A randomized controlled trial of a correspondence-based intervention for carers of relatives with psychosis

Background Family members play a crucial role in supporting the recovery of loved ones with psychosis. The journey of recovery is not only traversed by the person experiencing the mental illness but also by their family. Interventions to support these families have traditionally either focused on psychoeducation or addressed problematic interactions or expressed emotion. Family programmes have far less frequently emphasized supporting family members' adjustment to the challenges posed by their relative's disorder or their recovery from associated distress. The study compared a control condition that received only a psychoeducational booklet (Information) and a condition also receiving a correspondence-based interactive recovery-oriented intervention (Connections). The Connections group was expected to show greater improvements in recovery knowledge, well-being, experiences of caregiving, hopefulness and distress. Method A randomized controlled trial was conducted to evaluate the effectiveness of two correspondence-based family interventions delivered to 81 carers of relatives with psychosis. Results Intent-to-treat analyses showed no differential outcomes between conditions, but an analysis of participants who substantially completed their allocated treatment showed that carers receiving Connections had significantly more improvements in well-being, positive experiences of caregiving and distress. Conclusions Correspondence interventions that support carer's recovery may result in more positive mental health for those who complete key elements of the programme compared with information alone. However, many carers do not complete a correspondence programme and this may limit its impact.

Adolescent pedometer protocols : examining reactivity, tampering and participants' perceptions

The aim of this study was to investigate adolescents' potential reactivity and tampering while wearing pedometers by comparing different monitoring protocols to accelerometer output. The sample included adolescents (N=123, age range=14-15 years) from three secondary schools in New South Wales, Australia. Schools were randomised to one of the three pedometer monitoring protocols: (i) daily sealed (DS) pedometer group, (ii) unsealed (US) pedometer group or (iii) weekly sealed (WS) pedometer group. Participants wore pedometers (Yamax Digi-Walker CW700, Yamax Corporation, Kumamoto City, Japan) and accelerometers (Actigraph GT3X+, Pensacola, USA) simultaneously for seven days. Repeated measures analysis of variance was used to examine potential reactivity. Bivariate correlations between step counts and accelerometer output were calculated to explore potential tampering. The correlation between accelerometer output and pedometer steps/day was strongest among participants in the WS group (r=0.82, P <= 0.001), compared to the US (r=0.63, P <= 0.001) and DS (r=0.16, P=0.324) groups. The DS (P <= 0.001) and US (P=0.003), but not the WS (P=0.891), groups showed evidence of reactivity. The results suggest that reactivity and tampering does occur in adolescents and contrary to existing research, pedometer monitoring protocols may influence participant behaviour.

Drivers' ability to absorb information from co-located signs along motorways

The paper presents initial findings from an Austroads funded project NT1782 Ability to Absorb Information through Electronic and Static Signs. The paper aims to investigate how easily messages displayed on co-located signs can be absorbed, and if drivers can absorb messages and take appropriate action without any adverse impact on the safety and efficiency of driving. Co-location of three types of signs under motorway conditions was investigated: direction signs (DS), variable message signs (VMS) and variable speed limits/lane control signs (VSL/LCS). The authors reviewed global wide practices and research evidence on different types of sign co-locations. It was found that dual co-location of VSL/LCS, VMS and/or DS is a practical arrangement which has been widely practised overseas and in Australia. Triple co-location of VSL/LCS, VMS and DS is also practised overseas but is still new to the Australian driving community. The NT1782 project also employed an advanced driving simulator (ADS) to further investigate the possible impacts of sign co-location on drivers’ responses in an emergency situation and there were no obviously adverse impacts have been identified from the ADS study. The authors consolidated all findings and concluded that although there is no clear evidence showing that triple co-location gives rise to riskier behaviour, this proposition should be viewed with caution. Further evaluation of triple co-location in a real-life setting is called for.

Bringing academics on board : encouraging institution-wide diffusion of e-learning environments

Rapid advances in educational and information communications technology (ICT)have encouraged some educators to move beyond traditional face to face and distance education correspondence modes toward a rich, technology mediated e-learning environment. Ready access to multimedia at the desktop has provided the opportunity for educators to develop flexible, engaging and interactive learning resources incorporating multimedia and hypermedia. However, despite this opportunity, the adoption and integration of educational technologies by academics across the tertiary sector has typically been slow. This paper presents the findings of a qualitative study that investigated factors influencing the manner in which academics adopt and integrate educational technology and ICT. The research was conducted at a regional Australian university, the University of Southern Queensland (USQ), and focused on the development of e-learning environments. These e-learning environments include a range of multimodal learning objects and multiple representations of content that seek to cater for different learning styles and modal preferences, increase interaction, improve learning outcomes, provide a more inclusive and equitable curriculum and more closely mirror the on campus learning experience. This focus of this paper is primarily on the barriers or inhibitors academics reported in the study, including institutional barriers, individual inhibitors and pedagogical concerns. Strategies for addressing these obstacles are presented and implications and recommendations for educational institutions are discussed.

Does vigorous physical activity provide additional benefits beyond those of moderate?

Background Although guidelines suggest that vigorous physical activity (PA) confers “extra” benefits compared with those from moderate-intensity activity alone, the magnitude of this additional benefit is unclear. The aim was to compare the reduction in risk of hypertension (HT) and depressive symptoms (DS) for 12 yr in middle-age women who reported (a) only moderate-intensity PA (MOPA) and (b) a combination of moderate and vigorous PA (MVPA), after controlling for overall volume of activity. Methods The study involved 11,285 participants in the Australian Longitudinal Study on Women’s Health, who completed surveys in 1998 (age = 46–52 yr), 2001, 2004, 2007, and 2010. Generalized estimating equation models (with 3-yr time lag) were used to examine the relationship between PA in seven categories from 0 to >2000 MET·min·wk−1 and occurrence of HT and DS for women who reported MOPA or MVPA. Results For HT, risk was slightly lower for MVPA than for MOPA across the entire range of PA levels, but this difference was only significant at the highest PA level (>2000; odds ratio [OR] = 0.80 MOPA and 0.56 MVPA). For DS, OR values were similar in both groups up to 500 MET·min·wk−1, then slightly lower for MVPA than for MOPA at higher PA levels. Again, this difference was only significant at the highest PA level (>2000; OR = 0.57 MOPA and 0.42 MVPA). OR values were slightly attenuated in adjusted models. Conclusions Doing both vigorous and moderate activity does not have significant additional benefits in terms of HT and DS, above those from moderate-intensity activity alone, except at very high levels of PA.

Money laundering and FATF compliance by the international community

This paper examines the anti-money laundering systems of Australia, the United Arab Emirates (UAE), the United Kingdom (UK) and the United States of America (USA), the extent to which they have implemented the Financial Action Task Force (FATF) recommendations, and how compliance with these recommendations is affected by local cultural and economic factors. The paper makes use of FATF evaluation reports to compare the countries’ compliance; it examines some of the underlying cultural considerations and culture-specific ethical issues that affect the extent of compliance, and how cultural and ethical considerations may affect good governance. The findings indicate that the UK and the USA are the most advanced with regards to their compliance with the FATF recommendations and Australia and the UAE less so. The UAE is in particular found to be least compliant. We relate this finding to previous work on how a country’s legal and financial systems develop in line with its religion, culture and socio-economic situation, and examine how such local factors have affected the UAE’s financial and anti-money laundering and combating the financing of terrorism (AML/CFT) systems. This research will be of interest to policy-makers and government agencies involved in addressing money laundering and its successful detection and prosecution.

Editoral : Correspondence regarding Anker SD, Koehler F, Abraham WT. Telemedicine and remote management of patients with heart failure. The Lancet 2011; 378: 731–39. Published 20 August 2011.

We read the excellent review of telemonitoring in chronic heart failure (CHF)1 with interest and commend the authors on the proposed classification of telemedical remote management systems according to the type of data transfer, decision ability and level of integration. However, several points require clarification in relation to our Cochrane review of telemonitoring and structured telephone support2. We included a study by Kielblock3. We corresponded directly with this study team specifically to find out whether or not this was a randomised study and were informed that it was a randomised trial, albeit by date of birth. We note in our review2 that this randomisation method carries a high risk of bias. Post-hoc metaanalyses without these data demonstrate no substantial change to the effect estimates for all cause mortality (original risk ratio (RR) 0·66 [95% CI 0·54, 0·81], p<0·0001; revised RR 0·72 [95% CI 0·57, 0·92], p=0·008), all-cause hospitalisation (original RR 0·91 [95% CI 0·84, 0·99] p=0·02; revised RR 0.92 [95% CI 0·84, 1·02], p=0·10 ) or CHF-related hospitalisation (original RR 0·79 [95% CI 0·67, 0·94] p=0·008; revised RR 0·75 [95% CI 0·60, 0·94] p=0·01). Secondly, we would classify the Tele-HF study4, 5 as structured telephone support, rather than telemonitoring. Again, inclusion of these data alters the point-estimate but not the overall result of the meta-analyses4. Finally, our review2 does not include invasive telemonitoring as the search strategy was not designed to capture these studies. Therefore direct comparison of our review findings with recent studies of these interventions is not recommended.

Application of XRF and correspondence analysis to provenance studies of coastal and inland archaeological pottery from the Mngeni river area, South Africa

XRF spectrometry was applied to provenance studies of Iron Age pottery specimens that originated from the Mngeni river area in South Africa. Ten transition metals (Sc to Zn) mere determined in 107 potsherds, excavated from four different sites. The data were subjected to a computerized mathematical technique (correspondence analysis), which was used to group the samples according to the similarity of their elemental distributions. The groupings were interpreted in terms of social or cultural interaction between the sites. (C) 1997 by John Wiley & Sons, Ltd.

The use of correspondence analysis to compare major and trace elements for provenance studies of iron-age pottery from the Mngeni river area, South Africa

Provenance studies of iron-age pottery specimens originating from the Mngeni river area in South Africa was carried out by applying XRF spectrometry. A total of sixteen major and trace elements were analysed in a batch of 107 potsherds, excavated from four different archaeological sites in the aforementioned area. A multivariate statistical programme Correspondence Analysis was used in this study to obtain the relevant clustering patterns according to the similarity of the elemental distributions. Differences and similarities in the clusters obtained for the majors and trace elements are discussed.