The Early Prevention of Obesity in CHildren (EPOCH) collaboration : an individual patient data prospective meta-analysis

Background: Efforts to prevent the development of overweight and obesity have increasingly focused early in the life course as we recognise that both metabolic and behavioural patterns are often established within the first few years of life. Randomised controlled trials (RCTs) of interventions are even more powerful when, with forethought, they are synthesised into an individual patient data (IPD) prospective meta-analysis (PMA). An IPD PMA is a unique research design where several trials are identified for inclusion in an analysis before any of the individual trial results become known and the data are provided for each randomised patient. This methodology minimises the publication and selection bias often associated with a retrospective meta-analysis by allowing hypotheses, analysis methods and selection criteria to be specified a priori. Methods/Design: The Early Prevention of Obesity in CHildren (EPOCH) Collaboration was formed in 2009. The main objective of the EPOCH Collaboration is to determine if early intervention for childhood obesity impacts on body mass index (BMI) z scores at age 18-24 months. Additional research questions will focus on whether early intervention has an impact on children’s dietary quality, TV viewing time, duration of breastfeeding and parenting styles. This protocol includes the hypotheses, inclusion criteria and outcome measures to be used in the IPD PMA. The sample size of the combined dataset at final outcome assessment (approximately 1800 infants) will allow greater precision when exploring differences in the effect of early intervention with respect to pre-specified participant- and intervention-level characteristics. Discussion: Finalisation of the data collection procedures and analysis plans will be complete by the end of 2010. Data collection and analysis will occur during 2011-2012 and results should be available by 2013. Trial registration number: ACTRN12610000789066

Tyrosine monitoring in children with early and continuously treated phenylketonuria: Results of an international practice survey

Investigations into the biochemical markers associated with executive function (EF) impairment in children with early and continuously treated phenylketonuria (ECT-PKU) remain largely phenylalanine-only focused, despite experimental data showing that a high phenylalanine:tyrosine (phe:tyr) ratio is more strongly associated with EF deficit than phe alone. A high phe:tyr ratio is hypothesized to lead to a reduction in dopamine synthesis within the brain, which in turn results in the development of EF impairment. This paper provides a snapshot of current practice in the monitoring and/or treatment of tyrosine levels in children with PKU, across 12 countries from Australasia, North America and Europe. Tyrosine monitoring in this population has increased over the last 5 years, with over 80% of clinics surveyed reporting routine monitoring of tyrosine levels in infancy alongside phe levels. Twenty-five percent of clinics surveyed reported actively treating/managing tyrosine levels (with supplemental tyrosine above that contained in PKU formulas) to ensure tyrosine levels remain within normal ranges. Anecdotally, supplemental tyrosine has been reported to ameliorate symptoms of both attention deficit hyperactivity disorder and depression in this population. EF assessment of children with ECT-PKU was likewise highly variable, with 50% of clinics surveyed reporting routine assessments of intellectual function. However when function was assessed, test instruments chosen tended towards global measures of IQ prior to school entry, rather than specific assessment of EF development. Further investigation of the role of tyrosine and its relationship with phe and EF development is needed to establish whether routine tyrosine monitoring and increased supplementation is recommended.

The social work & human services workforce : report from a national study of education, training and workforce needs

This report analyses the national curriculum and workforce needs of the social work and human services workforce. Australia’s community and health services are among the fastest growing sectors of employment in the nation but the sustainability of an appropriately qualified workforce is threatened. Yet there is little integration of education and workforce planning for the community services sector. This contrasts markedly with the health services sector, where key stakeholders are collaboratively addressing workforce challenges. Our research confirmed rapid growth in the social work and human services workforce and it also identified: • an undersupply of professionally qualified social work and human service practitioners to meet workforce demand; • the rapid ageing of the workforce with many workers approaching retirement; • limited career and salary structures creating disincentives to retention; • a highly diverse qualification base across the workforce. This diversity is inconsistent with the specialist knowledge and skills required of practitioners in many domains of community service provision. Our study revealed a lack of co-ordination across VET and higher education to meet the educational needs of the social work and human services workforce. Our analysis identified: • strong representation of equity groups in social work and related human service programs, although further participation of these groups is still needed; • the absence of clear articulation pathways between VET and higher education programs due the absence of co-ordination and planning between these sectors; • substantial variation in the content of the diverse range of social work and human service programs, with accredited programs conforming to national standards and some others in social and behavioural sciences lacking any external validation; • financial obstacles and disincentives to social work and human service practitioners in achieving postgraduate level qualifications. We recommend that: • DEEWR identify accredited social work and human services courses as a national education priority (similar to education and nursing). This will help ensure the supply of professional workers to this sector; • VET and higher education providers are encouraged to collaboratively develop clear and accessible educational pathways across the educational sectors; • DEEWR undertake a national workforce analysis and planning processes in collaboration with CSDMAC, and all social and community services stakeholders, to ensure workforce sustainability; and • COAG develop a national regulation framework for the social and community services workforce. This would provide sound accountability systems, and rigorous practice and educational standards necessary for quality service provision. It will also ensure much needed public confidence in this workforce.

Assessment of the influence of cultural barriers to HDR supervision of non-English speaking background (NESD) students in engineering and information technology (IT) disciplines

The paper details the results of the first phase of an on-going research into the sociocultural factors that influence the supervision of higher degrees research (HDR) engineering students in the Faculty of Built Environment and Engineering (BEE) and Faculty of Science and Technology (FaST) at Queensland University of Technology. A quantitative analysis was performed on the results from an online survey that was administered to 179 engineering students. The study reveals that cultural barriers impact their progression and developing confidence in their research programs. We argue that in order to assist international and non-English speaking background (NESB) research students to triumph over such culturally embedded challenges in engineering research, it is important for supervisors to understand this cohort's unique pedagogical needs and develop intercultural sensitivity in their pedagogical practice in postgraduate research supervision. To facilitate this, the governing body (Office of Research) can play a vital role in not only creating the required support structures but also their uniform implementation across the board.

Enhancing the transition of commencing students into university : an institution-wide approach

The importance of the first year experience (FYE) to success at university is well documented and supported with the transition into university regarded as crucial. While there is also support for the notion that a successful FYE should have a whole-of-institution focus and models have been proposed, many institutions still face challenges in achieving institution-wide FYE program implementation. This paper discusses the origins, theoretical and empirical bases and structure of an institution-wide approach to the FYE. It uses a case study of the Transitions In Project (TIP) at the Queensland University of Technology to illustrate how institution-wide FYE program implementation can be achieved and sustained. TIP had four inter-related projects focussing on at-risk students, first year curriculum, learning resources and staff development. The key aim of TIP was to identify good practice and institutionalise it in a sustainable way. The degree of success in achieving this is evaluated.

Older adults’ safety perceptions of driving situations: Towards a new driving self-regulation scale

The term ‘driving self-restriction’ is used in the road safety literature to describe the behaviour of some older drivers. It includes the notion that older drivers will avoid driving in specific, usually self-identified situations, such as those in which safety is compromised. We sought to identify the situations that older drivers report avoiding; and, to determine the adequacy of a key measure of such behaviour. A sample of 75 drivers aged 65 years and older completed Baldock et al.’s modification of the Driving Habits Questionnaire avoidance items (Baldock et al., 2006), the Driving Behaviour Questionnaire, and open-ended items that elicited written descriptions of the most and least safe driving situation. Consistent with previous results, we found a relatively low level of driving self-restriction and infrequent episodes of aggressive violations. However, when combined with the situation descriptions, these data suggest that Driving Habits Questionnaire did not cover all of the situations that older drivers might choose avoid. We suggest that a new avoidance scale is needed and we present a new item pool that may be used for this purpose.

The novice researcher : interviewing young children

Being a novice researcher undertaking research interviews with young children requires understandings of the interview process. By investigating the interaction between a novice researcher undertaking her first interview and a child participant, we attend to theoretical principles, such as the competence of young children as informants, and highlight practical matters when interviewing young children. A conversation analysis approach examines the talk preceding and following a sticker task. By highlighting the conversational features of a research interview, researchers can better understand the co-constructed nature of the interview. This paper provides insights into how to prepare for the interview and manage the interview context to recognize the active participation of child participants, and the value of artifacts to promote interaction. These insights make more transparent the interactional process of a research interview and become part of the researcher’s collection of devices to manage the conduct of research interviews.

Alexithymia in alcohol dependent patients is partially mediated by alcohol expectancy

Background: Up to fifty percent of alcohol dependent individuals have alexithymia, a personality trait characterised by difficulties identifying and describing feelings, a lack of imagination and an externalised cognitive style. Although studies have examined alexithymia in relation to alcohol dependence, no research exists on mechanisms underlying this relationship. The present study examined the mediational effect of alcohol expectancies on alexithymia and alcohol dependence.----- ----- Methods: 230 outpatients completed the Toronto Alexithymia Scale (TAS-20), the Drinking Expectancy Questionnaire (DEQ) and the Alcohol Use Disorder Identification Test (AUDIT). Results: Regression analysis showed that alexithymia and alcohol dependence was, in two of three cases, partially mediated through alcohol expectancy.----- ----- Conclusions: Alcohol expectancies of assertion and affective change show promise as mediators of alcohol dependence in individuals with alexithymia.

Good practice for enhancing the engagement and success of commencing students

There is widespread recognition that higher education institutions (HEIs) must actively support commencing students to ensure equity in access to the opportunities afforded by higher education. This role is particularly critical for students who because of educational, cultural or financial disadvantage or because they are members of social groups currently under-represented in higher education, may require additional transitional support to “level the playing field.” The challenge faced by HEIs is to provide this “support” in a way that is integrated into regular teaching and learning practices and reaches all commencing students. The Student Success Program (SSP) is an intervention in operation at the Queensland University of Technology (QUT) designed to identify and support those students deemed to be at risk of disengaging from their learning and their institution. Two sets of evidence of the impact of the SSP are presented: First, its expansion (a) from a one-faculty pilot project (Nelson, Duncan & Clarke, 2009) to all faculties and (b) into a variety of applications mirroring the student life cycle; and second, an evaluation of the impact of the SSP on students exposed to it. The outcomes suggest that: the SSP is an example of good practice that can be successfully applied to a variety of learning contexts and student enrolment situations; and the impact of the intervention on student persistence is sustained for at least 12 months and positively influences student retention. It is claimed that the good practice evidenced by the SSP is dependent on its integration into the broader First Year Experience Program at QUT as an example of transition pedagogy in action.

Goreen Narrkwarren Ngrn-tuora : healthy family air : a literature review

This paper will focus on the literature review for Goreen Narrkwarren Ngrn-toura- Healthy Family Air, formerly known as Reducing smoking amongst pregnant Aboriginal women in Victoria: An Holistic Approach. Before we outline the findings from the literature review, we will provide some background information on the project, including why it is important and what and who are involved.

The experience of xenophobia in South Africa

In May 2008, xenophobic violence erupted in South Africa. The targets were individuals who had migrated from the north in search of asylum. Emerging first in township communities around Johannesburg, the aggression spread to other provinces. Sixty-two people died, and 100,000 (20,000 in the Western Cape alone) were displaced. As the attacks escalated across the country, thousands of migrants searched for refuge in police stations and churches. Chilling stories spread about mobs armed with axes, metal bars, and clubs. The mobs stormed from shack to shack, assaulted migrants, locked them in their homes, and set the homes on fire. The public reaction was one of shock and horror. The Los Angeles Times declared, “Migrants Burned Alive in S. Africa.” The South African president at the time, Thabo Mbeki, called for an end to “shameful and criminal attacks.” Commentators were stunned by the signs of hatred of foreigners (xenophobia) that emerged in the young South African democracy. The tragedy of the violence in South Africa was magnified by the fact that many of the victims had fled from violence and persecution in their countries of origin. Amid genocidal violations of human rights that had recently occurred in some countries in sub- Saharan Africa, the new South Africa stood as a beacon of democracy and respect for human dignity. With this openness in mind, many immigrants to South Africa sought safety and refuge from the conflicts in their homelands. More than 43,500 refugees and 227,000 asylum seekers now live in South Africa. The majority of people accorded refugee status came from Burundi, Democratic Republic of Congo, and Somalia. South Africa also hosts thousands of other migrants who remain undocumented.

Predicting single-vehicle fatal crashes for two-lane rural highways in Southeastern United States

The rural two-lane highway in the southeastern United States is frequently associated with a disproportionate number of serious and fatal crashes and as such remains a focus of considerable safety research. The Georgia Department of Transportation spearheaded a regional fatal crash analysis to identify various safety performances of two-lane rural highways and to offer guidance for identifying suitable countermeasures with which to mitigate fatal crashes. The fatal crash data used in this study were compiled from Alabama, Georgia, Mississippi, and South Carolina. The database, developed for an earlier study, included 557 randomly selected fatal crashes from 1997 or 1998 or both (this varied by state). Each participating state identified the candidate crashes and performed physical or video site visits to construct crash databases with enhance site-specific information. Motivated by the hypothesis that single- and multiple-vehicle crashes arise from fundamentally different circumstances, the research team applied binary logit models to predict the probability that a fatal crash is a single-vehicle run-off-road fatal crash given roadway design characteristics, roadside environment features, and traffic conditions proximal to the crash site. A wide variety of factors appears to influence or be associated with single-vehicle fatal crashes. In a model transferability assessment, the authors determined that lane width, horizontal curvature, and ambient lighting are the only three significant variables that are consistent for single-vehicle run-off-road crashes for all study locations.

Long term immunity to live attenuated Japanese encephalitis chimeric virus vaccine : randomized, double-blind, 5-year phase II study in healthy adults.

In a randomized, double-blind study, 202 healthy adults were randomized to receive a live, attenuated Japanese encephalitis chimeric virus vaccine (JE-CV) and placebo 28 days apart in a cross-over design. A subgroup of 98 volunteers received a JE-CV booster at month 6. Safety, immunogenicity, and persistence of antibodies to month 60 were evaluated. There were no unexpected adverse events (AEs) and the incidence of AEs between JE-CV and placebo were similar. There were three serious adverse events (SAE) and no deaths. A moderately severe case of acute viral illness commencing 39 days after placebo administration was the only SAE considered possibly related to immunization. 99% of vaccine recipients achieved a seroprotective antibody titer ≥ 10 to JE-CV 28 days following the single dose of JE-CV, and 97% were seroprotected at month 6. Kaplan Meier analysis showed that after a single dose of JE-CV, 87% of the participants who were seroprotected at month 6 were still protected at month 60. This rate was 96% among those who received a booster immunization at month 6. 95% of subjects developed a neutralizing titer ≥ 10 against at least three of the four strains of a panel of wild-type Japanese encephalitis virus (JEV) strains on day 28 after immunization. At month 60, that proportion was 65% for participants who received a single dose of JE-CV and 75% for the booster group. These results suggest that JE-CV is safe, well tolerated and that a single dose provides long-lasting immunity to wild-type strains

Concomitant or sequential administration of live attenuated Japanese encephalitis chimeric virus vaccine and yellow fever 17D vaccine : randomized double-blind phase II evaluation of safety and immunogenicity

A randomized, double-blind, study was conducted to evaluate the safety, tolerability and immunogenicity of a live attenuated Japanese encephalitis chimeric virus vaccine (JE-CV) co-administered with live attenuated yellow fever (YF) vaccine (YF-17D strain; Stamaril(®), Sanofi Pasteur) or administered successively. Participants (n = 108) were randomized to receive: YF followed by JE-CV 30 days later, JE followed by YF 30 days later, or the co-administration of JE and YF followed or preceded by placebo 30 days later or earlier. Placebo was used in a double-dummy fashion to ensure masking. Neutralizing antibody titers against JE-CV, YF-17D and selected wild-type JE virus strains was determined using a 50% serum-dilution plaque reduction neutralization test. Seroconversion was defined as the appearance of a neutralizing antibody titer above the assay cut-off post-immunization when not present pre-injection at day 0, or a least a four-fold rise in neutralizing antibody titer measured before the pre-injection day 0 and later post vaccination samples. There were no serious adverse events. Most adverse events (AEs) after JE vaccination were mild to moderate in intensity, and similar to those reported following YF vaccination. Seroconversion to JE-CV was 100% and 91% in the JE/YF and YF/JE sequential vaccination groups, respectively, compared with 96% in the co-administration group. All participants seroconverted to YF vaccine and retained neutralizing titers above the assay cut-off at month six. Neutralizing antibodies against JE vaccine were detected in 82-100% of participants at month six. These results suggest that both vaccines may be successfully co-administered simultaneously or 30 days apart.

Alexithymia, craving and attachment in a heavy drinking population

Up to fifty per cent of individuals with Alcohol use disorders (AUD) also have alexithymia a personality construct hypothesized to be related to attachment difficulties. The relationship between alexithymia, craving, anxious attachment and alcohol-dependence severity was examined in 254 patients participating in a Cognitive-Behavioral Therapy (CBT) program for alcohol-dependence. Participants completed the Toronto Alexithymia Scale (TAS-20), the Obsessive Compulsive Drinking Scale (OCDS), the Revised Adult Attachment Anxiety Subscale (RAAS-Anxiety) and the Alcohol Use Disorder Identification Test (AUDIT). MANOVA indicated that individuals with alexithymia reported significantly higher levels of total OCDS, obsessive thoughts about alcohol, and compulsive drinking urges and behavior, compared to the non-alexithymic group. Regression analyses found that anxious attachment partially mediated the relationship between alexithymia and craving. Anxious attachment may be a potential treatment target to reduce alcohol consumption in those with alcohol-dependence and alexithymia. Research Highlights ► There were significant relationships of alexithymia, craving and anxious attachment. ► Alexithymic alcoholics reported higher levels of craving and alcoholism severity. ► Anxious attachment partially mediated the relationship of alexithymia and craving.