The acceptability, usability and short-term outcomes of Get Real: A web-based program for psychotic-like experiences (PLEs)

Background Psychotic-like experiences (PLEs) are subclinical delusional ideas and perceptual disturbances that have been associated with a range of adverse mental health outcomes. This study reports a qualitative and quantitative analysis of the acceptability, usability and short term outcomes of Get Real, a web program for PLEs in young people. Methods Participants were twelve respondents to an online survey, who reported at least one PLE in the previous 3 months, and were currently distressed. Ratings of the program were collected after participants trialled it for a month. Individual semi-structured interviews then elicited qualitative feedback, which was analyzed using Consensual Qualitative Research (CQR) methodology. PLEs and distress were reassessed at 3 months post-baseline. Results User ratings supported the program's acceptability, usability and perceived utility. Significant reductions in the number, frequency and severity of PLE-related distress were found at 3 months follow-up. The CQR analysis identified four qualitative domains: initial and current understandings of PLEs, responses to the program, and context of its use. Initial understanding involved emotional reactions, avoidance or minimization, limited coping skills and non-psychotic attributions. After using the program, participants saw PLEs as normal and common, had greater self-awareness and understanding of stress, and reported increased capacity to cope and accept experiences. Positive responses to the program focused on its normalization of PLEs, usefulness of its strategies, self-monitoring of mood, and information putting PLEs into perspective. Some respondents wanted more specific and individualized information, thought the program would be more useful for other audiences, or doubted its effectiveness. The program was mostly used in low-stress situations. Conclusions The current study provided initial support for the acceptability, utility and positive short-term outcomes of Get Real. The program now requires efficacy testing in randomized controlled trials.

Development and evaluation of training in culturally specific screening and brief intervention for hospital patients with alcohol-related injuries

Objective To evaluate health practitioners’ confidence and knowledge of alcohol screening, brief intervention and referral after training in a culturally adapted intervention on alcohol misuse and well-being issues for trauma patients. Design Mixed methods, involving semi-structured interviews at baseline and a post-workshop questionnaire. Setting: Targeted acute care within a remote area major tertiary referral hospital. Participants Ten key informants and 69 questionnaire respondents from relevant community services and hospital-based health care professionals. Intervention Screening and brief intervention training workshops and resources for 59 hospital staff. Main outcome measures Self-reported staff knowledge of alcohol screening, brief intervention and referral, and satisfaction with workshop content and format. Results After training, 44% of participants reported being motivated to implement alcohol screening and intervention. Satisfaction with training was high, and most participants reported that their knowledge of screening and brief intervention was improved. Conclusion Targeted educational interventions can improve the knowledge and confidence of inpatient staff who manage patients at high risk of alcohol use disorder. Further research is needed to determine the duration of the effect and influence on practice behaviour. Ongoing integrated training, linked with systemic support and established quality improvement processes, is required to facilitate sustained change and widespread dissemination.

Inter-seasonal population dynamics and pest status of Bemisia tabaci (Gennadius) biotype B in an Australian cropping system

Bemisia tabaci, biotype B, commonly known as the silverleaf whitefly (SLW) is an alien species that invaded Australia in the mid-90s. This paper reports on the invasion ecology of SLW and the factors that are likely to have contributed to the first outbreak of this major pest in an Australian cotton cropping system, population dynamics of SLW within whitefly-susceptible crop (cotton and cucurbit) and non-crop vegetation (sowthistle, Sonchus spp.) components of the cropping system were investigated over four consecutive growing seasons (September-June) 2001/02-2004/05 in the Emerald Irrigation Area (EIA) of Queensland, Australia. Based on fixed geo-referenced sampling sites, variation in spatial and temporal abundance of SLW within each system component was quantified to provide baseline data for the development of ecologically sustainable pest management strategies. Parasitism of large (3rd and 4th instars) SLW nymphs by native aphelinid wasps was quantified to determine the potential for natural control of SLW populations. Following the initial outbreak in 2001/02, SLW abundance declined and stabilised over the next three seasons. The population dynamics of SLW is characterised by inter-seasonal population cycling between the non-crop (weed) and cotton components of the EIA cropping system. Cotton was the largest sink for and source of SLW during the study period. Over-wintering populations dispersed from weed host plant sources to cotton in spring followed by a reverse dispersal in late summer and autumn to broad-leaved crops and weeds. A basic spatial source-sink analysis showed that SLW adult and nymph densities were higher in cotton fields that were closer to over-wintering weed sources throughout spring than in fields that were further away. Cucurbit fields were not significant sources of SLW and did not appear to contribute significantly to the regional population dynamics of the pest. Substantial parasitism of nymphal stages throughout the study period indicates that native parasitoid species and other natural enemies are important sources of SLW mortality in Australian cotton production systems. Weather conditions and use of broad-spectrum insecticides for pest control are implicated in the initial outbreak and on-going pest status of SLW in the region.

Climate change effects on pasture systems in south-eastern Australia.

Climate change projections for Australia predict increasing temperatures, changes to rainfall patterns, and elevated atmospheric carbon dioxide (CO2) concentrations. The aims of this study were to predict plant production responses to elevated CO2 concentrations using the SGS Pasture Model and DairyMod, and then to quantify the effects of climate change scenarios for 2030 and 2070 on predicted pasture growth, species composition, and soil moisture conditions of 5 existing pasture systems in climates ranging from cool temperate to subtropical, relative to a historical baseline. Three future climate scenarios were created for each site by adjusting historical climate data according to temperature and rainfall change projections for 2030, 2070 mid-and 2070 high-emission scenarios, using output from the CSIRO Mark 3 global climate model. In the absence of other climate changes, mean annual pasture production at an elevated CO2 concentration of 550 ppm was predicted to be 24-29% higher than at 380 ppm CO2 in temperate (C-3) species-dominant pastures in southern Australia, with lower mean responses in a mixed C-3/C-4 pasture at Barraba in northern New South Wales (17%) and in a C-4 pasture at Mutdapilly in south-eastern Queensland (9%). In the future climate scenarios at the Barraba and Mutdapilly sites in subtropical and subhumid climates, respectively, where climate projections indicated warming of up to 4.4 degrees C, with little change in annual rainfall, modelling predicted increased pasture production and a shift towards C-4 species dominance. In Mediterranean, temperate, and cool temperate climates, climate change projections indicated warming of up to 3.3 degrees C, with annual rainfall reduced by up to 28%. Under future climate scenarios at Wagga Wagga, NSW, and Ellinbank, Victoria, our study predicted increased winter and early spring pasture growth rates, but this was counteracted by a predicted shorter spring growing season, with annual pasture production higher than the baseline under the 2030 climate scenario, but reduced by up to 19% under the 2070 high scenario. In a cool temperate environment at Elliott, Tasmania, annual production was higher than the baseline in all 3 future climate scenarios, but highest in the 2070 mid scenario. At the Wagga Wagga, Ellinbank, and Elliott sites the effect of rainfall declines on pasture production was moderated by a predicted reduction in drainage below the root zone and, at Ellinbank, the use of deeper rooted plant systems was shown to be an effective adaptation to mitigate some of the effect of lower rainfall.

Review of approaches to evaluate the effectiveness of weed biological control agents

We review key issues, available approaches and analyses to encourage and assist practitioners to develop sound plans to evaluate the effectiveness of weed biological control agents at various phases throughout a program. Assessing the effectiveness of prospective agents before release assists the selection process, while post-release evaluation aims to determine the extent that agents are alleviating the ecological, social and economic impacts of the weeds. Information gathered on weed impacts prior to the initiation of a biological control program is necessary to provide baseline data and devise performance targets against which the program can subsequently be evaluated. Detailed data on weed populations, associated plant communities and, in some instances ecosystem processes collected at representative sites in the introduced range several years before the release of agents can be compared with similar data collected later to assess agent effectiveness. Laboratory, glasshouse and field studies are typically used to assess agent effectiveness. While some approaches used for field studies may be influenced by confounding factors, manipulative experiments where agents are excluded (or included) using chemicals or cages are more robust but time-consuming and expensive to implement. Demographic modeling and benefit–cost analyses are increasingly being used to complement other studies. There is an obvious need for more investment in long-term post-release evaluation of agent effectiveness to rigorously document outcomes of biological control programs.

Lower preoperative quality of life increases postoperative risk of adverse events in women with endometrial cancer: results from the LACE trial

Objective: To examine the association between preoperative quality of life (QoL) and postoperative adverse events in women treated for endometrial cancer. Methods: 760 women with apparent Stage I endometrial cancer were randomised into a clinical trial evaluating laparoscopic versus open surgery. This analysis includes women with preoperative QoL measurements, from the Functional Assessment of Cancer Therapy- General (FACT-G) questionnaire, and who were followed up for at least 6 weeks after surgery (n=684). The outcomes for this study were defined as (1) the occurrence of moderate to severe AEs adverse events within 6 months (Common Toxicology Criteria (CTC) grade ≥3); and (2) any Serious Adverse Event (SAE). The association between preoperative QoL and the occurrence of AE was examined, after controlling for baseline comorbidity and other factors. Results: After adjusting for other factors, odds of occurrence of AE of CTC grade ≥3 were significantly increased with each unit decrease in baseline FACT-G score (OR=1.02, 95% CI 1.00-1.03, p=0.030), which was driven by physical well-being (PWB) (OR=1.09, 95% CI 1.04-1.13, p=0.0002) and functional well-being subscales (FWB) (OR=1.04, 95% CI 1.00-1.07, p=0.035). Similarly, odds of SAE occurrence were significantly increased with each unit decrease in baseline FACT-G score (OR=1.02, 95% CI 1.01-1.04, p=0.011), baseline PWB (OR=1.11, 95% CI 1.06-1.16, p<0.0001) or baseline FWB subscales (OR=1.05, 95% CI 1.01-1.10, p=0.0077). Conclusion: Women with early endometrial cancer presenting with lower QoL prior to surgery are at higher risk of developing a serious adverse event following surgery. Funding: Cancer Council Queensland, Cancer Council New South Wales, Cancer Council Victoria, Cancer Council, Western Australia; NHMRC project grant 456110; Cancer Australia project grant 631523; The Women and Infants Research Foundation, Western Australia; Royal Brisbane and Women’s Hospital Foundation; Wesley Research Institute; Gallipoli Research Foundation; Gynetech; TYCO Healthcare, Australia; Johnson and Johnson Medical, Australia; Hunter New England Centre for Gynaecological Cancer; Genesis Oncology Trust; and Smart Health Research Grant QLD Health.

Quality of life changes during conformal radiation therapy for prostate carcinoma

BACKGROUND: The objective of this study was to describe prospectively quality of life (QOL) before and after radiotherapy for patients with prostate carcinoma. METHODS: Forty-three patients with T1-T3 prostate carcinoma who underwent conformal external beam radiation therapy were randomized either to the complete European Organization for Research and Treatment of Cancer (EORTC) QOL questionnaire (EORTC QLQ-C30) or the Medical Outcomes Study Group Short Form Health Survey (SF-36) at baseline, at 3 weeks and 6 weeks after initial treatment, and at 6 weeks and 5 months after the completion of radiotherapy. The measures were self-reported patient QOL, and values are given as the mean +/- standard error of the mean. Changes in QOL are described from baseline to the end of treatment in both questionnaire groups. RESULTS: Emotional role functioning, as measured with the SF-36 questionnaire, significantly improved from 68.2 +/- 9.9 at baseline to 93.3 +/- 5.2 at the end of therapy (P = 0.02). The EORTC QLQ-C30 questionnaire revealed consistent values of emotional functioning during treatment (72.7 +/- 5.9 at baseline) but showed a significant improvement 6 weeks after therapy (89.0 +/- 4.4; P = 0.01). Role functioning deteriorated from 80.1 +/- 6.5 at baseline to 62.5 +/- 8.8 at the end of radiotherapy (P = 0.02). Symptoms of fatigue were shown to increase significantly from 26.9 +/- 6.0 at baseline to 37.7 +/- 7.6 at the end of therapy (P = 0.02). No significant changes in the other dimensions were observed in either questionnaire. CONCLUSIONS: After radiotherapy for prostate carcinoma, patients experience a temporary deterioration of fatigue and role functioning, as measured with the EORTC QLQ-C-30. Despite physical deterioration, the authors observed an improvement in emotional functioning scores with both questionnaires. This may have been due to psychological adaptation and coping.

Hypoxic corneal changes following 8 hours of scleral contact lens wear

- Purpose To examine the change in corneal thickness and posterior curvature following 8 hours of miniscleral contact lens wear. - Methods Scheimpflug imaging (Pentacam HR, Oculus) was captured before, and immediately following, 8 hours of miniscleral contact lens wear for 15 young (mean age 22 ± 3 years), healthy participants with normal corneae. Natural diurnal variations were considered by measuring baseline corneal changes obtained on a separate control day without contact lens wear. - Results Over the central 6 mm of the cornea, a small, but highly statistically significant amount of edema was observed following 8 hours of miniscleral lens wear, after accounting for normal diurnal fluctuations (mean ± standard deviation percentage swelling 1.70 ± 0.98%, p < 0.0001). Posterior corneal topography remained stable following lens wear (-0.01 ± 0.07 mm steepening over the central 6 mm, p = 0.60). The magnitude of posterior corneal topographical changes following lens wear did not correlate with the extent of lens-related corneal edema (r = -0.16, p = 0.57). Similarly, the initial central corneal vault (maximum post-lens tear layer depth) was not associated with corneal swelling following lens removal (r = 0.27, p = 0.33). - Conclusions While a small amount of corneal swelling was induced following 8 hours of miniscleral lens wear (on average <2%), modern high Dk miniscleral contact lenses that vault the cornea do not induce clinically significant corneal edema or hypoxic related posterior corneal curvature changes during short-term wear. Longer-term studies of compromised eyes (e.g. corneal ectasia) are still required to inform the optimum lens and fitting characteristics for safe scleral lens wear to minimize corneal hypoxia.

Family-based programmes for preventing smoking by children and adolescents: Evidence and implications for public health

- P -General population, nonsmoking children (aged 5 to 12) and adolescents (aged 13 to 18) with their parents - I -Interventions with children and family members intended to deter tobacco use. Any components to change parenting behaviour, parental or sibling smoking behaviour, or family communication and interaction. - C -Usual practice, or a program of no family intervention - O -Smoking status of children who reported no use of tobacco at baseline.

Growth and carcass characteristics of cast-for-age Merino ewes fed sorghum-based feedlot diets

Grain feeding low bodyweight, cast-for-age (CFA) sheep from pastoral areas of eastern Australia at the end of the growing season can enable critical carcass weight grades to be achieved and thus yield better economic returns. The aim of this work was to compare growth and carcass characteristics for CFA Merino ewes consuming either simple diets based on whole sorghum grain or commercial feed pellets. The experiment also compared various sources of additional nitrogen (N) for inclusion in sorghum diets and evaluated several introductory regimes. Seventeen ewes were killed initially to provide baseline carcass data and the remaining 301 ewes were gradually introduced to the concentrate diets over 14 days before being fed concentrates and wheaten hay ad libitum for 33 or 68 days. Concentrate treatments were: (i) commercial feed pellets, (ii) sorghum mix (SM; whole sorghum grain, limestone, salt and molasses) + urea and ammonium sulfate (SMU), (iii) SMU + whole cottonseed at 286 g/kg of concentrate dry matter (DM), (iv) SM + cottonseed meal at 139 g/kg of concentrate DM, (v) SMU + virginiamycin (20 mg/kg of concentrate) for the first 21 days of feeding, and (vi) whole cottonseed gradually replaced by SMU over the first 14 days of feeding. The target carcass weight of 18 kg was achieved after only 33 days on feed for the pellets and the SM + cottonseed meal diet. All other whole grain sorghum diets required between 33 and 68 days on feed to achieve the target carcass weight. Concentrates based on whole sorghum grain generally produced significantly (P < 0.05) lower carcass weight and fat score than pellets and this may have been linked to the significantly (P < 0.05) higher faecal starch concentrations for ewes consuming sorghum-based diets (270 v. 72 g/kg DM on day 51 of feeding for sorghum-based diets and pellets, respectively). Source of N in whole grain sorghum rations and special introductory regimes had no significant (P > 0.05) effects on carcass weight or fat score of ewes with the exception of carcass weight for SMU + whole cottonseed being significantly lower than SM + cottonseed meal at day 33. Ewes finished on all diets produced acceptable carcasses although muscle pH was high in all ewe carcasses (average 5.8 and 5.7 at 33 and 68 days, respectively). There were no significant (P > 0.05) differences between diets in concentrate DM intake, rumen fluid pH, meat colour score, fat colour score, eye muscle area, meat pH or meat temperature.

Concentrates based on sorghum grain provide a basis for a finishing system for crossbred lambs

In parts of Australia, sorghum grain is a cheaper alternative to other cereal grains but its use and nutritive value in sheep feeding systems is not well understood. The aim of this work was to compare growth and carcass characteristics for crossbred lambs consuming several simple, sorghum-based diets. The treatments were: (1) whole sorghum grain, (2) whole sorghum grain + urea and ammonium sulfate, (3) cracked sorghum grain + urea and ammonium sulfate, (4) expanded sorghum grain + urea and ammonium sulfate, (5) whole sorghum grain + cottonseed meal, and (6) whole sorghum grain + whole cottonseed. Nine lambs were slaughtered initially to provide baseline carcass data and the remaining 339 lambs were gradually introduced to the concentrate diets over 14 days before being fed concentrates and wheaten hay ad libitum for 41, 56 or 76 days. Neither cracking nor expanding whole sorghum grain with added non-protein nitrogen (N) resulted in significantly (P > 0.05) increased final liveweight, growth rates or carcass weights for lambs, or in decreased days on feed to reach 18-kg carcass weight, although carcass fat depth was significantly (P < 0.05) increased compared with the whole sorghum plus non-protein N diet. However, expanding sorghum grain significantly (P < 0.05) reduced faecal starch concentrations compared with whole or cracked sorghum diets with added non-protein N (79 v. 189 g/kg DM after 59 days on feed). Lambs fed whole sorghum grain without an additional N source had significantly (P < 0.05) lower concentrate intake and required significantly (P < 0.05) more days on feed to reach a carcass weight of 18 kg than for all diets containing added N. These lambs also had significantly (P < 0.05) lower carcass weight and fat depth than for lambs consuming whole sorghum plus true protein diets. Substituting sources of true protein (cottonseed meal and whole cottonseed) for non-protein N (urea and ammonium sulfate) did not significantly (P > 0.05) affect concentrate intakes or carcass weights of lambs although carcass fat depth was significantly (P < 0.05) increased and the days to reach 18-kg carcass weight were significantly (P < 0.05) decreased for the whole sorghum plus cottonseed meal diet. In conclusion, processing sorghum grain by cracking or expanding did not significantly improve lamb performance. While providing an additional N source with sorghum grain significantly increased lamb performance, there was no benefit in final carcass weight of lambs from substituting sources of true protein for non-protein N.

Queensland Coastal Wetland Resources: Cape Tribulation to Bowling Green Bay

This report provides key resource data for the ongoing assessment of the requirement for additional Marine Protected Areas (e.g. FHAs under the Queensland Fisheries Act 1994) in regions of high fish habitat value in northern Queensland from Cape Tribulation to Bowling Green Bay (hereafter referred to as the Study Area). The study also provides baseline information on the coastal wetlands within this Study Area for consideration in the Ramsar site nomination process. The Study Area extends from Cape Tribulation (16o 6’S, 145o 24’E) to Bowling Green Bay (19o 30’S, 147o 24’E) in tropical north Queensland. The project aimed to: 1. document and map the coastal wetland communities of the Study Area; 2. document levels of existing disturbance to and protection of the wetlands; 3. examine existing recreational, indigenous and commercial fisheries resources in the region; 4. evaluate the conservation values of the areas investigated from the viewpoint of fisheries productivity and as habitat for important and/or threatened species for future FHA/MPA declaration. Dataset URL Link: Queensland Coastal Wetlands Resources Mapping data. [Dataset]

Queensland Coastal Wetland Resource Investigation of the Bowen Region: Cape Upstart to Gloucester Island

The wetland resources of the Queensland coastline have been mapped as a baseline dataset for Marine Protected Area investigation and particularly Fish Habitat Area (FHA) declaration, Ramsar site nomination and continued monitoring of these important fish habitats. This report summarises the results of the mapping undertaken in the Bowen region from the East Coast of Cape Upstart (Abbot Bay) to Gloucester Island (encompassing Edgecumbe Bay). The study was undertaken in order to: 1. document and map the coastal wetland communities within the Bowen region; 2. document levels of existing disturbance to and protection of the wetlands; 3. examine existing recreational and commercial fisheries in the region; and 4. evaluate the significance of the coastal wetlands in the region. Dataset URL Link: Queensland Coastal Wetlands Resources Mapping data. [Dataset]

Lähiympäristö nepalilaisessa arjessa - oppilaiden ja opettajien käsityksiä omista vaikutusmahdollisuuksistaan

Aims. Sustainable development has become the most important theme in the development co-operation in the 21st century. Sustainable development is pursued by environmental education among other things. This research rose from the discussion about the meaning of environmental education in developing countries and especially the effect it might have in the environment and society. Nepal and one of its rural private schools was selected as a research object. The themes and questions of the research are: 1. Conceptions of the immediate environment of students and teachers: What does immediate environment mean according to the students and teachers? 2. Students most important acts in the environment: What kind of effect do the students think they can have on the environment in their everyday life? 3. Teachers opinions, experiences and methods in environmental education: What do teachers think should be taught to the students in environmental education? What are the teachers actually teaching? What kind of methods are the teachers using while teaching environmental education? Researching the conceptions of immediate environment and acts in the environment gives information about the students and teachers relation with the nature in their everyday life and the baseline from which environmental education will be implemented from. Teachers opinions, experiences and methods in environmental education provide information on the current implementation of the environmental education. Methods. Ethnography was selected as a research method. Before collecting the actual data, a pre-study was conducted. The aim of the pre-study was to specify the research themes and practice the cross-cultural interview as a research method. The actual data was collected in the last week of January 2010 in Dhangadhi, Nepal. The data included twenty-two drawings and captions from the students and one group interview with the teachers. The data was analyzed with brief quantitative analysis and full analysis was done with a qualitative method called content analysis. Results and conclusions. Teachers and student s conceptions of immediate environment differ from each other. Students saw the immediate environment from the scientific approach while the teachers thought it was more social conception. The interface was found in their own personal environment. This interface is a good baseline for environmental education. The most important acts in the environment for the students were protection towards the environment. The students saw their possibilities to have an influence in the environment through the school. A connection between the school and acting in the environment was evident. In the teachers opinions and experiences of environmental education, environmental problems and the importance of teaching attitudes and values were found. No logic thematic entities were discovered but the teachers did use different kinds of methods in their teaching. Achieving the international aims for environmental education was very challenging in the research school because of the teachers lack of information and skills to teach the subject. The context where the school works was also challenging.

Osseointegrated total knee replacement connected to a lower limb prosthesis: 4 cases

Background and purpose — Osseointegrated implants are an alternative for prosthetic attachment in individuals with amputation who are unable to wear a socket. However, the load transmitted through the osseointegrated fixation to the residual tibia and knee joint can be unbearable for those with transtibial amputation and knee arthritis. We report on the feasibility of combining total knee replacement (TKR) with an osseointegrated implant for prosthetic attachment. Patients and methods — We retrospectively reviewed all 4 cases (aged 38–77 years) of transtibial amputations managed with osseointegration and TKR in 2012–2014. The below-the-knee prosthesis was connected to the tibial base plate of a TKR, enabling the tibial residuum and knee joint to act as weight-sharing structures. A 2-stage procedure involved connecting a standard hinged TKR to custom-made implants and creation of a skin-implant interface. Clinical outcomes were assessed at baseline and after 1–3 years of follow-up using standard measures of health-related quality of life, ambulation, and activity level including the questionnaire for transfemoral amputees (Q-TFA) and the 6-minute walk test. Results — There were no major complications, and there was 1 case of superficial infection. All patients showed improved clinical outcomes, with a Q-TFA improvement range of 29–52 and a 6-minute walk test improvement range of 37–84 meters. Interpretation — It is possible to combine TKR with osseointegrated implants.