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Dysphagia (impaired swallowing) is known to contribute to decreased quality of life, and increased length of hospital stay and mortality post‐stroke. Despite the advancements in stroke treatment with the introduction of thrombolysis and endovascular clot retrieval (ECR), patients continue to present with high rates of dysphagia. Speech and language therapists and stroke teams should consider the presence of haemorrhagic transformation, success of reperfusion and presence of communication deficits as risk factors for dysphagia post‐ECR and/or thrombolysis. Purpose: To establish incidence rates and patterns of dysphagia following the administration of reperfusion therapies in acute ischaemic stroke management. Method: A retrospective review of 193 patients admitted with acute ischaemic stroke to a quaternary stroke unit in Australia over a three year period was completed. Clinical information extracted included demographics, type (thrombolysis and/or endovascular clot retrieval) and success of reperfusion therapy, and the progression of dysphagia and related factors. Results: Over half of all patients treated with reperfusion therapies presented with dysphagia on initial assessment by speech‐language pathology (SLP). The type of reperfusion therapy administered was not significantly correlated with the presence of dysphagia. Dysphagia on initial assessment was significantly correlated with the presence of aphasia on initial assessment, the presence of haemorrhagic transformation, and the success of reperfusion. Increased rates of enteral feeding were also found in this study compared to figures reported in literature. Conclusion: This study identified ongoing high rates of dysphagia amongst this patient population regardless of treatment type, demonstrating the need for ongoing SLP management post stroke. Further research is required in this area to develop an evidence‐base for SLPs and the wider medical team and to inform clinical practice guidelines. What this paper adds: What is already known on the subject: Stroke is one of the leading causes of disability and death internationally. Dysphagia (impaired swallowing), a common sequalae of stroke, is known to contribute to decreased quality of life, increased length of hospital stay and mortality. With advancements in technology, treatments for acute ischaemic stroke (endovascular clot retrieval and thrombolysis) are increasing in popularity. However, limited research exists exploring the impact of these therapies on dysphagia. What this paper adds: Despite the advancements in stroke treatment, patients continue to present with high rates of dysphagia. Dysphagia following thrombolysis and/or ECR was found to be significantly correlated to the presence of aphasia, haemorrhagic transformation, and the success of reperfusion (regardless of treatment type). Additionally, increased rates of enteral feeding were found amongst this patient population compared to figures reported in the literature for patients following traditional stroke management. Clinical implications of this study: Speech‐language pathologists and the wider medical team should consider dysphagia as an ongoing consequence of stroke following reperfusion therapies, with consideration for success of reperfusion and adverse outcomes i.e., haemorrhagic transformation. Further research is required to provide an evidence‐base and specific guidelines for the management of dysphagia post reperfusion therapies, including use of enteral feeding. [ABSTRACT FROM AUTHOR]

Background: It is estimated that up to one in three lesbian, bisexual or queer (LBQ) women in Australia have children. In the past decade, it has become common for LBQ women to pursue pregnancy using clinic‐acquired donor sperm. Aims: The aims of this paper are to explore pathways to parenthood among Australian LBQ women in the context of increased access to fertility clinics and identify the type of clinical fertility services being used. Materials and method: This paper reports on female LBQ parents and expectant/prospective parents who participated in a 2016/2017 online survey of Australian lesbian, gay, bisexual, transgender and queer (LGBTQ) adults exploring reproductive choices, pathways to parenthood, conception method and use of clinical fertility services. Results: More than half the children reported on by current parents (52%) had been conceived using clinical fertility services. When asked what factors influenced a parent respondent's decision to use fertility services: 80% indicated access to donor sperm, 41% indicated fertility problems. Of respondents who had accessed donor sperm, over half (57%) had used in vitro fertilisation (IVF) services. Conclusions: These findings indicate that use of fertility clinics to access donor sperm is common for LBQ women, including those with no known fertility problems, and that most women who access donor sperm conceive using IVF rather than intrauterine insemination. More needs to be known about the context and reasons for this, including factors that influence LBQ women's decision making on their pathway to parenthood. [ABSTRACT FROM AUTHOR]

Measures of self-forgiveness that merely focus on the outcome of positive self-regard risk neglecting the process through which offenders restore it. They may thus tap pseudo self-forgiveness where offenders downplay their responsibility for the wrongdoing. For genuine self-forgiveness, the process should instead involve an attenuation of the negative link between responsibility acceptance and positive self-regard. In this paper, we examine how acts of value reaffirmation facilitate genuine self-forgiveness. In Study 1, a role-play experiment (N = 90), participants either confessed their wrongdoing to the victim or not. Although responsibility acceptance was strongly negatively related to reported self-forgiveness (i.e., self-regard), this relationship was tempered when participants confessed their wrongdoing to the victim and, through this, reaffirmed the violated values. In Study 2, a longitudinal study referring to self-reported transgressions (N = 74), responsibility acceptance was negatively related to self-forgiveness measures as well as self-esteem when offenders showed little value reaffirmation, but not when they more strongly reaffirmed the violated values. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The aim of this paper was to provide a descriptive epidemiology of anterior cruciate ligament (ACL) reconstructions in Australia. Data on all ACL reconstructions were collected from July 1, 2003 till June 30, 2008. Main outcome measures were the incidence of ACL reconstructions for Australia, per age group, sex and sport, including estimates of direct costs. There were 50 187 ACL reconstructions over the 5-year period studied. The population-based incidence of ACL reconstructions per 100 000 person-years was 52.0 [95% confidence intervals (CI): 51.6; 52.5], higher than previously published incidences from other western countries (Scandinavia 32-38). The population incidence rose rapidly through adolescence and early adulthood and then gradually declined. Males had a higher population incidence than females. Skiing had the highest incidence of ACL reconstructions per 100 000 person-years, followed by Australian rules football, rugby, netball and soccer. The total estimated hospital costs associated with ACL reconstruction surgery were over A$75 million (€45 million) per year. Further research is necessary to examine the causes for the higher population incidence of ACL reconstructions in Australia compared with other countries. The establishment of a national register of ACL injuries, similar to those developed in Scandinavia should be considered. [ABSTRACT FROM AUTHOR]

Background/aim: Australian accreditation standards for occupational therapy courses require consumer participation in the design, delivery and evaluation of programs. This study investigated whether a mental health consumer – as one of two assessors for an oral assessment in a mental health unit – impacted engagement, anxiety states and academic performance of undergraduate occupational therapy students. Methods: Students (n = 131 eligible) self‐selected into two groups but were blinded to the group differences (assessor panel composition) until shortly prior to the oral assessment. Control group assessors were two occupational therapy educators, while consumer group assessors included an occupational therapy educator and a mental health consumer. Results: Pre‐ and post‐assessment data were successfully matched for 79 students (overall response rate = 73.1%). No evidence was found of significant differences between the two groups for engagement, anxiety or academic performance (all P values >0.05). Conclusion: Including mental health consumers as assessors did not negatively impact student engagement and academic performance, nor increase student anxiety beyond that typically observed in oral assessment tasks. The findings provide support for expanding the role of mental health consumers in the education and assessment of occupational therapy students. Development of methods to determine the efficacy of consumer involvement remains an area for future research. [ABSTRACT FROM AUTHOR]

Objectives Understanding the difficulties faced by different migrant groups is vital to address disparities and inform targeted health-care service delivery. Migrant oncology patients experience increased morbidity, mortality and psychological distress, with this tentatively linked to language and communication difficulties. The objective of this exploratory study was to investigate the communication barriers and challenges experienced by Arabic, Greek and Chinese (Mandarin and Cantonese) speaking oncology patients in Australia. Methods This study employed a cross-sectional design using patient-reported outcome survey data from migrant and English-speaking Australian-born patients with cancer. Patients were recruited through oncology clinics and Australian state cancer registries. Data were collected regarding patient clinical and demographic characteristics and health-care and communication experiences. Data from the clinics and registries were combined for analysis. Results Significant differences were found between migrant groups in demographic characteristics, communication and health-care experiences, and information and care preferences. Chinese patients cited problems with understanding medical information, the Australian health-care system, and communicating with their health-care team. Conversely, Arabic- and Greek-speaking patients reported higher understanding of the health-care system, and less communication difficulties. Conclusions Our study findings suggest that migrant groups differ from each other in their health communication expectations and requirements. Lower education and health literacy of some groups may play a role in poorer health outcomes. Public health interventions and assistance provided to migrants should be tailored to the specific needs and characteristics of that language or cultural group. Future research directions are discussed. [ABSTRACT FROM AUTHOR]

Cardiac disease and type 2 diabetes are prevalent diseases globally. Cardiac rehabilitation and diabetes self-management programs empower patients' self-management to improve their health outcomes. However, inappropriate delivery modes and continuing low participation rates indicate some programs are less than optimal. A previous study demonstrated the feasibility of incorporating telephone and text messages into a cardiac-diabetes self-management program in Australia; however, the program did not specifically address patients' cultural backgrounds. This current study used a randomized blocked design to evaluate short-term efficacy of the cardiac-diabetes self-management program incorporating telephone and text-messaging across different cultural contexts in Australia and Taiwan in comparison to usual care. No significant differences between groups were observed for outcomes of self-care behavior, self efficacy, knowledge and health-related quality of life, with patients in both groups demonstrating improvements. Patient-reported outcomes indicated some evidence of an interaction effect between country of origin and group allocation. Findings indicated an improved tendency of outcome measures between the baseline and follow-up assessments within usual care and intervention groups. Further research is required to clarify components of the program work for each cultural group. [ABSTRACT FROM AUTHOR]

Drawing from self-determination theory (Deci & Ryan, 2002), we developed and tested an intervention to train fitness instructors to adopt a motivationally adaptive communication style when interacting with exercisers. This was a parallel group, two-arm quasi-experimental design. Participants in the intervention arm were 29 indoor cycling instructors ( n = 10 for the control arm) and 246 class members ( n = 75 for the control arm). The intervention consisted of face-to-face workshops, education/information video clips, group discussions and activities, brainstorming, individual planning, and practical tasks in the cycling studio. Instructors and exercisers responded to validated questionnaires about instructors' use of motivational strategies and other motivation-related variables before the first workshop and at the end of the third and final workshop (4 months later). Time × arm interactions revealed no significant effects, possibly due to the large attrition of instructors and exercisers in the control arm. Within-group analyses in the intervention arm showed that exercisers' perceptions of instructor motivationally adaptive strategies, psychological need satisfaction, and intentions to remain in the class increased over time. Similarly, instructors in the intervention arm reported being less controlling and experiencing more need satisfaction over time. These results offer initial promising evidence for the positive impact of the training. [ABSTRACT FROM AUTHOR]

Background This study investigated the long-term effectiveness of Preventure, a selective personality-targeted prevention program, in reducing the uptake of alcohol, harmful use of alcohol, and alcohol-related harms over a 3-year period. Methods A cluster randomized controlled trial was conducted to assess the effectiveness of Preventure. Schools were block randomized to one of two groups: the Preventure group ( n = 7 schools) and the Control group ( n = 7 schools). Only students screening as high-risk on one of four personality profiles (anxiety sensitivity, negative thinking, impulsivity, and sensation seeking) were included in the analysis. All students were assessed at five time points over a 3-year period: baseline; immediately after the intervention; and 12, 24, and 36 months after baseline. Students were assessed on frequency of drinking, binge drinking, and alcohol-related harms. Two-part latent growth models were used to analyze intervention effects, which included all students with data available at each time point. This trial is registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12612000026820; ). Results A total of 438 high-risk adolescents (mean age, 13.4 years; SD = 0.47) from 14 Australian schools were recruited to the study and completed baseline assessments. Relative to high-risk Control students, high-risk Preventure students displayed significantly reduced growth in their likelihood to consume alcohol [ b = −0.225 (0.061); p < .001], to binge drink [ b = −0.305 (.096); p = 0.001], and to experience alcohol-related harms [ b = −0.255 (0.096); p = .008] over 36 months. Conclusions Findings from this study support the use of selective personality-targeted preventive interventions in reducing the uptake of alcohol, alcohol misuse, and related harms over the long term. This trial is the first to demonstrate the effects of a selective alcohol prevention program over a 3-year period and the first to demonstrate the effects of a selective preventive intervention in Australia. [ABSTRACT FROM AUTHOR]

Context There is ongoing debate regarding the optimal length of medical training, with concern about the cost of prolonged training. Two simultaneous tracks currently exist in Australia: direct entry from high school and graduate entry for students with a bachelor degree. Medical schools are switching to graduate entry based on maturity, academic preparedness and career-choice surety. We tested the assumption that graduate entry is better by exploring student preferences, coping, burnout, empathy and alcohol use. Methods From a potential pool of 2188 participants, enrolled at five Australian medical schools, a convenience sample of 688 (31%) first and second year students completed a survey in the middle of the academic year. Participants answered questions about demographics, satisfaction and coping and completed three validated instruments. Results Over 90% of students preferred their own entry-type, though more graduate-entry students were satisfied with their programme (82.4% versus 65.3%, p < 0.001). There was no difference between graduate-entry and direct-entry students in self-reported coping or in the proportion of students meeting criteria for burnout (50.7% versus 51.2%). Direct-entry students rated significantly higher for empathy (concern, p = 0.022; personal distress, p = 0.031). Graduate-entry students reported significantly more alcohol use and hazardous drinking (30.0% versus 22.8%; p = 0.017). Conclusions Our multi-institution data confirm that students are generally satisfied with their choice of entry pathway and do not confirm significant psychosocial benefits of graduate entry. Overall, our data suggest that direct-entry students cope with the workload and psychosocial challenges of medical school, in the first 2 years, as well as graduate-entry students. Burnout and alcohol use should be addressed in both pathways. Despite studies showing similar academic outcomes, and higher total costs, more programmes in Australia are becoming graduate entry. Further research on non-cognitive issues and outcomes is needed so that universities, government funders and the medical profession can decide whether graduate entry, direct entry, or a mix, is ideal. [ABSTRACT FROM AUTHOR]

Aim To evaluate the anthropometric indices in community-dwelling people aged 70-90 years in Sydney, Australia. Method Cross-sectional data were collected during the Sydney Memory and Ageing Study from two federal government electoral areas from 2005-2007. Participants with no dementia were recruited to the study (n = 1037). The anthropometric parameters including body weight, standing height, waist circumference and hip circumference were obtained with the average participation rate of 97%. The study population was then stratified by gender and age groups. Results With increasing age, the body weight and standing height decreased, while waist circumference and waist to hip ratio showed different patterns. With reference to the World Health Organization classification for body mass index, overweight and obesity were found in 75.3% of men and 61.2% of women. In particular, the result revealed that 23% of the study cohort was obese. While all men had mean waist to hip ratios exceeding the cut-off value (≥0.90), only 53.7% of women were categorised as having a condition leading to increased risk of mortality (≥0.85). The mean waist to hip ratio in men and women was 0.96 ± 0.06 and 0.86 ± 0.07, respectively (±standard deviation). Conclusions This study provides gender- and age-specific distributions for six anthropometric measurements for older Australians to identify individuals with potentially greater risk of disease. Overweight and obesity are common in the older population. However, more data from across Australia are needed to confirm the findings from this study. [ABSTRACT FROM AUTHOR]

Objective Little is known about whether rural-urban differences exist in patients after hip and knee joint replacement surgery. We compared patient characteristics, pain and functional outcomes of rural and urban patients undergoing joint replacement surgery in a single high-volume metropolitan centre. Design Prospective cohort study conducted in patients who underwent primary elective hip ( THJR) or knee replacement ( TKJR) between 1 January 2006 and 31 December 2009. Setting A university-affiliated tertiary referral centre situated in the central metropolitan region of Melbourne, Australia. Participants One thousand nine hundred fifty-five consecutive patients undergoing primary total joint replacement. Main outcome measure Pain and function were assessed preoperatively and 12 and 24 months postoperatively. The main independent variable was geographic location specifically comparing patients residing in rural/regional compared with urban communities. Results A total of 2193 primary joint replacements were performed (981 THJR and 1212 TKJR) in 1955 patients. Rural patients presented at a younger age and with earlier radiographic disease than their urban counterparts. There was a higher rate of rheumatoid arthritis among rural patients presenting for TKJR. There was no difference in pain and function scores between groups at 12 and 24 months post-surgery. Conclusion In our series of 1955 patients undergoing total hip and knee joint replacement surgery, rural patients presented at a younger age and an earlier stage of disease progression. At 24 months, rural patients had pain and functional outcomes as good as their urban counterparts. More research is required to determine which factors lead to the early presentation of rural patients. [ABSTRACT FROM AUTHOR]

Objectives To assess the efficacy of whole-body progressive resistance training ( PRT) as a treatment for the symptoms of peripheral arterial disease ( PAD) in older adults. Design Randomized controlled pilot trial. Setting University clinical weight training facility in Sydney, Australia. Participants Twenty-two older adults with symptomatic PAD. Interventions The efficacy of supervised whole-body high-intensity PRT (H- PRT) with low-intensity nonprogressive resistance training ( L- RT) and a usual care control group that performed unsupervised walking for 6 months was compared. Measurements Pilot outcome measures included 6-minute walk (6 MW) outcomes, body composition, dynamic muscle strength and endurance, and performance-based tests of function. Results Mean age was 71.1 ± 7.2. Mean ankle brachial index was 0.55 ± 0.13. Exercise adherence was similar in all groups ( P = .29). H- PRT (n = 8) improved total 6 MW distance (mean difference ( MD) 62.6 ± 58.0 m, P = .02) significantly more than L- RT (n = 7; MD=−48.2 ± 67.6 m) and controls (n = 7; MD=−9.9 ± 52.9 m). Change in 6 MW onset of claudication was significantly and independently related to change in bilateral calf endurance (correlation coefficient ( r) = 0.65, P = .03), and change in 6 MW distance was significantly and independently related to change in bilateral hip extensor endurance ( r = 0.71, P = .02) in all groups. Conclusion H- PRT significantly improved 6 MW ability in older adults with intermittent claudication from PAD, whereas L- RT and unsupervised walking did not. Improvement in walking ability was significantly related to improvements in bilateral calf and hip extensor endurance, supporting further investigations targeted at musculoskeletal impairment in this cohort. [ABSTRACT FROM AUTHOR]

Context Many studies indicate that increases in cognitive ability, maturity and educational experience lead to a general increase in moral reasoning skills. However, research has shown that moral development does not occur during medical school and that it may, in fact, plateau or even regress. There is no empirical evidence as to what might be the cause of such a result. Objectives The present study aimed to assess moral judgement competence in medical students and to investigate trends in moral judgement competence in relation to age, gender, culture, religion, year of medical course and different programmes within the medical curriculum. Methods We employed a cross-sectional and descriptive design over two consecutive years (2011 and 2012). Students completed Lind's Moral Judgement Test ( MJT), which is based on Kohlberg's stages of moral development and is used to measure moral judgement competence ( C- INDEX). C- INDEX results were analysed in relation to age, gender, cultural background, religion, cohort and specific programmes within the medical curriculum. Results The numbers of students who completed the MJT in 2011 and 2012 were 394 and 486, respectively. The two studies showed a significant difference and negative correlations between the moral judgement competence of medical students and both age and year of medical course (p < 0.001). The findings suggested the existence of a phenomenon known as 'moral segmentation', which increased significantly as students progressed through medical education, and were significantly linear between cohorts. Conclusions Students show a decline in moral judgement competence during medical education. This probably reflects an increase in moral segmentation rather than an inhibition in moral development. The challenge is to develop a curriculum that will enable medical students to maintain, or better, increase their moral judgement competence. [ABSTRACT FROM AUTHOR]

Objectives The present study examined junior residents' and registrars' preparedness to prescribe in an Australian ED. It measured the medication knowledge of participants and identified antecedent factors relevant to prescribing practice. Methods This is a prospective, exploratory study of the prescribing practices of 40 junior doctors. Data collection consisted of a participant questionnaire with three parts. Part A comprised demographic information; Part B comprised questions regarding prescribing practices; and Part C was an objective assessment of the doctor's knowledge of the most recently and most commonly prescribed medications. Results One hundred percent ( n = 40) of doctors in the study had inadequate knowledge about at least one medication when an accuracy threshold of <80% correct was used. Seventy percent ( n = 28) of the participants had inadequate knowledge of at least one medication when the lower accuracy threshold of <50% correct was used. Comparisons between medication knowledge score and Likert confidence scales showed that even though a doctor reported being completely sure about an individual medication, they most commonly only answered between four and six of the eight questions correctly for that medication. Their use of reference materials was also lacking in relation to their knowledge and level of confidence. The reported reasons for this included instructions by senior staff and time constraints. Conclusions The majority of participants in the study had inadequate knowledge on medications they had most recently prescribed and medications most commonly prescribed in the ED. Junior doctors' perceptions of their medication knowledge were inflated in relation to their actual knowledge. [ABSTRACT FROM AUTHOR]

Aims This study aimed to compare emotion perception and social inference in opioid maintenance patients with abstinent ex-users and non-heroin-using controls, and determine whether any deficits in could be accounted for by cognitive deficits and/or risk factors for brain damage. Design Case-control. Setting Sydney, Australia. Participants A total of 125 maintenance patients ( MAIN), 50 abstinent opiate users ( ABST) and 50 matched controls ( CON). Measurements The Awareness of Social Inference Test ( TASIT) was used to measure emotion perception and social inference. Measures were also taken of executive function, working memory, information processing speed, verbal/non-verbal learning and psychological distress. Findings After adjusting for age, sex, pre-morbid IQ and psychological distress, the MAIN group was impaired relative to CON (β = −0.19, P < 0.05) and ABST (β = −0.19, P < 0.05) on emotion perception and relative to CON (β = −0.25, P < 0.001) and ABST (β = −0.24, P < 0.01) on social inference. In neither case did the CON and ABST groups differ. For both emotion perception ( P < 0.001) and social inference ( P < 0.001), pre-morbid IQ was a significant independent predictor. Cognitive function was a major predictor of poor emotion perception (β = −0.44, P < 0.001) and social inference (β = −0.48, P < 0.001). Poor emotion recognition was also predicted by number of heroin overdoses (β = −0.14, P < 0.05). Neither time in treatment or type of maintenance medication (methadone or buprenorphine) were related to performance. Conclusions People in opioid maintenance treatment may have an impaired capacity for emotion perception and ability to make inferences about social situations. [ABSTRACT FROM AUTHOR]

Objectives To describe perceptions of medical students and emergency doctors towards careers in emergency medicine ( EM), and to identify influences on career choice. Methods A prospective, cross-sectional questionnaire study was performed in three EDs. The instrument used Likert-type items addressing: factors important in the choice of a career, factors offered by a career in EM, and opinions of EM. EM consultants and registrars and a cohort of final-year medical students participated. Results Overall, 22 consultants, 30 registrars and 164 students completed the questionnaire (77.1% overall response). Student interest in an EM career increased from 10/161 (6.2% [95% CI 3.0-11.1%]) before, to 26/137 (19.0% [95% CI 12.8-26.6%]) after an EM attachment ( P = 0.0014). The highest proportion of students chose work-life balance as being an important factor for career choice (143/163 students, 87.7% [95% CI 81.2-92.6%]). Compared with consultants and registrars, students had negative perceptions about lifestyle factors that EM offered, as well as about the future of the specialty, job security and workplace stress. Some students also preferred careers with opportunities for research, subspecialty practice, and better pay and conditions, yet perceived EM as not offering these factors. Students considered EM as an acute, procedural, public hospital specialty, with diverse patient problems and minimal continuity of care. Smaller proportions of students considered these factors important for career choice. Conclusion Increasing the attractiveness of a career in EM requires changing student perceptions of lifestyle and satisfaction benefits, access to EM subspecialties, increasing ED research, information about job security, and improved work conditions. [ABSTRACT FROM AUTHOR]

ABSTRACT Aims To assess the effects on brand appeal of plain packaging and size of pictorial health warnings (PHWs). Design Three (30%, 70% and 100% size front-of-pack PHWs) by two (branded versus plain) between-subjects online experiment. Setting Australia. Participants A total of 1203 adult smokers. Measurements Rating of cigarette brands, smoking attitudes and intentions, purchase intent. Findings Compared to branded packs, plain packs reduced smokers' ratings of 'positive pack characteristics' ( P < 0.001), 'positive smoker characteristics' ( P < 0.001) and 'positive taste characteristics' ( P = 0.039). Plain packs were rated as being smoked by people who were more 'boring' than those who smoked branded packs ( P = 0.001). By contrast, increasing size of PHW above 30% only reduced ratings of 'positive pack characteristics' ( P = 0.001), but also decreased ratings of smokers as being 'boring' ( P = 0.027). Plainness and size of PHW interacted in predicting ratings of 'positive pack characteristics' ( P = 0.008), so that when packs were plain, increasing the size of PHW above 30% did not further reduce ratings. Presentation of only plain packs increased the likelihood that smokers would not choose to purchase any pack (20.3%) compared to presentation of only branded packs (15.3%) (odds ratio = 1.4; P = 0.026), while size of PHWs had no influence upon purchase choice. Conclusions Plain packaging probably plays a superior role in undermining brand appeal and purchase intent to increasing health warning size. Policymakers should not rely solely upon large health warnings, which are designed primarily to inform consumers about smoking harms, to also reduce brand appeal: both strategies are likely to be required. [ABSTRACT FROM AUTHOR]

Background: Food preferences develop early in life and track into later life. There is limited information on food consumption and dietary patterns in Australian girls. The present study aimed to: (i) determine the frequency of food groups consumed over 1 day; (ii) identify dietary clusters based on food group consumption; and (iii) compare dietary intakes and activity variables between clusters. Methods: A cross-sectional analysis of 9-16-year-old girls ( n = 1114) from the 2007 Australian National Children's Nutrition and Physical Activity Survey was performed. Results: Over the whole day, 30% of all girls consumed carbonated sugar drinks, 46% consumed take-away food, 56% consumed fruit, 70% consumed at least one vegetable, and 19% and 30% consumed white and/or red meat, respectively. K-means cluster analysis derived four clusters. Approximately one-third of girls were identified in a Meat and vegetable cluster; these girls had the highest intakes of red meat and vegetables, and tended to have higher intakes of fruit, whole grain breads, low fat yoghurt, and lower intakes of take-away foods and soft drinks. They also had the highest intakes of protein, fibre and micronutrients; and tended to perform more physical activity, compared to girls in the remaining clusters. Conclusions: Girls identified in the Meat and vegetable cluster, on average, consumed more lean red meat, vegetables, fruits, and low-fat dairy products, and had a higher intakes of many nutrients. The high percentage of girls not identified in this cluster suggests the need to inform them on how to make healthy, nutrient dense food choices, and why they require increased nutrient intakes at this time. [ABSTRACT FROM AUTHOR]

Background: Infants, toddlers and preschoolers are the highest risk group for burn injury. However, to date this population has been largely neglected. This study examined the prevalence, onset, comorbidity and recovery patterns of posttrauma reactions in young children with burns. Methods: Parents of 130 unintentionally burned children (1-6 years) participated in the study. The Diagnostic Infant Preschool Assessment was conducted with parents at 1 and 6 months postinjury. Results: The majority of children were resilient. However, 35% were diagnosed with at least one psychological disorder, there was a high rate of comorbidity with posttraumatic stress disorder, and 8% of children did not experience recovery in distress levels over the course of 6 months. Conclusions: These outcomes are likely to have serious repercussions for a young child's medical and psychosocial recovery as well as their normal developmental trajectories. It is recommended that screening, prevention and early intervention resources are incorporated into paediatric health care settings to optimise children's psychological adjustment following burn injury. [ABSTRACT FROM AUTHOR]

The belief in the gender invariance of many traits is a view that dominates much of psychology. In social psychology, this position is clearly represented by social dominance theory and the construct of social dominance orientation (SDO) where it is argued that, all else being equal, men will be higher in SDO than women. In other domains, though, these assumptions are being questioned, and researchers are arguing for a gender similarities hypothesis. The argument is that men and women are more similar than different, and where there are effects for gender, these are small. In this investigation, men and women are compared under similar cultural (Study 1), ideological, (Study 2) and status (Study 3) contexts to examine whether, all else being equal, men really are higher in SDO than women. In an additional study (Study 4), a meta-analysis is conducted aggregating the effect sizes of the previous studies. Results demonstrated either no effect for gender or an interaction between gender and the relevant social context and only a small effect size of gender-findings that disconfirm the ceteris paribus assumption of social dominance theory. In conclusion, the implications of the findings for understanding gender effects in social psychology are discussed. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Women with a history of hypertensive disorders of pregnancy (HDP) are known to be at increased risk of subsequent hypertension and cardiovascular disease. Aims: In this study, we aimed to assess whether the long-term follow-up, diagnosis and treatment of hypertension in these women is adequate. Methods: Prospective study of 2112 women who were part of a Birth Cohort Study - The Mater University of Queensland Study of Pregnancy, who received antenatal care at a major public hospital in Brisbane between 1981 and 1983 and were followed up at 21 years. Results: Of the 191 women who had HDP, 62 (32.46%) were hypertensive (29 adequately treated, 33 inadequately identified or managed). Of the 1921 women without HDP, 280 (14.58%) were hypertensive (113 adequately treated, 167 inadequately identified or managed). Women with HDP were at higher risk of hypertension (OR 4.09, 95% CI 2.76, 6.07). Women with a history of HDP were more likely to have hypertension that was inadequately identified or managed (OR 3.56, 95% CI 2.06, 5.97). Conclusion: Women with HDP are at increased risk of undiagnosed or undertreated hypertension. Attention needs to be given to appropriate follow-up of women who have a pregnancy complicated by hypertensive disorders. [ABSTRACT FROM AUTHOR]

Aim: To examine current Australian dietetic practice in the management of gestational diabetes, to identify models of dietetic care and to determine the need for national evidence-based dietetic practice guidelines for gestational diabetes. Methods: A 55-item cross-sectional survey of Australian dietitians practicing in the area of gestational diabetes was undertaken. Participants were recruited via Dietitians Association of Australia interest group membership, public and private hospital maternity and diabetes services across Australia. The survey examined dietetic service provision, interventions, management recommendations, postnatal care, current guideline use and the perceived need for Australian evidence-based dietetic management guidelines. Results: A total of 220 eligible dietitians participated in the survey. The majority (77%) reported that all women with gestational diabetes attending their service were referred to a dietitian. Group (33%) and individual consults (93%) were provided and 67% provided one to two dietetic consults per client. Fifty-four per cent (54%) believed that their service currently offered adequate antenatal dietetic interventions and 8% adequate postnatal follow up for women with gestational diabetes. There were differences in the implementation of medical nutrition therapy by Australian dietitians in regards to nutrient recommendations. However, consistency was seen in key components of nutrition education. Dietitians perceived that there was a need for evidence-based gestational diabetes dietetic practice guidelines (86%) and nutrition recommendations (87%). Conclusion: The survey results strongly indicate there is a need for evidence-based gestational diabetes practice guidelines and nutritional recommendations and provide baseline data for future practice of Australian dietitians working in gestational diabetes. [ABSTRACT FROM AUTHOR]