The effectiveness of non-pharmacological interventions in improving psychological outcomes for heart transplant recipients : a systematic review

Background Post-heart transplant psychological distress may both directly hinder physiological health as well as indirectly impact on clinical outcomes by increasing unhealthy behaviours, such as immunosuppression non-adherence. Reducing psychological distress for heart transplant recipients is therefore vitally important, in order to improve patients’ overall health and well-being but also clinical outcomes, such as morbidity and mortality. Evidence from other populations suggests that non-pharmacological interventions may be an effective strategy. Aim To appraise the efficacy of non-pharmacological interventions on psychological outcomes after heart transplant. Method A systematic review was conducted using the Joanna Briggs Institute methodology. Experimental and quasi-experimental studies that involved any non-pharmacological intervention for heart transplant recipients were included, provided that data on psychological outcomes were reported. Multiple electronic databases were searched for published and unpublished studies and reference lists of retrieved studies were scrutinized for further primary research. Data were extracted using a standardised data extraction tool. Included studies were assessed by two independent reviewers using standardised critical appraisal instruments. Results Three studies fulfilled the inclusion and exclusion criteria, which involved only 125 heart transplant recipients. Two studies reported on exercise programs. One study reported a web-based psychosocial intervention. While psychological outcomes significantly improved from baseline to follow-up for the recipients who received the interventions, between-group comparisons were not reported. The methodological quality of the studies was judged to be poor. Conclusions Further research is required, as we found there is insufficient evidence available to draw conclusions for or against the use of non-pharmacological interventions after heart transplant.

Implementation of a better choice healthy food and drink supply strategy for staff and visitors in government owned health facilities in Queensland, Australia

Objective The present paper reports on a quality improvement activity examining implementation of A Better Choice Healthy Food and Drink Supply Strategy for Queensland Health Facilities (A Better Choice). A Better Choice is a policy to increase supply and promotion of healthy foods and drinks and decrease supply and promotion of energy-dense, nutrient-poor choices in all food supply areas including food outlets, staff dining rooms, vending machines, tea trolleys, coffee carts, leased premises, catering, fundraising, promotion and advertising. Design An online survey targeted 278 facility managers to collect self-reported quantitative and qualitative data. Telephone interviews were sought concurrently with the twenty-five A Better Choice district contact officers to gather qualitative information. Setting Public sector-owned and -operated health facilities in Queensland, Australia. Subjects One hundred and thirty-four facility managers and twenty-four district contact officers participated with response rates of 48·2 % and 96·0 %, respectively. Results Of facility managers, 78·4 % reported implementation of more than half of the A Better Choice requirements including 24·6 % who reported full strategy implementation. Reported implementation was highest in food outlets, staff dining rooms, tea trolleys, coffee carts, internal catering and drink vending machines. Reported implementation was more problematic in snack vending machines, external catering, leased premises and fundraising. Conclusions Despite methodological challenges, the study suggests that policy approaches to improve the food and drink supply can be implemented successfully in public-sector health facilities, although results can be limited in some areas. A Better Choice may provide a model for improving food supply in other health and workplace settings.

Quantitative proteomic approach to study subcellular localization of membrane proteins

As proteins within cells are spatially organized according to their role, knowledge about protein localization gives insight into protein function. Here, we describe the LOPIT technique (localization of organelle proteins by isotope tagging) developed for the simultaneous and confident determination of the steady-state distribution of hundreds of integral membrane proteins within organelles. The technique uses a partial membrane fractionation strategy in conjunction with quantitative proteomics. Localization of proteins is achieved by measuring their distribution pattern across the density gradient using amine-reactive isotope tagging and comparing these patterns with those of known organelle residents. LOPIT relies on the assumption that proteins belonging to the same organelle will co-fractionate. Multivariate statistical tools are then used to group proteins according to the similarities in their distributions, and hence localization without complete centrifugal separation is achieved. The protocol requires approximately 3 weeks to complete and can be applied in a high-throughput manner to material from many varied sources.

Supporting cooperation and caring through large group experiences

Cooperation and caring are best taught within a group as it promotes connectedness, collaborative effort, and relationship building.

Improving work and life balance : building a multilevel model of work-life balance focusing on group structure and relational job design

One in five Australian workers believes that work doesn’t fit well with their family and social commitments. Concurrently, organisations are recognising that to stay competitive they need policies and practices that support the multiple aspects of employees’ lives. Many employees work in group environments yet there is currently little group level work-life balance research. This paper proposes a new theoretical framework developed to understand the design of work groups to better facilitate work-life balance. This new framework focuses on task and relational job designs, group structures and processes and workplace culture.

An improved protection strategy for microgrids

Microgrids (MG) enable the integration of low capacity renewable energy resources with distribution systems. A recently proposed protection scheme for MGs utilising undervoltage, High Impedance Fault (HIF) detection, directional protection modules, and communication links significantly reduces the fault clearing time compared to previous schemes. In this paper, the effect of replacing undervoltage protection with differential protection in a scheme that also contains HIF and directional protection modules is studied. The MG model used in this study includes a diesel, wind, and two photovoltaic (PV) microsources. The alternative protection schemes are evaluated by simulation. It is found that the protection scheme consisting of differential, HIF detection, and directional protection modules is more effective compared to the alternative in protecting the MG from some fault conditions such as the phase-A-to-ground, phase-B-to-C, and phase-B-to-C-to-ground.

Soybean dwarf luteovirus contains the third variant genome type in the luteovirus group

Complementary DNAs covering the entire RNA genome of soybean dwarf luteovirus (SDV) were cloned and sequenced. Computer analysis of the 5861 nucleotide sequence revealed five major open reading frames (ORFs) possessing conservation of sequence and organisation with known luteovirus sequences. Comparative analyses of the genome structure show that SDV shares sequence homology and features of gene organisation with barley yellow dwarf virus (PAV isolate) in the 5' half of the genome, yet is more closely related to potato leafroll virus in its 3' coding regions. In addition, SDV differs from other known luteoviruses in possessing an exceptionally long 3' terminal sequence with no apparent coding capacity. We conclude from these data that the SDV genome represents a third variant genome type in the luteovirus group.

Multi-criteria optimization of group replacement schedules for distributed water pipeline assets

This thesis presents a multi-criteria optimisation study of group replacement schedules for water pipelines, which is a capital-intensive and service critical decision. A new mathematical model was developed, which minimises total replacement costs while maintaining a satisfactory level of services. The research outcomes are expected to enrich the body of knowledge of multi-criteria decision optimisation, where group scheduling is required. The model has the potential to optimise replacement planning for other types of linear asset networks resulting in bottom-line benefits for end users and communities. The results of a real case study show that the new model can effectively reduced the total costs and service interruptions.

Pooled biological specimens for human biomonitoring of environmental chemicals : opportunities and limitations

Biomonitoring has become the ‘gold standard’ in assessing chemical exposures, and plays an important role in risk assessment. The pooling of biological specimens – combining multiple individual specimens into a single sample – can be used in biomonitoring studies to monitor levels of exposure and identify exposure trends, or to identify susceptible populations in a cost-effective manner. Pooled samples provide an estimate of central tendency, and may also reveal information about variation within the population. The development of a pooling strategy requires careful consideration of the type and number of samples collected, the number of pools required, and the number of specimens to combine per pool in order to maximize the type and robustness of the data. Creative pooling strategies can be used to explore exposure-outcome associations, and extrapolation from other larger studies can be useful in identifying elevated exposures in specific individuals. The use of pooled specimens is advantageous as it saves significantly on analytical costs, may reduce the time and resources required for recruitment, and in certain circumstances, allows quantification of samples approaching the limit of detection. In addition, use of pooled samples can provide population estimates while avoiding ethical difficulties that may be associated with reporting individual results.

Recovering from the earthquake : early childhood teachers and children collaboratively telling stories about their experiences

Purpose – Traumatic events can cause post-traumatic stress disorder due to the severity of the often unexpected events. The purpose of this paper is to reveal how conversations around lived experiences of traumatic events, such as the Christchurch earthquake in February 2011, can work as a strategy for people to come to terms with their experiences collaboratively. By encouraging young children to recall and tell of their earthquake stories with their early childhood teachers they can begin to respond, renew, and recover (Brown, 2012), and prevent or minimise more stress being developed. Design/methodology/approach – The study involved collecting data of the participating children taking turns to wear a wireless microphone where their interactions with each other and with teachers were video recorded over one week in November 2011. A total of eight hours and 21 minutes of footage was collected; four minutes and 19 seconds of that footage are presented and analysed in this paper. The footage was watched repeatedly and transcribed using conversation analysis methods (Sacks, 1995). Findings – Through analysing the detailed turn-taking utterances between teachers and children, the orderliness of the co-production of remembering is revealed to demonstrate that each member orients to being in agreement about what actually happened. These episodes of story telling between the teachers and children demonstrate how the teachers encourage the children to tell about their experiences through actively engaging in conversations with them about the earthquake. Originality/value – The conversation analysis approach used in this research was found to be useful in investigating aspects of disasters that the participants themselves remember as important and real. This approach offers a unique insight into understanding how the earthquake event was experienced and reflected on by young children and their teachers, and so can inform future policy and provision in post-disaster situations.

Re-visioning the Queensland Youth Sector : principles to inform the Queensland Government's youth strategy and review process

This discussion paper has been provided to assist the Department of Communities, Child Safety and Disability Services (DOCCSDS) in developing the Queensland Government’s Youth Strategy and inform the review of state government funded youth services. The paper lists a number of key concepts and social determinants which need to be considered in this undertaking. Additionally, it proposes a number key concepts and principles pertinent to understanding and working with young people, and for quality youth service provision.

Process model comprehension : the effects of cognitive abilities, learning style, and strategy

Process models are used to convey semantics about business operations that are to be supported by an information system. A wide variety of professionals is targeted to use such models, including people who have little modeling or domain expertise. We identify important user characteristics that influence the comprehension of process models. Through a free simulation experiment, we provide evidence that selected cognitive abilities, learning style, and learning strategy influence the development of process model comprehension. These insights draw attention to the importance of research that views process model comprehension as an emergent learning process rather than as an attribute of the models as objects. Based on our findings, we identify a set of organizational intervention strategies that can lead to more successful process modeling workshops.

A novel protecting group methodology for syntheses using nitroxides

The methoxyamine group represents an ideal protecting group for the nitroxide moiety. It can be easily and selectively introduced in high yield (typically >90%) to a range of functionalised nitroxides using FeSO4.7H2O and H2O2 in DMSO. Its removal is readily achieved under mild conditions in high yield (70-90%) using mCPBA in a Cope-type elimination process.

A pilot study on understanding the journey of advanced prostate cancer patients

Objective: To understand the journey of advanced prostate cancer patients for supporting development of an innovative patient journey browser. Background: Prostate cancer is one of the common cancers in Australia. Due to the chronic nature of the disease, it is important to have effective disease management strategy and care model. Multi-disciplinary care is a well-proven approach for chronic disease management. The Multi-disciplinary team (MDT) can function more effectively if all the required information is available for the clinical decision support. The development of innovative technology relies on an accurate understanding of the advanced prostate cancer patient’s journey over a prolonged period. This need arises from the fact that advanced prostate cancer patients may follow various treatment paths and change their care providers. As a result of this, it is difficult to understand the actual sources of patient’s clinical records and their treatment patterns. The aim of the research is to understand variable sources of clinical records, treatment patterns, alternative therapies, over the counter (OTC) medications of advanced prostate cancer patients. This study provides better and holistic understanding of advanced prostate cancer journey. Methods: The study was conducted through an on-line survey developed to seek and analyse the responses from the participants. The on-line questionnaire was carefully developed through consultations with the clinical researchers at the Australian Prostate Cancer Research Centre-Queensland, prostate cancer support group representatives and health informaticians at the Australian e-Health Research Centre. The non-identifying questionnaire was distributed to the patients through prostate cancer support groups in Queensland, Australia. The pilot study was carried out between August 2010 and December 2010. Results: The research made important observations about the advanced prostate cancer journey. It showed that General Practitioner (GP) was the common source of patient’s clinical records (41%) followed by Urologist (14%) and other clinicians (14%). The data analysis also showed that selenium was the common complementary supplement (55%) used by the patients and about 48% patients did not use any OTC drugs. The most common OTC used by the patients was Paracetamol (about 45%). Conclusion: The results have provided a foundation to the architecture of the proposed technology solution. The outcomes of this study are incorporated in design of the proposed patient journey browser system. A basic version of the system is currently being used at the advanced prostate cancer MDT meetings.

Theory-based self-management programs for promoting recovery in community-dwelling stroke survivors : a systematic review

Background Post-stroke recovery is demanding. Increasing studies have examined the effectiveness of self-management programs for stroke survivors. However no systematic review has been conducted to summarize the effectiveness of theory-based stroke self-management programs. Objectives The aim is to present the best available research evidence about effectiveness of theory-based self-management programs on community-dwelling stroke survivors’ recovery. Inclusion criteria Types of participants All community-residing adults aged 18 years or above, and had a clinical diagnosis of stroke. Types of interventions Studies which examined effectiveness of a self-management program underpinned by a theoretical or conceptual framework for community-dwelling stroke survivors. Types of studies Randomized controlled trials. Types of outcomes Primary outcomes included health-related quality of life and self-management behaviors. Secondary outcomes included physical (activities of daily living), psychological (self-efficacy, depressive symptoms), and social outcomes (community reintegration, perceived social support). Search Strategy A three-step approach was adopted to identify all relevant published and unpublished studies in English or Chinese. Methodological quality The methodological quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal checklist for experimental studies. Data Collection A standardized JBI data extraction form was used. There was no disagreement between the two reviewers on the data extraction results. Data Synthesis There were incomplete details about the number of participants and the results in two studies, which makes it impossible to perform meta-analysis. A narrative summary of the effectiveness of stroke self-management programs is presented. Results Three studies were included. The key issues of concern in methodological quality included insufficient information about random assignment, allocation concealment, reliability and validity of the measuring instruments, absence of intention-to-treat analysis, and small sample sizes. The three programs were designed based on the Stanford Chronic Disease Self-management program and were underpinned by the principles of self-efficacy. One study showed improvement in the intervention group in family and social roles three months after program completion, and work productivity at six months as measured by the Stroke Specific Quality of Life Scale (SSQOL). The intervention group also had an increased mean self-efficacy score in communicating with physicians six months after program completion. The mean changes from baseline in these variables were significantly different from the control group. No significant difference was found in time spent in aerobic exercise between the intervention and control groups at three and six months after program completion. Another study, using SSQOL, showed a significant interaction effect by treatment and time on family roles, fine motor tasks, self-care, and work productivity. However there was no significant interaction by treatment and time on self-efficacy. The third study showed improvement in quality of life, community participation, and depressive symptoms among the participants receiving the stroke self-management program, Stanford Chronic Disease Self-management program, or usual care six months after program completion. However, there was no significant difference between the groups. Conclusions There is inconclusive evidence about the effectiveness of theory-based stroke self-management programs on community-dwelling stroke survivors’ recovery. However the preliminary evidence suggests potential benefits in improving stroke survivors’ quality of life and self-efficacy.