Randomized trial of a clinic-based, community-supported, lifestyle intervention to improve physical activity and diet : The North Carolina enhanced WISEWOMAN project

Objective To determine if a clinic-based behavioral intervention program for low-income mid-life women that emphasizes use of community resources will increase moderate intensity physical activity (PA) and improve dietary intake. Methods Randomized trial conducted from May 2003 to December 2004 at one community health center in Wilmington, NC. A total of 236 women, ages 40–64, were randomized to receive an Enhanced Intervention (EI) or Minimal Intervention (MI). The EI consisted of an intensive phase (6 months) including 2 individual counseling sessions, 3 group sessions, and 3 phone calls from a peer counselor followed by a maintenance phase (6 months) including 1 individual counseling session and 7 monthly peer counselor calls. Both phases included efforts to increase participants' use of community resources that promote positive lifestyle change. The MI consisted of a one-time mailing of pamphlets on diet and PA. Outcomes, measured at 6 and 12 months, included the comparison of moderate intensity PA between study groups as assessed by accelerometer (primary outcome) and questionnaire, and dietary intake assessed by questionnaire and serum carotenoids (6 months only). Results For accelerometer outcomes, follow-up was 75% at 6 months and 73% at 12 months. Though moderate intensity PA increased in the EI and decreased in the MI, the difference between groups was not statistically significant (p = 0.45; multivariate model, p = 0.08); however, moderate intensity PA assessed by questionnaire (92% follow-up at 6 months and 75% at 12 months) was greater in the EI (p = 0.01; multivariate model, p = 0.001). For dietary outcomes, follow-up was 90% for questionnaire and 92% for serum carotenoids at 6 months and 74% for questionnaire at 12 months. Dietary intake improved more in the EI compared to the MI (questionnaire at 6 and 12 months, p < 0.001; serum carotenoid index, p = 0.05; multivariate model, p = 0.03). Conclusion The EI did not improve objectively measured PA, but was associated with improved self-reported and objective measures of dietary intake.

Water Quality Indices from Unbalanced Spatio-Temporal Monitoring Designs

This chapter investigates a variety of water quality assessment tools for reservoirs with balanced/unbalanced monitoring designs and focuses on providing informative water quality assessments to ensure decision-makers are able to make risk-informed management decisions about reservoir health. In particular, two water quality assessment methods are described: non-compliance (probability of the number of times the indicator exceeds the recommended guideline) and amplitude (degree of departure from the guideline). Strengths and weaknesses of current and alternative water quality methods will be discussed. The proposed methodology is particularly applicable to unbalanced designs with/without missing values and reflects the general conditions and is not swayed too heavily by the occasional extreme value (very high or very low quality). To investigate the issues in greater detail, we use as a case study, a reservoir within South-East Queensland (SEQ), Australia. The purpose here is to obtain an annual score that reflected the overall water quality, temporally, spatially and across water quality indicators for each reservoir.

Evaluations of BIM : frameworks and perspectives

This paper examines the evaluation of BIM-enabled projects. It provides a critical review of the three main areas of measurement, namely technology, organization/people and process. Using two documented case studies of BIM implementation, the paper illustrates the benefits realized by project owners and contractors, and illustrates a lack of attention relative to contextual factors affecting the adoption and deployment of BIM. The paper has three main contributions. First, it identifies and discusses the lack of and difficulty surrounding standardized assessment methods for evaluating BIM-enabled projects. Second, it proposes a conceptual model that includes contextual attributes and demonstrates how the proposed framework reaches beyond simple evaluation to encompass the documentation of BIM’s benefits, lessons learned, challenges and adopted solutions. Third, it shows how the framework can account for existing business processes, organizational process assets, and enterprise level factors. The paper aims to provide a conceptual basis for evaluation and a starting point for benchmarking.

Food and beverage intake in Australian children aged 12-16 months participating in the NOURISH and SAIDI studies

Objective To describe the quantity and diversity of food and beverage intake in Australian children aged 12–16 months and to determine if the amount and type of milk intake is associated with dietary diversity. Methods Mothers participating in the NOURISH and South Australian Infant Dietary Intake (SAIDI) studies completed a single 24-hour recall of their child's food intake, when children (n=551) were aged 12–16 months. The relationship between dietary diversity and intake of cow's milk, formula or breastmilk was examined using one-way ANOVA. Results Dairy and cereal were the most commonly consumed food groups and the greatest contributors to daily energy intake. Most children ate fruit (87%) and vegetables (77%) on the day of the 24-hour recall while 91% ate discretionary items. Half the sample ate less than 30 g of meat/alternatives. A quarter of the children were breastfeeding while formula was consumed by 32% of the sample, providing 29% of daily energy intake. Lower dietary diversity was associated with increased formula intake. Conclusions The quality of dietary intake in this group of young children is highly variable. Most toddlers were consuming a diverse diet, though almost all ate discretionary items. The amount and type of meat/alternatives consumed was poor. Implications Health professionals should advise parents to offer iron-rich foods, while limiting discretionary choices and use of formula at an age critical in the development of long-term food preferences.

Ecological approaches in planning for sustainable cities : a review of the literature

Rapid urbanization has brought environmentally, socially, and economically great challenges to cities and societies. To build a sustainable city, these challenges need to be faced efficiently and successfully. This paper focuses on the environmental issues and investigates the ecological approaches for planning sustainable cities through a comprehensive review of the relevant literature. The review focuses on several differing aspects of sustainable city formation. The paper provides insights on the interaction between the natural environment and human activities by identifying environmental effects resulting from this interaction; provides an introduction to the concept of sustainable urban development by underlining the important role of ecological planning in achieving sustainable cities; introduces the notion of urban ecosystems by establishing principles for the management of their sustainability; describes urban ecosystem sustainability assessment by introducing a review of current assessment methods, and; offers an outline of indexing urban environmental sustainability. The paper concludes with a summary of the findings.

Interpersonal violence : an important risk factor for disease and injury in South Africa

Background Burden of disease estimates for South Africa have highlighted the particularly high rates of injuries related to interpersonal violence compared with other regions of the world, but these figures tell only part of the story. In addition to direct physical injury, violence survivors are at an increased risk of a wide range of psychological and behavioral problems. This study aimed to comprehensively quantify the excess disease burden attributable to exposure to interpersonal violence as a risk factor for disease and injury in South Africa. Methods The World Health Organization framework of interpersonal violence was adapted. Physical injury mortality and disability were categorically attributed to interpersonal violence. In addition, exposure to child sexual abuse and intimate partner violence, subcategories of interpersonal violence, were treated as risk factors for disease and injury using counterfactual estimation and comparative risk assessment methods. Adjustments were made to account for the combined exposure state of having experienced both child sexual abuse and intimate partner violence. Results Of the 17 risk factors included in the South African Comparative Risk Assessment study, interpersonal violence was the second leading cause of healthy years of life lost, after unsafe sex, accounting for 1.7 million disability-adjusted life years (DALYs) or 10.5% of all DALYs (95% uncertainty interval: 8.5%-12.5%) in 2000. In women, intimate partner violence accounted for 50% and child sexual abuse for 32% of the total attributable DALYs. Conclusions The implications of our findings are that estimates that include only the direct injury burden seriously underrepresent the full health impact of interpersonal violence. Violence is an important direct and indirect cause of health loss and should be recognized as a priority health problem as well as a human rights and social issue. This study highlights the difficulties in measuring the disease burden from interpersonal violence as a risk factor and the need to improve the epidemiological data on the prevalence and risks for the different forms of interpersonal violence to complete the picture. Given the extent of the burden, it is essential that innovative research be supported to identify social policy and other interventions that address both the individual and societal aspects of violence.

Synthetic rating system for railway bridge management

This thesis developed a condition assessment and rating method to identify those bridges in a network which are in most need of repair for an effective life cycle management. The method estimates the contribution of critical factors towards bridge deterioration and uses structural analysis to overcome the subjectivity of traditional current condition assessment methods. This research was a part of the CRC project titled 'Life Cycle Management of Railway Bridges'. Efficient usage of resources and enhancing the safety and serviceability of railway bridges are the significant outcomes of using the proposed method.

Normal reference values of strength in pelvic floor muscle of women: A descriptive and inferential study

Background To describe the clinical, functional and quality of life characteristics in women with Stress Urinary Incontinence (SUI). In addition, to analyse the relationship between the variables reported by the patients and those informed by the clinicians, and the relationship between instrumented variables and the manual pelvic floor strength assessment. Methods Two hundred and eighteen women participated in this observational, analytical study. An interview about Urinary Incontinence and the quality of life questionnaires (EuroQoL-5D and SF-12) were developed as outcomes reported by the patients. Manual muscle testing and perineometry as outcomes informed by the clinician were assessed. Descriptive and correlation analysis were carried out. Results The average age of the subjects was (39.93?±?12.27 years), (24.49?±?3.54 BMI). The strength evaluated by manual testing of the right levator ani muscles was 7.79?±?2.88, the strength of left levator ani muscles was 7.51?±?2.91 and the strength assessed with the perineometer was 7.64?±?2.55. A positive correlation was found between manual muscle testing and perineometry of the pelvic floor muscles (p?

Burden attributable to child maltreatment in Australia

Child maltreatment is a complex phenomenon, with four main types (childhood sexual abuse, physical abuse, emotional abuse, and neglect) highly interrelated. All types of maltreatment have been linked to adverse health consequences and exposure to multiple forms of maltreatment increases risk. In Australia to date, only burden attributable to childhood sexual abuse has been estimated. This study synthesized the national evidence and quantified the burden attributable to the four main types of child maltreatment. Meta-analyses, based on quality-effects models, generated pooled prevalence estimates for each maltreatment type. Exposure to child maltreatment was examined as a risk factor for depressive disorders, anxiety disorders and intentional self-harm using counterfactual estimation and comparative risk assessment methods. Adjustments were made for co-occurrence of multiple forms of child maltreatment. Overall, an estimated 23.5% of self-harm, 20.9% of anxiety disorders and 15.7% of depressive disorders burden in males; and 33.0% of self-harm, 30.6% of anxiety disorders and 22.8% of depressive disorders burden in females was attributable to child maltreatment. Child maltreatment was estimated to cause 1.4% (95% uncertainty interval 0.4–2.3%) of all disability-adjusted life years (DALYs) in males, and 2.4% (0.7–4.1%) of all DALYs in females in Australia in 2010. Child maltreatment contributes to a substantial proportion of burden from depressive and anxiety disorders and intentional self-harm in Australia. This study demonstrates the importance of including all forms of child maltreatment as risk factors in future burden of disease studies.

Enhancing information about sustainability features for sustainable housing delivery

Sustainability practices in government regulations and within the society influence the delivery of sustainable housing. The actual delivery rate of Australian sustain-able housing is not as high as other countries. There is an absence of engagement by stakeholders in adopting sustainable housing practices. This may be due, in the current Australian property market, to confusion as to what sustainability features should be considered, given the large range of environmental, economic and social sustainability options possible. One of the main problems appears to be that information demanders, especially real estate agents, valuers, insurance agents and mortgage lenders do not include sustainability perspectives in their advice or in their decision processes. Information distribution in the Australian property market is flawed, resulting in a lack of return-on-investment value of ‘green’ features implemented by some stakeholders. This paper reviewed the global sustainable development concept and Australian sustainable assessment methods. This review identified the possibility of a research project which aimed at identifying and integrating different perceptions and priority needs of the information demanders, for developing a model for the potential implementation of sustainability features distribution in the property industry. This research will reduce confusion on the sustainability-related information which can influence the decision making of stakeholders in the supply and demand of sustainable housing.

Assessing university students' prior knowledge

The aim of this dissertation was to explore how different types of prior knowledge influence student achievement and how different assessment methods influence the observed effect of prior knowledge. The project started by creating a model of prior knowledge which was tested in various science disciplines. Study I explored the contribution of different components of prior knowledge on student achievement in two different mathematics courses. The results showed that the procedural knowledge components which require higher-order cognitive skills predicted the final grades best and were also highly related to previous study success. The same pattern regarding the influence of prior knowledge was also seen in Study III which was a longitudinal study of the accumulation of prior knowledge in the context of pharmacy. The study analysed how prior knowledge from previous courses was related to student achievement in the target course. The results implied that students who possessed higher-level prior knowledge, that is, procedural knowledge, from previous courses also obtained higher grades in the more advanced target course. Study IV explored the impact of different types of prior knowledge on students’ readiness to drop out from the course, on the pace of completing the course and on the final grade. The study was conducted in the context of chemistry. The results revealed again that students who performed well in the procedural prior-knowledge tasks were also likely to complete the course in pre-scheduled time and get higher final grades. On the other hand, students whose performance was weak in the procedural prior-knowledge tasks were more likely to drop out or take a longer time to complete the course. Study II explored the issue of prior knowledge from another perspective. Study II aimed to analyse the interrelations between academic self-beliefs, prior knowledge and student achievement in the context of mathematics. The results revealed that prior knowledge was more predictive of student achievement than were other variables included in the study. Self-beliefs were also strongly related to student achievement, but the predictive power of prior knowledge overruled the influence of self-beliefs when they were included in the same model. There was also a strong correlation between academic self-beliefs and prior-knowledge performance. The results of all the four studies were consistent with each other indicating that the model of prior knowledge may be used as a potential tool for prior knowledge assessment. It is useful to make a distinction between different types of prior knowledge in assessment since the type of prior knowledge students possess appears to make a difference. The results implied that there indeed is variation between students’ prior knowledge and academic self-beliefs which influences student achievement. This should be taken into account in instruction.

Advanced practice: A survey of current perspectives of Australian pharmacists

Background An Advanced Pharmacy Practice Framework for Australia (the ‘APPF’) was published in October 2012. Further to the release of the APPF, the Advanced Pharmacy Practice Framework Steering Committee planned to develop an advanced practice recognition model for Australian pharmacists. Aim To gauge the perspectives of the pharmacy profession relating to advanced practice, via an online survey, in order to inform the design of the model. Method A survey was developed and administered to Australian pharmacists through SurveyMonkey . The survey content was based on findings from a review of national and international initiatives for recognition of advanced practice in pharmacy and other health disciplines, including medicine and nursing. Results The results of the survey showed that a high proportion of respondents considered they were already working at, or working towards achieving, an advanced level of practice. The responses relating to the assessment methods showed a clear preference for ‘submission of a professional portfolio’. A ‘written examination’ had a low level of support and in relation to an ‘oral examination by a panel’ there was a marked preference for a panel of multidisciplinary health professionals over a panel of pharmacists. Conclusion The survey outcomes will inform the development of an advanced pharmacy practice recognition model for Australian pharmacists, particularly in relation to the assessment methods. Survey outcomes also demonstrated that there is scope to further enhance the application of the APPF in the development and recognition of advanced practitioners, and to build greater awareness of the breadth of competencies encompassed by ‘advanced practice’.

Silvicultural decisions based on simulation-optimization systems

Forest management is facing new challenges under climate change. By adjusting thinning regimes, conventional forest management can be adapted to various objectives of utilization of forest resources, such as wood quality, forest bioenergy, and carbon sequestration. This thesis aims to develop and apply a simulation-optimization system as a tool for an interdisciplinary understanding of the interactions between wood science, forest ecology, and forest economics. In this thesis, the OptiFor software was developed for forest resources management. The OptiFor simulation-optimization system integrated the process-based growth model PipeQual, wood quality models, biomass production and carbon emission models, as well as energy wood and commercial logging models into a single optimization model. Osyczka s direct and random search algorithm was employed to identify optimal values for a set of decision variables. The numerical studies in this thesis broadened our current knowledge and understanding of the relationships between wood science, forest ecology, and forest economics. The results for timber production show that optimal thinning regimes depend on site quality and initial stand characteristics. Taking wood properties into account, our results show that increasing the intensity of thinning resulted in lower wood density and shorter fibers. The addition of nutrients accelerated volume growth, but lowered wood quality for Norway spruce. Integrating energy wood harvesting into conventional forest management showed that conventional forest management without energy wood harvesting was still superior in sparse stands of Scots pine. Energy wood from pre-commercial thinning turned out to be optimal for dense stands. When carbon balance is taken into account, our results show that changing carbon assessment methods leads to very different optimal thinning regimes and average carbon stocks. Raising the carbon price resulted in longer rotations and a higher mean annual increment, as well as a significantly higher average carbon stock over the rotation.

Sanailua, kynäilyä, intoilua ja epäilyä : Oppilaiden kirjoitustaito ja sen arvioiminen alkuopetuksessa

Objectives. In primary education the pupils form a basis for their writing skills. By assessing pupils writing skills the teacher gathers information about the development of their skills and notices possible learning disabilities. The assessment of writing skills requires both knowledge of different evaluation methods and the phonological system in Finnish language. The purpose of this study is to analyze the pupils writing skills and different assessment methods that help the teacher in writing evaluation. The pupils writing skills are viewed from spelling, composing and writing motivation s point of view. Methods. The research material consists of dictation exercises, written stories and writing motivation self-assessments of 19 pupils. Dictation exercises measured the spelling skills of pupils and they were written in the spring of the first grade and the autumn of the second grade. Dictation exercises were analyzed with two different methods: mistake analysis and word-structure analysis. Information of pupils spelling skills development was gathered by comparing their performance in autumn s dictation exercise to spring s dictation. Composing skills were measured with stories that the pupils wrote. Both the stories and the writing motivation s self-assessment were made in the autumn of the second grade. Composing skills were analyzed according to assessment criteria formed for this study. Results. The spelling skill of most of the pupils had developed from the first grade s spring to the second grade s autumn. The spelling skills of half of the pupils (N=9) had improved significantly. The composing skills of the pupils varied largely. Strongest part of the pupils composing skill was following instructions and the weakest part was the use of versatile vocabulary and clause structures. The girls outdid the boys in all segments of their composing skills. For most pupils their spelling skill reflected their composing skill: good spellers were also good story writers. The relation between writing motivation and general writing skill was not this simple: some pupils (N=5) writing motivation was much higher than what would have been expected based on their writing skills.

Tropical river fisheries valuation: background papers to a global synthesis

This report is a compilation of five regional reviews that document the global status of tropical rivers and inland fisheries in three continents: Latin America, Africa and Asia. It explores the role of ‘valuation’ methods and their contribution to policy-making and river fishery management. From the compilation, the best estimate of the global value of inland fisheries for those three continents is US$ 5.58 billion (gross market value), which is equivalent to 19 percent of the current value of annual fish exports from developing countries (US$ 29 billion) for 2004. The compilation shows that there is a general shortage of information on inland fisheries, especially derived from conventional economic valuation methods, though information from economic impact assessment methods and socio-economic and livelihood analysis methods is more widely available. The status of knowledge about the impact of changes in river management on the value of tropical river fisheries is weak and patchy. Although the impacts of large dams on the hydrology, ecology and livelihood support attributes of tropical rivers are well-recognized, there have been only few valuation studies of these issues. The document highlights the need for further valuation studies of tropical river and inland fisheries in developing countries. It underlines how vital it is for policy-makers and other stakeholders to understand the importance of these natural resources in order to make appropriate decisions concerning their role in development policy and illustrates why capacity building in valuation should become a major priority for agencies concerned with fisheries management and policy-making.