Alcohol consumption, obesity, and psychological distress in farming communities — an Australian study

Purpose: Alcohol consumption patterns nationally and internationally have been identified as elevated in rural and remote populations. In the general Australian population, 20.5% of adult males and 16.9% of adult females drink at short-term, high-risk levels. Farmers are more likely to drink excessively than those living in major cities. This study seeks to explore the relationships between farmers’ physical and mental health and their alcohol consumption patterns. Our hypothesis is that farmers consume alcohol at high-risk levels more often than the Australian average and that this consumption is associated with obesity and psychological distress.

Methods: Cross-sectional descriptive data were collected within Australian farming communities from 1,792 consenting adults in 97 locations across Australia. Data on anthropometric measurements, general physical attributes and biochemical assessments were used to explore the interrelationships of self-reported alcohol consumption patterns with obesity, psychological distress, and other physical health parameters.

Findings: There was a higher prevalence of short-term, high-risk alcohol consumption (56.9% in men and 27.5% in women) reported in the study compared with national data. There was also a significant positive association between the prevalence of high-risk alcohol consumption and the prevalence of obesity and abdominal adiposity in psychologically distressed participants.

Conclusions: The prevalence of short-term, high-risk alcohol consumption practices in this cohort of farming men and women is significantly higher than the Australian average. These consumption practices are coupled with a range of other measurable health issues within the farming population, such as obesity, hypertension, psychological distress, and age.

Morbid obesity in women on the rise : an observational, population-based study

Background The obesity epidemic is generally monitored by the proportion of the population whose body mass index (BMI) exceeds 30 kg/m2 but this masks the growing proportion of those who are morbidly obese. This issue is important as the adverse health risks amplify as the level of obesity increases. The aim of this study was to determine how the prevalence of morbid obesity (BMI >= 40.0 kg/m2) has changed over a decade among women living in south-eastern Australia.

Methods BMI was determined for women in the Geelong Osteoporosis study (GOS) during two time periods, a decade apart. Height and weight were measured for 1,494 women (aged 20--94 years) during 1993--7 and for 1,076 women (aged 20--93 years), 2004--8, and the BMI calculated as weight in kilograms divided by the square of the height in metres (kg/m2). Prevalence estimates were age-standardised to enable direct comparisons.

Results Mean BMI increased from 26.0 kg/m2 (95%CI 25.7-26.3) in 1993--7, to 27.1 kg/m2 (95%CI 26.8-27.4) in 2004--8. During this period, the prevalence of morbid obesity increased from 2.5% to 4.2% and the standardised morbidity ratio for morbid obesity was 1.69 (95%CI 1.26-2.27). Increases in mean BMI and prevalence of morbid obesity were observed for all ages and across the socioeconomic spectrum.

Conclusions These findings reveal that over a decade, there has been an increase in mean BMI among women residing in south-eastern Australia, resulting in a measurable increase in the prevalence of morbid obesity.

Assessing client outcomes in youth justice services : current status and future directions

Youth justice services are increasingly expected to demonstrate that the services and programs they provide lead to measurable outcomes. This paper considers how client outcomes other than recidivism, which are considered important to youth justice service providers, might be conceptualized and reliably assessed. We conclude that there is a need to develop methods of assessment that are consistent with the principles of evidence-based assessment and we make a number of suggestions for the development of practice in this area.

Implementation of a quality care management system for patients with arthritis of the hip and knee

The Orthopaedic Unit of the Repatriation General Hospital (RGH) in Adelaide, South Australia has implemented a quality care management system for patients with arthritis of the hip and knee. The system not only optimises conservative management but ensures that joint replacement surgery is undertaken in an appropriate and timely manner. This new service model addresses identified barriers to service access and provides a comprehensive, coordinated strategy for patient management. Over 4 years the model has reduced waiting times for initial outpatient assessment from 8 to 3 months and surgery from 18 to 8 months, while decreasing length of stay from 6.3 to 5.3 days for hips and 5.8 to 5.3 days for knees. The service reforms have been accompanied by positive feedback from patients and referring general practitioners in relation to the improved coordination of care and enhanced efficiency in service delivery.

What is known about the topic? Several important initiatives both overseas and within Australia have contributed significantly to the development of this model of care. These include the UK National Health Service ‘18 weeks’ Project, the Western Canada Waiting List Project, the New Zealand priority criteria project, the Queensland Health Orthopaedic Physiotherapy Screening Clinic, and most importantly the Melbourne Health–University of Melbourne Orthopaedic Waiting List Project where a wide range of models were explored across Victorian hospitals from 2005 and the Multi-Attribute Prioritisation Tool (MAPT) was developed, validated and tested. This project became the Osteoarthritis Hip and Knee Service (OAHKS) and was operationalised in the Victorian healthcare system from 2012. These initiatives examined and addressed various aspects of management systems for patients with arthritis of the hip and knee in their particular setting.

What does this paper add? The development of this system is an extension of what is already known and is the first to encompass a comprehensive and coordinated strategy across all stages of the care management pathway for this patient group. Their management extends from the initial referral to development and implementation of a management plan, including surgery if assessed as necessary and organisation of long-term post operative follow up as required. By detailing the elements, key processes and measurable outcomes of the service redesign this paper provides a model for other institutions to implement a similar initiative.

What are the implications for practitioners? An important aspect of the design process was practitioner acceptance and engagement and the ability to improve their capacity to deliver services within an efficient and effective model. Intrinsic to the model’s development was assessment of practitioner satisfaction. Data obtained including practitioner surveys indicated an increased level of both satisfaction with the redesigned management service, and confidence in it to deliver its intended improvements.

Connectivity, online social capital, and mood : a Bayesian nonparametric analysis

Social capital indicative of community interaction and support is intrinsically linked to mental health. Increasing online presence is now the norm. Whilst social capital and its impact on social networks has been examined, its underlying connection to emotional response such as mood, has not been investigated. This paper studies this phenomena, revisiting the concept of “online social capital†in social media communities using measurable aspects of social participation and social support. We establish the link between online capital derived from social media and mood, demonstrating results for different cohorts of social capital and social connectivity. We use novel Bayesian nonparametric factor analysis to extract the shared and individual factors in mood transition across groups of users of different levels of connectivity, quantifying patterns and degree of mood transitions. Using more than 1.6 million users from Live Journal, we show quantitatively that groups with lower social capital have fewer positive moods and more negative moods, than groups with higher social capital. We show similar effects in mood transitions. We establish a framework of how social media can be used as a barometer for mood. The significance lies in the importance of online social capital to mental well-being in overall. In establishing the link between mood and social capital in online communities, this work may suggest the foundation of new systems to monitor online mental well-being.

Short term aerobic exercise training in young males does not alter sensitivity to a central serotonin agonist

An increase in the concentration of serotonin in the brain has been shown to cause fatigue during exercise in humans and experimental animals. This type of fatigue is referred to as central fatigue and is likely to be mediated by the concentration of serotonin as well as serotonin receptor sensitivity. Serotonin (5-HT) receptor antagonism in humans and experimental animals has been shown to improve endurance performance. A previous report has shown decreased receptor sensitivity in athletes compared to sedentary controls. It is unclear whether this is due to a training adaptation or if individuals are predisposed to enhanced athletic performance due to their inherent decreased receptor sensitivity. The present study investigated changes in 5-HT receptor sensitivity in response to aerobic exercise. Subjects completed 3 × 30 min of stationary cycling at 70% of their peak aerobic power (V̇O2,peak) for 9 weeks. Serotonin receptor sensitivity was assessed indirectly by measuring the neuroendocrine response following administration of a serotonin agonist (buspirone hydrochloride). The neuroendocrine response following administration of a placebo was also investigated in a blind crossover design. A group of sedentary control subjects was also recruited to control for seasonal variations in central receptor sensitivity. The training caused a significant increase in V̇O2,peak (3.1 ± 0.16 to 3.6 ± 0.15 l min−1, P < 0.05) and endurance capacity (93 ± 8 to 168 ± 11 min, P < 0.05), but there was no change (P > 0.05) in the neuroendocrine response in the presence of a serotonin agonist. However, one-quarter of the subjects in the training group demonstrated decreases in receptor sensitivity. These results suggest that despite increases in V̇O2,peak and endurance performance, there was no measurable change in 5-HT receptor sensitivity in the presence of a serotonin agonist. In addition, it is possible that changes in receptor sensitivity may take longer to occur, that the training stimulus used in the present investigation was inadequate and/or that changes occurred in receptor subtypes that were not probed by the agonist used in the present investigation.

A surface-stress-based microcantilever aptasensor

Biosensors based on microcantilevers convert biological recognition events into measurable mechanical displacements. They offer advantages such as small size, low sample volume, label-free detection, ease of integration, high-throughput analysis, and low development cost. The design and development of a microcantilever-based aptasensor employing SU-8 polymer as the fabrication material is presented in this paper. Aptamers are employed as bioreceptor elements because they exhibit superior specificity compared to antibodies due to their small size and physicochemical stability. To immobilise thrombin DNA aptamer on the bare SU-8 surface of the aptasensor, a combined plasma mode treatment method is implemented which modifies the surface of the aptasensor. Label-free detection of thrombin molecules using the fabricated aptasensor is successfully demonstrated. The measured deflection is one order of magnitude higher than that of a silicon nitride microcantilever biosensor. The developed aptasensor also demonstrates high specificity.

A surface-stress-based microcantilever aptasensor

Biosensors based on microcantilevers convert biological recognition events into measurable mechanical displacements. They offer advantages such as small size, low sample volume, label-free detection, ease of integration, high-throughput analysis, and low development cost. The design and development of a microcantilever-based aptasensor employing SU-8 polymer as the fabrication material is presented in this paper. Aptamers are employed as bioreceptor elements because they exhibit superior specificity compared to antibodies due to their small size and physicochemical stability. To immobilise thrombin DNA aptamer on the bare SU-8 surface of the aptasensor, a combined plasma mode treatment method is implemented which modifies the surface of the aptasensor. Label-free detection of thrombin molecules using the fabricated aptasensor is successfully demonstrated. The measured deflection is one order of magnitude higher than that of a silicon nitride microcantilever biosensor. The developed aptasensor also demonstrates high specificity.

Expression of muscarinic receptor subtypes in tree shrew ocular tissues and their regulation during the development of myopia

Muscarinic receptors are known to regulate several important physiologic processes in the eye. Antagonists to these receptors such as atropine and pirenzepine are effective at stopping the excessive ocular growth that results in myopia. However, their site of action is unknown. This study details ocular muscarinic subtype expression within a well documented model of eye growth and investigates their expression during early stages of myopia induction. Total RNA was isolated from tree shrew corneal, iris/ciliary body, retinal, choroidal, and scleral tissue samples and was reverse transcribed. Using tree shrew-specific primers to the five muscarinic acetylcholine receptor subtypes (CHRM1-CHRM5), products were amplified using polymerase chain reaction (PCR) and their identity confirmed using automated sequencing. The expression of the receptor proteins (M1-M5) were also explored in the retina, choroid, and sclera using immunohistochemistry. Myopia was induced in the tree shrew for one or five days using monocular deprivation of pattern vision, and the expression of the receptor subtypes was assessed in the retina, choroid, and sclera using real-time PCR. All five muscarinic receptor subtypes were expressed in the iris/ciliary body, retina, choroid, and sclera while gene products corresponding to CHRM1, CHRM3, CHRM4, and CHRM5 were present in the corneal samples. The gene expression data were confirmed by immunohistochemistry with the M1-M5 proteins detected in the retina, choroid, and sclera. After one or five days of myopia development, muscarinic receptor gene expression remained unaltered in the retinal, choroidal, and scleral tissue samples. This study provides a comprehensive profile of muscarinic receptor gene and protein expression in tree shrew ocular tissues with all receptor subtypes found in tissues implicated in the control of eye growth. Despite the efficacy of muscarinic antagonists at inhibiting myopia development, the genes of the muscarinic receptor subtypes are neither regulated early in myopia (before measurable axial elongation) nor after significant structural change.

Rethinking Chinese power : a conceptual corrective to the 'power shift' narrative

A growing body of literature has focused on an alleged “power shift” from the United States to China (and from the West to the East more generally). For all its complexities and nuances, much of this power-shift literature continues to unreflectively hold onto a conventional way of conceptualizing power as a type of quantitatively measurable and zero-sum property possessed by the state.  Without critically engaging with the conceptual question of what power means, however, the power-shift debate is both inadequate and misleading. Drawing on some alternative ways of conceptualizing power, I aim to illustrate the contingent and socially constructed nature of “Chinese” economic power and, in doing so, problematize the widely held view of a US-China power shift. I contend that insofar as power is socially constructed, how it is conceptualized matters for international relations. The need to rethink power is at the core of building a new type of major power relationship.

Low spatial frequency contrast sensitivity deficits in migraine are not visual pathway selective

Some people who experience migraine demonstrate reduced visual contrast sensitivity that is measurable between migraines. Contrast sensitivity loss to low spatial frequency gratings has been previously attributed to possible impairment of magnocellular pathway function. This study measured contrast sensitivity using low spatial frequency targets (0.25–4 c/deg) where the adaptation aspects of the stimuli were designed to preferentially assess either magnocellular or parvocellular pathway function (steady and pulsed pedestal technique). Twelve people with migraine with measured visual field abnormalities and 17 controls participated. Subjects were tested foveally and at 10° eccentricity. Foveally, there was no significant difference in group mean contrast sensitivity. At 10°, the migraine group demonstrated reduced contrast sensitivity for both the stimuli designed to assess magnocellular and parvocellular function (P < 0.05). The functional deficits measured in this study infer that abnormalities of the low spatial frequency sensitive channels of both pathways contribute to contrast sensitivity deficits in people with migraine.

Creatine transporter (SLC6A8) knockout mice display an increased capacity for in vitro creatine biosynthesis in skeletal muscle.

The present study aimed to investigate whether skeletal muscle from whole body creatine transporter (CrT; SLC6A8) knockout mice (CrT(-/y)) actually contained creatine (Cr) and if so, whether this Cr could result from an up regulation of muscle Cr biosynthesis. Gastrocnemius muscle from CrT(-/y) and wild type (CrT(+/y)) mice were analyzed for ATP, Cr, Cr phosphate (CrP), and total Cr (TCr) content. Muscle protein and gene expression of the enzymes responsible for Cr biosynthesis L-arginine:glycine amidotransferase (AGAT) and guanidinoacetate methyltransferase (GAMT) were also determined as were the rates of in vitro Cr biosynthesis. CrT(-/y) mice muscle contained measurable (22.3 ± 4.3 mmol.kg(-1) dry mass), but markedly reduced (P < 0.05) TCr levels compared with CrT(+/y) mice (125.0 ± 3.3 mmol.kg(-1) dry mass). AGAT gene and protein expression were higher (~3 fold; P < 0.05) in CrT(-/y) mice muscle, however GAMT gene and protein expression remained unchanged. The in vitro rate of Cr biosynthesis was elevated 1.5 fold (P < 0.05) in CrT(-/y) mice muscle. These data clearly demonstrate that in the absence of CrT protein, skeletal muscle has reduced, but not absent, levels of Cr. This presence of Cr may be at least partly due to an up regulation of muscle Cr biosynthesis as evidenced by an increased AGAT protein expression and in vitro Cr biosynthesis rates in CrT(-/y) mice. Of note, the up regulation of Cr biosynthesis in CrT(-/y) mice muscle was unable to fully restore Cr levels to that found in wild type muscle.

Peptide-based biosensors

Peptides have been used as components in biological analysis and fabrication of novel biosensors for a number of reasons, including mature synthesis protocols, diverse structures and as highly selective substrates for enzymes. Bio-conjugation strategies can provide an efficient way to convert interaction information between peptides and analytes into a measurable signal, which can be used for fabrication of novel peptide-based biosensors. Many sensitive fluorophores can respond rapidly to environmental changes and stimuli manifest as a change in spectral characteristics, hence environmentally-sensitive fluorophores have been widely used as signal markers to conjugate to peptides to construct peptide-based molecular sensors. Additionally, nanoparticles, fluorescent polymers, graphene and near infrared dyes are also used as peptide-conjugated signal markers. On the other hand, peptides may play a generalist role in peptide-based biosensors. Peptides have been utilized as bio-recognition elements to bind various analytes including proteins, nucleic acid, bacteria, metal ions, enzymes and antibodies in biosensors. The selectivity of peptides as an enzymatic substrate has thus been utilized to construct enzyme sensors or enzyme-activity sensors. In addition, progress on immobilization and microarray techniques of peptides has facilitated the progress and commercial application of chip-based peptide biosensors in clinical diagnosis.

Enhancing and assessing group and team learning in architecture and related design contexts

EXECUTIVE SUMMARYTeamwork skills are essential in the design industry where practitioners negotiate often-conflicting design options in multi-disciplinary teams. Indeed, many of the bodies that accredit design courses explicitly list teamwork skills as essential attributes of design graduates e.g., the Australian Institute of Architects (AIA), Royal Institute of British Architects (RIBA), the National Council of Architectural Registration Boards (NCARB) of the United States and the Institution of Engineers, Australia (IEAust). In addition to the need to meet the demands of the accrediting bodies, there are many reasons for the ubiquitous use of teamwork assignments in design schools. For instance, teamwork learning is seen as being representative of work in practice where design is nearly always a collaborative activity. Learning and teaching in teamwork contexts in design education are not without particular challenges. In particular, two broad issues have been identified: first, many students leave academia without having been taught the knowledge and skills of how to design in teams; second, teaching, assessment and assignment design need to be better informed by a clear understanding of what leads to effective teamwork and the learning of teamwork skills. In recognition of the lack of a structured approach to integrating teamwork learning into the curricula of design programs, this project set out to answer three primary research questions: • How do we teach teamwork skills in the context of design? • How do we assess teamwork skills?• How do design students best learn teamwork skills?In addition, four more specific questions were investigated:1. Is there a common range of learning objectives for group-and-team-work in architecture and related design disciplines that will enable the teaching of consistent and measurable outcomes?2. Do group and team formation methods, learning styles and team-role preferences impact students’ academic and course satisfaction outcomes?3. What combinations of group-and-team formation methods, teaching and assessment models significantly improve learning outcomes?4. For design students across different disciplines with different learning styles and cultural origins, are there significant differences in performance, student satisfaction (as measured through questionnaires and unit evaluations), group-and-team working abilities and student participation?To elucidate these questions, a design-based research methodology was followed comprising an iterative series of enquiries: (a) A literature review was completed to investigate: what constitutes effective teamwork, what contributes to effectiveness in teams, what leads to positive design outcomes for teams, and what leads to effective learning in teams. The review encompassed a range of contexts: from work-teams in corporate settings, to professional design teams, to education outside of and within the design disciplines. The review informed a theoretical framework for understanding what factors impact the effectiveness of student design teams. (b) The validity of this multi-factorial Framework of Effectiveness in Student Design Teams was tested via surveys of educators’ teaching practices and attitudes, and of students’ learning experiences. 638 students and 68 teachers completed surveys: two pilot surveys for participants at the four partner institutions, which then informed two national surveys completed by participants from the majority of design schools across Australia. (c) The data collected provided evidence for 22 teamwork factors impacting team effectiveness in student design teams. Pedagogic responses and strategies to these 22 teamwork factors were devised, tested and refined via case studies, focus groups and workshops. (d) In addition, 35 educators from a wide range of design schools and disciplines across Australia attended two National Teaching Symposiums. The first symposium investigated the wider conceptualisation of teamwork within the design disciplines, and the second focused on curriculum level approaches to structuring the teaching of teamwork skills identified in the Framework.The Framework of Effectiveness in Student Design Teams identifies 22 factors impacting effective teamwork, along with teaching responses and strategies that design educators might use to better support student learning. The teamwork factors and teaching strategies are categorised according to three groups of input (Task Characteristics, Individual Level Factors and Team Level Factors), two groups of processes (Teaching Practice & Support Structures and Team Processes), and three categories of output (Task Performance, Teamwork Skills, and Attitudinal Outcomes). Eight of the 22 teamwork factors directly relate to the skills that need to be developed in students, one factor relates to design outputs, and the other thirteen factors inform pedagogies that can be designed for better learning outcomes. In Table 10 of Section 4, we outline which of the 22 teamwork factors pertain to each of five stakeholder groups (curriculum leaders, teachers, students, employers and the professional bodies); thus establishing who will make best use the information and recommendations we make. In the body of this report we summarise the 22 teamwork factors and teaching strategies informed by the Framework of Effectiveness in Student Design Teams, and give succinct recommendations arising from them. This material is covered in depth by the project outputs. For instance, the teaching and assessment strategies will be expanded upon in a projected book on Teaching Teamwork in Design. The strategies are also elucidated by examples of good practice presented in our case studies, and by Manuals on Teamwork for Teachers and Students. Moreover, the project website ( visited by representatives of stakeholder groups in Australia and Canada), is seeding a burgeoning community of practice that promises dissemination, critical evaluation and the subsequent refinement of our materials, tools, strategies and recommendations. The following three primary outputs have been produced by the project in answer to the primary research questions:1. A theoretical Framework of Effectiveness in Student Design Teams;2. Manuals on Teamwork for Teachers and Students (available from the website);3. Case studies of good/innovative practices in teaching and assessing teamwork in design;In addition, five secondary outputs/outcomes have been produced that provide more nuanced responses:4. Detailed recommendations for the professional accrediting bodies and curriculum leaders;5. Online survey data (from over 700 participants), plus Team Effectiveness Scale to determine the factors influencing effective learning and successful outputs for student design teams;6. A community of practice in policy, programs, practice and dialogue;7. A detailed book proposal (with sample chapter), submitted to prospective publishers, on Teaching Teamwork in Design; 8. An annotated bibliography (accessed via the project website) on learning, teaching and assessing teamwork.The project has already had an international impact. As well as papers presented in Canada and New Zealand, the surveys were participated in by six Canadian schools of architecture, whose teaching leaders also provided early feedback on the project aims and objectives during visits made to them by the project leader. In addition, design schools in Vancouver, Canada, and San Diego in the USA have already utilised the Teacher’s Manual, and in February 2014 the project findings were discussed at Tel Aviv University in a forum focusing on the challenges for sustainability in architectural education.

A collaborative approach to the treatment alliance in bipolar disorder.

The treatment alliance is the arena in which psychopharmacological and other therapeutic interventions occur. The nature and quality of the treatment alliance may affect adherence to treatment and the realization of the benefits of effective pharmacological treatment in clinical practice. It is an area that has attracted little systematic study, despite the available evidence suggesting that it plays a measurable role in clinical outcomes.