“Braking bad”:The influence of haptic feedback and tram driver experience on emergency braking performance

Trams are experiencing a resurgence with worldwide network expansion driven by the need for sustainable and efficient cities. Trams often operate in shared or mixed-traffic environments, which raise safety concerns, particularly in hazardous situations. This paper adopts an international, mixed-methods approach, conducted through two interconnected studies in Melbourne (Australia) and Birmingham (UK). The first study involved qualitative interviews, while the second was an experimental study involving a virtual reality (VR) simulator and haptic master controller (i.e., speed lever). In tram operations, master controllers play a critical role in ensuring a smooth ride, which directly influences passenger safety and comfort. The objective was to understand how a master control system, enhanced with additional haptic feedback, could improve tram driver braking performance and perceptions in safety-critical scenarios. Interview results indicate that the use of the emergency brake is considered the final or ultimate choice by drivers, and their driving experience is a moderating factor in limiting its application. Combined with the experimental results, this paper highlights how implementing haptic feedback within a master controller can reduce the performance disparity between novice and experienced tram drivers.</p

The CLIMATE schools combined study: a cluster randomised controlled trial of a universal Internet-based prevention program for youth substance misuse, depression and anxiety

Background: Anxiety, depressive and substance use disorders account for three quarters of the disability attributed to mental disorders and frequently co-occur. While programs for the prevention and reduction of symptoms associated with (i) substance use and (ii) mental health disorders exist, research is yet to determine if a combined approach is more effective. This paper describes the study protocol of a cluster randomised controlled trial to evaluate the effectiveness of the CLIMATE Schools Combined intervention, a universal approach to preventing substance use and mental health problems among adolescents. Methods/design: Participants will consist of approximately 8400 students aged 13 to 14-years-old from 84 secondary schools in New South Wales, Western Australia and Queensland, Australia. The schools will be cluster randomised to one of four groups; (i) CLIMATE Schools Combined intervention; (ii) CLIMATE Schools - Substance Use; (iii) CLIMATE Schools - Mental Health, or (iv) Control (Health and Physical Education as usual). The primary outcomes of the trial will be the uptake and harmful use of alcohol and other drugs, mental health symptomatology and anxiety, depression and substance use knowledge. Secondary outcomes include substance use related harms, self-efficacy to resist peer pressure, general disability, and truancy. The link between personality and substance use will also be examined.Discussion: Compared to students who receive the universal CLIMATE Schools - Substance Use, or CLIMATE Schools - Mental Health or the Control condition (who received usual Health and Physical Education), we expect students who receive the CLIMATE Schools Combined intervention to show greater delays to the initiation of substance use, reductions in substance use and mental health symptoms, and increased substance use and mental health knowledge

Oral abstracts 1: SpondyloarthropathiesO1. Detecting axial spondyloarthritis amongst primary care back pain referrals

Background: Inflammatory back pain (IBP) is an early feature of ankylosing spondylitis (AS) and its detection offers the prospect of early diagnosis of AS. However, since back pain is very common but only a very small minority of back pain sufferers have ASpA or AS, screening of back pain sufferers for AS is problematic. In early disease radiographs are often normal so that fulfilment of diagnostic criteria for AS is impossible though a diagnosis of axial SpA can be made if MRI evidence of sacroiliitis is present. This pilot study was designed to indicate whether a cost-effective pick up rate for ASpA/early AS could be achieved by identifying adults with IBP stratified on the basis of age. Methods: Patients aged between 18 and 45 years who were referred to a hospital physiotherapy service with back pain of more than 3 months duration were assessed for IBP. All were asked to complete a questionnaire based on the Berlin IBP criteria. Those who fulfilled IBP criteria were also asked to complete a second short questionnaire enquiring about SpA comorbidities, to have a blood test for HLA-B27 and CRP level and to undergo an MRI scan of the sacroiliac joints. This was a limited scan, using STIR, diffusion-weighted, T1 and T2 sequences of the sacroiliac joints to minimize time in the scanner and cost. The study was funded by a research grant from Abbott Laboratories Ltd. Results: 50 sequential patients agreed to participate in the study and completed the IBP questionnaire. Of these 27 (54%) fulfilled criteria for IBP. Of these, 2 patients reported a history of an SpA comorbidity - 1 psoriasis; 1 ulcerative colitis - and 3 reported a family history of an SpA comorbidity - 2 psoriasis; 1 Crohn's disease. 4 were HLA-B27 positive, though results were not available for 7. Two patients had marginally raised CRP levels (6, 10 -NR ≤ 5). 19 agreed to undergo MRI scanning of the sacroiliac joints and lumbar spine; 4 scans were abnormal, showing evidence of bilateral sacroiliitis on STIR sequences. In all cases the changes met ASAS criteria but were limited. Of these 4 patients 3 were HLA-B27 positive but none gave a personal or family history of an SpA-associated comorbidity and all had normal CRP levels. Conclusions: This was a pilot study yielding only limited conclusions. However, it is clear that: Screening of patients referred for physiotherapy for IBP is straightforward, inexpensive and quick. It appears that IBP is more prevalent in young adults than overall population data suggest so that targeting this population may be efficient. IBP questionnaires could be administered routinely during a physiotherapy assessment. HLA-B27 testing in this group of patients with IBP is a suitable screening tool. The sacroiliac joint changes identified were mild and their prognostic significance is not yet clear so that the value of early screening needs further evaluation. Disclosure statement: C.H. received research funding for this study from Abbott. A.K. received research funding for this study, and speaker and consultancy fees, from Abbott. All other authors have declared no conflicts of interes

Health, education, and social care provision after diagnosis of childhood visual disability

Aim: To investigate the health, education, and social care provision for children newly diagnosed with visual disability.Method: This was a national prospective study, the British Childhood Visual Impairment and Blindness Study 2 (BCVIS2), ascertaining new diagnoses of visual impairment or severe visual impairment and blindness (SVIBL), or equivalent vi-sion. Data collection was performed by managing clinicians up to 1-year follow-up, and included health and developmental needs, and health, education, and social care provision.Results: BCVIS2 identified 784 children newly diagnosed with visual impairment/SVIBL (313 with visual impairment, 471 with SVIBL). Most children had associated systemic disorders (559 [71%], 167 [54%] with visual impairment, and 392 [84%] with SVIBL). Care from multidisciplinary teams was provided for 549 children (70%). Two-thirds (515) had not received an Education, Health, and Care Plan (EHCP). Fewer children with visual impairment had seen a specialist teacher (SVIBL 35%, visual impairment 28%, χ2p < 0.001), or had an EHCP (11% vs 7%, χ2p < 0 . 01).Interpretation: Families need additional support from managing clinicians to access recommended complex interventions such as the use of multidisciplinary teams and educational support. This need is pressing, as the population of children with visual impairment/SVIBL is expected to grow in size and complexity.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited

Untangling co-morbidity: Alcohol use, anxiety and mood disorders in adolescence

It is well known that many individuals with anxiety and mood disorders also experience alcohol use problems (and vice versa). Yet it is unclear when, how and why these problems occur together. The proposed research will investigate these questions among Australian adolescents. Study one and two examine data collected as part of the 2007 Australian National Survey of Mental Health and Wellbeing. Study one investigates the impact of early onset anxiety disorders on age of first use of alcohol, while study two investigates the impact of early onset mood disorders on first use of alcohol. These studies are the first epidemiological investigations to model the impact of early onset anxiety and mood disorders on age of first alcohol use in a general population sample. Early onset anxiety and mood disorders were found to act as unique risk factors for first alcohol use, particularly after the age of 14 years. Significant interactions with developmental timing highlight the need to take into account age when examining the origins of the comorbidity between alcohol use and mood disorders. Different patterns were also observed in relation to individual anxiety and mood disorders.Study three examines the developmental trajectories of emotional symptoms in a sample of adolescents followed from 13 to 16 years old. Latent class growth analysis uncovered four different trajectories of emotional symptoms. Adolescents whose emotional symptoms remained relatively high-stable across the study period were found to be using alcohol at higher rates at age 16 years, compared to their peers. This is the first time this has been examined in an Australian longitudinal sample. Study four models the concurrent development of emotional symptoms and alcohol use in a cohort of 1,517 early adolescents over two years. Parallel latent growth modelling investigates whether growth in emotional symptoms is related to growth in alcohol use, and vice versa. Higher initial symptom levels predicted increasing alcohol use frequency. There was no relationship between growth in symptoms, or growth in alcohol use in a large sample of early adolescents from the general population.These four novel empirical studies make a significant contribution to the current literature, as well as informing prevention and treatment efforts to reduce the considerable burden of disease, social costs and harms associated with comorbidity

Evaluating a Peer-Support Mobile App for Mental Health and Substance Use Among Adolescents Over 12 Months During the COVID-19 Pandemic: Randomized Controlled Trial

BackgroundAlthough it is well known that adolescents frequently turn to their friends for support around mental health and substance use problems, there are currently no evidence-based digital programs to support them to do this. ObjectiveThe aim of this study was to evaluate the efficacy of the Mind your Mate program, a digital peer-support program, in improving mental health symptoms, reducing the uptake of substance use, and increasing help seeking. The Mind your Mate program consists of a 40-minute web-based classroom lesson and a companion smartphone mobile app. The active control group received school-based health education as usual. MethodsA cluster randomized controlled trial was conducted with 12 secondary schools and 166 students (mean age 15.3, SD 0.41 years; 72/166, 43.4% female; and 133/166, 80.1% born in Australia). Participants completed self-reported questionnaires assessing symptoms of mental health (depression, anxiety, and psychological distress), substance use (alcohol and other drug use), and help-seeking measures at baseline and at 6-month and 12-month follow-ups. ResultsStudents who received the Mind your Mate program had greater reductions in depressive symptoms over a 12-month period than controls (b=−1.86, 95% CI −3.73 to 0.02; Cohen d=−0.31). Anxiety symptoms decreased among students in the intervention group; however, these reductions did not meet statistical significance thresholds. No differences were observed in relation to psychological distress or help-seeking. ConclusionsSmall to moderate reductions in depression symptoms were observed among students allocated to receive the Mind your Mate intervention. Although the current results are encouraging, there is a need to continue to refine, develop, and evaluate innovative applied approaches for the prevention of mental disorders in real-world settings. Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620000753954; https://anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12620000753954 International Registered Report Identifier (IRRID)RR2-10.2196/2679

Meeting the rising challenges of depression through prevention: Report from the Satellite Meeting of the Global Consortium for Depression Prevention

In this report, we identify the key themes that emerged from the Satellite Meeting of the Global Consortium for Depression Prevention, convened in Providence USA in late September 2023. Over 40 international experts in the prevention of depression gathered to focus on two broad areas of prevention: examining evidence for school-based prevention programs and identifying new methodological approaches to advance prevention science. From these presentations and discussions, we summarise four overarching and inter-related challenges faced in the prevention of depression, along with potential solutions for each of these challenges.The report was supported by a grant from the Wellcome Trust, grant ref no: 228135/Z/23/Z</p