Finding My Way: Protocol of a randomised controlled trial evaluating an internet self-help program for cancer-related distress

Background A cancer diagnosis elicits greater distress than any other medical diagnosis, and yet very few studies have evaluated the efficacy of structured online self-help therapeutic programs to alleviate this distress. This study aims to assess the efficacy over time of an internet Cognitive Behaviour Therapy (iCBT) intervention (‘Finding My Way’) in improving distress, coping and quality of life for individuals with a recent diagnosis of early stage cancer of any type. Methods/Design The study is a multi-site Randomised Controlled Trial (RCT) seeking to enrol 188 participants who will be randomised to either the Finding My Way Intervention or an attention-control condition. Both conditions are delivered online; with 6 modules released once per week, and an additional booster module released one month after program-completion. Participants complete online questionnaires on 4 occasions: at baseline (immediately prior to accessing the modules); post-treatment (immediately after program-completion); then three and six months later. Primary outcomes are general distress and cancer-specific distress, with secondary outcomes including Health-Related Quality of Life (HRQoL), coping, health service utilisation, intervention adherence, and user satisfaction. A range of baseline measures will be assessed as potential moderators of outcomes. Eligible participants are individuals recently diagnosed with any type of cancer, being treated with curative intent, aged over 18 years with sufficient English language literacy, internet access and an active email account and phone number. Participants are blinded to treatment group allocation. Randomisation is computer generated and stratified by gender. Discussion Compared to the few prior published studies, Finding My Way will be the first adequately powered trial to offer an iCBT intervention to curatively treated patients of heterogeneous cancer types in the immediate post-diagnosis/treatment period. If found efficacious, Finding My Way will assist with overcoming common barriers to face-to-face therapy in a cost-effective and accessible way, thus helping to reduce distress after cancer diagnosis and consequently decrease the cancer burden for individuals and the health system. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12613000001​796 16.10.13

Pre-emptive breeding to combine superior eating quality in tropical super sweet corn with resistance to major diseases

This report presents the process and outcomes of a five year project, which employed genetics and breeding approach for integrating disease resistance,agronomy and quality traits that enhances sustainable productivity improvement in sweet corn production. The report outlines a molecular markers based approach to introgress quantitative traits loci that are believed to contribute to resistance to downy mildew, a potentially devastating disease that threatens sweet corn and other similar crops. It also details the approach followed to integrate resistances for other major diseases such as southern rust (caused by Puccinia polysora Underw), Northern Corn Leaf Blight (Exserohilum turcicum) with improved agronomy and eating quality. The report explains the importance of heterosis (hybrid vigour) and combining ability in the development of useful sweet corn hybrids. It also explains the relevance of parental performance to predict its breeding value and the performance of its hybrids.

Moving from evaluation to trial: How do SMEs start adopting Cloud ERP?

The advent of cloud technology involving low subscription overheads cost has provided small and medium-sized enterprises (SMEs) with the opportunity to adopt new cloud-based corporate-wide systems (i.e., cloud ERP). This technology, operating through subscription-based services, has now provided SMEs with a complete range of IT applications that were once restricted to larger organisations. As anecdotal evidences suggest, SMEs are increasingly adopting cloud-based ERP software. The selection of an ERP is a complex process involving multiple stages and stakeholders, suggesting the importance of closer examination of cloud ERP adoption in SMEs. Yet, prior studies have predominantly treated technology adoption as a single activity and largely ignored the issue of ERP adoption in SMEs. Understanding of the process nature of the adoption and the factors that are important in each stage of the adoption potentially may result in guiding SMEs to make well-informed decisions throughout the ERP selection process. Thus, our study proposes that the adoption of cloud ERP should be examined as a multi-stage process. Using the Theory of Planned Behaviour (TPB) and Ettlie’s adoption stages, as well as employing data gathered from 162 owners of SMEs, our findings show that the factors that influence the intention to adopt cloud ERP vary significantly across adoptive stages.

Public Demand for Safer Speeds: Identification of Interventions for Trial

Speeding is a major contributor to road injuries and fatalities and remains prevalent. Changing community perceptions about speeding is an important priority. Austroads commissioned research to identify a range of potential interventions for future trial and evaluation aimed at creating, increasing, and/or sustaining public demand for safer speeds. This project had three phases: a literature review; consultations with key stakeholders regarding intervention options (including feasibility, and likely benefits and costs of identified interventions); and providing research results, including recommendations for future phases of the program of work. The literature review led to the development of a draft Campaign Strategy targeting nine aims across three themes underpinning this research: 1) creating, 2) increasing, and 3) sustaining public demand for safer speeds on the road. Twenty-one stakeholders commented on the suitability and feasibility of, and likely barriers to, countermeasures within the draft Campaign Strategy and its applicability to the Australian and New Zealand context. There was overwhelming positive support for the proposed Campaign Strategy by the majority of respondents; many, noting that it addressed key misperceptions and complemented many existing approaches. A small number of respondents expressed some concerns with various aspects. Stakeholder feedback was incorporated into the final proposed Campaign Strategy to enhance its potential effectiveness. Wide diversity across jurisdictions makes the recommendation of individual interventions for specific areas problematic. Individual jurisdictions should consider a range of costs and benefits of the proposed Campaign Strategy to determine the likely feasibility from their unique perspective. Issues to be addressed when considering implementation of the proposed Campaign Strategy include speed limit setting policies, resourcing, messaging and advertising strategies, and political will associated with promoting safer speeds.

A randomized controlled trial protocol testing a decision support intervention for older patients with advanced kidney disease

Aim To assess the effectiveness of a decision support intervention using a pragmatic single blind Randomized Controlled Trial. Background Worldwide the proportion of older people (aged 65 years and over) is rising. This population is known to have a higher prevalence of chronic diseases including chronic kidney disease. The resultant effect of the changing health landscape is seen in the increase in older patients (aged ≥65 years) commencing on dialysis. Emerging evidence suggests that for some older patients dialysis may provide minimal benefit. In a majority of renal units non-dialysis management is offered as an alternative to undertaking dialysis. Research regarding decision-making support that is required to assist this population in choosing between dialysis or non-dialysis management is limited. Design. A multisite single blinded pragmatic randomized controlled trial is proposed. Methods Patients will be recruited from four Queensland public hospitals and randomizd into either the control or intervention group. The decision support intervention is multimodal and includes counselling provided by a trained nurse. The comparator is standard decision-making support. The primary outcomes are decisional regret and decisional conflict. Secondary outcomes are improved knowledge and quality of life. Ethics approval obtained November 2014. Conclusion This is one of the first randomized controlled trials assessing a decision support intervention in older people with advance chronic kidney disease. The results may provide guidance for clinicians in future approaches to assist this population in decision-making to ensure reduced decisional regret and decisional conflict.

An improved simulation model to predict pre-harvest aflatoxin risk in maize

Aflatoxin is a potent carcinogen produced by Aspergillus flavus, which frequently contaminates maize (Zea mays L.) in the field between 40° north and 40° south latitudes. A mechanistic model to predict risk of pre-harvest contamination could assist in management of this very harmful mycotoxin. In this study we describe an aflatoxin risk prediction model which is integrated with the Agricultural Production Systems Simulator (APSIM) modelling framework. The model computes a temperature function for A. flavus growth and aflatoxin production using a set of three cardinal temperatures determined in the laboratory using culture medium and intact grains. These cardinal temperatures were 11.5 °C as base, 32.5 °C as optimum and 42.5 °C as maximum. The model used a low (≤0.2) crop water supply to demand ratio—an index of drought during the grain filling stage to simulate maize crop's susceptibility to A. flavus growth and aflatoxin production. When this low threshold of the index was reached the model converted the temperature function into an aflatoxin risk index (ARI) to represent the risk of aflatoxin contamination. The model was applied to simulate ARI for two commercial maize hybrids, H513 and H614D, grown in five multi-location field trials in Kenya using site specific agronomy, weather and soil parameters. The observed mean aflatoxin contamination in these trials varied from <1 to 7143 ppb. ARI simulated by the model explained 99% of the variation (p ≤ 0.001) in a linear relationship with the mean observed aflatoxin contamination. The strong relationship between ARI and aflatoxin contamination suggests that the model could be applied to map risk prone areas and to monitor in-season risk for genotypes and soils parameterized for APSIM.

An improved simulation model to predict pre-harvest aflatoxin risk in maize

Aflatoxin is a potent carcinogen produced by Aspergillus flavus, which frequently contaminates maize (Zea mays L.) in the field between 40° north and 40° south latitudes. A mechanistic model to predict risk of pre-harvest contamination could assist in management of this very harmful mycotoxin. In this study we describe an aflatoxin risk prediction model which is integrated with the Agricultural Production Systems Simulator (APSIM) modelling framework. The model computes a temperature function for A. flavus growth and aflatoxin production using a set of three cardinal temperatures determined in the laboratory using culture medium and intact grains. These cardinal temperatures were 11.5 °C as base, 32.5 °C as optimum and 42.5 °C as maximum. The model used a low (≤0.2) crop water supply to demand ratio—an index of drought during the grain filling stage to simulate maize crop's susceptibility to A. flavus growth and aflatoxin production. When this low threshold of the index was reached the model converted the temperature function into an aflatoxin risk index (ARI) to represent the risk of aflatoxin contamination. The model was applied to simulate ARI for two commercial maize hybrids, H513 and H614D, grown in five multi-location field trials in Kenya using site specific agronomy, weather and soil parameters. The observed mean aflatoxin contamination in these trials varied from <1 to 7143 ppb. ARI simulated by the model explained 99% of the variation (p ≤ 0.001) in a linear relationship with the mean observed aflatoxin contamination. The strong relationship between ARI and aflatoxin contamination suggests that the model could be applied to map risk prone areas and to monitor in-season risk for genotypes and soils parameterized for APSIM.

Highly heritable resistance to root-lesion nematode (Pratylenchus thornei) in Australian chickpea germplasm observed using an optimised glasshouse method and multi-environment trial analysis

Pratylenchus thornei is a root-lesion nematode (RLN) of economic significance in the grain growing regions of Australia. Chickpea (Cicer arietinum) is a significant legume crop grown throughout these regions, but previous testing found most cultivars were susceptible to P. thornei. Therefore, improved resistance to P. thornei is an important objective of the Australian chickpea breeding program. A glasshouse method was developed to assess resistance of chickpea lines to P. thornei, which requires relatively low labour and resource input, and hence is suited to routine adoption within a breeding program. Using this method, good differentiation of chickpea cultivars for P. thornei resistance was measured after 12 weeks. Nematode multiplication was higher for all genotypes than the unplanted control, but of the 47 cultivars and breeding lines tested, 17 exhibited partial resistance, allowing less than two fold multiplication. The relative differences in resistance identified using this method were highly heritable (0.69) and were validated against P. thornei data from seven field trials using a multi-environment trial analysis. Genetic correlations for cultivar resistance between the glasshouse and six of the field trials were high (>0.73). These results demonstrate that resistance to P. thornei in chickpea is highly heritable and can be effectively selected in a limited set of environments. The improved resistance found in a number of the newer chickpea cultivars tested shows that some advances have been made in the P. thornei resistance of Australian chickpea cultivars, and that further targeted breeding and selection should provide incremental improvements.

Applicability of pebble matrix filtration for the pre-treatment of surface waters containing high turbidity and NOM

Purification of drinking water is routinely achieved by use of conventional coagulants and disinfection procedures. However, there are instances such as flood events when the level of turbidity reaches extreme levels while NOM may be an issue throughout the year. Consequently, there is a need to develop technologies which can effectively treat water of high turbidity during flood events and natural organic matter (NOM) content year round. It was our hypothesis that pebble matrix filtration potentially offered a relatively cheap, simple and reliable means to clarify such challenging water samples. Therefore, a laboratory scale pebble matrix filter (PMF) column was used to evaluate the turbidity and natural organic matter (NOM) pre-treatment performance in relation to 2013 Brisbane River flood water. Since the high turbidity was only a seasonal and short term problem, the general applicability of pebble matrix filters for NOM removal was also investigated. A 1.0 m deep bed of pebbles (the matrix) partly in-filled with either sand or crushed glass was tested, upon which was situated a layer of granular activated carbon (GAC). Turbidity was measured as a surrogate for suspended solids (SS), whereas, total organic carbon (TOC) and UV Absorbance at 254 nm were measured as surrogate parameters for NOM. Experiments using natural flood water showed that without the addition of any chemical coagulants, PMF columns achieved at least 50% turbidity reduction when the source water contained moderate hardness levels. For harder water samples, above 85% turbidity reduction was obtained. The ability to remove 50% turbidity without chemical coagulants may represent significant cost savings to water treatment plants and added environmental benefits accrue due to less sludge formation. A TOC reduction of 35-47% and UV-254 nm reduction of 24-38% was also observed. In addition to turbidity removal during flood periods, the ability to remove NOM using the pebble matrix filter throughout the year may have the benefit of reducing disinfection by-products (DBP) formation potential and coagulant demand at water treatment plants. Final head losses were remarkably low, reaching only 11 cm at a filtration velocity of 0.70 m/h.

A randomised controlled clinical trial of a post-discharge, nurse-led educational intervention to reduce anxiety and enhance self-efficacy in percutaneous coronary intervention (PCI) patients within the first week post-discharge: A pilot study

This research investigated the efficacy of a post-discharge nurse-led clinic, for patients who underwent a cardiovascular interventional procedure in Australia. A randomised controlled clinical trial measured the effects of the clinic on patient confidence to self-manage and minimise psychological distress given the strong link between anxiety, depression and coronary heart disease. Hospitalisation for the procedure is short and stressful, and patients may wait up to 7-64 days for post-discharge review. This study provides preliminary quantitative and qualitative evidence that nurse-led clinics undertaken within the first week post-percutaneous coronary intervention may fill a much-needed gap for patients during a potentially vulnerable period.

Connecting for innovation: Four universities collaboratively preparing pre-service teachers to teach in rural and remote Western Australia

In 2010 a group of teacher educators from four universities, experienced in rural and remote education, formed the Tertiary Educators Rural, Regional and Remote Network (TERRR Network). The collaborative goal was to improve the quality of graduates taking appointments beyond the metropolitan areas of Western Australia. The TERRR Network developed a research project to improve the capacity of universities to prepare teachers for employment in rural and remote locations. A range of outcomes emerged from the project, including: 1) the development of seven rural and remote-oriented curricula modules linked to the Australian Professional Standards for Teachers; 2) a cross-institutional field experience, and; 3) the development of a community of practice involving the Department of Education, universities and schools to address the logistical implications of placing pre-service students in rural and remote locations. This paper reports on the five phases of the project design, with a focus on learning in the field and concludes with reflections on the collaborative process used by the four universities in order to ensure that research evidence informs future policy and program development.

Going bush: Preparing pre-service teachers to teach in regional Western Australia

This paper reports on outcomes of Phases One and Two of the ALTC Competitive Research and Development Project "Developing Strategies at the Pre-Service Level to Address Critical Teacher Attraction and Retention Issues in Australian Rural, Regional and Remote Schools." This project funded over two years aims to strengthen the capacity and credibility of universities to prepare rural, regional and remote educators, similar to the capacity and credibility that has been created in preparing Australia's rural, regional and remote health workers. There is a strong recognition of the fundamental importance of quality teaching experiences rural, regional and remote schools and throughout this project over 200 pre-service teachers have participated in a curriculum module/object and completed a survey that encourages them to consider teaching in regional Western Australia. The project has mapped current Western Australian rural, regional and remote pre-service teacher education curriculum and field experience model. This mapping completed a comparison of national information with the identification of rural, regional and remote education curriculum and/or field experience models used nationally and internationally. In particular results from Phase One and Two will be presented reporting on the findings of the first year of the project.

New Frontiers or old certainties: The pre-service teacher internship

Teacher education in Australia has a rich history of evolution from apprenticeships to university education. In this chapter the teacher education internship is examined. More specifically, the chapter outlines the Western Australian Combined Universities Training School (WACUTS) project, with its focus on reducing the gap between theory and practice through a collaborative and reflective approach. The successes and challenges faced in the first six months of implementation are presented

Regional resilience: Pre-service teacher preparation to teach in the bush

This paper reports on the outcomes of a two year ALTC Competitive Research and Development Project that aimed to "Develop Strategies at the Pre-Service Level to Address Critical Teacher Attraction and Retention Issues in Australian Rural, Regional and Remote Schools". As well as developing a ‘training framework’ and teaching guides to increase the capacity and credibility of four universities to prepare educators who might venture out of the metropolitan area to teach, data were gathered from pre-service and graduate teachers to analyse regional resilience. It was found that there was a strong likelihood to participate in a regional practicum and stay in a non-metropolitan community once they graduated from university if they had a positive attitude to regional Western Australia either through a family connection or previous experience. Recommendations from this study emphasise the importance of having pre-service students participate in positive regional experiences early in their university study.