The NOURISH randomised control trial : positive feeding practices and food preferences in early childhood - a primary prevention program for childhood obesity

Background Primary prevention of childhood overweight is an international priority. In Australia 20-25% of 2-8 year olds are already overweight. These children are at substantially increased the risk of becoming overweight adults, with attendant increased risk of morbidity and mortality. Early feeding practices determine infant exposure to food (type, amount, frequency) and include responses (eg coercion) to infant feeding behaviour (eg. food refusal). There is correlational evidence linking parenting style and early feeding practices to child eating behaviour and weight status. A focus on early feeding is consistent with the national focus on early childhood as the foundation for life-long health and well being. The NOURISH trial aims to implement and evaluate a community-based intervention to promote early feeding practices that will foster healthy food preferences and intake and preserve the innate capacity to self-regulate food intake in young children. Methods/Design This randomised controlled trial (RCT) aims to recruit 820 first-time mothers and their healthy term infants. A consecutive sample of eligible mothers will be approached postnatally at major maternity hospitals in Brisbane and Adelaide. Initial consent will be for re-contact for full enrolment when the infants are 4-7 months old. Individual mother- infant dyads will be randomised to usual care or the intervention. The intervention will provide anticipatory guidance via two modules of six fortnightly parent education and peer support group sessions, each followed by six months of regular maintenance contact. The modules will commence when the infants are aged 4-7 and 13-16 months to coincide with establishment of solid feeding, and autonomy and independence, respectively. Outcome measures will be assessed at baseline, with follow up at nine and 18 months. These will include infant intake (type and amount of foods), food preferences, feeding behaviour and growth and self-reported maternal feeding practices and parenting practices and efficacy. Covariates will include sociodemographics, infant feeding mode and temperament, maternal weight status and weight concern and child care exposure. Discussion Despite the strong rationale to focus on parents’ early feeding practices as a key determinant of child food preferences, intake and self-regulatory capacity, prospective longitudinal and intervention studies are rare. This trial will be amongst to provide Level II evidence regarding the impact of an intervention (commencing prior to age 12 months) on children’s eating patterns and behaviours. Trial Registration: ACTRN12608000056392

Adopting building information modeling (BIM) as collaboration platform in the design industry

This paper discusses the preliminary findings of an ongoing research project aimed at developing a technological, operational and strategic analysis of adopting BIM in AEC/FM (Architecture-Engineering-Construction/Facility Management) industry as a collaboration tool. Outcomes of the project will provide specifications and guidelines as well as establish industry standards for implementing BIM in practice. This research primarily focuses on BIM model servers as a collaboration platform, and hence the guidelines are aimed at enhancing collaboration capabilities. This paper reports on the findings from: (1) a critical review of latest BIM literature and commercial applications, and (2) workshops with focus groups on changing work-practice, role of technology, current perception and expectations of BIM. Layout for case studies being undertaken is presented. These findings provide a base to develop comprehensive software specifications and national guidelines for BIM with particular emphasis on BIM model servers as collaboration platforms.

High impact training : achieving synergies between program management education and workplace practice

This paper addresses the challenges of transfer of training back to the workplace for programme and project managers who are being groomed for the leadership of large and complex projects. The paper draws on the experience of the development and delivery of Queensland University of Technology (QUT) education programs: an Executive Masters of Complex Project Management and a series of Continuing Professional Development (CPD) events for an Australian government agency, Defence Materiel Organisation (DMO). Drawing on notions of ‘far transfer’ (Laker 1990; Noe, 1986) and ‘transfer climate’ (Kozlowski & Salas, 1993; Yamnill & McLean, 2001), the paper describes the steps undertaken to achieve a design that ensures that programme and project leadership skills developed through these corporate education programs become successfully embedded back in the organisation. Further, the paper reports on a small qualitative study where the programme success was evaluated by the organisational sponsor, senior leaders and program participants. Nine interviews were conducted and analysed to identify the success of far transfer and transfer climate four months after the return of program participants from cohort 1 2008 to the workplace.

A short-term evaluation of a school-based early adolescent injury prevention program

This paper reports on the development of a school-based intervention to reduce risk-taking and associated injuries. There is limited but important evidence that intervention design should ensure participation does not lead to an increase in target risk behaviors with some studies in alcohol and drug prevention finding unexpected negative effects. The short-term evaluation of Skills for Preventing Injury in Youth (SPIY) examined change in interpersonal violence, alcohol and transport-related risks. Intervention (n = 360) and comparison (n = 180) students were surveyed pre/post-intervention. A qualitative analysis based on focus groups (70 students) explored experiences of change. Findings indicate significant positive changes reinforced by students’ reports. A decrease in reported risk-taking for the intervention group and an increase in the comparison group were observed. These findings endorse SPIY as a useful curriculum approach to reducing injuries and lend support to the future conduct of a long-term outcome evaluation.

Building research capacity in the nursing workforce : the design and evaluation of the nurse researcher role

Objectives: The Nurse Researcher Project (NRP) was initiated to support development of a nursing research and evidence based practice culture in Cancer Care Services (CCS) in a large tertiary hospital in Australia. The position was established and evaluated to inform future directions in the organisation.---------- Background: The demand for quality cancer care has been expanding over the past decades. Nurses are well placed to make an impact on improving health outcomes of people affected by cancer. At the same time, there is a robust body of literature documenting the barriers to undertaking and utilising research by and for nurses and nursing. A number of strategies have been implemented to address these barriers including a range of staff researcher positions but there is scant attention to evaluating the outcomes of these strategies. The role of nurse researcher has been documented in the literature with the aim to provide support to nurses in the clinical setting. There is, to date, little information in relation to the design, implementation and evaluation of this role.---------- Design: The Donabedian’s model of program evaluation was used to implement and evaluate this initiative.---------- Methods: The ‘NRP’ outlined the steps needed to implement the nurse researcher role in a clinical setting. The steps involved the design of the role, planning for the support system for the role, and evaluation of outcomes of the role over two years.---------- Discussion: This paper proposes an innovative and feasible model to support clinical nursing research which would be relevant to a range of service areas.---------- Conclusion: Nurse researchers are able to play a crucial role in advancing nursing knowledge and facilitating evidence based practice, especially when placed to support a specialised team of nurses at a service level. This role can be implemented through appropriate planning of the position, building a support system and incorporating an evaluation plan.

An exploratory study of online social networking within a Doctorate of Education program

The professional doctorate is a degree that is specifically designed for professionals investigating real-world problems and relevant issues for a profession, industry and/or the community. The exploratory study on which this paper is based sought to track the scholarly skill development of a cohort of professional doctoral students who commenced their course in January 2008 at an Australian university. Via an initial survey and two focus groups held six months apart, the study aimed to determine if there had been any qualitative shifts in students’ understandings, expectations and perceptions regarding their developing knowledge and skills. Three key findings that emerged from this study were: (i) the appropriateness of using a blended learning approach in this professional doctoral program; (ii) the challenges of using wikis as an online technology for creating communities of practice; and (iii) the transition from professional to scholar is a process that requires the guided support inherent in the design of this particular doctorate of education program.

Flexural behaviour and design of the new built-up LiteSteel beams

LiteSteel Beam (LSB) is a new cold-formed steel beam produced by OneSteel Australian Tube Mills. The new beam is effectively a channel section with two rectangular hollow flanges and a slender web, and is manufactured using a combined cold-forming and electric resistance welding process. OneSteel Australian Tube Mills is promoting the use of LSBs as flexural members in a range of applications, such as floor bearers. When LSBs are used as back to back built-up sections, they are likely to improve their moment capacity and thus extend their applications further. However, the structural behaviour of built-up beams is not well understood. Many steel design codes include guidelines for connecting two channels to form a built-up I-section including the required longitudinal spacing of connections. But these rules were found to be inadequate in some applications. Currently the safe spans of builtup beams are determined based on twice the moment capacity of a single section. Research has shown that these guidelines are conservative. Therefore large scale lateral buckling tests and advanced numerical analyses were undertaken to investigate the flexural behaviour of back to back LSBs connected by fasteners (bolts) at various longitudinal spacings under uniform moment conditions. In this research an experimental investigation was first undertaken to study the flexural behaviour of back to back LSBs including its buckling characteristics. This experimental study included tensile coupon tests, initial geometric imperfection measurements and lateral buckling tests. The initial geometric imperfection measurements taken on several back to back LSB specimens showed that the back to back bolting process is not likely to alter the imperfections, and the measured imperfections are well below the fabrication tolerance limits. Twelve large scale lateral buckling tests were conducted to investigate the behaviour of back to back built-up LSBs with various longitudinal fastener spacings under uniform moment conditions. Tests also included two single LSB specimens. Test results showed that the back to back LSBs gave higher moment capacities in comparison with single LSBs, and the fastener spacing influenced the ultimate moment capacities. As the fastener spacing was reduced the ultimate moment capacities of back to back LSBs increased. Finite element models of back to back LSBs with varying fastener spacings were then developed to conduct a detailed parametric study on the flexural behaviour of back to back built-up LSBs. Two finite element models were developed, namely experimental and ideal finite element models. The models included the complex contact behaviour between LSB web elements and intermittently fastened bolted connections along the web elements. They were validated by comparing their results with experimental results and numerical results obtained from an established buckling analysis program called THIN-WALL. These comparisons showed that the developed models could accurately predict both the elastic lateral distortional buckling moments and the non-linear ultimate moment capacities of back to back LSBs. Therefore the ideal finite element models incorporating ideal simply supported boundary conditions and uniform moment conditions were used in a detailed parametric study on the flexural behaviour of back to back LSB members. In the detailed parametric study, both elastic buckling and nonlinear analyses of back to back LSBs were conducted for 13 LSB sections with varying spans and fastener spacings. Finite element analysis results confirmed that the current design rules in AS/NZS 4600 (SA, 2005) are very conservative while the new design rules developed by Anapayan and Mahendran (2009a) for single LSB members were also found to be conservative. Thus new member capacity design rules were developed for back to back LSB members as a function of non-dimensional member slenderness. New empirical equations were also developed to aid in the calculation of elastic lateral distortional buckling moments of intermittently fastened back to back LSBs. Design guidelines were developed for the maximum fastener spacing of back to back LSBs in order to optimise the use of fasteners. A closer fastener spacing of span/6 was recommended for intermediate spans and some long spans where the influence of fastener spacing was found to be high. In the last phase of this research, a detailed investigation was conducted to investigate the potential use of different types of connections and stiffeners in improving the flexural strength of back to back LSB members. It was found that using transverse web stiffeners was the most cost-effective and simple strengthening method. It is recommended that web stiffeners are used at the supports and every third points within the span, and their thickness is in the range of 3 to 5 mm depending on the size of LSB section. The use of web stiffeners eliminated most of the lateral distortional buckling effects and hence improved the ultimate moment capacities. A suitable design equation was developed to calculate the elastic lateral buckling moments of back to back LSBs with the above recommended web stiffener configuration while the same design rules developed for unstiffened back to back LSBs were recommended to calculate the ultimate moment capacities.

Twelve-month effectiveness of a parent-led, family-focused weight-management program for prepubertal children : a randomized, controlled trial

BACKGROUND Parenting-skills training may be an effective age-appropriate child behavior-modification strategy to assist parents in addressing childhood overweight. OBJECTIVE Our goal was to evaluate the relative effectiveness of parenting-skills training as a key strategy for the treatment of overweight children. DESIGN The design consisted of an assessor-blinded, randomized, controlled trial involving 111 (64% female) overweight, prepubertal children 6 to 9 years of age randomly assigned to parenting-skills training plus intensive lifestyle education, parenting-skills training alone, or a 12-month wait-listed control. Height, BMI, and waist-circumference z score and metabolic profile were assessed at baseline, 6 months, and 12 months (intention to treat). RESULTS After 12 months, the BMI z score was reduced by ∼10% with parenting-skills training plus intensive lifestyle education versus ∼5% with parenting-skills training alone or wait-listing for intervention. Waist-circumference z score fell over 12 months in both intervention groups but not in the control group. There was a significant gender effect, with greater reduction in BMI and waist-circumference z scores in boys compared with girls. CONCLUSION Parenting-skills training combined with promoting a healthy family lifestyle may be an effective approach to weight management in prepubertal children, particularly boys. Future studies should be powered to allow gender subanalysis.

Creating global networks through an online engineering graduate program

Internationally the railway industry is facing a severe shortage of engineers with high level, relevant, profession and technical knowledge and abilities, in particular amongst engineers involved in the design, construction and maintenance of railway infrastructure. A unique graduate level program has been created to meet that global need via a fully online, distance education format. The development and operation of this Master of Engineering degree is proposed as a model of the process needed for the industry-relevance, flexible delivery, international networking, and professional development required for a successful graduate engineering program in the 21st century. In particular, the paper demonstrates how a mix of new and more familiar technologies are utilised through a variety of tasks to overcome the huge distances and multiple time zones that separate the participants across a growing number of countries, successfully achieving close and sustained interaction amongst the participants and railway experts.

Crossing boundaries to explore sustainable architecture by open system design

This paper argues a model of open system design for sustainable architecture, based on a thermodynamics framework of entropy as an evolutionary paradigm. The framework can be simplified to stating that an open system evolves in a non-linear pattern from a far-from-equilibrium state towards a non-equilibrium state of entropy balance, which is a highly ordered organization of the system when order comes out of chaos. This paper is work in progress on a PhD research project which aims to propose building information modelling for optimization and adaptation of buildings environmental performance as an alternative sustainable design program in architecture. It will be used for efficient distribution and consumption of energy and material resource in life-cycle buildings, with the active involvement of the end-users and the physical constraints of the natural environment.

Slum free India program. Report on the findings and recommendations of QUT BEE workshop to investigate strategies to deliver better outcomes

As a result of a broad invitation extended by Professor Martin Betts, Executive Dean of the Faculty of Built Environment and Engineering, to the community of interest at QUT, a cross-disciplinary collaborative workshop was conducted to contribute ideas about responding to the Government of India’s urgent requirement to implement a program to re-house slum dwellers. This is a complex problem facing the Indian Ministry of Housing. Not only does the government aspire to eradicate existing slum conditions and to achieve tangible results within five years, but it must also ensure that slums do not form in the future. The workshop focused on technological innovation in construction to deliver transformation from the current unsanitary and overcrowded informal urban settlements to places that provide the economically weaker sections of Indian society with healthy, environmentally sustainable, economically viable mass housing that supports successful urban living. The workshop was conducted in two part process as follows: Initially, QUT academics from diverse fields shared current research and provided technical background to contextualise the challenge at a pre-workshop briefing session. This was followed by a one-day workshop during which participants worked intensively in multi-disciplinary groups through a series of exercises to develop innovative approaches to the complex problem of slum redevelopment. Dynamic, compressed work sessions, interspersed with cross-functional review and feedback by the whole group took place throughout the day. Reviews emphasised testing the concepts for their level of complexity, and likelihood of success. The two-stage workshop process achieved several objectives:  Inspired a sense of shared purpose amongst a diverse group of academics  Built participants’ knowledge of each other’s capacity  Engaged multi disciplinary team in an innovative design research process  Built participants’ confidence in the collaborative process  Demonstrated that collaborative problem solving can create solutions that represent transformative change.  Developed a framework of how workable solutions might be developed for the program through follow up workshops and charrettes of a similar nature involving stakeholders drawn from the context of the slum housing program management.

Ecological aspects of biosecurity surveillance design for the detection of multiple invasive animal species

Complex surveillance problems are common in biosecurity, such as prioritizing detection among multiple invasive species, specifying risk over a heterogeneous landscape, combining multiple sources of surveillance data, designing for specified power to detect, resource management, and collateral effects on the environment. Moreover, when designing for multiple target species, inherent biological differences among species result in different ecological models underpinning the individual surveillance systems for each. Species are likely to have different habitat requirements, different introduction mechanisms and locations, require different methods of detection, have different levels of detectability, and vary in rates of movement and spread. Often there is a further challenge of a lack of knowledge, literature, or data, for any number of the above problems. Even so, governments and industry need to proceed with surveillance programs which aim to detect incursions in order to meet environmental, social and political requirements. We present an approach taken to meet these challenges in one comprehensive and statistically powerful surveillance design for non-indigenous terrestrial vertebrates on Barrow Island, a high conservation nature reserve off the Western Australian coast. Here, the possibility of incursions is increased due to construction and expanding industry on the island. The design, which includes mammals, amphibians and reptiles, provides a complete surveillance program for most potential terrestrial vertebrate invaders. Individual surveillance systems were developed for various potential invaders, and then integrated into an overall surveillance system which meets the above challenges using a statistical model and expert elicitation. We discuss the ecological basis for the design, the flexibility of the surveillance scheme, how it meets the above challenges, design limitations, and how it can be updated as data are collected as a basis for adaptive management.

Development and pilot test of a peer-support based Cardiac-Diabetes Self-Management program : a study protocol

Background: People with cardiac disease and type 2 diabetes have higher hospital readmission rates (22%)compared to those without diabetes (6%). Self-management is an effective approach to achieve better health outcomes; however there is a lack of specifically designed programs for patients with these dual conditions. This project aims to extend the development and pilot test of a Cardiac-Diabetes Self-Management Program incorporating user-friendly technologies and the preparation of lay personnel to provide follow-up support. Methods/Design: A randomised controlled trial will be used to explore the feasibility and acceptability of the Cardiac-Diabetes Self-Management Program incorporating DVD case studies and trained peers to provide follow-up support by telephone and text-messaging. A total of 30 cardiac patients with type 2 diabetes will be randomised, either to the usual care group, or to the intervention group. Participants in the intervention group will received the Cardiac-Diabetes Self-Management Program in addition to their usual care. The intervention consists of three faceto- face sessions as well as telephone and text-messaging follow up. The face-to-face sessions will be provided by a trained Research Nurse, commencing in the Coronary Care Unit, and continuing after discharge by trained peers. Peers will follow up patients for up to one month after discharge using text messages and telephone support. Data collection will be conducted at baseline (Time 1) and at one month (Time 2). The primary outcomes include self-efficacy, self-care behaviour and knowledge, measured by well established reliable tools. Discussion: This paper presents the study protocol of a randomised controlled trial to pilot evaluates a Cardiac- Diabetes Self-Management program, and the feasibility of incorporating peers in the follow-ups. Results of this study will provide directions for using such mode in delivering a self-management program for patients with both cardiac condition and diabetes. Furthermore, it will provide valuable information of refinement of the intervention program.

Included by design : a case for regulation for accessible housing in Australia

Accessible housing is a scarce yet much needed commodity in Australia. A national agreement between industry and advocacy groups to a voluntary approach, called the Livable Design program, aims to provide access features in all new housing by 2020. Through a range of awareness raising initiatives, the program is anticipating increased supply by builders and increased demand by home-buyers. However the people who need accessible housing are the least likely and least able to buy it at the point of new sale and average homebuyers do not consider access features as a priority. This approach has not been successful overseas or in Australia in the past. Regulation with incentives supported by education and awareness has provided the best results, yet, regulation typically comes with controversy and resistance from the housing industry. A study is planned to identify how effective the Livable Design program is likely to be, what is likely to hinder it and why regulation is likely to be needed.

Physical activity and nutrition program for seniors (PANS) : protocol of a randomized controlled trial

Background Along with reduced levels of physical activity, older Australian's mean energy consumption has increased. Now over 60% of older Australians are considered overweight or obese. This study aims to confirm if a low-cost, accessible physical activity and nutrition program can improve levels of physical activity and diet of insufficiently active 60-70 year-olds. Methods/Design This 12-month home-based randomised controlled trial (RCT) will consist of a nutrition and physical activity intervention for insufficiently active people aged 60 to 70 years from low to medium socio-economic areas. Six-hundred participants will be recruited from the Australian Federal Electoral Role and randomly assigned to the intervention (n = 300) and control (n = 300) groups. The study is based on the Social Cognitive Theory and Precede-Proceed Model, incorporating voluntary cooperation and self-efficacy. The intervention includes a specially designed booklet that provides participants with information and encourages dietary and physical activity goal setting. The booklet will be supported by an exercise chart, calendar, bi-monthly newsletters, resistance bands and pedometers, along with phone and email contact. Data will be collected over three time points: pre-intervention, immediately post-intervention and 6-months post-study. Discussion This trial will provide valuable information for community-based strategies to improve older adults' physical activity and dietary intake. The project will provide guidelines for appropriate sample recruitment, and the development, implementation and evaluation of a minimal intervention program, as well as information on minimising barriers to participation in similar programs.