Meet us where we are: non-Indigenous young peoples' ideas on how to reduce alcohol-related harm in Mparntwe (Alice Springs).

OBJECTIVE: This research sought to understand the strategies young people in a remote central Australian town believed would reduce alcohol-related harms amongst their peers. METHODS: A total of 38 non-Indigenous residents of Mparntwe (Alice Springs), aged between 14 and 18 years, participated in focus groups at their school. Participants discussed strategies they thought would reduce alcohol-related harms among people their age. Data were analysed using thematic analysis. RESULTS: Participants suggested that young peoples' drinking behaviour developed with peers. Through social learning in peer groups, drinking alcohol was perceived as fun and normal. Participants indicated a willingness to learn about strategies to stay safe around alcohol. Their ideas for doing so reflected their existing social methods of learning about alcohol: having comfortable conversations and storytelling with a small group of peers and a relatable role model. CONCLUSIONS: Young residents of Mparntwe (Alice Springs) advised that alcohol-related harm reduction strategies would be most effective if focussed on safety, rather than abstinence, and applied social-learning strategies. IMPLICATIONS FOR PUBLIC HEALTH: Young people value their burgeoning self-determination. Youth health interventions must engage youth in intervention co-design and aim to assist young people to make safer decisions, rather than making decisions on their behalf.

Sexual and reproductive health education for patients with myelomeningocele.

AIM: To evaluate the sexual and reproductive health education received by patients with myelomeningocele, the most severe form of spina bifida. METHOD: A survey designed to assess the sexual and reproductive health education given by a healthcare provider to patients with myelomeningocele was offered to all English-speaking patients aged 12 years or older with a myelomeningocele clinic visit. RESULTS: In total, 67 surveys were completed. Menstruation and menstrual management were discussed at a rate of 85% in females. Few patients had discussions with a provider about fertility (42%), sexuality (37%), risk of sexually transmitted infections (45%), or had a relationship with a reproductive healthcare provider (54%). Differences by sex were observed for contraceptive education. The rate of discussions increased with age. A total of 67% of female patients and 33% of male patients requested a referral to a reproductive healthcare provider. INTERPRETATION: Sexual and reproductive health education is part of comprehensive care for all patients and those with disabilities should not be excluded. The lack of consistent education received by patients supports the need for increased attention to this topic. We encourage multidisciplinary myelomeningocele clinics to establish a process for delivering complete and patient-specific sexual and reproductive health education.

Personalized 3D-printed anthropomorphic whole-body phantom irradiated by protons, photons, and neutrons.

The objective of this study was to confirm the feasibility of three-dimensionally-printed (3D-printed), personalized whole-body anthropomorphic phantoms for radiation dose measurements in a variety of charged and uncharged particle radiation fields. We 3D-printed a personalized whole-body phantom of an adult female with a height of 154.8 cm, mass of 90.7 kg, and body mass index of 37.8 kg/m2. The phantom comprised of a hollow plastic shell filled with water and included a watertight access conduit for positioning dosimeters. It is compatible with a wide variety of radiation dosimeters, including ionization chambers that are suitable for uncharged and charged particles. Its mass was 6.8 kg empty and 98 kg when filled with water. Watertightness and mechanical robustness were confirmed after multiple experiments and transportations between institutions. The phantom was irradiated to the cranium with therapeutic beams of 170-MeV protons, 6-MV photons, and fast neutrons. Radiation absorbed dose was measured from the cranium to the pelvis along the longitudinal central axis of the phantom. The dose measurements were made using established dosimetry protocols and well-characterized instruments. For the therapeutic environments considered in this study, stray radiation from intracranial treatment beams was the lowest for proton therapy, intermediate for photon therapy, and highest for neutron therapy. An illustrative example set of measurements at the location of the thyroid for a square field of 5.3 cm per side resulted in 0.09, 0.59, and 1.93 cGy/Gy from proton, photon, and neutron beams, respectively. In this study, we found that 3D-printed personalized phantoms are feasible, inherently reproducible, and well-suited for therapeutic radiation measurements. The measurement methodologies we developed enabled the direct comparison of radiation exposures from neutron, proton, and photon beam irradiations.

Using personas to exploit environmental attitudes and behaviour in sustainable product design.

The aim of this research was to study the relationship between user sustainable design attitudes versus behaviour, and to develop and test environmental personas as design tools. Current approaches towards environmentally sustainable design are primarily focused on capturing the environmentally conscious and pro-environmental consumers, or changing the attitude and behaviour of the anti-environmental consumer. In a survey of 521 consumers, environmental attitude was a poor predictor of environmental behaviour. A series of interviews was performed with different profiles of environmentally orientated users to assess their environmental attitudes and behaviour. The survey and interview data were used to develop four personas, one for each of the environmental attitude and behaviour types based on data from the consumer survey. A case study performed with university design students found that concepts generated by groups using environmentally orientated personas scored higher on environmental sustainability versus those generated by groups using an image board. This study illustrates how user-centred design approaches could be used to embed sustainable design in products by exploiting consumer environmental behaviour to overcome different attitudes and behaviour.

A Data Management System Integrating Web-based Training and Randomized Trials: Requirements, Experiences and Recommendations.

This article describes a data management system (DMS) developed to support a large-scale randomized study of an innovative web-course that was designed to improve substance abuse counselors' knowledge and skills in applying a substance abuse treatment method (i.e., cognitive behavioral therapy; CBT). The randomized trial compared the performance of web-course-trained participants (intervention group) and printed-manual-trained participants (comparison group) to determine the effectiveness of the web-course in teaching CBT skills. A single DMS was needed to support all aspects of the study: web-course delivery and management, as well as randomized trial management. The authors briefly reviewed several other systems that were described as built either to handle randomized trials or to deliver and evaluate web-based training. However it was clear that these systems fell short of meeting our needs for simultaneous, coordinated management of the web-course and the randomized trial. New England Research Institute's (NERI) proprietary Advanced Data Entry and Protocol Tracking (ADEPT) system was coupled with the web-programmed course and customized for our purposes. This article highlights the requirements for a DMS that operates at the intersection of web-based course management systems and randomized clinical trial systems, and the extent to which the coupled, customized ADEPT satisfied those requirements. Recommendations are included for institutions and individuals considering conducting randomized trials and web-based training programs, and seeking a DMS that can meet similar requirements.

Assessing the statistical and personal significance of the method of levels.

BACKGROUND: Perceptual Control Theory (PCT) suggests that psychological distress can be conceptualized as the by-product of conflicted control systems. METHOD: Using a program of psychotherapy based on the principles of PCT called the Method of Levels (MOL), a 12-month study was conducted with 120 patient participants and 4 clinicians. In this study, analyses of statistical significance were conducted. Qualitative data were also analysed to understand psychotherapy from patients' perspectives. Data were collected on the attendance patterns of patients, their ages, referral problem, and socio-economic background. A standardized questionnaire measured pre and post treatment effects. The null hypothesis of no difference between pre and post treatment scores was examined by the derivation of p values and the construction of 95% confidence intervals. RESULTS: In all cases the null hypothesis was rejected. CONCLUSIONS: Results suggest that MOL is a useful form of psychotherapy that warrants further investigation.