Development and evaluation of a youth mental health community awareness campaign - The Compass Strategy

Background: Early detection and treatment of mental disorders in adolescents and young adults can lead to better health outcomes. Mental health literacy is a key to early recognition and help seeking. Whilst a number of population health initiatives have attempted to improve mental health literacy, none to date have specifically targeted young people nor have they applied the rigorous standards of population health models now accepted as best practice in other health areas. This paper describes the outcomes from the application of a health promotion model to the development, implementation and evaluation of a community awareness campaign designed to improve mental health literacy and early help seeking amongst young people. Method: The Compass Strategy was implemented in the western metropolitan Melbourne and Barwon regions of Victoria, Australia. The Precede-Proceed Model guided the population assessment, campaign strategy development and evaluation. The campaign included the use of multimedia, a website, and an information telephone service. Multiple levels of evaluation were conducted. This included a cross-sectional telephone survey of mental health literacy undertaken before and after 14 months of the campaign using a quasi-experimental design. Randomly selected independent samples of 600 young people aged 12 - 25 years from the experimental region and another 600 from a comparison region were interviewed at each time point. A series of binary logistic regression analyses were used to measure the association between a range of campaign outcome variables and the predictor variables of region and time. Results: The program was judged to have an impact on the following variables, as indicated by significant region-by-time interaction effects ( p < 0.05): awareness of mental health campaigns, self-identified depression, help for depression sought in the previous year, correct estimate of prevalence of mental health problems, increased awareness of suicide risk, and a reduction in perceived barriers to help seeking. These effects may be underestimated because media distribution error resulted in a small amount of print material leaking into the comparison region. Conclusion: We believe this is the first study to apply the rigorous standards of a health promotion model including the use of a control region to a mental health population intervention. The program achieved many of its aims despite the relatively short duration and moderate intensity of the campaign.

Enhancement of drug affinity for cell membranes by conjugation with lipoamino acids II. Experimental and computational evidence using biomembrane models

Lipoamino acids (LAAs) are promoieties able to enhance the amphiphilicity of drugs, facilitating their interaction with cell membranes. Experimental and computational studies were carried out on two series of lipophilic amide conjugates between a model drug (tranylcypromine, TCP) and LAA or alkanoic acids containing a short, medium or long alkyl side chain (C-4 to C-16). The effects of these compounds were evaluated by monolayer surface tension analysis and differential scanning calorimetry using dimyristoylphosphatidylcholine nnonolayers and liposomes as biomembrane models. The experimental results were related to independent calculations to determine partition coefficient and blood-brain partitioning. The comparison of TCP-LAA conjugates with the related series of TCP alkanoyl amides confirmed that the ability to interact with the biomembrane models is not due to the mere increase of lipophilicity, but mainly to the amphipatic nature and the kind of LAA residue. (C) 2005 Elsevier B.V. All rights reserved.

Using epidemiological models to estimate the health effects of diet behaviour change: the example of tailored fruit and vegetable promotion

Objective: To explore the use of epidemiological modelling for the estimation of health effects of behaviour change interventions, using the example of computer-tailored nutrition education aimed at fruit and vegetable consumption in The Netherlands. Design: The effects of the intervention on changes in consumption were obtained from an earlier evaluation study. The effect on health outcomes was estimated using an epidemiological multi-state life table model. input data for the model consisted of relative risk estimates for cardiovascular disease and cancers, data on disease occurrence and mortality, and survey data on the consumption of fruits and vegetables. Results: if the computer-tailored nutrition education reached the entire adult population and the effects were sustained, it could result in a mortality decrease of 0.4 to 0.7% and save 72 to 115 life-years per 100000 persons aged 25 years or older. Healthy life expectancy is estimated to increase by 32.7 days for men and 25.3 days for women. The true effect is likely to lie between this theoretical maximum and zero effect, depending mostly on durability of behaviour change and reach of the intervention. Conclusion: Epidemiological models can be used to estimate the health impact of health promotion interventions.

Incremental cost-effectiveness of exercise echocardiography vs. SPECT imaging for the evaluation of stable chest pain

Aims Technological advances in cardiac imaging have led to dramatic increases in test utilization and consumption of a growing proportion of cardiovascular healthcare costs. The opportunity costs of strategies favouring exercise echocardiography or SPECT imaging have been incompletely evaluated. Methods and results We examined prognosis and cost-effectiveness of exercise echocardiography (n=4884) vs. SPECT (n=4637) imaging in stable, intermediate risk, chest pain patients. Ischaemia extent was defined as the number of vascular territories with echocardiographic wall motion or SPECT perfusion abnormalities. Cox proportional hazard models were employed to assess time to cardiac death or myocardial infarction (MI). Total cardiovascular costs were summed (discounted and inflation-corrected) throughout follow-up. A cost-effectiveness ratio = 2% annual event risk), SPECT ischaemia was associated with earlier and greater utilization of coronary revascularization (P < 0.0001) resulting in an incremental cost-effectiveness ratio of $32 381/LYS. Conclusion Health care policies aimed at allocating limited resources can be effectively guided by applying clinical and economic outcomes evidence. A strategy aimed at cost-effective testing would support using echocardiography in low-risk patients with suspected coronary disease, whereas those higher risk patients benefit from referral to SPECT imaging.

Evaluation of the indirect measures of rock brittleness and fracture toughness in rock cutting

Performance prediction models for partial face mechanical excavators, when developed in laboratory conditions, depend on relating the results of a set of rock property tests and indices to specific cutting energy (SE) for various rock types. There exist some studies in the literature aiming to correlate the geotechnical properties of intact rocks with the SE, especially for massive and widely jointed rock environments. However, those including direct and/or indirect measures of rock fracture parameters such as rock brittleness and fracture toughness, along with the other rock parameters expressing different aspects of rock behavior under drag tools (picks), are rather limited. With this study, it was aimed to investigate the relationships between the indirect measures of rock brittleness and fracture toughness and the SE depending on the results of a new and two previous linear rock cutting programmes. Relationships between the SE, rock strength parameters, and the rock index tests have also been investigated in this study. Sandstone samples taken from the different fields around Ankara, Turkey were used in the new testing programme. Detailed mineralogical analyses, petrographic studies, and rock mechanics and rock cutting tests were performed on these selected sandstone specimens. The assessment of rock cuttability was based on the SE. Three different brittleness indices (B1, B2, and B4) were calculated for sandstones samples, whereas a toughness index (T-i), being developed by Atkinson et al.(1), was employed to represent the indirect rock fracture toughness. The relationships between the SE and the large amounts of new data obtained from the mineralogical analyses, petrographic studies, rock mechanics, and linear rock cutting tests were evaluated by using bivariate correlation and curve fitting techniques, variance analysis, and Student's t-test. Rock cutting and rock property testing data that came from well-known studies of McFeat-Smith and Fowell(2) and Roxborough and Philips(3) have also been employed in statistical analyses together with the new data. Laboratory tests and subsequent analyses revealed that there were close correlations between the SE and B4 whereas no statistically significant correlation has been found between the SE and T-i. Uniaxial compressive and Brazilian tensile strengths and Shore scleroscope hardness of sandstones also exhibited strong relationships with the SE. NCB cone indenter test had the greatest influence on the SE among the other engineering properties of rocks, confirming the previous studies in rock cutting and mechanical excavation. Therefore, it was recommended to employ easy-to-use index tests of NCB cone indenter and Shore scleroscope in the estimation of laboratory SE of sandstones ranging from very low to high strengths in the absence of a rock cutting rig to measure it until the easy-to-use universal measures of the rock brittleness and especially the rock fracture toughness, being an intrinsic rock property, are developed.

Using front-end and formative evaluation to design and test persuasive bird feeding warning signs

Wildlife feeding is a wide-spread and controversial practice that can pose serious threats to the safety of both wildlife and visitors. The design and effectiveness of warning signs in recreational areas varies considerably and is rarely the product of theoretical models or scientific research. This study uses front-end and formative evaluation to design and test the perceived effectiveness of warning signs relating to bird feeding. Stage One examined visitors' beliefs, attitudes and bird feeding behaviour and found significant differences between feeders and non-feeders. Stage Two involved designing and evaluating three signs that built on the beliefs, knowledge and mis/conceptions identified in Stage One. Respondents thought the sign that focused on the birds' health and safety would be the most persuasive, however, elements of the other two signs were also positively evaluated. The article concludes with recommendations for the wording of future bird feeding warning signs. (c) 2004 Elsevier Ltd. All rights reserved.

Evaluation of parameters effective in FRP shear strengthening of RC beams using FE method

Shear strengthening is required when an RC beam is found deficient in shear, or when its shear capacity falls below its flexural capacity after flexural strengthening. A recent technique for the shear strengthening of RC beams is to provide additional FRP web reinforcement, commonly in the form of bonded external FRP strips/sheets. Over the last few years, several experimental studies have been conducted on this new strengthening technique, which has established its effectiveness. While experimental methods of investigation are extremely useful in obtaining information about the composite behaviour of FRP and reinforced concrete, the use of numerical models such as the one presented in this paper helps in developing a good understanding of the behaviour at lower costs. In the study presented in this paper, ANSYS finite element program is used to examine the response of beams strengthened in shear by FRPs. The FE model is calibrated against test results performed at the University of Kentucky. Once validated, the model is used to examine the influence of fibre orientation, compressive strength of concrete, area of tensile and compressive reinforcements, and amount and distance between stirrups on the strength and ductility of FRP strengthened beam.

An innovative use of the web to build graduate team skills

Successful graduates in today's competitive business environments must possess sound interpersonal skills and the ability to work effectively in team situations within, and across, disciplines. However, developing these skills within the higher education curriculum is fraught with organisational and pedagogical difficulties, with many teachers not having the skills, time or resources to facilitate productive group processes. Furthermore, many students find their teamwork experiences frustrating, demanding, conflict-ridden and unproductive. This paper brings together the perspectives and experiences of an engineer and a social scientist in a cross-disciplinary examination of the characteristics of effective teamwork skills and processes. A focus is the development and operation of 'TeamWorker', an innovative online system that helps students and staff manage their team activities and assessment. TeamWorker was created to enhance team teaching and learning processes and outcomes including team creation, administration, development and evaluation. Importantly, TeamWorker can facilitate the early identification of problematic group dynamics, thereby enabling early intervention.

Kick'n'on: The design and evaluation of a group programme for young males with psychotic disorders

Young men with psychotic disorders have persistently poorer outcomes in social functioning when interventions aimed at arresting social isolation are not implemented. Recent literature has indicated that it is important to develop rehabilitation programmes that are based on areas of needs that are identified by the participants. To assist in the design of a group programme, a qualitative (focus group) investigation of the perceptions of young males concerning male roles and identity in today’s society was conducted. The participants were six young males with psychotic disorders who had been referred to an Australian regional rehabilitation service to address poor social functioning and social isolation. Three main themes emerged from the focus groups. These were role models, concept of what is a man, and societal expectations. The findings were used to develop a group programme called Kick’n’On.

The design and evaluation of distributed virtual environment to support learning in global operations management

The primary goal of this research is to design and develop an education technology to support learning in global operations management. The research implements a series of studies to determine the right balance among user requirements, learning methods and applied technologies, on a view of student-centred learning. This research is multidisciplinary by nature, involving topics from various disciplines such as global operations management, curriculum and contemporary learning theory, and computer aided learning. Innovative learning models that emphasise on technological implementation are employed and discussed throughout this research.

An evaluation of the epidemiology of medication discrepancies and clinical significance of medicines reconciliation in children admitted to hospital

Aims: To determine the incidence of unintended medication discrepancies in paediatric patients at the time of hospital admission; evaluate the process of medicines reconciliation; assess the benefit of medicines reconciliation in preventing clinical harm. Method: A 5 month prospective multisite study. Pharmacists at four English hospitals conducted admission medicines reconciliation in children using a standardised data collection form. A discrepancy was defined as a difference between the patient's preadmission medication (PAM), compared with the initial admission medication orders written by the hospital doctor. The discrepancies were classified into intentional and unintentional discrepancies. The unintentional discrepancies were assessed for potential clinical harm by a team of healthcare professionals, which included doctors, pharmacists and nurses. Results: Medicines reconciliation was conducted in 244 children admitted to hospital. 45% (109/244) of the children had at least one unintentional medication discrepancy between the PAM and admission medication order. The overall results indicated that 32% (78/244) of patients had at least one clinically significant unintentional medication discrepancy with potential to cause moderate 20% (50/244) or severe 11% (28/244) harm. No single source of information provided all the relevant details of a patient's medication history. Parents/carers provided the most accurate details of a patient's medication history in 81% of cases. Conclusions: This study demonstrates that in the absence of medicines reconciliation, children admitted to hospitals across England are at risk of harm from unintended medication discrepancies at the transition of care from the community to hospital. No single source of information provided a reliable medication history.

A comparison of linear forecasting models and neural networks:an application to Euro inflation and Euro Divisia

Linear models reach their limitations in applications with nonlinearities in the data. In this paper new empirical evidence is provided on the relative Euro inflation forecasting performance of linear and non-linear models. The well established and widely used univariate ARIMA and multivariate VAR models are used as linear forecasting models whereas neural networks (NN) are used as non-linear forecasting models. It is endeavoured to keep the level of subjectivity in the NN building process to a minimum in an attempt to exploit the full potentials of the NN. It is also investigated whether the historically poor performance of the theoretically superior measure of the monetary services flow, Divisia, relative to the traditional Simple Sum measure could be attributed to a certain extent to the evaluation of these indices within a linear framework. Results obtained suggest that non-linear models provide better within-sample and out-of-sample forecasts and linear models are simply a subset of them. The Divisia index also outperforms the Simple Sum index when evaluated in a non-linear framework. © 2005 Taylor & Francis Group Ltd.