Stephen McKenzie

Systematic review of incidental physical activity community interventions.

BACKGROUND Increasing incidental physical activity (IPA) such as active transport has substantial public health potential. OBJECTIVE This systematic review describes community-based and community-wide IPA interventions and assesses their effectiveness. METHOD Data sources (Medline, Embase, PsycINFO and CINAHL) were searched along with the reference lists of identified systematic reviews and included articles. Eligibility criteria; 4+ weeks in duration; 20+ participants; community-based or community-wide; stated aim to increase IPA. RESULTS Forty three studies were identified from 42 original articles; more than half (60%) aimed to increase stair use compared to escalator and/or lift use; a quarter (23%) aimed to increase active transport; and, 16% to increase playground energy expenditure. More than two-thirds of studies reported a significant increase in IPA. Accurate comparisons between studies were not possible due to substantial heterogeneity in study design. Critical appraisal of studies revealed that the level of bias was moderate-high in most of the studies (77%). CONCLUSION Due to the heterogeneity and bias of included studies, only limited conclusions can be drawn about the effectiveness of IPA interventions. However, this systematic review provides a timely summary of current evidence that can be used to inform decision-makers in designing IPA interventions in the community.

Co-morbid depression and chronic illness related to coping and physical and mental health status

A partial latent structural regression analysis was used to evaluate the role of coping resources, depression, diet and exercise on mental and physical health status. The sample consisted of 113 participants (59 females and 54 males) with a mean age of 59.38 years (SD = 10.52). Coping resources, depression and exercise explained 52 and 26% of the variance in mental and physical health status, respectively. Fewer coping resources predicted higher levels of depression and both predicted worse mental health. Only higher levels of depression predicted worse physical health status. There were also significant indirect effects of coping on mental and physical health status through depression. The development of cognitive, social and emotional coping strategies is important for managing depression and supporting positive mental health. These results highlight the important role of health psychologists in the care of individuals with chronic illness. Additionally, the management of depression is important in maintaining positive physical health.

When the Cats are away: The impact of sporting events on assault‐ and alcohol‐related emergency department attendances

INTRODUCTION AND AIMS Despite the attention given to the broad topic of alcohol and violence, there are few studies of this relationship in the context of sporting events and their impact on alcohol-related hospital emergency department (ED) attendances, none of which are Australian. METHODS De-identified patient records from Barwon Healths Geelong Hospital ED were analysed from 1 July 2005 to 16 February 2010. Information contained in these records included age, gender, suburb of residence, attendance date and time, arrival mode and reason for attendance. The ED triage database was searched for attendances relating to alcohol, drugs and assault of which 16,940 cases were returned. RESULTS There was a substantial increase in annual alcohol-related ED attendances from 2006 to 2009. Hierarchical binary logistic regression analyses showed that having a game on a particular day did not contribute to the model, but there were significantly more ED attendances for assaults on days when the Geelong Cats won. There were no significant predictors of ED attendance for alcohol-related harm in the variables studied. DISCUSSION The findings of the study suggest that there are significantly more assault-related attendances at the ED in Geelong when the local national football team, the Geelong Cats, won. None of the variables under investigation appears to have impacted on alcohol-related attendances which were not assaults (i.e. injuries or intoxication). CONCLUSIONS It appears that increases in ED attendances associated with the success of a local sporting team are not significantly associated with alcohol use and are more influenced by other factors.

The community impact of RIOTT, a medically supervised injectable maintenance clinic in south London

Background: One of the major issues facing treatment services for alcohol and other drug users (current or ex-) around the world is community backlash, which has led to the closure of some much-needed drug treatment services. Aims: This study investigates the impact on the local community of a Medically Supervised Injectable Maintenance Clinic (MSIMC) implemented as part of the Randomised Injectable Opioid Treatment Trial (RIOTT), a trial into the effectiveness and efficacy of the provision of injectable opioids versus conventional oral methadone. The clinic model is based around a small number of the most entrenched and refractory patients (approx. 30) being treated by the service at any one time. Methods: The clinic and the trial were conceived primarily over 2002–2005, and the clinic began actual clinical operation in October 2005. The research was conducted between July 2005 and October 2007. Methods involved: pre-trial community key informant interviews; two-year follow-up key informant interviews; a...

Applying Best Practice Online Learning, Teaching, and Support to Intensive Online Environments: An Integrative Review

Demand for flexible online offerings has continued to increase as prospective students seek to upskill, re-train, and undertake further study. Education institutions are moving to intensive modes of online study delivered in six- to eight-week study periods which offer more frequent intake periods. Prior literature has established key success factors for non-intensive (12-13 week) online offerings; for teachers, skill development is critical to promote a flexible, responsive approach and maintain technological capabilities; for students, an ability to navigate the technology, interact with the learning environment in meaningful ways, and self-regulate learning is important, as the absence of physical infrastructure and opportunities for face-to-face interactions in online environments places a greater emphasis on alternate forms of communication and support. The current paper explores known best practice principles for online instructors, students and student support, and considers how these might apply to intensive online environments. It is suggested that the accelerated nature of learning in intensive settings may place additional demands on students, instructors and support mechanisms. Further research is imperative to determine predictors of success in online intensive learning environments.

Investigating the effect on public behaviour of patients of a Medically Supervised Injectable Maintenance Clinic

Purpose – The behaviour of patients of alcohol and other drug treatment services in the communities where the services are based has often been a major problem for the services. This study seeks to investigate the street behaviour of patients enrolled in a Medically Supervised Injectable Maintenance Clinic (MSIMC) implemented as part of the Randomised Injectable Opioid Treatment Trial (RIOTT), into the effectiveness and efficacy of providing injectable opioids versus conventional oral methadone.Design/methodology/approach – Patient behaviour on the streets of Camberwell was recorded via data from records of the fortnightly Camberwell Street Population Forum (CSPF), between 12/11/2004 and 08/09/2006.Findings – In total, 81 individuals were identified as engaging in anti‐social behaviour or being part of the street population, including seven (8.6 per cent) who had also taken part in the RIOTT. There was a clear treatment effect for RIOTT participants.Originality/value – The use of CSPF records suggests a s...