Resilience: A new definition of health for people and communities

What enables people to bounce back from stressful experiences? How do certain individuals maintain a sense of purpose and direction over the long term, even in the face of adversity? This is the first book to move beyond childhood and adolescence to explore resilience across the lifespan. Coverage ranges from genetic and physiological factors through personal, family, organizational, and community processes. Contributors examine how resilience contributes to health and well-being across the adult life cycle; why—and what happens when—resilience processes fail; ethnic and cultural dimensions of resilience; and ways to enhance adult resilience, including reviews of exemplary programs.

School counsellors' and students' attitudes to online counselling: A qualitative study

An exploratory qualitative study was conducted to examine the perceptions and attitudes of both school counsellors and students to online counselling. Focus groups were conducted with two groups of school counsellors and six groups of secondary students. It was found that counsellors were hesitant to use online counselling because they were not convinced that it was effective and without the necessary online skills, they were concerned they would not be competent to deal with potential litigious and security pitfalls. Students were generally positive about the opportunity to access the school counsellor online. Implications for practice and future research are discussed.

Information accountability and health big data analytics: A consent-based model

With the ever increasing amount of eHealth data available from various eHealth systems and sources, Health Big Data Analytics promises enticing benefits such as enabling the discovery of new treatment options and improved decision making. However, concerns over the privacy of information have hindered the aggregation of this information. To address these concerns, we propose the use of Information Accountability protocols to provide patients with the ability to decide how and when their data can be shared and aggregated for use in big data research. In this paper, we discuss the issues surrounding Health Big Data Analytics and propose a consent-based model to address privacy concerns to aid in achieving the promised benefits of Big Data in eHealth.

Managing and sharing health data through information accountability protocols

Concerns over the security and privacy of patient information are one of the biggest hindrances to sharing health information and the wide adoption of eHealth systems. At present, there are competing requirements between healthcare consumers' (i.e. patients) requirements and healthcare professionals' (HCP) requirements. While consumers want control over their information, healthcare professionals want access to as much information as required in order to make well-informed decisions and provide quality care. In order to balance these requirements, the use of an Information Accountability Framework devised for eHealth systems has been proposed. In this paper, we take a step closer to the adoption of the Information Accountability protocols and demonstrate their functionality through an implementation in FluxMED, a customisable EHR system.

Changing travel patterns and journeys to health services in Great Britain 1985-2012: An examination health service utilisation using the National Travel Survey

Background This paper examines changing patterns in the utilisation and geographic access to health services in Great Britain using National Travel Survey data (1985-2012). The National Travel Survey (NTS) is a series of household surveys designed to provide data on personal travel and monitor changes in travel behaviour over time. The utilisation rate was derived using the proportion of journeys made to access health services. Geographic access was analysed by separating the concept into its accessibility and mobility dimensions. Methods Variables from the PSU, households, and individuals datasets were used as explanatory variables. Whereas, variables extracted from the journeys dataset were used as dependent variables to identify patterns of utilisation i.e. the proportion of journeys made by different groups to access health facilities in a particular journey distance or time band or by mode of transport; and geographic access to health services. A binary logistic regression analysis was conducted to identify the utilisation rate over the different time periods between different groups. This analysis shows the Odds Ratios (ORs) for different groups making a trip to utilise health services compared to their respective counterparts. Linear multiple regression analyses were conducted to then identify patterns of change in the accessibility and mobility level. Results Analysis of the data has shown that that journey distances to health facilities were signi fi cantly shorter and also gradually reduced over the period in question for Londoners, females, those without a car or on low incomes, and older people. Although rates of utilisation of health services we re Oral Abstracts / Journal of Transport & Health 2 (2015) S5 – S63 S43 signi fi cantly lower because of longer journey times. These fi ndings indicate that the rate of utilisation of health services largely depends on mobility level although previous research studies have traditionally overlooked the mobility dimension. Conclusions This fi nding, therefore, suggests the need to improve geographic access to services together with an enhanced mobility option for disadvantaged groups in order for them to have improved levels of access to health facilities. This research has also found that the volume of car trips to health services also increased steadily over the period 1985-2012 while all other modes accounted for a smaller number of trips. However, it is dif fi cult to conclude from this research whether this increase in the volume of car trips was due to a lack of alternative transport or due to an increase in the level of car-ownership.

Time, place and space – student group collaboration using Google Drive

Virtual working environments are intrinsic to the contemporary workplace and collaborative skills are a vital graduate capability. To develop students’ collaborative skills, first year medical laboratory science students undertake a group poster project, based on a blended learning model. Learning is scaffolded in lectures, workshops in collaborative learning spaces, practitioner mentoring sessions, and online resources. Google Drive provides an online collaborative space for students to realise tangible outcomes from this learning. A Google Drive document is created for each group and shared with members. In this space, students assign tasks and plan workflow, share research, progressively develop poster content, reflect and comment on peer contributions and use the messaging functions to ‘talk’ to group members. This provides a readily accessible, transparent record of group work, crucial in peer assessment, and a communication channel for group members and the lecturer, who can support groups if required. This knowledge creation space also augments productivity and effectiveness of face-to-face collaboration. As members are randomly allocated to groups and are often of diverse backgrounds and unknown to each other, resilience is built as students navigate the uncertainties and complexities of group dynamics, learning to focus on the goal of the team task as they constructively and professionally engage in team dialogue. Students are responsible and accountable for individual and group work. The use of Google Drive was evaluated in a survey including Likert scale and open ended qualitative questions. Statistical analysis was carried out. Results show students (79%) valued the inclusion of online space in collaborative work and highly appreciated (78%) the flexibility provided by Google Drive, while recognising the need for improved notification functionality. Teaching staff recognised the advantages in monitoring and moderating collaborative group work, and the transformational progression in student collaborative as well as technological skill acquisition, including professional dialogue.

The modern day bystander: Online and face-to-face bystander actions of adolescents in traditional bullying and cyberbullying

This study investigated whether bystanders of traditional bullying and cyberbullying used face-to-face methods, online methods or both methods when reporting, discouraging and providing support to the victims of traditional bullying and cyberbullying. A questionnaire was completed by 348 high school students (Years 7 – 12) from seven independent schools in Australia. Overall, students predominantly utilized face-to-face methods when reporting to others for both types of bullying. Older students were more likely to use online methods to discourage the traditional bully (i.e., asking the bully to stop). Males and older students were more likely to use online methods to support victims of traditional bullying. Females were more likely to use face-to-face methods to support victims of cyberbullying. Implications for practice and future research are discussed.

Legal duties following the discharge of mental health patients

In the recent decision of Hunter and New England Local Health District v McKenna; Hunter and New England Local Health District v Simon, the High Court of Australia held that a hospital and its medical staff owed no common law duty of care to third parties claiming for mental harm, against the background of statutory powers to detain mentally ill patients. This conclusion was based in part on the statutory framework and in part on the inconsistency which would arise if such a duty was imposed. If such a duty was imposed in these circumstances, the consequence may be that doctors would generally detain rather than discharge mentally ill persons to avoid the foreseeable risk of harm to others. Such an approach would be inconsistent with the policy of the mental health legislation , which favours personal liberty and discharge rather than detention unless no other care of a less restrictive kind is appropriate and reasonably available.

An innovative online intervention: The Steering Clear First Offender Drink Driving Program

Drink driving remains a substantial public health issue warranting investigation. First offender drink drivers are seen to be less risky than repeat offenders, though the majority of first offenders report drink driving prior to detection, and many continue to drink drive following conviction. Few first offenders are offered treatment programs, and as such there is a need to address drink driving behaviour at this stage. A comprehensive approach including first offender treatment is needed to address the problem. Online interventions have demonstrated effectiveness in reducing risky behaviours such as harmful substance use. Such interventions allow for personalised tailored content to be delivered to individuals targeting specific mechanisms of behavioural change. This method also allows for targeting screening to ensure relevance of content on an individual level. However, there have been no research based online programs to date aimed at reducing repeat drink driving by first offenders. The Steering Clear First Offender Drink Driving Program is a self-guided, research based online program aimed at reducing recidivism by first time drink driving offenders. It includes a specialised web app to track drinks and build plans to prevent future drink driving. This allows for elongation of learning and encouragement of sustained behavioural change using self-monitoring after initial program completion. An outline of the program is discussed and the qualitative experience of the program on a sample of first offenders recruited at the time of court appearance is described.

Use of personal mobility devices for first-and-last mile travel: The Macquarie-Ryde trial

Electric-motored personal mobility devices (PMDs) are appearing on Australian roads. While legal to import and own, their use is typically illegal for adult riders within the road transport system. However, these devices could provide an answer to traffic congestion by getting people out of cars for short trips (“first-and-last mile” travel). City of Ryde council, Macquarie University, and Transport for NSW examined PMD use within the road transport system. Stage 1 of the project examined PMD use within a controlled pedestrian environment on the Macquarie University campus. Three PMD categories were used: one-wheelers (an electric unicycle, the Solowheel); two-wheelers (an electric scooter, the Egret); and three-wheelers (the Qugo). The two-wheeled PMD was most effective in terms of flexibility. In contrast, the three-wheeled PMD was most effective in terms of speed. One-wheeled PMD riders were very satisfied with their device, especially at speed, but significant training and practice was required. Two-wheeled PMD riders had less difficulty navigating through pedestrian precincts and favoured the manoeuvrability of the device as the relative narrowness of the two-wheeled PMD made it easier to use on a diversity of path widths. The usability of all PMDs was compromised by the weight of the devices, difficulties in ascending steeper gradients, portability, and parking. This was a limited trial, with a small number of participants and within a unique environment. However, agreement has been reached for a Stage 2 extension into the Macquarie Park business precinct for further real-world trials within a fully functional road transport system.

Comparison of active-set method deconvolution and matched-filtering for derivation of an ultrasound transit time spectrum

The quality of ultrasound computed tomography imaging is primarily determined by the accuracy of ultrasound transit time measurement. A major problem in analysis is the overlap of signals making it difficult to detect the correct transit time. The current standard is to apply a matched-filtering approach to the input and output signals. This study compares the matched-filtering technique with active set deconvolution to derive a transit time spectrum from a coded excitation chirp signal and the measured output signal. The ultrasound wave travels in a direct and a reflected path to the receiver, resulting in an overlap in the recorded output signal. The matched-filtering and deconvolution techniques were applied to determine the transit times associated with the two signal paths. Both techniques were able to detect the two different transit times; while matched-filtering has a better accuracy (0.13 μs vs. 0.18 μs standard deviation), deconvolution has a 3.5 times improved side-lobe to main-lobe ratio. A higher side-lobe suppression is important to further improve image fidelity. These results suggest that a future combination of both techniques would provide improved signal detection and hence improved image fidelity.

Medicines information sources and services for consumers : A special focus on the Internet and people with depression

The range of consumer health and medicines information sources has diversified along with the increased use of the Internet. This has led to a drive to develop medicines information services and to better incorporate the Internet and e-mail into routine practice in health care and in community pharmacies. To support the development of such services more information is needed about the use of online information by consumers, particularly of those who may be the most likely to use and to benefit from the new sources and modes of medicines communication. This study explored the role and utilization of the Internet-based medicines information and information services in the context of a wider network of information sources accessible to the public in Finland. The overall aim was to gather information to develop better and more accessible sources of information for consumers and services to better meet the needs of consumers. Special focus was on the needs and information behavior among people with depression and using antidepressant medicines. This study applied both qualitative and quantitative methods. Consumer medicines information needs and sources were identified by analyzing the utilization of the University Pharmacy operated national drug information call center (Study I) and surveying Finnish adults (n=2348) use of the different medicines information sources (Study II). The utilization of the Internet as a source of antidepressant information among people with depression was explored by focus group discussions among people with depression and with current or past use of the antidepressant(s) (n=29, Studies III & IV). Pharmacy response to the needs of consumers in term of providing e-mail counseling was assessed by conducting a virtual pseudo customer study among the Finnish community pharmacies (n=161, Study V). Physicians and pharmacists were the primary sources of medicines information. People with mental disorders were more frequent users of telephone- and Internet-based medicines information sources and patient information leaflets than people without mental disorders. These sources were used to complement rather than replace information provided face-to-face by health professionals. People with depression used the Internet to seek facts about antidepressants, to share experiences with peers, and for the curiosity. They described that the access to online drug information was empowering. Some people reported lacking the skills necessary to assess the quality of online information. E-mail medication counseling services provided by community pharmacies were rare and varied in quality. Study results suggest that rather than discouraging the use of the Internet, health professionals should direct patients to use accurate and reliable sources of online medicines information. Health care providers, including community pharmacies should also seek to develop new ways of communicating information about medicines with consumers. This study determined that people with depression and using antidepressants need services enabling interactive communication not only with health care professionals, but also with peers. Further research should be focused on developing medicines information service facilitating communication among different patient and consumer groups.

Pedagogical tools designed to promote engagement and active learning in the biomedical sciences and allied health disciplines

Perceiving students, science students especially, as mere consumers of facts and information belies the importance of a need to engage them with the principles underlying those facts and is counter-intuitive to the facilitation of knowledge and understanding. Traditional didactic lecture approaches need a re-think if student classroom engagement and active learning are to be valued over fact memorisation and fact recall. In our undergraduate biomedical science programs across Years 1, 2 and 3 in the Faculty of Health at QUT, we have developed an authentic learning model with an embedded suite of pedagogical strategies that foster classroom engagement and allow for active learning in the sub-discipline area of medical bacteriology. The suite of pedagogical tools we have developed have been designed to enable their translation, with appropriate fine-tuning, to most biomedical and allied health discipline teaching and learning contexts. Indeed, aspects of the pedagogy have been successfully translated to the nursing microbiology study stream at QUT. The aims underpinning the pedagogy are for our students to: (1) Connect scientific theory with scientific practice in a more direct and authentic way, (2) Construct factual knowledge and facilitate a deeper understanding, and (3) Develop and refine their higher order flexible thinking and problem solving skills, both semi-independently and independently. The mindset and role of the teaching staff is critical to this approach since for the strategy to be successful tertiary teachers need to abandon traditional instructional modalities based on one-way information delivery. Face-to-face classroom interactions between students and lecturer enable realisation of pedagogical aims (1), (2) and (3). The strategy we have adopted encourages teachers to view themselves more as expert guides in what is very much a student-focused process of scientific exploration and learning. Specific pedagogical strategies embedded in the authentic learning model we have developed include: (i) interactive lecture-tutorial hybrids or lectorials featuring teacher role-plays as well as class-level question-and-answer sessions, (ii) inclusion of “dry” laboratory activities during lectorials to prepare students for the wet laboratory to follow, (iii) real-world problem-solving exercises conducted during both lectorials and wet laboratory sessions, and (iv) designing class activities and formative assessments that probe a student’s higher order flexible thinking skills. Flexible thinking in this context encompasses analytical, critical, deductive, scientific and professional thinking modes. The strategic approach outlined above is designed to provide multiple opportunities for students to apply principles flexibly according to a given situation or context, to adapt methods of inquiry strategically, to go beyond mechanical application of formulaic approaches, and to as much as possible self-appraise their own thinking and problem solving. The pedagogical tools have been developed within both workplace (real world) and theoretical frameworks. The philosophical core of the pedagogy is a coherent pathway of teaching and learning which we, and many of our students, believe is more conducive to student engagement and active learning in the classroom. Qualitative and quantitative data derived from online and hardcopy evaluations, solicited and unsolicited student and graduate feedback, anecdotal evidence as well as peer review indicate that: (i) our students are engaging with the pedagogy, (ii) a constructivist, authentic-learning approach promotes active learning, and (iii) students are better prepared for workplace transition.

Eigennamen in Pressetexten : Ein Vergleich zweier Online-Zeitungen

Tämä pro gradu -tutkielma vertailee korpuksen avulla erisnimien kvantitatiivista jakautumista luokkiin kahdessa saksalaisessa verkkolehdessä. Työn tavoitteena on selvittää, kuinka erisnimiä voidaan luokitella ja mitä eroja niiden avulla on havaittavissa lehtien raportoinnissa. Laajempana kehyksenä toimii kysymys siitä, voidaanko erisnimiä hyödyntäen hahmottaa lehtien sisältöjä. Korpus on kerätty Frankfurter Allgemeine Zeitungin ja Süddeutsche Zeitungin verkkolehtien http: //www.faz.net (FAZ) ja http://www.sueddeutsche.de (SZ) artikkeleista ajalta 2.11.2004-8.11.2004. Valitut sivustot edustavat Saksan arvostetuimpien päivittäisten, koko maan kattavien sanomaleh- tien verkkojulkaisuja. Näistä FAZ:ia pidetään konservatiivisena ja SZ:ia liberaalina lehtenä. Kumpikin korpus käsittelee USA:n presidentinvaaleja syksyllä 2004 ja sisältää hieman alle 30 000 sanaa noin 40 lehtiartikkelista. Aihesidonnaisen korpuksen valinta perustuu erityisesti siihen, että tutkimuksen päämääränä on saada erisnimien avulla selville, miltä osin FAZ ja SZ eroavat toisistaan käsitellessään samaa aihetta. Teoriaosassa käydään läpi saksalaisten verkkolehtien taustaa, työhön liittyviä tekstilingvistisiä teo- rioita sekä erisnimien erikoispiirteitä. Siinä käsitellään myös kolmea aiempaa, saksankielisen eris- nimitutkimuksen luokittelua ja yhtä englanninkielistä, kieliteknologian luokittelua. Näissä havaitut puutteet motivoivat yhdistelemään ja muuttamaan olemassa olevia luokitteluja tätä työtä varten. Uusi luokittelu sisältää neljä yläluokkaa (olentojen, maantieteelliset, instituutioden ja asioiden ni- met), jotka kaikki kattavat kahdesta yhdeksään alaluokkaa. Kummankin korpuksen erisnimet luo- kitellaan tämän perusteella. Kvantitatiivinen analyysi keskittyy ylä- ja alaluokkien vertailuun lehtien välillä. Lisäksi se kattaa sekä kummankin aineiston että pääluokkien frekventimpien sanojen tarkastelun. Vaikka FAZ ja SZ käyttivätkin pääosin samoja erisnimiä raportoinnissaan, voidaan lehtien välillä osoittaa selkeitä eroja alaluokkien kohdalla ja vähäisiä eroja erisnimien jakautumisessa yläluokkiin. chi2 -testin näytti kuitenkin, että erisnimien jakautuminen yläluokkiin on lehtisidonnaista. Siksi voidaan väittää, että muun muassa valittu media vaikuttaa erisnimivalintoihin. Erisnimien frekvenssit antavat ymmärtää, että SZ raportoisi monipuolisemmin kuin FAZ, joka käyttää erisnimiä keskitetymmin. SZ:in aineiston erisnimiä yhdistää eurooppalainen näkökulma vaaleihin, kun taas FAZ pyrkii tuomaan esille tapahtumia USA:n eri osavaltioissa. Niin lehdissä mainitut henkilöiden kuin instituutioden nimet tukevat tätä väitetettä. SZ korostaa maantieteellisesti kaupunkien merkitystä, FAZ osavaltioiden. Saadut tulokset osoittavat, että tämänkaltaisen erisnimitutkimuksen soveltaminen lehtiteksteihin on mahdollista. Luokitellut erisnimet heijastavat osittain käsiteltyjen aineistojen sisältöä ja paljastavat raportoinnin painopisteistä.