The CLIMATE schools combined study : a cluster randomised controlled trial of a universal Internet-based prevention program for youth substance misuse, depression and anxiety

Background Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders and frequently co-occur. While programs for the prevention and reduction of symptoms associated with (i) substance use and (ii) mental health disorders exist, research is yet to determine if a combined approach is more effective. This paper describes the study protocol of a cluster randomised controlled trial to evaluate the effectiveness of the CLIMATE Schools Combined intervention, a universal approach to preventing substance use and mental health problems among adolescents. Methods/design Participants will consist of approximately 8400 students aged 13 to 14-years-old from 84 secondary schools in New South Wales, Western Australia and Queensland, Australia. The schools will be cluster randomised to one of four groups; (i) CLIMATE Schools Combined intervention; (ii) CLIMATE Schools - Substance Use; (iii) CLIMATE Schools - Mental Health, or (iv) Control (Health and Physical Education as usual). The primary outcomes of the trial will be the uptake and harmful use of alcohol and other drugs, mental health symptomatology and anxiety, depression and substance use knowledge. Secondary outcomes include substance use related harms, self-efficacy to resist peer pressure, general disability, and truancy. The link between personality and substance use will also be examined. Discussion Compared to students who receive the universal CLIMATE Schools - Substance Use, or CLIMATE Schools - Mental Health or the Control condition (who received usual Health and Physical Education), we expect students who receive the CLIMATE Schools Combined intervention to show greater delays to the initiation of substance use, reductions in substance use and mental health symptoms, and increased substance use and mental health knowledge

Typology of phishing email victims based on their behavioural response

A victim of phishing emails could be subjected to money loss and identity theft. This paper investigates the different types of phishing email victims, with the goal of increasing such victims' defences. To obtain this kind of information, an experiment which involves sending a phishing email to participants is conducted. Quantitative and qualitative methods are also used to collect users' information. A model for detecting deception has been employed to understand victims' behaviour. This paper reports the qualitative results. The findings suggest that victims of phishing emails do not always exhibit the same vulnerability. The cause of being a victim is a result of three weaknesses in the detection process: (1) lack of knowledge; (2) weak confirmation channel, and; (3) victims' high propensity towards risk-taking. Therefore, it is suggested that users be provided with suitable confirmation channels and be more risk averse in their behaviour so that they would not fall victim to phishing emails.

A systematic review of community-based interventions for emerging zoonotic diseases in Southeast Asia

Background Southeast Asia has been at the epicentre of recent epidemics of emerging and re-emerging zoonotic diseases. Community-based surveillance and control interventions have been heavily promoted but the most effective interventions have not been identified. Objectives This review evaluated evidence for the effectiveness of community-based surveillance interventions at monitoring and identifying emerging infectious disease; the effectiveness of community-based control interventions at reducing rates of emerging infectious disease; and contextual factors that influence intervention effectiveness. Inclusion criteria Participants Communities in Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand and Viet Nam. Types of intervention(s) Non-pharmaceutical, non-vaccine, and community-based surveillance or prevention and control interventions targeting rabies, Nipah virus , dengue, SARS or avian influenza. Types of outcomes Primary outcomes: measures: of infection or disease; secondary outcomes: measures of intervention function. Types of studies Original quantitative studies published in English. Search strategy Databases searched (1980 to 2011): PubMed, CINAHL, ProQuest, EBSCOhost, Web of Science, Science Direct, Cochrane database of systematic reviews, WHOLIS, British Development Library, LILACS, World Bank (East Asia), Asian Development Bank. Methodological quality Two independent reviewers critically appraised studies using standard Joanna Briggs Institute instruments. Disagreements were resolved through discussion. Data extraction A customised tool was used to extract quantitative data on intervention(s), populations, study methods, and primary and secondary outcomes; and qualitative contextual information or narrative evidence about interventions. Data synthesis Data was synthesised in a narrative summary with the aid of tables. Meta-analysis was used to statistically pool quantitative results. Results Fifty-seven studies were included. Vector control interventions using copepods, environmental cleanup and education are effective and sustainable at reducing dengue in rural and urban communities, whilst insecticide spraying is effective in urban outbreak situations. Community-based surveillance interventions can effectively identify avian influenza in backyard flocks, but have not been broadly applied. Outbreak control interventions for Nipah virus and SARS are effective but may not be suitable for ongoing control. Canine vaccination and education is more acceptable than culling, but still fails to reach coverage levels required to effectively control rabies. Contextual factors were identified that influence community engagement with, and ultimately effectiveness of, interventions. Conclusion Despite investment in community-based disease control and surveillance in Southeast Asia, published evidence evaluating interventions is limited in quantity and quality. Nonetheless this review identified a number of effective interventions, and several contextual factors influencing effectiveness. Identification of the best programs will require comparative evidence of effectiveness acceptability, cost-effectiveness and sustainability.

Physical activity levels among children attending after-school programs

Purpose To describe the physical activity (PA) levels of children attending after-school programs, 2) examine PA levels in specific after-school sessions and activity contexts, and 3) evaluate after-school PA differences in groups defined by sex and weight status. Methods One hundred forty-seven students in grades 3-6 (mean age: 10.1 +/- 0.7, 54.4% male, 16.5% overweight (OW), 22.8% at-risk for OW) from seven after-school programs in the midwestern United States wore Actigraph GT1M accelerometers for the duration of their attendance to the program. PA was objectively assessed on six occasions during an academic year (three fall and three spring). Stored activity counts were uploaded to a customized data-reduction program to determine minutes of sedentary (SED), light (LPA), moderate (MPA), vigorous (VPA), and moderate-to-vigorous (MVPA) physical activity. Time spent in each intensity category was calculated for the duration of program attendance, as well as specific after-school sessions (e.g., free play, snack time). Results On average, participants exhibited 42.6 min of SED, 40.8 min of LPA, 13.4 min of MPA, and 5.3 min of VPA. The average accumulation of MVPA was 20.3 min. Boys exhibited higher levels of MPA, VPA, and MVPA, and lower levels of SED and LPA, than girls. OW and at-risk-for-OW students exhibited significantly less VPA than nonoverweight students, but similar levels of LPA, MPA, and MVPA. MVPA levels were significantly higher during free-play activity sessions than during organized or structured activity sessions. Conclusion After-school programs seem to be an important contributor to the PA of attending children. Nevertheless, ample room for improvement exists by making better use of existing time devoted to physical activity.

Evaluation of a community-based intervention to promote physical activity in youth : lessons from active winners

Purpose To test the effects of a community-based physical activity intervention designed to increase physical activity and to conduct an extensive process evaluation of the intervention. Design Quasi-experimental. Setting Two rural communities in South Carolina. One community received the intervention, and the other served as the comparison. Subjects Public school students who were in fifth grade at the start of the study (558 at baseline) were eligible to participate. A total of 436 students participated over the course of the study. Intervention The intervention included after-school and summer physical activity programs and home, school, and community components designed to increase physical activity in youth. The intervention took place over an 18-month period. Measures. Students reported after-school physical activity at three data collection points (prior to, during, and following the intervention) using the Previous Day Physical Activity Recall (PDPAR). They also completed a questionnaire designed to measure hypothesized psychosocial and environmental determinants of physical activity behavior The process evaluation used meeting records, documentation of program activities, interviews, focus groups, and heart rate monitoring to evaluate the planning and implementation of the intervention. Results There were no significant differences in the physical activity variables and few significant differences in the psychosocial variables between the intervention and comparison groups. The process evaluation indicated that the after-school and summer physical activity component of the intervention was implemented as planned, but because of resource and time limitations, the home, school, and community components were not implemented as planned. Conclusions The intervention did not have a significant effect on physical activity in the target population of children in the intervention community. This outcome is similar to that reported in other studies of community-based physical activity intervention.

School physical education in the post-report era : an analysis from public health

The 1996 United States Surgeon General’s report on physical activity and health represents a watershed moment in the modern history of physical activity and public health. Based on a compelling body of scientific evidence from the fields of medicine, epidemiology, physiology, and health psychology, the Surgeon General’s report proclaimed that people of all ages could improve their health and quality of life through lifelong practice of moderate physical activity (United States Department of Health and Human Services [USDHHS], 1996). Physical Activity and Health: A Report of the Surgeon General was an especially important publication for school physical education. Not only did the report acknowledge the importance of regular physical activity during childhood and adolescence, it also identified school physical education as an important vehicle for promoting healthenhancing physical activity in young people. “With evidence that success in this arena is possible, every effort should be made to encourage schools to require daily physical education in each grade and to promote physical activities that can be enjoyed throughout life” (USDHHS, 1996, p. 6). The purpose of this article is to discuss the status of school physical education since the release of the Surgeon General’s report on physical activity and health nearly a decade ago. Specifically, the article will address four questions: 1) What has been the historical role of physical education in physical activity and public health? 2) What impact, if any, has the Surgeon General’s report has had on physical education programs? 3) What impact should physical education have on public health and physical activity? 4) What should teacher education programs in physical education do to prepare physical education teachers, given the current role of physical education?

Asian international student attrition among Australian universities : are wellness programs the answer?

Education is one of Australia’s largest service-based exports. International students comprise approximately 24% of enrolments at Australian universities (Sawir, Marginson, Deumert, Nyland, & Ramia, 2008); and approximately 80% of these students are from the Asian region (Australian Federal Government, 2012). The financial cost of international student attrition for universities is significant. The Australian Federal Government Department of Education, Science and Training reports the attrition rates for first-year international undergraduate students ranged between 4% and 22.5% across all Australian Universities (2013). Academic, psychological, and sociocultural adjustments to a new environment can be challenging for international students. This process manifests from various stressors such as communication difficulties, adjustment to a new teaching style, new cultural norms and pressure on academic performance. These stressors result in an often overwhelming attempt to integrate and function effectively, and can consequently affect a student’s ability to meet academic requirements. The relationship between a student’s ability to successfully complete a higher education program is consistently related to a range of academic and non-academic factors. The role of specific Australian higher education institutions is vital in facilitating the continued education of Asian International students. Initiatives targeting an enhancement of modifiable lifestyle factors may have the potential to enhance a student’s ability to effectively and successfully transition into a lifestyle that facilitates their ability to adjust to the requirements of Australian universities. One possibility is the prospect of providing wellness programming, coaching and education targeting lifestyle behaviours for acculturation.

Better cars or older cars?: Assessing CO2 emission reduction potential of passenger vehicle replacement programs

The primary motivation for the vehicle replacement schemes that were implemented in many countries was to encourage the purchase of new cars. The basic assumption of these schemes was that these acquisitions would benefit both the economy and the environment as older and less fuel-efficient cars were scrapped and replaced with more fuel-efficient models. In this article, we present a new environmental impact assessment method for assessing the effectiveness of scrappage schemes for reducing CO2 emissions taking into account the rebound effect, driving behavior for older versus new cars and entire lifecycle emissions for during the manufacturing processes of new cars. The assessment of the Japanese scrappage scheme shows that CO2 emissions would only decrease if users of the scheme retained their new gasoline passenger vehicles for at least 4.7 years. When vehicle replacements were restricted to hybrid cars, the reduction in CO2 achieved by the scheme would be 6-8.5 times higher than the emissions resulting from a scheme involving standard, gasoline passenger vehicles. Cost-benefit analysis, based on the emission reduction potential, showed that the scheme was very costly. Sensitivity analysis showed that the Japanese government failed to determine the optimum, or target, car age for scrapping old cars in the scheme. Specifically, scrapping cars aged 13 years and over did not maximize the environmental benefits of the scheme. Consequently, modifying this policy to include a reduction in new car subsidies, focused funding for fuel-efficient cars, and modifying the target car age, would increase environmental benefits. © 2013 Elsevier Ltd.

Quality assurance of aerial applications of larvicides for mosquito control : effects of granule and catch tray size on field monitoring programs

Aerial applications of granular insecticides are preferable because they can effectively penetrate vegetation, there is less drift, and no loss of product due to evaporation. We aimed to 1) assess the field efficacy ofVectoBac G to control Aedes vigilax (Skuse) in saltmarsh pools, 2) develop a stochastic-modeling procedure to monitor application quality, and 3) assess the distribution of VectoBac G after an aerial application. Because ground-based studies with Ae. vigilax immatures found that VectoBac G provided effective control below the recommended label rate of 7 kg/ha, we trialed a nominated aerial rate of 5 kg/ha as a case study. Our distribution pattern modeling method indicated that the variability in the number of VectoBac G particles captured in catch-trays was greater than expected for 5 kg/ha and that the widely accepted contour mapping approach to visualize the deposition pattern provided spurious results and therefore was not statistically appropriate. Based on the results of distribution pattern modeling, we calculated the catch tray size required to analyze the distribution of aerially applied granular formulations. The minimum catch tray size for products with large granules was 4 m2 for Altosid pellets and 2 m2 for VectoBac G. In contrast, the minimum catch-tray size for Altosid XRG, Aquabac G, and Altosand, with smaller granule sizes, was 1 m2. Little gain in precision would be made by increasing the catch-tray size further, when the increased workload and infrastructure is considered. Our improved methods for monitoring the distribution pattern of aerially applied granular insecticides can be adapted for use by both public health and agricultural contractors.

A review of international speed enforcement policies and practices : evidence-based recommendations for best practice

Extensive research has highlighted the positive and exponential relationship between vehicle speed and crash risk and severity. Speed enforcement policies and practices throughout the world have developed dramatically as new technology becomes available, however speeding remains a pervasive problem internationally that significantly contributes to road trauma. This paper adopted a three-pronged approach to review speed enforcement policies and practices by: (i) describing and comparing policies and practices adopted in a cross-section of international jurisdictions; (ii) reviewing the available empirical evidence evaluating the effectiveness of various approaches, and; (iii) providing recommendations for the optimisation speed enforcement. The review shows the enforcement strategies adopted in various countries differ both in terms of the approaches used and how they are specifically applied. The literature review suggests strong and consistent evidence that police speed enforcement, in particular speed cameras, can be an effective tool for reducing vehicle speeds and subsequent traffic crashes. Drawing from this evidence, recommendations for best practice are proposed, including the specific instances in which various speed enforcement approaches typically produce the greatest road safety benefits, and perhaps most importantly, that speed enforcement programs must utilise a variety of strategies tailored to specific situations, rather than a one-size-fits-all approach.

Evaluation of assessment in the context of work-based learning: Qualitative perspectives of new graduates

Aim Evaluation or assessment of competence is an important step to ensure the safety and efficacy of health professionals, including dietitians. Most competency-based assessment studies are focussed on valid and reliable methods of assessment for the preparation of entry-level dietitians, few papers have explored student dietitians’ perceptions of these evaluations. This study aimed to explore the perceptions of recent graduates from accredited nutrition and dietetics training programs in Australia. It also aimed to establish the relevance of competency-based assessment to adequately prepare them for entry-level work roles. Methods A purposive sample of newly-graduated dietitians with a range of assessment experiences and varied employment areas was recruited. A qualitative approach, using in-depth interviews with 13 graduates, with differing assessment experiences was undertaken. Graduates were asked to reflect upon their competency-based assessment experiences whilst a student. Data was thematically analysed by multiple authors. Results Four themes emerged from the data analysis: (i) Transparency and consistency are critical elements of work-based competency assessment. (ii) Students are willing to take greater responsibility in their assessment process. (iii) Work-based competency assessment prepares students for employment. (iv) The relationship between students and their assessors can impact on the student experience and their assessment performance. Conclusions Understanding this unique perspective of students can improve evaluation of future health professionals and assist in designing valid competency-based assessment approaches.

Boosting the effects of a curriculum based injury prevention program through a school connectedness intervention : final report to NRMA-ACT Road Safety Trust

Injury is the leading cause of death among young people (AIHW, 2008). A primary contributing factor to injury among adolescents is risk taking behaviour, including road related risks such as risky bicycle and motorcycle use and riding with dangerous or drink-drivers. Injury rates increase dramatically throughout adolescence, at the same time as adolescents are becoming more involved in risk taking behaviour. Also throughout this period, adolescents‟ connectedness to school is decreasing (Monahan, Oesterle & Hawkins, 2010; Whitlock, 2004). School connectedness refers to „the extent to which students feel personally accepted, respected, included, and supported by others in the school‟ (Goodenow, 1993, p. 80), and has been repeatedly shown to be a critical protective factor in adolescent development. For example, school connectedness has been shown to be associated with decreased risk taking behaviour, including violence and alcohol and other drug use (e.g., Resnick et al., 1997), as well as with decreased transport risk taking and vehicle related injuries (Chapman et al., accepted April 2011). This project involved the pilot evaluation of a school connectedness intervention (a professional development program for teachers) to reduce adolescent risk taking behaviour and injury. This intervention has been developed for use as a component of the Skills for Preventing Injury in Youth (SPIY) curriculum based injury prevention program for early adolescents. The objectives of this research were to: 1. Implement a trial School Connectedness intervention (professional development program for teachers) in ACT high schools, and evaluate using comparison high schools. 2. Determine whether the School Connectedness program impacts on adolescent risk taking behaviour and associated injuries (particularly transport risks and injuries). 3. Evaluate the process effectiveness of the School Connectedness program.

The impact of work-family programs on the relationship between gender diversity and performance

Work–family programs signal an employer's perspective on gender diversity to employees, and can influence whether the effects of diversity on performance are positive or negative. This article tests the interactive effects of nonmanagement gender diversity and work–family programs on productivity, and management gender diversity and work–family programs on financial performance. The predictions were tested in 198 Australian publicly listed organizations using primary (survey) and secondary (publicly available) data based on a two-year time lag between diversity and performance. The findings indicate that nonmanagement gender diversity leads to higher productivity in organizations with many work–family programs, and management gender diversity leads to lower financial performance in organizations with few work–family programs. The results suggest different business cases at nonmanagement and management levels for the adoption of work–family programs in gender-diverse organizations.

How small business advisory program delivery methods (collective learning, tailored, and practice-based approaches) affect learning and innovation

Past studies relate small business advisory program effectiveness to advisory characteristics such as advisory intensity and scope. We contribute to existing literature by seeking to identify the impact of different advisory program methods of delivery on learning and subsequent firm innovation behavior. Our research is based on a survey of 257 Australian firms completing small business advisory programs in the three years preceding the research. We explore the range of small business advisory program delivery methods in which our surveyed firms participated and, with reference to the literature on organizational learning and innovation, we analyze predictors of firms' learning ability and innovativeness based on the identified delivery methods. First, we found that business advisory programs that involved high levels of collective learning and tailored approaches enhanced firms' perceptions of their learning of critical skills or capabilities. We also found that small business advisory programs that were delivered by using practice-based approaches enhanced firms' subsequent organizational innovation. We verified this finding by testing whether firms that have participated in small business advisory services subsequently demonstrate improved behavior in terms of organizational innovativeness, when compared with matched firms that have not participated in an advisory program.

Patient perspectives of using a web based intervention program for patients with type 2 diabetes and acute coronary syndrome

Introduction Research highlights patients with dual diagnoses of type 2 diabetes and acute coronary syndrome (ACS) have higher readmission rates and poorer health outcomes than patients with singular chronic conditions. Despite this, there is a lack of education programs targeted for this dual diagnosis population to improve self-management and decrease negative health outcomes. There is evidence to suggest that internet based interventions may improve health outcomes for patients with singular chronic conditions, however there is a need to develop an evidence base for ACS patients with comorbid diabetes. There is a growing awareness of the importance of a participatory model in developing effective online interventions. That is, internet interventions are more effective if end users’ perceptions of the intervention are incorporated in their final development prior to testing in large scale trials. Objectives This study investigated patients’ perspectives of the web-based intervention designed to promote self-management of the dual conditions in order to refine the intervention prior to clinical trial evaluation. Methods An interpretive approach with thematic analysis was used to obtain deeper understanding regarding participants’ experience when using web-application interventions for patients with ACS and type 2 diabetes. Semi-structured interviews were undertaken on a purposive sample of 30 patients meeting strict inclusion and exclusion criteria to obtain their perspectives on the program. Results Preliminary results indicate patients with dual diagnoses express more complex needs than those with a singular condition. Participants express a positive experience with the proposed internet intervention and emerging themes include that the web page is seen as easy to use and comforting as a support, in that patients know they are not alone. Further results will be reported as they become available. Conclusion The results indicate potential for patient acceptability of the newly developed internet intervention for patients with ACS and comorbid diabetes. Incorporation of patient perspectives into the final development of the intervention is likely to maximise successful outcomes of any future trials that utilise this intervention. Future quantitative evaluation of the effectiveness of the intervention is being planned.