A randomised, feasibility trial of a tele-health intervention for Acute Coronary Syndrome patients with depression ('MoodCare')

Background Coronary heart disease (CHD) and depression are leading causes of disease burden globally and the two often co-exist. Depression is common after Myocardial Infarction (MI) and it has been estimated that 15-35% of patients experience depressive symptoms. Co-morbid depression can impair health related quality of life (HRQOL), decrease medication adherence and appropriate utilisation of health services, lead to increased morbidity and suicide risk, and is associated with poorer CHD risk factor profiles and reduced survival. We aim to determine the feasibility of conducting a randomised, multi-centre trial designed to compare a tele-health program (MoodCare) for depression and CHD secondary prevention, with Usual Care (UC). Methods Over 1600 patients admitted after index admission for Acute Coronary Syndrome (ACS) are being screened for depression at six metropolitan hospitals in the Australian states of Victoria and Queensland. Consenting participants are then contacted at two weeks post-discharge for baseline assessment. One hundred eligible participants are to be randomised to an intervention or a usual medical care control group (50 per group). The intervention consists of up to 10 × 30-40 minute structured telephone sessions, delivered by registered psychologists, commencing within two weeks of baseline screening. The intervention focuses on depression management, lifestyle factors (physical activity, healthy eating, smoking cessation, alcohol intake), medication adherence and managing co-morbidities. Data collection occurs at baseline (Time 1), 6 months (post-intervention) (Time 2), 12 months (Time 3) and 24 months follow-up for longer term effects (Time 4). We are comparing depression (Cardiac Depression Scale [CDS]) and HRQOL (Short Form-12 [SF-12]) scores between treatment and UC groups, assessing the feasibility of the program through patient acceptability and exploring long term maintenance effects. A cost-effectiveness analysis of the costs and outcomes for patients in the intervention and control groups is being conducted from the perspective of health care costs to the government. Discussion This manuscript presents the protocol for a randomised, multi-centre trial to evaluate the feasibility of a tele-based depression management and CHD secondary prevention program for ACS patients. The results of this trial will provide valuable new information about potential psychological and wellbeing benefits, cost-effectiveness and acceptability of an innovative tele-based depression management and secondary prevention program for CHD patients experiencing depression.

Front page schools, back page schools : a case study of factors perceived to affect academic performance in five Papua New Guinea secondary schools

Papua New Guinea has reformed its colonial established education system and made huge investments with the help of donors to achieve equal access and quality education for all its citizens. Despite this national aspiration and these policy reforms and investments, secondary schools that enrol grade 9 students who are relatively equal in education ability show huge disparities in their grade 10 academic performances. This study examined perceptions of students, teachers and principals regarding factors affecting the disparity in academic performance in the context of a developing country. The central question for the study is: What are the perceptions of students and teachers of the factors that affect disparities in secondary schools' academic performance? This qualitative case study involved two high and three low academic performing secondary schools in Western Highlands Province of Papua New Guinea. Primary data were collected through focus groups and semi-structured interviews involving 112 participants. Students and teachers are key participants in this study, as it intends to find out the realities of schools, yet they are an under-researched group. A postcolonial and sense of community conceptual framework was developed for the analysis of the participants. perceptions. In addition, scholarship on school effectiveness and equity in education informed the interpretation of the findings. Three themes were evident in participants. views. First, participants expressed their view that differences in academic performance were related to the adequacy and equitability of resources. The inequities in resource inputs led some of them to coin the metaphor of .back page and front page. schools. Second, many expressed the view that deficiencies in implementing bilingual education, given the difficulty of catering for 800 vernacular languages, contribute to poor English proficiency and subsequent poor academic performance. Finally, participants believed that, in order to have a positive school culture, it is necessary for educators to recognise and respect contemporary students. identities, communal/tribal membership and needs. This study has implications for national education policy on resource allocation to address equality and equity, bilingual education and teacher education. Moreover, as the study found that high academic performance in this context is also influenced by intra-school social relationships, these relationships need to be nurtured. When appropriately nurtured, they become an important factor in sustaining quality education for all secondary school students. This thesis has laid the foundations for further research and invites further investigations into policy and implementation of school reforms aimed at improving academic achievement.

A randomised controlled trial of a theory-based intervention to improve sun protective behaviour in adolescents ('you can still be HOT in the shade') : study protocol

Background: Most skin cancers are preventable by encouraging consistent use of sun protective behaviour. In Australia, adolescents have high levels of knowledge and awareness of the risks of skin cancer but exhibit significantly lower sun protection behaviours than adults. There is limited research aimed at understanding why people do or do not engage in sun protective behaviour, and an associated absence of theory-based interventions to improve sun safe behaviour. This paper presents the study protocol for a school-based intervention which aims to improve the sun safe behaviour of adolescents. Methods/design: Approximately 400 adolescents (aged 12-17 years) will be recruited through Queensland, Australia public and private schools and randomized to the intervention (n = 200) or 'wait-list' control group (n = 200). The intervention focuses on encouraging supportive sun protective attitudes and beliefs, fostering perceptions of normative support for sun protection behaviour, and increasing perceptions of control/self-efficacy over using sun protection. It will be delivered during three × one hour sessions over a three week period from a trained facilitator during class time. Data will be collected one week pre-intervention (Time 1), and at one week (Time 2) and four weeks (Time 3) post-intervention. Primary outcomes are intentions to sun protect and sun protection behaviour. Secondary outcomes include attitudes toward performing sun protective behaviours (i.e., attitudes), perceptions of normative support to sun protect (i.e., subjective norms, group norms, and image norms), and perceived control over performing sun protective behaviours (i.e., perceived behavioural control). Discussion: The study will provide valuable information about the effectiveness of the intervention in improving the sun protective behaviour of adolescents.

The impact of English as a Foreign Language (EFL) listening comprehension through first language (L1) listening strategy training

Listening is the basic and complementary skill in second language learning. The term listening is used in language teaching to refer to a complex process that allows us to understand spoken language. Listening, the most widely used language skill, is often used in conjunction with the other skills of speaking, reading and writing. Listening is not only a skill area in primary language performance (L1), but is also a critical means of acquiring a second language (L2). Listening is the channel in which we process language in real time – employing pacing, units of encoding and decoding (the 2 processes are central to interpretation and meaning making) and pausing (allows for reflection) that are unique to spoken language. Despite the wide range of areas investigated in listening strategies during training, there is a lack of research looking specifically at how effectively L1 listening strategy training may transfer to L2. To investigate the development of any such transfer patterns the instructional design and implementation of listening strategy of L1 will be critical.

Corneal nerve structure and function as markers of diabetic neuropathy

Diabetic neuropathy is a significant clinical problem that currently has no effective therapy, and in advanced cases, leads to foot ulceration and lower limb amputation. The accurate detection, characterisation and quantification of this condition are important in order to define at-risk patients, anticipate deterioration, monitor progression and assess new therapies. This thesis evaluates novel corneal methods of assessing diabetic neuropathy. Over the past several years two new non-invasive corneal markers have emerged, and in cross-sectional studies have demonstrated their ability to stratify the severity of this disease. Corneal confocal microscopy (CCM) allows quantification of corneal nerve parameters and non-contact corneal aesthesiometry (NCCA), the presumed functional correlate of corneal structure, assesses the sensitivity of the cornea. Both these techniques are quick to perform, produce little or no discomfort for the patient, and with automatic analysis paradigms developed, are suitable for clinical settings. Each has advantages and disadvantages over established techniques for assessing diabetic neuropathy. New information is presented regarding measurement bias of CCM images, and a unique sampling paradigm and associated accuracy determination method of combinations is described. A novel high-speed corneal nerve mapping procedure has been developed and application of this procedure in individuals with neuropathy has revealed regions of sub-basal nerve plexus that dictate further evaluation, as they appear to show earlier signs of damage than the central region of the cornea that has to date been examined. The discriminative capacity of corneal sensitivity measured by NCCA is revealed to have reasonable potential as a marker of diabetic neuropathy. Application of these new corneal markers for longitudinal evaluation of diabetic neuropathy has the potential to reduce dependence on more invasive, costly, and time-consuming assessments, such as skin biopsy.

Symmetry of in-shoe force signatures in athletes under field conditions : an application for injury prevention

The aetiology behind overuse injuries such as stress fractures is complex and multi-factorial. In sporting events where the loading is likely to be uneven (e.g. hurdling and jumps), research has suggested that the frequency of stress fractures seems to favour the athlete’s dominant limb. The tendency for an individual to have a preferred limb for voluntary motor acts makes limb selection a possible factor behind the development of unilateral overuse injuries, particularly when repeatedly used during high loading activities. The event of sprint hurdling is well suited for the study of loading asymmetry as the hurdling technique is repetitive and the limb movement asymmetrical. Of relevance to this study is the high incidence of Navicular Stress Fractures (NSF) in hurdlers, with suggestions there is a tendency for the fracture to develop in the trail leg foot, although this is not fully accepted. The Ground Reaction Force (GRF) with each foot contact is influenced by the hurdle action, with research finding step-to-step loading variations. However, it is unknown if this loading asymmetry extends to individual forefoot joints, thereby influencing stress fracture development. The first part of the study involved a series of investigations using a commercially available matrix style in-shoe sensor system (FscanTM, Tekscan Inc.). The suitability of insole sensor systems and custom made discrete sensors for use in hurdling-related training activities was assessed. The methodology used to analyse foot loading with each technology was investigated. The insole and discrete sensors systems tested proved to be unsuitable for use during full pace hurdling. Instead, a running barrier task designed to replicate the four repetitive foot contacts present during hurdling was assessed. This involved the clearance of a series of 6 barriers (low training hurdles), place in a straight line, using 4 strides between each. The second part of the study involved the analysis of "inter-limb" and "within foot loading asymmetries" using stance duration as well as vertical GRF under the Hallux (T1), the first metatarsal head (M1) and the central forefoot peak pressure site (M2), during walking, running, and running with barrier clearances. The contribution to loading asymmetry that each of the four repetitive foot contacts made during a series of barrier clearances was also assessed. Inter-limb asymmetry, in forefoot loading, occurred at discrete forefoot sites in a non-uniform manner across the three gait conditions. When the individual barrier foot contacts were compared, the stance duration was asymmetrical and the proportion of total forefoot load at M2 was asymmetrical. There were no significant differences between the proportion of forefoot load at M1, compared to M2; for any of the steps involved in the barrier clearance. A case study testing experimental (discrete) sensors during full pace sprinting and hurdling found that during both gait conditions, the trail limb experienced the greater vertical GRF at M1 and M2. During full pace hurdling, increased stance duration and vertical loading was a characteristic of the trail limb hurdle foot contacts. Commercially available in-shoe systems are not suitable for on field assessment of full pace hurdling. For the use of discrete sensor technology to become commonplace in the field, more robust sensors need to be developed.

Scenes, quarters and clusters : new experiments in the formation and governance of creative places in China

This thesis examines the formation and governance patterns of the social and spatial concentration of creative people and creative business in cities. It develops a typology for creative places, adding the terms 'scene' and 'quarter' to 'clusters', to fill in the literature gap of partial emphasis on the 'creative clusters' model as an organising mechanism for regional and urban policy. In this framework, a cluster is the gathering of firms with a core focus on economic benefits; a quarter is the urban milieu usually driven by a growth coalition consisting of local government, real estate agents and residential communities; and a scene is the spontaneous assembly of artists, performers and fans with distinct cultural forms. The framework is applied to China, specifically to Hangzhou – a second-tier city in central eastern China that is ambitious to become a 'national cultural and creative industries centre'. The thesis selects three cases – Ideal & Silian 166 Creative Industries Park, White-horse Lake Eco-creative City and LOFT49 Creative Industries Park – to represent scene, quarter and cluster respectively. Drawing on in-depth interviews with initiators, managers and creative professionals of these places, together with extensive documentary analysis, the thesis investigates the composition of actors, characteristics of the locality and the diversity of activities. The findings illustrate that, in China, planning and government intervention is the key to the governance of creative space; spontaneous development processes exist, but these need a more tolerant environment, a greater diversity of cultural forms and more time to develop. Moreover, the main business development model is still real estate based: this model needs to incorporate more mature business models and an enhanced IP protection system. The thesis makes a contribution to literature on economic and cultural geography, urban planning and creative industries theory. It advocates greater attention to self-management, collaborative governance mechanisms and business strategies for scenes, quarters and clusters. As intersections exist in the terms discussed, a mixed toolkit of the three models is required to advance the creative city discourse in China.

Quantity of documentation of maltreatment risk factors in injury-related paediatric hospitalisations

Background While child maltreatment is recognised as a global problem, solid epidemiological data on the prevalence of child maltreatment and risk factors associated with child maltreatment is lacking in Australia and internationally. There have been recent calls for action to improve the evidence-base capturing and describing child abuse, particularly those data captured within the health sector. This paper describes the quantity of documentation of maltreatment risk factors in injury-related paediatric hospitalisations in Queensland, Australia. Methods This study involved a retrospective medical record review, text extraction and coding methodology to assess the quantity of documentation of risk factors and the subsequent utility of data in hospital records for describing child maltreatment and data linkage to Child Protection Service (CPS). Results There were 433 children in the maltreatment group and 462 in the unintentional injury group for whom medical records could be reviewed. Almost 93% of the any maltreatment code sample, but only 11% of the unintentional injury sample had documentation identified indicating the presence of any of 20 risk factors. In the maltreatment group the most commonly documented risk factor was history of abuse (41%). In those with an unintentional injury, the most commonly documented risk factor was alcohol abuse of the child or family (3%). More than 93% of the maltreatment sample also linked to a child protection record. Of concern are the 16% of those children who linked to child protection who did not have documented risk factors in the medical record. Conclusion Given the importance of the medical record as a source of information about children presenting to hospital for treatment and as a potential source of evidence for legal action the lack of documentation is of concern. The details surrounding the injury admission and consideration of any maltreatment related risk factors, both identifying their presence and ruling them out are required for each and every case. This highlights the need for additional training for clinicians to understand the importance of their documentation in child injury cases.

Domestic and international strategies in the Queensland wine industry

Purpose Over the past decade, the Queensland wine industry has experienced a greater percentage growth than the Australian national average. The aim of the research undertaken for this article is to identify specific national and international strategies that have allowed the industry to achieve this level of growth. Design/methodology/approach The study involved a quantitative survey of all Queensland wineries at the time (n=101), using a five-point Likert-scaled questionnaire with questions developed from the literature, together with a small-scale qualitative survey involving in-depth interviews of winery managers and industry leaders. Findings The findings indicated that key strategies in the domestic sector included a focus on cellar door sales combined with establishing links with the tourism industry, together with an incremental expansion of domestic markets. For the international sector, additional strategies included targeting familiar, psychically-close and niche markets in the initial stages of exporting, as well as taking advantage of firm-specific strengths and managerial competencies. Originality/value Not previously regarded as a major wine producing region of Australia, the Queensland wine industry has received limited attention in the literature, particularly the reasons for its rapid growth in recent years. The article helps to identify the strategies used by wineries in growing the industry.

Why the construction quality of design-build projects is not satisfactory : a Queensland study

Design-build (DB) system is well-known to be a popular and effective delivery method of construction work worldwide. It has been demonstrated as superior to the traditional delivery system in regards to time and cost performance. However, it suffers a major flaw, in that the performance of project quality cannot be guaranteed. This paper aims to investigate the underlying factors attributing to the poor quality performance of design-build projects in Queensland. Five major factors were first identified through a comprehensive literature review, which relate to (1) project briefing and scope definition, (2) client’s role and responsibility, (3) procurement selection, (4) contractor’s incentive, and (5) design document quality. A questionnaire survey with 127 DB professionals was conducted to determine how these factors affect various quality criteria, i.e. functional quality, architectural quality, technical quality, workmanship quality, client satisfaction and overall quality. With the architectural quality reduced greatly, the research findings reveal that the DB projects in Queensland have the reduced overall quality compared with traditional projects. The impacts of different factors on the quality performance of DB projects have been closely examined and summarized. The research findings will facilitate project stakeholder’s better understanding of the delivery process of the DB system and provide guidelines to improve the quality performance.

An interpretation of current progress towards an industry model for Queensland's surveying and mapping industry

A strongly progressive surveying and mapping industry depends on a shared understanding of the industry as it exists, some shared vision or imagination of what the industry might become, and some shared action plan capable of bringing about a realisation of that vision. The emphasis on sharing implies a need for consensus reached through widespread discussion and mutual understanding. Unless this occurs, concerted action is unlikely. A more likely outcome is that industry representatives will negate each other's efforts in their separate bids for progress. The process of bringing about consensual viewpoints is essentially one of establishing an industry identity. Establishing the industry's identity and purpose is a prerequisite for rational development of the industry's education and training, its promotion and marketing, and operational research that can deal .with industry potential and efficiency. This paper interprets evolutionary developments occurring within Queensland's surveying and mapping industry within a framework that sets out logical requirements for a viable industry.

ACE research briefing paper 005: Global Entrepreneurship Monitor (GEM) - Australia 2011 National Report

This report maps the current state of entrepreneurship in Australia using data from the Global Entrepreneurship Monitor (GEM) for the year 2011. Entrepreneurship is regarded as a crucial driver for economic well-being. Entrepreneurial activity in new and established firms drives innovation and creates jobs. Entrepreneurs also fuel competition thereby contributing indirectly to market and productivity growth along with improving competitiveness of the national economy. Given the economic landscape that exists as a result of the global financial crisis (GFC), it is probably more important than ever for us to understand the effects and drivers of entrepreneurial activity and attitudes in Australia. The central finding of this report is that entrepreneurship is certainly alive and well in Australia. With 10.5 per cent of the adult population involved in setting up a new business or owning a newly founded business as measured by the total entrepreneurial activity rate (TEA) in 2011, Australia ranks second only to the United States among the innovation-driven (developed) economies. Compared with 2010 the TEA rate has increased by 2.7 percentage points. Furthermore, in regard to employee entrepreneurial activity (EEA) rate in established firms, Australia ranks above average. According to GEM data, 5 per cent of the adult population is engaged in developing or launching new products, a new business unit or subsidiary for their employer. Further analysis of the GEM data also clearly shows that Australia compares well with other major economies in terms of the ‘quality’ of entrepreneurial activities being pursued. Indeed, it is not only the quantity of entrepreneurs but also the level of their aspirations and business goals that are important drivers for economic growth. On average, for each business started in Australia driven by the lack of alternatives for the founder to generate income from any other source, there are five other businesses started where the founders specifically want to take advantage of a business opportunity that they believe will increase their personal income or independence. With respect to innovativeness, 31 per cent of Australian new businesses offer products or services which they consider to be new to customers or where very few, or in some cases no, other businesses offer the same product or service. Both these indicators are higher than the average for innovation-driven economies. Somewhat below average is the international orientation of Australian entrepreneurs whereby only 12 per cent aim at having a substantial share of customers from international markets. So what drives this high quantity and quality of entrepreneurship in Australia? The analysis of the data suggests it is a combination of both business opportunities and entrepreneurial skills. It seems that around 50 per cent of the Australian population identify opportunities for a start-up venture and believe that they have the necessary skills to start a business. Furthermore, a large majority of the Australian population report that high media attention for entrepreneurship provides successful role models for prospective entrepreneurs. As a result, 12 per cent of our respondents have expressed the intention to start a business within the next three years. These numbers are all well above average when compared to the other major economies. With regard to gender, the GEM survey shows a high proportion of female entrepreneurs. Approximately 8.4 per cent of adult females are actually involved in setting up a business or have recently done so. Although this female TEA rate is slightly down from 2010, Australia ranks second among the innovation-driven economies. This paints a healthy picture of access to entrepreneurial opportunities for Australian women.

Bicycle safety for children and young people : an analysis of child deaths in Queensland

Bicycle riding can be a positive experience for children and young people that builds confidence, independence and promotes healthy recreation. However, these benefits are dependent upon safe bicycle riding practices. Between 1 January 2004 and 31 December 2011, 12 children and young people under the age of 18 years died in bicycle incidents in Queensland. An additional 1736 bicycle-related injuries requiring emergency department attendance are estimated to have occurred between 2008 and 2009 in Queensland for children and young people under the age of 18 years. Of the twelve bicycle-related deaths between 2004 and 2011 in Queensland, two children were aged between 5-9 years, 5 young people were 10-14 years of age and 5 young people were between 15-17 years. The two children aged 5-9 years were riding their bikes for recreation. Children aged 10-14 years were most likely to have been killed in an incident while riding to school in the morning, with teenagers aged 15-17 years most likely to be killed in incidents occurring after school and in the evening. Bicycle riders are vulnerable road users, particularly children and young people. This is due to several factors that can be grouped into: 1) developmental characteristics such as body size and proportions, perceptional and attentional issues, road safety awareness and risk taking behaviours, and 2) environmental factors such as supervision and shared road use with vehicles. This paper examines safety issues for children and young people who have died in bicycle-related incidents in Queensland, and outlines areas of focus for injury prevention practitioners.

Factors facilitating or constraining the fieldwork practicum experience for culturally and linguistically diverse student teachers in Queensland schools

Increasing numbers of Culturally And Linguistically Diverse (CALD) students, both from the international and domestic sectors are undertaking teacher education programs at Australian universities. While many have positive practicum experiences, there are a significant number who experience difficulties. Little work has been done on viewing this situation from a sociocultural perspective where learning is seen as a form of socialisation into the different beliefs, values and practices of the new community, the placement school. This study argues that all student teachers, particularly pre-service CALD teachers, require active learning communities to become successful. Using perspectives derived from situated learning (Lave & Wenger, 1991) and community of practice theory (Wenger, 1998) this study illustrates the processes of learning and identity development and the factors that facilitate or constrain the practicum experience for CALD pre-service teachers. This study adopts a methodology that is grounded in narrative inquiry, with in-depth interview techniques used to explore CALD teachers’ experiences of their fieldwork practicum and their attempts to participate and practice successfully. The data derived from fourteen in-depth narratives of pre-service CALD teachers is analysed from a sociocultural perspective. The practicum for these students is an experience of legitimate peripheral participation in a community of practice (the practicum school), and the complex nature of the social experience as they engaged in building their professional identity as a teacher is discussed. This analysis is used to propose recommendations and strategies at the faculty and school levels to support positive learning and practicum experiences for this group of student teachers.