Expanding a successful community-based obesity prevention approach into new communities : challenges and achievements

OBJECTIVE: A previously successful community-based obesity prevention intervention with a focus on school settings was expanded into new communities with varying contexts. In order to understand the complexities involved in implementing health promotion activities in schools, this study examined experiences of school staff and project officers including barriers, contextual factors and achievements. METHODS: School environment assessments were conducted in schools across four Victorian communities with school staff (n=1-5 staff plus a trained researcher per group in 9 primary and 8 secondary schools) 12-18 months post-intervention. Process reports from project officers were also reviewed and analysed (n=4). RESULTS: School staff commonly reported time pressures as a barrier to implementation and project officers working within schools reported competing priorities and limited health promotion experience of staff; lack of stakeholder engagement; low participation in some activities and insufficient implementation time. Contextual factors included community socioeconomic status, student ethnicity and living rurally. Achievements included student and staff enjoyment from programme activities, staff capacity building, partnerships, embedding activities into existing infrastructure and programmes, and having consistent health-related messages repeated through a variety of strategies. CONCLUSIONS: Community-based interventions with a focus on school settings need to consider system level, organisational and contextual (i.e. socioeconomic, ethnicity, family and town characteristics) factors when expanding previously effective strategies into new communities. Implementation benefits may have added whole of school benefits in addition to child health. Focussing on overcoming the challenges experienced in this complex initiative is required for future interventions.

Faster, richer, better: rapid appraisal techniques for the study of IS implementation in virtual communities

A major issue in Information Systems (IS) research is how to combine relevance and rigor (Benbasat and Zmud, 1999) and reduce the widening gap between research results and adoption (Dunn, 1994). Qualitative researchers make use of interpretivist methods to add richness and depth to their understanding of user problems. Interpretivist methods applied to IS implementations can thus result in research which communicates those findings more effectively. However standard interpretivist data-collection and analysis methods can be time-consuming and expensive. Findings based on these methods may be irrelevant to practitioners by the time they reach publication stage. A potential solution to this problem lies in Rapid Appraisal or RA, a qualitative appraisal methodology derived from rural development-related research. It offers IS researchers an additional technique for learning and acquiring relevant information in a limited period of time that  supplements current data collection and analysis techniques. RA adds value to the traditional approach for studying diffusion of innovation, supporting and extending the IS researcher’s qualitative ‘tool-kit’. In this paper we review an electronic gateway designed to facilitate the diffusion of an Australian government to business [G2B] export documentation system, EXDOC, which was first implemented with meat producers. RA techniques were used to collect and analyse data regarding the implementation of the first regional Electronic Trade Facilitation Center [ETFC] successfully established for Australian exporters in the horticulture sector. The findings from the original EXDOC implementation in the meat sector were confirmed and extended through this study. These include the importance of developing a governance structure that ensures all community members share the benefits of an implementation and the fact that virtual trading communities are attractive to users only if they add value to their business and extend standard ways of operating. Interactive interviews, part of the RA approach; also enabled us to expand our understanding of the way in which procedures developed in the course of implementing an electronic market represent value-adding opportunities for virtual trading communities. The paper has special relevance for researchers investigating adoption and diffusion issues experienced by small-scale producers with low exposure to technology in remote and rural settings.

Development, implementation, and evaluation of a continence education package in acute and subacute care settings

OBJECTIVE: The objective of the study was to trial and evaluate the effect that a discharge Continence Education Package (CEP) had on patients' continence awareness and management preferences.
DESIGN: An exploratory descriptive design was used.
SETTINGS AND SUBJECTS: A total of 631 participants were included in the study: 352 females (55.8%) and 279 males (44.2%) from 4 rural and regional settings in Victoria, Australia.
INSTRUMENTS AND METHODS: A specifically designed questionnaire was used to assess participants' knowledge of incontinence and its management and also to investigate their treatment preferences and intentions if they experienced this type of problem. Data were collected at 2 time periods. Specifically, patients were interviewed before discharge from acute and subacute settings identified as Time 1 (T1). Then the participants were given the CEP and asked to complete a similar questionnaire.
RESULTS: The findings revealed that fewer than 25% of participants had received information on continence before the study being conducted, yet the majority had indicated that they had experienced continence symptoms. The majority of participants found the CEP easy to understand (98.2%) and helpful (95.3%). Most participants said it provided them with information about types of actions to take and/or treatment options for incontinence problems. It also raised their awareness of the signs and symptoms associated with incontinence and provided them with a useful self-administered gauge with which to assess their continence status.
CONCLUSIONS: These findings suggest that the CEP may be a useful educational tool for use in the general population.

AQIS, EXDOC and the 'meaties' : an interpretivist case study of an Australian export documentation system implementation

EXDOC is an on-line export documentation system implemented by the Australian Quarantine Inspection Service [AQIS] and used currently by 90% of meat exporters. At a time when governments world-wide are increasingly committed to introducing electronic service delivery [ESD], this is a timely exemplar of innovative practice. In this paper, we consider the initial implementation of EXDOC in the meat export sector in order to identify the factors that led to the successful adoption of this system.

We consider these factors in the context of diffusion of innovation literature supplemented with Bijker’s social constructivist framework. The theoretical flexibility provided by this combination of approaches enabled us to draw out a number of implications from the data that bear on strategy formulation.

Factors found to have significant bearing on the early adoption of EXDOC included: (1) idiosyncratic factors precipitating the initial implementation (2) the constraints based on accommodating user capabilities (3) the organisational role taken by AQIS (4) diffusion as a self-reinforcing and value-adding effect.

A standard represents both a problem as a requirement of such a system and a problem solving strategy eliciting compliance to the system requirements. Over the period of shaping and stabilizing of the industry standard, AQIS was required to act as facilitator in the coordination of the actors.

The implementation of systems like EXDOC enables users to identify what they want from a system, specifying their preferences and tradeoffs. Such implementations offer opportunities for systems redesign within export business sectors with major strategic implications for the industry.

Time to make a difference: using action research to foster student engagement

This paper reports on a project, funded by the Victorian Department of Education and Training (Australia), undertaken to explore the capacity for teachers to develop innovative teaching and learning strategies aimed at improving the educational experiences of students in the middle years. Central to this charter was the need for local schools to form Clusters, share ideas and develop strategies designed to improve student engagement and connection. In forming the Buxton (pseudonym) Cluster, four schools came together to declare their shared interest in improving student connection through the teaching and learning of mathematics. The 22 teachers involved in the project shared a broad concern that the traditional pedagogies built up around the maths discipline were contributing to the wider level of student disconnection observed in the middle years. In thinking about change, the group were attracted to constructivist approaches to pedagogy in which learning opportunities and tasks are varied sufficiently to appeal to the various learning styles and aptitudes of learners. Favouring an action research framework teachers involved in the project embarked on the implementation of pedagogic reforms aimed at improving levels of student engagement.

Peer mentoring the first time around : Is it all a matter of negotiation?

In 2002, the senior executive at Deakin University sought applications from staff for academic professional development funding. This was intended to support programs related to the Deakin First Year Initiative, a university-wide coordinated approach to transition. The Faculty of Health & Behavioural Sciences was successful in gaining a grant for the design, implementation and evaluation of a peer mentoring pilot program, which has been introduced this year for students undertaking the Bachelor of Applied Science (Health Sciences). This generic undergraduate program draws from and complements the specialist fields of study on offer in the Faculty. It is very flexible, within given parameters, allowing students to combine study according to their interests, abilities and career aspirations. In this session, we will explore the challenges faced so far by the program managers in devising a program that will successfully cater for approximately 50 first year students undertaking diverse majors across the Faculty.

Australian implementation and evaluation of active support

Background The implementation and evaluation of Active Support in Australia is reported, the first such formal evaluation outside the UK.

Method Residents and staff of five group homes participated. Active Support was introduced by training staff in one home at a time. Effectiveness was assessed using direct observation of resident engagement in activity and of staff help, as well as written assessments of resident outcomes.

Results Staff help and resident engagement increased in four of five group homes. There was significantly greater participation in a wider variety of domestic activities, as well as more frequent and varied community participation. Change in resident engagement was positively related to change in staff help, but not related to residents' level of adaptive behaviour.

Conclusions Most of our findings were consistent with earlier UK studies. There was evidence of the successful transfer of Active Support training skills to an Australian training team. Nonsignificant trends towards reduced depression and increased adaptive behaviour warrant further investigation.

Implementation of evidence into practice : Development of a tool to improve emergency nursing care of acute stroke

Background
Stroke is an increasing global health issue that places considerable burden on society and health care services. An important part of acute stroke management and decreasing stroke-related mortality is preventing complications within the first 24–48 hours. The current climate of prolonged time spent in the Emergency Department (ED) means that many aspects of stroke management are now the responsibility of emergency nurses.

Aims
The aims of this paper are to: i) examine the evidence related to nursing care of acute stroke, ii) identify evidence-based elements of stroke care with most applicability to emergency nursing and iii) use evidence-based stroke care recommendations to develop a guideline for the emergency nursing management of acute stroke.

Results
Emergency nursing care of acute stroke should focus on optimal triage decisions, physiological surveillance, fluid management, risk management, and early referral to specialists.

Conclusions
The role of emergency nurses in stroke care will increase and it is important that emergency nurses deliver evidence-based stroke care in order to optimise patient outcomes. Guidelines and decision support tools for use in emergency nursing must be practical and have high levels of clinical utility for maximum uptake in a busy clinical environment.

Extended supervision of sexual offenders in Australia and New Zealand : differences in implementation across jurisdictions

Australia and New Zealand have joined the movement of many Western societies in recent years to address a perceived gap in public safety by passing legislation allowing for extended supervision of sex offenders in the community after their release from prison. The Australian State of Victoria passed a law similar to that of New Zealand, and both laws have now been in effect for a similar period of time. Yet despite having comparable laws and approximately comparable base populations, there have been 145 extended supervision orders imposed in New Zealand and 20 such orders in Victoria. This article examines the differences in implementation and the underlying procedures used in the two jurisdictions to understand these very different outcomes. Implications for professional practice, ethics, public safety, and policy development are discussed.

Low-sodium dietary approaches to stop hypertension-type diet including lean red meat lowers blood pressure in postmenopausal women

Low-sodium Dietary Approaches to Stop Hypertension (DASH) diets are base producing but restrict red meat without clear justification. We hypothesized that a vitality diet (VD), a low-sodium DASH-type diet with a low dietary acid load containing 6 servings of 100 g cooked lean red meat per week, would be more effective in reducing blood pressure (BP) compared with a higher acid load reference healthy diet (RHD) based on general dietary guidelines to reduce fat intake and increase intake of breads and cereals. A randomized, parallel dietary intervention study was conducted to compare the BP-lowering effect of these 2 diets in postmenopausal women with high/normal BP. Women were randomly assigned to follow either VD or RHD for 14 weeks. Home BP was measured daily with an automated BP monitor under standard conditions. Of 111 women commencing the study, 95 completed (46 VD, 49 RHD). Systolic BP (SBP) throughout the intervention was lower in the VD group compared to the RHD group (repeated-measures analysis of variance time by diet, P = .04), such that at the end of the study, the VD had a fall of SBP by 5.6 ± 1.3 mm Hg (mean ± SEM) compared with a fall of 2.7 ± 1.0 mm Hg in the RHD (group difference, P = .08). When only those taking antihypertensive medications were assessed, the VD (n = 17) had a significant fall of 6.5 ± 2.5 mm Hg SBP (P = .02) and 4.6 ± 1.4 mm Hg diastolic BP (P = .005) after 14 weeks, and their BP was lower than that of the RHD group (n = 18) throughout the study (P < .05). We concluded that a low-sodium DASH diet with a low dietary acid load, which also included lean red meat on most days of the week, was effective in reducing BP in older women, particularly in those taking antihypertensive medications.

Power and politics in a system implementation

The central concern of this study is to identify the role of power and politics in systems implementation. The current literature on systems implementation is typically divided into two areas, process modelling and factor based studies. Process modelling classifies the implementation into a linear process, whereas factor based studies have argued that in order to ‘successfully’ implement a system, particular critical factors are required. This literature misses the complexities involved in systems implementation through the human factors and political nature of systems implementation and is simplistic in its nature and essentially de-contextualises the implementation process. Literature has investigated some aspects of human factors in systems implementation. However, it is believed that these studies have taken a simplistic view of power and politics. It is argued in this thesis that human factors in systems implementation are constantly changing and essentially operating in a dynamic relationship affecting the implementation process. The concept of power relations, as proposed by Foucault (1976, 1977, 1978, 1980, 1982), have been utilised in order to identify the dynamic nature of power and politics. Foucault (1978) argued that power is a dynamic set of relationships constantly changing from one point in time to the next. It is this recognition that is lacking from information systems. Furthermore, these power relations are created through the use of discourse. Discourse represents meaning and social relationships, forming both subjectivity and power relations. Discourses are also the practices of talk, text and argument that continuously form that which actors speak. A post-structuralist view of power as both an obvious and hidden concept has provided the researcher a lens through which the selection and implementation of an enterprise-wide learning management system can be observed. The framework aimed to identify the obvious process of system selection implementation, and then deconstruct that process to expose the hegemonic nature of policy, the reproduction of organisational culture, the emancipation within discourse, and the nature of resistance and power relations. A critical case study of the selection and implementation of an enterprise-wide learning management system at the University of Australia was presented providing an in-depth investigation of the implementation of an enterprise-wide learning management system, spanning five years. This critical case study was analysed using social dramas to distinguish between the front stage issues of power and the hidden discourses underpinning the front stage dramas. The enterprise-wide learning management system implemented in the University of Australia in 2003 is a system which enables academic staff to manage learners, the students, by keeping track of their progress and performance across all types of training activities. Through telling the story of the selection and implementation of an enterprise-wide learning management system at the University of Australia discourses emerged. The key findings from this study have indicated that the system selection and implementation works at two levels. The low level is the selection and implementation process, which operates for the period of the project. The high level is the arena of power and politics, which runs simultaneously to the selection and implementation process. Challenges for power are acted out in the front stage, or public forums between various actors. The social dramas, as they have been described here, are superfluous to the discourse underpinning the front stage. It is the discourse that remains the same throughout the system selection and implementation process, but it is through various social dramas that reflect those discourses. Furthermore, the enactment of policy legitimises power and establishes the discourse, limiting resistance. Additionally, this research has identified the role of the ‘State’ and its influence at the organisational level, which had been previously suggested in education literature (Ball, 1990).

Kernel performance in meeting hard real-time system characteristics (the ARTOS real-time kernel)

Describes the design and implementation of an operating system kernel specifically designed to support real-time applications. It emphasises portability and aims to support state-of-the-art concepts in real-time programming. Discusses architectural aspects of the ARTOS kernel, and introduces new concepts on the areas of interrupt processing, scheduling, mutual exclusion and inter-task communication. Also explains the programming environment of ARTOS kernal and its task model, defines the real-time task states and system data structures and discusses exception handling mechanisms which are used to detect missed deadlines and take corrective action.

ID scanners in the night time economy

ID scanners are quickly emerging as a new technological fix to long-standing problems of security and safety within licensed venues. Yet at this point in time detailed research of this rapidly expanding security technology is remarkably limited. To address this analytical deficit we are currently examining the uptake of ID scanners in licensed venues operating in the night-time economy. We have found significant interest in the implementation of ID scanners in other Australian cities. However, the introduction of ID scanners in late-night licensed venues has occurred with little public awareness, no policy consideration and questionable claims concerning their effectiveness in enhancing safety and reducing crime. This article explores the factors shaping the introduction of ID scanners and the underlying beliefs concerning their utility as a crime prevention technology. The article then considers some broader implications to be explored in future analyses.

Implementation and applications of the distortion operator

The distortion operator transforms 2D images in a manner similar to image warping or morphing, allowing source pixels to be mapped to any destination pixel. This operator can be implemented on current hardware, allowing at least one distortion per frame at interactive frame rates. Potential applications are numerous, but those described include re-mapping images for correct projection onto curved screens, correcting camera distortion from multiple sources simultaneously, and allowing constant time dynamic texturing and lighting of a static scene which is independent of geometric complexity.

The development of a generic framework for the implementation of a cheap, component-based virtual video-conferencing system

We address the problem of virtual-videoconferencing. The proposed solution is effected in terms of a generic framework based on an in-house Virtual Reality system. The framework is composed of a number of distinct components: model acquisition, head tracking, expression analysis, network transmission and avatar reconstruction. The framework promises to provide a unique, cheap, and fast system for avatar construction, transmission and animation. This approach affords a conversion from the traditional video stream approach to the management of an avatar remotely and consequently makes minimal demands on network resources.