Introducing mental health and substance use screening into a community-based health service in Australia : usefulness and implications for service change

Mental health issues such as depression or anxiety and alcohol or other drug (AOD) problems often remain undiagnosed and untreated despite their prevalence in the community. This paper reports on the implementation and evaluation of an AOD and depression/anxiety screening programme within two Community Health Services (CHS) in Australia. Study 1 examined results from 5 weeks of screening (March–April 2008) using the Patient Health Questionnaire (two- and nine-item, Kroenke et al. 2001, 2003), the Conjoint Screen for Alcohol and other Drug Problems (Brown et al. 2001) and the Alcohol, Smoking and Substance Involvement Screening Test (Humeniuk & Ali 2006). Of the 55 clients screened, 33% were at risk of depression or anxiety, 22% reporting moderate-severe depression. Thirteen per cent were at risk of substance use disorders. A substantial proportion of at-risk clients were not currently accessing help for these issues from the CHS and therefore screening can facilitate identification and treatment referral. However, the majority of eligible clients were not screened, limiting screening reach. A second study evaluated the screening implementation from a process perspective via thematic analysis of focus group data from six managers and 14 intake/assessment workers (April 2008). This showed that when screening occurred, it facilitated opportunities for education and intervention with at-risk clients, although cultural mores, privacy concerns and shame/stigma could affect accuracy of screen scores at times. Importantly, the evaluation revealed that most decisions not to screen were made by workers, not by clients. Reasons for non-screening related to worker discomfort in asking sensitive questions and/or managing client distress, and a reluctance to spend long periods of time screening in time-pressured environments. The evaluation suggested that these problems could be resolved by splitting screening responsibilities, enhancing worker training and expanding follow-up screening. Findings will inform any community-based health system considering introducing screening.

Corticospinal excitability following short-term motor imagery training of a strength task

Motor imagery and actual movement engage similar neural structures, however, whether they produce similar training-related corticospinal adaptations has yet to be established. The aim of this study was to compare changes in strength and corticospinal excitability following short-term motor imagery strength training and short-term strength training. Transcranial magnetic stimulation (TMS) was applied over the contralateral motor cortex (M1) to elicit motor-evoked potentials in the dominant biceps brachii muscle prior to and following 3-week strength training using actual bicep curls or motor imagery of bicep curls. The strength training (n = 6) and motor imagery (n = 6) groups underwent three supervised training sessions per week for 3 weeks. Participants completed four sets of six to eight repetitions (actual or imagined) at a training load of 80% of their one-repetition maximum. The control group (n = 6) were required to maintain their current level of physical activity. Both training groups exhibited large performance gains in strength (p < 0.001; strength training 39% improvement, imagery 16% improvement), which were significantly different between groups (p = 0.027). TMS revealed that the performance improvements observed in both imagery and strength training were accompanied by increases in corticospinal excitability (p < 0.001), however, these differences were not significantly different between groups (p = 0.920). Our findings suggest that both strength training and motor imagery training utilised similar neural substrates within the primary M1, however, strength training resulted in greater gains in strength than motor imagery strength training. This difference in strength increases may be attributed to adaptations during strength training that are not confined to the primary M1. These findings have theoretical implications for functional equivalent views of motor imagery as well as important therapeutic implications.

Protocol for a home-based integrated physical therapy program to reduce falls and improve mobility in people with Parkinson’s disease

Background The high incidence of falls associated with Parkinson’s disease (PD) increases the risk of injuries and immobility and compromises quality of life. Although falls education and strengthening programs have shown some benefit in healthy older people, the ability of physical therapy interventions in home settings to reduce falls and improve mobility in people with Parkinson’s has not been convincingly demonstrated.
Methods/design 180 community living people with PD will be randomly allocated to receive either a home-based integrated rehabilitation program (progressive resistance strength training, movement strategy training and falls education) or a home-based life skills program (control intervention). Both programs comprise one hour of treatment and one hour of structured homework per week over six weeks of home therapy. Blinded assessments occurring before therapy commences, the week after completion of therapy and 12 months following intervention will establish both the immediate and long-term benefits of home-based rehabilitation. The number of falls, number of repeat falls, falls rate and time to first fall will be the primary measures used to quantify outcome. The economic costs associated with injurious falls, and the costs of running the integrated rehabilitation program from a health system perspective will be established. The effects of intervention on motor and global disability and on quality of life will also be examined.
Discussion This study will provide new evidence on the outcomes and cost effectiveness of home-based movement rehabilitation programs for people living with PD.

The Role of TAFE as an Equity Pathway to Social Inclusion, Employment, and to University : a submission from The Deakin University Social Work/Gordon TAFE Community Services Work, Geelong Based Project Team

Executive Summary

The Deakin University Social Work/Gordon TAFE Community Services Work Geelong Based Project Team (the Project Team) was assisted by Higher Education Partnership and Participation funding made available through Deakin University Participation and Partnerships Program (DUPPP) to carry out research and project work in 2012/13.

In the following submission to the House of Representatives Inquiry into the role of Technical and Further Education (TAFE) system and its operation, this Project Team seeks to establish a case for:

1. Funding to enable TAFE to continue as:

a) an equity pathway to social inclusion, employment, and to university, particularly in regional areas.
b) an integral complement to the University education sector to deliver on the ambitious objectives of the Federal Government’s widening participation agenda, as a mechanism to deliver the skills, knowledge and workforce needed now, and in the future, in the Australian economy.
2. Increased resources for separate and joint sector development
a) Publicly funded TAFEs need funding to be restored and increased to enable them to maintain the high quality education they provide and to maintain their successful work in supporting communities, regions and disadvantaged individuals to gain skills, training and employment.
b) Universities need increased funding to increase staffing levels and therefore free up teaching staff to spend the necessary time to develop relationships with and provide support to students. This is important for the achieving the goals of the widening participation agenda of increasing access without increasing attrition at the same time.
c) TAFEs and Universities need funding to do the work required to further develop and formalise diploma-degree pathways so that disadvantaged individuals can exit into employment at the diploma level or be supported in an efficient and seamless way to undertake further study.
3. Active use of localised and nuanced partnership approaches by education institutions. This includes:
• Cross teaching by TAFEs and Universities in courses that can be articulated, such as professional practice diplomas and degrees
• Programs negotiated and designed according to the needs of students in each location. TAFEs and Universities need resources in order to do this work
• Focus on regional centres where there is a particular opportunity for government to make an impact on TAFE pathways to employment and/or further education
• Workforce development in regional areas due to new industries is a particular area of need
4. Recognise and capitalise on the complementary and symbiotic nature of each sector’s skills, strengths and capacities.
The submission responds to the second, third and fifth points of the Terms of Reference of the Inquiry and is based on the research work carried out by the Project Team in 2012/13.

We provide evidence of Gordon TAFE in Geelong working as an equity mechanism in the particular case of the welfare/ community services diploma to social work degree pathway. The project team considers that there is a strong case for additional resourcing of TAFE to enable it to continue what it does well. TAFE is the key training and education sectorthe ‘education and social hub’that can successfully attract, retain, and graduate people who may not otherwise access education due to one or more combinations of:

1. having a low SES current or past background;
2. living in regional areas;
3. receiving interrupted primary and secondary education;
4. having disabilities;
5. being sole parents;
6. being from refugee backgrounds;
7. having English as an additional language/culture;
8. retrenchment from employment in dying industries;
9. short, medium and long term unemployment;
10. past and/or current caring roles;
11. marriage/relationship breakdowns;
12. domestic violence;
13. gender, class, age, race/ethnicity and dis/ability discriminations; and
14. socialised expectations and fears.

The recommendations in this submission are based on research findings about important similarities and differences between Gordon TAFE welfare and Deakin University social work students in Geelong, and their respective institutional organisations and contexts. The two institutions employ a repertoire of diverse administrative, teaching, learning and support approaches to meet different mission goals, requirements and needs.

A novel defect detection and identification method in optical inspection

Optical inspection techniques have been widely used in industry as they are non-destructive. Since defect patterns are rooted from the manufacturing processes in semiconductor industry, efficient and effective defect detection and pattern recognition algorithms are in great demand to find out closely related causes. Modifying the manufacturing processes can eliminate defects, and thus to improve the yield. Defect patterns such as rings, semicircles, scratches, and clusters are the most common defects in the semiconductor industry. Conventional methods cannot identify two scale-variant or shift-variant or rotation-variant defect patterns, which in fact belong to the same failure causes. To address these problems, a new approach is proposed in this paper to detect these defect patterns in noisy images. First, a novel scheme is developed to simulate datasets of these 4 patterns for classifiers' training and testing. Second, for real optical images, a series of image processing operations have been applied in the detection stage of our method. In the identification stage, defects are resized and then identified by the trained support vector machine. Adaptive resonance theory network 1 is also implemented for comparisons. Classification results of both simulated data and real noisy raw data show the effectiveness of our method.

Reducing intoxication among bar patrons: some lessons from prevention of drinking and driving

Intoxication in and around licensed premises continues to be common, despite widespread training in the responsible service of alcohol and laws prohibiting service to intoxicated individuals. However, research suggests that training and the existence of laws are unlikely to have an impact on intoxication without enforcement, and evidence from a number of countries indicates that laws prohibiting service to intoxicated individuals are rarely enforced. Enforcement is currently hampered by the lack of a standardized validated measure for defining intoxication clearly, a systematic approach to enforcement and the political will to address intoxication. We argue that adoption of key principles from successful interventions to prevent driving while intoxicated could be used to develop a model of consistent and sustainable enforcement. These principles include: applying validated and widely accepted criteria for defining when a person is ‘intoxicated’; adopting a structure of enforceable consequences for violations; implementing procedures of unbiased enforcement; using publicity to ensure that there is a perceived high risk of being caught and punished; and developing the political will to support ongoing enforcement. Research can play a critical role in this process by: developing and validating criteria for defining intoxication based on observable behaviour; documenting the harms arising from intoxication, including risk curves associated with different levels of intoxication; estimating the policing, medical and social costs from intoxicated bar patrons; and conducting studies of the cost-effectiveness of different interventions to reduce intoxication.

Accurate and efficient face recognition from video

As a problem of high practical appeal but outstanding challenges, computer-based face recognition remains a topic of extensive research attention. In this paper we are specifically interested in the task of identifying a person from multiple training and query images. Thus, a novel method is proposed which advances the state-of-the-art in set based face recognition. Our method is based on a previously described invariant in the form of generic shape-illumination effects. The contributions include: (i) an analysis of computational demands of the original method and a demonstration of its practical limitations, (ii) a novel representation of personal appearance in the form of linked mixture models in image and pose-signature spaces, and (iii) an efficient (in terms of storage needs and matching time) manifold re-illumination algorithm based on the aforementioned representation. An evaluation and comparison of the proposed method with the original generic shape-illumination algorithm shows that comparably high recognition rates are achieved on a large data set (1.5% error on 700 face sets containing 100 individuals and extreme illumination variation) with a dramatic improvement in matching speed (over 700 times for sets containing 1600 faces) and storage requirements (independent of the number of training images).

Using recovery modalities between training sessions in elite athletes: does it help?

Achieving an appropriate balance between training and competition stresses and recovery is important in maximising the performance of athletes. A wide range of recovery modalities are now used as integral parts of the training programmes of elite athletes to help attain this balance. This review examined the evidence available as to the efficacy of these recovery modalities in enhancing between-training session recovery in elite athletes. Recovery modalities have largely been investigated with regard to their ability to enhance the rate of blood lactate removal following high-intensity exercise or to reduce the severity and duration of exercise-induced muscle injury and delayed onset muscle soreness (DOMS). Neither of these reflects the circumstances of between-training session recovery in elite athletes. After high-intensity exercise, rest alone will return blood lactate to baseline levels well within the normal time period between the training sessions of athletes. The majority of studies examining exercise-induced muscle injury and DOMS have used untrained subjects undertaking large amounts of unfamiliar eccentric exercise. This model is unlikely to closely reflect the circumstances of elite athletes. Even without considering the above limitations, there is no substantial scientific evidence to support the use of the recovery modalities reviewed to enhance the between-training session recovery of elite athletes. Modalities reviewed were massage, active recovery, cryotherapy, contrast temperature water immersion therapy, hyperbaric oxygen therapy, nonsteroidal anti-inflammatory drugs, compression garments, stretching, electromyostimulation and combination modalities. Experimental models designed to reflect the circumstances of elite athletes are needed to further investigate the efficacy of various recovery modalities for elite athletes. Other potentially important factors associated with recovery, such as the rate of post-exercise glycogen synthesis and the role of inflammation in the recovery and adaptation process, also need to be considered in this future assessment.

Influence of field position and phase of play on the physical demands of match-play in professional rugby league forwards

This article describes the utilisation of an unsupervised machine learning technique and statistical approaches (e.g., the Kolmogorov-Smirnov test) that assist cycling experts in the crucial decision-making processes for athlete selection, training, and strategic planning in the track cycling Omnium. The Omnium is a multi-event competition that will be included in the summer Olympic Games for the first time in 2012. Presently, selectors and cycling coaches make decisions based on experience and intuition. They rarely have access to objective data. We analysed both the old five-event (first raced internationally in 2007) and new six-event (first raced internationally in 2011) Omniums and found that the addition of the elimination race component to the Omnium has, contrary to expectations, not favoured track endurance riders. We analysed the Omnium data and also determined the inter-relationships between different individual events as well as between those events and the final standings of riders. In further analysis, we found that there is no maximum ranking (poorest performance) in each individual event that riders can afford whilst still winning a medal. We also found the required times for riders to finish the timed components that are necessary for medal winning. The results of this study consider the scoring system of the Omnium and inform decision-making toward successful participation in future major Omnium competitions.

Modelling and analysing track cycling Omnium performances using statistical and machine learning techniques

This article describes the utilisation of an unsupervised machine learning technique and statistical approaches (e.g., the Kolmogorov-Smirnov test) that assist cycling experts in the crucial decision-making processes for athlete selection, training, and strategic planning in the track cycling Omnium. The Omnium is a multi-event competition that will be included in the summer Olympic Games for the first time in 2012. Presently, selectors and cycling coaches make decisions based on experience and intuition. They rarely have access to objective data. We analysed both the old five-event (first raced internationally in 2007) and new six-event (first raced internationally in 2011) Omniums and found that the addition of the elimination race component to the Omnium has, contrary to expectations, not favoured track endurance riders. We analysed the Omnium data and also determined the inter-relationships between different individual events as well as between those events and the final standings of riders. In further analysis, we found that there is no maximum ranking (poorest performance) in each individual event that riders can afford whilst still winning a medal. We also found the required times for riders to finish the timed components that are necessary for medal winning. The results of this study consider the scoring system of the Omnium and inform decision-making toward successful participation in future major Omnium competitions.

Virtual worlds in Australian and New Zealand higher education: Remembering the past, understanding the present and imagining the future

3D virtual reality, including the current generation of multi-user virtual worlds, has had a long history of use in education and training, and it experienced a surge of renewed interest with the advent of Second Life in 2003. What followed shortly after were several years marked by considerable hype around the use of virtual worlds for teaching, learning and research in higher education. For the moment, uptake of the technology seems to have plateaued, with academics either maintaining the status quo and continuing to use virtual worlds as they have previously done or choosing to opt out altogether. This paper presents a brief review of the use of virtual worlds in the Australian and New Zealand higher education sector in the past and reports on its use in the sector at the present time, based on input from members of the Australian and New Zealand Virtual Worlds Working Group. It then adopts a forward-looking perspective amid the current climate of uncertainty, musing on future directions and offering suggestions for potential new applications in light of recent technological developments and innovations in the area.

Scaling up diabetes prevention in Victoria, Australia: policy development, implementation and evaluation

Objective
The Australian lifestyle intervention program Life! is only the second reported, large-scale diabetes prevention program. This paper describes the genesis and the successful establishment of Life! and its key outcomes for participants and implementation.

Research
Design and Methods Life!, a behavior change intervention, comprises six group sessions over eight months. The Victorian Department of Health funded Diabetes Australia-Victoria to implement the program. Experience of the Greater Green Triangle diabetes prevention implementation trial was used for intervention design, workforce development, training and infrastructure. Clinical and anthropometric data from participants, used for program evaluation, was recorded on a central database.

Results
Life! has a state-wide workforce of 302 trained facilitators within 137 organizations. 29,000 Victorians showed interest in Life! and 15,000 individuals have been referred to the program. In total, 8,412 participants commenced a Life! program between October 2007 and June 2011. 37% of the original participants completed the eight month program. Participants completing sessions one to five lost an average of 1·4 kg weight (p<0·001) and waist circumference of 2·5cm (p<0.001). Those completing six sessions lost an average of 2·4 kg weight (p<0·001) and waist circumference of 3·8 cm (p<0·001). The weight loss of 2.4 kg represents 2.7% of participants’ starting body weight.

Conclusion
The impact of Life! is attributable to applying available evidence for the systems design of the intervention, and collaboration between policy makers, implementers and evaluators using the principles of continuous quality improvement to support successful, large scale recruitment and implementation.

Expatriate skills training strategies of Chinese multinationals operating in Australia

Recent years have witnessed a phenomenal growth in outward foreign direct investment (FDI) by Chinese multinationals. In contrast to their developed country counterparts, Chinese multinationals lack experience in foreign expansion and international operation. Although there has been increasing academic attention placed on Chinese outward FDI, little research on expatriate skills training of Chinese multinational enterprises (MNEs) has been conducted. Since the mainstream research focuses on expatriate pre-departure training rather than on learning during assignment, this study aims to bridge this gap by exploring how Chinese MNEs cope with expatriate training and skill enhancement when operating in an advanced economy such as Australia. The study utilises cross-level, in-depth interviews to analyse expatriate training in seven Chinese multinationals. Drawing on social learning theory, some patterns of Chinese expatriate skills training strategies are revealed, such as internationalisation as learning, the use of subsidiaries as a training tool, and learning as belonging.

Pathway from vocational education and associate degree to higher education: Chinese international students in Australia

Understanding factors influencing international students' decision to engage in international education is essential for education providers to better cater for students' educational expectations and enhance their attractiveness to international students. Whilst there has been extensive research on the reasons why international students undertake cross-border higher education, international students' motivations for enrolling in vocational education and associate degree programmes are still under-researched. Drawing on semi-structured interviews with 30 international students from China, this research found that pathway to higher education appears to be the most important factor motivating international students to undertake vocational education and associate degree programmes. In addition, prospect of immigration, English language proficiency, previous academic performance, agent's recommendations and relatives' and friends' advice are amongst the important factors that students take into account in their decision to choose vocational education and associate degree programmes. This research also examines why Chinese international students have chosen vocational education programmes in a dual-sector university over vocational education colleges. It found that the flexibility to articulate to higher education, international reputation of the programme, practical training and favourable location are key issues that these students draw on when making their decision to study in a dual-sector university.

Viewpoints, creativity and embodied learning : developing perceptual and kinaesthetic skills in non-dancers studying undergraduate university drama

Viewpoints are a structural approach to training and directing for theatre. Originating from the innovative, inventive and exploratory approach of Mary Overlie and the self- confessed scavenger approach of Anne Bogart, Viewpoints offers a practical philosophy of working. As a training approach it begins with a disciplined engagement  of the body in space and time. The tangible elements of the Viewpoints provide a set of tasks on which the student can focus, thus freeing the imagination and spirit to  create. Yet at the same time the systematic logic of Viewpoints supports novice practitioners to begin to question their perception, invest in creative practice that demands action and exploration, and to deconstruct, re-organise and rebuild scores and sequences in the pursuit of theatre that is visceral and visual. This essay reports on undergraduate student experiences of learning Viewpoints. It interrogates the demands of embodied learning of the movement/structural system on non- ancers and examines student-actor experiences of embodied learning from multiple of subject positions – observer/participant/creator/reflector/actor.