Life! in Australia : translating prevention research into a large-scale intervention

The increasing prevalence of type 2 diabetes is of great public health concern. In the state of Victoria, Australia, a group-based lifestyle intervention programme, Life! – Taking Action on Diabetes, was developed for people over the age of 50 years who are at high risk of diabetes. It aims to reduce the risk of diabetes by providing practical skills, including goal setting and problem solving, to encourage participants to adopt a healthy diet and active lifestyle. The programme is delivered by specially trained facilitators who have undergone an accredited three-stage training programme. A quality assurance process is also in place to ensure that it is delivered to a consistently high standard. The Life! program
is a direct progression from the Finnish randomised controlled trial and the Greater Green Triangle Diabetes Prevention Project implementation trial. This paper describes how a diabetes prevention programme was implemented at a state-wide level and the training of facilitators to conduct the group sessions. Future studies are needed to examine the cost effectiveness and development of specific programmes for diverse population groups.

Using the Rose Angina Questionnaire cross-culturally : the importance of consulting lay people when translating epidemiological questionnaires

Objectives. The Rose Angina Questionnaire (RAQ) is an important measure of coronary heart disease prevalence. It has been shown to perform inconsistently across some ethnic groups in Britain. This study investigates whether the best available versions of the RAQ in Punjabi and Cantonese were linguistically equivalent to the English version.

Design. Interviews were carried out with lay people from the Pakistani, Chinese and European-origin communities in Scotland to assess the versions of the RAQ used in the Newcastle Heart Project (the best available versions). For each questionnaire item, participants were asked to elaborate on their understanding of the question and the meaning of keywords or phrases.

Results. Problems were discovered with the Punjabi and Cantonese translations of the RAQ. For example, the translation for ‘chest’ was interpreted by some Pakistani and Chinese women to mean ‘breasts’. ‘Walking uphill’ was translated in Chinese as ‘walking the hill’, without stipulation of the direction, so that some Cantonese speakers interpreted the question as pertaining to walking downhill. Many Chinese interpreted RAQ items to be referring to breathlessness rather than chest pain due to ambiguous wording.

Conclusion. Existing versions of the RAQ are unlikely to be yielding data that are cross-culturally valid or comparable. For robust health survey research in languages other than that in which the questionnaire was developed, lay assessment of questionnaires prior to and after translation is a necessity rather than a luxury.

Translating the gothic tradition: St Patrick's Cathedral Melbourne

During the 1850s, England and France were the leading centres of debate over the Gothic Revival. As Barry Bergdoll argues, the issues that loomed large were at once architectural and political: stylistic eclecticism versus national purity, invention versus tradition, nationalism versus cosmopolitanism, as well as the challenge of new building programmes and new materials to the historicist logic of the Gothic Revival position. William Wilkinson Wardell (1823-99), the architect of St Patrick's Cathedral, Melbourne, Victoria, Australia (1858-97) found himself in the midst of this debate. ln.,1858, Wardell's client, James Alipius Goold, Bishop of the Catholic Diocese of Melbourne, found that local circumstances significantly influenced his aspirations for a new Catholic cathedral for Melbourne. The choices Wardell made eventually gave shape to the Gothic Revival in Australia.The New World perhaps echoing Didron, demanded of the past all it could offer the present and especially the future: a Gothic cathedral was deemed a fitting carrier of the principles, morals, beliefs and spirit of a Christian civilisation. Unlike many of his contemporaries in Britain and Europe, Wardell in Australia was to see his Gothic Cathedrals of St Patrick's and St Mary's substantially realised in his lifetime. This paper presents a building history of Wardell's St Patrick's, Melbourne, and critically examines the translations which are embedded in the design and fabric of this nineteenth-century Gothic revival cathedral.

Therapist-assisted Internet-delivered cognitive behavior therapy for depression and anxiety: translating evidence into clinical practice.

This dissemination study examined the effectiveness of therapist-assisted Internet-delivered Cognitive Behavior Therapy (ICBT) when offered in clinical practice. A centralized unit screened and coordinated ICBT delivered by newly trained therapists working in six geographically dispersed clinical settings. Using an open trial design, 221 patients were offered 12 modules of ICBT for symptoms of generalized anxiety (n=112), depression (n=83), or panic (n=26). At baseline, midpoint and post-treatment, patients completed self-report measures. On average, patients completed 8 of 12 modules. Latent growth curve modeling identified significant reductions in depression, anxiety, stress and impairment (d=.65-.78), and improvements in quality of life (d=.48-.66). Improvements in primary symptoms were large (d=.91-1.25). Overall, therapist-assisted ICBT was effective when coordinated across settings in clinical practice, but further attention should be given to strategies to improve completion of treatment modules.