A stakeholder process evaluation of a social marketing walking intervention targeting children

One quarter of Australian children are overweight or obese (ABS, 2010), putting them at increased risk of physical and psychological health problems (Reilly et al., 2003). Overweight and obesity in childhood tends to persist into adulthood and is associated with premature death and morbidity (Reilly & Kelly, 2011). Increases in Australian children’s weight have coincided with declines in active transportation, such as walking, to school (Salmon et al., 2005). To address this problem, the Victorian Health Promotion Foundation (VicHealth), which is an independent statutory authority which advises government and contributes to promoting good health in Victoria (VicHealth, 2014), developed the Walk to School program. Walk to School aims to encourage primary school children in Victoria to walk to and from school more often. Walking to school is a low cost and effective means of reducing excess weight (Rosenberg et al., 2006) that can be easily integrated into daily routine (Brophy et al., 2011). The purpose of this paper is to present the results of the stakeholder process evaluation of Walk to School 2013, which forms part of a broader outcome evaluation that is currently in field. Although there is an emphasis on outcome evaluation of programs, process evaluation can be equally important in determining program success (Saunders et al., 2005). Further, process evaluation to assess program delivery and utilization is explicitly recommended by two social marketing frameworks (see Lefebvre et al., 1988; Walsh et al., 1993).

Second-order quantile methods for experts and combinatorial games

We aim to design strategies for sequential decision making that adjust to the difficulty of the learning problem. We study this question both in the setting of prediction with expert advice, and for more general combinatorial decision tasks. We are not satisfied with just guaranteeing minimax regret rates, but we want our algorithms to perform significantly better on easy data. Two popular ways to formalize such adaptivity are second-order regret bounds and quantile bounds. The underlying notions of 'easy data', which may be paraphrased as "the learning problem has small variance" and "multiple decisions are useful", are synergetic. But even though there are sophisticated algorithms that exploit one of the two, no existing algorithm is able to adapt to both. In this paper we outline a new method for obtaining such adaptive algorithms, based on a potential function that aggregates a range of learning rates (which are essential tuning parameters). By choosing the right prior we construct efficient algorithms and show that they reap both benefits by proving the first bounds that are both second-order and incorporate quantiles.

Cost effectiveness of osseointegration

Individuals with limb amputation fitted with conventional socket-suspended prostheses often experience socket-related discomfort leading to a significant decrease in quality of life. Bone-anchored prostheses are increasingly acknowledged as viable alternative method of attachment of artificial limb. In this case, the prosthesis is attached directly to the residual skeleton through a percutaneous fixation. To date, a few osseointegration fixations are commercially available. Several devices are at different stages of development particularly in Europe and the US. [1-15] Clearly, surgical procedures are currently blooming worldwide. Indeed, Australia and Queensland, in particular, have one of the fastest growing populations. Previous studies involving either screw-type implants or press-fit fixations for bone-anchorage have focused on biomechanics aspects as well as the clinical benefits and safety of the procedure. [16-25] In principle, bone-anchored prostheses should eliminate lifetime expenses associated with sockets and, consequently, potentially alleviate the financial burden of amputation for governmental organizations. Sadly, publications focusing on cost-effectiveness are sparse. In fact, only one study published by Haggstrom et al (2012), reported that “despite significantly fewer visits for prosthetic service the annual mean costs for osseointegrated prostheses were comparable with socket-suspended prostheses”.[26] Consequently, governmental organizations such as Queensland Artificial Limb Services (QALS) are facing a number of challenges while adjusting financial assistance schemes that should be fair and equitable to their clients fitted with bone-anchored prostheses. Clearly, more scientific evidence extracted from governmental databases is needed to further consolidate the analyses of financial burden associated with both methods of attachment (i.e., conventional sockets prostheses, bone-anchored prostheses). The purposes of the presentation will be: 1. To outline methodological avenues to assess the cost-effectiveness of bone-anchored prostheses compared to conventional sockets prostheses, 2. To highlight the potential obstacles and limitations in cost-effectiveness analyses of bone-anchored prostheses, 3. To present preliminary results of a cost-comparison analysis focusing on the comparison of the costs expressed in dollars over QALS funding cycles for both methods of attachment.

Osseointegration internationally: Australia is playing a key role?

Individuals with limb amputation fitted with conventional socket-suspended prostheses often experience socket-related discomfort leading to a significant decrease in quality of life. Bone-anchored prostheses are increasingly acknowledged as viable alternative method of attachment of artificial limb. In this case, the prosthesis is attached directly to the residual skeleton through a percutaneous fixation. To date, a few osseointegration fixations are commercially available. Several devices are at different stages of development particularly in Europe and the US.[1-15] Clearly, surgical procedures are currently blooming worldwide. Indeed, Australia and Queensland in particular have one of the fastest growing populations. Previous studies involving either screw-type implants or press-fit fixations for bone-anchorage have focused on fragmented biomechanics aspects as well as the clinical benefits and safety of the procedure. [16-25] However, very few publications have synthetized this information and provided an overview of the current developments in bone-anchored prostheses worldwide, let alone in Australia. The purposes of the presentation will be: 1. To provide an overview of the state-of-art developments in bone-anchored prostheses with as strong emphasis on the design of fixations, treatment, benefits, risks as well as future opportunities and challenges, 2. To present the current international developments of procedures for bone-anchored prostheses in terms of numbers of centers, number of cases and typical case-mix, 3. To highlight the current role Australia is playing as a leader worldwide in terms of growing population, broadest range of case-mix, choices of fixations, development of reimbursement schemes, unique clinical outcome registry for evidence-based practice, cutting-edge research, consumer demand and general public interest.

Examining well-being, anxiety, and self-deception in university students

This study examined the combined influence of six positive psychology variables (optimism, hope, self-efficacy, grit, gratitude, and subjective life satisfaction), termed covitality, in relation to buffering individuals against anxiety symptoms. In addition, the influence of self-deception was examined to test whether this construct had an influence on the reporting of these positive psychology variables. A total of 268 individuals (203 females and 65 males) with a mean age of 22.2 years (SD = 7.4 years) from one Queensland university took part in the study. The participants completed an online questionnaire, which included a battery of positive psychological measures, plus a measure of anxiety and self-deception. The results indicated that the covitality constructs had a moderation effect on anxiety. In a regression analysis, the six covitality constructs explained an additional 24.5% of the variance in anxiety, after controlling for self-deception. Further analyses revealed that those higher in self-deception scored higher in self-efficacy and all positive covitality measures and lower in anxiety, than those lower in self-deception. These findings illustrate the importance of considering the role that self-deception might play in the reporting of positive psychology variables.

The effects of parental illness and other ill family members on youth caregiving experiences

Informed by a model of family role-redistribution derived from the Family Ecology Framework (Pedersen & Revenson, 2005), this study examined differences in two proposed psychological components of role-redistribution (youth caregiving experiences and responsibilities) between youth of a parent with illness and their peers from ‘healthy’ families controlling for the effects of whether a parent is ill or some other family member, illness type, and demographics. Based on self-report questionnaire data, four groups of Australian children were derived from a community sample of 2474youth (‘healthy’ family, n=1768; parental illness, n=336; other family member illness, n=254; both parental and other family member illness, n=116). The presence of any family member with a serious illness is associated with an intensification of youth caregiving experiences relative to peers from healthy families. This risk is elevated if the ill family member is a parent, if more illnesses are present, and by certain youth and family demographics, and especially by higher caregiving responsibilities. The presence of a family member, particularly a parent, with a serious medical condition has pervasive increased effects on youth caregiving compared to healthy families, and these effects are not fully accounted for by illness type, demographics or caregiving responsibilities.

Evaluation framework to assess benefits and harms of bone-anchored prosthesis

Bone-anchored prostheses are increasingly acknowledged as viable alternative method of attachment of artificial limb compared to socket-suspended prostheses. To date, a few osseointegration fixations are commercially available. Several devices are at different stages of development particularly in Europe and the US. Clearly, the current momentum experienced worldwide is creating a need for a standardized evaluation framework to assess the benefits and safety of each procedure.

Experiencing information use for early career academics’ learning: A knowledge ecosystem model

Purpose This study explores the informed learning experiences of early career academics while building their networks for professional and personal development. The notion that information and learning are inextricably linked via the concept of ‘informed learning’ is used as a conceptual framework to gain a clearer picture of what informs early career academics while they learn and how they experience using that which informs their learning within this complex practice: to build, maintain and utilise their developmental networks. Methodology This research employs a qualitative framework using a constructivist grounded theory approach (Charmaz, 2006). Through semi-structured interviews with a sample of fourteen early career academics from across two Australian universities, data were generated to investigate the research questions. The study used the methods of constant comparison to create codes and categories towards theme development. Further examination considered the relationship between thematic categories to construct an original theoretical model. Findings The model presented is a ‘knowledge ecosystem’, which represents the core informed learning experience. The model consists of informal learning interactions such as relating to information to create knowledge and engaging in mutually supportive relationships with a variety of knowledge resources found in people who assist in early career development. Originality/Value Findings from this study present an alternative interpretation of informed learning that is focused on processes manifesting as human interactions with informing entities revolving around the contexts of reciprocal human relationships.

Structural and electronic properties of layered arsenic and antimony arsenide

Layered materials exhibit intriguing electronic characteristics and the search for new types of two-dimensional (2D) structures is of importance for future device fabrication. Using state-of-art first principle calculations, we identify and characterize the structural and electronic properties of two 2D layered arsenic materials, namely, arsenic and its alloy AsSb. The stable 2D structural configuration of arsenic is confirmed to be the low-buckled two-dimensional hexagonal structure by phonon and binding energy calculations. The monolayer exhibits indirect semiconducting properties with gap around 1.5 eV (corrected to 2.2 eV by hybrid function), which can be modulated into a direct semiconductor within a small amount of tensile strain. These semiconducting properties are preserved when cutting into 1D nanoribbons, but the band gap is edge dependent. It is interesting to find that an indirect to direct gap transition can be achieved under strain modulation of the armchair ribbon. Essentially the same phenomena can be found in layered AsSb, except a weak Rashba induced band splitting is present in AsSb due to the nonsymmetric structure and spin orbit coupling. When an additional layer is added on the top, a semiconductor–metal transition will occur. The findings here broaden the family of 2D materials beyond graphene and transition metal dichalcogenides and provide useful information for experimental fabrication of new layered materials with possible application in optoelectronics.

Osseointegrated prosthetic limb for amputees: Over hundred cases

The Osseointegrated Prosthetic Limb (OPL) was introduced in 2011. Prior to its advent all prostheses consisted of stump and socket mechanisms which did not changed dramatically since Ambroise Pare lower limb prosthesis in 1525. These socket prostheses failed to address a few major requirements of normal gait. Our hypothesis was that using an Osseointegrated Prosthetic limb will result in superior function of daily activities, without compromising patients’ safety.The aims of this paper are (A) to describe the surgical procedure of the OPL; and (B) to present data on potential risks and benefits with assessment of clinical and functional outcomes at follow up

Health-related quality of life of individuals with transfemoral amputation fitted with the Transcutaneous Bone Anchoring Prosthesis following the OGAAP

The benefits and safety transcutaneous bone anchored prosthesis relying on a screw fixation are well reported. However, most of the studies on press-fit implants and joint replacement technology have focused on surgical techniques. One European centre using this technique has reported on health-related quality of life (HRQOL) for a group of individuals with transfemoral amputation (TFA). Data from other centres are needed to assess the effectiveness of the technique in different settings. The aim of this study is to report HRQOL data at baseline and up to 2-year follow-up for a group of TFAs treated by Osseointegration Group of Australia who followed the Osseointegration Group of Australia Accelerated Protocol (OGAAP), in Sydney between 08/12/2011 and 09/04/2014.

Osseointegrated prosthetic limb for amputees: Single stage surgery

The Osseointegrated Prosthetic Limb (OPL) was introduced in 2011. The socket prostheses failed to address a few major requirements of normal gait. Our hypothesis was that using an Osseointegrated Prosthetic limb will result in superior function of daily activities, without compromising patients’ safety. Traditionally this surgery was done as a two-stage procedure. The aims of this study were (A)to describe the single - surgical procedure of the OPL; and (B)To present data on potential risks and benefits with sssessment of clinical and functional outcomes at follow up.

Transcutaneous bone-anchoring prosthesis with knee replacement: A novel treatment for amputees

Over the last two decades, Transcutaneous Bone-Anchored Prosthesis (TCBAP) has proven to be an effective alternative for prosthetic attachment for amputees, particularly for individuals unable to wear a socket. However, the load transmitted through a typical TCBAP to the residual tibia and knee joint can be unbearable for transtibial amputees with knee arthritis. The aims of this study are (A) to describe the surgical procedure combining TKR with TCBAP for the first time; and (B) to present preliminary data on potential risks and benefits with assessment of clinical and functional outcomes at follow up.

Load bearing exercises and functional outcome of individuals with transfemoral amputation fitted with OPRA fixation

Individuals with lower limb amputation fitted with an OPRA osseointegrated fixation are facing an extensive rehabilitation program including static load bearing exercises (LBE). The application of a suitable amount of stress stimulates osseointegration and prepares the bone to tolerate the forces and moments that will be incurred during activities of daily living (ADL. At present, the monitoring is typically carried out using a normal bathroom weighing scale. This scale provides information only on the magnitude of the vertical component of the applied force. The moment around the long axis of the fixation when the femur is perpendicular to the ground is not assessed and neither are the components of force and moment generated on the other two axes.

Spatio-temporal characteristics of locomotion and functional outcomes of individuals with transfemoral amputation fitted with OPRA fixation

The conventional method of attachment of prosthesis involves a socket. A new method relying on osseointegrated fixation has emerged in the last decades. It has significant prosthetic benefits. Only a few studies demonstrated the biomechanical benefits. The ultimate aim of this study was to characterise the functional outcome of individuals with lower limb amputation fitted with osseointegrated fixation, which can be assess through temporal and spatial gait characteristics. The specific objective of this study was to present the key temporal and spatial gait characteristics of individuals with transfemoral amputation (TFA).