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Living walls (LW) have been widely proposed as a form of green infrastructure to improve aesthetics, energy consumption, and microclimate in urban environments by adding densely-planted vegetation to the outside walls of buildings. Scientific studies using multiple treatments in a single LW face challenges due to the close physical proximity of different treatments, particularly the potential for plants above to influence those below. A study on a west-facing LW was undertaken to investigate 36 unique treatments in Adelaide, South Australia, for nine months. The LW comprised combinations of six native plant species, three soil substrates and two irrigation volumes. The LW consisted of 144 modular trays mounted on a wall in a 12 × 12 grid with four replicates of each treatment. The location of each treatment was designed to account for a cascading carry-over effect that may be present when one plant is placed above another. Carry-over effect of the model designed showed mixed results among the plant groups identified. It was also found that long-form plants can significantly shade smaller plants below them. Experimental research into the performance of plants in mixed species LW should consider the carry-over effect to account for this.

A comparison of leafy green plant species’ (lettuce (Lactuca sativa L.), dill (Anethum graveolens L.), rocket (Eruca sativa), coriander (Coriandrum sativum L.), and parsley (Petroselinum crispum)) growth rates was performed between an Nutrient Film Technique (NFT)hydroponic system, using standard commercial nutrient solution, and an NFT aquaponic system, using fish waste from Grass Carp, (Ctenopharyngodon idella) which provided the majority of the nutrients required by the plants. The results demonstrated that the aquaponic method performed well, and, in many cases, the growth rates produced were similar to those of the hydroponic method. Lettuce growth was compared across three seasons (summer, winter, and spring), and, in all cases, the aquaponically-grown lettuce equalled, or bettered, the hydroponic equivalent. Herb growth was compared over a five-month period (February to June—summer/autumn), and in 17 out of 23 comparisons, the aquaponic method produced results similar to those of the hydroponic method. Thus, while the NFT method may not be the most appropriate technical approach for aquaponic integration, the results suggest that the overall aquaponic method has the potential to produce plant growth rates at least equal to those of standard hydroponics.

Abstract Objective: To measure chlamydia testing and positivity rates among 16–39 year olds attending Aboriginal Community Controlled Health Services (ACCHSs). Methods: Retrospective non‐identifiable computerised records containing consultation and chlamydia testing data were collected for patients (16–39 years) attending eight ACCHSs during 2008–09 in urban, regional and remote settings for the Australian Collaboration for Chlamydia Enhanced Sentinel Surveillance (ACCESS) system. Annual chlamydia testing and positivity rates were estimated. Results: Over two years, 13,809 patients aged 16–39 years (57.8% female, 82.3% Aboriginal or Torres Strait Islander) attended. The annual overall chlamydia testing rate was 13.0% (2008) and 16.0% (2009). Testing rates were higher among females (p

Abstract Objective: To describe the methods and basic demographics of participants in a national survey of Aboriginal and Torres Strait Islander (Aboriginal) people specific to sexually transmissible infections and bloodborne viruses. Methods: A national cross‐sectional survey of Aboriginal people aged 16–29 years in all Australian jurisdictions between 2011 and 2013 conducted at Aboriginal community events. Questions comprised demographic information, knowledge, risk behaviours and health service utilisation. Questionnaires were completed on personal digital assistants (PDAs). Results: A total of 2,877 people at 21 unique community events completed the questionnaire. A total of 59% of participants were female, median age was 21 years and more than 60% were single at the time of the survey. Just over half the participants were resident in an urban area (53%) and 38% were from a regional area. Aboriginal health organisations played an important role in implementing the research. PDAs were found to be an acceptable method for collecting health information. Conclusion: This survey has recruited a large representative sample of Aboriginal people aged 16–29 years using a methodology that is feasible, acceptable and repeatable. Implications: The methodology provides a model for ongoing monitoring of this population as programs and policies are implemented to address young Aboriginal people's STI and BBV risks.

Water use and the cost of water are key factors when considering the net value of urban agriculture (UA). This systematic review critically evaluates past and recent UA yield research from the perspective of water use efficiency. A systematic literature search was conducted using the databases Scopus, ProQuest Agriculture and Environment, and Web of Science for references from 1975 to 2018, with 25 articles meeting the inclusion criteria. Of these, only five articles had actively collected UA water use data, all on purpose-built experimental gardens. Considering the scarcity of UA water use efficiency and water measurement literature, South Australia is presented as a case study to demonstrate the considerable diversity of water pricing, water sources and irrigation methods available to urban food growers. The practical challenges of garden placement and the wide variety of cultivation techniques, water sources and irrigation methods are reviewed. Four equations to calculate the water use efficiency (WUE) of UA are proposed and demonstrated. Collection of additional UA water use data would support more robust evaluations of the water use efficiency and economic implications of different cultivation techniques. Further work in this field will enable a realistic understanding of the current and future contribution of UA to our society.

We are living in an age of concern for mental health and wellbeing. The objective of the research presented in this paper is to investigate the perceived health, social value and happiness benefits of urban agriculture (UA) by focusing on home and community food gardens in South Australia. The results reported in this paper are from “Edible Gardens”, a citizen science project designed to investigate the social value, productivity and resource efficiency of UA in South Australia. Methods include an online survey and in-field garden data collection. Key findings include: dominant home gardener motivations were the produce, enjoyment, and health, while dominant community gardener motivations were enjoyment, connection to others and the produce. Exploratory factor analysis revealed four key factors: Tranquillity and Timeout, Develop and Learn Skills, the Produce, and Social Connection. The key difference between home and community gardeners was an overall social connection. Although home gardeners did not appear to actively value or desire inter-household social connection, this does not mean they do not value or participate in other avenues of social connection, such as via social learning sources or by sharing food with others. The combined results from this research regarding health and wellbeing, social connection and happiness support the premise that engagement in home or community food gardening may provide a preventative or supportive role for gardener health and wellbeing, regardless of whether it is a conscious motivation for participation.

The uptake of HIV prevention services is lower among youth than adults in sub-Saharan Africa. Existing youth livelihood trainings offer a potential entry point to HIV prevention services. We determined feasibility and preliminary effectiveness of integrating HIV prevention into youth clubs implementing an empowerment and livelihood for adolescents (ELA) intervention in rural Uganda. Staff conducted community mobilization for youth (15-24 years) over one month. Clubs met (3×/week) over six months, with local peer mentors trained to teach life-skills and sexual/reproductive health education. We integrated mentor-led education on HIV prevention, including pre- and post-exposure prophylaxis (PrEP/PEP). Clubs offered on-site HIV testing, a field trip to a local clinic and PrEP referrals after one month and six months. Surveys were conducted at baseline and six months. Forty-two participants (24 adolescent girls/young women (AGYW) and 18 adolescent boys/young men (ABYM)) joined the clubs. At baseline, no participants accepted referral for PrEP, whereas 5/18 (28%) sexually active, HIV-negative AGYW requested PrEP referral at follow-up. One ABYM requested PEP referral. Integration of HIV prevention services into an established ELA curriculum at mentor-led youth clubs in rural Uganda was feasible. PrEP uptake increased among sexually active AGYW. Evaluation of this approach for HIV prevention among youth merits further study.

Surveillance for gonorrhoea antimicrobial resistance (AMR) is compromised by a move away from culture-based testing in favour of more convenient nucleic acid amplification test (NAAT) tests. We assessed the potential benefit of a molecular resistance test in terms of the timeliness of detection of gonorrhoea AMR.An individual-based mathematical model was developed to describe the transmission of gonorrhoea in a remote Indigenous population in Australia. We estimated the impact of the molecular test on the time delay between first importation and the first confirmation that the prevalence of gonorrhoea AMR (resistance proportion) has breached the WHO-recommended 5% threshold (when a change in antibiotic should occur). In the remote setting evaluated in this study, the model predicts that when culture is the only available means of testing for AMR, the breach will only be detected when the actual prevalence of AMR in the population has already reached 8 - 18%, with an associated delay of ~43 - 69 months between first importation and detection. With the addition of a molecular resistance test, the number of samples for which AMR can be determined increases facilitating earlier detection at a lower resistance proportion. For the best case scenario, where AMR can be determined for all diagnostic samples, the alert would be triggered at least 8 months earlier than using culture alone and the resistance proportion will have only slightly exceeded the 5% notification threshold.Molecular tests have the potential to provide more timely warning of the emergence of gonorrhoea AMR. This in turn will facilitate earlier treatment switching and more targeted treatment, which has the potential to reduce the population impact of gonorrhoea AMR.

BACKGROUND:Point-of-care tests for chlamydia (CT) and gonorrhoea (NG) could increase the uptake and timeliness of testing and treatment, contribute to improved disease control and reduce reproductive morbidity. The GeneXpert (Xpert CT/NG assay), suited to use at the point-of-care, is being used in the TTANGO randomised controlled trial (RCT) in 12 remote Australian health services with a high burden of sexually transmissible infections (STIs). This represents the first ever routine use of a molecular point-of-care diagnostic for STIs in primary care. The purpose of this study was to explore the acceptability of the GeneXpert to primary care staff in remote Australia. METHODS:In-depth qualitative interviews were conducted with 16 staff (registered or enrolled nurses and Aboriginal Health Workers/Practitioners) trained and experienced with GeneXpert testing. Interviews were digitally-recorded and transcribed verbatim prior to content analysis. RESULTS:Most participants displayed positive attitudes, indicating the test was both easy to use and useful in their clinical context. Participants indicated that point-of-care testing had improved management of STIs, resulting in more timely and targeted treatment, earlier commencement of partner notification, and reduced follow up efforts associated with client recall. Staff expressed confidence in point-of-care test results and treating patients on this basis, and reported greater job satisfaction. While point-of-care testing did not negatively impact on client flow, several found the manual documentation processes time consuming, suggesting that improved electronic connectivity and test result transfer between the GeneXpert and patient management systems could overcome this. Managing positive test results in a shorter time frame was challenging for some but most found it satisfying to complete episodes of care more quickly. CONCLUSIONS:In the context of a RCT, health professionals working in remote primary care in Australia found the GeneXpert highly acceptable. These findings have implications for use in other primary care settings around the world.

ObjectivesPoint-of-care (POC) testing for chlamydia (CT) and gonorrhoea (NG) offers a new approach to the diagnosis and management of these sexually transmitted infections (STIs) in remote Australian communities and other similar settings. Diagnosis of STIs in remote communities is typically symptom driven, and for those who are asymptomatic, treatment is generally delayed until specimens can be transported to the reference laboratory, results returned and the patient recalled. The objective of this study was to explore the clinical implications of using CT/NG POC tests in routine clinical care in remote settings.MethodsIn-depth qualitative interviews were conducted with a purposively selected group of 18 key informants with a range of sexual health and laboratory expertise.ResultsParticipants highlighted the potential impact POC testing would have on different stages of the current STI management pathway in remote Aboriginal communities and how the pathway would change. They identified implications for offering a POC test, specimen collection, conducting the POC test, syndromic management of STIs, pelvic inflammatory disease diagnosis and management, interpretation and delivery of POC results, provision of treatment, contact tracing, management of client flow and wait time, and re-testing at 3 months after infection.ConclusionsThe introduction of POC testing to improve STI service delivery requires careful consideration of both its advantages and limitations. The findings of this study will inform protocols for the implementation of CT/NG POC testing, and also STI testing and management guidelines.

The presence and severity of pelvic inflammatory disease (PID) symptoms are thought to vary by microbiological etiology but there is limited empirical evidence. We sought to estimate and compare the rates of hospitalisation for PID temporally related to diagnoses of gonorrhoea and chlamydia.All women, aged 15-45 years in the Australian state of New South Wales (NSW), with a diagnosis of chlamydia or gonorrhoea between 01/07/2000 and 31/12/2008 were followed by record linkage for up to one year after their chlamydia or gonorrhoea diagnosis for hospitalisations for PID. Standardised incidence ratios compared the incidence of PID hospitalisations to the age-equivalent NSW population.A total of 38,193 women had a chlamydia diagnosis, of which 483 were hospitalised for PID; incidence rate (IR) 13.9 per 1000 person-years of follow-up (PYFU) (95%CI 12.6-15.1). In contrast, 1015 had a gonorrhoea diagnosis, of which 45 were hospitalised for PID (IR 50.8 per 1000 PYFU, 95%CI 36.0-65.6). The annual incidence of PID hospitalisation temporally related to a chlamydia or gonorrhoea diagnosis was 27.0 (95%CI 24.4-29.8) and 96.6 (95%CI 64.7-138.8) times greater, respectively, than the age-equivalent NSW female population. Younger age, socio-economic disadvantage, having a diagnosis prior to 2005 and having a prior birth were also associated with being hospitalised for PID.Chlamydia and gonorrhoea are both associated with large increases in the risk of PID hospitalisation. Our data suggest the risk of PID hospitalisation is much higher for gonorrhoea than chlamydia; however, further research is needed to confirm this finding.

At the onset of the 21st century, the United States ushered in a new era of school accountability and reform with the No Child Left Behind Act [NCLB] (United States Department of Education, 2010). Until and unless it is repealed or replaced, this law continues in effect today, with many states now applying to renew their NCLB waivers (Klein, 2015). Moreover, the responsibility for meeting the expectations of accountability and the need for ongoing improvement continue to rest squarely on the shoulders of school principals, many of whom may broadly understand data-driven decision making, but may lack the knowledge and strategic information to maximize the use of data findings in improving student achievement. The Mid-Continent Research for Education and Learning organization (McREL) has identified 21 leadership responsibilities that describe the knowledge and skills school leaders need to positively impact student achievement. This analysis centers around the McREL leadership responsibilities with an effect size of 0.25 or higher that require a focus on data. The use of hard and soft data to focus improvement is then analyzed and expanded upon through the McREL leadership framework lens.

This descriptive study investigates the development of a district leadership coaching program. Specifically, the study examines the creation of a coaching program for elementary principals, the first six months of monthly meetings between the coaches and district leaders, and the perceived utility of the meetings by the district coaches. Qualitative methods were used to examine: (a) the development of a leadership coaching program for principals, (b) the communication and interaction between coaches and district leadership, and (c) the perceived effectiveness of the infrastructure. The findings indicate that when there is a cluster of leadership coaches, as well as regularly scheduled meetings between district leadership and coaches, there may be advantages to the district, the coached principals, and the coaches. (Contains 2 footnotes.)

With the enactment of No Child Left Behind, districts across the country have been consumed with ensuring that students are proficient in math and reading. However, by the very nature of the law, the definition of "proficient" varies from state to state as well as within states. Since countless resources are being poured into this endeavor and since there are extreme sanctions for schools and districts that are not meeting the Annual Measurable Objective (AMO), which dictates the percentage of students that must be proficient each year, the definition should be clear.