Encouraging practitioners to use resources: evaluation of the national implementation of a resource to improve the clinical management of alcohol-related problems in Indigenous primary care settings

This paper reports on the evaluation of the implementation of the National Recommendations for the Clinical Management of Alcohol-Related Problems in Indigenous Primary Care Settings undertaken in 2001 through 74 standardized workshops, which sought to determine: ( 1) whether this approach to implementation influenced the likelihood that the National Recommendations would be used; ( 2) whether it influenced participants' willingness to engage with Indigenous patients regarding alcohol-related issues; and ( 3) whether the implementation as a whole influenced both practice and clinicians' willingness to engage. Evaluation included pre-/post-workshop and follow-up questionnaires and a focus group. The findings presented indicate that distribution of clinical resources alone is not sufficient to ensure use and that, particularly for medical practitioners, appropriate introduction not only increases use but also positively influences willingness to engage with alcohol-related problems as part of primary clinical care. Further, the enthusiasm for guideline production should be tempered by the need to develop effective implementation strategies.

Asthma and internalizing behavior problems in adolescence: A longitudinal study

Objective: Clinical studies of asthmatic children have found an association between lung disease and internalizing behavior problems. The causal direction of this association is, however, unclear. This article examines the nature of the relationship between behavior and asthma problems in childhood and adolescence. Methods: Data were analyzed on 5135 children from the Mater University Study of Pregnancy and its outcomes (MUSP), a large birth cohort of mothers and children started in Brisbane, Australia, in 1981. Lung disease was measured from maternal reports of asthma/bronchitis when the children were aged 5 and maternal reports of asthma symptoms when the children were aged 14. Symptoms of internalizing behaviors were obtained by maternal reports (Child Behavior Checklist) at 5 years and by maternal and children's reports at 14 years (Child Behavior Checklist and Youth Self Report). Results: Although there was no association between prevalence of asthma and externalizing symptoms, asthma and internalizing symptoms were significantly associated in cross-sectional analyses at 5 and 14 years. In prospective analyses, after excluding children with asthma at 5 years, internalizing symptoms at age 5 were not associated with the development of asthma symptoms at age 14. After excluding children with internalizing symptoms at 5 years, those who had asthma at 5 years had greater odds of developing internalizing symptoms at age 14. Conclusion: Children who have asthma/bronchitis by the age of 5 are at greater risk of having internalizing behavior problems in adolescence.

Responding to interpersonal and physically provoking situations in classrooms: emotional intensity in children with attention deficit hyperactivity disorder

The present research investigated the emotional functioning of children with and without Attention Deficit Hyperactivity Disorder (ADHD), in order to examine the relationships between emotional intensity and classroom-based responses to physically and interpersonally provoking situations. Seventy children (35 with ADHD and 35 without ADHD) in Years 3–8 participated and were matched on age, gender, grade, and school class. Each child was observed individually in the classroom over two 20-min periods. The Responses to Interpersonal and Physically Provoking Situations Observation Schedule was used to record the frequency and severity of responses and the triggers for these during the observational periods. Children later rated their emotional intensity in response to hypothetical scenarios on the Emotional Intensity Scale for Children. Results revealed children with ADHD displayed significantly more frequent and severe challenging and solitary off-task behaviours, and significantly more frequent vocalisations and severe interactional off-task behaviours. For triggers, environmental and teacher-initiated distractions were significantly more frequently observed in children with ADHD. There were no differences in ratings of emotional intensity between children with and without ADHD, although a number of significant and meaningful correlations were observed between positive emotional intensity scores and responses and triggers.

Proceedings of Computational Methods for Coupled Problems in Science and Engineering

Computational Methods for Coupled Problems in Science and Engineering

Theory and application of inverse problems in groundwater: numerical, laboratory and field studies.

Aquifers are a vital water resource whose quality characteristics must be safeguarded or, if damaged, restored. The extent and complexity of aquifer contamination is related to characteristics of the porous medium, the influence of boundary conditions, and the biological, chemical and physical processes. After the nineties, the efforts of the scientists have been increased exponentially in order to find an efficient way for estimating the hydraulic parameters of the aquifers, and thus, recover the contaminant source position and its release history. To simplify and understand the influence of these various factors on aquifer phenomena, it is common for researchers to use numerical and controlled experiments. This work presents some of these methods, applying and comparing them on data collected during laboratory, field and numerical tests. The work is structured in four parts which present the results and the conclusions of the specific objectives.

Application of the finite element method to problems in fracture mechanics

Numerical techniques have been finding increasing use in all aspects of fracture mechanics, and often provide the only means for analyzing fracture problems. The work presented here, is concerned with the application of the finite element method to cracked structures. The present work was directed towards the establishment of a comprehensive two-dimensional finite element, linear elastic, fracture analysis package. Significant progress has been made to this end, and features which can now be studied include multi-crack tip mixed-mode problems, involving partial crack closure. The crack tip core element was refined and special local crack tip elements were employed to reduce the element density in the neighbourhood of the core region. The work builds upon experience gained by previous research workers and, as part of the general development, the program was modified to incorporate the eight-node isoparametric quadrilateral element. Also. a more flexible solving routine was developed, and provided a very compact method of solving large sets of simultaneous equations, stored in a segmented form. To complement the finite element analysis programs, an automatic mesh generation program has been developed, which enables complex problems. involving fine element detail, to be investigated with a minimum of input data. The scheme has proven to be versati Ie and reasonably easy to implement. Numerous examples are given to demonstrate the accuracy and flexibility of the finite element technique.