Implementation of diabetes prevention programs in rural areas : Montana and south-eastern Australia compared

Objective: To identify the key elements that enabled the Greater Green Triangle Diabetes Prevention Project (GGT DPP) and the Montana Cardiovascular Disease and Diabetes Prevention (CDDP) programs successful establishment and implementation in rural areas, as well as identifying specific challenges or barriers for implementation in rural communities.
Methods: Focus groups were held with the facilitators who delivered the GGT DPP in Australia and the Montana CDDP programs in the USA. Interview questions covered the facilitators’ experiences with recruitment, establishing the program, the components and influence of rurality on the program, barriers and challenges to delivering the program, attributes of successful participants, and the influence of community resources and partnerships on the programs.
Results: Four main themes emerged from the focus groups: establishing and implementing the diabetes prevention program in the community; strategies for recruitment and retention of participants; what works in lifestyle intervention programs; and rural-centred issues.
Conclusions: The results from this study have assisted in determining the factors that contribute to developing, establishing and implementing successful diabetes prevention programs in two rural areas. Recommendations to increase the likelihood of success of programs in rural communities include: securing funding early for the program; establishing support from community leaders and developing positive relationships with health care providers; creating a professional team with passion for the program; encouraging participants to celebrate their small and big successes; and developing procedures for providing post-intervention support to help participants maintain their success.

The spread and uptake of diabetes prevention programs around the world : a case study from Finland and Australia

Type 2 diabetes is a major public health issue in most countries around the world. Efficacy trials have demonstrated that lifestyle modification programs can significantly reduce the risk of type 2 diabetes. Two key challenges are: [1] to develop programs that are more feasible for “real world” implementation and [2] to extend the global reach of such programs, particularly to resource-poor countries where the burden of diabetes is substantial. This paper describes the development, implementation, and evaluation of such “real world” programs in Finland and Australia, the exchange between the two countries, and the wider uptake of such programs. Drawing on the lessons from these linked case studies, we discuss the implications for improving the “spread” of diabetes prevention programs by more effective uptake of lifestyle change programs and related strategies for more resource-poor countries and settings.

Pathways to industry : work practices of undergraduate students in construction programs in Australia

This research reports the impact of work on undergraduate students enrolled in construction programs. Students responded to a questionnaire on the nature of their paid work while enrolled in full-time study in six universities across Australia. The results indicate that students are working on average 19 hours per week during semester time. The results indicate that students in the early years tend to undertake casual work that is not related to their degree. However, this pattern changes in the later years of the program, where students switch to roles in construction that does relate to their coursework. The students start working on average 16 hours in the first year of their degree, and the number rises to 24 hours in their final year. Past research suggests that students may be working to an extent beyond what is considered beneficial to their studies. Past research has shown that working long hours has a negative effect on the study patterns of undergraduate students. The implications of the amount of time working and the type of work are discussed. The paper concludes by suggesting that universities need a greater awareness of the impact of paid employment on student engagement.

Evaluating the outcomes of adolescent day programs in an Australian child and adolescent mental health service

Adolescent day programs (ADPs) are an increasingly used approach to treating adolescents with mental health issues. However, there is a dearth of studies empirically examining the outcomes of adolescent day programs. This study retrospectively examined the mental health functioning of 84 adolescents, pre- and post-treatment, who in addition to their ongoing outpatient treatment had participated in an ADP during a five-year period. Their functioning was compared to matched adolescents who participated only in outpatient treatment during the same time period. Statistical and clinical examinations revealed the reported outcomes following ADP treatment were at least comparable, and sometimes significantly better, when compared to the reported outcomes following outpatient treatment excluding ADP involvement. This study, while having some methodological shortcomings, provides some evidence for the efficacy of ADPs.

Granular Activated Carbon (GAC) adsorption in tertiary wastewater treatment : experiments and models

Wastewater treatment has always been a major concern in the developed countries. Over the last few decades, activated carbon adsorption has gained importance as an alternative tertiary wastewater treatment and purification process. In this study, granular activated carbon (GAC) adsorption was evaluated in terms of total organic carbon (TOC) removal from low strength synthetic wastewater. This paper provides details on adsorption experiments conducted on synthetic wastewater to develop suitable adsorption isotherms. Although the inorganics used in the synthetic wastewater solution had an overall unfavourable effect on adsorption of organics, the GAC adsorption system was found to be effective in removing TOC from the wastewater. This study showed that equation of state (EOS) theory was able to fit the adsorption isotherm results more precisely than the most commonly used Freundlich isotherm. Biodegradation of the organics with time was the most crucial and important aspect of the system and it was taken into account in determining the isotherm parameters. Initial organic concentration of the wastewater was the determining factor of the model parameters, and hence the isotherm parameters were determined covering a wide range of initial organic concentrations of the wastewater. As such, the isotherm parameters derived using the EOS theory could predict the batch adsorption and fixed bed adsorption results of the multi-component system successfully. The isotherm parameters showed a significant effect on the determination of the mass transfer coefficients in batch and fixed bed systems.

Clarifying creative nonfiction through the personal essay

In a recent issue of TEXT, Matthew Ricketson sought to clarify the ‘boundaries between fiction and nonfiction’. In his capacity as a teacher of the creative nonfiction form he writes, ‘I have lost count of the number of times, in classes and in submitted work, that students have described a piece of nonfiction as a novel’. The confusion thus highlighted is not restricted to Ricketson’s journalism students. In our own university’s creative writing cohort, students also struggle with difficulties in melding the research methodology of the journalist with the language and form of creative writing required to produce nonfiction stories for a 21st century readership.
Currently in Australia creative nonfiction is enthusiastically embraced by publishers and teaching institutions. Works of memoir proliferate in the lists of mainstream publishers, as do anthologies of the essay form. During a time of increasing competition and desire for differentiation between institutions, when graduate outcomes form a basis for marketing university degrees, it is hardly surprising that, increasingly, tertiary writing teachers focus on this genre in their writing programs.
A second tension has arisen in higher education more generally, which affects our writing students’ approaches to tertiary study. The student writers of the 21st century emerge from a digitally literate and socially collaborative generation: the NetGen(eration). From a learner-centric viewpoint, they could be described as time-poor, and motivated by work-integrated learning with its perceived close links to workplace contexts and to writing genres. They seek just-in-time learning to meet their immediate employment needs, which inhibits the development of their capacity to adapt their researching and writing to various genres and audiences.
This article examines issues related to moving these NetGen student writers into the demanding and rapidly expanding creative nonfiction market. It is form rather than genre that denotes creative nonfiction and, we argue, it is the unique features of the personal essay, based as it is on doubt, discovery and the writer’s personal voice that can be instrumental in teaching creative nonfiction writing to our digitally and socially literate cohort of students.

The economic analysis of prevention in mental health programs

This article introduces the role economics can play in deciding whether programs designed to prevent mental disorders, which carry large disease and economic burdens, are a worthwhile use of limited healthcare resources. Fortunately, preventive interventions for mental disorders exist; however, which interventions should be financed is a common issue facing decision makers, and economic evaluation can provide answers. Unfortunately, existing economic evaluations of preventive interventions have limited applicability to local healthcare contexts. An approach to priority setting largely based on economic techniques— Assessing Cost-Effectiveness (ACE)—has been developed and used in Australia to answer questions regarding the economic credentials of competing interventions. Eleven preventive interventions for mental disorders and suicide, mostly psychological in nature, have been evaluated using this approach, with many meeting the criteria of good value for money. Interventions targeting the prevention of suicide, adult and childhood depression, childhood anxiety, and early psychosis have particular merit.

Outreach programs too little, too late

Efforts to attract more disadvantaged young people to participate in university studies are too limited and targeted too late in schooling, according to a new report commissioned by the government.