Effect of mobile phone-based psychotherapy in suicide prevention : a randomized controlled trial in Sri Lanka

We conducted a randomized controlled trial to test whether a Brief Mobile Treatment (BMT) intervention could improve outcomes relative to usual care among suicide attempters. The intervention included training in problem solving therapy, meditation, a brief intervention to increase social support as well as advice on alcohol and other drugs, and mobile phone follow-up. The effect of the intervention was measured in terms of a reduction in suicidal ideation, depression and self-harm at Baseline, six and 12 months. A wait-list control group received usual care. A total of 68 participants was recruited from a Sri Lankan hospital following a suicide attempt. Participants who received the intervention were found to achieve significant improvements in reducing suicidal ideation and depression than those receiving usual care. The BMT group also experienced a significant improvement of social support when compared to the control group. However, the BMT group did not demonstrate a significant effect in reducing actual self-harm and most substance use, and differential effects on alcohol use were restricted to men. Although the present study was limited in revealing which component of the intervention was more effective in preventing suicide, it showed its efficacy in reducing suicide as a whole.

Ask : a health advocacy program for adolescents with an intellectual disability : a cluster randomised controlled trial

Background Adolescents with intellectual disability often have poor health and healthcare. This is partly as a consequence of poor communication and recall difficulties, and the possible loss of specialised paediatric services. Methods/Design A cluster randomised trial was conducted with adolescents with intellectual disability to investigate a health intervention package to enhance interactions among adolescents with intellectual disability, their parents/carers, and general practitioners (GPs). The trial took place in Queensland, Australia, between February 2007 and September 2010. The intervention package was designed to improve communication with health professionals and families’ organisation of health information, and to increase clinical activities beneficial to improved health outcomes. It consisted of the Comprehensive Health Assessment Program (CHAP), a one-off health check, and the Ask Health Diary, designed for on-going use. Participants were drawn from Special Education Schools and Special Education Units. The education component of the intervention was delivered as part of the school curriculum. Educators were surveyed at baseline and followed-up four months later. Carers were surveyed at baseline and after 26 months. Evidence of health promotion, disease prevention and case-finding activities were extracted from GPs clinical records. Qualitative interviews of educators occurred after completion of the educational component of the intervention and with adolescents and carers after the CHAP. Discussion Adolescents with intellectual disability have difficulty obtaining many health services and often find it difficult to become empowered to improve and protect their health. The health intervention package proposed may aid them by augmenting communication, improving documentation of health encounters, and improving access to, and quality of, GP care. Recruitment strategies to consider for future studies in this population include ensuring potential participants can identify themselves with the individuals used in promotional study material, making direct contact with their families at the start of the study, and closely monitoring the implementation of the educational intervention.

Pre-service teachers' pedagogical relationships and experiences of embedding Indigenous Australian knowledge in teaching practicum

This paper argues from the standpoint that embedding Indigenous knowledge and perspectives in Australian curricula occurs within a space of tension, ‘the cultural interface’ (Nakata, 2002), in negotiation and contestation with other dominant knowledge systems. In this interface, Indigenous knowledge (IK) is in a state of constancy and flux, invisible and simultaneously pronounced depending on the teaching and learning contexts. More often than not, IK competes for validity and is vexed by questions of racial and cultural authenticity, and therefore struggles to be located centrally in educational systems, curricula and pedagogies. Interrogating normative western notions of what constitutes authentic or legitimate knowledge is critical to teaching Indigenous studies and embedding IK. The inclusion (and exclusion) of IK at the interface is central to developing curriculum that allows teachers to test and prod, create new knowledge and teaching approaches. From this perspective, we explore Indigenous Australian pre-service teachers’ experiences of pedagogical relationships within the teaching habitus of Australian classrooms. Our study is engaged with the strategic transgressions of praxis. We contend that tensions that participant Indigenous Australian pre-service teachers experience mirror the broader (and unresolved) political status of Indigenous people and thus where and why IK is strategically deployed as ‘new’ or ‘old knowledge within Australian liberal democratic systems of curriculum and schooling. It is significant to discuss the formation and transformation of the pedagogical cultural identity of the teaching profession within which Indigenous and non-Indigenous pre-service teachers are employed.

Iterative development of MobileMums : a physical activity intervention for women with young children.

Background To describe the iterative development process and final version of ‘MobileMums’: a physical activity intervention for women with young children (<5 years) delivered primarily via mobile telephone (mHealth) short messaging service (SMS). Methods MobileMums development followed the five steps outlined in the mHealth development and evaluation framework: 1) conceptualization (critique of literature and theory); 2) formative research (focus groups, n= 48); 3) pre-testing (qualitative pilot of intervention components, n= 12); 4) pilot testing (pilot RCT, n= 88); and, 5) qualitative evaluation of the refined intervention (n= 6). Results Key findings identified throughout the development process that shaped the MobileMums program were the need for: behaviour change techniques to be grounded in Social Cognitive Theory; tailored SMS content; two-way SMS interaction; rapport between SMS sender and recipient; an automated software platform to generate and send SMS; and, flexibility in location of a face-to-face delivered component. Conclusions The final version of MobileMums is flexible and adaptive to individual participant’s physical activity goals, expectations and environment. MobileMums is being evaluated in a community-based randomised controlled efficacy trial (ACTRN12611000481976).

The effect of Tai Chi on health related quality of life in people with elevated blood glucose or diabetes : a randomized controlled trial

Purpose The aim was to assess the effects of a Tai Chi based program on health related quality of life (HR-QOL) in people with elevated blood glucose or diabetes who were not on medication for glucose control. Method 41 participants were randomly allocated to either a Tai Chi intervention group (N = 20) or a usual medical care control group (N = 21). The Tai Chi group involved 3 x 1.5 hour supervised and group-based training sessions per week for 12 weeks. Indicators of HR-QOL were assessed by self-report survey immediately prior to and after the intervention. Results There were significant improvements in favour of the Tai Chi group for the SF36 subscales of physical functioning (mean difference = 5.46, 95% CI = 1.35-9.57, P < 0.05), role physical (mean difference = 18.60, 95% CI = 2.16-35.05, P < 0.05), bodily pain (mean difference = 9.88, 95%CI = 2.06-17.69, P < 0.05) and vitality (mean difference = 9.96, 95% CI = 0.77-19.15, P < 0.05). Conclusions The findings show that this Tai Chi program improved indicators of HR-QOL including physical functioning, role physical, bodily pain and vitality in people with elevated blood glucose or diabetes who were not on diabetes medication.

The Gold Coast marine precinct : pre-packaging entrepreneurship

We investigate the evolving quality of entrepreneurship in the Gold Coast Marine Precinct, a purpose-built industrial district in Southeast Queensland, Australia. Our findings are that the environment in the Precinct can be conducive to a better quality of entrepreneurship than may be feasible for firms in other settings; that a successful industrial district can be created artificially, with appropriate social relationships evolving afterwards; and that improvements in information and communications technology have undermined some aspects of traditional behaviour in the Precinct, but the essential nature of internal relationships remains intact.

Exploring the effect of companion robots on emotional expression in older people with dementia : a pilot randomized controlled trial

This pilot study aimed to compare the effect of companion robots (PARO) to participation in an interactive reading group on emotions in people living with moderate to severe dementia in a residential care setting. A randomized crossover design, with PARO and reading control groups, was used. Eighteen residents with mid- to late-stage dementia from one aged care facility in Queensland, Australia, were recruited. Participants were assessed three times using the Quality of Life in Alzheimer’s Disease, Rating Anxiety in Dementia, Apathy Evaluation, Geriatric Depression, and Revised Algase Wandering Scales. PARO had a moderate to large positive influence on participants’ quality of life compared to the reading group. The PARO intervention group had higher pleasure scores when compared to the reading group. Findings suggest PARO may be useful as a treatment option for people with dementia; however, the need for a larger trial was identified.

Adaptive radiotherapy for virally mediated head and neck cancer

Purpose: Virally mediated head and neck cancers (VMHNC) often present with nodal involvement, and are generally considered radioresponsive, resulting in the need for plan adaptation during radiotherapy in a subset of patients. We sought to identify a high-risk group based on pre-treatment nodal size to be evaluated in a future prospective adaptive radiotherapy trial. Methodology: Between 2005-2010, 121 patients with virally-mediated, node positive nasopharyngeal or oropharyngeal cancers, receiving definitive radiotherapy were reviewed. Patients were analysed based on maximum size of the dominant node at diagnosis with a view to grouping them in varying risk categories for the need of re-planning. The frequency and timing of the re-planning scans were also evaluated. Results: Sixteen nasopharyngeal and 105 oropharyngeal tumours were reviewed. Twenty-five (21%) patients underwent a re-planning CT at a median of 22 (range, 0-29) fractions with 1 patient requiring re-planning prior to the commencement of treatment. Based on the analysis, patients were subsequently placed into 3 groups defined by pre-treatment nodal size; ≤ 35mm (Group 1), 36-45mm (Group 2), ≥ 46mm (Group 3). Applying these groups to the patient cohort, re-planning CT’s were performed in Group 1- 8/68 (11.8%), Group 2- 4/28 (14.3%), Group 3- 13/25 (52%). Conclusion: In this series, patients with VMHNC and nodal size > 46mm appear to be a high-risk group for the need of plan adaptation during a course of definitive radiotherapy. This finding will now be tested in a prospective adaptive radiotherapy study.

Recruitment and results of a pilot trial of vitamin D supplementation in the general population of Australia

Context: The benefits of high serum levels of 25-hydroxyvitamin D [25(OH)D] are unclear. Trials are needed to establish an appropriate evidence base. Objective: We plan to conduct a large-scale trial of vitamin D supplementation for the reduction of cancer incidence and overall mortality and report here the methods and results of a pilot trial established to inform its design. Design: Pilot D-Health was a randomized trial carried out in a general community setting with 12 months intervention and follow-up. Participants: Participants were 60- to 84-yr-old residents of one of the four eastern Australian states who did not have any vitamin D-related disorders and who were not taking more than 400 IU supplementary vitamin D per day. A total of 644 participants were randomized, and 615 completed the study (two persons withdrew because of nonserious adverse events). Interventions: The interventions were monthly doses of placebo or 30,000 or 60,000 IU vitamin D3. Main Outcomes: The main outcomes were the recruitment rate and changes in serum 25(OH)D. Results: Ten percent of those approached were recruited. At baseline, the mean 25(OH)D was 42 nmol/liter in all three study arms. The mean change in 25(OH)D in the placebo group was 0.12 nmol/liter, compared with changes of 22 and 36 nmol/liter in the 30,000- and 60,000-IU groups, respectively. Conclusions: The D-Health pilot has shown that a large trial is feasible in Australia and that a dose of 2000 IU/d will be needed to ensure that a large proportion of the population reaches the target serum 25(OH)D level. Copyright © 2012 by The Endocrine Society.

Improving the efficiency of RFID authentication with pre-computation

Security of RFID authentication protocols has received considerable interest recently. However, an important aspect of such protocols that has not received as much attention is the efficiency of their communication. In this paper we investigate the efficiency benefits of pre-computation for time-constrained applications in small to medium RFID networks. We also outline a protocol utilizing this mechanism in order to demonstrate the benefits and drawbacks of using thisapproach. The proposed protocol shows promising results as it is able to offer the security of untraceableprotocols whilst only requiring the time comparable to that of more efficient but traceable protocols.

K from zeolite : glasshouse trial for testing K availability to the plants

MesoLite, a zeolite material manufactured by NanoChem Holdings Pty Ltd is made by caustic reaction of kaolin at temperatures between 80-95°C. This material has a moderate surface area (9~12 m2/g) and very high cation exchange capacity (500meq/100g). To measure the availability of K in K-MesoLite to plants, wheat was grown with K-MesoLite or a soluble fertiliser (e.g. KCl) in non-leached pots in a glasshouse. The weights and elemental compositions of the plants were compared after four weeks growth. Plants grown with K-MesoLite were slightly larger than those grown with KCl. The elemental compositions of the plants were similar except for Si, which was significantly higher in the plants grown with K-MesoLite than in those fertilised with KCl. K from K-MesoLite is readily available to plants.

Mentoring pre-service teachers on school students’ differentiated learning

This Australian study explores the mentoring of pre-service teachers in selecting and implementing teaching strategies to meet students‟ learning needs. Two case studies involving 28 mentor teachers in a professional development program and a mentor-mentee partnership during a four week practicum provided data about mentoring teaching strategies for differentiated learning. Findings showed that contexts for learning about differentiation occurred at the pre action, in-action, and post-action stages. Central to each stage were pedagogical knowledge practices such as planning, preparation, classroom management, assessment, and problem solving (reflection-in-action to present solutions to problems) as key to in-action strategising and the mentoring processes. Mentoring pre-service teachers on how to devise teaching strategies for differentiated learning needs to be researched with a wider range of mentors and pre-service teachers, including those at different stages of development.

Commercial vehicle pre-clearance programs : current issues and recommendations for potential implementation

The regulation of overweight trucks is of increasing importance. Quickly growing heavy vehicle volumes over-proportionally contribute to roadway damage. Raising maintenance costs and compromised road safety are also becoming a major concern to managing agencies. Minimizing pavement wear is done by regulating overloaded trucks on major highways at weigh stations. However, due to lengthy inspections and insufficient capacities, weigh stations tend to be inefficient. New practices, using Radio Frequency Identification (RFID) transponders and weigh-in-motion technologies, called preclearance programs, have been set up in a number of countries. The primary aim of this study is to investigate the current issues with regard to the implementation and operation of the preclearance program. The State of Queensland, Australia, is used as a case study. The investigation focuses on three aspects; the first emphasizes on identifying the need for improvement of the current regulation programs in Queensland. Second, the operators of existing preclearance programs are interviewed for their lessons-learned and the marketing strategies used for promoting their programs. The trucking companies in Queensland are interviewed for their experiences with the current weighing practices and attitudes toward the potential preclearance system. Finally, the estimated benefit of the preclearance program deployment in Queensland is analyzed. The penultimate part brings the former four parts together and provides the study findings and recommendations. The framework and study findings could be valuable inputs for other roadway agencies considering a similar preclearance program or looking to promote their existing ones.

Histological and morphometric lesions in the pre-clinical, developmental phase of insulin-induced laminitis in Standardbred horses

Lamellar pathology in experimentally-induced equine laminitis associated with euglycaemic hyperinsulinaemia is substantial by the acute, clinical phase (∼48 h post-induction). However, lamellar pathology of the developmental, pre-clinical phase requires evaluation. The aim of this study was to analyse lamellar lesions both qualitatively and quantitatively, 6, 12 and 24 h after the commencement of hyperinsulinaemia. Histological and histomorphometrical analyses of lamellar pathology at each time-point included assessment of lamellar length and width, epidermal cell proliferation and death, basement membrane (BM) pathology and leucocyte infiltration. Archived lamellar tissue from control horses and those with acute, insulin-induced laminitis (48 h) was also assessed for cellular proliferative activity by counting the number of cells showing positive nuclear immuno labelling for TPX2. Decreased secondary epidermal lamellar (SEL) width and increased histomorphological evidence of SEL epidermal basal (and supra-basal) cell death occurred early in disease progression (6 h). Increased cellular proliferation in SELs, infiltration of the dermis with small numbers of leucocytes and BM damage occurred later (24 and 48 h). Some lesions, such as narrowing of the SELs, were progressive over this time period (6–48 h). Cellular pathology preceded leucocyte infiltration and BM pathology, indicating that the latter changes may be secondary or downstream events in hyperinsulinaemic laminitis.