Scaling up diabetes prevention in Victoria, Australia: policy development, implementation and evaluation

Objective
The Australian lifestyle intervention program Life! is only the second reported, large-scale diabetes prevention program. This paper describes the genesis and the successful establishment of Life! and its key outcomes for participants and implementation.

Research
Design and Methods Life!, a behavior change intervention, comprises six group sessions over eight months. The Victorian Department of Health funded Diabetes Australia-Victoria to implement the program. Experience of the Greater Green Triangle diabetes prevention implementation trial was used for intervention design, workforce development, training and infrastructure. Clinical and anthropometric data from participants, used for program evaluation, was recorded on a central database.

Results
Life! has a state-wide workforce of 302 trained facilitators within 137 organizations. 29,000 Victorians showed interest in Life! and 15,000 individuals have been referred to the program. In total, 8,412 participants commenced a Life! program between October 2007 and June 2011. 37% of the original participants completed the eight month program. Participants completing sessions one to five lost an average of 1·4 kg weight (p<0·001) and waist circumference of 2·5cm (p<0.001). Those completing six sessions lost an average of 2·4 kg weight (p<0·001) and waist circumference of 3·8 cm (p<0·001). The weight loss of 2.4 kg represents 2.7% of participants’ starting body weight.

Conclusion
The impact of Life! is attributable to applying available evidence for the systems design of the intervention, and collaboration between policy makers, implementers and evaluators using the principles of continuous quality improvement to support successful, large scale recruitment and implementation.

Design, fabrication and evaluation of universal polymerase chain reaction devices

Novel and low cost PCR devices were developed to perform rapid polymerase chain reaction based diagnostics for infectious diseases. The main advantages of using these devices are that it can perform multi sample and also multiplexing of DNA samples woth low sample volume compared to the conventional PCR devices.

Design, development, and evaluation of a pinch-grasp haptic interface

Interaction with virtual or teleoperated environments requires contact with objects on a multipoint level. We describe the design of a pinch--grasp hand interface device for use as a grasping mechanism to complement haptic interfaces. To preserve a suitable level of transparency for human--computer interaction, this novel interface is designed for high-resolution contact forces, while centered around a lightweight structure. This functionality renders the device scalable and adaptable to a wide range of haptic interface structures and force level requirements. We present an optimal configuration for a pinch--grasp interface, which produces bidirectional forces to an operator's fingers and a rotational force to the wrist through a cable drive system. The device is characterized for use on a commercial haptic interface through demonstration of sustained peak performance and also workspace utilization. The dynamic performance of the pinch--grasp interface is experimentally determined, and the frequency response is identified to illustrate its contact force resolution.

Development and implementation of agri-environmental policy: english experience and lessons for Australia

In this article we consider what Australia can learn from English experience with regard to the design, implementation and evaluation of Agri-Environmental Policy (AEP). First, we examine the emergence of the
need for farmers to meet Good Farming Practice standards to receive AEP payments. This concept closely relates to the 'duty of care' idea in Australia. Second, we explain how contracts have been used to implement AEP identifying important issues in design. Finally, we consider the importance of benefit and costs estimates of AEP implementation in determining policy developments. We conclude with a summary of results for AEP design and implementation in Australia.

Design and evaluation of a microcantilever aptasensor

Aptamers enhance flexibility in biosensor design. An aptasensor employs aptamers as a biological recognition element for biosensing. This paper presents design, fabrication, and evaluation of a microcantilever aptasensor. To identify and avoid potential bottlenecks in the aptasensor design, the parameters of the aptasensor are investigated through modelling and simulation. Next, thin SU-8 microcantilevers are fabricated to form the aptasensor. Characterization of the fabricated aptasensor is presented. Next, a plasma-based surface funtionalisation method is used to immobilize aptamers on the atasensor. Finally, an evaluation of the performance of the aptasensor is performed through detection of thrombin molecules. The evaluation results are presented and discussed. © 2014 IEEE.

Moving beyond a ‘bums-on-seats’ analysis of progress towards widening participation: reflections on the context, design and evaluation of an Australian government-funded mentoring programme

In 2010 the Australian Government established the Higher Education Participation and Partnerships programme – a funding agenda to promote programmes that respond to the underrepresentation in higher education of people from what is often denoted low socioeconomic status (SES) backgrounds. Many government-funded programmes and projects have since emerged that respond to the problem of low SES underrepresentation, based on partnerships between higher education providers and other organisations. The arguments made in this paper draw on one such project: a mentoring programme implemented from 2011 to 2013 that targeted the aspirations of Year 9 regional secondary students. We discuss data and documentation that provide insights into the conception and design of the mentoring programme, and the strategies used to evaluate it, in order to discuss how funding and policy contexts influences the possible solutions that might be implemented in response to the underrepresentation in higher education of people from low SES backgrounds.

Evaluation of the implementation of a state government community design policy aimed at increasing local walking : design issues and baseline results from RESIDE, Perth Western Australia

Objectives.
To describe the design and baseline results of an evaluation of the Western Australian government's pedestrian-friendly subdivision design code (Liveable Neighborhood (LN) Guidelines).
Methods.

Baseline results (2003–2005) from a longitudinal study of people (n = 1813) moving into new housing developments: 18 Liveable, 11 Hybrid and 45 Conventional (i.e., LDs, HDs and CDs respectively) are presented including usual recreational and transport-related walking undertaken within and outside the neighborhood, and 7-day pedometer steps.
Results.

At baseline, more participants walked for recreation and transport within the neighborhood (52.6%; 36.1% respectively), than outside the neighborhood (17.7%; 13.2% respectively). Notably, only 20% of average total duration of walking (128.4 min/week (SD159.8)) was transport related and within the neighborhood. There were few differences between the groups' demographic, psychosocial and perceived neighborhood environmental characteristics, pedometer steps, or the type, amount and location of self-reported walking (p > 0.05). However, asked what factors influenced their choice of housing development, more participants moving into LDs reported aspects of their new neighborhood's walkability as important (p < 0.05).
Conclusions.

The baseline results underscore the desirability of incorporating behavior and context-specific measures and value of longitudinal designs to enable changes in behavior, attitudes, and urban form to be monitored, while adjusting for baseline residential location preferences.

Scaling up community-based obesity prevention in Australia : background and evaluation design of the health promoting communities : being active eating well initiative

Background : There is only limited evidence available on how best to prevent childhood obesity and community-based interventions hold promise, as several successful interventions have now been published. The Victorian Government has recently funded six disadvantaged communities across Victoria, Australia for three years to promote healthy eating and physical activity for children, families, and adults in a community-based participatory manner. Five of these intervention communities are situated in Primary Care Partnerships and are the subject of this paper. The interventions will comprise a mixture of capacity-building, environmental, and whole-of-community approaches with targeted and population-level interventions. The specific intervention activities will be determined locally within each community through stakeholder and community consultation. Implementation of the interventions will occur through funded positions in primary care and local government. This paper describes the design of the evaluation of the five primary care partnership-based initiatives in the 'Go for your life' Health Promoting Communities: Being Active Eating Well (HPC:BAEW) initiative.

Methods/Design : A mixed method and multi-level evaluation of the HPC:BAEW initiative will capture process, impact and outcome data and involve both local and state-wide evaluators. There will be a combined analysis across the five community intervention projects with outcomes compared to a comparison group using a cross-sectional, quasi-experimental design. The evaluation will capture process, weight status, socio-demographic, obesity-related behavioral and environmental data in intervention and comparison areas. This will be achieved using document analysis, paper-based questionnaires, interviews and direct measures of weight, height and waist circumference from participants (children, adolescents and adults).

Discussion : This study will add significant evidence on how to prevent obesity at a population level in disadvantaged and ethnically diverse communities. The outcomes will have direct influence on policy and practice and guide the development and implementation of future obesity prevention efforts in Australia and internationally.

Enhancing quality in online learning : scaffolding planning and design through proactive evaluation

A major issue confronting educators is the extent to which they wish to conform to so-called paradigm shifts in teaching and learning. In the contemporary world of tertiary education these shifts embrace both pedagogy (from instructivist to constructivist) and technology (from classroom to online). As teachers and learners are faced with the potential of these new learning environments, the extent to which learning outcomes are achieved remains a high priority and subject to a wide range of evaluation strategies. Conventionally, evaluation has been positioned at the end of the instructional development cycle, to assess first whether or not the creative effort achieved the original product goals and second whether or not the desired learning outcomes were realized. In the context of online teaching and learning environments, however, the level of understanding teachers, learners and developers have of the medium can impact the ultimate effectiveness of the product. This paper articulates an additional dimension to post-development evaluation processes in proposing proactive evaluation, a framework that identifies critical online learning factors and influences that will better inform the planning, design and development of learning resources. This notion of proactive evaluation advocates resource development being undertaken where all planning activities are assessed against the evaluation criteria that would normally be applied during formative assessment. By performing these evaluation checks proactively, online learning resources will, in principle, work first time as all relevant factors and issues will have been considered and resolved. More importantly, for those participants who are new to online environments, proactive evaluation will perform a scaffolding and professional development role by enhancing online teaching or learning competencies.

Research designs and scientific identity in marketing journals: review and evaluation

Purpose - This research is based upon the assumption that the empirical research designs and the scientific identity of a journal are related. The objective is to review and evaluate the empirical research design of papers to determine the scientific identity of a selection of academic marketing journals. Design/methodology/approach – The journal sample consists of the Australasian Marketing Journal (AMJ), the European Journal of Marketing (EJM) and the Journal of Marketing (JM). The review and evaluation considers a six-year period, namely 2000-2005. The content analysis consisted of 811 papers. Findings – The scientific identity of JM may be seen as built upon quantitative research designs and the North American paradigm of research values. The scientific identity of AMJ is based upon a mix of empirical research designs and the Australian paradigm of research values. The scientific identity of EJM is also based upon a mix of empirical research designs, but a multi-continental paradigm of research values. Research limitations/implications – The leading continental journals in marketing maintain a scientific identity based upon the continental paradigm of research values. If it is driven to the extremes, a paradigmatic myopia and inertia of research designs may evolve that limit the scientific identity to be dogmatic and narrow-focused rather than variable and broad-focused. Originality/value – A cross-continental eview and evaluation of research designs and scientific identity of academic marketing journals is presented.

Evidence-based clinical policy: case report of a reproducible process to encourage understanding and evaluation of evidence

We report within a case study a reproducible process to facilitate the explicit incorporation of evidence by a multidisciplinary group into clinical policy development. To support the decision-making of a multidisciplinary Intersectoral Advisory Group (IAG) convened by the Royal Australasian College of Physicians Health Policy Unit, a systematic review of randomized controlled trials about environmental tobacco smoke and smoking cessation interventions in paediatric settings was first undertaken. As reported in detail here, IAG members were then formally engaged in a transparent and replicable process to understand and interpret the synthesized evidence and to proffer their independent reactions regarding policy, practice and research. Our intention was to ensure that all IAG members were democratically engaged and made aware of the available evidence. As clinical policy must engage stakeholder representatives from diverse backgrounds, a process to equalize understanding of the evidence and 'democratize' judgment about its implications is needed. Future research must then examine the benefits of such explicit steps when guidelines, in turn, are implemented. We hypothesize that changes to future practice will be more likely if processes undertaken to develop guidelines are transparent to clinicians and other target groups.

Obesity policy action framework and analysis grids for a comprehensive policy approach to reducing obesity

A comprehensive policy approach is needed to control the growing obesity epidemic. This paper proposes the Obesity Policy Action (OPA) framework, modified from the World Health Organization framework for the implementation of the Global Strategy on Diet, Physical Activity and Health, to provide specific guidance for governments to systematically identify areas for obesity policy action. The proposed framework incorporates three different public health approaches to addressing obesity: (i) 'upstream' policies influence either the broad social and economic conditions of society (e.g. taxation, education, social security) or the food and physical activity environments to make healthy eating and physical activity choices easier; (ii) 'midstream' policies are aimed at directly influencing population behaviours; and (iii) 'downstream' policies support health services and clinical interventions. A set of grids for analysing potential policies to support obesity prevention and management is presented. The general pattern that emerges from populating the analysis grids as they relate to the Australian context is that all sectors and levels of government, non-governmental organizations and private businesses have multiple opportunities to contribute to reducing obesity. The proposed framework and analysis grids provide a comprehensive approach to mapping the policy environment related to obesity, and a tool for identifying policy gaps, barriers and opportunities.

Additional exercise for older subacute hospital inpatients to prevent falls: benefits and barriers to implementation and evaluation

Objective: To evaluate the clinical effectiveness and implementation of a falls prevention exercise programme for preventing falls in the subacute hospital setting.

Design: Randomized controlled trial, subgroup analysis.

Participants: Patients of a metropolitan subacute/aged rehabilitation hospital who were recommended for a falls prevention exercise programme when enrolled in a larger randomized controlled trial of a falls prevention programme.

Methods: Participants in both the control and intervention groups who were recommended for the exercise programme intervention were followed for the duration of their hospital stay to determine if falls occurred. Participants had their balance, strength and mobility assessed upon referral for the exercise programme and then again prior to discharge. Participation rates in the exercise programme were also recorded.

Results: Intervention group participants in this subgroup analysis had a significantly lower incidence of falls than their control group counterparts (control: 16.0 falls/1000 participant-days, intervention: 8.2 falls/1000 participant-days, log-rank test: P = 0.007). However few differences in secondary balance, strength and mobility outcomes were evident.

Conclusion: This exercise programme provided in addition to usual care may assist in the prevention of falls in the subacute hospital setting.

The design and evaluation of two types of chemical sensor

During the course of this investigation it was discovered that functionalised Ruthenium tris(bipyridyl) complexes exhibit different chemical, spectroscopic and electrochemical properties to those of the parent compound. Furthermore, it was possible to develop 1,8-naphthalimide-based compounds that furnished strong 1:1 host:guest complexes with larger anions such as hydrogen pyrophosphate. This dissertation presents in investigation into the systhesis and analytical evaluation of two types of chemical sensors: chemiluminescent and fluorescent.

Design, synthesis and preliminary analytical evaluation of water soluble reagents for peroxyoxalate chemiluminescence

Describes the investigation into a number of facets of the peroxyoxalate chemiluminescence reaction, and the application of this chemistry to the detection of certain analytes under purely aqueous conditions.