Markers of chronic disease in offenders in a high secure correctional centre in Queensland

This study aimed to gauge the presence of markers of chronic disease, as a basis for food and nutrition policy in correctional facilities. One hundred and twenty offenders, recruited from a Queensland Correctional Centre, provided informed consent and completed both dietary interviews and physical measurements. Mean age of the sample was 35.5 ± 12 years (range = 19–77 yrs); mean age of the total population (n = 945) was 32.8 ± 10 years (range = 19–80 yrs). Seventy-nine participants also provided fasting blood samples. The mean body mass index (BMI) was 27 ± 3.5 kg/m2; 72% having a BMI > 25 kg/m2. Thirty-three percent were classified overweight or obese using waist circumference (mean = 92 ± 10 cm). Mean blood pressure measurement was systolic = 130 ± 14 mmHg and diastolic = 73 ± 10 mmHg. Twenty-four percent were classified as hypertensive of whom three were on antihypertensive medication. Eighteen percent had elevated triglycerides, and 40% unfavourable total cholesterol to HDL ratios. Homeostatic Model Assessment (HOMA scores) were calculated from glucose and insulin. Four participants were insulin resistant, two of whom had known diabetes. Metabolic syndrome, based on waist circumference (adjusted for ethnicity), blood lipids, blood pressure and plasma glucose indicated that 25% (n = 20) were classified with metabolic syndrome. Eighty-four percent (n = 120) reported some physical activity each day, with 51 percent participating ≥two times daily. Fifty-four percent reported smoking with an additional 20% having smoked in the past. Findings suggest that waist circumference rather than weight and BMI only should be used in this group to determine weight status. The data suggest that markers of chronic disease are present and that food and nutrition policy must reflect this. Further analysis is being completed to determine relevant policy initiatives.

The influence of motorcyclist behavior in crash involvement

Introduction: In Singapore, motorcycle crashes account for 50% of traffic fatalities and 53% of injuries. While extensive research efforts have been devoted to improve the motorcycle safety, the relationship between the rider behavior and the crash risk is still not well understood. The objective of this study is to evaluate how behavioral factors influence crash risk and to identify the most vulnerable group of motorcyclists. Methods: To explore the rider behavior, a 61-item questionnaire examining sensation seeking (Zuckerman et al., 1978), impulsiveness (Eysenck et al., 1985), aggressiveness (Buss & Perry, 1992), and risk-taking behavior (Weber et al., 2002) was developed. A total of 240 respondents with at least one year riding experience form the sample that relate behavior to their crash history, traffic penalty awareness, and demographic characteristics. By clustering the crash risk using the medoid portioning algorithm, the log-linear model relating the rider behavior to crash risk was developed. Results and Discussions: Crash-involved motorcyclists scored higher in impulsive sensation seeking, aggression and risk-taking behavior. Aggressive and high risk-taking motorcyclists were respectively 1.30 and 2.21 times more likely to fall under the high crash involvement group while impulsive sensation seeking was not found to be significant. Based on the scores on risk-taking and aggression, the motorcyclists were clustered into four distinct personality combinations namely, extrovert (aggressive, impulsive risk-takers), leader (cautious, aggressive risk-takers), follower (agreeable, ignorant risk-takers), and introvert (self-consciousness, fainthearted risk-takers). “Extrovert” motorcyclists were most prone to crashes, being 3.34 times more likely to involve in crash and 8.29 times more vulnerable than the “introvert”. Mediating factors like demographic characteristics, riding experience, and traffic penalty awareness were found not to be significant in reducing crash risk. Conclusion: The findings of this study will be useful for road safety campaign planners to be more focused in the target group as well as those who employ motorcyclists for their delivery business.

Evaluation of an intervention to promote protective infant feeding practices to prevent childhood obesity : outcomes of the NOURISH RCT at 14 months of age and 6 months post the first of two intervention modules

OBJECTIVE: To evaluate a universal obesity prevention intervention, which commenced at infant age 4-6 months, using outcome data assessed 6-months after completion of the first of two intervention modules and 9 months from baseline. DESIGN: Randomised controlled trial of a community-based early feeding intervention. SUBJECTS AND METHODS: 698 first-time mothers (mean age 30±5 years) with healthy term infants (51% male) aged 4.3±1.0 months at baseline. Mothers and infants were randomly allocated to self-directed access to usual care or to attend two group education modules, each delivered over three months, that provided anticipatory guidance on early feeding practices. Outcome data reported here were assessed at infant age 13.7±1.3 months. Anthropometrics were expressed as z-scores (WHO reference). Rapid weight gain was defined as change in weight-for-age z-score (WAZ) > +0.67. Maternal feeding practices were assessed via self-administered questionnaire. RESULTS: There were no differences according to group allocation on key maternal and infant characteristics. At follow up (n=598 [86%]) the intervention group infants had lower BMIZ (0.42±0.85 vs 0.23±0.93, p=0.009) and infants in the control group were more likely to show rapid weight gain from baseline to follow up (OR=1.5 CI95%1.1-2.1, p=0.014). Mothers in the control group were more likely to report using non- responsive feeding practices that fail to respond to infant satiety cues such as encouraging eating by using food as a reward (15% vs 4%, p=0.001) or using games ( 67% vs 29%, p<0.001). CONCLUSIONS: These results provide early evidence that anticipatory guidance targeting the ‘when, what and how’ of solid feeding can be effective in changing maternal feeding practices and, at least in the short term, reducing anthropometric indicators of childhood obesity risk. Analyses of outcomes at later ages are required to determine if these promising effects can be sustained.

Metacognitive instruction does improve listening comprehension

This paper reports on a small-scale study, which looked into the impact of metacognitive instruction on listeners’ comprehension. Twenty-eight adult, Iranian, high-intermediate level EFL listeners participated in a “strategy-based” approach of advance organisation, directed attention, selective attention, and self-management in each of four listening lessons focused on improving listeners’ comprehension of IELTS listening texts. A comparison of pretest and posttest scores showed that the “less-skilled” listeners improved more than “more-skilled” listeners in the IELTS listening tests. Findings also supported the view that metacognitive instruction assisted listeners in considering the process of listening input and promoting listening comprehension ability.

Enhancing foreign language learning through listening strategy delivered in L1: an experimental study

Listening used in language teaching refers to a complex process that allows us to understand spoken language. The current study, conducted in Iran with an experimental design, investigated the effectiveness of teaching listening strategies delivered in L1 (Persian) and its effect on listening comprehension in L2. Five listening strategies: Guessing, making inferences, identifying topics, repetition, and note-taking were taught over 14 weeks during a semester. Sixty lower intermediate female participants came from two EFL classrooms in an English language institute. The experimental class (n = 30) who listened to their classroom activities performed better (t value = 10.083) than the control class using a methodology that led learners through five listening strategies in Persian. The same teacher taught the students in the control class (n = 30), who listened to the same classroom listening activities without any of the above listening strategies. A pre and post listening test made by a group of experts in the language institute assessed the effect of teaching listening strategies delivered in L1. Results gathered on the post intervention listening test revealed that listening strategies delivered in L1 led to a statistically significant improvement in their discrete listening scores compared with the control group.

Teaching and assessing critical thinking : the interaction of student approaches to learning and teaching approaches

This study explored the relationship among student approaches to learning and teaching methods on critical thinking in two business units. Key findings included differences in critical thinking scores between student approaches to learning and some evidence of an interaction between student approaches to learning and critical thinking teach method (immersion vs. infusion). Possible explanations for the results are examined and implications for developing critical thinking skills across a degree discussed. What is apparent is that as Universities move towards program-wide level assessment of critical thinking, further work is required in terms of the design of critical thinking teaching interventions and assessment at the unit, school, and degree level. The session will discuss the challenges in developing critical thinking programs in individual units and at the Faculty level.

A parent-led family-focused treatment program for overweight children aged 5 to 9 years : The PEACH RCT

OBJECTIVE: To evaluate a healthy lifestyle intervention to reduce adiposity in children aged 5 to 9 years and assess whether adding parenting skills training would enhance this effect. PARTICIPANTS AND METHODS: We conducted a single-blinded randomized controlled trial of prepubertal moderately obese (International Obesity Task Force cut points) children, aged 5 to 9 years. The 6-month program targeted parents as the agents of change for implementing family lifestyle changes. Only parents attended group sessions. We measured BMI and waist z scores and parenting constructs at baseline, 6, 12, 18, 24 months. RESULTS: Participants (n = 169; 56% girls) were randomized to a parenting skills plus healthy lifestyle group (n = 85) or a healthy lifestyle–only group (n = 84). At final 24-month assessment 52 and 54 children remained in the parenting skills plus healthy lifestyle and the healthy lifestyle–only groups respectively. There were reductions (P < .001) in BMI z score (0.26 [95% confidence interval: 0.22–0.30]) and waist z score (0.33 [95% confidence interval: 0.26–0.40]). There was a 10% reduction in z scores from baseline to 6 months that was maintained to 24 months with no additional intervention. Overall, there was no significant group effect. A similar pattern of initial improvement followed by stability was observed for parenting outcomes and no group effect. CONCLUSIONS: Using approaches that specifically target parent behavior, relative weight loss of ∼10% is achievable in moderately obese prepubertal children and can be maintained for 2 years from baseline. These results justify an investment in treatment as an effective secondary obesity-prevention strategy.

A randomised, feasibility trial of a tele-health intervention for Acute Coronary Syndrome patients with depression ('MoodCare')

Background Coronary heart disease (CHD) and depression are leading causes of disease burden globally and the two often co-exist. Depression is common after Myocardial Infarction (MI) and it has been estimated that 15-35% of patients experience depressive symptoms. Co-morbid depression can impair health related quality of life (HRQOL), decrease medication adherence and appropriate utilisation of health services, lead to increased morbidity and suicide risk, and is associated with poorer CHD risk factor profiles and reduced survival. We aim to determine the feasibility of conducting a randomised, multi-centre trial designed to compare a tele-health program (MoodCare) for depression and CHD secondary prevention, with Usual Care (UC). Methods Over 1600 patients admitted after index admission for Acute Coronary Syndrome (ACS) are being screened for depression at six metropolitan hospitals in the Australian states of Victoria and Queensland. Consenting participants are then contacted at two weeks post-discharge for baseline assessment. One hundred eligible participants are to be randomised to an intervention or a usual medical care control group (50 per group). The intervention consists of up to 10 × 30-40 minute structured telephone sessions, delivered by registered psychologists, commencing within two weeks of baseline screening. The intervention focuses on depression management, lifestyle factors (physical activity, healthy eating, smoking cessation, alcohol intake), medication adherence and managing co-morbidities. Data collection occurs at baseline (Time 1), 6 months (post-intervention) (Time 2), 12 months (Time 3) and 24 months follow-up for longer term effects (Time 4). We are comparing depression (Cardiac Depression Scale [CDS]) and HRQOL (Short Form-12 [SF-12]) scores between treatment and UC groups, assessing the feasibility of the program through patient acceptability and exploring long term maintenance effects. A cost-effectiveness analysis of the costs and outcomes for patients in the intervention and control groups is being conducted from the perspective of health care costs to the government. Discussion This manuscript presents the protocol for a randomised, multi-centre trial to evaluate the feasibility of a tele-based depression management and CHD secondary prevention program for ACS patients. The results of this trial will provide valuable new information about potential psychological and wellbeing benefits, cost-effectiveness and acceptability of an innovative tele-based depression management and secondary prevention program for CHD patients experiencing depression.

Parenting satisfaction and self-efficacy : a longitudinal study of mothers of children with Down Syndrome

Continuities and changes in parenting sense of competence were examined for mothers of children with Down syndrome from early childhood to adolescence. The sample comprised 25 mothers whose child with Down syndrome was aged 4-6 years in the first phase of the study, and 11-15 years at the second time point. Maternal satisfaction with parenting increased over time, but there were no changes in parenting self-efficacy. Scores on these measures were no different from those reported in a normative sample of mothers of typically developing children, suggesting that the challenges of parenting a child with Down syndrome do not impact significantly on parenting sense of competence during the early childhood and adolescent periods. There were some significant relationships of maternal sense of competence with child characteristics and self-reported parenting style, mostly in the expected direction.

Assessing intellectual functioning in young adolescents : how do the WISC-IV and SB5 compare?

The Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV) and the Stanford-Binet – Fifth Edition (SB5) are two of the most commonly used intelligence tests for children and adolescents. No comparative studies of the WISC-IV and SB5 have yet been published. In the current study the WISC-IV and SB5 were administered in counterbalanced order to 30 typically-developing 12- to 14-year-old adolescents. There was a significant difference between Full Scale IQs on the two measures, with scores being higher on the WISC-IV. A significant difference was also found between Verbal IQs and there were large score differences for some participants. The paper concludes that the WISC-IV and SB5 cannot be presumed to be interchangeable measures of intelligence.

The effectiveness of a four layer compression bandage system in comparison to Class 3 compression hosiery on healing and quality of life for patients with venous leg ulcers : a randomised controlled trial

There are an increasing number of compression systems available for treatment of venous leg ulcers and limited evidence on the relative effectiveness of these systems. The purpose of this study was to conduct a randomised controlled trial to compare the effectiveness of a 4-layer compression bandage system with Class 3 compression hosiery on healing and quality of life in patients with venous leg ulcers. Data were collected from 103 participants on demographics, health, ulcer status, treatments, pain, depression and quality of life for 24 weeks. After 24 weeks, 86% of the 4-layer bandage group and 77% of the hosiery group were healed (p=0.24). Median time to healing for the bandage group was 10 weeks, in comparison to 14 weeks for the hosiery group (p=0.018). Cox proportional hazards regression found participants in the 4-layer system were 2.1 times (95% CI 1.2–3.5) more likely to heal than those in hosiery, while longer ulcer duration, larger ulcer area and higher depression scores significantly delayed healing. No differences between groups were found in quality of life or pain measures. Findings indicate these systems were equally effective in healing patients by 24 weeks, however a 4-layer system may produce a more rapid response.

Behavioural changes add validity to the construct of posttraumatic growth

The research aimed to identify positive behavioural changes that people may make as a result of negotiating the aftermath of a traumatic experience, thereby extending the current cognitive model of posttraumatic growth (PTG). It was hypothesised that significant others would corroborate survivor’s cognitive and behavioural reports of PTG. The sample comprised 176 participants; 88 trauma survivors and 88 significant others. University students accounted for 64% of the sample and 36% were from the broader community. Approximately one third were male. All participants completed the Posttraumatic Growth Inventory [PTGI] and open ended questions regarding behavioural changes. PTGI scores in the survivor sample were corroborated by the significant others with only the Appreciation of Life factor of the PTGI differing between the two groups (e.g., total PTGI scores between groups explained 33.64% of variance). Nearly all of the survivors also reported positive changes in their behaviour and these changes were also corroborated by the significant others. Results provide validation of the posttraumatic growth construct and the PTGI as an instrument of measurement. Findings may also influence therapeutic practice for example, the potential usefulness of corroborating others.

Document clustering evaluation : Divergence from a random baseline

Divergence from a random baseline is a technique for the evaluation of document clustering. It ensures cluster quality measures are performing work that prevents ineffective clusterings from giving high scores to clusterings that provide no useful result. These concepts are defined and analysed using intrinsic and extrinsic approaches to the evaluation of document cluster quality. This includes the classical clusters to categories approach and a novel approach that uses ad hoc information retrieval. The divergence from a random baseline approach is able to differentiate ineffective clusterings encountered in the INEX XML Mining track. It also appears to perform a normalisation similar to the Normalised Mutual Information (NMI) measure but it can be applied to any measure of cluster quality. When it is applied to the intrinsic measure of distortion as measured by RMSE, subtraction from a random baseline provides a clear optimum that is not apparent otherwise. This approach can be applied to any clustering evaluation. This paper describes its use in the context of document clustering evaluation.

Educational stress among Chinese adolescents : measurement, risk factors and associations with mental health

Academic pressure among adolescents is a major risk factor for poor mental health and suicide and other harmful behaviours. While this is a worldwide phenomenon, it appears to be especially pronounced in China and other East Asian countries. Despite a growing body of research into adolescent mental health in recent years, the multiple constructs within the ‘educational stress’ phenomenon have not been clearly articulated in Chinese contexts. Further, the individual, family, school and peer influencing factors for educational stress and its associations with adolescent mental health are not well understood. An in-depth investigation may provide important information for the ongoing educational reform in Mainland China with a special focus on students’ mental health and wellbeing. The primary goal of this study was to examine the relative contribution of educational stress to poor mental health, in comparison to other well-known individual, family, school and peer factors. Another important task was to identify significant risk factors for educational stress. In addition, due to the lack of a culturally suitable instrument for educational stress in this population, a new tool – the Educational Stress Scale for Adolescents (ESSA) was initially developed in this study and tested for reliability and validity. A self-administered questionnaire was used to collect information from convenient samples of secondary school students in Shandong, China. The pilot survey was conducted with 347 students (grades 8 and 11) to test the psychometric properties of the ESSA and other scales or questions in the questionnaire. Based on factor analysis and reliability and validity testing, the 16-item scale (the ESSA) with five factors showed adequate to good internal consistency, 2-week test-retest reliability, and satisfactory concurrent and predictive validity. Its factor structure was further demonstrated in the main survey with a confirmatory factor analysis illustrating a good fit of the proposed model based on a confirmatory factor analysis. The reliabilities of other scales and questions were also adequate to be used in this study. The main survey was subsequently conducted with a sample of 1627 secondary school (grades 7-12) students to examine the influencing factors of educational stress and its associations with mental health outcomes, including depression, happiness and suicidal behaviours. A wide range of individual, family, school and peer factors were found to have a significant association with the total ESSA and subscale scores. Most of the strong factors for academic stress were school or study-related, including rural school location, low school connectedness, perceived poor academic grades and frequent emotional conflicts with teachers and peers. Unexpectedly, family and parental factors, such as parental bonding, family connectedness and conflicts with parents were found to have little or no association with educational stress. Educational stress was the most predictive variable for depression, but was not strongly associated with happiness. It had a strong association with suicide ideation but not with suicide attempts. Among five subscales of the ESSA, ‘Study despondency’ score had the strongest associations with these mental health measures. Surprising, two subscales, ‘Self-expectation’ and ‘Worry about grades’ showed a protective effect on suicidal behaviours. An additional analysis revealed that although academic pressure was the most commonly reported reason for suicidal thinking, the occurrence of problems in peer relationships such as peer teasing and bullying, and romantic problems had a much stronger relationship with actual attempts. This study provides some insights into the nature and health implications of educational stress among Chinese adolescents. Findings in this study suggest that interventions on educational stress should focus on school environment and academic factors. Intervention programs focused on educational stress may have a high impact on the prevalence of common mental disorders such as depression. Efforts to increase perceived happiness however should cover a wider range of individual, family and school factors. The importance of healthy peer relationships should be adequately emphasised in suicide prevention. In addition, the newly developed scale (the ESSA) demonstrates sound psychometric properties and is expected to be used in future research into academic-related stress among secondary school adolescents.

The effect of implementing a modified early warning scoring (MEWS) system on the adequacy of vital sign documentation

Introduction and objectives Early recognition of deteriorating patients results in better patient outcomes. Modified early warning scores (MEWS) attempt to identify deteriorating patients early so timely interventions can occur thus reducing serious adverse events. We compared frequencies of vital sign recording 24 h post-ICU discharge and 24 h preceding unplanned ICU admission before and after a new observation chart using MEWS and an associated educational programme was implemented into an Australian Tertiary referral hospital in Brisbane. Design Prospective before-and-after intervention study, using a convenience sample of ICU patients who have been discharged to the hospital wards, and in patients with an unplanned ICU admission, during November 2009 (before implementation; n = 69) and February 2010 (after implementation; n = 70). Main outcome measures Any change in a full set or individual vital sign frequency before-and-after the new MEWS observation chart and associated education programme was implemented. A full set of vital signs included Blood pressure (BP), heart rate (HR), temperature (T°), oxygen saturation (SaO2) respiratory rate (RR) and urine output (UO). Results After the MEWS observation chart implementation, we identified a statistically significant increase (210%) in overall frequency of full vital sign set documentation during the first 24 h post-ICU discharge (95% CI 148, 288%, p value <0.001). Frequency of all individual vital sign recordings increased after the MEWS observation chart was implemented. In particular, T° recordings increased by 26% (95% CI 8, 46%, p value = 0.003). An increased frequency of full vital sign set recordings for unplanned ICU admissions were found (44%, 95% CI 2, 102%, p value = 0.035). The only statistically significant improvement in individual vital sign recordings was urine output, demonstrating a 27% increase (95% CI 3, 57%, p value = 0.029). Conclusions The implementation of a new MEWS observation chart plus a supporting educational programme was associated with statistically significant increases in frequency of combined and individual vital sign set recordings during the first 24 h post-ICU discharge. There were no significant changes to frequency of individual vital sign recordings in unplanned admissions to ICU after the MEWS observation chart was implemented, except for urine output. Overall increases in the frequency of full vital sign sets were seen.