Investigations of the physical and chemical properties of ambient fine particles in urban schools

This thesis reports a comprehensive study on the physical and chemical properties of airborne particles in Brisbane, especially around schools. The sources and potential toxicity of the particles were identified, enabling an assessment of the contributing factors to children's exposure at school. The results from this thesis give a quantitative estimate of the range of airborne particles that children are exposed to at urban schools with different traffic conditions.

Screening for youth depression in schools : a review of the literature

This paper provides a review of the literature pertaining to screening for youth depression in schools. It provides the rationale regarding this topic – why this topic is important and needs to be explored. This justification is followed by an investigation of the importance of mental health intervention in general – including depression. Analysis will then shift to the current literature surrounding screening for youth depression in schools, followed by additional information relating to this topic.

Design and ethics in digital mental health promotion

This chapter presents a case study of Participatory Design as a design framework for developing interactive digital tools for promoting children’s resilience. The author argues for a participatory methodology as an ethical approach that involves children as co-designers in the process from which they are traditionally excluded, namely the creative design process and the process of mental health promotion.

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.

The CLIMATE schools combined study : a cluster randomised controlled trial of a universal Internet-based prevention program for youth substance misuse, depression and anxiety

Background Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders and frequently co-occur. While programs for the prevention and reduction of symptoms associated with (i) substance use and (ii) mental health disorders exist, research is yet to determine if a combined approach is more effective. This paper describes the study protocol of a cluster randomised controlled trial to evaluate the effectiveness of the CLIMATE Schools Combined intervention, a universal approach to preventing substance use and mental health problems among adolescents. Methods/design Participants will consist of approximately 8400 students aged 13 to 14-years-old from 84 secondary schools in New South Wales, Western Australia and Queensland, Australia. The schools will be cluster randomised to one of four groups; (i) CLIMATE Schools Combined intervention; (ii) CLIMATE Schools - Substance Use; (iii) CLIMATE Schools - Mental Health, or (iv) Control (Health and Physical Education as usual). The primary outcomes of the trial will be the uptake and harmful use of alcohol and other drugs, mental health symptomatology and anxiety, depression and substance use knowledge. Secondary outcomes include substance use related harms, self-efficacy to resist peer pressure, general disability, and truancy. The link between personality and substance use will also be examined. Discussion Compared to students who receive the universal CLIMATE Schools - Substance Use, or CLIMATE Schools - Mental Health or the Control condition (who received usual Health and Physical Education), we expect students who receive the CLIMATE Schools Combined intervention to show greater delays to the initiation of substance use, reductions in substance use and mental health symptoms, and increased substance use and mental health knowledge

Good Starts for recently arrived youth with refugee backgrounds : promoting wellbeing in the first three years of settlement in Melbourne, Australia

This report describes the key findings of a longitudinal study (2004—2008) investigating the experiences of settlement among a group of 120 recently arrived young people with refugee backgrounds settling in Melbourne, Australia. Each year, less than one per cent of the world’s refugees are offered resettlement in one of 18 countries participating in The Office of the United Nations High Commissioner for Refugees (UNHCR) resettlement programme. Australia offers places to around 13,500 people per year, of whom about 26 per cent are between the ages of 10 and 19. What are the experiences of these young people in their early settlement years? How do they negotiate the transition from childhood to adulthood given the traumas of their past and the challenges of their present and future in Australia? What are the key social determinants of wellbeing and good settlement and what can we learn from these young people about what social policies and services will most effectively support them to make successful lives in their new home? This study explores these questions, the overall aim being to identify the key social determinants of wellbeing and settlement and to describe the lived experiences of these young people as they shape their lives in Australia.

Promoting resilience and posttraumatic growth in medical professionals

Across the lifespan traumatic experiences are common with more people experiencing such events than not. Within the context of being a medical professional trauma may result from a direct experience (e.g., in a person’s personal life) but may also occur vicariously. For example, a medical professional may be traumatized during the course of their employ as they come to the aid of a trauma survivor. Although there can be long term negative sequale for trauma survivors (e.g., PTSD, depression), the majority of people who experience trauma, vicariously or otherwise, are resilient to long term effects and some people grow or develop beyond their pre-event level of functioning. Therefore, in addition to interest in antecedents and correlates of pathology, research examining the predictors and correlates of resilience and growth has gained notable attention. In this chapter the fundamental assumptions of the salutogenic theory are discussed. Salutogenisis refers to the study of the origins of health and to that end has a goal to determine factors involved in promoting and maintaining health. The chapter then goes on to describe posttraumatic growth, a term used to denote positive post-trauma changes as well as resilience including discussion of the similarities and differences between these two constructs. Ways of promoting growth and resilience in medical professionals are then identified. The chapter concludes with discussion of ways in which individuals can enhance their potential for growth and also of ways in which the organization they work for can best facilitate and promote resilience and growth in its employees.

Promoting active lifestyles in young children: investigating mothers’ decisions about their child’s physical activity and screen time behaviours

Objectives Given increasing trends of obesity being noted from early in life and that active lifestyles track across time, it is important that children at a very young age be active to combat a foundation of unhealthy behaviours forming. This study investigated, within a theory of planned behaviour (TPB) framework, factors which influence mothers’ decisions about their child’s 1) adequate physical activity (PA) and 2) limited screen time behaviours. Methods Mothers (N = 162) completed a main questionnaire, via on-line or paper-based administration, which comprised standard TPB items in addition to measures of planning and background demographic variables. One week later, consenting mothers completed a follow-up telephone questionnaire which assessed the decisions they had made regarding their child’s PA and screen time behaviours during the previous week. Results Hierarchical multiple regression analyses revealed support for the predictive model, explaining an overall 73% and 78% of the variance in mothers’ intention and 38% and 53% of the variance in mothers’ decisions to ensure their child engages in adequate PA and limited screen time, respectively. Attitude and subjective norms predicted intention in both target behaviours, as did intentions with behaviour. Contrary to predictions, perceived behavioural control (PBC) in PA behaviour and planning in screen time behaviour were not significant predictors of intention, neither was PBC a predictor of either behaviour. Conclusions The findings illustrate the various roles that psycho-social factors play in mothers’ decisions to ensure their child engages in active lifestyle behaviours which can help to inform future intervention programs aimed at combating very young children’s inactivity.

Primary schools and the delivery of relationships and sexuality education : the experience of Queensland teachers

Primary school provides an appropriate opportunity for children to commence comprehensive relationships and sexuality education (RSE), yet many primary school teachers avoid teaching this subject area. In the absence of teacher confidence and competence, schools have often relied on health promotion professionals, external agencies and/or one-off issue related presentations rather than cohesive, systematic and meaningful health education. This study examines the implementation of a ten-lesson pilot RSE unit of work and accompanying assessment task in two primary schools in South-East Queensland, Australia. Drawing predominantly from qualitative data, this research explores the experiences of primary school teachers as they engage with RSE curriculum resources and content delivery. The results show that the provision of a high quality RSE curriculum resource grounded in contemporary educational principles and practices enables teachers to feel more confident to deliver RSE and minimises potential barriers such as parental objections and fear of mishandling sensitive content.

An ICT Implementation Strategy for Primary Schools in Fiji

Information and Communication Technology (ICT) has been embraced with hope and optimism in both developing and developed countries. While in the developed countries most citizens have access to one or many of the devices which utilize this technology (e.g. desktop, laptop, tablet, mobile phone), in developing countries this “luxury” can only be afforded by a privileged few. The use of these technologies in primary schools in developing countries is low. This is due to the fact that there are other bigger issues that some of these countries have to grapple with such as meeting the basic health and education needs of its citizens. Quality primary education and global development partnerships are two of the eight Millennium Development Goals of the United Nations (UNDP, 2012). Many Governments, NGO’s, service organizations, and individuals in developing countries are always looking at ways in which the disparity (not just in terms of ICT) can be narrowed. There has to be a greater collaboration between stakeholders in developing and developed countries (Mutonyi & Norton, 2007). How do stakeholders from developed countries engage with partners in developing countries to deliver meaningful and relevant outcomes for primary school students using ICT? As a first step getting the key stakeholders on side is critical. In the Fijian context, schools are managed and run by committees who are members of the community. Therefore, getting the committee on side together with the head-teachers and teachers is critical. Conversations about teaching and learning with technology can then follow with greater ease. The sustainability of any innovative approaches is also an essential element of this equation. Through this lens, this chapter investigates how ICT can be implemented in primary schools in Fiji. It proposes a three-layered approach which focuses on: (1) the community, school leadership, and teachers; (2) content, pedagogy, and technology, and (3) sustainability.

The importance of social support for students with intellectual disability : an intervention to promote mental health and well-being

Children and adolescents with intellectual disability have higher rates of mental health problems compared with there typically developing peers. Social support has been identified as an important protective factor for psychological well - being. In this paper we discuss the benefits of social support networks, and consider approaches for promoting children’s perceptions of the availability of social support. We describe an evidence-based intervention that has been specially adapted and implemented for students with intellectual disability in school settings. In a randomised controlled trial, the Aussie Optimism Resilience Skills Program was associated with improved perceptions of social support following a 10-week intervention. Educators need to be aware of the increased vulnerability of students with intellectual disability to the development mental health problems and the proactive ways in which they can promote psychological well - being within their classrooms.

Regulatory options for gender equity in health research

It is clear that where a disease affects men and women differently, research on potential therapies or cures should include both men and women and should examine whether the therapy is effective and safe for both sexes. In this paper we consider whether there is an appropriate role for law in regulating to ensure an examination of these sex- and gender-specific aspects in health research. We consider the relative advantages and disadvantages of pursuing a regulatory approach to achieving gender equity in the field of women's health by exploring first, the meaning of gender equity, and second, the regulatory mechanisms that might be best suited to promoting the goal of gender equity. Within our examination of different regulatory forms and mechanisms, we also interrogate the shift from gender-neutral provisions relating to sex in favor of generalized notions of fairness that remove any specific consideration of sex.

Elemental composition and potential toxicity of airborne particles at some urban schools

Although both the size and chemical composition of ambient particles are important parameters in determining their toxicities, their relative contributions are unclear (Heal et al., 2012). Children are particularly at risk to the detrimental health effects that have been linked to long term exposure to airborne particles (See e.g. Ruckerl et al., 2011). However, there is currently limited understanding of the health effects in children due to long term exposure to airborne particles. Schools are locations within an urban environment where children experience significant exposure to vehicle emissions, and to date there is limited information assessing children’s exposure at school. This study is a part of a large project aimed at gaining a holistic picture of the exposure of children to traffic related pollutants. In the current paper, results from the investigation of the elemental composition of airborne particle at urban schools are presented.

Every step counts : promoting activity among obese adolescents

In separate articles, two projects are described. The first describes a community project in Rockhampton to encourage people to walk more often and the second, a project to encourage more walking in obese adolescents

Asthma interventions in primary schools : a review

Objective To explore, in depth, the literature for evidence supporting asthma interventions delivered within primary schools and to identify any “gaps” in this research area. Methods A literature search using electronic search engines (i.e. Medline, PubMed, Education Resources Information Center (ERIC), International Pharmaceutical Abstracts (IPA), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and Informit) and the search terms “asthma”, “asthma intervention” and “school-based asthma education program” (and derivatives of these keywords) was conducted. Results Twenty-three articles met the inclusion criteria; of these eight were Randomised Controlled Trials. There was much variety in the type, content, delivery and outcome measures in these 23 studies. The most common intervention type was asthma education delivery. Most studies demonstrated improvement in clinical and humanistic markers, for example, asthma symptoms medication use (decrease in reliever medication use or decrease in the need for rescue oral steroid), inhaler use technique and spacer use competency, lung function and quality of life. Relatively few studies explored the effect of the intervention on academic outcomes. Most studies did not report on the sustainability or cost effectiveness of the intervention tested. Another drawback in the literature was the lack of details about the intervention and inconsistency in instruments selected for measuring outcomes. Conclusion School-based asthma interventions regardless of their heterogeneity have positive clinical, humanistic, health economical and academic outcomes.