Investigating the validity and usability of an interactive computer programme for assessing competence in telephone-based mental health triage

Telephone-based mental health triage services are frontline health-care providers that operate 24/7 to facilitate access to psychiatric assessment and intervention for people requiring assistance with a mental health problem. The mental health triage clinical role is complex, and the populations triage serves are typically high risk; yet to date, no evidence-based methods have been available to assess clinician competence to practice telephone-based mental health triage. The present study reports the findings of a study that investigated the validity and usability of the Mental Health Triage Competency Assessment Tool, an evidence-based, interactive computer programme designed to assist clinicians in developing and assessing competence to practice telephone-based mental health triage.

Perceptions of crisis care in populations who self-referred to a telephone-based mental health triage service

Although psychiatric crises are very common in people with mental illness, little is known about consumer perceptions of mental health crisis care. Given the current emphasis on recovery-oriented approaches, shared decision-making, and partnering with consumers in planning and delivering care, this knowledge gap is significant. Since the late 1990s, access to Australian mental health services has been facilitated by 24/7 telephone-based mental health triage systems, which provide initial psychiatric assessment, referral, support, and advice. A significant proportion of consumers access telephone-based mental health triage services in a state of crisis, but to date, there has been no published studies that specifically report on consumer perceptions on the quality and effectiveness of the care provided by these services. This article reports on a study that investigated consumer perceptions of accessing telephone-based mental health triage services. Seventy-five mental health consumers participated in a telephone interview about their triage service use experience. An eight-item survey designed to measure the responsiveness of mental health services was used for data collection. The findings reported here focus on the qualitative data produced in the study. Consumer participants shared a range of perspectives on telephone-based mental health triage that provide invaluable insights into the needs, expectations, and service use experiences of consumers seeking assistance with a mental health problem. Consumer perceptions of crisis care have important implications for practice. Approaches and interventions identified as important to quality care can be used to inform educational and practice initiatives that promote person-centred, collaborative crisis care.

Translating research for evidence-based public health: key concepts and future directions

Applying research to guide evidence-based practice is an ongoing and significant challenge for public health. Developments in the emerging field of ‘translation’ have focused on different aspects of the problem, resulting in competing frameworks and terminology. In this paper the scope of ‘translation’ in public health is defined, and four related but conceptually different ‘translation processes’ that support evidence-based practice are outlined: (1) reviewing the transferability of evidence to new settings, (2) translation research, (3) knowledge translation, and (4) knowledge translation research. Finally, an integrated framework is presented to illustrate the relationship between these domains, and priority areas for further development and empirical research are identified.

Change in well-being amongst participants in a four-month pedometer-based workplace health program

BACKGROUND: There is increasing uptake of workplace physical activity programs to prevent chronic disease. While they are frequently evaluated for improvement in biomedical risk factors there has been little evaluation of additional benefits for psychosocial health. We aimed to evaluate whether participation in a four-month, team-based, pedometer-based workplace health program known to improve biomedical risk factors is associated with an improvement in well-being, immediately after the program and eight-months after program completion.

METHODS: At baseline (2008), 762 adults (aged 40 ± 10 SD years, 42% male) employed in primarily sedentary occupations and voluntarily enrolled in a physical activity program were recruited from ten Australian worksites. Data was collected at baseline, at the completion of the four-month program and eight-months after program completion. The outcome was the WHO-Five Well-being Index (WHO-5), a self-administered five-item scale that can be dichotomised as 'poor' (less than 52%) or 'positive' (more than or equal to 52%) well-being.

RESULTS: At baseline, 75% of participants had positive well-being (mean: 60 ± 19 SD WHO-5 units). On average, well-being improved immediately after the health program (+3.5 units, p < 0.001) and was sustained eight-months later (+3.4 units from baseline, p < 0.001). In the 25% with poor well-being at baseline, 49.5% moved into the positive well-being category immediately after program completion, sustained eight-months later (p < 0.001).

CONCLUSIONS: Clinically relevant immediate and sustained improvements in well-being were observed after participation in the health program. These results suggest that participation in workplace programs, such as the one evaluated here, also has the potential to improve well-being.

Changes in health-related quality of life amongst participants in a four month pedometer-based workplace health program

Background: Regular physical activity (PA) is associated with a reduced risk for chronic health conditions and improved health-related quality of life (HRQoL). Efforts to increase PA have included workplace health promotion. Currently, little is known about the effect of these programs on overall HRQoL. Aim: To evaluate whether participation in a pedometer-based PA program in the workplace was associated with changes in HRQoL. Methods: 487 voluntary employees enrolled in a health program completed the SF-12 Health Survey at baseline and 4 months. Change in Physical and Mental component summary scores (PCS; MCS) was assessed with multivariable regression analysis, adjusting for covariates. Results: Participation in the program was associated with an increase of 1.5 MCS units (95% CI: 0.76, –2.09). Greater improvements in MCS were observed in those reporting an increased level of PA during the program [1.9 (CI: 0.78, 2.92) versus 0.9 (CI: –0.12, 2.03)] and a lower baseline MCS score [6.3 (CI: 4.80, 7.62) versus –1.5 (CI: –2.21, –0.80)]. No change in PCS was observed. Conclusions: Participation in this workplace PA program was associated with improvements in the mental component of HRQoL. We recommend the use of a broad perspective of health be used in both the implementation and evaluation of workplace PA programs.

Participant characteristics associated with greater reductions in waist circumference during a four-month, pedometer-based, workplace health program

BACKGROUND: Workplace health programs have demonstrated improvements in a number of risk factors for chronic disease. However, there has been little investigation of participant characteristics that may be associated with change in risk factors during such programs. The aim of this paper is to identify participant characteristics associated with improved waist circumference (WC) following participation in a four-month, pedometer-based, physical activity, workplace health program.

METHODS: 762 adults employed in primarily sedentary occupations and voluntarily enrolled in a four-month workplace program aimed at increasing physical activity were recruited from ten Australian worksites in 2008. Seventy-nine percent returned at the end of the health program. Data included demographic, behavioural, anthropometric and biomedical measurements. WC change (before versus after) was assessed by multivariable linear and logistic regression analyses. Seven groupings of potential associated variables from baseline were sequentially added to build progressively larger regression models.

RESULTS: Greater improvement in WC during the program was associated with having completed tertiary education, consuming two or less standard alcoholic beverages in one occasion in the twelve months prior to baseline, undertaking less baseline weekend sitting time and lower baseline total cholesterol. A greater WC at baseline was strongly associated with a greater improvement in WC. A sub-analysis in participants with a 'high-risk' baseline WC revealed that younger age, enrolling for reasons other than appearance, undertaking less weekend sitting time at baseline, eating two or more pieces of fruit per day at baseline, higher baseline physical functioning and lower baseline body mass index were associated with greater odds of moving to 'low risk' WC at the end of the program.

CONCLUSIONS: While employees with 'high-risk' WC at baseline experienced the greatest improvements in WC, the other variables associated with greater WC improvement were generally indicators of better baseline health. These results indicate that employees who started with better health, potentially due to lifestyle or recent behavioural changes, were more likely to respond positively to the program. Future health program initiators should think innovatively to encourage all enrolees along the health spectrum to achieve a successful outcome.

Impact of a pedometer-based workplace health program on cardiovascular and diabetes risk profile

OBJECTIVE: To evaluate whether participation in a four-month, pedometer-based, physical activity, workplace health programme results in an improvement in risk factors for diabetes and cardiovascular disease. METHODS: Adults employed within Australia in primarily sedentary occupations and voluntarily enrolled in a workplace programme, the Global Corporate Challenge®, aimed at increasing physical activity were recruited. Data included demographic, behavioural, anthropometric and biomedical measurements. Measures were compared between baseline and four-months. RESULTS: 762 participants were recruited in April/May 2008 with 79% returning. Improvements between baseline and four-months amongst programme participants were observed for physical activity (an increase of 6.5% in the proportion meeting guidelines, OR(95%CI): 1.7(1.1, 2.5)), fruit intake (4%, OR: 1.7(1.0, 3.0)), vegetable intake (2%, OR: 1.3(1.0, 1.8)), sitting time (-0.6(-0.9, -0.3) hours/day), blood pressure (systolic: -1.8(-3.1, -.05) mmHg; diastolic: -1.8(-2.4, -1.3) mmHg) and waist circumference (-1.6(-2.4, -0.7) cm). In contrast, an increase was found for fasting total cholesterol (0.3(0.1, 0.4) mmol/L) and triglycerides (0.1(0.0, 0.1) mmol/L). CONCLUSION: Completion of this four-month, pedometer-based, physical activity, workplace programme was associated with improvements in behavioural and anthropometric risk factors for diabetes and cardiovascular disease. Long-term evaluation is required to evaluate the potential of such programmes to prevent the onset of chronic disease.

Bioinformatics based structural characterization of glucose dehydrogenase (gdh) gene and growth promoting activity of Leclercia sp. QAU-66

Glucose dehydrogenase (GDH; EC 1.1. 5.2) is the member of quinoproteins group that use the redox cofactor pyrroloquinoline quinoine, calcium ions and glucose as substrate for its activity. In present study, Leclercia sp. QAU-66, isolated from rhizosphere of Vigna mungo, was characterized for phosphate solubilization and the role of GDH in plant growth promotion of Phaseolus vulgaris. The strain QAU-66 had ability to solubilize phosphorus and significantly (p ≤ 0.05) promoted the shoot and root lengths of Phaseolus vulgaris. The structural determination of GDH protein was carried out using bioinformatics tools like Pfam, InterProScan, I-TASSER and COFACTOR. These tools predicted the structural based functional homology of pyrroloquinoline quinone domains in GDH. GDH of Leclercia sp. QAU-66 is one of the main factor that involved in plant growth promotion and provides a solid background for further research in plant growth promoting activities.

A brief review on offshore wind turbine fault detection and recent development in condition monitoring based maintenance system

Offshore wind turbine requires more systematized operation and maintenance strategies to ensure systems are harmless, profitable and cost-effective. Condition monitoring and fault diagnostic systems ominously plays an important role in offshore wind turbine in order to cut down maintenance and operational costs. Condition monitoring techniques which describing complex faults and failure mode types and their generated traceable signs to provide cost-effective condition monitoring and predictive maintenance and their diagnostic schemes. Continuously monitor the condition of critical parts are the most efficient way to improve reliability of wind turbine. Implementation of Condition Based Maintenance (CBM) strategy provides right time maintenance decisions and Predictive Health Monitoring (PHM) data to overcome breakdown and machine downtime. Fault detection and CBM implementation is challenging for off shore wind farm due to the complexity of remote sensing, components health and predictive assessment, data collection, data analysis, data handling, state recognition, and advisory decision. The rapid expansion of wind farms, advanced technological development and harsh installation sites needs a successful CM approach. This paper aims to review brief status of recent development of CM techniques and focusing with major faults takes place in gear box and bearing, rotor and blade, pitch, yaw and tower system and generator and control system.

The association between urban or rural locality and hip fracture in community-based adults : a systematic review

Urban or rural locality has been suggested to influence musculoskeletal health, with lower bone mineral density (BMD) and greater prevalence of fracture identified in urban residents. A computer-aided search of Medline, EMBASE, CINAHL and PsychINFO, January 1966 to November 2007 was conducted to identify studies investigating the relationship between urban or rural locality and the occurrence of hip fracture. The methodological quality of studies was assessed, and a best-evidence synthesis was used to summarise the results. Fourteen cohort studies and one case-control study were identified for inclusion in this review, indicating a lack of literature in the field. Best-evidence analysis identified moderate evidence for residents of rural regions to have lower risk of hip fracture compared to urban residents. Examining principal mechanisms for the observed relationship between urban/rural locality and hip fracture, such as factors at the person or area level, may help to identify modifiable risk factors and inform appropriate prevention strategies.

Empirical investigation of decision tree ensembles for monitoring cardiac complications of diabetes

Cardiac complications of diabetes require continuous monitoring since they may lead to increased morbidity or sudden death of patients. In order to monitor clinical complications of diabetes using wearable sensors, a small set of features have to be identified and effective algorithms for their processing need to be investigated. This article focuses on detecting and monitoring cardiac autonomic neuropathy (CAN) in diabetes patients. The authors investigate and compare the effectiveness of classifiers based on the following decision trees: ADTree, J48, NBTree, RandomTree, REPTree, and SimpleCart. The authors perform a thorough study comparing these decision trees as well as several decision tree ensembles created by applying the following ensemble methods: AdaBoost, Bagging, Dagging, Decorate, Grading, MultiBoost, Stacking, and two multi-level combinations of AdaBoost and MultiBoost with Bagging for the processing of data from diabetes patients for pervasive health monitoring of CAN. This paper concentrates on the particular task of applying decision tree ensembles for the detection and monitoring of cardiac autonomic neuropathy using these features. Experimental outcomes presented here show that the authors' application of the decision tree ensembles for the detection and monitoring of CAN in diabetes patients achieved better performance parameters compared with the results obtained previously in the literature.

Critical design features for establishing a childhood obesity monitoring program in Australia

Efforts to combat childhood obesity in Australia are hampered by the lack of quality epidemiological data to routinely monitor the prevalence and distribution of the condition. This paper summarises the literature on issues relevant to childhood obesity monitoring and makes recommendations for implementing a school-based childhood obesity monitoring program in Australia. The primary purpose of such a program would be to collect population-level health data to inform both policy and the development and evaluation of community-based obesity prevention interventions. Recommendations are made for the types of data to be collected, data collection procedures and program management and evaluation. Data from an obesity monitoring program are crucial for directing and informing policies, practices and services, identifying subgroups at greatest risk of obesity and evaluating progress towards meeting obesity-related targets. Such data would also increase the community awareness necessary to foster change.

Mobile health (mHealth) biomedical imaging paradigm

Technology assisted methods for medical diagnosis and biomedical health monitoring are rapidly shifting from classical invasive methods to handheld-based non-invasive approaches. Biomedical imagining is one of the most prominent practices of non-invasive mechanisms in medical applications. This paper considers the medical imaging schemes for Mobile Health (mHealth) applications and studies the feasibility of future mobile systems for accommodating image informatics capabilities.