH study is based on an innovative 'telephone coaching' program that has been used effectively in a post cardiac event trial. This intervention will be tested in a General Practice setting in a pragmatic trial using existing Practice Nurses (PN) as coaches for people with type 2 diabetes (T2D). Actual clinical care often fails to achieve standards, that are based on evidence that self-management interventions (educational and psychological) and intensive pharmacotherapy improve diabetes control. Telephone coaching in our study focuses on both. This paper describes our study protocol, which aims to test whether goal focused telephone coaching in T2D can improve diabetes control and reduce the treatment gap between guideline based standards and actual clinical practice.
Methods/design
In a cluster randomised controlled trial, general practices employing Practice Nurses (PNs) are randomly allocated to an intervention or control group. We aim to recruit 546 patients with poorly controlled T2D (HbA1c >7.5%) from 42 General Practices that employ PNs in Melbourne, Australia. PNs from General Practices allocated to the intervention group will be trained in diabetes telephone coaching focusing on biochemical targets addressing both patient self-management and engaging patients to work with their General Practitioners (GPs) to intensify pharmacological treatment according to the study clinical protocol. Patients of intervention group practices will receive 8 telephone coaching sessions and one face-to-face coaching session from existing PNs over 18 months plus usual care and outcomes will be compared to the control group, who will only receive only usual care from their GPs. The primary outcome is HbA1c levels and secondary outcomes include cardiovascular disease risk factors, behavioral risk factors and process of care measures.
Discussion
Understanding how to achieve comprehensive treatment of T2D in a General Practice setting is the focus of the PEACH study. This study explores the potential role for PNs to help reduce the treatment and outcomes gap in people with T2D by using telephone coaching. The intervention, if found to be effective, has potential to be sustained and embedded within real world General Practice.

Fun or profit : primary students' perceptions of mathematics and science

As the number of students pursuing mathematics and science in higher education decline, it becomes imperative· that we look for the causes of the decline. As part of the Australian Improving Middle Years Mathematics and Science (IMYMS) project, students were asked to rate their perceptions of classroom practice in mathematics and science and their attitudes to these subjects. Results of this survey reveal little difference in perceptions of classroom practice, but significant differences in students' attitudes between mathematics and science. Differences were particularly evident for items relating to the usefulness of mathematics and science (mathematics was more useful) and enjoyment of the subjects (science is more fun). If teachers are aware of such perspectives, it may be possible to change students' attitudes.

Effective student engagement depends on students enjoying their studies in mathematics and science, being confident in their ability and recognising the relevance of these subjects to everyday life, now and in the future.
(Education Training Committee, 2006, p. xvii)

Science and technology are the widely acknowledged foundation of Australia's future development. Underpinning these are the key learning areas of mathematics and science. However, Australia is experiencing a decline in numbers of mathematics and science students in higher education. Moreover, studies over the last two decades have shown a general decline in Australian students' interest and enjoyment of science across the compulsory secondary school years, with a particularly sharp decline across the primary to secondary school transition (e.g. Adams, Doig, & Rosier 1991; Goodrum, Hackling, & Rennie, 200 I) and a decline in the numbers of students studying' advanced mathematical courses in upper secondary school (Thomas, 2000).

Improving teaching and learning in the middle years of schooling (Years 5 to 9) is receiving particular attention because of the coincidence of the disengagement of students with the significance of these years for the preparation of students for their future role in society. Thus the Improving Middle Years Mathematics and Science: The role of subject cultures in school and teacher change (IMYMS) project, which is the source of data for this paper, is investigating the role of mathematics and science' knowledge and subject cultures in mediating change processes in the middle years of schooling.

Mathematics and science are sometimes seen as "love-hate" subjects, rating highest for subjects disliked, but also rating relatively highly among preferred subjects (Hendley & Stables, 1996). Students, even primary aged students, can often shed light on what constitutes good practice (see, for example, 'van den Heuvel-Panhuizen, 2005). Students' attitudes towards mathematics and science and their perceptions of what they regard as positive aspects of classroom practice have been shown to decline from the primary years to junior secondary (Race, 2000). The decline in interest in science in the early years of secondary school is of particular concern, since it is in these years that attitudes to the pursuit of science subjects and careers are formed (Speering & Rennie, 1996). Students' negative attitude towards the relevance of science ,content for their lives was a strong theme in the report by Goodrum, Hackling, & Rennie (2001) on the status and quality of teaching and learning of science.

As part of the IMYMS project, the IMYMS Student Survey was administered to all students in 2004 and 2005. The survey included a 36 item section on students' perceptions of classroom practice and attitudes towards mathematics and science, and a 24 item section on students' learning preferences. Students completed separate, parallel surveys for mathematics and science.

This paper focuses on students' perceptions and attitudes. It explores the differences in 700 Year 5 and 6 students' perceptions of their learning environment and their attitudes to mathematics and science during 2005, the second (and final) year of schools , involvement in the IMYMS project.

Barriers to continuing medical education in Australian prevocational doctors

To determine perceived barriers to continuing education for Australian hospital-based prevocational doctors, a cross sectional cohort survey was distributed to medical administrators for secondary redistribution to 2607 prevocational doctors from August 2003 to October 2004. Four hundred and seventy valid questionnaires (18.1%) were returned. Only seven per cent (33/470) did not identify any barriers to continuing education. Barriers identified the most were lack of time (85% [371/437]), clinical commitment (65% [284/437]), resistance from registrars (13% [57/437]) and resistance from consultant staff (10% [44/437]). Other barriers included workload issues (27% [27/98]), teaching program inadequacies (26% [25/98]), lack of protected time for education (17% [17/98]), motivational issues (11% [10/98]) and geographic remoteness (10% [10/98]). Australian graduates (87%) identified lack of time more frequently than international medical graduates (77%) (P=0.036). Perceived barriers did not differ significantly between doctors of differing postgraduate years.

Primary school teacher perceived self-efficacy to teach fundamental motor skills

Fundamental Movement Skills (FMS) are a part of the school curricula, yet many Australian primary-age children are not mastering FMS. One reason may be a lack of perceived self-efficacy of primary teachers to teach FMS. This study investigated the level of perceived self-efficacy of primary school teachers to teach FMS in Victoria, Australia. A cross-sectional survey, based on the Victorian Institute of Teaching Standards of Professional Practice, was used to sample sixty-five pre-service and forty-six in-service teachers. Most primary school teachers were self-efficacious in teaching FMS (67.59 per cent); almost one-third (32.41 per cent) were not. Male teachers had higher perceived self-efficacy than female teachers, and a positive relationship was found between perceived self-efficacy to teach FMS and interest in, and participation in, physical activity (r = 0.52 and r = 0.31 respectively). Implications for practice include providing FMS teaching resources and professional training. Further research should explore the effect of perceived self-efficacy on teaching performance.

Using everyday experiences in teaching secondary mathematics in Malawi : possibilities and constraints for change

Proponents of socially and culturally oriented mathematics education have argued that teaching approaches which value and connect with the learner's prior knowledge and everyday experience are more likely to promote active, meaningful, relevant and liberatory learning than approaches which rely on transmission and abstract presentation of mathematical content. In Malawi, proposals to reform the outdated secondary mathematics curriculum have been made with the aim of aligning mathematics instruction with the social and political changes in the current Malawian society. Using a case study approach, this study investigated the extent to which everyday experiences could be used as a vehicle for changing the learning and teaching of secondary mathematics in Malawi. The study was collaborative, taking place over a period of five months in severely overcrowded and poorly resourced classes in two schools. It involved three mathematics teachers in a cycle of planning and teaching mathematics lessons based on the use of everyday experiences, and observation of and reflection on these lessons, in order to document the effects of using everyday experiences on student learning and teachers' teaching practices. The data was collected through student questionnaires; classroom observations and fieldnotes; interviews and reflective meetings with teachers; and informal meetings with key education officials in Malawi. Mathematics examination results from students involved in this study and a corresponding group from the previous year were collected. A reflective and critical approach was adopted in the interpretation and discussion of the data. Teachers' participation in this study resulted in heightened awareness of their teaching roles and the value of linking school mathematics with everyday experience. The study also shows that students found mathematics interesting and important to learn despite their lack of success in it. In addition, the study documented a number of constraints to change in mathematics instruction such as teachers' focus on mathematics content and examination requirements, and students' resistance to inquiry learning. It also recorded possibilities and barriers to collaboration both between teachers and researchers, and teachers themselves. The findings of this study are timely since they could serve to inform the reform of the Malawian secondary mathematics curriculum currently being undertaken, which began without a critical examination of the classroom conditions necessary to accommodate a socio-politically relevant mathematics education.