Refrigerated storage and cryopreservation of hormonally induced sperm in the threatened frog, Litoria aurea.

As sperm cryopreservation and other assisted reproductive technologies (ARTs) advance in common amphibian species, focus on applying non-lethal sperm collection methods to the conservation and genetic management of threatened species is imperative. The goal of this study was to examine the application of logistically practical ART protocols in a threatened frog (Litoria aurea). First, we tested the efficacy of various concentrations of human chorionic gonadotropin (hCG) (20, 40 IU/g bodyweight) and Gonadotropin releasing hormone antagonist (0.25 µg/g and 0.5 µg/g body weight GnRH-a) on the induction of spermatozoa. Using the samples obtained from the previous trials, we tested the effect of cold storage and cryopreservation protocols on long-term refrigerated storage and post-thaw sperm recovery. Our major findings include: (1) high quality sperm were induced with 20 and 40 IU/g bodyweight of (hCG); (2) proportions of live, motile sperm post-thaw, were recovered at higher levels than previously reported for L. aurea (>50%) when preserved with 15% v/v DMSO and 1% w/v sucrose; and (3) spermic urine stored at 5 °C retained motility for up to 14 days. Our findings demonstrate that the protocols developed in this study allowed for successful induction and recovery of high-quality spermatozoa from a threatened Australian anuran, L. aurea, providing a prime example of how ARTs can contribute to the conservation of rare and threatened species.

Curriculum effectiveness for secondary-aged students with severe intellectual disabilities or profound and multiple learning difficulties in Australia: Teacher perspectives.

The active inclusion of students within education systems relies on a curriculum that caters to all. This article presents partial findings from Australian mixed methods research examining 46 teacher perspectives on the curriculum and its ability to support their practice in supporting students aged 12-19 years with severe intellectual disability or profound and multiple learning difficulties who attend specialist school settings. Results reveal that Australian teachers see the current curriculum as insufficient in its design and content and unable to cater to their students educational and social capacities or needs. Strengths essential to the reform process are highlighted, emergent challenges discussed and recommendations for future action are presented.

A three-arm randomised controlled trial of a telehealth intervention targeting improvement in addictive eating for Australian adults (the TRACE program).

There is a substantial research base for addictive eating with development of interventions. The current 3-arm RCT aimed to investigate the efficacy of the TRACE (Targeted Research for Addictive and Compulsive Eating) program to decrease addictive eating symptoms and improve mental health. Participants (18-85 yrs) endorsing ≥3 addictive eating symptoms were randomly allocated to 1) active intervention, 2) passive intervention, or 3) control group. Primary outcome was change in addictive eating symptoms 3-months post-baseline measured by the Yale Food Addiction Scale. Depression, anxiety and stress were also assessed. A total of 175 individuals were randomised. Using Linear Mixed Models, from baseline to 3-months, there was significant improvement in symptom scores in all groups with mean decrease of 4.7 (95% CI: -5.8, -3.6; p < 0.001), 3.8 (95% CI: -5.2, -2.4; p < 0.001) and 1.5 (95% CI: -2.6, -0.4; p = 0.01) respectively. Compared with the control group, participants in the active intervention were five times more likely to achieve a clinically significant change in symptom scores. There was a significant reduction in depression scores in the active and passive intervention groups, but not control group [-2.9 (95% CI: -4.5, -1.3); -2.3 (95% CI: -4.3, -0.3); 0.5 (95% CI: -1.1, 2.1), respectively]; a significant reduction in stress scores within the active group, but not passive intervention or control groups [-1.3 (95% CI: -2.2, -0.5); -1.0 (95% CI: -2.1, 0.1); 0.4 (95% CI: -0.5, 1.2), respectively]; and the reduction in anxiety scores over time was similar for all groups. A dietitian-led telehealth intervention for addictive eating in adults was more effective than a passive or control condition in reducing addictive eating scores from baseline to 6 months. Trial registration: Australia New Zealand Clinical Trial Registry ACTRN12621001079831.

Development of a Brief Coparenting Measure: The Coparenting Competence Scale.

Coparenting competence (CC) is a concept that describes the sense of collective efficacy that parents experience in raising children. An advantage of CC is that it bridges a gap between family systems thinking and efficacy theory, where extant research and theory have focused on the self-efficacy of one or both parents. This study aimed to develop a self-reported measure of CC. METHODOLOGY: Participants (n = 302), including cohabiting mothers (n = 240) and fathers (n = 62), completed an online survey (112 items) comprising demographic questions, the Coparenting Relationship Scale (CRS), the Parenting Sense of Competence Scale (PSOC), the Strengths and Difficulties Questionnaire (SDQ), and 36 items designed to explore perceptions of CC. RESULTS: Factor analyses on 36-CC items identified 10 items that reliably formed a brief Coparenting Competence Scale (CCS; Alpha = 0.89). Analysis of convergent and divergent validity demonstrated that the CCS measures a unique construct that is linked to parenting self-efficacy, measured by PSOC (r = 0.47), and coparenting quality, assessed by the CRS (r = 0.63). There was a significant association between CCS and SDQ across age groups and an association stronger than that found for the CRS and SDQ in the current cohort. CONCLUSIONS AND IMPLICATIONS: The study found support for the reliability and validity of the CCS. Coparenting competence, assessed by the CCS, was found to be distinct from factors previously used to represent coparenting quality in multivariate scales. The strength of associations between the CCS and SDQ suggests this new measure may have an important role in coparenting research.

Examining the efficacy of a telehealth intervention targeting addictive eating in Australian adults (the TRACE Programme): a randomised controlled trial protocol.

INTRODUCTION: Approximately 15%-20% of the adult population self-report symptoms of addictive eating. There are currently limited options for management. Motivational interviewing-based interventions, containing personalised coping skills training, have been found to be effective for behaviour change in addictive disorders (eg, alcohol). This project builds upon foundations of an addictive eating feasibility study previously conducted and co-design process involving consumers. The primary aim of this study is to examine the efficacy of a telehealth intervention targeting addictive eating symptoms in Australian adults compared with passive intervention and control groups. METHODS AND ANALYSIS: This three-arm randomised controlled trial will recruit participants 18-85 years, endorsing ≥3 symptoms on the Yale Food Addiction Scale (YFAS) 2.0, with body mass index >18.5 kg/m2. Addictive eating symptoms are assessed at baseline (pre-intervention), 3 months (post-intervention) and 6 months. Other outcomes include dietary intake and quality, depression, anxiety, stress, quality of life, physical activity and sleep hygiene. Using a multicomponent clinician-led approach, the active intervention consists of five telehealth sessions (15-45 min each) delivered by a dietitian over 3 months. The intervention uses personalised feedback, skill-building exercises, reflective activities and goal setting. Participants are provided with a workbook and website access. The passive intervention group receives the intervention via a self-guided approach with access to the workbook and website (no telehealth). The control group receives personalised written dietary feedback at baseline and participants advised to follow their usual dietary pattern for 6 months. The control group will be offered the passive intervention after 6 months. The primary endpoint is YFAS symptom scores at 3 months. A cost-consequence analysis will determine intervention costs alongside mean change outcomes. ETHICS AND DISSEMINATION: Human Research Ethics Committee of University of Newcastle, Australia provided approval (H-2021-0100). Findings will be disseminated via publication in peer-reviewed journals, conference presentations, community presentations and student theses. TRIAL REGISTRATION NUMBER: Australia New Zealand Clinical Trials Registry (ACTRN12621001079831).

Changes in the length of speeches in the plays of William Shakespeare and his contemporaries: A mixed models approach.

Since 2007 a number of investigators have compiled statistics on the length in words of speeches in plays by William Shakespeare and his contemporaries, focusing on a change to shorter speeches around 1600. In this article we take account of several potentially confounding factors in the variation of speech lengths in these works and present a model of this variation in the period 1538-1642 through Linear Mixed Models. We confirm that the mode of speech lengths in English plays changed from nine words to four words around 1600, and that Shakespeare's plays fit this wider pattern closely. We establish for the first time: that this change is independent of authorship, dramatic genre, theatrical company, and the proportion of verse in a play's dialogue; that the chosen time span can be segmented into pre-1597 plays (with high modes), 1597-1602 plays (with mixed high and low modes), and post-1602 plays (with low modes); that some additional secondary modes are evident in speech lengths, at 16 and 24 words, suggesting that the length of a standard blank verse line (around 8 words) is an underlying unit in speech length; and that the general change to short speeches also holds true when the data is viewed through the perspective of the median and the mean. The change in speech lengths is part of a collective drift in the plays towards liveliness and verisimilitude and is evidence of a hitherto hidden constraint on the playwrights: whether or not they were aware of the fact, playwrights as a group were conforming to a structure for the distribution of speech lengths peculiar to the era they were writing in. The authors hope that the full modelling of this variation in the article will help bring this change to the attention of scholars of Shakespeare and his contemporaries.

Paradigm shift in frog sperm cryopreservation: reduced role for non-penetrating cryoprotectants.

In brief: Sperm cryopreservation has been recognised as a tool for preventing loss of genetic diversity in amphibians; however, the combined effect of penetrative and non-penetrative cryoprotectants in cryodiluents is poorly understood. We demonstrate a clear benefit of using low concentrations of non-penetrative cryoprotectants when cryopreserving sperm of Australian tree frogs. Abstract: Sperm cryopreservation protocols have been developed for an increasing number of amphibian species since the recognition of a global amphibian decline. Yet, the development of these protocols has neglected to elucidate the combined effect of the penetrative(PCP) and non-penetrative cryoprotectant (NPCP) on the recovery of live, motile sperm. The two-factor hypothesis of cryoinjury recognises a trade-off between cooling cells slowly enough to allow osmotic dehydration and therefore avoid intracellular ice formation, but fast enough to minimise effects from increasing extracellular osmolality as the frozen fraction of the media increases during freezing. We tested the effect of two concentrations of a PCP (10 and 15% v/v dimethyl sulfoxide (Me2SO)) and two concentrations of an NPCP (1 and 10% w/v sucrose) in various combinations on the sperm of six pelodryadid frogs. In all species, 15% v/v Me2SO with 1% w/v sucrose provided superior post-thaw recovery with high proportions of forward progressive motility, live cells and intact acrosomes (typically >50% for each). Theoretically, it has been suggested that increased NPCP concentration should improve cell survival by increasing the rate and extent of cell dehydration. We suggest, however, that the elevated osmolality in the unfrozen water fraction when 10% sucrose is used may be causing damage to cells via excessive cell shrinkage and solute effects as proposed in the two-factor hypothesis of cryoinjury. We showed this response in sperm across a range of frog species, providing compelling evidence for this hypothesis. We suggest protocol development using the PCP/NPCP ratios demonstrated in our study will be broadly applicable to many amphibian species.

Primary and secondary cardiovascular disease prevention interventions targeting lifestyle risk factors in women: A systematic review and meta-analysis.

Background and aims: Over seven million women die from cardiovascular disease (CVD) annually. While lifestyle modification is recommended for CVD prevention, there are no systematic reviews evaluating the effectiveness of interventions targeted to women. The primary aim of this systematic review is to determine the efficacy of primary and secondary CVD prevention interventions targeting lifestyle risk factors in women. Methods: Six electronic databases were searched up to January 2022. Eligible studies included randomized controlled trials of primary or secondary CVD prevention interventions targeting CVD lifestyle risk factors (diet, physical activity, sedentary behavior, smoking, alcohol, sleep, and weight management) in women (≥18 years) that reported CVD risk markers or lifestyle risk factors. Meta-analyses were conducted on CVD risk markers and body mass index (BMI), and the level of evidence was applied to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria and reported. Results: Thirty-five RCTs were included (24 primary and 11 secondary prevention). Meta-analyses demonstrated that lifestyle CVD prevention interventions achieved statistically significant reductions in BMI at ≤ 6 months (0.95 kg/m2, 95% CI = 0.54 to 1.35, p < 0.0001), 12 months (0.61 kg/m2, 95% CI = 0.07 to 1.16, p = 0.03) and >12 months (0.58 kg/m2, 95% CI = 0.01 to 1.16, p = 0.05), and systolic blood pressure (mmHg) at ≤ 6 months (3.51, p < 0.001). Conclusions: Lifestyle interventions are important for the prevention of CVD in women, specifically to reduce systolic blood pressure in the short term (≤ 6 months) and BMI long term (>12 months). Systematic review registration: https://osf.io/bkwqm, identifier: osf-registrations-bkwqm-v1.

Seasonal variation in bull semen quality demonstrates there are heat-sensitive and heat-tolerant bulls.

Using semen data from 1271 ejaculates (79 different bulls, 11 different breeds) we have investigated the variability of semen quality in cattle living in sub-tropical conditions. Modelling shows definitive evidence of seasonal variation. Semen quality from the same bulls had a 90% "pass rate" for cryopreservation purposes in winter, dropping to less than 50% in summer. Notably, individual bulls could be classified as either "heat-tolerant" (produce good quality spermatozoa all year regardless of temperature) or "heat-sensitive" (only produce good quality sperm in summer). Nominal logistic regression demonstrated when temperatures reach 30.5 °C, 40% of heat-sensitive bulls fail a semen analysis 17 days later. At 34 °C, the proportion of bulls failing reached 63%. Ratifying this, the purposeful heating of bulls to 40 °C for 12 h showed that individual animals had different degrees of heat-sensitivity. Using historical temperature data, we then modelled how many days/decade bulls would be subject to heat-events. Beginning from 1939 to 1949, on average, the area in which bulls were kept recorded 19, 7 and 1 day over 38 °C, 39 °C and 40 °C respectively. This number steadily increases and of last decade (2010-2010), the numbers of days per decade over 38 °C, 39 °C and 40 °C jumped to a staggering 75, 39 and 15 respectively. These data show the urgent need to identify heat-tolerant bulls as future sires. Such variation likely explains why the veterinary bull breeding test often fails to accurately predict bull breeding potential.

Systematic review of lifestyle interventions to improve weight, physical activity and diet among people with a mental health condition.

BACKGROUND: People with a mental health condition experience an elevated risk of chronic disease and greater prevalence of health and behaviours. Lifestyle interventions aim to reduce this risk by modifying health behaviours such as physical activity and diet. Previous reviews exploring the efficacy of such interventions for this group have typically limited inclusion to individuals with severe mental illness (SMI), with a focus of impact on weight. This review assessed the efficacy of lifestyle interventions delivered in community or outpatient settings to people with any mental health condition, on weight, physical activity and diet. METHODS: Eligible studies were randomised or cluster-randomised controlled trials published between January 1999 and February 2019 aiming to improve weight, physical activity or diet, for people with any mental health condition. Two reviewers independently completed study screening, data extraction and assessment of methodological quality. Primary outcome measures were weight, physical activity and diet. Secondary outcome measures were body mass index (BMI), waist circumference, sedentary behaviour and mental health. Where possible, meta-analyses were conducted. Narrative synthesis using vote counting based on direction of effect was used where studies were not amenable to meta-analysis. RESULTS: Fifty-seven studies were included (49 SMI only), with 46 contributing to meta-analyses. Meta-analyses revealed significant (< 0.05) effect of interventions on mean weight loss (-1.42 kg), achieving 5% weight loss (OR 2.48), weight maintenance (-2.05 kg), physical activity (IPAQ MET minutes: 226.82) and daily vegetable serves (0.51), but not on fruit serves (0.01). Significant effects were also seen for secondary outcomes of BMI (-0.48 units) and waist circumference (-0.87cm), but not mental health (depression: SMD -0.03; anxiety: SMD -0.49; severity of psychological symptoms: SMD 0.72). Studies reporting sedentary behaviour were not able to be meta-analysed. Most trials had high risk of bias, quality of evidence for weight and physical activity were moderate, while quality of evidence for diet was low. CONCLUSION: Lifestyle interventions delivered to people with a mental health condition made statistically significant improvements to weight, BMI, waist circumference, vegetable serves and physical activity. Further high-quality trials with greater consistency in measurement and reporting of outcomes are needed to better understand the impact of lifestyle interventions on physical activity, diet, sedentary behaviour and mental health and to understand impact on subgroups. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019137197.

Associations between Suboptimal Sleep and Smoking, Poor Nutrition, Harmful Alcohol Consumption and Inadequate Physical Activity ('SNAP Risks'): A Comparison of People with and without a Mental Health Condition in an Australian Community Survey.

INTRODUCTION: People with a mental health condition experience disproportionate morbidity and mortality compared to the general population. This inequity has been largely attributed to a higher prevalence of chronic disease risk behaviours including smoking, poor nutrition, harmful alcohol consumption and inadequate physical activity ('SNAP risks'). Suboptimal sleep is highly prevalent among people with a mental health condition and, as an identified risk behaviour for several chronic diseases, has been implicated as an additional contributor to this health inequity. Research involving people without a mental health condition suggests associations between poor sleep and each SNAP risk; however, interactions with mental health status have not been reported in an Australian population. This study explored associations between suboptimal sleep and all four SNAP risks, and assessed whether they vary by mental health status. MATERIALS AND METHODS: A descriptive study (n = 1265) was undertaken using self-report data from a cross-sectional telephone survey of Australian adults. Based on national guidelines and recommendations that indicate when someone might be at risk of adverse health effects, SNAP risks and sleep variables were reduced to two levels: 'at risk' or 'not at risk'; and 'appropriate' or 'suboptimal', respectively. Chi square tests and multivariable logistic regression models explored associations between suboptimal sleep, SNAP risks and mental health status. RESULTS: Fifteen per cent (n = 184) of participants identified as having a mental health condition in the past 12 months. Being at risk of adverse health effects due to smoking had the strongest association with several measures of suboptimal sleep (ps < 0.05). Two-way interactions revealed that being at risk of adverse health effects due to alcohol use and physical inactivity resulted in a significantly greater likelihood of suboptimal sleep duration (OR 3.06, 95% CI 1.41 to 6.64; OR 3.06, 95% CI 1.41 to 6.69) and nap duration (OR 7.96, 95% CI 1.90 to 33.22), respectively, for people with a mental health condition compared to those without. CONCLUSIONS: The findings suggest associations between suboptimal sleep and smoking, risky alcohol consumption and physical inactivity, with the latter two perhaps being stronger among people with a mental health condition compared to those without such a condition. Poor sleep should be considered in interventions to address smoking, alcohol and physical activity; and vice versa. This study lends further support for the value of multirisk lifestyle interventions to promote physical and mental health for people with mental health conditions.

Interpretation, confidence and application of the standardised terms: Identified, Probable, Possible, Exclude and Insufficient in forensic odontology identification.

Forensic odontology identification scales are used to express certainty of identifications of deceased persons. These standardized scales are assumed to convey unambiguous expert opinions and facilitate communication between forensic odontologists and end users. However, to date no studies have investigated how the experts interpret and use these scales. Forensic odontology identification scales are used to express certainty of identifications of deceased persons. These standardized scales are assumed to convey unambiguous expert opinions and facilitate communication between forensic odontologists and end users. However, to date no studies have investigated how the experts interpret and use these scales. This paper aims to examine the interpretation of the DVISYS forensic identification scale and choices of the levels in the scale subsequent to, and derived from, comparison of pairs of dental radiographs by extending the analysis of the data collected in the study by Page and Lain et. al. 2017. The studied variables: self-reported confidence, forced binary decision of match and non-match, choice of level in the DVISYS scale (Identified, Probable, Possible, Insufficient and Exclude) were further analysed in this study using mixed models for relationships between the choices of level in the identification scale and the fundamental beliefs of likelihood of identification. The results of this further analysis showed that the reported confidence of the decisions was correlated to the difficulty of cases, and as confidence decreased the use of less definitive terms ('Probable', 'Possible' and 'Insufficient') increased. 'Probable' and 'Possible' were used mainly in underlying beliefs below that of 'Identified' whereas 'Insufficient' was used mainly to convey a sublevel of 'Exclude'. The use of 'Insufficient' in this study was not consistent with the prescribed definition of the term. The participants of the original study were not aware of the difficulty grading of the cases nor were required to grade them, however the reported confidence was systematically correlated to difficulty. Furthermore, indicated confidence level was correlated with choice of level on the scale in general, but the interpretation of the definition and application of the terms varied. The findings reported here contribute to the foundational knowledge of factors governing the interpretation and application of the DVISYS forensic odontology identification scale and suggest that this scale may need to be modified.

Generation of reproductively mature offspring from the endangered green and golden bell frog Litoria aurea using cryopreserved spermatozoa.

Amphibians are becoming increasingly reliant on captive breeding programs for continued survival. Assisted reproductive technologies including gamete cryopreservation and IVF can help reduce costs of breeding programs, provide insurance against extinction and assist genetic rescue in wild populations. However, the use of these technologies to produce reproductively mature offspring has only been demonstrated in a few non-model species. We aimed to optimise sperm cryopreservation in the threatened frog Litoria aurea and generate mature offspring from frozen-thawed spermatozoa by IVF. We tested three concentrations (1.4, 2.1 and 2.8M) of the cryoprotectants dimethylsulfoxide (DMSO) and glycerol with 0.3M sucrose. Using DMSO was more likely to result in recovery of sperm motility, vitality and acrosome integrity than glycerol, regardless of concentration, with forward progressive motility being most sensitive to damage. The lowest concentrations of 1.4 and 2.1M provided the best protection regardless of cryoprotectant type. Spermatozoa cryopreserved in 2.1M DMSO outperformed spermatozoa cryopreserved in equivalent concentrations of glycerol in terms of their ability to fertilise ova, resulting in higher rates of embryos hatching and several individuals reaching sexual maturity. We have demonstrated that sperm cryopreservation and subsequent offspring generation via IVF is a feasible conservation tool for L. aurea and other threatened amphibians.

Carbon sequestration value of biosolids applied to soil: A global meta-analysis.

Biosolids produced at wastewater treatment facilities are extensively used in agricultural land and degraded mine sites to improve soil health and soil organic carbon (SOC) stocks. Many studies have reported increases in SOC due to application of biosolids to such sites. However, lack of a comprehensive quantification on overall trends and changes of magnitude in SOC remains. Here, we performed a meta-analysis to identify drivers with a relationship with SOC stocks. A meta-regression of 297 treatments found four variables with a relationship with SOC stocks: cumulative biosolids carbon (C) input rate, time after application, soil depth and type of biosolids. The cumulative biosolids C input rate was the most influencing driver. The highest mean difference for SOC% of 3.3 was observed at 0-15 cm soil depth for a cumulative C input of 100 Mg ha-1 at one year after biosolids application. Although years after biosolids application demonstrated a negative relationship with SOC stocks, mineralization of C in biosolids-applied soils is slow, as indicated with the SOC% decrease from 4.6 to 2.8 at 0-15 cm soil depth over five years of 100 Mg ha-1 biosolids C input. Soil depth illustrated a strong negative effect with SOC stocks decreasing by 2.7% at 0-15 cm soil depth at a cumulative biosolids C input of 100 Mg ha-1 over a year. Overall, our model estimated an effect of 2.8 SOC% change, indicating the application of biosolids as a viable strategy for soil C sequestration on a global scale.

Examining service participation and outcomes from a population-level telephone-coaching service supporting changes to healthy eating, physical activity and weight: A comparison of participants with and without a mental health condition.

Population-level telephone coaching services provide accessible behaviour change support for modifiable health risk behaviours. The NSW Get Healthy Information and Coaching Service® (GHS) is a free telephone-based coaching service in Australia, supporting improvements in healthy eating, physical activity and achieving or maintaining a healthy weight. This study compared measures of participation (such as program completion) and outcomes achieved immediate post-program (including changes in fruit and vegetable consumption, physical activity and weight) for GHS participants with and without a self-identified mental health condition (MHC). Secondary data analysis was conducted on service data collected at program intake and completion for individuals who enrolled in a coaching program between January 2018 and October 2019 (n = 5,629); 33% identified as having had an MHC. While those with and without an MHC had similar rates of completion, those with an MHC were less likely to complete a coaching program (31% vs 36%, p = .003). Participants with an MHC made significant positive changes to their fruit and vegetable consumption, physical activity (walking and moderate), weight and BMI, but not to waist circumference or vigorous physical activity. When comparing the magnitude of change for those with and without an MHC, individuals without made greater improvements to their weight (adjusted mean difference -0.623 kg, p = .034) and daily vegetable intake (adjusted mean difference -0.199 serves; p = .01). There were no differences for other variables. The GHS is an effective means of supporting behaviour change for people with an MHC who complete a coaching program. Further research should consider means of improving retention rates.

Social Capital, Loneliness, and Peer Relationships of Adolescents who are Deaf or Hard of Hearing.

There are many documented benefits of social capital to adolescents in general, and for young people who are deaf or hard of hearing social capital can potentially have a buffering effect against adverse life outcomes. Using the Loneliness and Social Dissatisfaction Questionnaire ( Asher et al., 1984; Cassidy & Asher, 1992) and the Looman Social Capital Scale ( Looman, 2006), this research investigated changes in levels of social capital and loneliness and peer relationships of deaf or hard of hearing adolescents before attending a residential camp and then three, six- and 12-months post-camp. The camp was specifically for DHH adolescents whose primary communication mode was spoken language. The study also investigated associations between social capital and adolescents' perceptions of loneliness and peer relationships. Results indicated no statistically significant change in social capital and loneliness and peer relations over the four-time points. There was a significant association between one social capital scale, common good, and loneliness. Implications of these findings are discussed, and recommendations are made for enhancing social capital development within a residential camp experience.

A new island-scale tropical cyclone outlook for southwest Pacific nations and territories.

The southwest Pacific (SWP) region is vulnerable to tropical cyclone (TC) related impacts which adversely affect people, infrastructure and economies across several nations and territories. Skilful TC outlooks are needed for this region, but the erratic nature of SWP TCs and the complex ocean-atmosphere interactions that influence TC behaviour on seasonal timescales presents significant challenges. Here, we present a new TC outlook tool for the SWP using multivariate Poisson regression with indices of multiple climate modes. This approach provides skilful, island-scale TC count outlooks from July (four months ahead of the official TC season start in November). Monthly island-scale TC frequency outlooks are generated between July and December, enabling continuous refinement of predicted TC counts before and during a TC season. Use of this approach in conjunction with other seasonal climate guidance (including dynamical models) has implications for preparations ahead of severe weather events, resilience and risk reduction.

Effectiveness of embedding a specialist preventive care clinician in a community mental health service in increasing preventive care provision: A randomised controlled trial.

OBJECTIVE: Clinical practice guidelines recommend that community mental health services provide preventive care for clients' chronic disease risk behaviours; however, such care is often not routinely provided. This study aimed to assess the effectiveness of offering clients an additional consultation with a specialist clinician embedded within a community mental health service, in increasing client-reported receipt of, and satisfaction with, preventive care. METHOD: A randomised controlled trial was undertaken in one Australian community mental health service. Participants (N = 811) were randomised to receive usual care (preventive care in routine consultations; n = 405) or usual care plus the offer of an additional consultation with a specialist preventive care clinician (n = 406). Blinded interviewers assessed at baseline and 1-month follow-up the client-reported receipt of preventive care (assessment, advice and referral) for four key risk behaviours individually (smoking, poor nutrition, alcohol overconsumption and physical inactivity) and all applicable risks combined, acceptance of referrals and satisfaction with preventive care received. RESULTS: Analyses indicated significantly greater increases in 12 of the 18 preventive care delivery outcomes in the intervention compared to the usual care condition from baseline to follow-up, including assessment for all risks combined (risk ratio = 4.00; 95% confidence interval = [1.57, 10.22]), advice for all applicable risks combined (risk ratio = 2.40; 95% confidence interval = [1.89, 6.47]) and offer of referral to applicable telephone services combined (risk ratio = 20.13; 95% confidence interval = [2.56, 158.04]). For each component of care, there was a significant intervention effect for at least one of the individual risk behaviours. Participants reported high levels of satisfaction with preventive care received, ranging from 77% (assessment) to 87% (referral), with no significant differences between conditions. CONCLUSION: The intervention had a significant effect on the provision of the majority of recommended elements of preventive care. Further research is needed to maximise its impact, including identifying strategies to increase client uptake.

An economic evaluation of a specialist preventive care clinician in a community mental health service: a randomised controlled trial.

BACKGROUND: Clinical practice guidelines and policies direct community mental health services to provide preventive care to address chronic disease risks, however, such care is infrequently provided in routine consultations. An alternative model of care is to appoint a clinician to the dedicated role of offering and providing preventive care in an additional consultation: the 'specialist clinician' model. Economic evaluations of models of care are needed to determine the cost of adhering to guidelines and policies, and to inform pragmatic service delivery decisions. This study is an economic evaluation of the specialist clinician model; designed to achieve policy concordant preventive care delivery. METHODS: A retrospective analysis of the incremental costs, cost-effectiveness, and budget impact of a 'specialist preventive care clinician' (an occupational therapist) was conducted in a randomised controlled trial, where participants were randomised to receive usual care; or usual care plus the offer of an additional preventive care consultation with the specialist clinician. The study outcome was client acceptance of referrals to two free telephone-based chronic disease prevention services. This is a key care delivery outcome mandated by the local health district policy of the service. The base case analysis assumed the mental health service cost perspective. A budget impact analysis determined the annual budget required to implement the model of care for all clients of the community mental health service over 5 years. RESULTS: There was a significantly greater increase from baseline to follow-up in the proportion of intervention participants accepting referrals to both telephone services, compared to usual care. The incremental cost-effectiveness ratio was $347 per additional acceptance of a referral (CI: $263-$494). The annual budget required to implement the model of care for all prospective clients was projected to be $711,446 over 5-years; resulting in 2616 accepted referrals. CONCLUSIONS: The evaluation provides key information regarding the costs for the mental health service to adhere to policy targets, indicating the model of care involved a low per client cost whilst increasing key preventive care delivery outcomes. Additional modelling is required to further explore its economic benefits. TRIAL REGISTRATION: ACTRN12616001519448. Registered 3 November 2016, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371709.

The association between the receipt of primary care clinician provision of preventive care and short term health behaviour change.

Primary healthcare services are recommended to provide preventive care to address chronic disease risk behaviours. However, all care elements are infrequently provided, and there is a need to understand the impact of partial care provision on behaviour change. This study examined the association between variable levels of preventive care receipt from primary care clinicians on short-term behaviour change for four risk behaviours. A survey was undertaken with 5639 Australian community health service clients (2009-2014). Clients self-reported: engagement in risk behaviours (tobacco smoking, harmful alcohol consumption, inadequate fruit and/or vegetable consumption, physical inactivity) in the month prior to and four week post their community health service appointment; receipt of preventive care during appointments (assessment, advice, referral/follow-up) for each behaviour. Univariate regression models explored the association between change in risk status and preventive care received. The odds of behaviour change for those receiving all three care elements was significant for all behaviours, compared to no care, ranging from 2.02 (alcohol consumption, 95% CI 1.16-3.49) to 4.17 (inadequate fruit and/or vegetable consumption, 95% CI 2.91-5.96). Receipt of both assessment and advice increased the odds of behaviour change, compared to no care, for all behaviours except smoking, ranging from 2.32 (physical inactivity, 95% CI 1.60-3.35) to 2.83 (alcohol consumption, 95% CI 1.84-4.33). Receipt of 'assessment only' increased the odds of behaviour change, compared to no care, for inadequate fruit and/or vegetable consumption (OR = 2.40, 95% CI 1.60-3.59) and physical inactivity (OR = 2.81, 95% CI 1.89-4.17). Results highlight the importance of primary care clinicians providing best practice preventive care to maximise client behaviour change.