Severe hypoglycaemia in type 1 diabetes mellitus: underlying drivers and potential strategies for successful prevention

Hypoglycaemia remains an over-riding factor limiting optimal glycaemic control in type 1 diabetes. Severe hypoglycaemia is prevalent in almost half of those with long-duration diabetes and is one of the most feared diabetes-related complications. In this review, we present an overview of the increasing body of literature seeking to elucidate the underlying pathophysiology of severe hypoglycaemia and the limited evidence behind the strategies employed to prevent episodes. Drivers of severe hypoglycaemia including impaired counter-regulation, hypoglycaemia-associated autonomic failure, psychosocial and behavioural factors and neuroimaging correlates are discussed. Treatment strategies encompassing structured education, insulin analogue regimens, continuous subcutaneous insulin infusion pumps, continuous glucose sensing and beta-cell replacement therapies have been employed, yet there is little randomized controlled trial evidence demonstrating effectiveness of new technologies in reducing severe hypoglycaemia. Optimally designed interventional trials evaluating these existing technologies and using modern methods of teaching patients flexible insulin use within structured education programmes with the specific goal of preventing severe hypoglycaemia are required. Individuals at high risk need to be monitored with meticulous collection of data on awareness, as well as frequency and severity of all hypoglycaemic episodes.

Strategic business plan: Strategies to make coaching for all a successful project

Coaching for all (C4all) is a project created by TESE-Associação para o Desenvolvimento or TESE-Association for development (TESE), aimed at disseminating and democratizing access to coaching methods among people seeking employment and other vulnerable groups of people. The initial results of the C4All project were well below their expectations. Therefore, we developed a Business Plan in order to understand if and how the performance of C4all can be improved. The results of our analysis suggest a number of changes that C4all need to undertake in order to survive and achieve better outcomes in the future

Building a successful partnership to increase affordable rental housing supply in Queensland

Accessibility to housing for low to moderate income groups in Australia has been experiencing a severe decline since 2001. On the supply side, the public sector has been reducing its commitment to the direct provision of public housing. Despite high demand for affordable housing, there has been limited supply generated by non-government housing providers. One possible solution to promote an increase in affordable housing supply, like other infrastructure, is through the development of multi-stakeholder partnerships and private financing. This research aims to identify current issues underlying decision-making criteria for building multi-stakeholder partnerships to deliver affordable housing projects. It also investigates strategies for minimising risk and ensuring the financial outcomes of these partnership arrangements. A mix of qualitative in-depth interviews and quantitative surveys has been used as the main method to explore stakeholder experiences regarding their involvement in partnership arrangements in the affordable housing sector in Queensland. Two sets of interviews were conducted following an exploratory pilot study: one set in 2003-2004 and the other in 2007-2008. There were nineteen respondents representing government, private and not-for-profit organisations in the first stage interviews and surveys. The second stage interviews were focussed on twenty-two housing providers in South East Queensland. Initial analyses have been conducted using thematic and statistical analyses. This study extends the use of existing decision making tools and combines the use of a Soft System Framework to analyse the ideal state questionnaires using qualitative thematic analysis. Soft System Methodology (SSM) has been used to analyse this unstructured complex problem by using systematic thinking to develop a conceptual model and carrying it to the real world situations to solve the problem. This research found that the diversity of stakeholder capability and their level of risk acceptance will allow partnerships to develop the best synergies and a degree of collaboration which achieves the required financial return within acceptable risk parameters. However, some of the negativity attached to future commitment to such partnerships has been found to be the anticipation of a worse outcome than that expected from independent action. Many interviewees agree that housing providers' fear of financial risk and community rejection has been central to dampening their enthusiasm for entering such investment projects. The creation of a mixed-use development structure will mitigate both risk and return as the commercial income will subsidise the affordable housing development and will normalise concentration of marginalised low-income people who live in a prime location with an award winning design. In addition, tenant support schemes and rent-to-buy incentive programs will encourage them to secure their tenancies and significantly reduce the risk of rent arrears and property damage. There is also a breakthrough investment vehicle offered by the social developer which sells the non-physical but financial product to individual and institutional investors to mitigate further financial risk. Finally, this study recommends modification of the current value-for-money framework in favour of broader partnership arrangements which are more closely aligned with risk minimisation strategies.

Towards a new model of successful faking

Existing literature has failed to find robust relationships between individual differences and the ability to fake psychological tests, possibly due to limitations in how successful faking is operationalised. In order to fake, individuals must alter their original profile to create a particular impression. Currently, successful faking is operationalised through statistical definitions, informant ratings, known groups comparisons, the use of archival and baseline data, and breaches of validity indexes. However, there are many methodological limitations to these approaches. This research proposed a three component model of successful faking to address this, where an original response is manipulated into a strategic response, which must match a criteria target. Further, by operationalising successful faking in this manner, this research takes into account the fact that individuals may have been successful in reaching their implicitly created profile, but that this may not have matched the criteria they were instructed to fake.Participants (N=48, 22 students and 26 non-students) completed the BDI-II honestly. Participants then faked the BDI-II as if they had no, mild, moderate and severe depression, as well as completing a checklist revealing which symptoms they thought indicated each level of depression. Findings were consistent with a three component model of successful faking, where individuals effectively changed their profile to what they believed was required, however this profile differed from the criteria defined by the psychometric norms of the test.One of the foremost issues for research in this area is the inconsistent manner in which successful faking is operationalised. This research allowed successful faking to be operationalised in an objective, quantifiable manner. Using this model as a template may allow researchers better understanding of the processes involved in faking, including the role of strategies and abilities in determining the outcome of test dissimulation.

Slum free India program. Report on the findings and recommendations of QUT BEE workshop to investigate strategies to deliver better outcomes

As a result of a broad invitation extended by Professor Martin Betts, Executive Dean of the Faculty of Built Environment and Engineering, to the community of interest at QUT, a cross-disciplinary collaborative workshop was conducted to contribute ideas about responding to the Government of India’s urgent requirement to implement a program to re-house slum dwellers. This is a complex problem facing the Indian Ministry of Housing. Not only does the government aspire to eradicate existing slum conditions and to achieve tangible results within five years, but it must also ensure that slums do not form in the future. The workshop focused on technological innovation in construction to deliver transformation from the current unsanitary and overcrowded informal urban settlements to places that provide the economically weaker sections of Indian society with healthy, environmentally sustainable, economically viable mass housing that supports successful urban living. The workshop was conducted in two part process as follows: Initially, QUT academics from diverse fields shared current research and provided technical background to contextualise the challenge at a pre-workshop briefing session. This was followed by a one-day workshop during which participants worked intensively in multi-disciplinary groups through a series of exercises to develop innovative approaches to the complex problem of slum redevelopment. Dynamic, compressed work sessions, interspersed with cross-functional review and feedback by the whole group took place throughout the day. Reviews emphasised testing the concepts for their level of complexity, and likelihood of success. The two-stage workshop process achieved several objectives:  Inspired a sense of shared purpose amongst a diverse group of academics  Built participants’ knowledge of each other’s capacity  Engaged multi disciplinary team in an innovative design research process  Built participants’ confidence in the collaborative process  Demonstrated that collaborative problem solving can create solutions that represent transformative change.  Developed a framework of how workable solutions might be developed for the program through follow up workshops and charrettes of a similar nature involving stakeholders drawn from the context of the slum housing program management.

Procurement strategies : a relationship-based approach

Construction has been an industry characterised by disputes, fierce competitiveness and fragmentation - all major obstacles to development. Now, however, a relationship-based approach to project procurement, through partnering and alliancing, aims to bring about a fundamental change. ----- ----- ----- This book addresses the critical relationship issues for a more collaborative and sustainable construction industry. It looks at how project procurement and project alliancing partner selection works, and how risk and crisis resolution are managed. It provides readers with guidance and models on how to put a relationship-based approach to procurement into practice, drawing on specific prototypes from an actual, successful project that can be adapted.

Reproducing successful rituals in bad times : exploring interactions of a new science teacher

Teaching is emotional work. This is especially the case in the first years of teaching when new teachers are particularly vulnerable. By understanding changes in teacher emotions in the early years of teaching we hope to identify strategies that might ultimately reduce teacher attrition. As part of a larger study of the transition of new teachers to the profession, this ethnographic case study explores how a new science teacher produced and reproduced positive emotional interaction rituals with her students in her first year of teaching. We show how dialogical interactions were positive and satisfying experiences for the teacher, and how they were reproduced successfully in different contexts. We also illustrate how both teacher and students used humor to create a structure for dialogical interactions. During these successful interactions the students used shared resources to satisfy their teacher that they were engaging in the relevant science content. The implications of what we have learned for the professional development of new teachers are discussed in relation to an expanded understanding of teacher emotions.

The effects of weight loss strategies on gastric emptying and appetite control

The gastrointestinal tract plays an important role in the improved appetite control and weight loss in response to bariatric surgery. Other strategies which similarly alter gastrointestinal responses to food intake could contribute to successful weight management. The aim of this review is to discuss the effects of surgical, pharmacological and behavioural weight loss interventions on gastrointestinal targets of appetite control, including gastric emptying. Gastrointestinal peptides are also discussed because of their integrative relationship in appetite control. This review shows that different strategies exert diverse effects and there is no consensus on the optimal strategy for manipulating gastric emptying to improve appetite control. Emerging evidence from surgical procedures (e.g., sleeve gastrectomy and Roux en-Y gastric bypass) suggests a faster emptying rate and earlier delivery of nutrients to the distal small intestine may improve appetite control. Energy restriction slows gastric emptying, while the effect of exercise-induced weight loss on gastric emptying remains to be established. The limited evidence suggests that chronic exercise is associated with faster gastric emptying which we hypothesise will impact on appetite control and energy balance. Understanding how behavioural weight loss interventions (e.g., diet and exercise) alter gastrointestinal targets of appetite control may be important to improve their success in weight management.

Strategies for the prevention of cervical cancer by human papillomavirus vaccination

As cervical cancer is causally associated with 14 high-risk types of human papillomavirus (HPV), a successful HPV vaccine will have a major impact on this disease. Although some persistent HPV infections progress to cervical cancer, host immunity is generally able to clear most HPV infections. Both cell-mediated and antibody responses have been implicated in influencing the susceptibility, persistence or clearance of genital HPV infection. There have been two clinical trials that show that vaccines based on virus-like particles (VLPs) made from the major capsid protein, L1, are able to type specifically protect against cervical intra-epithelial neoplasia and infection. However, there is no evidence that even a mixed VLP vaccine will protect against types not included in the vaccine, and a major challenge that remains is how to engineer protection across a broader spectrum of viruses. Strategies for production of HPV vaccines using different vaccine vectors and different production systems are also reviewed. © 2005 Elsevier Ltd. All rights reserved.

Transferring a successful strategy for supporting accelerated nursing students from a small to a large cohort

In 2009 and 2010, withdrawal rates from a Pharmacology unit of accelerated QUT nursing students in the first year of their degree, were higher than for continuing students. The cohort of 216 accelerated students in 2011 had university or non-university qualification or equivalent experience and included domestic and international students. A previously tested intervention was introduced in 2011 to improve retention rates and support all Pharmacology students in their first year of nursing. The intervention involved a community website, on-line tutors and an “O week” workshop comprising information about library resources, effective learning strategies and learning tips from a previous student as well as review anatomy, physiology and microbiology lectures. Withdrawal rates for accelerated students in the Pharmacology unit improved and all students found the workshop and review lectures to be informative and valuable. The intervention was therefore successfully transferred to a large, diverse cohort of accelerated nursing students.

Successful outcomes in vocational education and training courses : how pedagogy and expectations influence achievement

This paper reports on a four year Australian Research Council funded Linkage Project titled Skilling Indigenous Queensland, conducted in regional areas of Queensland, Australia from 2009 to 2013. The project sought to investigate vocational education, training (VET) and teaching, Indigenous learners’ needs, employer cultural and expectations and community culture and expectations to identify best practice in numeracy teaching for Indigenous VET learners. Specifically it focused on ways to enhance the teaching and learning of courses and the associated mathematics in such courses to benefit learners and increase their future opportunities of employment. To date thirty-nine teachers/trainers/teacher aides and two hundred and thirty-one students consented to participate in the project. Nine VET courses were nominated to be the focus on the study. This paper focuses on questionnaire and interview responses from four trainers, two teacher aides and six students. In recent years a considerable amount of funding has been allocated to increasing Indigenous Peoples’ participation in education and employment. This increased funding is predicated on the assumption that it will make a difference and contribute to closing the education gap between Indigenous and non-Indigenous Australians (Council of Australia Governments, 2009). The central tenet is that access to education for Indigenous People will create substantial social and economic benefits for regional and remote Indigenous People. The project’s aim is to address some of the issues associated with the gap. To achieve the aims, the project adopted a mixed methods design aimed at benefitting research participants and included: participatory collaborative action research (Kemmis & McTaggart, 1988) and, community research (Smith, 1999). Participatory collaborative action research refers to a is a “collective, self-reflective enquiry undertaken by participants in social situations in order to improve the rationality and justice of their own social and educational practices” (Kemmis et al., 1988, p. 5). Community research is described as an approach that “conveys a much more intimate, human and self-defined space” (p. 127). Community research relies on and validates the community’s own definitions. As the project is informed by the social at a community level, it is described as “community action research or emancipatory research” (Smith, 1999, p. 127). It seeks to demonstrate benefit to the community, making positive differences in the lives of Indigenous People and communities. The data collection techniques included survey questionnaires, video recording of teaching and learning processes, teacher reflective video analysis of teaching, observations, semi-structured interviews and student numeracy testing. As a result of these processes, the findings indicate that VET course teachers work hard to adopt contextualising strategies to their teaching, however this process is not always straight forward because of the perceptions of how mathematics has been taught and learned historically. Further teachers, trainers and students have high expectations of one another with the view to successful outcomes from the courses.

Why trust the Head? : key strategies for transformational school leaders for building a purposeful relationship of trust

Trust is widely recognised as one of the key qualities that a successful leader needs to bring about change within their organization. Browning’s study aimed to identify practices which a school leader can effectively use to inspire, build, and maintain trust between themselves, their staff and Chair of governing body. The study was undertaken in two phases. Phase One was the identification of four highly trusted transformational leaders from the Australian independent schooling sector. Phase Two was a multicase study of the four school leaders. The findings provide practical advice for school leaders wishing to have a positive impact on the outcomes of the students in their school.

The university of the digital future : a reimagining based on the learning strategies of professionals in the digital media sectors

This article explores how universities might engage more effectively with the imperative to develop students’ 21st century skills for the information society, by examining learning challenges and strategies of successful digital media professionals. The findings support a significant body of literature, which argues that legacy university structures and pedagogical approaches are not conducive to optimal professional learning in the digital age. A model of one reimagining of the university is presented, which draws upon the learning preferences of the professionals in this study, as linked with extant theory relating to informal, situated, self-determined learning, communities of practice and personal learning environments.