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Objective: Describe the ear and hearing outcomes in Aboriginal infants in an Australian urban area. Design: Aboriginal infants enrolled in the Djaalinj Waakinj prospective cohort study had ear health screenings at ages 2-4, 6-8 and 12-18 months and audiological assessment at ∼12 months of age. Sociodemographic, environmental characteristics, otoscopy, otoacoustic emissions, tympanometry and visual reinforcement audiometry data were collected. Study Sample: 125 infants were enrolled in the study; 67 completed audiological assessment, 62, 54, and 58 of whom attended ear screenings at 2-4, 6-8 and 12-18 months. Results: Of the children that attended the audiological assessment, 36.5%, 50% and 64.3% of infants had otitis media (OM) at 2-4, 6-8 and 12-18 months. Using a 10 dB correction factor, 44.8% of infants had hearing loss (HL) (≥ 25 dB HL) at ∼ 12 months of age. More males (X2=5.4 (1df, p = 0.02)) and infants with OM at audiological assessment (X2=5.8 (1df, p = 0.02)) had HL. More infants that used a pacifier at 12-18 months of age had HL (X2=4.7 (1df, p = 0.03)). Conclusion: Aboriginal infants in an urban area have high rates of HL and OM, which requires early surveillance and timely treatment to reduce the medical and developmental impacts of OM and HL. [ABSTRACT FROM AUTHOR]

Purpose: Participating in home and community activities can be influenced by environmental factors and parent strategies. Children on the autism spectrum are reported to participate less in home and community activities than their neurotypical peers. Little is known about environmental factors that may influence their participation, and ways parents support their child's participation. Materials and methods: Parents of children on the autism spectrum aged 5–6 years (n = 72) and 10–11 years (n = 94) completed the Participation and Environment Measure for Children and Youth. This study reports on the perceived support, barriers, and resources in the home and the community environment. Parents reported strategies they used to support their child's participation in home and the community. Results: Home environmental factors were identified as more supportive by the parents of younger children. The sensory quality of activities and social demands were factors identified as making community participation harder for both groups. Parents used a range of different strategies in the home and the community to support their child's participation. Conclusions: Identifying environmental barriers and supports to participation can assist in developing interventions to support meaningful participation in activities for children on the autism spectrum. Implications for rehabilitation: Skills required for the activity and preferences of children on the autism spectrum are important considerations when supporting their participation in activities. When exploring a child's level of participation, it may be helpful to ask parents about what their child can do with or without their support. The sensory quality of the environment is a consideration when supporting the participation of children on the autism spectrum in community activities. As sensory processing is an individual experience, the impact of sensory elements of the environment may differ for individuals. [ABSTRACT FROM AUTHOR]

Knowing how to respond effectively to an acutely deteriorating patient is a National Safety and Quality Health Service Standard and a requirement for nurse registration with the Australian Health Practitioner Regulatory Authority. Literature has highlighted that a lack of knowledge, skills and confidence in healthcare professionals to perform basic life support may be a contributing factor to the high mortality and morbidity rates associated with cardiac arrest in the hospital setting. To explore first-year nursing students' knowledge and confidence to perform basic life support according to the Australian Resuscitation Council guidelines before and after watching an online video lecture. A quantitative quasi-experimental pre- and post-test design to measure changes, if any, in first-year nursing students' knowledge and confidence to perform basic life support at an Australian university in 2021. The collected data were analysed using Stata, a statistical software for data sciences. Participants' mean knowledge score increased from 9.3 (SD: 2.5) in the pre-test to 13.9 (SD: 3) (p < 0.001) in the post-test (maximum possible score: 19). Participants' mean confidence score increased from 17.0 (SD: 6.3) in the pre-test to 24.5 (SD: 4.4) (p < 0.001) in the post-test (maximum possible score: 30; p < 0.001). The most significant improvement in knowledge was observed in chest compression rate, breathing/ ventilation and checking patient response. The study found that the video lecture is an effective teaching method to increase students' confidence to perform basic life support. An online video-recorded lecture can increase undergraduate student nurses' knowledge and confidence to perform basic life support. This is one educational strategy that universities can use to improve students' knowledge and confidence to perform this essential skill for practice. [ABSTRACT FROM AUTHOR]

In Australia participation rate in Advance Care Directives is 14%, and research is limited on Advance Care Planning (ACP) invitations and uptake among the patients with advanced cancer (PwAC). This study identifies the prevalence and types of documented ACP discussions in PwAC who died within two or four weeks of receiving chemotherapy. A retrospective audit was conducted. Statistical analysis was calculated in SPSS. Difference in ACP invitation and utilization between three groups [control, <2-weeks, and –4 weeks] was measured by Kruskal–Wallis and Chi-square (or Fisher-Exact) tests. Post-hoc follow-up pair-wise comparisons were performed. Adjusted prevalence ratios were estimated using two logistic regression models. This study was conducted in XXX Coast University Hospital, Australia. The records of 339 patients were examined and 320 patients were found eligible. Of the 320 PwAC [male: 55%; median age: 65 years], 227 (71%) received ACP invitation, and among the invited patients, 89% used Acute Resuscitation Plan; 54% used Enduring Power-of-Attorney; and 20% completed Advance Health Directives. From 7.5% [n = 24] of the patients who received chemotherapy in their last 2-weeks of life, 42% had not received an ACP invitation, 29% didn't have Acute Resuscitation Plan and only 4% completed Advance Health Directives. There were significant differences among Control, <2-weeks, and 2–4 weeks groups in completing Acute Resuscitation Plan (P = 0.003) and Advance Health Directives (P = 0.045). A significant difference was also observed between control and <2-weeks groups in number of days since Acute Resuscitation Plan used. Completing an Acute Resuscitation Plan was associated with a lower risk of dying within two-weeks of chemotherapy (OR = 0.246; P = 0.008). Low rates of ACP invitation and use in PwAC, especially who received chemotherapy in 2-weeks of dying confirm a need for embedding and regularly revisiting ACP framework in cancer care and educating staff, patients, and their family caregivers to increase uptake. [ABSTRACT FROM AUTHOR]

To investigate the sustainability of Robot-assisted upper limb therapy (RT-UL) as part of routine occupational therapy and physiotherapy clinical practice. Two separate audits, 12 months apart, of RT-UL computer data records were undertaken to determine sustainability in a subacute rehabilitation unit. Records of the two audits were compared in terms of the number of early subacute stroke survivors using RT-UL, the number of RT-UL sessions, duration of RT-UL sessions, and disciplines prescribing RT-UL. During Audit 1 58% (n = 18) of stroke survivors received RT-UL compared to 50% (n = 7) in Audit 2. The total number of RT-UL sessions reduced between audits (148 vs. 36 sessions) reflecting the overall reduction in admission rates for stroke survivors. There was no significant difference between audits in the average number of RT-UL sessions per patient (p = 0.203) nor the length of sessions (p = 0.762). Patients engaged in active therapy more than three-quarters of the time when on the robotic device. Physiotherapists were the primary prescribers of RT-UL when compared to occupational therapists. RT-UL was in continued and regular use with stroke survivors 2 years after initial implementation within an inpatient rehabilitation setting. RT-UL practice was intensive and used routinely with patients. RT-UL is a sustainable and intensive intervention for stroke survivors within an inpatient rehabilitative setting. The cost-benefits of RT-UL should be evaluated from the perspective of the whole rehabilitation service not just at an individual patient level. RT-UL may be considered a "bridging" form of UL practice for those with more limited active UL movement until there is sufficient UL movement and power for more complex real-world task-specific practice. [ABSTRACT FROM AUTHOR]

Background: ST-segment elevation myocardial infarction (STEMI) is a common cause of out-of-hospital cardiac arrest (OHCA). For these patients, urgent angiography and revascularization is an important treatment goal. There is a lack of data on the prognosis of STEMI patients after OHCA, who are diagnosed and treated by paramedics prior to hospital transport for primary percutaneous coronary intervention (PCI). Methods: Included were adult STEMI patients identified and treated by paramedics in Queensland (Australia) from January 2016 to December 2019, transported to a hospital for primary PCI, and receiving primary PCI. Patients were grouped into those with resuscitated OHCA and those without OHCA. Clinically-important time intervals, angiographic and clinical profiles, and survival were described. Results: Patients with OHCA had longer time intervals from prehospital STEMI identification to reperfusion than those without OHCA (median 97 versus 87 mins, p = 0.001). The former had higher rates of cardiac arrhythmia history (50.5 versus 12.4%, p < 0.001), classified low left ventricular ejection fraction on admission (64.9 versus 50.1%, p = 0.006), and cardiogenic shock (5.2 versus 1.2%, p = 0.011) than the latter. A significantly higher proportion of patients with OHCA had multiple diseased vessels (16.9 versus 8.3%, p = 0.005). In-hospital, 30-day, and one-year mortality was low, being 4.1%, 4.1% and 5.2%, respectively, for STEMI patients with OHCA. The corresponding figures for those without OHCA were 1.6%, 1.8% and 3.3%, respectively. Conclusions: Survival in paramedic-identified STEMI patients treated with primary PCI following OHCA resuscitation was high. Rapid angiography and reperfusion are critical in these patients. [ABSTRACT FROM AUTHOR]

Robot assisted upper limb (UL) therapy has been identified as an intervention with the potential to help improve the amount of practice performed by stroke survivors. This study aimed to measure the amount of UL practice (i.e., repetitions, duration, intensity) performed by subacute stroke survivors, in particular those with severe UL impairment, pre and post implementation of robot assisted upper limb therapy (RT-UL) into an inpatient rehabilitation setting. Two observational study phases (pre-RT-UL and post-RT-UL) were undertaken of occupational therapy and physiotherapy sessions performed by subacute stroke survivors. Upper limb tasks observed and recorded in therapy were classified as either impairment-related therapy or activity-related. In the pre-RT-UL observational phase, 7 subacute stroke survivors were observed across 11 days involving 25 therapy sessions. Post-RT-UL, 12 subacute stroke survivors were observed across 12 days involving 29 therapy sessions. There were no significant differences in characteristics of patients observed in each phase (p >.05). The mean difference (95% CI) between pre and post RT-UL for repetitions (reps) (569 (1 to 1136) and intensity (7 (4–11)) reps/min of practice increased for all patients, including those with severe UL impairment (337 (37–638)) reps and 8 (2–14) reps/minute, with the duration of therapy unchanged. This is the first study to have observed an increase in UL practice with the inclusion of RT-UL as part of routine clinical practice. This increase in practice is considered to be due to RT-UL providing highly supportive and expeditious semi-supervised practice. Notably, RT-UL was able to be implemented within the existing organisational structures with only basic training of therapy staff. Robotics presents as a viable intervention to increase the amount and intensity of upper limb practice performed by stroke survivors in routine clinical practice Robotics were able to be implemented within the existing organisational structures with only basic training of therapy staff [ABSTRACT FROM AUTHOR]

In search of Kipling's six honest serving men in upper limb rehabilitation after stroke, we sought to investigate clinicians' perspective of when and where to begin therapy, how much and what therapy to provide, and who and why (or not) to provide therapy. Materials & methods: Within-participant case cross-over experiments were nested within an anonymous web-based questionnaire (21 questions, three cases). Graph theory-based voting to produce ranked ordered lists and mixed-effect logistic regression were performed. In total, 225 Australian stroke clinicians responded: 53% occupational therapists, 61% working in acute/inpatient stroke setting. Most respondents indicated they did not have a protocol/expectation regarding when (62%), how much (84%) or what (60%) therapy to provide in their setting. Respondents ranked 24-h to 7-days post-stroke as the optimal time to commence therapy, and 30- to 60-min per day as the optimal dose to provide. Within-participant experiments demonstrated that greater motor recovery as time progressed increased the odds of offering therapy, while lack of motor recovery, shoulder pain, neurological decline and sole therapist reduced the odds. We need to develop an evidence base concerning Kipling's six honest serving men and equip clinicians with clinical decision-making skills aligned with this focus. Most clinicians did not have access to a protocol / clinical pathway which defines when, how much and what upper limb therapy to provide after stroke, which may be improved by providing individual clinicians with organisational support to make therapy decisions. To improve the personalisation of upper limb rehabilitation in clinical practice, we need to understand when and where after stroke to begin therapy, how much and what therapy to provide, as well as who and why (clinical decision-making) to provide therapy. Clinicians perceive clinical trials as successful if the therapy can demonstrate recovery that is greater than a minimal clinical important difference (MCID). [ABSTRACT FROM AUTHOR]

In Australia, school-based immunisation programmes (SBIP) provide Human Papillomavirus (HPV) vaccinations to secondary school students. However, despite such free programmes, around 20% of girls and 25% of boys do not complete all doses. This formative study identified barriers and enablers to vaccine completion. Online surveys were conducted with senior school administrators and nurses from Western Australian secondary schools across all three school sectors. Year 8 students participated in focus group discussions. Parents participated in one-on-one interviews (n = 22). Administrators were supportive of vaccination and the SBIP. Nurses and administrators perceived lack of parental awareness, issues around consent and school absenteeism as the main barriers to completion. Parent and student knowledge concerning HPV, the HPV vaccine and immunisation in general were low. Despite this, students and parents were supportive of the SBIP and wanted the opportunity to learn more about HPV, the vaccination and immunisation in general. There are opportunities for targeted school-based work to increase awareness and provision of consent. [ABSTRACT FROM AUTHOR]

People with a mental illness may be exposed to stigma which, when internalised, negatively influences self-esteem, personal goal attainment and quality of life. However, people who are empowered may actively challenge stigma by engaging in meaningful opportunities, furthering their self-worth as they achieve control within their lives. People who are empowered through active treatment participation are more likely to reach recovery goals and experience the benefits of evidence-based practices. Hence, empowerment can be viewed as essential to the recovery and well-being of people with a mental illness. Participants in this quantitative study (N = 173) were diagnosed with a mental illness and were recruited via convenience sampling from mental health support groups in Australia. Internalised stigma was less common and empowerment more prevalent in this study than was found in previous studies. However high internalised stigma and low empowerment were present. The terms 'individual' and 'person with lived experience' which have been identified as the preferred terms in a previous study were highlighted as both empowering and recovery focussed. [ABSTRACT FROM AUTHOR]

This study evaluated the characteristics of suicide news articles in the digital press, their adherence to World Health Organization (WHO) recommendations, and the effectiveness of interventions. We assessed adherence, avoidability, frequency and typology of suicide news over a six-month period in the four main digital media outlets of the Canary Islands (Spain). A brief training and information package intervention to the Canary Islands media outlets was carried out. We compared the quality of media reporting at both the pre-intervention and post-intervention timepoints, and compared the quality of reporting at the post-intervention timepoint in Victoria (Australia), where media interventions have been well-resourced and running for several years. We evaluated 339 suicide news articles: 38 from the pre-intervention period, 64 from the post-intervention period, and 237 from Victoria. News articles showed a very low degree of adherence to WHO recommendations, especially to those recommendations thought to have a protective effect. Post-intervention news articles showed better adherence than pre-intervention ones, but lower than those of Victoria, where constant interventions have been developed for years. We conclude that adherence to WHO recommendations is low. Simple interventions aimed at media professionals can improve adherence. However, constant and complex interventions seem to be more effective. [ABSTRACT FROM AUTHOR]

People with a mental illness may be exposed to stigma which, when internalised, negatively influences self-esteem, personal goal attainment and quality of life. Avoiding the use of stigmatising language and using terminology that does not exclude the positive characteristics of the individual may play an important role in challenging stigma. This study involved a mixed method approach to identify the terminology preferences of people with a mental illness in Australia. N = 173 participants were recruited via convenience sampling. The humanistic terms 'individual' and 'person with lived experience' were identified as the preferred terms. Qualitatively there was a wide variation in how the terms made the respondents think or feel, with only one of the terms – 'survivor,' having solely negative themes. When contrasting the two most commonly used clinical terms, 'client' was significantly preferred to 'patient'. The term 'consumer' was one of the least preferred terms. This suggests that the use of this term, which is in regular use in Australia, should be reconsidered. [ABSTRACT FROM AUTHOR]

Purpose: To explore possible factors contributing to paediatric tube feeding dependency from the speech-language pathology perspective. Tube feeding dependency can have serious repercussions for children and their families with failed or slow weaning/transitioning from tube to oral feeding, more likely after the age of five. Method: A mixed methods approach was conducted. During the first quantitative phase, an online national survey of speech-language pathologists (SLPs) from the health and non-health sectors was carried out followed by interviews with a subset of the respondents. Forty-three SLPs completed the survey. In the second qualitative phase, 10 participants from the survey were interviewed in depth as to their opinions about why tube dependency occurs. Survey data from phase one were analysed using descriptive statistics and chi square comparisons. Interview data were categorised using thematic analysis. Findings from both methodologies were combined to report the results. Result: Two interlinking meta-themes were identified from the combined data sets. These were: (1) Medicalisation of tube fed children in infancy as a root cause of tube feeding dependency and (2) Fragmentation of the tube fed child's continuity of care. The specific results indicated several possible reasons for tube feeding dependency including medical emphasis on weight gain, prolonged nasogastric tube feeding and waiting too long for transition from tube to oral feeding. A lack of integrated care and clinician confidence in non-health settings also appeared to be a factor contributing to tube feeding dependency. Conclusion: Early and ongoing biomedical focus on weight gain affected long-term goals for transitioning leading, subsequently, to tube feeding becoming normalised by school age. [ABSTRACT FROM AUTHOR]

Purpose: To establish the clinical profiles of individuals with and without dysphagia following non-traumatic subarachnoid haemorrhage (SAH), and to further describe the clinical progression and outcome of dysphagia within the acute phase for those individuals with dysphagia. Method: Retrospective chart review of 250 patients consecutively admitted with non-traumatic SAH to a major, tertiary neurosurgery referral centre in Australia over a three-year period. Clinical information associated with usual clinical care was collected for the duration of the acute hospital admission. Characteristics of participants with dysphagia (n = 73/250) were further analysed to evaluate dysphagia progression and recovery. Result: Participants with dysphagia took 10.93 times longer to commence oral intake following admission than those without dysphagia (p < 0.01). Those with dysphagia took approximately 12.86 times longer to reach total oral feeding than those without dysphagia (p < 0.01). There was no statistically significant difference between groups for time to SLP referral (p = 0.549) or commencement of supplemental feeding (p = 0.256). Safe management of thin fluids occurred for >50% of participants by weeks 2 and 3 following admission, with 75.34% of participants with dysphagia resuming thin fluids by discharge. Safe management of full diet took slightly longer with 32.88% of participants resuming unmodified diet by week 3. By discharge, only 53.42% of participants resumed a full diet. Conclusion: The clinical progression and recovery of dysphagia within the acute phase following non-traumatic SAH can be protracted for some patients, necessitating ongoing speech-language pathology (SLP) input after discharge. The study findings will enhance SLP assessment processes, management focuses and guide prognostic decision making for this population. [ABSTRACT FROM AUTHOR]

Aim: To examine the reliability and validity of the Daily Living Self-Efficacy Scale (DLSES) with patients participating in subacute geriatric rehabilitation. Methods: A prospective single-center cohort study of 151 patients was completed. Construct validity, convergent validity and internal consistency reliability were examined. Results: Cronbach's α for the DLSES and the activities of daily living and psychosocial subscale were 0.73, 0.72 and 0.75, respectively, demonstrating sufficient evidence of internal consistency reliability. Principal components analysis established construct validity as three components with eigenvalues exceeding 1 (eigenvalues = 3.20, 1.31, 1.23) were generated, accounting for 63.69% of the variance in self-efficacy. Convergent validity was indicated as the DLSES was significantly positively correlated with the Cognitive Functional Independent Measure with r = 0.196 (p ≤ 0.001). Conclusion: This research has provided initial evidence for the reliability and validity of the DLSES with a general geriatric subacute rehabilitation population. [ABSTRACT FROM AUTHOR]

Background: Junior physiotherapists require satisfactory clinical skills to work effectively within the acute hospital setting for service quality and consistency. Objective: To investigate the effects of stream-specific clinical training on junior physiotherapist self-efficacy, self-rated confidence, and self-rated ability to work independently during weekend shifts. Design: Prospective cohort study. Participants: Eighteen junior physiotherapists. Methods: Physiotherapists undertook 8 h of stream-specific education in: pediatrics, women's health, neuro-medical, musculoskeletal, cardiorespiratory, and critical care over 8 weeks. Learning objectives were evaluated using a self-efficacy (0–100) scale and self-rated confidence was measured with a 4-point Likert scale (not confident to independent). Self-rated ability to independently work weekend shifts was measured dichotomously (yes/no). Results: Participants completed an average of three stream-specific programs in the study period. Post-training, mean improvement in self-efficacy across objectives ranged from 2.9 (95% CI −8.7 to 14.5) to 43.3 (95% CI 4.8–81.8) points, p < 0.05 for 80% of objectives. Self-rated confidence scores improved for 45.6% of stream-specific learning objectives; 52.8% were unchanged and 1.7% reported a decrease in confidence. Self-rated ability to work stream-specific weekend shifts increased from 56–70%, but no stream achieved a significant increase in staff able to independently work weekend shifts (p range 0.10 to 1.0). Conclusions: A stream-specific education program increased junior physiotherapists' self-efficacy and self-rated confidence but not perceived ability to work independently on weekends. Results were non-randomized and actual practice change was not assessed. Future studies could investigate different educational structures in a blinded, randomized manner on clinical practice change. [ABSTRACT FROM AUTHOR]

Little is understood about restrictive practices (seclusion, physical restraint, mechanical restraint) for those admitted to mental health services from prison. This study aimed to determine restrictive practices use on males admitted involuntarily from prison compared to those admitted from the community. A retrospective cross-sectional, comparative research design was used. Those admitted from prison were no more likely to experience restrictive practices; but were more likely to have a co-existing diagnosis of alcohol/substance use or personality disorder, in addition to a primary diagnosis of psychotic illness. The proportionate use of restrictive practices despite such complex presentations is potentially indicative of the clinical use of effective alternative management strategies. [ABSTRACT FROM AUTHOR]

Electronic assistive technologies (EATs) are fast becoming considered an essential component of everyday life. To date, there has been little research on the use of EAT by people living in shared supported accommodation (SSA), one of the major community-based housing options for people with disability (PwD) in Australia. This study aimed to (1) audit current EAT use by PwD living in SSA, (2) describe the impact of Internet access on EAT use, and (3) examine potential relationships between individual characteristics and EAT use. A customized survey administered with 32 house managers, representing 52 SSAs, gathered data on the EAT use of 254 people. Only 45.7% of residents used EAT, and devices available to the mainstream market were most frequently used. Access to home-based Internet was not a predictor of the number of devices in use. Disability type (congenital or acquired) was found to be significantly correlated with the number of devices in use, however, associations across a number of variables suggest complex mediational interactions. These findings provide an insight into the EAT use trends of PwD living in SSA, indicating that further work needs to be done to support the uptake and continued use of EAT by PwD Implications for Rehabilitation: Further work needs to be done to promote the uptake and use of electronic assistive technology (EAT) by people with disability (PwD). Personal characteristics and experiences need to be considered in the prescription of EAT to PwD, as these may explain variations in use between individuals. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to assess audiologists’ perceptions of ethics and moral climate in the workplace. Design: The Ethics Environmental Questionnaire (EEQ) was sent out to all audiologists registered with the professional body Audiology Australia. Participants were also invited to undertake a semi-structured interview. Study sample: A total of 301 audiologists completed the questionnaire. Eight of these participants also agreed to complete the interview. Results: The overall mean on the EEQ was approximately equivalent to that of a positive ethical environment, with the exception of those working in adult rehabilitation settings who scored significantly poorer. Scores were significantly associated with state and age. Qualitative analysis from the interviews found that sales pressure from employers was the dominant cause for concern amongst the group. Conclusions: For those working in adult rehabilitation, moral distress is most likely to occur as the result of conflicting goals between the organisation and the audiologist. There is a need to regulate the practice at an organisational as well as individual level to ensure the focus remains on ethical practice. [ABSTRACT FROM AUTHOR]

Purpose: A variety of dysphagia management options are available for the treatment of dysphagia following a stroke, however, it is unknown which of these approaches are most commonly utilised by Australian speech-language pathologists (SLPs) and whether particular factors influence decision-making. Method: The aim of this study was to investigate, through an online survey, the treatment practices of SLPs in Australia for the treatment of dysphagia post-stroke and identify the factors influencing treatment decisions. Result: A total of 118 SLPs completed the online survey. Descriptive statistics identified large variability in the dysphagia treatments utilised, with all 24 therapies listed in the online survey reported as being routinely used. Compensatory therapies were ranked as being utilised more frequently than rehabilitative approaches, with six of the seven highly utilised therapies being compensatory in nature. A client’s cognitive capacity was the most prominent factor influencing SLPs’ treatment decisions. Conclusion: This study provides insight into the practices of SLPs in Australia for the treatment of dysphagia following stroke and discusses potential for shifts in practice. It highlights the complexity involved in the decision-making process and that clinicians consider evidence, as well as client, clinician and service factors, when selecting between the range of options available. [ABSTRACT FROM AUTHOR]

The Interpersonal Psychological Theory of suicide proposes that the interaction between Thwarted Belongingness, Perceived Burdensomeness, and Acquired Capability for Suicide (ACS) predicts proximal risk of death by suicide. Instruments to assess all three constructs are available. However, research on the validity of one of them, the acquired capability for suicide scale (ACSS), has been limited, especially in terms of its clinical relevance. This study aimed to explore the utility of the different versions of the ACSS in clinical assessment. Three versions of the scale were investigated, the full 20-item version, a 7-item version and a single item version representing self-perceived capability for suicide. In a sample of patients recruited from a clinic specialising in the treatment of suicidality and in a community sample, all versions of the ACSS were found to show reasonable levels of reliability and to correlate as expected with reports of suicidal ideation, self-harm, and attempted suicide. The item assessing self-perceived acquired capacity for suicide showed highest correlations with all levels of suicidal behaviour. However, no version of the ACSS on its own showed a capacity to indicate suicide attempts in the combined sample. It is concluded that the versions of the scale have construct validity, but their clinical utility is limited. An assessment using a single item on self-perceived ACS outperforms the full and shortened versions of ACSS in clinical settings and can be recommended with caution for clinicians interested in assessing this characteristic. [ABSTRACT FROM PUBLISHER]

Aims: Investigate changes to a prospective cohort of methamphetamine users over 12 months, predictors of remission from methamphetamine dependence and past-month abstinence from methamphetamine use. Method: Structured interviews were administered to 255 regular methamphetamine users at baseline (2010) and 12 months (2011). A multivariate generalised estimating equation (GEE) model identified adjusted associations with past-month abstinence at follow-up. A multivariate logistic regression analysis identified factors independently associated with remission from methamphetamine dependence. Results: Most (60%) participants were methamphetamine-dependent at baseline. Remission from dependence (n = 38) was independently associated with age (OR: 0.93; 95% CI: 0.88–1.00), maintaining/gaining employment since baseline (OR: 3.14; 95% CI: 1.21–8.14) and a greater increase in self-perceived social support (OR: 1.08; 95% CI: 1.01–1.16). Past-month abstinence at follow-up was independently associated with being female (OR: 1.94; 95% CI: 1.10–3.44), recent criminal behaviours (OR: 0.46; 95% CI: 0.26–0.82), recent ecstasy (OR: 0.30; 95% CI: 0.12–0.72) and benzodiazepine use (OR: 0.53; 95% CI: 0.29–0.96), and being less methamphetamine-dependent (OR: 0.79; 95% CI: 0.72–0.88). Drug treatment was not independently associated with either outcome at follow-up. Conclusions: Our findings highlight the potential for natural remission from methamphetamine dependence; however, targeted interventions should be developed for individuals who are likely to maintain dependent/harmful use patterns. [ABSTRACT FROM PUBLISHER]

Background:Professionalism in health care comprises adherence to professional values and ethical codes, discipline-specific standards of practice and competencies, and specific expectations about appearance and social standing. Specialisation in a particular area of practice further increases expectations of professionalism and competency-based standards. Objective:To investigate, in an Australian setting, patients’ and physiotherapists’ perceptions of the features and value of professionalism in specific physiotherapy practice contexts. Major Findings:The professional standing of physiotherapists was similar to that of chiropractors, with judges, general practitioners and solicitors more highly regarded by both patients and physiotherapists. Participants had similar views about the importance of several elements of professionalism. In response to questions about professional appearance, both patients and physiotherapists preferred business attire for male physiotherapists, whereas opinions varied for female physiotherapists. Patient/therapist views diverged regarding the link between specialisation and professionalism. Patient participants presented with a list of physiotherapists with differing nomenclature/titles to treat their back pain indicated they were more likely to select a physiotherapist with a special interest in back pain and factors such as location of the physiotherapy service and recommendations from a friend influenced their choice of physiotherapist. In contrast, physiotherapist participants responded that postgraduate qualifications, years of experience and facilities were more important in the choice of a physiotherapist. Conclusions:Patients and physiotherapists share some views on professional behaviours and values, professional appearance and standing within the community. They differ with regard to perceptions of specialisation and how extra qualifications add to their perception of trust and professionalism. [ABSTRACT FROM AUTHOR]

We aimed to assess the prevalence of sleep disturbance in a cardiac patient population over a 12-month period and assess its relationship with treatment adherence, self-efficacy, anxiety and depression. A total of 134 patients consecutively admitted to two Australian hospitals after acute myocardial infarction (31%), or to undergo bypass surgery (29%) or percutaneous coronary intervention (40%) were interviewed at six weeks and four and 12 months. Sleep disturbance was measured using a recode of the Beck Depression Inventory (v.2) item 16. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale. Sleep disturbance was highly prevalent (69%) at 6 weeks but was not associated with 12-month psychological outcomes. Path analysis revealed that sleep disturbance at 4 months was, however, associated with reduced treatment adherence and self-efficacy, and higher anxiety and depression scores at 12 months. The high prevalence of sleep disturbance in this study and its association with psychological outcomes may have adverse prognostic implications and possibly impede cardiac rehabilitation efforts. [ABSTRACT FROM PUBLISHER]

Aims:Workforce entry is a key transition period. It offers an ideal, but under-utilised opportunity to implement intervention strategies to prevent mental health and substance use problems among young people. A brief psychological wellbeing and substance use intervention targeting a high-risk group – apprentice chefs – was undertaken to explore this opportunity.Method:A RCT design (N = 71) was used. The intervention group received two face-to-face sessions, and controls received five related information sheets during the first 2 weeks of training, with 4-month follow-up.Results:These apprentices were a high-risk group for alcohol and other drug harm and poor psychological wellbeing. At T1, 70% of the participants had AUDIT scores indicating problem drinking; 28% had used cannabis and 18% had used amphetamines in the last 12 months; and 24% had high K10 scores. At T2, the intervention group had significantly reduced risky alcohol use (p = 0.008), improved psychological distress (p = 0.045) and ability to talk with supervisors about work issues (p = 0.001) and cope with work stress (p = 0.001) and verbal abuse (p = 0.005), compared to the control group.Conclusions:Brief tailored interventions, delivered in an occupational training environment, have potential to reduce substance use risk and enhance young workers’ psychological wellbeing. [ABSTRACT FROM PUBLISHER]

Objective This study investigated the Diffusion of Innovation ( Do I) model in explaining the frequency of adoption and intention to adopt Cattell- Horn- Carroll ( CHC) theory by practicing Australian psychologists as a well-validated interpretive model when conducting cognitive assessments. Method Participants were psychologists with general registration ( N = 42 -78 depending on the analysis) who completed a survey assessing cognitive assessment practices and perceived innovation characteristics of the CHC model. Results Few psychologists in the sample were found to be employing CHC in practice, supporting the presence of a theory-practice gap within the cognitive assessment field in Australia. In addition, it was found that the Do I perceptions of compatibility, complexity, and relative advantage were helpful in explaining adoption/non-adoption. Conclusions Highlighting the compatibility, complexity and relative advantage of the CHC model to psychologists could assist with addressing the theory-practice gap in cognitive assessment in Australia [ABSTRACT FROM AUTHOR]

The understanding of modern young people's conceptions of adulthood has largely been informed and constructed through the lens of the theory of emerging adulthood. As a consequence, a relatively unquestioned belief is that there has been a trend towards the gradual development of internal, subjective characteristics and away from the attainment of traditional adult roles in emerging adults' conceptions of adulthood. Using both quantitative and qualitative methods, we surveyed Australian university students about their understanding of what it means to be an adult. Exploratory factor analysis of the Criteria for Adulthood Scale emphasised family capacities, demographic markers, norm compliance, and 'novelty of adulthood,' while qualitative themes emphasised both personal and environmental characteristics. We suggest that rather than being independent, individual development and broad social-environmental trends are likely to be interrelated, and to develop in response to each other over time. [ABSTRACT FROM AUTHOR]

Background: Alcohol disproportionately affects socially disadvantaged groups including Aboriginal and Torres Strait Islander Australians. Methods to assess alcohol intake for disadvantaged communities need to be able to capture variable or episodic drinking. The ability of a seven-day diary to capture typical consumption for a predominantly Aboriginal sample has not been assessed. Objective: One aim of this paper was to examine agreement between a seven-day retrospective diary and 'usual' drinking assessed by a modified version of the Alcohol Use Disorders Identification Test question 3 (AUDIT-3m; two questions). Other aims were to describe drinking patterns as reported in the seven-day diary. Method: In 2012, consecutive adults attending an Aboriginal Community Controlled Health Service completed a cross-sectional health risk survey on a touch screen laptop ( n = 188). Alcohol consumption questions included the retrospective diary and AUDIT-3m. Agreement was assessed using weighted kappa analysis. Results: There was good agreement between the two measures of consumption; however, the AUDIT-3m questions identified more current drinkers. Respondents who were drinkers (54%) tended to consume large amounts per drinking occasion: almost half (46%) of diary completers reported nine or more standard drinks on at least one occasion in the last week. Conclusions: The seven-day diary did not adequately capture variability in alcohol consumption common among this sample. Although the AUDIT-3m appeared acceptable, alternative approaches to assess usual or risky alcohol consumption, such as asking about specific drinking occasions, or allowing participants to respond in non-standard drink sizes, also need to be considered for indigenous and other disadvantaged communities. [ABSTRACT FROM AUTHOR]

Theory: Immersive simulation is a common mode of education for medical students. Observation of clinical simulations prior to participation is believed to be beneficial, though this is often a passive process. Active observation may be more beneficial.Hypotheses: The hypothesis tested in this study was that the active use of a simple checklist during observation of an immersive simulation would result in better participant performance in a subsequent scenario compared with passive observation alone.Methods: Medical students were randomized to either passive or active (with checklist) observation of an immersive simulation involving cardiac arrest prior to participating in their own simulation. Performance measures included time to cardiopulmonary resuscitation (CPR) and time to defibrillation and were compared between first and second scenarios as well as between passive and active observers.Results: Seventy-nine simulations involving 232 students were conducted. Mean time to CPR was 18 seconds (SD= 11.6) for those using the checklist and 24 seconds (SD =15.8) for those who observed passively (Mdifference = 6 seconds),t(35) = 1.46,p=.153. Time to defibrillation was 94 seconds (SD =26.4) for those using the checklist and 92 seconds (SD =23.8) for those who observed passively (Mdifference = –2 seconds),t(38) =.21,p=.837. Time to CPR was 24 seconds (SD =15.8) for passive observers and 31 seconds (SD =21.0;Mdifference = 7 seconds),t(35) = 1.13,p=.265, for their first scenario counterparts. Time to CPR was 18 seconds (SD =11.6) for active observers and 36 seconds (SD =26.2;Mdifference = 18 seconds),t(24) = 2.81,p=.010, for their first scenario counterparts. Time to defibrillation was 92 seconds (SD =23.8) for passive observers and 125 seconds (SD =32.2;Mdifference = 33 seconds),t(33) = 3.63,p=.001, for their first scenario counterparts. Time to defibrillation was 94 seconds (SD =26.4) for the active observers and 132 seconds (SD =52.9;Mdifference = 38 seconds),t(28) =.46,p=.008, for their first scenario counterparts.Conclusions: Observation alone leads to improved performance in the management of a simulated cardiac arrest. The active use of a simple skills-based checklist during observation did not appear to improve performance over passive observation alone. [ABSTRACT FROM AUTHOR]

Background Functional abilities and social outcomes of young adults with cerebral palsy (CP) are relatively underresearched. Improvements in paediatric care have extended the expectation of achieving adulthood to 90%. Method Young adults aged 20-30 years with CP ( n = 335) were compared to a population-based control group ( n = 2,152) of the same age. Motor function, self-care abilities, educational level, and social outcomes were determined by questionnaire. Results Half the study group walked independently, but only 35.5% were independent in self-care. In comparison to their peers without disability, the study group's highest educational level was lower ( p < .0001), as were rates of employment (36.3% compared with 80%), they were more likely to be living with parents (80% compared with 21%), to be single, and to have limited financial resources. Conclusion Young adults with CP are functionally and socially disadvantaged in contrast with their peers without disability. Self-care dependence, intellectual disability, and communication impairments contribute to these outcomes but are not solely responsible. [ABSTRACT FROM AUTHOR]

Objective: Chemotherapy treatment for acute lymphoblastic leukaemia (ALL) may disrupt motor development, with suggestions that gross and fine motor deficits are different depending on time since treatment. Methods: Thirty-seven participants aged between 2.5 to 5 years at the time of diagnosis were assessed using the Movement Assessment Battery for Children, 2nd Edition (MABC-2) and the Bruininks-Oseretsky Test of Motor Proficiency, 2nd Edition, Short Form (BOT-2 SF), and divided into groups (i.e. months-off-treatment): (1) 0-12, (2) 13-24, and (3) 25-60 for comparison. Results: MABC-2 and BOT-2 SF mean total scores fell within the average range. Twenty-six percent of the sample performed in the impaired range on the MABC-2. Group 2 had significantly lower Manual Dexterity scores than the normative population and lower BOT-2 SF scores than Group 1. Conclusion: Most children treated for ALL display appropriate motor skills, yet around a quarter experience general motor difficulties. Time-off-treatment did not affect the prevalence of motor impairments on any measure. [ABSTRACT FROM AUTHOR]

Cognitive impairment is one factor known to affect people's ability to participate in substance misuse treatment because of the range of cognitive, behavioural and emotional problems such impairment can cause. Some of the behaviours described as common features of cognitive impairment, such as impaired self-monitoring and self-regulation and lack of initiative are seen in some treatment modalities to be causes and consequences of addiction thereby prescribing a moral rationale to behaviour that may have a physical cause. The aim of this study was to identify the prevalence of cognitive impairment in a rural Australian substance treatment in-patient population. The Addenbrook's Cognitive Examination – Revised (ACE-R) was used to screen consenting patients (n = 50). Six (12%) scores were less than or equal to 82 (moderate to severe cognitive impairment), and 20 (40%) were less than or equal to 88 (mild to moderate cognitive impairment). Statistical techniques were used to determine if cognitive impairment was related to different demographic variables. The tests showed that cognitive impairment was not related to age or gender, weakly related to level of education and strongly related to Indigenous status. For example, 82% of Indigenous clients had a score indicating possible impairment, compared to 28% for non-Indigenous. A significant number of people attending in-patient drug and alcohol treatment have some form of cognitive impairment that may affect their ability to participate in the treatment. Indigenous people in rural substance treatment services appear highly likely to have some cognitive impairment. However, further work is required to ensure the screening tool is appropriate for use with Indigenous Australians. Substance misuse treatment providers need to ensure treatment programmes are suitable for people with cognition problems. [ABSTRACT FROM PUBLISHER]

This study was designed to conduct systematic reviews of existing evaporative cooling system maintenance guidelines and of published Legionnaires' disease outbreaks to determine what, if any, maintenance practices were in place at the time of the disease outbreaks and then to contrast the reported practices with the published guidelines for evaporative cooling systems. For the first review, similarities in the reported recommendations were assessed; in the second review, any reported information about the state of the evaporative cooling system during the outbreak investigation was summarized. The systematic reviews yielded 38 current guidelines for evaporative cooling systems and 38 published outbreak investigations. The guidelines varied regarding the recommended type and dose of biocides, frequency of general inspections and total system maintenance, the preferred disinfection and cleaning procedures when testing a system for microbiological contamination, the type and frequency of testing procedures, and interpretation of test results. Overall, the maintenance guidelines did not contain sufficiently detailed procedures to prevent the problems that were observed in the outbreak investigations. These maintenance procedures included lack or improper use of a biocide; infrequent testing for microbiological contamination; improper use or maintenance of drift eliminators; and lack of a total system cleaning within 6 months of the outbreak for cooling systems that were either under continuous use, recently started up, or frequently switched on and off. This study suggests that more specific and standardized maintenance guidelines for the control of Legionella bacteria are needed and that these guidelines must be properly implemented to help reduce further Legionnaires' disease outbreaks associated with evaporative cooling systems. [ABSTRACT FROM AUTHOR]