Systematic review of interventions to improve the provision of information for adults with primary brain tumors and their caregivers

Background: Adults with primary brain tumors and their caregivers have significant information needs. This review assessed the effect of interventions to improve information provision for adult primary brain tumor patients and/or their caregivers. Methods: We included randomized or nonrandomized trials testing educational interventions that had outcomes of information provision, knowledge, understanding, recall, or satisfaction with the intervention, for adults diagnosed with primary brain tumors and/or their family or caregivers. PubMed, MEDLINE, EMBASE and Cochrane Reviews databases were searched for studies published between 1980 and June 2014. Results: Two randomized controlled, one non-randomized controlled, and 10 single group pre-post trials enrolled more than 411 participants. Five group, four practice/process change and four individual interventions assessed satisfaction (12 studies), knowledge (four studies) or information provision (2 studies). Nine studies reported high rates of satisfaction. Three studies showed statistically significant improvements over time in knowledge and two showed greater information was provided to intervention than control group participants, although statistical testing was not performed. Discussion: The trials assessed intermediate outcomes such as satisfaction, and only 4/13 reported on knowledge improvements. Few trials had a randomized controlled design and risk of bias was either evident or could not be assessed in most domains.

Community wide interventions for increasing physical activity

Background Multi-strategic community wide interventions for physical activity are increasingly popular but their ability to achieve population level improvements is unknown. Objectives To evaluate the effects of community wide, multi-strategic interventions upon population levels of physical activity. Search methods We searched the Cochrane Public Health Group Segment of the Cochrane Register of Studies,The Cochrane Library, MEDLINE, MEDLINE in Process, EMBASE, CINAHL, LILACS, PsycINFO, ASSIA, the British Nursing Index, Chinese CNKI databases, EPPI Centre (DoPHER, TRoPHI), ERIC, HMIC, Sociological Abstracts, SPORTDiscus, Transport Database and Web of Science (Science Citation Index, Social Sciences Citation Index, Conference Proceedings Citation Index). We also scanned websites of the EU Platform on Diet, Physical Activity and Health; Health-Evidence.org; the International Union for Health Promotion and Education; the NIHR Coordinating Centre for Health Technology (NCCHTA); the US Centre for Disease Control and Prevention (CDC) and NICE and SIGN guidelines. Reference lists of all relevant systematic reviews, guidelines and primary studies were searched and we contacted experts in the field. The searches were updated to 16 January 2014, unrestricted by language or publication status. Selection criteria Cluster randomised controlled trials, randomised controlled trials, quasi-experimental designs which used a control population for comparison, interrupted time-series studies, and prospective controlled cohort studies were included. Only studies with a minimum six-month follow up from the start of the intervention to measurement of outcomes were included. Community wide interventions had to comprise at least two broad strategies aimed at physical activity for the whole population. Studies which randomised individuals from the same community were excluded. Data collection and analysis At least two review authors independently extracted the data and assessed the risk of bias. Each study was assessed for the setting, the number of included components and their intensity. The primary outcome measures were grouped according to whether they were dichotomous (per cent physically active, per cent physically active during leisure time, and per cent physically inactive) or continuous (leisure time physical activity time (time spent)), walking (time spent), energy expenditure (as metabolic equivalents or METS)). For dichotomous measures we calculated the unadjusted and adjusted risk difference, and the unadjusted and adjusted relative risk. For continuous measures we calculated percentage change from baseline, unadjusted and adjusted. Main results After the selection process had been completed, 33 studies were included. A total of 267 communities were included in the review (populations between 500 and 1.9 million). Of the included studies, 25 were set in high income countries and eight were in low income countries. The interventions varied by the number of strategies included and their intensity. Almost all of the interventions included a component of building partnerships with local governments or non-governmental organisations (NGOs) (29 studies). None of the studies provided results by socio-economic disadvantage or other markers of equity. However, of those included studies undertaken in high income countries, 14 studies were described as being provided to deprived, disadvantaged or low socio-economic communities. Nineteen studies were identified as having a high risk of bias, 10 studies were unclear, and four studies had a low risk of bias. Selection bias was a major concern with these studies, with only five studies using randomisation to allocate communities. Four studies were judged as being at low risk of selection bias although 19 studies were considered to have an unclear risk of bias. Twelve studies had a high risk of detection bias, 13 an unclear risk and four a low risk of bias. Generally, the better designed studies showed no improvement in the primary outcome measure of physical activity at a population level. All four of the newly included, and judged to be at low risk of bias, studies (conducted in Japan, United Kingdom and USA) used randomisation to allocate the intervention to the communities. Three studies used a cluster randomised design and one study used a stepped wedge design. The approach to measuring the primary outcome of physical activity was better in these four studies than in many of the earlier studies. One study obtained objective population representative measurements of physical activity by accelerometers, while the remaining three low-risk studies used validated self-reported measures. The study using accelerometry, conducted in low income, high crime communities of USA, emphasised social marketing, partnership with police and environmental improvements. No change in the seven-day average daily minutes of moderate to vigorous physical activity was observed during the two years of operation. Some program level effect was observed with more people walking in the intervention community, however this result was not evident in the whole community. Similarly, the two studies conducted in the United Kingdom (one in rural villages and the other in urban London; both using communication, partnership and environmental strategies) found no improvement in the mean levels of energy expenditure per person per week, measured from one to four years from baseline. None of the three low risk studies reporting a dichotomous outcome of physical activity found improvements associated with the intervention. Overall, there was a noticeable absence of reporting of benefit in physical activity for community wide interventions in the included studies. However, as a group, the interventions undertaken in China appeared to have the greatest possibility of success with high participation rates reported. Reporting bias was evident with two studies failing to report physical activity measured at follow up. No adverse events were reported.The data pertaining to cost and sustainability of the interventions were limited and varied. Authors' conclusions Although numerous studies have been undertaken, there is a noticeable inconsistency of the findings in the available studies and this is confounded by serious methodological issues within the included studies. The body of evidence in this review does not support the hypothesis that the multi-component community wide interventions studied effectively increased physical activity for the population, although some studies with environmental components observed more people walking. Plain language summary Community wide interventions for increasing physical activity Not having enough physical activity leads to poorer health. Regular physical activity can reduce the risk of chronic disease and improve one's health and wellbeing. The lack of physical activity is a common and in some cases a growing health problem. To address this, 33 studies have used improvement activities directed at communities, using more than one approach in a single program. When we first looked at the available research in 2011 we observed that there was a lack of good studies which could show whether this approach was beneficial or not. Some studies claimed that community wide programs improved physical activities and other studies did not. In this update we found four new studies that were of good quality; however none of these four studies increased physical activity levels for the population. Some studies reported program level effects such as observing more people walking, however the population level of physical activity had not increased. This review found that community wide interventions are very difficult to undertake, and it appears that they usually fail to provide a measurable benefit in physical activity for a population. It is apparent that many of the interventions failed to reach a substantial portion of the community, and we speculate that some single strategies included in the combination may lack individual effectiveness. Laički sažetak Intervencije u zajednici za povećanje tjelesne aktivnosti Nedostatna tjelesna aktivnost povezana je s lošijim zdravljem.Redovita tjelesna aktivnost može umanjiti rizik od kroničnih bolesti te poboljšati zdravlje i kvalitetu života pojedinca.Manjak tjelesne aktivnosti čest je problem, a učestalost tog problema se povećava.Cochrane sustavni pregled je analizirao 33 studije koje su istražile programe za povećanje tjelesne aktivnosti u zajednici, u kojima se koristilo više od jednog pristupa.Kad su prvi put pregledani dokazi iz istraživanja koja su bila dostupna 2011. godine, utvrđeno je da nema dovoljno dobrih studija koje bi mogle pokazati je li takav pristup koristan ili ne.Primjerice, neke studije tvrde da programi za povećanje tjelesne aktivnosti u zajednici poboljšavaju tjelesnu aktivnost pojedinaca u zajednici, a druge studije tvrde suprotno.U ovom obnovljenom sustavnom pregledu pronađene su 4 nove studije koje su bile visoke kvalitete, ail nijedna od tih studija nije pokazala da je istraživana intervencija dovela do povećanja tjelesne aktivnosti u zajednici.Neke su studije opisale učinak na način da je opisano da je uočeno da više ljudi u zajednici hoda, međutim, ukupna razina tjelesne aktivnosti u promatranoj populaciji nije se povećala.Ovaj sustavni pregled je utvrdio da je intervencije za povećanje tjelesne aktivnosti u zajednici teško provesti i čini se da one obično ne uspijevaju u svojoj namjeri da na mjerljiv način povećaju tjelesnu aktivnost u populaciji.Čini se da mnoge intervencije nisu uspjele doseći veći broj stanovnika u zajednici pa se može smatrati da neke od strategija uključene u analizirane kombinacije nisu zasebno učinkovite.

Battery energy storage systems to improve power system frequency response

Battery energy storage systems (BESS) are becoming feasible to provide system frequency support due to recent developments in technologies and plummeting cost. Adequate response of these devices becomes critical as the penetration of the renewable energy sources increases in the power system. This paper proposes effective use of BESS to improve system frequency performance. The optimal capacity and the operation scheme of BESS for frequency regulation are obtained using two staged optimization process. Furthermore, the effectiveness of BESS for improving the system frequency response is verified using dynamic simulations.

Understanding preservice teachers’ development of pedagogical knowledge practices when co-teaching primary science to peers

Preservice teachers articulate the need for more teaching experiences for developing their practices, however, extending beyond existing school arrangements may present difficulties. Thus, it is important to understand preservice teachers’ development of pedagogical knowledge practices when in the university setting. This mixed-method study investigated 48 second-year preservice teachers’ development of pedagogical knowledge practices as a result of co-teaching primary science to peers. Data were collected through a survey, video-recorded lessons, extended written responses and researcher observations. The study showed how these preservice teachers demonstrated 9 of 11 pedagogical knowledge practices within the co-teaching arrangement. However, research is needed to determine the level of development on each pedagogical knowledge practice and how these practices can be transferred into authentic primary classroom settings.

Linking pedagogical knowledge practices and student outcomes in STEM education for primary schools

STEM education is a new frontier in Australia, particularly for primary schools. However, the E in STEM needs to have a stronger focus with science and mathematics concepts aligned to the presiding curricula. In addition, pedagogical knowledge practices such as planning, preparation, teaching strategies, assessment and so forth need to be connected to key concepts for developing a STEM education. One of the aims of this study was to understand how a pedagogical knowledge practice framework could be linked to student outcomes in STEM education. Specifically, this qualitative research investigated Year 4 students’ involvement in an integrated STEM education program that focused on science concepts (e.g., states of matter, testing properties of materials) and mathematics concepts (such as 3D shapes and metric measurements: millilitres, temperature, grams, centimetres) for designing, making and testing a strong and safe medical kit to insulate medicines at desirable temperatures. Eleven pedagogical knowledge practices (e.g., planning, preparation, teaching strategies, classroom management, and assessment) were used as a framework for understanding how teaching may be linked to student outcomes in STEM education. For instance, “planning” involved devising a student booklet as a resource for students to understand the tasks required of them, which also provided space for them to record ideas, results and information. Planning involved linking national and state curriculum documents to the STEM education activities. More studies are required around pedagogical knowledge frameworks to understand what students learn when involved in STEM education, particularly with the inclusion of engineering education.

A framework for sustainable energy reduction in modern breweries

This thesis examines the existing frameworks for energy management in the brewing industry and details the design, development and implementation of a new framework at a modern brewery. The aim of the research was to develop an energy management framework to identify opportunities in a systematic manner using Systems Engineering concepts and principles. This work led to a Sustainable Energy Management Framework, SEMF. Using the SEMF approach, one of Australia's largest breweries has achieved number 1 ranking in the world for water use for the production of beer and has also improved KPI's and sustained the energy management improvements that have been implemented during the past 15 years. The framework can be adapted to other manufacturing industries in the Australian context and is considered to be a new concept and a potentially important tool for energy management.

Primary and secondary neural networks of auditory prepulse inhibition: a functional magnetic resonance imaging study of sensorimotor gating of the human acoustic startle response

Feedforward inhibition deficits have been consistently demonstrated in a range of neuropsychiatric conditions using prepulse inhibition (PPI) of the acoustic startle eye-blink reflex when assessing sensorimotor gating. While PPI can be recorded in acutely decerebrated rats, behavioural, pharmacological and psychophysiological studies suggest the involvement of a complex neural network extending from brainstem nuclei to higher order cortical areas. The current functional magnetic resonance imaging study investigated the neural network underlying PPI and its association with electromyographically (EMG) recorded PPI of the acoustic startle eye-blink reflex in 16 healthy volunteers. A sparse imaging design was employed to model signal changes in blood oxygenation level-dependent (BOLD) responses to acoustic startle probes that were preceded by a prepulse at 120 ms or 480 ms stimulus onset asynchrony or without prepulse. Sensorimotor gating was EMG confirmed for the 120-ms prepulse condition, while startle responses in the 480-ms prepulse condition did not differ from startle alone. Multiple regression analysis of BOLD contrasts identified activation in pons, thalamus, caudate nuclei, left angular gyrus and bilaterally in anterior cingulate, associated with EMGrecorded sensorimotor gating. Planned contrasts confirmed increased pons activation for startle alone vs 120-ms prepulse condition, while increased anterior superior frontal gyrus activation was confirmed for the reverse contrast. Our findings are consistent with a primary pontine circuitry of sensorimotor gating that interconnects with inferior parietal, superior temporal, frontal and prefrontal cortices via thalamus and striatum. PPI processes in the prefrontal, frontal and superior temporal cortex were functionally distinct from sensorimotor gating.

From ideation to sculpture : digital sculpting as the primary 'ideation' tool for creature design

This research project examined the potential for circumventing drawing in the ideation process by adopting digital sculpture as the primary conceptual development and design tool for the digital sculpting of creature designs. Through a series of experimental research cycles, multiple frameworks were explored with the aim of identifying a methodology for creating '3D sculpted sketches' for the initial phases of the ideation process. This research project acknowledges that drawing still remains the predominant method of visualising design ideas for characters and creatures for many artists. However, alongside other ideation techniques digital sculpting can function as a rapid and responsive tool to visualize and explore forms in a digital sculpting environment for the conceptualisation of multiple creature design variations. The results of this study are significant for emerging digital sculptors who may not necessarily have a well-defined creative brief or initial concept.

Magnetic resonance imaging: An accurate, radiation-free, alternative to computed tomography for the primary imaging and three-dimensional reconstruction of the bony orbit

Purpose: To determine the extent to which the accuracy of magnetic resonance imaging (MRI) based virtual 3-dimensional (3D) models of the intact orbit can approach that of the gold standard, computed tomography (CT) based models. The goal was to determine whether MRI is a viable alternative to CT scans in patients with isolated orbital fractures and penetrating eye injuries, pediatric patients, and patients requiring multiple scans in whom radiation exposure is ideally limited. Materials and Methods: Patients who presented with unilateral orbital fractures to the Royal Brisbane and Women’s Hospital from March 2011 to March 2012 were recruited to participate in this cross-sectional study. The primary predictor variable was the imaging technique (MRI vs CT). The outcome measurements were orbital volume (primary outcome) and geometric intraorbital surface deviations (secondary outcome)between the MRI- and CT-based 3D models. Results: Eleven subjects (9 male) were enrolled. The patients’ mean age was 30 years. On average, the MRI models underestimated the orbital volume of the CT models by 0.50 0.19 cm3 . The average intraorbital surface deviation between the MRI and CT models was 0.34 0.32 mm, with 78 2.7% of the surface within a tolerance of 0.5 mm. Conclusions: The volumetric differences of the MRI models are comparable to reported results from CT models. The intraorbital MRI surface deviations are smaller than the accepted tolerance for orbital surgical reconstructions. Therefore, the authors believe that MRI is an accurate radiation-free alternative to CT for the primary imaging and 3D reconstruction of the bony orbit. �

An Investigation into the Options for Increasing the Extent of Energy Efficiency Knowledge and Skills in Engineering Education

Society is increasingly calling for professionals across government, industry, business and civil society to be able to problem-solve issues related to climate change and sustainable development as part of their work. In particular there is an emerging realisation of the fundamental need to swiftly reduce the growing demand for energy across society, and to then meet the demand with low emissions options. A key ingredient to addressing such issues is equipping professionals with emerging knowledge and skills to address energy challenges in all aspects of their work. The Council of Australian Governments has recognised this need, signing the National Partnership Agreement on Energy Efficiency in July 2009, which included a commitment to assist business and industry obtain the knowledge, skills and capacity to pursue cost-effective energy efficiency opportunities.2 Engineering will play a critical part among the professions, with Engineers Australia acknowledging that, ‘The need to make changes in the way energy is used and supplied throughout the world represents the greatest challenge to engineers in moving toward sustainability.’

Energy Efficiency Resources for Undergraduate Engineering Education: Final Report

This report presents the findings of an investigation of energy efficiency resources for undergraduate engineering education, undertaken by web-based research, conversations with educators, and a university survey. The investigation draws on the results of a number of previous investigations undertaken by the research team for NFEE related to energy efficiency education and presents the following findings and recommendations, as explained in greater detail in the body of the report. The findings suggest that even though certain EE concepts and principles have been identified by lecturers as being important there is little to no coverage of a number of these concepts in some programs/courses. Similarly, many topics relating to the most important EE workforce skills and significant shortages as identified in industry research, do not rate highly in terms of both perceived importance by lecturers, or coverage within existing courses. Overall, these findings suggest that despite growing awareness of the importance of EE in both industry and academia, the current depth and breadth of EE content in courses does not reflect this. It confirms that efforts in these areas can be better supported.

Energy Efficiency Graduate Attributes Project: Final Report

The Energy Efficiency (EE) Graduate Attributes Project focuses on engineering as a priority profession that has a significant role to play in addressing energy demand and supply issues in Australia. Specifically, this project aims to support embedding EE knowledge and skills throughout the engineering undergraduate curriculum, to help build capacity within the Australian workforce across major sectors of the economy, from mining, manufacturing and industrial applications to design, construction, maintenance and retrofitting built environments. The resultant report is intended to assist in future consultation with key groups such as Engineers Australia (EA), the Australian Council of Engineering Deans (ACED) and the eight EA colleges, to support systemic curriculum renewal and promote the design and development of high quality EE engineering education resources. The project is based on a whole-of-program outcomes-based approach to curriculum renewal, creating a transparent framework for integrating EE. This comprises collaborative consideration by academics and professional engineers who have experience in teaching and practising EE, to identify what students should learn to be equipped with relevant competencies by the time they graduate.