Physical activity promotion in primary care: Bridging the gap between research and practice

Background: Aflifle a growing literature supports the effectiveness of physical activity interventions delivered in the primary care setting, few studies have evaluated efforts to increase physician counseling on physical activity during routine practice (i.e., outside the context of controlled research). This paper reports the results of a dissemination trial of a primary care-based physical activity counseling intervention conducted within the context of a larger, multi-strategy, Australian community-based, physical activity intervention, the 10,000 Steps Rockhampton Project. Methods: All 23 general practices and 66 general practitioners (GPs, the Australian equivalent of family physicians) were invited to participate. Practice visits were made to consenting practices during which instruction in brief physical activity counseling was offered, along with physical activity promotion resources (print materials and pedometers). The evaluation, guided by the RE-AIM framework, included collection of process data, as well as pre-and post-inteivention data from a mailed GP survey, and data from the larger project's random-digit-dialed, community-based, cross-sectional telephone survey that was conducted in Rockhampton and a comparison community, Results: Ninety-one percent of practices were visited by 10,000 Steps staff and agreed to participate, with 58% of GPs present during the visits. General practitioner survey response rates were 67% (n =44/66 at baseline) and 71% (n =37/52, at 14-month follow-up). At follow-up, 62% had displayed the poster, 81% were using the brochures, and 70% had loaned pedometers to patients, although the number loaned was relatively small. No change was seen in GP self-report of the percentage of patients counseled on physical activity. However, data from the telephone surveys showed a 31% increase in the likelihood of recalling GP advice on physical activity in Rockhampton (95% confidence interval [CI]=1.11-1.54) compared to a 16% decrease (95% CI=0.68-1.04) in the comparison community. Conclusions: This dissemination study achieved high rates of GP uptake, reasonable levels of implementation, and a significant increase in the number of community residents counseled on physical activity. These results suggest that evidence-based primary care physical activity counseling protocols can be translated into routine practice, although the initial and ongoing investment of time to develop partnerships with relevant healthcare organizations, and the interest generated by the overall 10,000 Steps program should not be underestimated. ((C) 2004 American journal of Preventive Medicine.

The International Consortium on Mental Health Policy and Services: objectives, design and project implementation

The concept of the burden of disease, introduced and estimated for a broad range of diseases in the World Bank report of 1993 illustrated that mental and neurological disorders not only entail a higher burden than cancer, but are responsible, in developed and developing countries, for more than 15% of the total burden of all diseases. As a consequence, over the past decade, mental disorders have ranked increasingly highly on the international agenda for health. However, the fact that mental health and nervous system disorders are now high on the international health agenda is by no means a guarantee that the fate of patients suffering from these disorders in developing countries will improve. In most developing countries the treatment gap for mental and neurological disorders is still unacceptably high. To address this problem, an international network of collaborating institutions in low-income countries has been set up. The establishment and the achievements of this network-the International Consortium on Mental Health Policy and Services-are reported. Sixteen institutions in developing countries collaborate (supported by a small number of scientific resource centres in industrialized nations) in projects on applied mental health systems research. Over a two-year period, the network produced the key elements of a national mental health policy; provided tools and methods for assessing a country's current mental health status (context, needs and demands, programmes, services and care and outcomes); established a global network of expertise, i.e., institutions and experts, for use by countries wishing to reform their mental health policy, services and care; and generated guidelines and examples for upgrading mental health policy with due regard to the existing mental health delivery system and demographic, cultural and economic factors.

The impact of organizational culture and reshaping capabilities on change implementation success: The mediating role of readiness for change

It was hypothesized that employees' perceptions of an organizational culture strong in human relations values and open systems values would be associated with heightened levels of readiness for change which, in turn, would be predictive of change implementation success. Similarly, it was predicted that reshaping capabilities would lead to change implementation success, via its effects on employees' perceptions of readiness for change. Using a temporal research design, these propositions were tested for 67 employees working in a state government department who were about to undergo the implementation of a new end-user computing system in their workplace. Change implementation success was operationalized as user satisfaction and system usage. There was evidence to suggest that employees who perceived strong human relations values in their division at Time 1 reported higher levels of readiness for change at pre-implementation which, in turn, predicted system usage at Time 2. In addition, readiness for change mediated the relationship between reshaping capabilities and system usage. Analyses also revealed that pre-implementation levels of readiness for change exerted a positive main effect on employees' satisfaction with the system's accuracy, user friendliness, and formatting functions at post-implementation. These findings are discussed in terms of their theoretical contribution to the readiness for change literature, and in relation to the practical importance of developing positive change attitudes among employees if change initiatives are to be successful.

The AustLit Gateway and Scholarly Bibliography: A Specialist Implementation of the FRBR

This paper discusses how the AustLit: Australian Literature Gateway's interpretation, enhancement, and implementation of the International Federation of Library Associations and Institutions' Functional Requirements for Bibliographic Records (FRBR Final Report 1998) model is meeting the needs of Australian literature scholars for accurate bibliographic representation of the histories of literary texts. It also explores how the AustLit Gateway's underpinning research principles, which are based on the tradition of scholarly enumerative and descriptive bibliography, with enhancements from analytical bibliography and literary biography, have impacted upon our implementation of the FRBR model. The major enhancement or alteration to the model is the use of enhanced manifestations, which allow the full representation of all agents' contributions to be shown in a highly granular format by enabling creation events to be incorporated at all levels of the Work, Expression, and Manifestation nexus.

A simple implementation of a normal mixture approach to differential gene expression in multiclass microarrays

Motivation: An important problem in microarray experiments is the detection of genes that are differentially expressed in a given number of classes. We provide a straightforward and easily implemented method for estimating the posterior probability that an individual gene is null. The problem can be expressed in a two-component mixture framework, using an empirical Bayes approach. Current methods of implementing this approach either have some limitations due to the minimal assumptions made or with more specific assumptions are computationally intensive. Results: By converting to a z-score the value of the test statistic used to test the significance of each gene, we propose a simple two-component normal mixture that models adequately the distribution of this score. The usefulness of our approach is demonstrated on three real datasets.

Healthy waterways: Healthy catchments - An integrated research/management program to understand and reduce impacts of sediments and nutrients on waterways in Queensland, Australia

The Moreton Bay Waterways and Catchments Partnership, now branded the Healthy Waterways Partnership, has built on the experience of the past 15 years here in South East Queensland (SEQ). It focuses on water quality and the ecosystem health of our freshwater, estuarine and marine systems through the implementation of actions by individual partners and the collective oversight of a regional work program that assists partners to prioritise their investments and address emerging issues. This regional program includes monitoring, reporting, marketing and communication, development of decision support tools, research that is directed to problem solving, and maintaining extensive consultative and engagement arrangements. The Partnership has produced information-based outcomes which have led to significant cost savings in the protection of water quality and ecosystem resources by its stakeholders. This has been achieved by: – providing a clear focus for management actions that has ownership of governments, industry and community; – targeted scientific research to address issues requiring appropriate management actions; – management actions based on a sound understanding of the waterways and rigorous public consultation; and, – development and implementation of a strategy that incorporates commitments from all levels of stakeholders. While focusing on our waterways, the Partnership’s approach includes addressing catchment management issues particularly relating to the management of diffuse pollution sources in both urban and rural landscapes as well as point source loads. We are now working with other stakeholders to develop a framework for integrated water management that will link water quality and water quantity goals and priorities.

Parallel implementation of stochastic simulation for large scale cellular processes

Experimental and theoretical studies have shown the importance of stochastic processes in genetic regulatory networks and cellular processes. Cellular networks and genetic circuits often involve small numbers of key proteins such as transcriptional factors and signaling proteins. In recent years stochastic models have been used successfully for studying noise in biological pathways, and stochastic modelling of biological systems has become a very important research field in computational biology. One of the challenge problems in this field is the reduction of the huge computing time in stochastic simulations. Based on the system of the mitogen-activated protein kinase cascade that is activated by epidermal growth factor, this work give a parallel implementation by using OpenMP and parallelism across the simulation. Special attention is paid to the independence of the generated random numbers in parallel computing, that is a key criterion for the success of stochastic simulations. Numerical results indicate that parallel computers can be used as an efficient tool for simulating the dynamics of large-scale genetic regulatory networks and cellular processes

A Research Agenda for Strategic Management Research in Developing Countries

This paper explores the extent to which it is possible to address issues pertaining to developing countries with significant socio-cultural and political interventions. Examples from the Sri Lankan tea plantations are used to illustrate the necessity to understand the context from actors’ perspectives using rigorous case study research, before making prescriptive recommendations. Current problems faced by the Sri Lankan tea industry are identified as not merely micro-institutional or managerial. We argue that their roots lie in reproduction of social struggles at the level of production. We propose a research agenda, in the doctrine of critical theory, for exploring the formation and implementation of business strategies in developing countries, using the tea plantation sector as a case. Our primary attempt here is to conceptualize strategic management in the context of political economy and to identify central issues to be addressed. Accordingly, we argue that researching historical dynamics of strategic management facilitates understanding and interpreting the articulation of modes of production in a given social formation. We further argue that a highly context specific research agenda is required to fully comprehend idiosyncratic characteristics of Sri Lankan strategy structures and organizational forms. Then, it is proposed that explaining the role of social formation in shaping and reshaping strategy relations should be at the centre of the research due to the social significance attached to ‘strategy’. Finally, methodological and epistemological necessities arising from the nature of strategy relationships are discussed.