A randomised controlled trial of an intervention to increase the implementation of a healthy canteen policy in Australian primary schools: study protocol

Background: The implementation of healthy school canteen policies has been recommended as a strategy to help prevent unhealthy eating and excessive weight gain. Internationally, research suggests that schools often fail to implement practices consistent with healthy school canteen policies. Without a population wide implementation, the potential benefits of these policies will not be realised. The aim of this trial is to assess the effectiveness of an implementation intervention in increasing school canteen practices consistent with a healthy canteen policy of the New South Wales (NSW), Australia, government known as the 'Fresh Tastes @ School NSW Healthy School Canteen Strategy'.Methods/design: The parallel randomised trial will be conducted in 70 primary schools located in the Hunter region of New South Wales, Australia. Schools will be eligible to participate if they are not currently meeting key components of the healthy canteen policy. Schools will be randomly allocated after baseline data collection in a 1:1 ratio to either an intervention or control group using a computerised random number function in Microsoft Excel. Thirty-five schools will be selected to receive a multi-component intervention including implementation support from research staff, staff training, resources, recognition and incentives, consensus and leadership strategies, follow-up support and implementation feedback. The 35 schools allocated to the control group will not receive any intervention support as part of the research trial. The primary outcome measures will be i) the proportion of schools with a canteen menu that does not contain foods or beverages restricted from regular sale ('red' and 'banned' items) and ii) the proportion of schools where healthy canteen items ('green' items) represent the majority (>50%) of products listed on the menu. Outcome data will be collected via a comprehensive menu audit, conducted by dietitians blind to group allocation. Intervention effectiveness will be assessed using logistic regression models adjusting for baseline values.Discussion: The proposed trial will represent a novel contribution to the literature, being the first randomised trial internationally to examine the effectiveness of an intervention to facilitate implementation of a healthy canteen policy.

Development in Kyrgyzstan : Failed State or Failed Statebuilding?

This chapter examines the tensions present in approaches to development in Kyrgyzstan. It argues that development in this small post-Soviet republic has been approached primarily as formal statebuilding (Marquette & Beswick 2011), implying a belief that domestic political institutions and processes are the primary cause of fragility and that the adoption of democratic institutions and free market economic policies will result in development. The consequences of this inherently normative endeavour are explored in terms of the local political economy that has developed since independence and especially in the 2000s. Centrally, it is demonstrated how the competing interests and priorities of donors and local elite have undermined development efforts. On the basis of this analysis, it is suggested that rather than being framed as a failing or failed state, Kyrgyzstan is better understood as a case of failed statebuilding that cannot be remedied by the adoption of the current principles for development in fragile states situations, as adopted by the international community. Instead, the focus needs to be on facilitating the rebuilding of state-society relations both locally and internationally with a view to beginning to check the marketization of the state that has occurred.

Opportunity lost? The major in mental health nursing in Australia

The ongoing difficulty in educating and sustaining an adequate nursing workforce in mental health settings has been identified throughout the world. Different strategies have been implemented internationally to deal with this situation. In Australia major streams in mental health nursing were introduced in some Australian universities to promote mental health nursing as a viable career choice for nursing students. Fourteen universities had implemented or planned to implement a major stream in mental health nursing. From a survey of these programs a lack of consistency in the structure and content of programs was evident. For most programs the intakes had been relatively small, although retention rates appeared promising.

Determining criteria to assess patient readiness for discharge from postanaesthetic care: An international Delphi study

Aims and objectives: To obtain expert consensus on essential criteria required to assess patient readiness for discharge from the postanaesthetic care unit. Background: A patient's condition can deteriorate after surgery, and the immediate postoperative period is recognised internationally as a time of increased risk to patient safety. A recent systematic review identified evidence-based assessment criteria for the safe discharge of patients from the postanaesthetic care unit and identified gaps in the evidence. Design: Descriptive consensus study using the Delphi method. Methods: Members of international clinical specialist groups with expertise in anaesthesia or postanaesthetic care participated in three consultation rounds. Online surveys were used to determine expert consensus with regard to aspects of postanaesthetic care and specific criteria for assessing patient readiness for discharge. Three rounds of surveys were conducted from May 2011-September 2012. Results: Twenty-three experts contributed to the panel. Consensus, that is, at least 75% agreement, was reached in regard to 24 criteria considered essential (e.g. respiratory rate 100%; pain 100%; heart rate 95%; temperature 91%). Consensus was also reached for 15 criteria not considered essential (e.g. appetite 96%; headache 76%). Consensus was not obtained for a further 10 criteria. Participants (95%) agreed that a discharge tool was important to ensure safe patient discharge. Conclusion: Consensus was achieved by a panel of international experts on the use of a tool to assess patient readiness for discharge from postanaesthesia care unit and specific variables to be included or excluded from the tool. Further work is required to develop a tool and test its reliability and validity. Relevance to clinical practice: The findings of this study have informed the development of an evidence-based tool to be piloted in a subsequent funded study of nursing assessment of patient readiness for discharge from the postanaesthetic care unit.

Tube-weaning infants and children: a survey of Australian and international practice

The aim of this study was to describe paediatric feeding-tube weaning practice in Australian children's hospitals and to compare this with practice in tube weaning programmes internationally.

Dancing with inter-disciplinarity: strategies and practices in higher education dance drama and music

The rise of inter-disciplinarity has not occurred without debate and controversy. Often responding to government agendas, it is not uncommon for university research strategies to include inter-disciplinarity by default, by supporting multidisciplinary collaborations across the institution, nationally and internationally – industry and business being a particular focus. Beginning from the premise that Inter-disciplinary is where students/staff from more than one discipline learn with, from and about one another through a common activity, usually in the context of practice, this report documents the findings of a recent research project aimed to document ways in which inter-disciplinary approaches were active in universities, how they were resourced, what made them effective, and in what ways they are limited.

International perspectives on psychosocial working conditions, mental health, and stress of dairy farm operators

Dairy farm operators-farmers, workers, and family members-are faced with many demands and stressors in their daily work and these appear to be shared across countries and cultures. Dairy operators experience high psychosocial demands with respect to a hard work and production ethos, economic influences, and social and environmental responsibility. Furthermore, both traditional and industrial farms are highly dependent on external conditions, such as weather, fluctuating markets, and regulations from government authorities. Possible external stressors include disease outbreaks, taxes related to dairy production, and recent negative societal attitudes to farming in general. Dairy farm operators may have very few or no opportunities to influence and control these external conditions, demands, and expectations. High work demands and expectations coupled with low control and lack of social support can lead to a poor psychosocial work environment, with increased stress levels, ill mental health, depression, and, in the worst cases, suicide. Internationally, farmers with ill mental health have different health service options depending on their location. Regardless of location, it is initially the responsibility of the individual farmer and farm family to handle mental health and stress, which can be of short- or long-term duration. This paper reviews the literature on the topics of psychosocial working conditions, mental health, stress, depression, and suicide among dairy farm operators, farm workers, and farm family members in an international perspective.

Predictors and risks of body fat profiles in young New Zealand European, Māori and Pacific women: study protocol for the women's EXPLORE study.

Body mass index (BMI) (kg/m(2)) is used internationally to assess body mass or adiposity. However, BMI does not discriminate body fat content or distribution and may vary among ethnicities. Many women with normal BMI are considered healthy, but may have an unidentified "hidden fat" profile associated with higher metabolic disease risk. If only BMI is used to indicate healthy body size, it may fail to predict underlying risks of diseases of lifestyle among population subgroups with normal BMI and different adiposity levels or distributions. Higher body fat levels are often attributed to excessive dietary intake and/or inadequate physical activity. These environmental influences regulate genes and proteins that alter energy expenditure/storage. Micro ribonucleic acid (miRNAs) can influence these genes and proteins, are sensitive to diet and exercise and may influence the varied metabolic responses observed between individuals. The study aims are to investigate associations between different body fat profiles and metabolic disease risk; dietary and physical activity patterns as predictors of body fat profiles; and whether these risk factors are associated with the expression of microRNAs related to energy expenditure or fat storage in young New Zealand women. Given the rising prevalence of obesity globally, this research will address a unique gap of knowledge in obesity research.

Graduate Nurse Program Coordinators' perspectives on graduate nurse programs in Victoria, Australia: A descriptive qualitative approach

Aims: The purpose of this study was to describe the formal preparation nursing graduates are given throughout their first year of nursing in terms of educational structure and content of work-based year-long graduate nurse programs, from the perspectives of Graduate Nurse Program Coordinators. Background: In Australia, graduate nurse programs aim to provide a supportive learning environment, assisting nursing graduates in applying their theory to practice and supporting them in becoming safe, competent and responsible professionals. Internationally, research has demonstrated an increase in the job satisfaction and more importantly retention rates of newly qualified nurses who are supported in their first year of employment in some type of transition program. Method: Using a descriptive qualitative approach, individual semi-structured interviews were used. These interviews were audio recorded, transcribed verbatim and thematically analysed to reveal themes and sub-themes. Results: The interviews provided an insight into the various aspects of preparation that nursing graduates are given in their first year of practice with the main theme to emerge from analysis, nature of transition programs. The three subthemes associated with nature of transition programs consisted of composition of rotations and study days and supernumerary strategies. Findings indicate variation in pedagogical models underpinning graduate nurse programs across Victoria. Clinical rotations varied between three to twelve months, the number of study days offered were between four and thirteen days and there was variation in supernumerary time and strategies within the programs investigated.

Teamwork benefits in tertiary education

Purpose – The purpose of this paper is to contribute to the understanding of the development ofstudents’ skills in the context of team-based learning. Academics have heeded the call to incorporateteam learning activities into the curricula, yet little is known of student perception of teamworkand whether they view it as beneficial to them and their future professional career. Further, this studypresents an instructional framework to guide best practice in higher education practitioners withregard to the design of teamwork assessment.Design/methodology/approach – The paper adopts a qualitative approach utilising 190 students’reflections to examine their perception of the benefits of teamwork and whether it will contribute totheir future professional work.Findings – Results indicate students perceive team-based assessment tasks require them to adopt adeep approach to learning together with a deep approach to study, as well as improving their skillsin the areas of collaboration, team unity and cultural diversity. Further, the study identified a bestpractice approach that higher education practitioners should adopt in teamwork assessment designgiving this study both national and international significance and aids fellow educators in theirpractices.Research limitations/implications – Because of the chosen research approach, the results maylack generalisability. Therefore, researchers are encouraged to test the proposed propositions further.Practical implications – The paper presents important implications for those involved in thedevelopment of assessment items where objectives include the development of team skills and qualitylearning outcomes. The findings are vital for unit and course planning and design generally, andassessment planning, design and processes, specifically, both nationally and internationally.Originality/value – This paper fulfils an identified need to study students’ perceptions of teamwork,whether they view it as beneficial to them and their future professional career, and presents a bestpractice approach for teamwork assessment design.

Lynsey Martin: A case study in 1970s Australian experimental animation

Lynsey Martin’s short experimental Animations remain largely unknown internationally. His graphic 16mm films Approximately Water (4 minutes 1972), Whitewash (1973, 4 minutes), Interview (25 minutes 1973) and Leading Ladies (1975 5 minutes) are analysed for their technique and cultural position, artifacts of a productive if marginalized period of artist made films. These graphic films stand as critical works at the heart experimental filmmaking in Australia and speak through their design and production method to current trends in digital media. Martin’s work includes the use of collage and its erasure, the grain of the photographic image and handpainting and drawing imagery directly on the film surface. Martin deals with the graphic and material elements of the filmstrip, the nature of filmic movement and the nature of photography in public space. For martin his films deal with films deal abstraction and illusionism, elements of chance, the deconstruction of film language, the diary film and process as content. These films stand as historic aesthetic traces of an immediate hands-on approach to image making that came into crisis in Australia through the disappearance of technical education in the 1980s when Martin taught graphic design in technical schools.

Sakyadhita International: gender equity in ultramodern Buddhism

The nexus between religion and violence has been widely debated in the public sphere at the turn of the twenty-first century. Much of these discourses have centered on direct violence, and on terrorism in particular. Yet, structural violence also remains endemic within many religious traditions, including Buddhism. Buddhist women, and men, continue to challenge these gender inequalities in various ways, notably Sakyadita, the International Association of Buddhist Women founded in 1987, is committed to improving conditions for Buddhist women worldwide. This article investigates how Sakyadhita is promoting gender equity in global Buddhism. It explores Sakyadhita’s origin, and focuses on the 13th Sakyadhita Conference, to examine the role of religious social movements in advancing gender parity. It also proposes an innovative ultramodern Buddhism framework for understanding contemporary global Buddhism, building on existing Buddhist studies, critical feminist and sociological theories. While focused on a Buddhist women’s social movement, this article provides new knowledge that may assist diverse religious communities in addressing gender disparities both locally and internationally.

Cross-cultural examination of the structure of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R)

This study investigated the cross-cultural factor stability and internal consistency of the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R); a measure of the quality of postoperative pain management employed internationally. We conducted exploratory factor analysis (EFA) of APS-POQ-R data from two point-prevalence studies comprising 268 and 311 surveys of Danish and Australian medical-surgical patients. Parallel analysis indicated four and three factor solutions for Danish and Australian patients respectively, which accounted for 58.1% and 52.9% of variance. Internal consistency was unsatisfactory among both Danish (Cronbach α=.54) and Australian (Cronbach α=.63) cohorts. There was a high degree of between-group similarity in item-factor loadings of variables coded as "pain experience", but not "pain management". This reflected cross-cultural differences in ratings of treatment satisfaction. For Danish patients, satisfaction was associated with the degree of pain severity and activity interference whereas for Australian patients, satisfaction was associated with their perceived ability to participate in treatment. To facilitate further cross-cultural comparison, we compared our findings to past research conducted in the U.S. and Iceland. EFA supported the construct validity of the APS-POQ-R as a measure of "pain experience", but indicated that items measuring "pain management" may vary cross-culturally. Findings highlighted the need for further validation of the APS-POQ-R internationally. PERSPECTIVE: This study revealed the APS-POQ-R as a valid measure of postoperative pain experience for Danish and Australian patients. Measures of patients' perception of pain management were not robust to group differences in treatment expectations and demonstrated cross-cultural instability. Results highlighted difficulties in establishing stable cross-cultural, cross-population subscales for the APS-POQ-R.

Youth mental health first aid: a description of the program and an initial evaluation

BACKGROUND: Adolescence is the peak age of onset for mental illness, with half of all people who will ever have a mental illness experiencing their first episode prior to 18 years of age. Early onset of mental illness is a significant predictor for future episodes. However, adolescents and young adults are less likely than the population as a whole to either seek or receive treatment for a mental illness. The knowledge and attitudes of the adults in an adolescent's life may affect whether or not help is sought, and how quickly. In 2007, the Youth Mental Health First Aid Program was launched in Australia with the aim to teach adults, who work with or care for adolescents, the skills needed to recognise the early signs of mental illness, identify potential mental health-related crises, and assist adolescents to get the help they need as early as possible. This paper provides a description of the program, some initial evaluation and an outline of future directions.

METHODS: The program was evaluated in two ways. The first was an uncontrolled trial with 246 adult members of the Australian public, who completed questionnaires immediately before attending the 14 hour course, one month later and six months later. Outcome measures were: recognition of schizophrenia or depression; intention to offer and confidence in offering assistance; stigmatising attitudes; knowledge about adolescent mental health problems and also about the Mental Health First Aid action plan. The second method of evaluation was to track the uptake of the program, including the number of instructors trained across Australia to deliver the course, the number of courses they delivered, and the uptake of the YMHFA Program in other countries.

RESULTS: The uncontrolled trial found improvements in: recognition of schizophrenia; confidence in offering help; stigmatising attitudes; knowledge about adolescent mental health problems and application of the Mental Health First Aid action plan. Most results were maintained at follow-up. Over the first 3 years of this program, a total of 318 instructors were trained to deliver the course and these instructors have delivered courses to 10,686 people across all states and territories in Australia. The program has also spread to Canada, Singapore and England, and will spread to Hong Kong, Sweden and China in the near future.

CONCLUSIONS: Initial evaluation suggests that the Youth Mental Health First Aid course improves participants' knowledge, attitudes and helping behaviour. The program has spread successfully both nationally and internationally.

Spatial design 3.0

Spatial Design 3.0 forms a new dialogue between the artist and design artefacts, lens-based practice and the entanglements of contemporary critical theory. The artist was invited to exhibit at the Peninsula Art Gallery in Plymouth, UK at the Envelop Exhibition as part of the UK Festival of Design 2015. The artwork involves wire, photography, printing, mark making, typography and patterns negotiated and frozen within spatial arrangements. These elements are manipulated as a means to engage the traditional tools and instruments of art and design methodology in contemporary practice. The work was published and internationally distributed in the accompanying catalogue.