Breastfeeding self-efficacy of women using second-line strategies for healthy term infants in the first week postpartum : an Australian observational study

Background Breastfeeding self-efficacy (BFSE) supports breastfeeding initiation and duration. Challenges to breastfeeding may undermine BFSE, but second-line strategies including nipple shields, syringe, cup, supply line and bottle feeding may support breastfeeding until challenges are resolved. The primary aim of this study was to examine BFSE in a sample of women using second-line strategies for feeding healthy term infants in the first week postpartum. Methods A retrospective self-report study was conducted using the Breastfeeding Self-Efficacy Scale - Short Form (BSES-SF), demographic and infant feeding questionnaires. Breastfeeding women who gave birth to a singleton healthy term infant at one private metropolitan birthing facility in Australia from November 2008 to February 2009 returned anonymous questionnaires by mail. Results A total of 128 (73 multiparous, 55 primiparous) women participated in the study. The mean BSES-SF score was 51.18 (Standard deviation, SD: 12.48). The median BSES-SF score was 53. Of women using a second-line strategy, 16 exceeded the median, and 42 were below. Analyses using Kruskal-Wallis tests confirmed this difference was statistically significant (H = 21.569, p = 0.001). The rate of second-line strategy use was 48%. The four most commonly used second-line strategies were: bottles with regular teats (77%); syringe feeding (44%); bottles with wide teats (34%); and nipple shields (27%). Seven key challenges were identified that contributed to the decision to use second-line strategies, including: nipple pain (40%); unsettled infant (40%); insufficient milk supply (37%); fatigue (37%); night nursery care (25%); infant weight loss > 10% (24%); and maternal birth associated pain (20%). Skin-to-skin contact at birth was commonly reported (93%). At seven days postpartum 124 women (97%) were continuing to breastfeed. Conclusions The high rate of use of second-line strategies identified in this study and high rate of breastfeeding at day seven despite lower BFSE indicate that such practices should not be overlooked by health professionals. The design of this study does not enable determination of cause-effect relationships to identify factors which contribute to use of second-line strategies. Nevertheless, the significantly lower BSES-SF score of women using a second-line strategy highlights this group of women have particular needs that require attention.

Older driver safety and mobility : where to from here?

The older adult population (65 years and over) represents a rapid growing segment of the population in many developed countries. Unlike earlier cohorts of older drivers that included many who were familiar with public transportation, the present cohort of older drivers historically has a greater reliance on the private automobile as their main form of transportation. Recent studies of older adults’ travel patterns reported automobile to be responsible for over 80% of the total number of hours spent on all trips. While older drivers, as a group, does not demonstrate a particular road risk, the evident demographic change and the increased physical fragility and severity of crash-related injuries makes older driver safety a prevalent public health issue. This study systematically reviewed the safety and mobility outcomes of existing strategies used internationally to manage older driver safety, with a specific focus on age-based testing (ABT), license restriction and self-regulation (i.e. voluntary limiting driving in potentially hazardous situations). ABT remains the most commonly adopted strategy by licensing authorities both within Australia and internationally. Heterogeneity in the development of functional declines, and in driving behaviours within the older driver population, makes age an unreliable index of driving capacity. Given the counter-productive safety and mobility outcomes of ABT strategies, their continued popularity within both the legislative and public domains remains problematic. Self-regulation may provide greater potential for reducing older drivers’ crash risk while maintaining their mobility and independence. The current body of literature on older drivers’ self-regulation is systematically reviewed. Despite being promoted by researchers and licensing authorities as a strategy to maintain older driver safety and mobility, the proportion of older drivers who self-regulate, and exactly how they do so, remains unclear. Future research on older drivers’ adoption of self-regulation, particularly the underlying psychological factors that underlies this process, is needed in order to promote its use within the older driver community.

A coordinated voltage support strategy for LV network with multiple DSTATCOMs

Voltage rise and drop are the main power quality challenges in Low Voltage (LV) network with Renewable Energy (RE) generators. This paper proposes a new voltage support strategy based on coordination of multiple Distribution Static Synchronous Compensators (DSTATCOMs) using consensus algorithm. The study focuses on LV network with PV as the RE source for customers. The proposed approach applied to a typical residential LV network and its advantages are shown comparing with other voltage control strategies.

Control strategies to prevent total hip replacement-related infections : a systematic review and mixed treatment comparison

OBJECTIVE: To synthesise the available evidence and estimate the comparative efficacy of control strategies to prevent total hip replacement (THR)-related surgical site infections (SSIs) using a mixed treatment comparison. DESIGN: Systematic review and mixed treatment comparison. SETTING: Hospital and other healthcare settings. PARTICIPANTS: Patients undergoing THR. PRIMARY AND SECONDARY OUTCOME MEASURES: The number of THR-related SSIs occurring following the surgical operation. RESULTS: 12 studies involving 123 788 THRs and 9 infection control strategies were identified. The strategy of 'systemic antibiotics+antibiotic-impregnated cement+conventional ventilation' significantly reduced the risk of THR-related SSI compared with the referent strategy (no systemic antibiotics+plain cement+conventional ventilation), OR 0.13 (95% credible interval (CrI) 0.03-0.35), and had the highest probability (47-64%) and highest median rank of being the most effective strategy. There was some evidence to suggest that 'systemic antibiotics+antibiotic-impregnated cement+laminar airflow' could potentially increase infection risk compared with 'systemic antibiotics+antibiotic-impregnated cement+conventional ventilation', 1.96 (95% CrI 0.52-5.37). There was no high-quality evidence that antibiotic-impregnated cement without systemic antibiotic prophylaxis was effective in reducing infection compared with plain cement with systemic antibiotics, 1.28 (95% CrI 0.38-3.38). CONCLUSIONS: We found no convincing evidence in favour of the use of laminar airflow over conventional ventilation for prevention of THR-related SSIs, yet laminar airflow is costly and widely used. Antibiotic-impregnated cement without systemic antibiotics may not be effective in reducing THR-related SSIs. The combination with the highest confidence for reducing SSIs was 'systemic antibiotics+antibiotic-impregnated cement+conventional ventilation'. Our evidence synthesis underscores the need to review current guidelines based on the available evidence, and to conduct further high-quality double-blind randomised controlled trials to better inform the current clinical guidelines and practice for prevention of THR-related SSIs.

Measuring the effects of small group deliberation on public attitudes towards sentencing : benefits and challenges

This article reports on the outcomes of small group deliberations on levels of punitiveness and public confidence in the sentencing functions of Australian criminal courts, conducted as part of a larger project investigating public attitudes to sentencing. One hypothesis of the project as a whole was that a more informed and involved public is likely to be less punitive in their views on the sentencing of offenders, and to express less cynical views about the role of sentencing courts. The aim of the small group deliberations as part of the broader project was to engender a more thoughtful and considered approach by participants to issues around sentencing. It was hypothesised that the opportunity to discuss, deliberate and consider would lead to a measurable reduction in punitiveness and an increase in people’s confidence in the courts. While the results do indeed indicate such changes in attitudes, the current study also shed light on some of the conceptual, methodological and practical challenges inherent in this type of research.

A novel process of group-oriented question reduction for rule-based recommendation websites

Several websites utilise a rule-base recommendation system, which generates choices based on a series of questionnaires, for recommending products to users. This approach has a high risk of customer attrition and the bottleneck is the questionnaire set. If the questioning process is too long, complex or tedious; users are most likely to quit the questionnaire before a product is recommended to them. If the questioning process is short; the user intensions cannot be gathered. The commonly used feature selection methods do not provide a satisfactory solution. We propose a novel process combining clustering, decisions tree and association rule mining for a group-oriented question reduction process. The question set is reduced according to common properties that are shared by a specific group of users. When applied on a real-world website, the proposed combined method outperforms the methods where the reduction of question is done only by using association rule mining or only by observing distribution within the group.

Revisiting sub-topic retrieval in the ImageCLEF 2009 photo retrieval task

Ranking documents according to the Probability Ranking Principle has been theoretically shown to guarantee optimal retrieval effectiveness in tasks such as ad hoc document retrieval. This ranking strategy assumes independence among document relevance assessments. This assumption, however, often does not hold, for example in the scenarios where redundancy in retrieved documents is of major concern, as it is the case in the sub–topic retrieval task. In this chapter, we propose a new ranking strategy for sub–topic retrieval that builds upon the interdependent document relevance and topic–oriented models. With respect to the topic– oriented model, we investigate both static and dynamic clustering techniques, aiming to group topically similar documents. Evidence from clusters is then combined with information about document dependencies to form a new document ranking. We compare and contrast the proposed method against state–of–the–art approaches, such as Maximal Marginal Relevance, Portfolio Theory for Information Retrieval, and standard cluster–based diversification strategies. The empirical investigation is performed on the ImageCLEF 2009 Photo Retrieval collection, where images are assessed with respect to sub–topics of a more general query topic. The experimental results show that our approaches outperform the state–of–the–art strategies with respect to a number of diversity measures.

Technique for evaluating photo sharing interfaces with the early prototypes - group simulation

User evaluations using paper prototypes commonly lack social context. The Group simulation technique described in this paper offers a solution to this problem. The study introduces an early-phase participatory design technique targeted for small groups. The proposed technique is used for evaluating an interface, which enables group work in photo collection creation. Three groups of four users, 12 in total, took part in a simulation session where they tested a low-fidelity design concept that included their own personal photo content from an event that their group attended together. The users’ own content was used to evoke natural experiences. Our results indicate that the technique helped users to naturally engage with the prototype in the session. The technique is suggested to be suitable for evaluating other early-phase concepts and to guide design solutions, especially with the concepts that include users’ personal content and enable content sharing.

Producing while consuming: Social interaction around photos shared within private group

User-generated content plays a pivotal role in the current social media. The main focus, however, has been on the explicitly generated user content such as photos, videos and status updates on different social networking sites. In this paper, we explore the potential of implicitly generated user content, based on users’ online consumption behaviors. It is technically feasible to record users’ consumption behaviors on mobile devices and share that with relevant people. Mobile devices with such capabilities could enrich social interactions around the consumed content, but it may also threaten users’ privacy. To understand the potentials of this design direction we created and evaluated a low-fidelity prototype intended for photo sharing within private groups. Our prototype incorporates two design concepts, namely, FingerPrint and MoodPhotos that leverage users’ consumption history and emotional responses. In this paper, we report user values and user acceptance of this prototype from three participatory design workshops.

Tethering for Selective Synthesis of 2,2′-Biphenols : the Acetal Method

2,2'-Biphenols are a large and diverse group of compounds with exceptional properties both as ligands and bioactive agents. Traditional methods for their synthesis by oxidative dimerisation are often problematic and lead to mixtures of ortho- and para-connected regioisomers. To compound these issues, an intermolecular dimerisation strategy is often inappropriate for the synthesis of heterodimers. The ‘acetal method’ provides a solution for these problems: stepwise tethering of two monomeric phenols enables heterodimer synthesis, enforces ortho regioselectivity and allows relatively facile and selective intramolecular reactions to take place. The resulting dibenzo[1,3]dioxepines have been analysed by quantum chemical calculations to obtain information about the activation barrier for ring flip between the enantiomers. Hydrolytic removal of the dioxepine acetal unit revealed the 2,2′-biphenol target.

Building and sustaining a culture to support peer review of teaching

1. Background/context This presentation will report on emerging results from a two phase project funded by the Australian Learning and Teaching Council (ALTC). The project was designed in partnership with five universities and aimed to embed peer review within the local teaching and learning culture by using a distributive leadership framework. 2. The initiative/practice The presentation will highlight research outcomes that bring together both the fundamentals of peer review of teaching with the broader contextual elements of Integration, Leadership and Development. It will be demonstrated that peer review of teaching can be implemented and have advantages for academic staff, teaching evaluation and an organisation if attention is given to strategies that influence the contexts and cultures of teaching. Peer review as a strategy to develop excellence in teaching is considered from a holistic perspective that by necessity encompasses all elements of an educational environment. Results demonstrate achievements that can be obtained through working to foster conditions needed for sustainable leadership and change. The work has implications for policy, research, teaching development and student outcomes and has potential application world-wide. 3. Method(s) of evaluative data collection and analysis The 2 phase project collected focus group and questionnaire data to inform research results that were analysed using a thematic qualitative approach and statistical exploration. 4. Evidence of effectiveness The presentation will demonstrate the effectiveness of distributive leadership and strategic approaches to working for cultural change through the presentation of project findings.

Developing a culture to support peer review of teaching in higher education

This presentation addresses issues related to leadership, academic development and scholarship of teaching and learning, and highlights research funded by the Australian Office of Learning and Teaching (OLT) designed to embed and sustain peer review of teaching within the culture of 5 Australian universities: Queensland University of Technology, University of Technology, Sydney, University of Adelaide, Curtin University, and Charles Darwin University. Peer review of teaching in higher education will be emphasised as a professional process for providing feedback on teaching and learning practice, which if sustained, can become an effective ongoing strategy for academic development (Barnard et al, 2011; Bell, 2005; Bolt and Atkinson, 2010; McGill & Beaty 2001, 1992; Kemmis & McTaggart, 2000). The research affirms that using developmental peer review models (Barnard et al, 2011; D'Andrea, 2002; Hammersley-Fletcher & Orsmond, 2004) can bring about successful implementation, especially when implemented within a distributive leadership framework (Spillane & Healey, 2010). The project’s aims and objectives were to develop leadership capacity and integrate peer review as a cultural practice in higher education. The research design was a two stage inquiry process over 2 years. The project began in July 2011 and encompassed a development and pilot phase followed by a cascade phase with questionnaire and focus group evaluation processes to support ongoing improvement and measures of outcome. Leadership development activities included locally delivered workshops complemented by the identification and support of champions. To optimise long term sustainability, the project was implemented through existing learning and teaching structures and processes within the respective partner universities. Research outcomes highlight the fundamentals of peer review of teaching and the broader contextual elements of integration, leadership and development, expressed as a conceptual model for embedding peer review of teaching within higher education. The research opens a communicative space about introduction of peer review that goes further than simply espousing its worth and introduction. The conceptual model highlights the importance of development of distributive leadership capacity, integration of policies and processes, and understanding the values, beliefs, assumptions and behaviors embedded in an organizational culture. The presentation overviews empirical findings that demonstrate progress to advance peer review requires an ‘across-the-board’ commitment to embed change, and inherently demands a process that co-creates connection across colleagues, discipline groups, and the university sector. Progress toward peer review of teaching as a cultural phenomenon can be achieved and has advantages for academic staff, scholarship, teaching evaluation and an organisation, if attention is given to strategies that influence the contexts and cultures of teaching practice. Peer review as a strategy to develop excellence in teaching is considered from a holistic perspective that by necessity encompasses all elements of an educational environment and has a focus on scholarship of teaching. The work is ongoing and has implication for policy, research, teaching development and student outcomes, and has potential application world-wide.

Evaluating NEXUS: A suicide prevention program for young people from refugee backgrounds (2007 – 2009)

Although suicide deaths in Australia continue to decline since the peak of 2,720 suicide deaths in 1997, youth suicide and self-harm are a major health issue. In 2006, in the 20 to 24 year age group, suicide accounted for approximately 21% of all male deaths and 14% of all female deaths. There is a lack of solid data on the rates of suicide and self-harm among young people from refugee backgrounds. However, this population faces a significant number of post-resettlement stressors that may add to their vulnerability and increase their risk of suicide and self-harm. The NEXUS program is an innovative strategy developed by the Queensland Program of Assistance to Survivors of Torture and Trauma (QPASTT) that aims to reduce risk factors for suicide and self-harm and to promote protective factors among youth from refugee backgrounds living in Brisbane and Toowoomba. QPASTT is a non-government organisation that provides culturally appropriate support services to refugee and humanitarian entrants to Australia. QPASTT’s primary function is to provide counselling, advocacy support and community development activities for survivors of torture and trauma at an individual, family and community level. Since 2002 the NEXUS program has been developed and implemented by QPASTT. Since then, this multi-component program has been funded by the Commonwealth Department of Health and Ageing through the National Suicide Prevention Strategy (NSPS). NSPS funding of local community suicide prevention activities will contribute to the outcomes specified in the strategic framework: Living is for Everyone (LIFE): A framework for prevention of suicide and self-harm in Australia. The focus of this report is the evaluation of the NEXUS program conducted by QPASTT between August 2007 and May 2009.

Mifepristone in the central nucleus of the amygdala reduces yohimbine stress-induced reinstatement of ethanol-seeking

Chronic ethanol exposure leads to dysregulation of the hypothalamic-pituitary-adrenal axis, leading to changes in glucocorticoid release and function that have been proposed to maintain pathological alcohol consumption and increase vulnerability to relapse during abstinence. The objective of this study was to determine whether mifepristone, a glucocorticoid receptor antagonist, plays a role in ethanol self-administration and reinstatement. Male, Long-Evans rats were trained to self-administer either ethanol or sucrose in daily 30 min operant self-administration sessions using a fixed ratio 3 schedule of reinforcement. Following establishment of stable baseline responding, we examined the effects of mifepristone on maintained responding and yohimbine-induced increases in responding for ethanol and sucrose. Lever responding was extinguished in separate groups of rats and animals were tested for yohimbine-induced reinstatement and corticosterone release. We also investigated the effects of local mifepristone infusions into the central amygdala (CeA) on yohimbine-induced reinstatement of ethanol- and sucrose-seeking. In addition, we infused mifepristone into the basolateral amygdala (BLA) in ethanol-seeking animals as an anatomical control. We show that both systemic and intra-CeA (but not BLA) mifepristone administration suppressed yohimbine-induced reinstatement of ethanol-seeking, while only systemic injections attenuated sucrose-seeking. In contrast, baseline consumption, yohimbine-induced increases in responding, and circulating CORT levels were unaffected. The data indicate that the CeA plays an important role in the effects of mifepristone on yohimbine-induced reinstatement of ethanol-seeking. Mifepristone may be a valuable pharmacotherapeutic strategy for preventing relapse to alcohol use disorders and, as it is FDA approved, may be a candidate for clinical trials in the near future.

Winning the phishing war : a strategy for Australia

Phishing, a form of on-line identity theft, is a major problem worldwide, accounting for more than $7.5 Billion in losses in the US alone between 2005 and 2008. Australia was the first country to be targeted by Internet bank phishing in 2003 and continues to have a significant problem in this area. The major cyber crime groups responsible for phishing are based in Eastern Europe. They operate with a large degree of freedom due to the inherent difficulties in cross border law enforcement and the current situation in Eastern Europe, particularly in Russia and the Ukraine. They employ highly sophisticated and efficient technical tools to compromise victims and subvert bank authentication systems. However because it is difficult for them to repatriate the fraudulently obtained funds directly they employ Internet money mules in Australia to transfer the money via Western Union or Money gram. It is proposed a strategy, which firstly places more focus by Australian law enforcement upon transactions via Western Union and Money gram to detect this money laundering, would significantly impact the success of the Phishing attack model. This combined with a technical monitoring of Trojan technology and education of potential Internet money mules to avoid being duped would provide a winning strategy for the war on phishing for Australia.