Reducing falls in hospital through education to change patient and staff behaviour: A stepped wedge cluster randomised controlled effectiveness trial

Background: Falls remain the most frequent adverse event reported in hospitals, particularly geriatric rehabilitation wards. Randomised trials reducing fall injuries in hospitals have been elusive. Our previous randomised trial (n = 1206) demonstrated that multimedia education with physiotherapist falls educator support reduced falls among patients with higher cognition levels, but this benefit was offset by a potential increase in falls rates among patients with poor cognition. In the previous trial, hospital staff were blinded to the allocation of individual patients, and only delivered usual care.

The pandemic of conflict-related sexual violence and the political economy of gender inequality

Since the 1998 Rome Statute recognized widespread and systematic acts of sexual and gender-based violence (SGBV) as an act of genocide, a war crime and crime against humanity, the last decade has seen historic recognition that egregious acts of sexual violence merit international political and legal attention (UN General Assembly, 1998). Notably there are now no fewer than seven United Nations Security Council resolutions on the cross-cutting theme of Women, Peace and Security.

Child dietary and eating behaviour outcomes up to 3.5 years after an early feeding intervention: the NOURISH RCT

- Objective To evaluate dietary intake impact outcomes up to 3.5 years after the NOURISH early feeding intervention (concealed allocation, assessor masked RCT). - Methods 698 first-time mothers with healthy term infants were allocated to receive anticipatory guidance on protective feeding practices or usual care. Outcomes were assessed at 2, 3.7 and 5 years (3.5 years post-intervention). Dietary intake was assessed by 24-hour recall and Child Dietary Questionnaire. Mothers completed a food preference questionnaire and Children’s Eating Behaviour Questionnaire. Linear mixed models assessed group, time and time x group effects. - Results There were no group or time x group effects for fruit, vegetables, discretionary food and non-milk sweetened beverages intake. Intervention children showed a higher preference for fruits (74.6% vs 69.0% liked, P<.001), higher Child Dietary Questionnaire score for fruit and vegetables (15.3 vs 14.5, target>18, P=0.03), lower food responsiveness (2.3 vs 2.4, of maximum 5, P=.04) and higher satiety responsiveness (3.1 vs 3.0, of maximum 5, P=.04). - Conclusions Compared to usual care, an early feeding intervention providing anticipatory guidance regarding positive feeding practices led to small improvements in child dietary score, food preferences and eating behaviours up to 5 years of age, but not in dietary intake measured by 24-hour recall.

Studies on the out-of-plane behaviour of masonry walls

The prime aim of this PhD thesis is to contribute to the current body of knowledge on the out-of-plane performance of masonry walls through systematic investigation of the key parameters and provide insight into the design clauses of Australian Masonry Standard (AS3700-2011). The research work has been carried out through numerical simulation based on a 3D layered shell element model. The model demonstrated capability to simulate various forms of new and existing masonry systems commonly constructed in Australia such as unreinforced, internally and externally reinforced, confined and dry-stack masonry. In addition, the model simultaneously simulates in-plane and out-of-plane responses.

Factors influencing kinetic and equilibrium behaviour of sodium ion exchange with strong acid cation resin

This study reports an investigation of the ion exchange treatment of sodium chloride solutions in relation to use of resin technology for applications such as desalination of brackish water. In particular, a strong acid cation (SAC) resin (DOW Marathon C) was studied to determine its capacity for sodium uptake and to evaluate the fundamentals of the ion exchange process involved. Key questions to answer included: impact of resin identity; best models to simulate the kinetics and equilibrium exchange behaviour of sodium ions; difference between using linear least squares (LLS) and non-linear least squares (NLLS) methods for data interpretation; and, effect of changing the type of anion in solution which accompanied the sodium species. Kinetic studies suggested that the exchange process was best described by a pseudo first order rate expression based upon non-linear least squares analysis of the test data. Application of the Langmuir Vageler isotherm model was recommended as it allowed confirmation that experimental conditions were sufficient for maximum loading of sodium ions to occur. The Freundlich expression best fitted the equilibrium data when analysing the information by a NLLS approach. In contrast, LLS methods suggested that the Langmuir model was optimal for describing the equilibrium process. The Competitive Langmuir model which considered the stoichiometric nature of ion exchange process, estimated the maximum loading of sodium ions to be 64.7 g Na/kg resin. This latter value was comparable to sodium ion capacities for SAC resin published previously. Inherent discrepancies involved when using linearized versions of kinetic and isotherm equations were illustrated, and despite their widespread use, the value of this latter approach was questionable. The equilibrium behaviour of sodium ions form sodium fluoride solution revealed that the sodium ions were now more preferred by the resin compared to the situation with sodium chloride. The solution chemistry of hydrofluoric acid was suggested as promoting the affinity of the sodium ions to the resin.

Documenting the inevitable: Voting behaviour at the 2013 Australian election

This chapter uses data from the 2013 Australian Election Study (AES), conducted by Clive Bean, Ian McAllister, Juliet Pietsch and Rachel Gibson (Bean et al. 2014) to investigate political attitudes and voting behaviour in the election. The study was funded by the Australian Research Council and involved a national survey of political attitudes and behaviour using a self-completion questionnaire mailed to respondents on the day before the 7 September election. The sample was a systematic random sample of enrolled voters throughout Australia, drawn by the Australian Electoral Commission. Respondents were given the option of returning the completed questionnaire by reply-paid mail or completing the survey online. Non-respondents were sent several follow-up mailings and the final sample size was 3955, representing a response rate of 34 per cent. The data were weighted to reflect population parameters for gender, age, state and vote.

An object-centred approach to encourage online participation in the context of behaviour change

Online groups rely on contributions from their members to flourish, but in the context of behaviour change individuals are typically reluctant to participate actively before they have changed successfully. We took inspiration from CSCW research on objects to address this problem by shifting the focus of online participation from the exchange of personal experiences to more incidental interactions mediated by objects that offer support for change. In this article we describe how we designed, deployed and studied a smartphone application that uses different objects, called distractions and tips, to facilitate social interaction amongst people trying to quit smoking. A field study with 18 smokers revealed different forms of interaction: purely instrumental interactions with the objects, subtle engagement with other users through receptive and covert interactions, as well as explicit interaction with other users through disclosure and mutual support. The distraction objects offered a stepping-stone into interaction, whereas the tips encouraged interaction with the people behind the objects. This understanding of interaction through objects complements existing frameworks of online participation and adds to the current discourse on object-centred sociality. Furthermore, it provides an alternative approach to the design of online support groups, which offers the users enhanced control about the information they share with other users. We conclude by discussing how researchers and practitioners can apply the ideas of interaction around objects to other domains where individuals may have a simultaneous desire and reluctance to interact.

Social interaction and reflection for behaviour change

This article introduces the theme issue on social interaction and reflection for behaviour change. A large body of research exists on systems designed to help users in changing their behaviours, for instance, to exercise more regularly or to reduce energy consumption. Increasingly, these systems focus on multiple users, often to encourage open-ended reflection rather than prescribing a particular course of action. As background for this theme issue, this article presents a literature review on behaviour change support systems that focus on social interaction and reflection. The review highlights five key approaches amongst these systems: social traces, social support, collective use, reflection-in-action, and reflection-on-action. Each approach offers unique benefits, but also challenges for the design of behaviour change support systems. We highlight how the articles in this theme issue contribute to our current understanding of these five approaches, and beyond that, set out some broad directions for future work.

Things you don't want to know about yourself: Ambivalence about tracking and sharing personal information for behaviour change

Technologies that facilitate the collection and sharing of personal information can feed people's desire for enhanced self-knowledge and help them to change their behaviour, yet for various reasons people can also be reluctant to use such technologies. This paper explores this tension through an interview study in the context of smoking cessation. Our findings show that smokers and recent ex-smokers were ambivalent about their behaviour change as well as about collecting personal information through technology and sharing it with other users. We close with a summary of three challenges emerging from such ambivalence and directions to address them.

Formal network behaviour analysis using model checking

In this research we modelled computer network devices to ensure their communication behaviours meet various network standards. By modelling devices as finite-state machines and examining their properties in a range of configurations, we discovered a flaw in a common network protocol and produced a technique to improve organisations' network security against data theft.

Atomistic investigation into the mechanical behaviour of crystalline and amorphous TiO2 nanotubes

Titanium dioxide (TiO2) nanotubes are appealing to research communities due to their excellent functional properties. However, there is still a lack of understanding of their mechanical properties. In this work, we conduct molecular dynamics (MD) simulations to investigate the mechanical behaviour of rutile and amorphous TiO2 nanotubes. The results indicate that the rutile TiO2 nanotube has a much higher Young's modulus (∼800 GPa) than the amorphous one (∼400 GPa). Under tensile loading, rutile nanotubes fail in the form of brittle fracture but significant ductility (up to 30%) has been observed in amorphous nanotubes. This is attributed to a unique ‘repairing’ mechanism via bond reconstruction at under-coordinated sites as well as bond conversion at over-coordinated sites. In addition, it is observed that the fracture strength of rutile nanotubes is strongly dependent on their free surfaces. These findings are considered to be useful for development of TiO2 nanostructures with improved mechanical properties.

Behaviour of natural zeolites used for the treatment of simulated and actual coal seam gas water

Coal seam gas operations produce significant quantities of associated water which often require demineralization. Ion exchange with natural zeolites has been proposed as a possible approach. The interaction of natural zeolites with solutions of sodium chloride and sodium bicarbonate in addition to coal seam gas water is not clear. Hence, we investigated ion exchange kinetics, equilibrium, and column behaviour of an Australian natural zeolite. Kinetic tests suggested that the pseudo first order equation best simulated the data. Intraparticle diffusion was part of the rate limiting step and more than one diffusion process controlled the overall rate of sodium ion uptake. Using a constant mass of zeolite and variable concentration of either sodium chloride or sodium bicarbonate resulted in a convex isotherm which was fitted by a Langmuir model. However, using a variable mass of zeolite and constant concentration of sodium ions revealed that the exchange of sodium ions with the zeolite surface sites was in fact unfavourable. Sodium ion exchange from bicarbonate solutions (10.3 g Na/kg zeolite) was preferred relative to exchange from sodium chloride solutions (6.4 g Na/kg zeolite). The formation of calcium carbonate species was proposed to explain the observed behaviour. Column studies of coal seam gas water showed that natural zeolite had limited ability to reduce the concentration of sodium ions (loading 2.1 g Na/kg zeolite) with rapid breakthrough observed. It was concluded that natural zeolites may not be suitable for the removal of cations from coal seam gas water without improvement of their physical properties.

Season of birth and location of residence: Defining the role of ultraviolet radiation exposure on childhood temperament and behaviour

This thesis added new insight to research knowledge about the role that season and ultraviolet radiation (UV) exposure during pregnancy has on children's temperament and behaviours, using a nation-wide longitudinal study. It was found that young children born in summer months are likely to have problematic behaviours. The thesis also found that summer-born children are likely to receive lowest levels of UV exposure during the gestational period. Finally, this work showed that low gestational UV exposure is associated with an increased risk of behavioural problems in children.

Glycaemic behaviour during breastfeeding in women with Type 1 diabetes

Aim To describe glycaemia in both breastfeeding women and artificially feeding women with Type 1 diabetes, and the changes in glycaemia induced by suckling. Methods A blinded continuous glucose monitor was applied for up to 6 days in eight breastfeeding and eight artificially feeding women with Type 1 diabetes 2–4 months postpartum. Women recorded glucose levels, insulin dosages, oral intake and breastfeeding episodes. A standardized breakfast was consumed on 2 days. A third group (clinic controls) were identified from a historical database. Results Carbohydrate intake tended to be higher in breastfeeding than artificially feeding women (P = 0.09) despite similar insulin requirements. Compared with breastfeeding women, the high blood glucose index and standard deviation of glucose were higher in artificially feeding women (P = 0.02 and 0.06, respectively) and in the clinical control group (P = 0.02 and 0.05, respectively). The low blood glucose index and hypoglycaemia were similar. After suckling, the low blood glucose index increased compared with before (P < 0.01) and during (P < 0.01) suckling. Hypoglycaemia (blood glucose < 4.0 mmol/l) occurred within 3 h of suckling in 14% of suckling episodes, and was associated with time from last oral intake (P = 0.04) and last rapid-acting insulin (P = 0.03). After a standardized breakfast, the area under the glucose curve was positive. In breastfeeding women the area under the glucose curve was positive if suckling was avoided for 1 h after eating and negative if suckling occurred within 30 min of eating. Conclusions Breastfeeding women with Type 1 diabetes had similar hypoglycaemia but lower glucose variability than artificially feeding women. Suckling reduced maternal glucose levels but did not cause hypoglycaemia in most episodes.

Augmenting process elicitation with visual priming: An empirical exploration of user behaviour and modelling outcomes

Business process models have become an effective way of examining business practices to identify areas for improvement. While common information gathering approaches are generally efficacious, they can be quite time consuming and have the risk of developing inaccuracies when information is forgotten or incorrectly interpreted by analysts. In this study, the potential of a role-playing approach to process elicitation and specification has been examined. This method allows stakeholders to enter a virtual world and role-play actions similarly to how they would in reality. As actions are completed, a model is automatically developed, removing the need for stakeholders to learn and understand a modelling grammar. An empirical investigation comparing both the modelling outputs and participant behaviour of this virtual world role-play elicitor with an S-BPM process modelling tool found that while the modelling approaches of the two groups varied greatly, the virtual world elicitor may not only improve both the number of individual process task steps remembered and the correctness of task ordering, but also provide a reduction in the time required for stakeholders to model a process view.