Depression among Chinese stroke survivors six months after discharge from a rehabilitation hospital

Aim and objective: The primary aim was to examine the prevalence of poststroke depression in Chinese stroke survivors six months after discharge from a rehabilitation hospital. A second aim was to determine whether six-month poststroke depression was associated with psychological, social and physical outcomes and demographic variables.---------- Background: There has been increasing recognition of the influence of depression on poststroke recovery. While some previous studies report associations between depression and social, psychological, physical and clinical outcomes, few studies had sufficient sample sizes for regression analysis thereby limiting the clinical applicability of their findings. ---------- Design: A cross-sectional design was used.---------- Method: Data were collected from 124 male and 86 female stroke survivors (mean age 71Æ7, SD 10Æ2 years). The Geriatric Depression Scale was used to measure depression, the State Self-esteem Scale to measure state self-esteem, the London Handicap Scale to measure participation restriction, the Social Support Questionnaire to measure satisfaction with social support and the Modified Barthel Index to measure functional ability. Results. Forty-two survivors (20Æ5%) reported mild and 33 (16Æ1%) reported severe depression. The presence of depression was associated with low levels of state self-esteem, social support satisfaction and functional ability. Logistic regression analysis revealed that these variables were statistically significant in predicting the probability of having depression (p < 0Æ05). ---------- Conclusions: Analyses in the present study revealed distinct patterns of correlates of depression, and the results were in agreement with prior studies that depression has a consistent positive ssociation with physical disability, living arrangements and social support and no significant association with the different types of brain lesion. Relevance to clinical practice. There is a need, routinely, to assess stroke survivors for depression and, where necessary, to intervene with the aim of enhancing psychological and social well-being.

European advanced driver training programs : reasons for optimism

Post license advanced driver training programs in the US and early programs in Europe have often failed to accomplish their stated objectives because, it is suspected, that drivers gain self perceived driving skills that exceed their true skills—leading to increased post training crashes. The consensus from the evaluation of countless advanced driver training programs is that these programs are a detriment to safety, especially for novice, young, male drivers. Some European countries including Sweden, Finland, Austria, Luxembourg, and Norway, have continued to refine these programs, with an entirely new training philosophy emerging around 1990. These ‘post-renewal’ programs have shown considerable promise, despite various data quality and availability concerns. These programs share in common a focus on teaching drivers about self assessment and anticipation of risk, as opposed to teaching drivers how to master driving at the limits of tire adhesion. The programs focus on factors such as self actualization and driving discipline, rather than low level mastery of skills. Drivers are meant to depart these renewed programs with a more realistic assessment of their driving abilities. These renewed programs require considerable specialized and costly infrastructure including dedicated driver training facilities with driving modules engineered specifically for advanced driver training and highly structured curricula. They are conspicuously missing from both the US road safety toolbox and academic literature. Given the considerable road safety concerns associated with US novice male drivers in particular, these programs warrant further attention. This paper reviews the predominant features and empirical evidence surrounding post licensing advanced driver training programs focused on novice drivers. A clear articulation of differences between the renewed and current US advanced driver training programs is provided. While the individual quantitative evaluations range from marginally to significantly effective in reducing novice driver crash risk, they have been criticized for evaluation deficiencies ranging from small sample sizes to confounding variables to lack of exposure metrics. Collectively, however, the programs sited in the paper suggest at least a marginally positive effect that needs to be validated with further studies. If additional well controlled studies can validate these programs, a pilot program in the US should be considered.

The effectiveness of a short-term group music therapy intervention for parents who have a child with a disability

Background The relationship between positive parent-child interactions and optimal child development is well established. Families with a child with a disability may face additional challenges to establishing positive parent-child relationships. There are limited studies addressing the effectiveness of interventions which seek to address these issues with parents and young children with a disability. In particular, prior studies of music therapy with this group have been limited by small sample sizes and the use of measures of limited reliability and validity. Objective This study investigates the effectiveness of a short-term group music therapy intervention for parents who have a child with a disability and explores the factors associated with higher outcomes for participating families. Methods The participants were 201 mother-child dyads, where the child had a disability. Pre and post intervention parental questionnaires and clinician observation measures were taken on a range of parental wellbeing, parenting behaviours and child developmental factors. Descriptive data, t-tests for repeated measures and a predictive model tested via logistic regression are presented. Results Significant improvements pre to post were found for parent mental health, child communication and social skills, parenting sensitivity, parental engagement with child and acceptance of child, child responsiveness to parent, and child interest and participation in program activities. There was also evidence that parents were very satisfied with the program and that it brought social benefits to families. Reliable change on six or more indicators of parent or child functioning was predicted by attendance and parent education. Conclusions This study provides positive evidence for the effectiveness of group music therapy in promoting improved parental mental health, positive parenting and key child developmental areas. Whilst several limitations are discussed, the study does address some of the gaps in the music therapy evidence base in this area.

Online alcohol interventions : a systematic review

Background: There has been a significant increase in the availability of online programs for alcohol problems. A systematic review of the research evidence underpinning these programs is timely. Objectives: Our objective was to review the efficacy of online interventions for alcohol misuse. Systematic searches of Medline, PsycINFO, Web of Science, and Scopus were conducted for English abstracts (excluding dissertations) published from 1998 onward. Search terms were: (1) Internet, Web*; (2) online, computer*; (3) alcohol*; and (4) E\effect*, trial*, random* (where * denotes a wildcard). Forward and backward searches from identified papers were also conducted. Articles were included if (1) the primary intervention was delivered and accessed via the Internet, (2) the intervention focused on moderating or stopping alcohol consumption, and (3) the study was a randomized controlled trial of an alcohol-related screen, assessment, or intervention. Results: The literature search initially yielded 31 randomized controlled trials (RCTs), 17 of which met inclusion criteria. Of these 17 studies, 12 (70.6%) were conducted with university students, and 11 (64.7%) specifically focused on at-risk, heavy, or binge drinkers. Sample sizes ranged from 40 to 3216 (median 261), with 12 (70.6%) studies predominantly involving brief personalized feedback interventions. Using published data, effect sizes could be extracted from 8 of the 17 studies. In relation to alcohol units per week or month and based on 5 RCTs where a measure of alcohol units per week or month could be extracted, differential effect sizes to post treatment ranged from 0.02 to 0.81 (mean 0.42, median 0.54). Pre-post effect sizes for brief personalized feedback interventions ranged from 0.02 to 0.81, and in 2 multi-session modularized interventions, a pre-post effect size of 0.56 was obtained in both. Pre-post differential effect sizes for peak blood alcohol concentrations (BAC) ranged from 0.22 to 0.88, with a mean effect size of 0.66. Conclusions: The available evidence suggests that users can benefit from online alcohol interventions and that this approach could be particularly useful for groups less likely to access traditional alcohol-related services, such as women, young people, and at-risk users. However, caution should be exercised given the limited number of studies allowing extraction of effect sizes, the heterogeneity of outcome measures and follow-up periods, and the large proportion of student-based studies. More extensive RCTs in community samples are required to better understand the efficacy of specific online alcohol approaches, program dosage, the additive effect of telephone or face-to-face interventions, and effective strategies for their dissemination and marketing.

Full circle : the future of sustainable fashion manufacturing in New Zealand

Many fashion businesses in New Zealand have followed a global trend towards inexpensive off shore manufacturing. The transfer of the production of garments to overseas workers has had consequences for the wellbeing of local businesses, fashion designers and garment makers. The gradual decline of fashion manufacturing also appears to have resulted in a local fashion scene where many garments look the same in style, colour, fabric, cut and fit. The excitement of the past, where the majority of fashion designers established their own individuality through the cut and shape of the garments that they produced, may have been inadvertently lost in an effort to take advantage of cost savings achieved through mass production and manufacturing methods which are now largely unavailable in New Zealand. Consequently, a sustainable local fashion and manufacturing industry, with design integrity, seems further out of reach. This paper is focussed upon the thesis that the design and manufacture of a fashion garment, bearing in mind certain economic and practical restrictions at its inception, can contribute to a more sustainable fashion manufacturing industry in New Zealand.

Full Circle : a collection of prototypes

This exhibition engages with one of the key issues facing the fashion textiles industry in terms of future sustainability: that of the well being of fashion industry workers in Australia and New Zealand (people). This collection formed the basis of my honours dissertation (completed in New Zealand in 2008) which examines the contribution that design can make to sustainable manufacturing; particularly design for local production and consumption. An important aspect this work is the discussion of source, the work suggests that the made in China syndrome (in reference to the current state of over-consumerism in Australia and New Zealand) could be bought to a close through design to minimize waste and maximize opportunity for ‘people’: in this case both garment workers and the SMEs that employ them. The garments reflect the possibilities of focusing on a local approach that could be put into practice by a framework of SMEs that already exist. In addition the design process is highly transferrable and could be put into practice almost anywhere with minimal set up costs and a design ethos that progresses at the same pace as the skills of workers. This collection is a physical and conceptual embodiment of a source local/make local/sell local approach. The collection is an example of design that demonstrates that this is not an unrealistic ideal and is in fact possible through the development of a sustainable industry, in the sense of people, profit and planet, through adoption of a design process model that stops the waste at the source, by making better use of the raw materials and labour involved in making fashion garments. Although the focus of this research appears to centre on people and profit, this kind of source local/make local/sell local approach also has great benefits in terms of environmental sustainability.

Discovering characteristics of stochastic collections of process models

Process models in organizational collections are typically modeled by the same team and using the same conventions. As such, these models share many characteristic features like size range, type and frequency of errors. In most cases merely small samples of these collections are available due to e.g. the sensitive information they contain. Because of their sizes, these samples may not provide an accurate representation of the characteristics of the originating collection. This paper deals with the problem of constructing collections of process models, in the form of Petri nets, from small samples of a collection for accurate estimations of the characteristics of this collection. Given a small sample of process models drawn from a real-life collection, we mine a set of generation parameters that we use to generate arbitrary-large collections that feature the same characteristics of the original collection. In this way we can estimate the characteristics of the original collection on the generated collections.We extensively evaluate the quality of our technique on various sample datasets drawn from both research and industry.

Evangeline Series : An interpretation of Classic Gothic Lolita

This series comprises three artefacts described below: Evangeline: Classic Gothic Lolita [3 piece garment]. Evangeline 2: Classic Gothic Lolita Pullip Doll Costume [2 piece garment]. Evangeline 3: Classic Gothic Lolita Mini Pullip Doll Costume [3 piece garment]. The series was part of an exhibition curated by Kathryn Hardy Bernal entitled: "Loli-Pop: A downtown Auckland view on Japanese street fashion". The exhibition explored the connections between gothic lolita fashion and popular culture. This work reflects on the aspect of collections in respect of the work of Hardy Bernal in relation to the connection between the japanese classic gothic lolita and the doll culture surrounding the movement. The pieces are interconnected and intended to communicate these aspects through a doll like dress worn by a model (Evangeline 1], carrying a doll wearing the same dress [Evangeline 2], carrying a smaller doll again wearing the same dress [Evangeline 3]. The artefacts appeared appeared as a central piece in the exhibition which was held at the War Memorial Museum in Auckland, New Zealand (15 September - 25 November 2007).

The big picture : an integrated approach to fashion design education

This paper examines current teaching practice within the context of the Bachelor of Design (Fashion) programme at AUT University and compares it to the approach adopted in previous years. In recent years, staff on the Bachelor of Design (Fashion) adopted a holistic approach to the assessment of design projects similar to the successful ideas and methods put forward by Stella Lange at the FINZ conference, 2005. Prior to adopting this holistic approach, the teaching culture at AUT University was modular and divorced the development of conceptual design ideas from the technical processes of patternmaking and garment construction, thus limiting the creative potential of integrated project work. Fashion Design is not just about drawing pretty pictures but is rather an entire process that encapsulates conceptual design ideas and technical processes within the context of a target market. Fashion design at AUT being under the umbrella of a wider Bachelor of Design must encourage a more serious view of Fashion and Fashion Design as a whole. In the development of the Bachelor of Design degree at AUT, the university recognised that design education would be best serviced by an inclusive approach. At inception, Core Studio and Core Theory papers formed the first semester of the programme across the discipline areas of Fashion, Spatial Design, Graphic Design and Digital Design. These core papers reinforce the reality that there is a common skill set that transcends all design disciplines with the differentiation between disciplines being determined by the techniques and processes they adopt. Studio based teaching within the scope of a major design project was recognised and introduced some time ago for students in their graduating year, however it was also expected that by year 3 the student had amassed the basic skills required to be able to work in this way. The opinion concerning teaching these basic skills was that they were best serviced by a modular approach. Prior attempts to manage design project delivery leant towards deconstructing the newly formed integrated papers in order to ensure key technical skills were covered in enough depth. So, whilst design projects have played an integral part in the delivery of fashion design over the year levels, the earlier projects were timetabled by discipline and unconvincingly connected. This paper discusses how the holistic approach to assessment must be coupled with an integrated approach to delivery. The methods and processes used are demonstrated and some recently trialled developments are shown to have resulted in achieving the integrated approach in both delivery and assessment.

Electrospraying a reproducible method for production of polymeric microspheres for biomedical applications

The ability to reproducibly load bioactive molecules into polymeric microspheres is a challenge. Traditional microsphere fabrication methods typically provide inhomogeneous release profiles and suffer from lack of batch to batch reproducibility, hindering their potential to up-scale and their translation to the clinic. This deficit in homogeneity is in part attributed to broad size distributions and variability in the morphology of particles. It is thus desirable to control morphology and size of non-loaded particles in the first instance, in preparation for obtaining desired release profiles of loaded particles in the later stage. This is achieved by identifying the key parameters involved in particle production and understanding how adapting these parameters affects the final characteristics of particles. In this study, electrospraying was presented as a promising technique for generating reproducible particles made of polycaprolactone, a biodegradable, FDA-approved polymer. Narrow size distributions were obtained by the control of electrospraying flow rate and polymer concentration, with average particle sizes ranging from 10 to 20 um. Particles were shown to be spherical with a homogenous embossed texture, determined by the polymer entanglement regime taking place during electrospraying. No toxic residue was detected by this process based on preliminary cell work using DNA quantification assays, validating this method as suitable for further loading of bioactive components.

Uncertainty and innovation in fashion design

Generally speaking, psychologists have suggested three traditional views of how people cope with uncertainty. They are the certainty maximiser, the intuitive statistician-economist and the knowledge seeker (Smithson, 2008). In times of uncertainty, such as the recent global financial crisis, these coping methods often result in innovation in industry. Richards (2003) identifies innovation as different from creativity in that innovation aims to transform and implement rather than simply explore and invent. An examination of the work of iconic fashion designers, through case study and situational analysis, reveals that coping with uncertainty manifests itself in ways that have resulted in innovations in design, marketing methods, production and consumption. In relation to contemporary fashion, where many garments look the same in style, colour, cut and fit (Finn, 2008), the concept of innovation is an important one. This paper explores the role of uncertainty as a driver of innovation in fashion design. A key aspect of seeking knowledge, as a mechanism to cope with this uncertainty, is a return to basics. This is a problem for contemporary fashion designers who are no longer necessarily makers and therefore do not engage with the basic materials and methods of garment construction. In many cases design in fashion has become digital, communicated to an unseen, unknown production team via scanned image and specification alone. The disconnection between the design and the making of garments, as a result of decades of off-shore manufacturing, has limited the opportunity for this return to basics. The authors argue that the role of the fashion designer has become about the final product and as a result there is a lack of innovation in the process of making: in the form, fit and function of fashion garments. They propose that ‘knowledge seeking’ as a result of uncertainty in the fashion industry, in particular through re-examination of the methods of making, could hold the key to a new era of innovation in fashion design.

Sustainable fashion textiles design : value adding through technological enhancement

A key concern in the field of contemporary fashion/textiles design is the emergence of ‘fast fashion’: best explained as "buy it Friday, wear it Saturday and throw it away on Sunday" (O'Loughlin, 2007). In this contemporary retail atmosphere of “pile it high: sell it cheap” and “quick to market”, even designer goods have achieved a throwaway status. This modern culture of consumerism is the antithesis of sustainability and is proving a dilemma surrounding sustainable practice for designers and producers in the disciplines (de Blas, 2010). Design researchers including those in textiles/fashion have begun to explore what is a key question in the 21st century in order to create a vision and reason for their disciplines: Can products be designed to have added value to the consumer and hence contribute to a more sustainable industry? Fashion Textiles Design has much to answer for in contributing to the problems of unsustainable practices on a global scale in design, production and waste. However, designers within this field also have great potential to contribute to practical ‘real world’ solutions. ----- ----- This paper provides an overview of some of the design and technological developments from the fashion/textiles industry, endorsing a model where designers and technicians use their transferrable skills for wellbeing rather than desire. Smart materials in the form of responsive and adaptive fibres and fabrics combined with electro active devices, and ICT are increasingly shaping many aspects of society particularly in the leisure industry and interactive consumer products are ever more visible in healthcare. Combinations of biocompatible delivery devices with bio sensing elements can create analyse, sense and actuate early warning and monitoring systems which can be linked to data logging and patient records via intelligent networks. Patient sympathetic, ‘smart’ fashion/textiles applications based on interdisciplinary expertise utilising textiles design and technology is emerging. An analysis of a series of case studies demonstrates the potential of fashion textiles design practitioners to exploit the concept of value adding through technological garment and textiles applications and enhancement for health and wellbeing and in doing so contribute to a more sustainable future fashion/textiles design industry.

Energy and cost savings from pipe insulation on domestic, pumped storage (split), solar water heating systems in Australia and New Zealand

Appropriate pipe insulation on domestic, pumped storage (split), solar water heating systems forms an integral part of energy conservation measures of well engineered systems. However, its importance over the life of the system is often overlooked. This study outlines the findings of computer modelling to quantify the energy and cost savings by using pipe insulation between the collector and storage tank. System sizes of 270 Litre storage tank, together with either selectively surfaced, flat plate collectors (4m2 area), or 30 evacuated tube collectors, were used. Insulation thicknesses of 13mm and 15mm, pipe runs both ways of 10, 15 and 20 metres and both electric and gas boosting of systems were all considered. The TRNSYS program was used to model the system performance at a representative city in each of the 6 climate zones for Australia and New Zealand, according to AS/NZS4234 – Heat Water Systems – Calculation of energy consumption and the ORER RECs calculation method. The results show:  Energy savings from pipe insulation are very significant, even in mild climates such as Rockhampton. Across all climates zones, savings ranged from 0.16 to 3.5GJ per system per year, or about 2 to 23 percent of the annual load.  There is very little advantage in increasing the insulation thickness from 13 to 15mm. For electricity at 19c/kWh and gas at 2 c/MJ, cost savings of between $27 and $100 per year are achieved across the climate zones. Both energy and cost savings would increase in colder climates with increased system size, solar contribution and water temperatures.  The pipe insulation substantially improves the solar contribution (or fraction) and Renewable Energy Certificates (RECs), as well as giving small savings in circulating pump running costs in milder climates. Solar contribution increased by up to 23 percent points and RECs by over 7 in some cases.  The study highlights the need to install and maintain the integrity of appropriate pipe insulation on solar water heaters over their life time in Australia and New Zealand.

Validation and automation of the DYNJAWS component module of the BEAMnrc Monte Carlo code

The purpose of this work is to validate and automate the use of DYNJAWS; a new component module (CM) in the BEAMnrc Monte Carlo (MC) user code. The DYNJAWS CM simulates dynamic wedges and can be used in three modes; dynamic, step-and-shoot and static. The step-and-shoot and dynamic modes require an additional input file defining the positions of the jaw that constitutes the dynamic wedge, at regular intervals during its motion. A method for automating the generation of the input file is presented which will allow for the more efficient use of the DYNJAWS CM. Wedged profiles have been measured and simulated for 6 and 10 MV photons at three field sizes (5 cm x 5 cm , 10 cm x10 cm and 20 cm x 20 cm), four wedge angles (15, 30, 45 and 60 degrees), at dmax and at 10 cm depth. Results of this study show agreement between the measured and the MC profiles to within 3% of absolute dose or 3 mm distance to agreement for all wedge angles at both energies and depths. The gamma analysis suggests that dynamic mode is more accurate than the step-and-shoot mode. The DYNJAWS CM is an important addition to the BEAMnrc code and will enable the MC verification of patient treatments involving dynamic wedges.

The effects of pore architecture in silk fibroin scaffolds on the growth and differentiation of BMP7-expressing mesenchymal stem cells

Pore architecture of scaffolds is known to play a critical role in tissue engineering as it provides the vital framework for the seeded cells to organize into a functioning tissue. In this report, we investigated the effects of different concentration on silk fibroin protein 3D scaffold pore microstructure. Four pore size ranges of silk fibroin scaffolds were made by freeze-dry technique, with the pore sizes ranging from 50 to 300 µm. The pore size of the scaffold decreases as the concentration increases. Human mesenchymal stem cells were in vitro cultured in these scaffolds. After BMP7 gene transferred, DNA assay, ALP assay, hematoxylin–eosin staining, alizarin red staining and reverse transcription-polymerase chain reaction were performed to analyze the effect of the pore size on cell growth, differentiation and the secretion of extracellular matrix (ECM). Cell morphology in these 3D scaffolds was investigated by confocal microscopy. This study indicates mesenchymal stem cells prefer the group of scaffolds with pore size between 100 and 300 µm for better proliferation and ECM production