The Alcohol Intervention Training Program (AITP) : a response to alcohol misuse in the farming community

Background
Farm men and women in Australia have higher levels of problematic alcohol use than their urban counterparts and experience elevated health risks associated with excessive alcohol consumption. The Sustainable Farm Families (SFF) program has worked successfully with farm men and women to address health, well- being and safety and has identified that further research and training is required to understand and address alcohol misuse behaviours. This project will add an innovative component to the program by training health professionals working with farm men and women to discuss and respond to alcohol-related physical and mental health problems.

Methods/Design
A mixed method design with multi-level evaluation will be implemented following the development and delivery of a training program (The Alcohol Intervention Training Program {AITP}) for Sustainable Farm Families health professionals. Pre-, post- and follow-up surveys will be used to assess both the impact of the training on the knowledge, confidence and skills of the health professionals to work with alcohol misuse and associated problems, and the impact of the training on the attitudes, behaviour and mental health of farm men and women who participate in the SFF project. Evaluations will take a range of forms including self-rated outcome measures and interviews.

Discussion
The success of this project will enhance the health and well-being of a critical population, the farm men and women of Australia, by producing an evidence-based strategy to assist them to adopt more positive alcohol-related behaviours that will lead to better physical and mental health.

Do healthy cities work? A logic of method for assessing impact and outcome of healthy cities

In this article, we discuss an appropriate methodology for assessing complex urban programs such as the WHO European Healthy Cities Network. The basic tenets and parameters for this project are reviewed, and situated in the broader urban health tradition. This leads to a delineation of the types of questions researchers can address when looking at a complex urban health program. Such questions reach appropriately beyond traditional public health concepts involving proximal and distal determinants of health (and associated upstream, midstream, and downstream rhetoric). Espousing a multi-level, reciprocal pathways perspective on Healthy Cities research, we also adopt a distinction between impacts and outcomes of Healthy Cities. The former are value driven, the latter intervention-driven. These approaches lead to the acknowledgment of a logic of method that includes situational and contextual appreciation of unique Healthy City experiences in a Realist Evaluation paradigm. The article concludes with a reflection of evaluation and assessment procedures applied to Phase IV (2003-2008) of the WHO European Healthy Cities Network and an interpretation of response rates to the range of methods that have been adopted.

A cross-sectional study of the individual, social, and built environmental correlates of pedometer based physical activity among elementary school children

Background: Children who participate in regular physical activity obtain health benefits. Preliminary pedometerbased cut-points representing sufficient levels of physical activity among youth have been established; however limited evidence regarding correlates of achieving these cut-points exists. The purpose of this study was to identify correlates of pedometer-based cut-points among elementary school-aged children.
Method: A cross-section of children in grades 5-7 (10-12 years of age) were randomly selected from the most (n = 13) and least (n = 12) ‘walkable’ public elementary schools (Perth, Western Australia), stratified by socioeconomic status. Children (n = 1480; response rate = 56.6%) and parents (n = 1332; response rate = 88.8%) completed a survey, and steps were collected from children using pedometers. Pedometer data were categorized to reflect the sex-specific pedometer-based cut-points of ≥15000 steps/day for boys and ≥12000 steps/day for girls. Associations between socio-demographic characteristics, sedentary and active leisure-time behavior, independent mobility, active transportation and built environmental variables - collected from the child and parent surveys - and meeting pedometer-based cut-points were estimated (odds ratios: OR) using generalized estimating equations.
Results: Overall 927 children participated in all components of the study and provided complete data. On average, children took 11407 ± 3136 steps/day (boys: 12270 ± 3350 vs. girls: 10681 ± 2745 steps/day; p < 0.001) and 25.9% (boys: 19.1 vs. girls: 31.6%; p < 0.001) achieved the pedometer-based cut-points. After adjusting for all other variables and school clustering, meeting the pedometer-based cut-points was negatively associated (p < 0.05) with being male (OR = 0.42), parent self-reported number of different destinations in the neighborhood (OR 0.93), and a friend’s (OR 0.62) or relative’s (OR 0.44, boys only) house being at least a 10-minute walk from home. Achieving the pedometer-based cut-points was positively associated with participating in screen-time < 2 hours/day (OR 1.88), not being driven to school (OR 1.48), attending a school located in a high SES neighborhood (OR 1.33), the average number of steps among children within the respondent’s grade (for each 500 step/day increase: OR 1.29), and living further than a 10-minute walk from a relative’s house (OR 1.69, girls only).
Conclusions: Comprehensive multi-level interventions that reduce screen-time, encourage active travel to/from school and foster a physically active classroom culture might encourage more physical activity among children.

What are the policy priorities for sustaining ecological processes? A case study from Victoria, Australia

Developments in ecological theory indicate that ecological processes have major implications for sustaining biodiversity and the provision of ecosystem services. Consequently, conservation actions that focus solely on particular species, vegetation communities, habitats or sites ('assets') are unlikely to be effective over the long term unless the ecological processes that support them continue to function. Efforts to sustain biodiversity must embrace both 'assets' and 'process-oriented' approaches. Existing knowledge about ecological processes, incomplete though it is, has not been adequately considered in government decision making. It is, therefore, necessary to consider how to build consideration of ecological processes into legislative and institutional frameworks, policy and planning processes, and on-ground environmental management. Drawing on insights from interviews, a facilitated workshop, and a literature review, this paper identifies a suite of policy priorities and associated reforms which should assist in ensuring that ecological processes are given more attention in policy-making processes. It is concluded that a multi-pronged approach is required, because there are no 'silver bullets' for sustaining ecological processes.

Contribution of climate and air pollution to variation in coronary heart disease mortality rates in England

There are substantial geographic variations in coronary heart disease (CHD) mortality rates in England that may in part be due to differences in climate and air pollution. An ecological cross-sectional multi-level analysis of male and female CHD mortality rates in all wards in England (1999–2004) was conducted to estimate the relative strength of the association between CHD mortality rates and three aspects of the physical environment - temperature, hours of sunshine and air quality. Models were adjusted for deprivation, an index measuring the healthiness of the lifestyle of populations, and urbanicity. In the fully adjusted model, air quality was not significantly associated with CHD mortality rates, but temperature and sunshine were both significantly negatively associated (p<0.05), suggesting that CHD mortality rates were higher in areas with lower average temperature and hours of sunshine. After adjustment for the unhealthy lifestyle of populations and deprivation, the climate variables explained at least 15% of large scale variation in CHD mortality rates. The results suggest that the climate has a small but significant independent association with CHD mortality rates in England.

School day segmented physical activity patterns of high and low active children

Background

Variability exists in children's activity patterns due to the association with environmental, social, demographic, and inter-individual factors. This study described accelerometer assessed physical activity patterns of high and low active children during segmented school week days whilst controlling for potential correlates.
Methods

Two hundred and twenty-three children (mean age: 10.7 +/- 0.3 yrs, 55.6% girls, 18.9% overweight/obese) from 8 north-west England primary schools wore ActiGraph GT1M accelerometers for 7 consecutive days during autumn of 2009. ActiGraph counts were converted to minutes of moderate (MPA), vigorous (VPA) and moderate-to-vigorous (MVPA) physical activity. Children were classified as high active (HIGH) or low active (LOW) depending on the percentage of week days they accumulated at least 60 minutes of MVPA. Minutes spent in MPA and VPA were calculated for school time and non-school time and for five discrete school day segments (before-school, class time, recess, lunchtime, and after-school). Data were analysed using multi-level modelling.
Results

The HIGH group spent significantly longer in MPA and/or VPA before-school, during class time, lunchtime, and after-school (P < .05), independent of child and school level factors. The greatest differences occurred after-school (MPA = 5.5 minutes, VPA = 3.8 minutes, P < 0.001). MPA and VPA were also associated with gender, BMI z-score, number of enrolled children, playground area per student, and temperature, depending on the segment analysed. The additive effect of the segment differences was that the HIGH group accumulated 12.5 minutes per day more MVPA than the LOW group.
Conclusions

HIGH active children achieved significantly more MPA and VPA than LOW active during four of the five segments of the school day when analyses were adjusted for potential correlates. Physical activity promotion strategies targeting low active children during discretionary physical activity segments of the day, and particularly via structured after-school physical activity programs may be beneficial.

The influence of families on early adolescent school connectedness : evidence that this association varies with adolescent involvement in peer drinking networks

School connectedness is central to the long term well-being of adolescents, and high quality parent–child relationships facilitate school connectedness. This study examined the extent to which family relationship quality is associated with the school connectedness of pre- and early teenagers, and how this association varies with adolescent involvement in peer drinking networks. The sample consisted of 7,372 10–14 year olds recruited from 231 schools in 30 Australian communities. Participants completed the Communities that Care youth survey. A multi-level model of school connectedness was used, with a random term for school-level variation. Key independent variables included family relationship quality, peer drinking networks, and school grade. Control variables included child gender, sensation seeking, depression, child alcohol use, parent education, and language spoken at home. For grade 6 students, the association of family relationship quality and school connectedness was lower when peer drinking networks were present, and this effect was nonsignificant for older (grade 8) students. Post hoc analyses indicated that the effect for family relationship quality on school connectedness was nonsignificant when adolescents in grade 6 reported that the majority of friends consumed alcohol. The results point to the importance of family-school partnerships in early intervention and prevention.

Predicting landscape-genetic consequences of habitat loss, fragmentation and mobility for multiple species of woodland birds

Inference concerning the impact of habitat fragmentation on dispersal and gene flow is a key theme in landscape genetics. Recently, the ability of established approaches to identify reliably the differential effects of landscape structure (e.g. land-cover composition, remnant vegetation configuration and extent) on the mobility of organisms has been questioned. More explicit methods of predicting and testing for such effects must move beyond post hoc explanations for single landscapes and species. Here, we document a process for making a priori predictions, using existing spatial and ecological data and expert opinion, of the effects of landscape structure on genetic structure of multiple species across replicated landscape blocks. We compare the results of two common methods for estimating the influence of landscape structure on effective distance: least-cost path analysis and isolation-by-resistance. We present a series of alternative models of genetic connectivity in the study area, represented by different landscape resistance surfaces for calculating effective distance, and identify appropriate null models. The process is applied to ten species of sympatric woodland-dependant birds. For each species, we rank a priori the expectation of fit of genetic response to the models according to the expected response of birds to loss of structural connectivity and landscape-scale tree-cover. These rankings (our hypotheses) are presented for testing with empirical genetic data in a subsequent contribution. We propose that this replicated landscape, multi-species approach offers a robust method for identifying the likely effects of landscape fragmentation on dispersal.

Nursing home administrators’ perspectives on a study feedback report : a cross sectional survey

Background
This project is part of the Translating Research in Elder Care (TREC) program of research, a multi-level and longitudinal research program being conducted in 36 nursing homes in three Canadian Prairie Provinces. The overall goal of TREC is to improve the quality of care for older persons living in nursing homes and the quality of work life for care providers. The purpose of this paper is to report on development and evaluation of facility annual reports (FARs) from facility administrators’ perspectives on the usefulness, meaningfulness, and understandability of selected data from the TREC survey.
Methods
A cross sectional survey design was used in this study. The feedback reports were developed in collaboration with participating facility administrators. FARs presented results in four contextual areas: workplace culture, feedback processes, job satisfaction, and staff burnout. Six weeks after FARs were mailed to each administrator, we conducted structured telephone interviews with administrators to elicit their evaluation of the FARs. Administrators were also asked if they had taken any actions as a result of the FAR. Descriptive and inferential statistics, as well as content analysis for open-ended questions, were used to summarize findings.
Results
Thirty-one facility administrators (representing thirty-two facilities) participated in the interviews. Six administrators had taken action and 18 were planning on taking action as a result of FARs. The majority found the four contextual areas addressed in FAR to be useful, meaningful, and understandable. They liked the comparisons made between data from years one and two and between their facility and other TREC study sites in their province. Twenty-two indicated that they would like to receive information on additional areas such as aggressive behaviours of residents and information sharing. Twenty-four administrators indicated that FARs contained enough information, while eight found FARs ‘too short’. Administrators who reported that the FAR contained enough information were more likely to take action within their facilities than administrators who reported that they needed more information.
Conclusions
Although the FAR was brief, the presentation of the four contextual areas was relevant to the majority of administrators and prompted them to plan or to take action within their facility.

(Re)viewing the landscape inside and outside the box : providing effective support for early childhood student teachers

This paper presents key findings from a study that investigated how early childhood student teachers perceived the support, guidance and mentoring facilities that were available to them and aspects of their courses. The study was conducted by lecturers who were delivering the three year Bachelor of Teaching (ECE) degree to a multicultural student cohort in a New Zealand polytechnic. A multi-method approach was taken and involved practitioner action research, questionnaires and interviews with students. The findings showed that whilst first year students found large group guidance useful, second and third year students preferred small group and individual support. Being able to email lecturers, particularly during practicum placements, was important for students. During practicum placements Associate Teachers who were culturally competent communicators and fully informed about students’ coursework were important for student success. Practicums where students experienced open communication were included as part of the teaching team and felt well-informed about the philosophy and practices of the centre were found to increase their confidence and competence. However, students expressed concern that in some placements, they felt under informed or isolated. Hence, this paper argues that lecturers and Associate Teachers should be proactive about initiating communication with students and optimize opportunities for individual mentoring through questions and guided reflection.

Three year follow-up of an early childhood intervention : is movement skill sustained?

Background
Movement skill competence (e.g. the ability to throw, run and kick) is a potentially important physical activity determinant. However, little is known about the long-term impact of interventions to improve movement skills in early childhood. This study aimed to determine whether intervention preschool children were still more skill proficient than controls three years after a 10 month movement skill focused intervention: ‘Tooty Fruity Vegie in Preschools’.

Methods
Children from 18 intervention and 13 control preschools in NSW, Australia were assessed at ages four (Time1), five (T2) and eight years (T3) for locomotor (run, gallop, hop, leap, horizontal jump, slide) and object control proficiency (strike, bounce, catch, kick, overhand throw, underhand roll) using the Test of Gross Motor Development-2. Multi-level object control and locomotor regression models were fitted with variables time, intervention (yes/no) and a time*intervention interaction. Both models added sex of child and retained if significant, in which case interactions of sex of child with other variables were modelled and retained. SPSS (Version 17.0) was used.

Results
Overall follow-up rate was 29% (163/560). Of the 137 students used in the regression models, 53% were female (n = 73). Intervention girls maintained their object control skill advantage in comparison to controls at T3 (p = .002), but intervention boys did not (p = .591). At T3, there were no longer intervention/control differences in locomotor skill (p = .801).

Conclusion
Early childhood settings should implement movement skill interventions and more intensively target girls and object control skills.

Patterns of physical activity and sedentary behaviour in preschool children

Background
Little is known about patterns of sedentary behavior (SB) and physical activity among preschoolers. Therefore, in this observational study patterns of SB and moderate-to-vigorous physical activity (MVPA) were examined in detail throughout the week in preschool-aged boys and girls.

Methods
A sample of 703 Melbourne preschool children (387 boys; 4.6 ± 0.7 y) were included in data analysis. SB and MVPA data were collected using accelerometry over an eight-day period. Percentage of time per hour in SB and in MVPA between 08:00 h and 20:00 h was calculated. Multi-level logistic regression models were created to examine the hour-by-hour variability in SB and MVPA for boys and girls across weekdays and weekend days. Odds ratios (OR) were calculated to interpret differences in hour-by-hour SB and MVPA levels between boys and girls, and between weekdays and weekend days.

Results
The highest SB levels co-occurred with the lowest MVPA levels from the morning till the early afternoon on weekdays, and during the morning and around midday on weekends. Besides, participation in SB was the lowest and participation in MVPA was the highest from the mid afternoon till the evening on weekdays and weekend days. The variability across the hours in SB and, especially, in MVPA was rather small throughout weekdays and weekends. These patterns were found in both boys and girls. During some hours, girls were found to be more likely than boys to demonstrate higher SB levels (OR from 1.08 to 1.16; all p < 0.05) and lower MVPA levels (OR from 0.75 to 0.88; all p < 0.05), but differences were small. During weekends, hour-by-hour SB levels were more likely to be lower (OR from 0.74 to 0.98; all p < 0.05) and hour-by-hour MVPA levels were more likely to be higher (OR from 1.15 to 1.50; all p < 0.05), than during weekdays, in boys and girls.

Conclusion
Entire weekdays, especially from the morning till the early afternoon, and entire weekend days are opportunities to reduce SB and to promote MVPA in preschool-aged boys and girls. Particularly weekdays hold the greatest promise for improving SB and MVPA. No particular time of the week was found where one sex should be targeted.

Indian media in a globalised world

This book explores the transformation of Indian media in the context of two major developments: globalisation (which Sociologist Anthony Giddens terms as being ‘revolutionary’) and advances in communication technologies. It is rich in empirical details of how the Indian media has evolved in the past two decades, particularly in the context of potential to transform, construct and nurture particular identities in response to globalisation. The study of the transformation of Indian media is significant because not only has globalisation allowed access to a host of things hitherto represented as ‘foreign’ to Indian culture by the media, but it has also opened the floodgates for foreign media.

Adopting a multi-disciplinary approach, this book looks at the role of media in purveying political, economic and cultural identities, the current definitions of ‘we’, ‘they’, and the ‘other’, and how the ‘other’ is perceived in contemporary India. The discussions cover all forms of media, that is, newspaper, films, radio, television and online media, along with media policy and other economic challenges facing the media.