Peer-led diabetes self-management programme for community-dwelling older people in China : study protocol for a quasi-experimental design

Aim. A protocol for a new peer-led self-management programme for communitydwelling older people with diabetes in Shanghai, China. Background. The increasing prevalence of type 2 diabetes poses major public health challenges. Appropriate education programmes could help people with diabetes to achieve self-management and better health outcomes. Providing education programmes to the fast growing number of people with diabetes present a real challenge to Chinese healthcare system, which is strained for personnel and funding shortages. Empirical literature and expert opinions suggest that peer education programmes are promising. Design. Quasi-experimental. Methods. This study is a non-equivalent control group design (protocol approved in January, 2008). A total of 190 people, with 95 participants in each group, will be recruited from two different, but similar, communities. The programme, based on Social Cognitive Theory, will consist of basic diabetes instruction and social support and self-efficacy enhancing group activities. Basic diabetes instruction sessions will be delivered by health professionals, whereas social support and self-efficacy enhancing group activities will be led by peer leaders. Outcome variables include: self-efficacy, social support, self-management behaviours, depressive status, quality of life and healthcare utilization, which will be measured at baseline, 4 and 12 weeks. Discussion. This theory-based programme tailored to Chinese patients has potential for improving diabetes self-management and subsequent health outcomes. In addition, the delivery mode, through involvement of peer leaders and existing community networks,is especially promising considering healthcare resource shortage in China.

A reliable real-time transport protocol for control systems over wireless networks

Deploying networked control systems (NCSs) over wireless networks is becoming more and more popular. However, the widely-used transport layer protocols, Transmission Control Protocol (TCP) and User Datagram Protocol (UDP), are not designed for real-time applications. Therefore, they may not be suitable for many NCS application scenarios because of their limitations on reliability and/or delay performance, which real-control systems concern. Considering a typical type of NCSs with periodic and sporadic real-time traffic, this paper proposes a highly reliable transport layer protocol featuring a packet loss-sensitive retransmission mechanism and a prioritized transmission mechanism. The packet loss-sensitive retransmission mechanism is designed to improve the reliability of all traffic flows. And the prioritized transmission mechanism offers differentiated services for periodic and sporadic flows. Simulation results show that the proposed protocol has better reliability than UDP and improved delay performance than TCP over wireless networks, particularly when channel errors and congestions occur.

The magic of numbers and the amazing disappearing act : the politics of counting youth homelessness

No-one wants to see young people who are no longer able to stay at home with their parents living in situations that are neither stable nor safe. Most Australians also appreciate that youth homelessness is typically a result of factors beyond the control of young people like poverty, lack of affordable housing, parental divorce or separation, family conflict and violence, sexual abuse, or mental health problems.1 Since the Burdekin Report of 1989 first put the issue on the national agenda, youth homelessness has been a point of some political sensitivity as the numbers of young homeless stayed stubbornly high through the 1990s and into the 2000s.

Calling for help : a responsive evaluation of Child Health Line

The project examined the responsiveness of the telenursing service provided by the Child Health Line (hereinafter referred to as CHL). It aimed to provide an account of population usage of the service, the call request types and the response of the service to the calls. In so doing, the project extends the current body of knowledge pertaining to the provision of parenting support through telenursing. Approximately 900 calls to the CHL were audio-recorded over the December 2005-2006 Christmas-New Year period. A protocol was developed to code characteristics of the call, the interactional features between the caller and nurse call-taker, and the extent to which there was (a) agreement on problem definition and the plan of action and (b) interactional alignment between nurse and caller. A quantitative analysis examined the frequencies of the main topics covered in calls to the CHL and any statistical associations between types of calls, length of calls and nurse-caller alignment. In addition, a detailed qualitative analysis was conducted on a subset of calls dealing with the nurse management of calls seeking medical advice and information. Key findings include: • Overall, 74% of the calls discussed parenting and child development issues, 48% discussed health/medical issues, and 16% were information-seeking calls. • More specifically: o 21% discussed health/medical and parenting and child development issues. o 3% discussed parenting and information-seeking issues. o 5% discussed health/medical, parenting/development and information issues. o 18% exclusively focussed on health and medical issues and therefore were outside the remit of the intended scope of the CHL. These calls caused interactional dilemmas for the nurse call-takers as they simultaneously dealt with parental expectations for help and the CHL guidelines indicating that offering medical advice was outside the remit of the service. • Most frequent reasons for calling were to discuss sleep, feeding, normative infant physical functions and parenting advice. • The average length of calls to the CHL was 7 minutes. • Longer calls were more likely to involve nurse call-takers giving advice on more than one topic, the caller displaying strong emotions, the caller not specifically providing the reason for the call, and the caller discussing parenting and developmental issues. • Shorter calls were characterised by the nurse suggesting that the child receive immediate medical attention, the nurse emphasising the importance or urgency of the plan of action, the caller referring to or requesting confirmation of a diagnosis, and caller and nurse call-taker discussion of health and medical issues. • The majority of calls, 92%, achieved parent-nurse alignment by the conclusion of the call. However, 8% did not. • The 8% of calls that were not aligned require further quantitative and qualitative investigation of the interactional features. The findings are pertinent in the current context where Child Health Line now resides within 13HEALTH. These findings indicate: 1. A high demand for parenting advice. 2. Nurse call-takers have a high level of competency in dealing with calls about parenting and normal child development, which is the remit of the CHL. 3. Nurse call-takers and callers achieve a high degree of alignment when both parties agree on a course of action. 4. There is scope for developing professional practice in calls that present difficulties in terms of call content, interactional behaviour and call closure. Recommendations of the project: 1. There are numerous opportunities for further research on interactional aspects of calls to the CHL, such as further investigations of the interactional features and the association of the features to alignment and nonalignment. The rich and detailed insights into the patterns of nurse-parent interactions were afforded by the audio-recording and analysis of calls to the CHL. 2. The regular recording of calls would serve as a way of increasing understanding of the type and nature of calls received, and provide a valuable training resource. Recording and analysing calls to CHL provides insight into the operation of the service, including evidence about the effectiveness of triaging calls. 3. Training in both recognising and dealing with problem calls may be beneficial. For example, calls where the caller showed strong emotion, appeared stressed, frustrated or troubled were less likely to be rated as aligned calls. In calls where the callers described being ‘at their wits end’, or responded to each proposed suggestion with ‘I’ve tried that’, the callers were fairly resistant to advice-giving. 4. Training could focus on strategies for managing calls relating to parenting support and advice, and parental well-being. The project found that these calls were more likely to be rated as being nonaligned. 5. With the implementation of 13HEALTH, future research could compare nurse-parent interaction following the implementation of triaging. Of the calls, 21% had both medical and parenting topics discussed and 5.3% discussed medical, parenting and information topics. Added to this, in 12% of calls, there was ambiguity between the caller and nurse call-taker as to whether the problem was medical or behavioural.

Towards a secure human-and-computer mutual authentication protocol

We blend research from human-computer interface (HCI) design with computational based crypto- graphic provable security. We explore the notion of practice-oriented provable security (POPS), moving the focus to a higher level of abstraction (POPS+) for use in providing provable security for security ceremonies involving humans. In doing so we high- light some challenges and paradigm shifts required to achieve meaningful provable security for a protocol which includes a human. We move the focus of security ceremonies from being protocols in their context of use, to the protocols being cryptographic building blocks in a higher level protocol (the security cere- mony), which POPS can be applied to. In order to illustrate the need for our approach, we analyse both a protocol proven secure in theory, and a similar proto- col implemented by a �nancial institution, from both HCI and cryptographic perspectives.

Interventions for preventing abuse in the elderly (protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows:The primary objective of the review is to assess the effectiveness of primary, secondary and tertiary intervention programmes utilised to reduce or prevent, or both, elderly abuse in organisational, institutional and community settings. We will also identify and report on adverse consequences or effects of the intervention/s in the review.The secondary objective is to investigate whether intervention?s effects are modified by types of abuse, types of participants, setting of intervention or cognitive status of the elderly.

Family-based programmes for preventing smoking by children and adolescents (Protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows: To assess the effectiveness of interventions to help family members strengthen non-smoking attitudes and promote non-smoking by children and other family members by identifying and assessing RCT's that provide training, skills and support to family members to prevent smoking initiation. Hypothesis: This is an exploratory review, and only one hypothesis based on the literature review will be tested: "Interventions to help family members strengthen non-smoking attitudes and promote non-smoking by children and other family members are more effective in preventing children starting smoking than no intervention."

Tech-Savvy Youth and Participatory Research in “iScapes”

This chapter provides a theoretically and empirically grounded discussion of participatory research methodologies with respect to investigating the dynamic and evolving phenomenon of young people constructing identities and social relations in “iScapes”. We coin the term iScapes to refer to the online/offline interconnectedness of spaces in the fabric of everyday life. Specifically, we offer a critical analysis of the participatory research methods we used in our own research project to understand the ways in which high school students use new media and information communication technologies (ICTs) to construct identities, form social relations, and engage in creative practices as part of their everyday lives. The chapter concludes with reflexive deliberations on our approach to participatory research that may benefit other researchers who share a similar interest in youth and new media.

Kerberos based security system for session initiation protocol

Session Initiation Protocol (SIP) is developed to provide advanced voice services over IP networks. SIP unites telephony and data world, permitting telephone calls to be transmitted over Intranets and Internet. Increase in network performance and new mechanisms for guaranteed quality of service encourage this consolidation to provide toll cost savings. Security comes up as one of the most important issues when voice communication and critical voice applications are considered. Not only the security methods provided by traditional telephony systems, but also additional methods are required to overcome security risks introduced by the public IP networks. SIP considers security problems of such a consolidation and provides a security framework. There are several security methods defined within SIP specifications and extensions. But, suggested methods can not solve all the security problems of SIP systems with various system requirements. In this thesis, a Kerberos based solution is proposed for SIP security problems, including SIP authentication and privacy. The proposed solution tries to establish flexible and scalable SIP system that will provide desired level of security for voice communications and critical telephony applications.

Ingenious : Emerging Youth Cultures in Urban Australia

The book documents new findings on the contribution of migrant young people to Australia’s urban life. The essays collected traces teenagers within a world of city suburbs and P plates, shopping malls and chat rooms and text messages. Proud of their migrant backgrounds, they are moving away from explicit ethnically defined cultural groups to focus on their place in contemporary Australian society. These young people through their every day activities are redefining what it means to be an Australian The book is edited by widely published cultural researchers Melissa Butcher from the University of Sydney and Mandy Thomas from the Australian National University who together worked on the GENERATE project. It is far too common for our youth to be portrayed as not belonging to our dominant or mainstream culture. In Ingenious, the editors study the kaleidoscope of influences and environments our youth move within - online networks, dance parties and more - to paint a flexible, innovative generation.

Interpersonal coordination tendencies shape 1-vs-1 sub-phase performance outcomes in youth soccer

This study investigated the influence of interpersonal coordination tendencies on performance outcomes of 1-vs-1 subphases in youth soccer. Eight male developing soccer players (age: 11.8+0.4 years; training experience: 3.6+1.1 years) performed an in situ simulation of a 1-vs-1 sub-phase of soccer. Data from 82 trials were obtained with motion-analysis techniques, and relative phase used to measure the space-time coordination tendencies of attacker-defender dyads. Approximate entropy (ApEn) was then used to quantify the unpredictability of interpersonal interactions over trials. Results revealed how different modes of interpersonal coordination emerging from attacker-defender dyads influenced the 1-vs-1 performance outcomes. High levels of space-time synchronisation (47%) and unpredictability in interpersonal coordination processes (ApEn: 0.91+0.34) were identified as key features of an attacking player’s success. A lead-lag relation attributed to a defending player (34% around 7308 values) and a more predictable coordination mode (ApEn: 0.65+0.27, P50.001), demonstrated the coordination tendencies underlying the success of defending players in 1-vs-1 sub-phases. These findings revealed how the mutual influence of each player on the behaviour of dyadic systems shaped emergent performance outcomes. More specifically, the findings showed that attacking players should be constrained to exploit the space-time synchrony with defenders in an unpredictable and creative way, while defenders should be encouraged to adopt postures and behaviours that actively constrain the attacker’s actions.

Risk-taking, harm and help-seeking : reported by young people in treatment at a youth alcohol and drug counselling service

Regarded as a normative component of development, risk-taking by young people is a well-researched subject, and some risk-taking behaviours, such as substance use, are particularly well covered because of their potential to adversely affect health and wellbeing. What has remained unclear is the extent of young people's risk-taking while engaged in alcohol and other drug (AOD) treatment, their awareness of the related harms of risk-taking behaviours, and their prior help-seeking for these harms - information which may have a significant impact on the quality and relevance of the care they receive. This paper reports the findings from a brief pilot study exploring those factors in a clinical sample of young people engaged in ongoing AOD counselling.

Changes in Knee Biomechanics After a Hip-Abductor Strengthening Protocol for Runners With Patellofemoral Pain Syndrome

Context: Very few authors have investigated the relationship between hip-abductor muscle strength and frontal-plane knee mechanics during running. Objective: To investigate this relationship using a 3-week hip-abductor muscle-strengthening program to identify changes in strength, pain, and biomechanics in runners with patellofemoral pain syndrome (PFPS). Design: Cohort study. Setting: University-based clinical research laboratory. Patients or Other Participants: Fifteen individuals (5 men, 10 women) with PFPS and 10 individuals without PFPS (4 men, 6 women) participated. Intervention(s): The patients with PFPS completed a 3-week hip-abductor strengthening protocol; control participants did not. Main Outcome Measure(s): The dependent variables of interest were maximal isometric hip-abductor muscle strength, 2-dimensional peak knee genu valgum angle, and stride-to-stride knee-joint variability. All measures were recorded at baseline and 3 weeks later. Between-groups differences were compared using repeated-measures analyses of variance. Results: At baseline, the PFPS group exhibited reduced strength, no difference in peak genu valgum angle, and increased stride-to-stride knee-joint variability compared with the control group. After the 3-week protocol, the PFPS group demonstrated increased strength, less pain, no change in peak genu valgum angle, and reduced stride-to-stride knee-joint variability compared with baseline. Conclusions: A 3-week hip-abductor muscle-strengthening protocol was effective in increasing muscle strength and decreasing pain and stride-to-stride knee-joint variability in individuals with PFPS. However, concomitant changes in peak knee genu valgum angle were not observed.