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Background: Recent research has focused on the potential benefits of physical activity in occupational settings in addition to leisure time. However, occupational physical activity (OPA) differs substantially for occupations that require heavy and repetitive physical work, such as nursing. We explored associations between leisure time and OPA and health outcomes in working nurses and midwives. Methods: Nurses who were enrolled in the Fit For the Future study (New South Wales, Australia) and who completed physical activity questionnaires (n = 4343) were classified according to high (HO) or low (LO) occupational and high (HL) or low (LL) leisure-time physical activity (LTPA): HO performed walking/heavy labor most/all of the time at work; HL met the guidelines of 150 minutes per week moderate to vigorous LTPA, creating 4 categories: HOLL, HOHL, LOHL, and LOLL. Results: HL predicted better self-rated health (unstandardized B = 0.51, 95% confidence interval, 0.44 to 0.57) and lower likelihood of ≥3 sick days in the past 12 months (OR: 0.71, 95% confidence interval, 0.61 to 0.83), whereas HO predicted higher likelihood of ≥3 sick days (OR: 1.17, 95% confidence interval, 1.01 to 1.35), adjusting for all variables. Conclusions: OPA may not confer the same health benefits as LTPA for nurses. Health-promoting interventions should emphasize the importance of achieving adequate moderate to vigorous LTPA for all, including those undertaking substantial OPA.

Nurses and midwives (nurses) are the principle role models and health educators for the wider population. This study sought to identify the health-related behaviors of the nursing workforce of New South Wales (NSW), Australia, compared to contemporary recommendations for healthy living and to the Australian general population, matched by gender and age. An electronic cross-sectional survey delivered in 2014–2015 recruited 5041 nurses through the NSW Nurses and Midwives Association and professional networks. Validated health behavior measures were collected and compared to Australian National Health Survey data. Compared with younger nurses, older nurses reported greater adherence to fruit and vegetable guideline recommendations, but were more likely to be overweight or obese. Younger nurses (25–34 years) had the highest risk of harmful drinking. Compared with the Australian general population, slightly higher percentages of nurses met dietary recommendations and slightly fewer were obese, had central adiposity or smoked. Nurses had lower physical activity levels and higher levels of risky drinking across most gender and age groups. Many nurses have lifestyle health behaviors that place them at high risk for developing non-communicable diseases, sometimes at higher risk than the Australian population to whom they deliver health education. Health promotion strategies for nurses are urgently required.

Nurses and midwives (nurses) are the principle role models and health educators for the wider population. This study sought to identify the health-related behaviors of the nursing workforce of New South Wales (NSW), Australia, compared to contemporary recommendations for healthy living and to the Australian general population, matched by gender and age. An electronic cross-sectional survey delivered in 2014–2015 recruited 5041 nurses through the NSW Nurses and Midwives Association and professional networks. Validated health behavior measures were collected and compared to Australian National Health Survey data. Compared with younger nurses, older nurses reported greater adherence to fruit and vegetable guideline recommendations, but were more likely to be overweight or obese. Younger nurses (25–34 years) had the highest risk of harmful drinking. Compared with the Australian general population, slightly higher percentages of nurses met dietary recommendations and slightly fewer were obese, had central adiposity or smoked. Nurses had lower physical activity levels and higher levels of risky drinking across most gender and age groups. Many nurses have lifestyle health behaviors that place them at high risk for developing non-communicable diseases, sometimes at higher risk than the Australian population to whom they deliver health education. Health promotion strategies for nurses are urgently required.

Objective: To examine anti-microbial prescribing practices associated with ventilator-associated pneumonia from data gathered during an audit of practice and outcomes in intensive care units (ICUs) in a previously published study. Results: The patient sample of 169 was 65% male with an average age of 59.7 years, a mean APACHE II score of 20.6, and a median ICU stay of 11 days. While ventilator-associated pneumonia was identified using a specific 4-item checklist in 29 patients, agreement between the checklist and independent physician diagnosis was only 17%. Sputum microbe culture reporting was sparse. Approximately 75% of the sample was administered an antimicrobial (main indications: lung infection [54%] and prophylaxis [11%]). No clinical justification was documented for 20% of prescriptions. Piperacillin/tazobactam was most frequently prescribed (1/3rd of all antimicrobial prescriptions) with about half of those for prophylaxis. Variations in prescribing practices were identified, including apparent gaps in antimicrobial stewardship; particularly in relation to prescribing for prophylaxis and therapy de-escalation. Sputum microbe culture reports for VAP did not appear to contribute to prescribing decisions but physician suspicion of lung infection and empiric therapy rather than ventilator-associated pneumonia criteria and guideline concordance.

Aim To examine the workforce, workplace, psychosocial and health characteristics of nurses and midwives in relation to their reported use of sickness absence described as ‘mental health days’. Background The occupational stress associated with the nursing profession is increasingly recognized and nurse/midwifery absenteeism is a significant global problem. Taking a ‘mental health day’ as sickness absence is a common phenomenon in Australian health care. No previous studies have empirically explored the characteristics of nurses and midwives using such sickness absence. Design Online cross-sectional survey. Methods Survey comprising validated tools and questions on workplace and health characteristics was distributed to nurses and midwives in New South Wales, Australia, between May 2014 - February 2015. Sample characteristics were reported using descriptive statistics. Factors independently predictive of ‘mental health day’ reportage were determined using logistic regression. Results Fifty-four percentage of the n = 5041 nurse and midwife respondents took ‘mental health days’. Those affected were significantly more likely to be at younger ages, working shifts with less time sitting at work; to report workplace abuse and plans to leave; having been admitted to hospital in previous 12 months; to be current smokers; to report mental health problems, accomplishing less due to emotional problems and current psychotropic medication use. Conclusion Specific characteristics of nurses and midwives who report taking ‘mental health day’ sickness absence offer healthcare administrators and managers opportunities for early identification and intervention with workplace measures and support frameworks to promote well-being, health promotion and safety.

Background The level of traditional medicine use, particularly Jamu use, in Indonesia is substantial. Indonesians do not always seek timely treatment for malaria and may seek self-medication via traditional medicine. This paper reports findings from the first focused analyses of traditional medicine use for malaria in Indonesia and the first such analyses worldwide to draw upon a large sample of respondents across high-risk malaria endemic areas. Methods A sub-study of the Indonesia Basic Health Research/Riskesdas Study 2010 focused on 12,226 adults aged 15 years and above residing in high-risk malaria-endemic provinces. Logistic regression was undertaken to determine the significant associations for traditional medicine use for malaria symptoms. Findings Approximately one in five respondents use traditional medicine for malaria symptoms and the vast majority experiencing multiple episodes of malaria use traditional medicine alongside free antimalarial drug treatments. Respondents consuming traditional medicine for general health/common illness purposes every day (odds ratio: 3.75, 95% Confidence Interval: 2.93 4.79), those without a hospital in local vicinity (odds ratio: 1.31, 95% Confidence Interval: 1.10 1.57), and those living in poorer quality housing, were more likely to use traditional medicine for malaria symptoms. Conclusion A substantial percentage of those with malaria symptoms utilize traditional medicine for treating their malaria symptoms. In order to promote safe and effective malaria treatment, all providing malaria care in Indonesia need to enquire with their patients about possible traditional medicine use.

Aim To examine the workforce, workplace, psychosocial and health characteristics of nurses and midwives in relation to their reported use of sickness absence described as ‘mental health days’. Background The occupational stress associated with the nursing profession is increasingly recognized and nurse/midwifery absenteeism is a significant global problem. Taking a ‘mental health day’ as sickness absence is a common phenomenon in Australian health care. No previous studies have empirically explored the characteristics of nurses and midwives using such sickness absence. Design Online cross-sectional survey. Methods Survey comprising validated tools and questions on workplace and health characteristics was distributed to nurses and midwives in New South Wales, Australia, between May 2014 - February 2015. Sample characteristics were reported using descriptive statistics. Factors independently predictive of ‘mental health day’ reportage were determined using logistic regression. Results Fifty-four percentage of the n = 5041 nurse and midwife respondents took ‘mental health days’. Those affected were significantly more likely to be at younger ages, working shifts with less time sitting at work; to report workplace abuse and plans to leave; having been admitted to hospital in previous 12 months; to be current smokers; to report mental health problems, accomplishing less due to emotional problems and current psychotropic medication use. Conclusion Specific characteristics of nurses and midwives who report taking ‘mental health day’ sickness absence offer healthcare administrators and managers opportunities for early identification and intervention with workplace measures and support frameworks to promote well-being, health promotion and safety.

AIM: To estimate the prevalence of diabetes, heart disease, hypertension and stroke in self-report and hospital data in two cohorts of women; measure sensitivity and agreement between data sources; and compare between cohorts. METHODS: Women born between 1946-1951 and 1921-1926 who participated in the Australian Longitudinal Study on Women's Health (ALSWH); were New South Wales residents; and admitted to hospital (2004-2008) were included in the present study. The prevalence of diabetes, heart disease, hypertension and stroke was estimated using self-report (case 1 at latest survey, case 2 across multiple surveys) and hospital records. Agreement (kappa) and sensitivity (%) were calculated. Logistic regression measured the association between patient characteristics and agreement. RESULTS: Hypertension had the highest prevalence and estimates were higher for older women: 32.5% case 1, 45.4% case 2, 12.8% in hospital data (1946-1951 cohort); 57.8% case 1, 73.2% case 2, 38.2% in hospital data (1921-1926 cohort). Agreement was substantial for diabetes: κ = 0.75 case 1, κ = 0.70 case 2 (1946-1951 cohort); κ = 0.77 case 1, κ = 0.80 case 2 (1921-1926 cohort), and lower for other conditions. The 1946-1951 cohort had 2.08 times the odds of agreement for hypertension (95% CI 1.56 to 2.78; P < 0.0001), and 6.25 times the odds of agreement for heart disease (95% CI 4.35 to 10.0; P < 0.0001), compared with the 1921-1926 cohort. CONCLUSION: Substantial agreement was found for diabetes, indicating accuracy of ascertainment using self-report or hospital data. Self-report data appears to be less accurate for heart disease and stroke. Hypertension was underestimated in hospital data. These findings have implications for epidemiological studies relying on self-report or administrative data. Geriatr Gerontol Int 2015

Aim: To investigate and describe nurses’ and midwives’ physical health, rates of symptoms and disease, and to determine if these factors contribute to intention to leave. Background: The nursing and midwifery workforce is ageing yet little is known about their physical health or its relationship to intention to leave. Methods: An online survey of health and work-related assessments was distributed through the New South Wales Nurses and Midwives Association and professional contacts. Results: Nurses and midwives (n = 5041) reported good-very good health overall. With 22.2% intending to leave in the next 12 months, older age, better perceived health and job satisfaction, regional residence and not working shifts predicted no intention to leave while breathing problems predicted intention to leave. Conclusions: Study findings flag the importance of health as an influence on intention to leave. Alongside job satisfaction and shift-working, health presents opportunities for workplace initiatives to maintain nurses in the workforce. Implications for nursing management: Educators, managers and policy makers should heed the significant influence of health for retention of staff and consider what strategies may mitigate health risks for this workforce.

Objectives: To determine the prevalence and characteristics of users of prayer or spiritual healing among Australian women aged 31-36 years. Design and setting: This cross-sectional study was conducted as a part of the Australian Longitudinal Study on Women's Health (ALSWH). The sample used in the current sub-study were participants from the 'young' cohort (1973-78) (n = 8180) aged between 31 and 36 years. Main outcome measure: Use of prayer or spiritual healing. Results: Prayer or spiritual healing was used on a regular basis by 20% of women aged between 31 and 36 years in 2009. Women who had symptoms of chronic illnesses (p = 0.001), women who had never smoked (p = 0.001) and women who used other forms of CAM (p < 0.001) were significantly more likely to use prayer or spiritual healing. Conclusion: A signifibasis. Further research is required to better understand their rationale for using prayer or spiritual healing and its perceived impact on health related outcomes and general well-being.cant proportion of women use prayer or spiritual healing on a regular basis. Further research is required to better understand their rationale for using prayer or spiritual healing and its perceived impact on health related outcomes and general well-being.

Background Emerging evidence suggests that some people living with non-communicable diseases (NCDs) have integrated energy healing into their self-management strategy, however little is known about its efficacy. Purpose To identify energy healing interventions that impacted positively on the symptom management outcomes for patients living in the community with various NCDs. Methods A systematic review of energy healing interventions for the management of non-communicable disease related symptoms, conducted between 01 January 2000 and 21 April 2015, published in an English peer-reviewed journal. This review conforms to the PRISMA statement. Results Twenty seven studies were identified that evaluated various energy healing interventions involving 3159 participants. Thirteen of the energy healing trials generated statistically significant outcomes. Conclusions Energy healing has demonstrated some improvement in illness symptoms, however high level evidence consistently demonstrating efficacy is lacking. Further more robust trials are required to better understand which elements of energy healing interventions are associated with positive outcomes.

Aim: To investigate and describe nurses’ and midwives’ physical health, rates of symptoms and disease, and to determine if these factors contribute to intention to leave. Background: The nursing and midwifery workforce is ageing yet little is known about their physical health or its relationship to intention to leave. Methods: An online survey of health and work-related assessments was distributed through the New South Wales Nurses and Midwives Association and professional contacts. Results: Nurses and midwives (n = 5041) reported good-very good health overall. With 22.2% intending to leave in the next 12 months, older age, better perceived health and job satisfaction, regional residence and not working shifts predicted no intention to leave while breathing problems predicted intention to leave. Conclusions: Study findings flag the importance of health as an influence on intention to leave. Alongside job satisfaction and shift-working, health presents opportunities for workplace initiatives to maintain nurses in the workforce. Implications for nursing management: Educators, managers and policy makers should heed the significant influence of health for retention of staff and consider what strategies may mitigate health risks for this workforce.

Objectives: To determine the prevalence and characteristics of users of prayer or spiritual healing among women. Design and setting: This cross sectional study was conducted as a part of the Australian Longitudinal Study on Women's Health (ALSWH), a 20-year study that examines various factors affecting women's health and well-being. Participants: The sample used in the current study were women from the 1946-1951 cohort (n=9965) (59-64 years) who were surveyed in 2010.Outcome measures: Use of prayer or spiritual healing; demographic factors and measures of health status. x2 Tests, analyses of variance (to determine associations) and a stepwise backward logistic regression model (for the most significant predictors) using a likelihood ratio test were used to determine the outcome measures. Results: It is estimated that 26% of Australian women from the 1946-1951 cohort (aged 59-64 years) use prayer or spiritual healing on a regular basis. Women were significantly more likely to use prayer or spiritual healing if they were non-smokers, non-drinkers or lowrisk drinkers, had symptoms of severe tiredness (OR 1.25; 95% CI 1.12 to 1.40), depression, (OR 1.30; 95% CI 1.11 to 1.53), anxiety (OR 1.33; 95% CI 1.15to 1.53), diagnosed cancer (OR 1.84; 95% CI 1.28 to 2.65) or other major illnesses (OR 1.43; 95% CI 1.18to 1.75) and used other complementary therapies. Conclusions: A significant proportion of adult women are using prayer or spiritual healing. Given that prayer or spiritual healing was significantly associated with health symptoms, chronic illnesses and positive health seeking behaviours, respect for prayer or spiritual healing practices is required within health care settings. Future research is recommended around specific populations using prayer or spiritual healing, reasons for their use and potential benefits on health related outcomes and general well-being.

Objectives: With disagreements on diagnostic criteria for ventilator-Associated pneumonia (VAP) hampering efforts to monitor incidence and implement preventative strategies, the study objectives were to develop a checklist for clinical surveillance of VAP, and conduct an audit in Australian/New Zealand intensive care units (ICUs) using the checklist. Setting: Online survey software was used for checklist development. The prospective audit using the checklist was conducted in 10 ICUs in Australia and New Zealand. Participants: Checklist development was conducted with members of a bi-national professional society for critical care physicians using a modified Delphi technique and survey. A 30-day audit of adult patients mechanically ventilated for >72 h. Primary and secondary outcome measures: Presence of items on the screening checklist; physician diagnosis of VAP, clinical characteristics, investigations, treatments and patient outcome. Results: AVAP checklist was developed with five items: decreasing gas exchange, sputum changes, chest X-ray infiltrates, inflammatory response, microbial growth. Of the 169 participants, 17% (n=29) demonstrated characteristics of VAP using the checklist. A similar proportion had an independent physician diagnosis (n=30), but in a different patient subset (only 17% of cases were identified by both methods). The VAP rate per 1000 mechanical ventilator days for the checklist and clinician diagnosis was 25.9 and 26.7, respectively. The item 'inflammatory response' was most associated with the first episode of physician-diagnosed VAP. Conclusions: VAP rates using the checklist and physician diagnosis were similar to ranges reported internationally and in Australia. Of note, different patients were identified with VAP by the checklist and physicians. While the checklist items may assist in identifying patients at risk of developing VAP, and demonstrates synergy with the recently developed Centers for Disease Control (CDC) guidelines, decisi

Background: Violence is a major problem in India with family, domestic and honour-related violence having significant impacts on the wellbeing of Indian families and communities. There has been little attention paid to men's experiences, particularly in the Indian State's of Gujarat and Uttar Pradesh. The objective of this study was to provide baseline data on Indian men's experiences of violence and the key predictors such as age, income, education and religion. Methods: A cross-sectional survey of men from Uttar Pradesh and Gujarat. Data were obtained from a non-probability purposive sample of 1000 adult men over a two-month period in late 2009. The respondents were selected from public spaces in 10 cities or towns within these two provinces. Results: The results found a lifetime prevalence of experiencing family violence of 99.2% (15.6% often and 64.1% sometimes), domestic violence 92.2% (21.1% often and 44.9% sometimes), and honour-related violence 99.7% (45.1% often and 41.7% sometimes). Moreover, when we analysed the men's responses across socio-demographic factors, age, income, religion, education and region were each shown to be important predictors of regular exposure to family, domestic and honour-related violence. Conclusions: The results of this survey provide much needed insight into the factors that predict experiences of violence. Such data can inform targeting by community development programs and Government policy in order to provide additional support to individuals and communities most likely to be exposed to these types of violence.

Background: Palliative care should be provided according to the individual needs of the patient, caregiver and family, so that the type and level of care provided, as well as the setting in which it is delivered, are dependent on the complexity and severity of individual needs, rather than prognosis or diagnosis. This paper presents a study designed to assess the feasibility and efficacy of an intervention to assist in the allocation of palliative care resources according to need, within the context of a population of people with advanced cancer. ---------- Methods/design: People with advanced cancer and their caregivers completed bi-monthly telephone interviews over a period of up to 18 months to assess unmet needs, anxiety and depression, quality of life, satisfaction with care and service utilisation. The intervention, introduced after at least two baseline phone interviews, involved a) training medical, nursing and allied health professionals at each recruitment site on the use of the Palliative Care Needs Assessment Guidelines and the Needs Assessment Tool: Progressive Disease - Cancer (NAT: PD-C); b) health professionals completing the NAT: PD-C with participating patients approximately monthly for the rest of the study period. Changes in outcomes will be compared pre-and post-intervention.---------- Discussion: The study will determine whether the routine, systematic and regular use of the Guidelines and NAT: PD-C in a range of clinical settings is a feasible and effective strategy for facilitating the timely provision of needs based care.

Needs assessment strategies can facilitate prioritisation of resources. To develop a needs assessment tool for use with advanced cancer patients and caregivers, to prompt early intervation. A convenience sample of 103 health professionals viewed three videotaped consultations involving a simulated patient, his/her caregiver and a health professional, completed the Palliative Care Needs Assessment Tool (PC-NAT) and provided feedback on clarity, content and acceptability of the PC-NAT. Face and content validity, acceptability and feasibility of the PC-NAT were confirmed. Kappa scores indicated adequate inter-rater reliability for the majority of domains; the patient spirituality domain and the caregiver physical and family and relationship domains had low reliability. The PC-NAT can be used by health professionals with a range of clinical expertise to identify individuals' needs, thereby enabling early intervention. Further psychometric testing and an evaluation to assess the impact of the systematic use of the PC-NAT on quality of life, unmet needs and service utilisation of patients and caregivers are underway.

Perry, L., Xu, X., Duffield, C., Gallagher, R., Nicholls, R., & Sibbritt, D. (2017). Health, workforce characteristics, quality of life and intention to leave: The ‘fit for the future’survey of Australian nurses and midwives. Journal of Advanced Nursing, 73(11), 2745-2756. Available here

Perry, Lin, et al. "Does nurses’ health affect their intention to remain in their current position?." Journal of Nursing Management 24.8 (2016): 1088-1097. Available here

Nicholls, R., Perry, L., Gallagher, R., Duffield, C., Sibbritt, D., & Xu, X. (2017). The personal cancer screening behaviours of nurses and midwives. Journal of Advanced Nursing. 73(6), 1403 - 1420. Available here

Lamont,S. ,Brunero,S. , Perry,L. ,Duffield, C.M. ,Sibbritt, D., Gallagher, R., Nicholls, R. (2017). ‘Mental health day’ sickness absence amongst nurses and midwives: workplace, workforce, psychosocial and health characteristics. Journal of Advanced Nursing. 73(5), 1172 - 1181. Available here

Gallagher, R., Perry, L., Duffield, C., Sibbritt, D., & Ying Ko, C. (2018). The health of working nurses: Hypertension prevalence, awareness, treatment and control by medication. Journal of Nursing Management 26(4). 403-410. doi:here.

Perry, L., Xu, X., Gallagher, R., Nicholls, R., Sibbritt, D., & Duffield, C. (2018). Lifestyle Health Behaviors of Nurses and Midwives: The ‘Fit for the Future’Study. International journal of environmental research and public health, 15(5), 945. Available here