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This study aimed to highlight the praxis of various mainstream and alternative faith traditions in Australia with relation to environmental sustainability issues. A mixed methods approach (surveys, interviews, site visits) was used to investigate the levels of awareness and involvement of faith communities on issues including biodiversity protection, water conservation, energy efficiency, waste management and cultural property heritage. The aim of this chapter is to highlight a theme of integration (or lack thereof) that arose out of the interviews which formed a critical part of the participants’ worldview. A brief overview of the relationships of attitudes and behaviours to environmental issues and the importance placed on values and worldviews is provided. Individuals from 40 faith groups participated in the study; in this chapter, individuals and case studies from ten different groups are highlighted. These range from the conventional, mainstream Christian traditions to alternative Christian and Eastern traditions as well as the new age movement. The study found that mainstream traditions were making important attempts at integrating their worldview into appropriate environmental management strategies; however, the impact was marginal overall. The lesser known and alternative traditions, however, were at a significant leading edge of integrating praxis; yet, because these traditions are viewed with an element of suspicion, their efforts were marginalized by members of other faiths and the public. Thus, there are several points of convergence and divergence that faith traditions have with regard to environmental sustainability.

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In March this year, prime minister Julia Gillard boasted that she led a Labor government, not a social democratic one or a progressive one. She described Labor as ‘politically, organisationally, spiritually and even literally, the party of work’. Her academic admirers were in agreement, with labour historian Nick Dyrenfurth arguing that, unlike that latter-day Trotsky, Kevin Rudd, ‘Gillard “gets” the labour movement’.

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Estuaries are a transition zone for fresh and saline water and sediments, providing a range of ecosystem services for the local population, infrastructure and industries located in their environs. They are also governance transition zones where jurisdictions often overlap and focused attention is often lacking. As Australia’s population continues to expand, particularly in the south, estuaries are increasingly becoming popular locations for settlement due to their picturesque surrounds and accessibility for water-based activities. This results in expanding human and industry activities and pressures along estuaries and adjacent coastal settings impacting ecosystem service delivery. The absence of dedicated national and state estuary legislation in addition to decades of poor land and waterway management decisions paints a ‘doom and gloom’ picture for temperate southern Australian estuaries. Against this backdrop, there are number of estuary ‘bright spots’ where natural resource management bodies in strong partnership with local actors are moving forward in overcoming challenges to estuary conservation. Using case studies, this paper describes the key elements for effective estuary management that can lead to improved estuary health.

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PURPOSE: To determine the feasibility and pilot a sleep education program in New Zealand high school students.

METHODS: A parallel, two-arm randomized controlled pilot trial was conducted. High school students (13 to 16 years) were randomly allocated to either a classroom-based sleep education program intervention (n = 15) or to a usual curriculum control group (n = 14). The sleep education program involved four 50-minute classroom-based education sessions with interactive groups. Students completed a 7-day sleep diary, a sleep questionnaire (including sleep hygiene, knowledge and problems) at baseline, post-intervention (4 weeks) and 10 weeks follow-up.

RESULTS: An overall treatment effect was observed for weekend sleep duration (F 1,24 = 5.21, p = 0.03). Participants in the intervention group slept longer during weekend nights at 5 weeks (1:37 h:min, p = 0.01) and 10 weeks: (1:32 h:min, p = 0.03) compared to those in the control group. No differences were found between groups for sleep duration on weekday nights. No significant differences were observed between groups for any of the secondary outcomes (sleep hygiene, sleep problems, or sleep knowledge).

CONCLUSIONS: A sleep education program appears to increase weekend sleep duration in the short term. Although this program was feasible, most schools are under time and resource pressure, thus alternative methods of delivery should be assessed for feasibility and efficacy. Larger trials of longer duration are needed to confirm these findings and determine the sustained effect of sleep education on sleep behavior and its impact on health and psychosocial outcomes.

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BACKGROUND: Involving stakeholders and consumers throughout the content and study design ensures interventions are engaging and relevant for end-users. The aim of this paper is to present the content development process for a mHealth (mobile phone and internet-based) cardiac rehabilitation (CR) exercise intervention.

METHODS: An innovative mHealth intervention was developed with patient input using the following steps: conceptualization, formative research, pre-testing, and pilot testing. Conceptualization, including theoretical and technical aspects, was undertaken by experts. For the formative component, focus groups and interviews with cardiac patients were conducted to discuss their perceptions of a mHealth CR program. A general inductive thematic approach identified common themes. A preliminary library of text and video messages were then developed. Participants were recruited from CR education sessions to pre-test and provide feedback on the content using an online survey. Common responses were extracted and compiled. An iterative process was used to refine content prior to pilot testing and conduct of a randomized controlled trial.

RESULTS: 38 CR patients and 3 CR nurses participated in the formative research and 20 CR patients participated in the content pre-testing. Participants perceived the mHealth program as an effective approach to inform and motivate patients to exercise. For the qualitative study, 100% (n = 41) of participants thought it to be a good idea, and 11% of participants felt it might not be useful for them, but would be for others. Of the 20 participants who completed the online survey, 17 out of 20 (85%) stated they would sign up to a program where they could receive information by video messages on a website, and 12 out of 20 (60%) showed interest in a texting program. Some older CR patients viewed technology as a potential barrier as they were unfamiliar with text messaging or did not have mobile phones. Steps to instruct participants to receive texts and view the website were written into the study protocol. Suggestions to improve videos and wording of texts were fed back to the content development team and refined.

CONCLUSIONS: Most participants thought a mHealth exercise program was an effective way to deliver exercise-based CR. The results were used to develop an innovative multimedia exercise intervention. A randomized controlled trial is currently underway.

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OBJECTIVE:
Our prespecified dose-response analyses of A Very Early Rehabilitation Trial (AVERT) aim to provide practical guidance for clinicians on the timing, frequency, and amount of mobilization following acute stroke.

METHODS:
Eligible patients were aged ≥18 years, had confirmed first (or recurrent) stroke, and were admitted to a stroke unit within 24 hours of stroke onset. Patients were randomized to receive very early and frequent mobilization, commencing within 24 hours, or usual care. We used regression analyses and Classification and Regression Trees (CART) to investigate the effect of timing and dose of mobilization on efficacy and safety outcomes, irrespective of assigned treatment group.

RESULTS:
A total of 2,104 patients were enrolled, of whom 2,083 (99.0%) were followed up at 3 months. We found a consistent pattern of improved odds of favorable outcome in efficacy and safety outcomes with increased daily frequency of out-of-bed sessions (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.09 to 1.18, p < 0.001), keeping time to first mobilization and mobilization amount constant. Increased amount (minutes per day) of mobilization reduced the odds of a good outcome (OR 0.94, 95% CI 0.91 to 0.97, p < 0.001). Session frequency was the most important variable in the CART analysis, after prognostic variables age and baseline stroke severity.

CONCLUSION:
These data suggest that shorter, more frequent mobilization early after acute stroke is associated with greater odds of favorable outcome at 3 months when controlling for age and stroke severity.

CLASSIFICATION OF EVIDENCE:
This study provides Class III evidence that shorter, more frequent early mobilization improves the chance of regaining independence after stroke.

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Dispersal knowledge is essential for conservation management, and demand is growing. But are we accumulating dispersal knowledge at a pace that can meet the demand? To answer this question we tested for changes in dispersal data collection and use over time. Our systematic review of 655 conservation-related publications compared five topics: climate change, habitat restoration, population viability analysis, land planning (systematic conservation planning) and invasive species. We analysed temporal changes in the: (i) questions asked by dispersal-related research; (ii) methods used to study dispersal; (iii) the quality of dispersal data; (iv) extent that dispersal knowledge is lacking, and; (v) likely consequences of limited dispersal knowledge. Research questions have changed little over time; the same problems examined in the 1990s are still being addressed. The most common methods used to study dispersal were occupancy data, expert opinion and modelling, which often provided indirect, low quality information about dispersal. Although use of genetics for estimating dispersal has increased, new ecological and genetic methods for measuring dispersal are not yet widely adopted. Almost half of the papers identified knowledge gaps related to dispersal. Limited dispersal knowledge often made it impossible to discover ecological processes or compromised conservation outcomes. The quality of dispersal data used in climate change research has increased since the 1990s. In comparison, restoration ecology inadequately addresses large-scale process, whilst the gap between knowledge accumulation and growth in applications may be increasing in land planning. To overcome apparent stagnation in collection and use of dispersal knowledge, researchers need to: (i) improve the quality of available data using new approaches; (ii) understand the complementarities of different methods and; (iii) define the value of different kinds of dispersal information for supporting management decisions. Ambitious, multi-disciplinary research programs studying many species are critical for advancing dispersal research.

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AIM: To investigate the relationship between diabetic peripheral neuropathy (DPN) and retinal tissue thickness.

METHODS: Full retinal thickness in the central retinal, parafoveal, and perifoveal zones and thickness of the ganglion cell complex and retinal nerve fiber layer (RNFL) were assessed in 193 individuals (84 with type 1 diabetes, 67 with type 2 diabetes, and 42 healthy controls) using spectral domain optical coherence tomography. Among those with diabetes, 44 had neuropathy defined using a modified neuropathy disability score recorded on a 0-10 scale. Multiple regression analysis was performed to investigate the relationship between diabetic neuropathy and retinal tissue thickness, adjusted for the presence of diabetic retinopathy (DR), age, sex, duration of diabetes, and HbA1c levels.

RESULTS: In individuals with diabetes, perifoveal thickness was inversely related to the severity of neuropathy (p < 0.05), when adjusted for age, sex, duration of diabetes, and HbA1c levels. DR was associated with reduced thickness in parafovea (p < 0.01). The RNFL was thinner in individuals with greater degrees of neuropathy (p < 0.04).

CONCLUSIONS: DPN is associated with structural compromise involving several retinal layers. This compromise may represent a threat to visual integrity and therefore warrants examination of functional correlates.

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BACKGROUND: The visual demands of modern classrooms are poorly understood yet are relevant in determining the levels of visual function required to perform optimally within this environment. METHODS: Thirty-three Year 5 and 6 classrooms from eight south-east Queensland schools were included. Classroom activities undertaken during a full school day (9 am to 3 pm) were observed and a range of measurements recorded, including classroom environment (physical dimensions, illumination levels), text size and contrast of learning materials, habitual working distances (distance and estimated for near) and time spent performing various classroom tasks. These measures were used to calculate demand-related minimum criteria for distance and near visual acuity, contrast and sustained use of accommodation and vergence. RESULTS: The visual acuity demands for distance and near were 0.33 ± 0.13 and 0.72 ± 0.09 logMAR, respectively (using habitual viewing distances and smallest target sizes) or 0.33 ± 0.09 logMAR assuming a 2.5 times acuity reserve for sustained near tasks. The mean contrast levels of learning materials at distance and near were greater than 70 per cent. Near tasks (47 per cent) dominated the academic tasks performed in the classroom followed by distance (29 per cent), distance to near (15 per cent) and computer-based (nine per cent). On average, children engaged in continuous near fixation for 23 ± 5 minutes at a time and during distance-near tasks performed fixation changes 10 ± 1 times per minute. The mean estimated habitual near working distance was 23 ± 1 cm (4.38 ± 0.24 D accommodative demand) and the vergence demand was 0.86 ± 0.07(Δ) at distance and 21.94 ± 1.09(Δ) at near assuming an average pupillary distance of 56 mm. CONCLUSIONS: Relatively high levels of visual acuity, contrast demand and sustained accommodative-convergence responses are required to meet the requirements of modern classroom environments. These findings provide an evidence base to inform prescribing guidelines and develop paediatric vision screening protocols and referral criteria.