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Objectives: This study evaluated multiple computed tomography (CT) workforce models to identify any implications on efficiency (length of stay, scan frequency and workforce cost) and scanning radiographer interruptions through substituting or supplementing with a trained CT assistant. Methods: The study was conducted in a CT unit of a tertiary Queensland hospital and prospectively compared four workforce models, including usual practice: Model 1 used an administrative assistant (AA) and one radiographer; Model 2 substituted a medical imaging assistant (MIA) for the AA; Model 3 was usual practice, consisting of two radiographers; and Model 4 included two radiographers, with a supplemented MIA. Observational data were collected over 7 days per model and were cross-checked against electronic records. Data for interruption type and frequency, as well as scan type and duration, were collected. Annual workforce costs were calculated as measures of efficiency. Results: Similar scan frequency and parameters (complexity) occurred across all models, averaging 164 scans (interquartile range 160–172 scans) each. The median times from patient arrival to examination completion in Models 1–4 were 47, 35, 46 and 33 min respectively. There were between 34 and 104 interruptions per day across all models, with the 'assistant role' fielding the largest proportion. Model 4 demonstrated the highest workforce cost, and Model 2 the lowest. Conclusion: This study demonstrated that assistant models offer similar patient throughput to usual practice at a reduced cost. Model 2 was the most efficient of all two-staff models (Models 1–3), offering the cheapest workforce, slightly higher throughput and faster examination times. Not surprisingly, the additional staff model (Model 4) offered greater overall examination times and throughput, with fewer interruptions, although workforce cost and possible role ambiguity were both limitations of this model. These findings may assist decision makers in selecting the optimal workforce design for their own individual contexts. What is known about the topic?: Innovative solutions are required to address ongoing health workforce sustainability concerns. Workforce substitution models using trained assistants have demonstrated numerous benefits internationally, with translation to the Australian allied health setting showing promise. What does this paper add?: Building on existing research, this study provides clinical workforce alternatives that maintain patient throughput while offering cost efficiencies. This study also quantified the many daily interruptions that occur within the CT setting, highlighting a potential clinical risk. To the best of our knowledge, this study is the first to empirically test the use of allied health assistants within CT. What are the implications for practitioners?: Role substitution in CT may offer solutions to skills shortages, increasing expenditure and service demand. Incorporating appropriate assistant workforce models can maintain throughput while demonstrating implications for efficiency and interruptions, potentially affecting staff stress and burnout. In addition, the assistant's scope and accepted level of interruptions should be considerations when choosing the most appropriate model. [ABSTRACT FROM AUTHOR]

Objective This study aims to ascertain if differences exist in the perception of the professional practice environment and personal well-being of nurses across different geographical areas in Queensland. Design This paper was performed on a prospective, self-report cross-sectional on-line survey. Setting The study was conducted among the nurses employed in public and private health care settings: acute hospitals, community health and aged care in Queensland, Australia. Participants Participants of this study were 1608 registered and enrolled nurses and assistants in nursing, current members of the Queensland Nurses Union in 2013 and who provided a workplace postcode. One thousand eight of these participants worked in major cities, while 382 in rural locations and 238 in remote areas. Interventions None. Main outcome measures Scores of well-being as determined by the following scales: the Depression, Anxiety and Stress Scale, the Professional Quality of Life Scale version 5, the Connor-Davidson Resilience Scale and of the Professional Practice Environment using the Practice Environment Scale - Nursing Work Index Revised. Results Nurses employed in major cities perceived 'nursing foundations for quality care' more favourably than those from other settings. Remote area nurses had lower levels of secondary traumatic stress than nurses in major cities and rural areas. There was no difference between nurses across their geographical locations for stress, anxiety, depression, compassion satisfaction, burnout, resilience and the four other measures of the Practice Environment Scale. Conclusions The study findings provide new data suggesting that, with the exception of secondary traumatic stress, the personal well-being of nurses does not differ across geographical settings. Similarly, with the exception of the subscale of 'nursing foundations for quality care' there was no difference in perceptions of the professional practice environment. As secondary traumatic stress is associated with burnout, this finding needs to be investigated further. [ABSTRACT FROM AUTHOR]

Background: Public policy across the world is increasingly focusing on the role of mental health promotion in whole of health strategies. There is a growing evidence-base that mental health promotion, delivered by trained facilitators, is effective in promoting self-awareness and self-care to prevent the damaging effects of ongoing stress in one's life and to promote early detection of any possible emerging mental health problems. Within Australia, however, few clinicians or school staff are confident or trained in mental health promotion. Aims: This paper reports the results of a two-day training designed for facilitators of a mental health program for secondary-school students. The goal was to develop facilitators' knowledge and understanding of best practice in youth mental health promotion and to increase their confidence in delivering the program. Design: A mixed methods evaluation assessed the impact that a solution-focused training program had on participating facilitators. Methods: A questionnaire was created and included eight quantitative items and one open ended, qualitative question. Twenty-seven nurses and guidance officers from central Queensland were recruited via convenience sampling and data were analysed using descriptive statistics and thematic analysis. Results: The evaluation revealed that participants' perception of their ability to facilitate a youth mental health program significantly improved after completing the training. Qualitative data indicated that participants found the professional development experience to be valuable, provide useful and transferable skills, and believed it to be necessary for mental health promotion work. Conclusion: By providing detailed description of the program's content and processes, other mental health professionals may be inspired to further develop effective learning experiences. [ABSTRACT FROM AUTHOR]

Objective: The aims of this paper were to report on the global psychosocial functioning of 5-year-old DHH children and examine the risk and protective factors that predict outcomes. Design: A cross-sectional analysis of data collected from a prospective, population-based longitudinal study. Study sample: Parents/caregivers of 356 children completed questionnaires on psychosocial development (CDI, SDQ), functional communication (PEACH) and demographic information. Children completed standardized assessments of non-verbal cognitive ability (WNV) and language (PLS-4). Results: On average, global psychosocial functioning was within the range of typically developing children; however, variability was high and 12% of children had scores that were more than 2 SDs below the norm. Non-verbal cognitive ability, presence of additional disabilities, language and functional communication significantly predicted outcomes. In contrast, type of hearing device, severity of hearing loss and age at intervention did not. Conclusion: The global psychosocial functioning of this cohort of 5-year-old DHH children fell within the range of typically developing children. The findings suggest that spoken language ability and functional communication skills are vital for healthy psychosocial development. [ABSTRACT FROM AUTHOR]

Purpose:This paper presents an exploratory investigation of the talk time of people with non-fluent aphasia, as measured by the CommFit™ app. Aims were to compare the talk time of people with aphasia with non-aphasic peers and measures of impairment, activity and participation. The variability of talk time over weeks and days of the week was also investigated. Method:Twelve people with post-stroke, non-fluent aphasia and seven non-aphasic controls measured their talk time using the CommFit™ app for 6 h/day for 14 days. Result:People with aphasia talked for a mean of 4.5 min/h and non-aphasic controls 7.2 min/h, which was not a significant difference (p = 0.056). Talk time of people with aphasia was not significantly correlated with WAB-R AQ or CADL-2 scores, but a moderate-high positive relationship between talk time and SIPSO scores was found (r = 0.648,p = 0.015). Talk time was not significantly different between the first and second weeks of recording for either group, and days of the week were not significantly different except for Saturdays, in which talk time was higher. Conclusion: This study provides some preliminary data on talk time in people with aphasia, suggesting that talk time is an indicator of participation. [ABSTRACT FROM PUBLISHER]

Aim This study aimed to demonstrate how supervisors and students use their time during the three domains of nutrition and dietetic clinical placement and to what extent patient-care and non-patient activities change during placement compared with pre- and post-placement. Methods A cohort survey design was used with students from two Queensland universities, and their supervisors in 2010. Participants recorded their time use in either a paper-based or an electronic survey. Supervisors' and students' time use was calculated as independent daily means according to time-use categories reported over the length of the placement. Mean daily number of occasions of service, length of occasions of service, project activities and other time use in minutes was reported as productivity output indicators and the data imputed. A linear mixed modelling approach was used to describe the relationship between the stage of placement and time use in minutes. Results Combined students' (n = 21) and supervisors' (n = 29) time use as occasions of service or length of occasions of service in patient-care activities were significantly different pre, during and post placement. On project-based placements in food-service management and community public health nutrition, supervisors' project activity time significantly decreased during placements with students undertaking more time in project activities. Conclusions This study showed students do not reduce occasions of service in patient care, and they enhance project activities in food service and community public health nutrition while on placement. A larger study is required to confirm these results. [ABSTRACT FROM AUTHOR]

Little is known outside of the United States about the risk of violence-related death among young people who have had contact with the youth justice system (justice-involved young people). We examined violence-related deaths among justice-involved young people in Queensland, Australia. In this study, youth justice records for 48,647 young people (10–18 years at baseline) who were charged, or experienced a community-based order or youth detention in Queensland, Australia (1993–2014) were probabilistically linked with death, coroner, and adult correctional records (1993–2016). We calculated violence-related crude mortality rates (CMRs) and age- and sex-standardized mortality ratios (SMRs). We constructed a cause-specific Cox regression model to identify predictors of violence-related deaths. Of 1,328 deaths in the cohort, 57 (4%) were from violence. The violence-related CMR was 9.5 per 100,000 person-years (95% confidence interval [95% CI] [7.4, 12.4]) and the SMR was 6.8 [5.3, 8.9]. Young Indigenous people had a greater risk of violence-related death than non-Indigenous people (cause-specific hazard ratio [csHR] 2.5; [1.5, 4.4]). Young people who experienced detention had more than twice the risk of violence-related death than those who were charged only (csHR 2.5; [1.2, 5.3]). We found that justice-involved young people have a risk of dying from violence that far exceeds that of the general population. The rate of violence-related death found in this study is lower than that in U.S.-based studies, which most likely reflects lower population level firearm violence in Australia. In Australia, young Indigenous people and those released from detention appear key groups to target for violence prevention efforts. [ABSTRACT FROM AUTHOR]

Objective: To investigate student supervisor experiences of supervising students on clinical placements since the onset of the COVID‐19 pandemic. Background: Studies on the impact of COVID‐19 on student clinical placements have focused largely on student reports and have been specific to individual professions or topic areas. There is a need to investigate student supervisor experiences. This study was conducted in Queensland (Australia) in four regional and rural public health services and four corresponding primary health networks. Methods: The anonymous, mixed methods online survey, consisting of 35 questions, was administered to student supervisors from allied health, medicine, nursing and midwifery between May and August 2021. Numerical data were analysed descriptively using chi‐square tests. Free‐text comments were analysed using content analysis. Results: Complete datasets were available for 167 respondents. Overall trends indicated perceived significant disruptions to student learning and support, plus mental health and well‐being concerns for both students and supervisors. Extensive mask wearing was noted to be a barrier to building rapport, learning and teaching. Some positive impacts of the pandemic on student learning were also noted. Conclusions: This study has highlighted the perceived impact of the pandemic on supervisors' mental health, and on the mental health, learning and work readiness of students. This study provides evidence of the pandemic impacts on student clinical placements from a supervisor point of view. Findings can assist in future‐proofing clinical education and ensuring that students continue to receive learning experiences of benefit to them, meeting curriculum requirements, in the event of another pandemic. [ABSTRACT FROM AUTHOR]

Objective: The longer-term effectiveness of silicone and pressure burn scar interventions was evaluated at 12-months postburn. Design: Parallel group, randomised trial. Setting: Hospital outpatient clinics, research centre. Participants: Children referred for burn scar management following grafted or spontaneously healed acute burn injuries or scar reconstruction surgery. Interventions: Participants were randomised to: (1) topical silicone gel only, (2) pressure garment only, or (3) combined topical silicone gel and pressure garment. Main measures: Primary outcomes were scar thickness (blinded ultrasound measurement) and itch intensity (caregiver proxy-report, numeric rating scale). Results: Of 153 participants randomised who received the interventions (silicone n = 51, pressure garment n = 49, combined n = 53), 86 were followed-up at 12-months postburn (n = 34, n = 28, n = 24). No differences were identified for the primary outcomes using intention-to-treat analysis. Scar thickness mean difference (95% confidence interval) = 0.00 cm (−0.04, 0.05); −0.03 cm (−0.07, 0.02); 0.03 cm (−0.02, 0.08) and scar itch = 0.09 (−0.88, 1.06); −0.21 (−1.21, 0.79); 0.30 (−0.73, 1.32) for silicone vs pressure; silicone vs combined and combined vs pressure respectively. No serious adverse effects occurred. Conclusion: Similar to short-term results, the combined intervention offered no statistically or clinically significant benefit for improving the primary outcomes compared to each intervention alone. No differences in the primary outcomes were identified between the silicone and pressure alone groups. [ABSTRACT FROM AUTHOR]

People with spinal cord damage (SCD) report a high level of GP use. There is a dearth of research investigating factors that contribute to GP identification and retention for people with SCD. Furthermore, a GP satisfaction measure developed specifically for people with SCD is non-existent. This preliminary study sought to identify factors contributing to GP identification and retention. A total of 266 people with SCD primarily based in Queensland, Australia, completed a cross-sectional survey that aimed to fill these knowledge gaps. Descriptive statistics and correlational analyses clarified the factors contributing to GP identification and GP retention respectively. An exploratory factor analysis utilising the principal components analysis method clarified a set of items that could underpin key domains for a SCD-specific GP satisfaction measure. The findings confirm that knowledge about SCD, physically accessible services, and trust are seminal considerations aligned with GP identification and retention for people with SCD. A dearth of research investigates GP satisfaction among people who have experienced neurotrauma, with specific measures of GP satisfaction being non-existent. This study identifies the factors contributing to GP retention for people with spinal cord damage and establishes domains for a GP satisfaction measure, and model of GP satisfaction. The findings clarify that knowledge of condition and trust are factors important to include in a future measure and model. [ABSTRACT FROM AUTHOR]

Background: Case‐finding for dementia is practised by general practitioners (GPs) in Australia but without an awareness of community preferences. We explored the values and preferences of informed community members around case‐finding for dementia in Australian general practice. Design, setting and participants: A before and after, mixed‐methods study in Gold Coast, Australia, with ten community members aged 50‐70. Intervention: A 2‐day citizen/community jury. Participants were informed by experts about dementia, the potential harms and benefits of case‐finding, and ethical considerations. Primary and secondary outcomes: We asked participants, "Should the health system encourage GPs to practice 'case‐finding' of dementia in people older than 50?" Case‐finding was defined as a GP initiating testing for dementia when the patient is unaware of symptoms. We also assessed changes in participant comprehension/knowledge, attitudes towards dementia and participants' own intentions to undergo case‐finding for dementia if it were suggested. Results: Participants voted unanimously against case‐finding for dementia, citing a lack of effective treatments, potential for harm to patients and potential financial incentives. However, they recognized that case‐finding was currently practised by Australian GPs and recommended specific changes to the guidelines. Participants increased their comprehension/knowledge of dementia, their attitude towards case‐finding became less positive, and their intentions to be tested themselves decreased. Conclusion: Once informed, community jury participants did not agree case‐finding for dementia should be conducted by GPs. Yet their personal intentions to accept case‐finding varied. If case‐finding for dementia is recommended in the guidelines, then shared decision making is essential. [ABSTRACT FROM AUTHOR]

Objective: To examine the efficacy of a multi-modal web-based therapy program, Move it to improve it (Mitii™) delivered at home to improve Executive Functioning (EF) in children with an acquired brain injury (ABI). Design: Randomised Waitlist controlled trial. Setting: Home environment. Participants: Sixty children with an ABI were matched in pairs by age and intelligence quotient then randomised to either 20-weeks of Mitii™ training or 20 weeks of Care As Usual (waitlist control; n=30; 17 males; mean age=11y, 11m (±2y, 6m); Full Scale IQ=76.24± 17.84). Fifty-eight children completed baseline assessments (32 males; mean age=11.87±2.47; Full Scale IQ=75.21±16.76). Main Measures: Executive functioning was assessed on four domains: attentional control, cognitive flexibility, goal setting, and information processing using subtests from the Wechsler Intelligence Scale for Children (WISC-IV), Delis-Kaplan Executive Functioning System (D-KEFS), Comprehensive Trail Making Test (CTMT), Tower of London (TOL), and Test of Everyday Attention for Children (Tea-Ch). Executive functioning performance in everyday life was assessed via parent questionnaire (Behaviour Rating Inventory of Executive Functioning; BRIEF). Results: No differences were observed at baseline measures. Groups were compared at 20-weeks using linear regression with no significant differences found between groups on all measures of EF. Out of a potential total dose of 60 hours, children in the Mitii™ group completed a mean of 17 hours of Mitii™ intervention. Conclusion: Results indicate no additional benefit to receiving Mitii™ compared to standard care. Mitii™, in its current form, was not shown to improve EF in children with ABI. [ABSTRACT FROM AUTHOR]

BackgroundPersistent impairments resulting from childhood acquired brain injury (ABI) can impact performance of activities of daily living (ADL). Objective and reliable measures of ADL skills are required for treatment planning and research.AimTo evaluate test–retest reproducibility of the Assessment of Motor and Process Skills (AMPS) for children with ABI.MethodsTwenty-eight children with ABI (mean age 11 years 7 months, SD 2 years 4 months; males = 11) were recruited. Two AMPS tasks were performed over two consecutive days, as per standardized AMPS procedures. Intraclass correlation coefficients (ICC; 2,1), standard error of measurement (SEM), smallest detectable difference (SDD), and 95% limits of agreement (Bland–Altman) were calculated.ResultsTest–retest reliability was fair to good for AMPS ADL motor (ICC 0.55) and ADL process (ICC 0.58) measures. The SEM was 0.36 and 0.34 logits for AMPS ADL motor and ADL process measures respectively. The SDD was 1.0 (motor) and 0.93 logits (process) measures. A learning effect was evident.ConclusionTest–retest reproducibility of the AMPS was fair to good for children with ABI, which is poorer than previously published data. Administration of the AMPS in an unfamiliar environment, fatigue, and the small time interval between testing sessions may have contributed to poorer results. The AMPS remains a useful measure of ADL, contributing to our understanding of task execution processes. [ABSTRACT FROM PUBLISHER]

Non-resident work practices, which involve prolonged separations from family, long-distance commuting between home and remote work sites and long work hours across compressed rosters, are now commonplace in Australia. This study examined the impact of these work arrangements, often termed Fly-In/Fly-Out (FIFO), on children and families, and to identify family-related and employment-related factors that influence child and family outcomes. Anonymous online surveys containing measures of family and couple relationship quality, child behavioral and emotional adjustment, parenting and personal adjustment were completed by 232 partners of FIFO workers, 46 FIFO workers, and a comparison group of community parents ( N = 294 mothers, N = 36 fathers). There were no differences between FIFO partners and community parents on family or couple relationship quality, parenting competence and child behavioral or emotional difficulties. FIFO partners reported higher levels of personal emotional problems and greater usage of harsh discipline practices than community mothers, while FIFO workers reported greater work to family conflict and alcohol use than community fathers. Regression analyses on the FIFO partners sample indicated that child and family functioning were best predicted by family factors, including harsh parenting and parental emotional adjustment. Implications of the findings for the design and provision of family-based support for FIFO families are discussed. [ABSTRACT FROM AUTHOR]

Previous research has shown an association between children's development of psychosocial and motor skills. This study evaluated the development of these skills in 301 three-year-old deaf and hard of hearing children (M: 37.8 months) and considered a range of possible predictors including gender, birth weight, age at first fitting with hearing devices, hearing device used, presence of additional disabilities, severity of hearing loss, maternal education, socio-economic status (SES), language ability, and communication mode. Caregivers reported on children's development using the Child Development Inventory (CDI). On average, both psychosocial and motor development quotients were within the typical range for hearing children, with large individual differences. There was a positive correlation between language ability and both social and motor development, and also between social and motor development. Age at first fitting of hearing aids (as an indicator of age at identification of hearing loss), SES, degree of hearing loss, and maternal education were not significant predictors of social skill or motor development, whereas presence of additional disabilities and birth weight were. Girls performed better than boys on all but the Gross Motor subscale of the CDI. Children with hearing aids tended to perform better than those with cochlear implants on the Gross Motor subscale. [ABSTRACT FROM AUTHOR]

Background Personality traits refer to habitual patterns of behaviour, thought and emotions, and have been shown to influence health professionals' career decisions, career development, job satisfaction and retention. There is an opportunity to better understand and support the career pathways of dietitians by exploring their personality traits. The two primary aspects of personality are: (i) temperament traits, which determine automatic emotional responses to experiences, and are generally stable over lifetime, and (ii) character traits, which reflect personal goals and values, and tend to develop with life experience. The present study explored the levels of temperament and character traits of dietitians, as well as their relationship to demographic variables. Methods The study comprised a cross-sectional online survey of 346 Australian dietitians [95% female; mean ( SD) age 32 (10) years; mean ( SD) time since graduation 7 (9) years]. Temperament and character traits were measured by the Temperament and Character Inventory. Key demographic variables were measured to describe career decisions and pathways of dietitians. Multivariate analyses of variance was used to investigate the relationship between demographic variables and personality traits. Results Levels of several traits were significantly associated with gender, age and highest level of education. In comparison to the general population, the dietitians displayed average levels of Novelty Seeking; high levels of Harm Avoidance, Reward Dependence, Persistence, Self-Directedness and Cooperativeness; and low levels of Self-Transcendence. Conclusions The dietitians in the present study displayed levels of personality traits that were similar to other health professionals, although they differed from the general population. These findings are the precursor to further work that may inform recruitment strategies and career counselling in dietetics. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to validate a modified version of the Paddington Alcohol Test for use in the Australian emergency department (ED) setting. Methods: A cross sectional survey was used to screen patients attending an Australian tertiary hospital ED. Datawere collected over a three-month period at randomly allocated time periods and days. Consenting participants were screened using the Alcohol Use Disorders Identification Test (AUDIT) and a modified-for-Australia version of the Paddington Alcohol Test (AusPAT). The association between the two tools was investigated, as well as the sensitivity and specificity of AusPAT at various AUDIT cut-off scores and by gender and age group. Results: The sample comprised 637 ED attendees. Their mean age was 49.9 (SD 20.0) years with a mean AUDIT score of 5.21 (SD 6.58). Most (73.2%) consumed alcohol, and a quarter was AusPATpositive (n = 153, 24.0%). AusPAT demonstrated a moderate fit with AUDIT at a cut-off score of 8 (Kappa = 0.63, P < 0.001). At this cut-off 23.4% (n = 149) were identified by AUDIT as problematic drinkers. AusPAT sensitivity was 72.5% (95% CI 65.3–79.7) with a specificity of 90.8% (95% CI 88.3–93.4). Conclusion: Our results indicate that AusPAT was moderately well associated with AUDIT. When used universally in the ED setting, its sensitivity and specificity were moderate. [ABSTRACT FROM AUTHOR]

Purpose: Research into the language sampling practices of Australian speech pathologists suggests the Bus Story Test is a frequently used standardized tool for eliciting story retelling samples for screening, diagnosis, goal-setting, and progress monitoring purposes. Because this task has not been normed on an Australian population, this study investigated the usefulness of the Bus Story for young school-age Australian children. Method: In total, 125 Australian primary-school children (aged 5;3-8;9) participated in the Bus Story task. Children attending Year 2 also retold the story Frog Where Are You. Children's performance was analysed for measures of information and sentence length ( Bus Story only), story length, MLU, number of different words and clausal density. Result: Performance on the Bus Story improved with year-of-schooling for all measures. Between 21-64% of the children performed below expectations on information or length scores when using the published norms. The retell task Frog Where Are You elicited longer samples, containing a higher number of different words. Conclusion: Using the published Bus Story norms will potentially result in over- identification of language impairment. The retell task Frog Where Are You may provide a useful alternative for assessing young school-aged children's story retelling ability. [ABSTRACT FROM AUTHOR]

Objective. The aims of this study were to determine the prevalence of erosion in a birth cohort at 24, 36, and 48 months and to investigate risk factors for erosion. Methods. One hundred and fifty-four children from a birth cohort were followed at 24, 36, and 48 months of age. Results. Of the 154 children examined, 0% (0/ 154), 7% (11/154), and 28% (40/154) had erosion detected for the first time at 24, 36, and 48 months, respectively (P < 0.001). A cumulative total of 51 (33%) children and 256 (8%) teeth had erosion by the age of 48 months. There were no significant associations between erosive lesions first detected at 36 months and oral hygiene behaviour, medical conditions, or dietary habits reported at the 24- or 36-month examinations (all P > 0.05). In contrast, erosive lesion first detected at 48 months was positively associated with the use of a feeding bottle reported at the 36-month examination (P = 0.026). Conclusions. The prevalence of dental erosion in young children increased with age, with clinically detectable lesions forming between 24 and 36 months of age. Erosive lesions first detected at 48 months were positively associated with the use of a feeding bottle reported at 36 months. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore the impact of an educational programme focused on social behaviours and relationships on organisational learning culture in the residential aged care context. Background The number of aged care homes will continue to rise as the frail older elderly live longer, requiring more formal care and support. As with other small- to medium-sized health services, aged care homes are faced with the challenge of continuous development of the workforce and depend upon registered nurses to lead staff development. Design A mixed-method evaluation research design was used to determine the impact of an educational programme focused on social aspects of learning on organisational learning culture. Methods One hundred and fifty-nine (pre) and 143 (post) participants from three aged care homes completed the Clinical Learning Organisational Culture survey, and three participant-researcher registered nurse clinical educators provided regular journal entries for review. Results While each site received the same educational programme over a six-month period, the change in organisational learning culture at each site was notably different. Two aged care homes had significant improvements in affiliation, one in accomplishment and one in recognition. The educators' journals differed in the types of learning observed and interventions undertaken, with Eucalyptus focused on organisational change, Grevillea focused on group (student) change and the Wattle focused on individual or situational change. Conclusion Clinical educator activities appear to have a significant effect on organisational learning culture, with a focus on the organisational level having the greatest positive effect on learning culture and on individual or situational level having a limited effect. Relevance to clinical practice Clinical educator facilitation that is focused on organisational rather than individual interests may offer a key to improving organisational learning culture. [ABSTRACT FROM AUTHOR]

Aim: The benefits of Transition Care Programs (TCPs) for patients with cognitive impairment are not well established. This study aimed to investigate the impact of TCP on patients according to their cognitive status. Methods: In this prospective cohort study, 351 patients were comprehensively assessed at TCP admission using the interRAI Home Care instrument and divided into two groups based on scores on the Cognitive Performance Scale. Results: Of 346 patients assessed for cognition, 242 (69.9%) were considered cognitively intact, and 104 (30.1%) were classified as cognitively impaired (Cognitive Performance Scale ⩾ 2). There were no significant differences in TCP outcomes between the two groups, including community living at six months (P = 0.1), hospital readmission rates (P = 0.6), or achievement of TCP goals (P = 0.3). Conclusions: Cognitively intact and cognitively impaired patients have similar outcomes post-TCP. Older patients should not be refused Transition Care based on the presence of cognitive impairment. [ABSTRACT FROM AUTHOR]

Prenatal maternal stress can adversely affect birth outcomes, likely reflecting effects of maternal stress hormones on fetal development. Maternal stress might also induce behavioural changes, such as dietary change, that might influence fetal development. Few studies have documented relationships between stress and dietary change in pregnancy. We analysed stress and dietary change among 222 pregnant women exposed to the 2011 Queensland Floods. We assessed women's objective hardship, subjective distress and cognitive appraisal of the disaster; changes in their diets and their associations with infants' gestational age, weight, length and head circumference at birth, head circumference to birth length ratio (HC/BL) and ponderal index. Greater objective hardship was correlated with more negative dietary change, skipped meals and skipped multivitamins. There were no direct effects of stress or dietary change on birth outcomes. However, we observed an interactive effect of dietary change and exposure timing on head circumference for gestational age (HC for GA) ( p = 0.010) and a similar trend for HC/BL ( p = 0.064). HC for GA and HC/BL were larger among children whose mothers experienced negative changes to their diet in early pregnancy compared with later pregnancy, consistent with a 'head-sparing' response with early gestation exposure. Further analyses indicated that dietary change mediates the relationship between objective hardship because of the floods and these outcomes. This is the first report of relationships among an independent stressor, dietary change and birth outcomes. It highlights another possible mechanism in the relationship between prenatal maternal stress and child development that could guide future research and interventions. [ABSTRACT FROM AUTHOR]