Validation of the Edinburgh Postnatal Depression Scale for men, and comparison of item endorsement with their partners

BACKGROUND: The Edinburgh Postnatal Depression Scale (EPDS) has been validated and used extensively in screening for depression in new mothers, both in English speaking and non-English speaking communities. While some studies have reported the use of the EPDS with fathers, none have validated it for this group, and thus the appropriate cut-off score for screening for depression or anxiety caseness for this population is not known. METHODS: Couples were recruited antenatally and interviewed at six weeks postpartum. EPDS scores and distress caseness (depression or anxiety disorders) for 208 fathers and 230 mothers were determined using the Diagnostic Interview Schedule. RESULTS: Analyses of the EPDS for fathers using distress caseness (depression or anxiety disorders) as the criterion shows that a cut-off of 5/6 has optimum receiver operating characteristics. Furthermore acceptable reliability (split-half and internal consistency) and validity (concurrent) coefficients were obtained. For mothers the optimum cut-off screening value to detect distress caseness was 7/8. Item analysis revealed that fathers endorsed seven of the ten items at lower rates to mothers, with the most significant being that referring to crying. CONCLUSIONS: The EPDS is a reliable and valid measure of mood in fathers. Screening for depression or anxiety disorders in fathers requires a two point lower cut-off than screening for depression or anxiety in mothers, and we recommend this cut-off to be 5/6

Tissue engineering of articular cartilage with biomimetic zones

Articular cartilage damage is a persistent and increasing problem with the aging population, and treatments to achieve biological repair or restoration remain a challenge. Cartilage tissue engineering approaches have been investigated for over 20 years, but have yet to achieve the consistency and effectiveness for widespread clinical use. One of the potential reasons for this is that the engineered tissues do not have or establish the normal zonal organization of cells and extracellular matrix that appears critical for normal tissue function. A number of approaches are being taken currently to engineer tissue that more closely mimics the organization of native articular cartilage. This review focuses on the zonal organization of native articular cartilage, strategies being used to develop such organization, the reorganization that occurs after culture or implantation, and future prospects for the tissue engineering of articular cartilage with biomimetic zones.

Construction virtual prototyping : a survey of use

Purpose –The introduction of Building Information Model tools over the last 20 years is resulting in radical changes in the Architectural, Engineering and Construction industry. One of these changes concerns the use of Virtual Prototyping - an advanced technology integrating BIM with realistic graphical simulations. Construction Virtual Prototyping (CVP) has now been developed and implemented on ten real construction projects in Hong Kong in the past three years. This paper reports on a survey aimed at establishing the effects of adopting this new technology and obtaining recommendations for future development. Design/methodology/approach – A questionnaire survey was conducted in 2007 of 28 key participants involved in four major Hong Kong construction projects – these projects being chosen because the CVP approach was used in more than one stage in each project. In addition, several interviews were conducted with the project manager, planning manager and project engineer of an individual project. Findings –All the respondents and interviewees gave a positive response to the CVP approach, with the most useful software functions considered to be those relating to visualisation and communication. The CVP approach was thought to improve the collaboration efficiency of the main contractor and sub-contractors by approximately 30 percent, and with a concomitant 30 to 50 percent reduction in meeting time. The most important benefits of CPV in the construction planning stage are the improved accuracy of process planning and shorter planning times, while improved fieldwork instruction and reducing rework occur in the construction implementation stage. Although project teams are hesitant to attribute the use of CVP directly to any specific time savings, it was also acknowledged that the workload of project planners is decreased. Suggestions for further development of the approach include incorporation of automatic scheduling and advanced assembly study. Originality/value –Whilst the research, development and implementation of CVP is relatively new in the construction industry, it is clear from the applications and feedback to date that the approach provides considerable added value to the organisation and management of construction projects.

Measuring factors that influence the utilisation of preventive care services provided by general practitioners in Australia

Background: Relatively little research attention has been given to the development of standardised and psychometrically sound scales for measuring influences relevant to the utilisation of health services. This study aims to describe the development, validation and internal reliability of some existing and new scales to measure factors that are likely to influence utilisation of preventive care services provided by general practitioners in Australia.----- Methods: Relevant domains of influence were first identified from a literature review and formative research. Items were then generated by using and adapting previously developed scales and published findings from these. The new items and scales were pre-tested and qualitative feedback was obtained from a convenience sample of citizens from the community and a panel of experts. Principal Components Analyses (PCA) and internal reliability testing (Cronbach's alpha) were then conducted for all of the newly adapted or developed scales utilising data collected from a self-administered mailed survey sent to a randomly selected population-based sample of 381 individuals (response rate 65.6 per cent).----- Results: The PCA identified five scales with acceptable levels of internal consistency were: (1) social support (ten items), alpha 0.86; (2) perceived interpersonal care (five items), alpha 0.87, (3) concerns about availability of health care and accessibility to health care (eight items), alpha 0.80, (4) value of good health (five items), alpha 0.79, and (5) attitudes towards health care (three items), alpha 0.75.----- Conclusion The five scales are suitable for further development and more widespread use in research aimed at understanding the determinants of preventive health services utilisation among adults in the general population.

Prevalence and determinants of sunburn in Queensland

Issue addressed: Australia records the highest incidence of skin cancer in the world. In response to this public education campaigns have incorporated messages about reducing sun exposure and avoiding sunburn. This study sought to describe the prevalence of and factors associated with sunburn in Queensland residents. Methods: The Queensland Cancer Risk Study was a population-based, cross-sectional survey of 9,298 respondents conducted via computer-assisted telephone interview during 2004. Sunburn prevalence and its association with sociodemographics and skin cancer risk variables were examined. Results: More than two-thirds (70.4%) of respondents reported at least one episode of sunburn in the past 12 months, and one in ten respondents reported at least one episode of sever sunburn in the past 12 months. Experiences of sunburn on two or more occasions were reported more frequently by males than females (57.6% versus 46.5%, p < 0.001), and by nearly two-thirds (65.8%) of those aged 20-39 years compared to 48.0% of 40-59 year olds, and 26.7% of 60-75 year olds (p < 0.001). Episodes of sunburn were strongly associated with being male (OR=2.20 95%CI 1.84-2.63) and being aged 20 to 39 years compared to 60 to 75 years (OR=9.79, 95%CI=7.66-12.50). Conclusions: Sunburn remains highly prevalent among Queensland residents particularly among men and in the younger age groups. So what? More effective strategies and methods may be required to extend the influence of health promotion campaigns.

Cost-effectiveness of a telephone-delivered intervention for physical activity and diet

Background: Given escalating rates of chronic disease, broad-reach and cost-effective interventions to increase physical activity and improve dietary intake are needed. The cost-effectiveness of a Telephone Counselling intervention to improve physical activity and diet, targeting adults with established chronic diseases in a low socio-economic area of a major Australian city was examined. Methodology/Principal Findings: A cost-effectiveness modelling study using data collected between February 2005 and November 2007 from a cluster-randomised trial that compared Telephone Counselling with a “Usual Care” (brief intervention) alternative. Economic outcomes were assessed using a state-transition Markov model, which predicted the progress of participants through five health states relating to physical activity and dietary improvement, for ten years after recruitment. The costs and health benefits of Telephone Counselling, Usual Care and an existing practice (Real Control) group were compared. Telephone Counselling compared to Usual Care was not cost-effective ($78,489 per quality adjusted life year gained). However, the Usual Care group did not represent existing practice and is not a useful comparator for decision making. Comparing Telephone Counselling outcomes to existing practice (Real Control), the intervention was found to be cost-effective ($29,375 per quality adjusted life year gained). Usual Care (brief intervention) compared to existing practice (Real Control) was also cost-effective ($12,153 per quality adjusted life year gained). Conclusions/Significance: This modelling study shows that a decision to adopt a Telephone Counselling program over existing practice (Real Control) is likely to be cost-effective. Choosing the ‘Usual Care’ brief intervention over existing practice (Real Control) shows a lower cost per quality adjusted life year, but the lack of supporting evidence for efficacy or sustainability is an important consideration for decision makers. The economics of behavioural approaches to improving health must be made explicit if decision makers are to be convinced that allocating resources toward such programs is worthwhile.

Long-term exposure to gaseous air pollutants and cardio-respiratory mortality in Brisbane, Australia

Air pollution is ranked by the World Health Organisation as one of the top ten contributors to the global burden of disease and injury. Exposure to gaseous air pollutants, even at a low level, has been associated with cardiorespiratory diseases (Vedal, Brauer et al. 2003). Most recent epidemiological studies of air pollution have used time-series analyses to explore the relationship between daily mortality or morbidity and daily ambient air pollution concentrations based on the same day or previous days (Hajat, Armstrong et al. 2007). However, most of the previous studies have examined the association between air pollution and health outcomes using air pollution data from a single monitoring site or average values from a few monitoring sites to represent the whole population of the study area. In fact, for a metropolitan city, ambient air pollution levels may differ significantly among the different areas. There is increasing concern that the relationships between air pollution and mortality may vary with geographical area (Chen, Mengersen et al. 2007). Additionally, some studies have indicated that socio-economic status can act as a confounder when investigating the relation between geographical location and health (Scoggins, Kjellstrom et al. 2004). This study examined the spatial variation in the relationship between long-term exposure to gaseous air pollutants (including nitrogen dioxide (NO2), ozone (O3) and sulphur dioxide (SO2)), and cardiorespiratory mortality in Brisbane, Australia, during the period 1996 - 2004.

Vitronectin modulates human mesenchymal stem cell response to insulin-like growth factor-I and transforming growth factor beta 1 in a serum-free environment

The use of animal sera for the culture of therapeutically important cells impedes the clinical use of the cells. We sought to characterize the functional response of human mesenchymal stem cells (hMSCs) to specific proteins known to exist in bone tissue with a view to eliminating the requirement of animal sera. Insulin-like growth factor-I (IGF-I), via IGF binding protein-3 or -5 (IGFBP-3 or -5) and transforming growth factor-beta 1 (TGF-beta(1)) are known to associate with the extracellular matrix (ECM) protein vitronectin (VN) and elicit functional responses in a range of cell types in vitro. We found that specific combinations of VN, IGFBP-3 or -5, and IGF-I or TGF-beta(1) could stimulate initial functional responses in hMSCs and that IGF-I or TGF-beta(1) induced hMSC aggregation, but VN concentration modulated this effect. We speculated that the aggregation effect may be due to endogenous protease activity, although we found that neither IGF-I nor TGF-beta(1) affected the functional expression of matrix metalloprotease-2 or -9, two common proteases expressed by hMSCs. In summary, combinations of the ECM and growth factors described herein may form the basis of defined cell culture media supplements, although the effect of endogenous protease expression on the function of such proteins requires investigation.

The evaluation of a biphasic osteochondral implant coupled with an electrospun membrane in a large animal model

Conventional clinical therapies are unable to resolve osteochondral defects adequately, hence tissue engineering solutions are sought to address the challenge. A biphasic implant which was seeded with Mesenchymal Stem Cells (MSC) and coupled with an electrospun membrane was evaluated as an alternative. This dual phase construct comprised of a Polycaprolactone (PCL) cartilage scaffold and a Polycaprolactone - Tri Calcium Phosphate (PCL - TCP) osseous matrix. Autologous MSC was seeded into the entire implant via fibrin and the construct was inserted into critically sized osteochondral defects located at the medial condyle and patellar groove of pigs. The defect was resurfaced with a PCL - collagen electrospun mesh that served as a substitute for periosteal flap in preventing cell leakage. Controls either without implanted MSC or resurfacing membrane were included. After 6 months, cartilaginous repair was observed with a low occurrence of fibrocartilage at the medial condyle. Osteochondral repair was promoted and host cartilage degeneration was arrested as shown by the superior Glycosaminoglycan (GAG) maintenance. This positive morphological outcome was supported by a higher relative Young's modulus which indicated functional cartilage restoration. Bone in growth and remodeling occurred in all groups with a higher degree of mineralization in the experimental group. Tissue repair was compromised in the absence of the implanted cells or the resurfacing membrane. Moreover healing was inferior at the patellar groove as compared to the medial condyle and this was attributed to the native biomechanical features.

Supply chain collaboration : capabilities for continuous innovation

Purpose – The purpose of this study is to investigate how collaborative relationships enhance continuous innovation in the supply chain using case studies. Design/methodology/approach – The data were collected from semi-structured interviews with 23 managers in ten case studies. The main intention was to comprehend how these firms engaged in collaborative relationships and their importance for successful innovation. The study adopted a qualitative approach to investigating these factors. Findings – The findings demonstrate how differing relationships can impact on the operation of firms and their capacities to innovate. The ability to work together with partners has enabled firms to integrate and link operations for increased effectiveness as well as embark on both radical and incremental innovation. Research limitations/implications – The research into the initiatives and strategies for collaboration was essentially exploratory. A qualitative approach using case studies acknowledged that the responses from managers were difficult to quantify or gauge the extent of these factors. Practical implications – The findings have shown various methods where firms integrated with customers and suppliers in the supply chain. This was evident in the views of managers across all the firms examined, supporting the importance of collaboration and efficient allocation of resources throughout the supply chain. They were able to set procedures in their dealings with partners, sharing knowledge and processes, and subsequently joint-planning and investing with them for better operations, systems and processes in the supply chain. Originality/value – The case studies serve as examples for managers in logistics organisation who are contemplating strategies and issues on collaborative relationships. The study provides important lessons on how such relationships can impact on the operation of firms and their capability to innovate. Keywords Supply chain management, Innovation, Relationship marketing

Blogs, wikis and podcasts : collaborative knowledge building tools in a design and technology course

Design and Technology has become an important part of the school curriculum. In Queensland, Australia, Technology (which encompasses Design) is one of the Key Learning Areas (KLAs) for students in the first ten years of schooling. This KLA adopts a student-centred, hands-on constructivist approach to teaching and learning. The ability to conceptualise and implement appropriate learning experiences, however, has been a challenge for some early career teachers. This paper describes how Design and Technology is being taught to pre-service primary teachers at an Australian University through their involvement in a range of authentic problem-solving activities supported by social learning tools such as wikis and blogs. An interview with a sample from this group (N=5) provides an insight into how these social software tools enhanced their knowledge and learning. This paper will describe how these social learning tools impact on the agency of learning.

Just Relations : Indigenous families in Australian lifestyle media

This paper argues that the increasing visibility of Indigenous families in the mainstream Australian media over the past ten years has produced new opportunities for addressing national injustices of the Stolen Generations. It shows how, as certain celebrities like Ernie Dingo, Nova Peris and Cathy Freeman, have become popular household names, a concurrent public interest in their family backgrounds has grown. Descriptive accounts of relationships and shared histories – propelled by the expansion of the lifestyle television genre in this context – has enabled some stories of the ‘Stolen Generations’ to be seen as ‘ordinary’, and part of a broader sense of everyday Australian life for the first time. With the aid of recent sexual citizenship research, the article illustrates that such middle-class representations give voice to new embodiments of citizenship in the post-apology era, making Indigenous justice more subjectively interconnected with life in the white Australian public sphere.

Teaching and learning in a context-based chemistry classroom

Many current chemistry programs privilege de-contextualised conceptual learning, often limited by a narrow selection of pedagogies that too often ignore the realities of studentse own lives and interests (e.g., Tytler, 2007). One new approach that offers hope for improving studentse engagement in learning chemistry and perceived relevance of chemistry is the context-based approach. This study investigated how teaching and learning occurred in one year 11 context-based chemistry classroom. Through an interpretive methodology using a case study design, the teaching and learning that occurred during one term (ten weeks) of a unit on Water Quality are described. The researcher was a participant observer in the study who co-designed the unit of work with the teacher. The research questions explored the structure and implementation of the context-based approach, the circumstances by which students connected concepts and context in the context-based classroom and the outcome of the approach for the students and the teacher. A dialectical sociocultural theoretical framework using the dialectics of structure | agency and agency | passivity was used as a lens to explore the interactions between learners in different fields, such as the field of the classroom and the field of the local community. The findings of this study highlight the difficulties teachers face when implementing a new pedagogical approach. Time constraints and opportunities for students to demonstrate a level of conceptual understanding that satisfied the teacher, hindered a full implementation of the approach. The study found that for high (above average) and sound (average) achieving students, connections between sanctioned science content of school curriculum and the studentse out-of-school worlds were realised when students actively engaged in fields that contextualised inquiry and gave them purpose for learning. Fluid transitions or the toing and froing between concepts and contexts occurred when structures in the classroom afforded students the agency to connect concepts and contexts. The implications for teaching by a context-based approach suggest that keeping the context central, by teaching content on a "need-to-know" basis, contextualises the chemistry for students. Also, if teachers provide opportunities for student-student interactions and written work student learning can improve.