Search

Objectives: This study investigated associations between weather conditions, physical activity, and sedentary time in primary school-aged children in Australia and Canada. Methods: Cross-sectional data on 9-11-year-old children from the Australian (n = 491 ) and Canadian (n = 524) sites of the International Study of Childhood Obesity, Lifestyle and the Environment were used. Minutes of daily moderate-to-vigorous-physical-activity (MVPA) and sedentary time were determined from 7-day, 24-h accelerometry (Actigraph GT3X+ triaxial accelerometer). Day-matched weather data (temperature, rainfall, snowfall, relative humidity, wind speed) were obtained from the closest weather station to participants' schools. Covariates included parental highest education level, day type, sex, and BMI z-scores. Generalized mixed model analyses allowing for clustering of participants within schools were completed. Scatterplots with Loess curves were created for maximum temperature, MVPA, and sedentary time. Results: Daily maximum temperature was significantly associated with MVPA and sedentary time in Australia (MVPA p = .05, sedentary p = .01) and Canada (p < .001, p = .001). Rainfall was negatively associated with MVPA in Australia (p < .001) and positively associated with sedentary time in Canada (p = .02). Conclusions: MVPA and sedentary time appear to be optimal when the maximum temperature ranges between 20°C and 25°C in both countries. The findings have implications for study design and interpretation for surveillance and intervention studies. [ABSTRACT FROM AUTHOR]

This study examined levels of, and relationships between, self-care ability, self-compassion, and compassion among palliative care nurses and doctors. Methods: A total of 369 participants across Australia completed a cross-sectional survey comprising a demographic questionnaire and outcome measures for each variable. Descriptive and inferential statistics were analysed, controlling for potential social-desirability bias. Results: Levels of compassion, self-compassion and self-care ability varied, with some individuals scoring high or low in each. Self-compassion and self-care ability were positively correlated (r = .412, p<.001), whereas a negative correlation was observed between compassion and self-compassion (r = -.122, p<.05). Linear regression further indicated that: increased compassion was associated with a decrease in self-compassion, and increased self-care ability was associated with an increase in self-compassion. Conclusion: These results suggest important implications for self-care in the palliative care workforce. Moreover, this study contributes an empirical basis to inform future research and education to promote balanced compassion and compassion literacy in palliative care practice. [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 and objectives The aim of this study was to evaluate the effect of the new evidence-informed nursing assessment framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, reassessment and communication) on the quality of patient assessment and fundamental nontechnical skills including communication, decision making, task management and situational awareness. Background Assessment is a core component of nursing practice and underpins clinical decisions and the safe delivery of patient care. Yet there is no universal or validated system used to teach emergency nurses how to comprehensively assess and care for patients. Design A pre-post design was used. Methods The performance of thirty eight emergency nurses from five Australian hospitals was evaluated before and after undertaking education in the application of the HIRAID assessment framework. Video recordings of participant performance in immersive simulations of common presentations to the emergency department were evaluated, as well as participant documentation during the simulations. Paired parametric and nonparametric tests were used to compare changes from pre to postintervention. Results From pre to postintervention, participant performance increases were observed in the percentage of patient history elements collected, critical indicators of urgency collected and reported to medical officers, and patient reassessments performed. Participants also demonstrated improvement in each of the four nontechnical skills categories: communication, decision making, task management and situational awareness. Conclusion The HIRAID assessment framework improves clinical patient assessments performed by emergency nurses and has the potential to enhance patient care. Relevance to clinical practice HIRAID should be considered for integration into clinical practice to provide nurses with a systematic approach to patient assessment and potentially improve the delivery of safe patient care. [ABSTRACT FROM AUTHOR]

This study explored psychological well-being in Australian adults with a particular focus on meaning in life. Older adults (N = 57) reported lower levels of search for meaning and higher levels of presence of meaning than young adults (N = 208) suggesting that both groups were able to distinguish between the two aspects of meaning. For older adults, higher presence was associated with better mental health and well-being outcomes, regardless of level of search. For the young adults, higher presence and lower search was associated with better outcomes. These results suggest that presence of meaning is an important aspect of well-being for older adults living in a high income English-speaking country and may be an important focus when working with depressed or anxious older adults, while both presence of, and search for meaning may be more meaningful therapeutic targets when working with depressed or anxious younger adults. Theoretical implications are discussed. [ABSTRACT FROM AUTHOR]

This study aimed to determine if the Garmin Vector (Schaffhausen, Switzerland) power meter produced acceptable measures when compared with the Schoberer Rad Messetechnik (SRM; Julich, Germany) power meter across a range of high-intensity efforts. Twenty-one well-trained cyclists completed power profiles (seven maximal mean efforts between 5 and 600 s) using Vector and SRM power meters. Data were compared using assessments of heteroscedasticity,ttests, linear regression, and typical error of estimate (TEE). The data were heteroscedastic, whereby the Vector pedals increasingly overestimated values at higher power outputs; however,ttests did not identify any significant differences between power meters (p > .05). Using linear regression, Vector data were fit to an SRM equivalent (slope = .99; intercept = −9.87) and TEE produced by this equation was 3.3% (3.0%–3.8%). While the data shows slight heteroscedasticity due to differing strain-gauge placement and resultant torque measurement variance, the Vector appears acceptable for measures of power output across various cycling efforts. [ABSTRACT FROM PUBLISHER]

Aim This study investigated whether multiple health-care robots could have any benefits or cause any problems in an aged care facility. Method Fifty-three residents and 53 staff participated in a non-randomised controlled trial over 12 weeks. Six robots provided entertainment, communication and health-monitoring functions in staff rooms and activity lounges. These settings were compared to control settings without robots. Results There were no significant differences between groups in resident or staff outcomes, except a significant increase in job satisfaction in the control group only. The intervention group perceived the robots had more agency and experience than the control group did. Perceived agency of the robots decreased over time in both groups. Overall, we received very mixed responses with positive, neutral and negative comments. Conclusions The robots had no major benefits or problems. Future research could give robots stronger operational roles, use more specific outcome measures, and perform cost-benefit analyses. [ABSTRACT FROM AUTHOR]

Objective Coping skills contribute to positive parenting and children's healthy adaptation to everyday experiences. This study evaluated the utility of a new group-based universal social emotional parenting programme, Families Coping (previously named Parents Can Do Coping). This programme has the twin aims of teaching communication and coping skills to parents within a positive parenting framework. Method The participant group comprised 14 parents of preschoolers in an early learning centre located in the inner-metropolitan Melbourne area. Parents were provided with effective communication skills, developed an understanding of their own coping and that of their children, and learnt how to actively engage their child in shared conversations about coping. To assess change, a mixed-methods design was employed, where parents completed pre- and-post-programme paper and pencil surveys and open-ended responses. Results Results showed a number of statistically significant changes in parents' coping skills. Specifically, parents reported greater use of productive coping and a concurrent reduction in non-productive coping strategies. Despite there being no statistically significant change in child coping or parent and child well-being, written responses indicated that most parents perceived a trend towards the development of more positive parenting practices and use of productive coping by their child, as well as some aspect of improvement in both parent and child well-being. Conclusions There is benefit in incorporating parent and child coping skills into a universal positive parenting programme for preschool-aged children. Findings are considered in view of methodological strengths and shortcomings, as well as the value of Families Coping as an addition to the pool of programmes currently available to parents. [ABSTRACT FROM AUTHOR]

Background: The relationship between migration and pregnancy outcomes is complex, with little insight into whether women of refugee background have greater risks of adverse pregnancy outcomes than other migrant women. This study aimed to describe maternal health, pregnancy care, and pregnancy outcomes among migrant women from humanitarian and nonhumanitarian source countries. Methods: Retrospective, observational study of singleton births, at a single maternity service in Australia 2002-2011, to migrant women born in humanitarian source countries (HSCs, n = 2,713) and non-HSCs (n = 10,606). Multivariable regression analysis assessed associations between maternal HSC-birth and pregnancy outcomes. Results: Compared with women from non-HSCs, the following were more common in women from HSCs: age < 20 years (0.6 vs 2.9% p < 0.001), multiparity (51 vs 76% p < 0.001), body mass index (BMI) > 25 (38 vs 50% p < 0.001), anemia (3.2 vs 5.9% p < 0.001), tuberculosis (0.1 vs 0.4% p = 0.001), and syphilis (0.4 vs 2.5% p < 0.001). Maternal HSC-birth was independently associated with poor or no pregnancy care attendance (OR 2.5 [95% CI 1.8-3.6]), late first pregnancy care visit (OR 1.3 [95% CI 1.1-1.5]), and postterm birth (> 41 weeks gestation) (OR 2.5 [95% CI 1.9-3.4]). Stillbirth (0.8 vs 1.2% p = 0.04, OR 1.5 [95% CI 1.0-2.4]) and unplanned birth before arrival at the hospital (0.6 vs 1.2% p < 0.001, OR 1.3 [95% CI 0.8-2.1]) were more common in HSC-born women but not independently associated with maternal HSC-birth after adjusting for age, parity, BMI and relative socioeconomic disadvantage. Conclusions: These findings suggest areas where women from HSCs may have additional needs in pregnancy compared with women from non-HSCs. Refugee-focused strategies to support engagement in pregnancy care and address maternal health needs would be expected to improve health outcomes in resettlement countries. [ABSTRACT FROM AUTHOR]

Aim To explore compassion fatigue and compassion satisfaction with the potential contributing factors of anxiety, depression and stress. Background To date, no studies have connected the quality of work-life with other contributing and co-existing factors such as depression, anxiety and stress. Method A self-report exploratory cross sectional survey of 132 nurses working in a tertiary hospital. Result The reflective assessment risk profile model provides an excellent framework for examining the relationships between the professional quality of work factors and contributing factors within the established risk profiles. The results show a definite pattern of risk progression for the six factors examined for each risk profile. Additionally, burnout and secondary traumatic stress were significantly related to higher anxiety and depression levels. Higher anxiety levels were correlated with nurses who were younger, worked full-time and without a postgraduate qualification. Twenty percent had elevated levels of compassion fatigue: 7.6% having a very distressed profile. At-risk nurses' stress and depression scores were significantly higher than nurses with higher compassion satisfaction scores. Implications for nursing managers The employed nurse workforce would benefit from a psychosocial capacity building intervention that reduces a nurse's risk profile, thus enhancing retention. [ABSTRACT FROM AUTHOR]

Background: Nephron number in humans is determined during fetal life. The objective of this study was to investigate the effects of preterm birth on nephron number using renal volume as a surrogate for nephron number. Methods: This observational study was conducted over 12 months in a tertiary perinatal center. Preterm babies less than 32 weeks of gestation were recruited and followed until discharge. Term infants were recruited for comparison. The babies underwent renal sonography and renal function measurements at 32 and 38 weeks corrected age. The primary outcome measurement was total kidney volume at 38 weeks and the secondary outcome was estimated glomerular filtration rate (eGFR). Results: Forty-four preterm infants and 24 term infants were recruited. At 38 weeks corrected age, premature infants had lower total kidney volume than term infants (21.6 ± 5.7 vs. 25.2 ± 5.7 ml; p = 0.02) and a significantly lower eGFR (73.6 [IQR 68.1-77.6] vs. 79.3 [IQR 72.5-86.6] ml·min·1.73 m; p = 0.03). There was a significant correlation between total kidney volume and eGFR in premature and term babies. Conclusions: Premature infants have smaller kidney volume and likely decreased nephron number and lower estimated glomerulofiltration rate relative to infants born at term. [ABSTRACT FROM AUTHOR]

Purpose Alcohol consumption patterns nationally and internationally have been identified as elevated in rural and remote populations. In the general Australian population, 20.5% of adult males and 16.9% of adult females drink at short-term, high-risk levels. Farmers are more likely to drink excessively than those living in major cities. This study seeks to explore the relationships between farmers' physical and mental health and their alcohol consumption patterns. Our hypothesis is that farmers consume alcohol at high-risk levels more often than the Australian average and that this consumption is associated with obesity and psychological distress. Methods Cross-sectional descriptive data were collected within Australian farming communities from 1,792 consenting adults in 97 locations across Australia. Data on anthropometric measurements, general physical attributes and biochemical assessments were used to explore the interrelationships of self-reported alcohol consumption patterns with obesity, psychological distress, and other physical health parameters. Findings There was a higher prevalence of short-term, high-risk alcohol consumption (56.9% in men and 27.5% in women) reported in the study compared with national data. There was also a significant positive association between the prevalence of high-risk alcohol consumption and the prevalence of obesity and abdominal adiposity in psychologically distressed participants. Conclusions The prevalence of short-term, high-risk alcohol consumption practices in this cohort of farming men and women is significantly higher than the Australian average. These consumption practices are coupled with a range of other measurable health issues within the farming population, such as obesity, hypertension, psychological distress, and age. [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted to investigate the effect including a series of isometric contractions to a rowing warm-up had on rowing ergometer time trial performance. Researchers evaluated 10 national level rowers from Australia with an ergometer. They found that the inclusion of isometric conditioning contractions to the rowing warm-up enhanced short-term rowing ergometer performance more than a rowing warm-up alone.

Context-Resources are currently targeted at increasing organ and tissue donation rates from emergency departments in Australia. Health care professionals' beliefs and personal attitudes regarding organ and tissue donation are known to influence professional attitudes and practice. Objective-To assess emergency department clinicians' general beliefs and personal attitudes toward organ and tissue donation, how general beliefs influence personal attitudes, and which demographic characteristics are related. Design-A cross-sectional online survey, based on available literature and the validated and widely used Hospital Attitude Survey (DonorAction). Participants-Data were collected from 811 Australian emergency department clinicians, invited to participate through the College of Emergency Nursing Australasia, and the Australasian College for Emergency Medicine. Results-Most clinicians were very supportive of organ and tissue donation (96.2%), believed that organ and tissue donation can save lives (98.5%), and that organs and tissues will be allocated fairly (82.6%); however, 30.1% did not agree that organ and tissue donation can help the next of kin cope with grief. Holding positive general beliefs increased positive personal attitudes toward organ and tissue donation (P< .001). Most reported willingness to donate their own organs and tissues after death (90%) and give family consent for their children (79.6%) or adult family (86.6%) member to donate. Eighty-six percent had discussed their wishes with next of kin, but only 50.7% had registered on the Australian Organ Donor Register. Older clinicians, male clinicians, and clinicians of certain religious and cultural backgrounds were identified as having less positive general beliefs and personal attitudes. Conclusion-Although Australian emergency department clinicians are generally positive toward organ and tissue donation, some groups could potentially benefit from education to change their beliefs and attitudes about organ and tissue donation further. [ABSTRACT FROM AUTHOR]

Medical Education 2012 Context Education in simulated learning environments (SLEs) has grown rapidly across health care professions, yet no substantive randomised controlled trial (RCT) has investigated whether SLEs can, in part, substitute for traditional clinical education. Methods Participants were physiotherapy students (RCT 1, n = 192; RCT 2, n = 178) from six Australian universities undertaking clinical education in an ambulatory care setting with patients with musculoskeletal disorders. A simulated learning programme was developed as a replica for clinical education in musculoskeletal practice to replace 1 week of a 4-week clinical education placement. Two SLE models were designed. Model 1 provided 1 week in the SLE, followed by 3 weeks in clinical immersion; Model 2 offered training in the SLE in parallel with clinical immersion during the first 2 weeks of the 4-week placement. Two single-blind, multicentre RCTs (RCT 1, Model 1; RCT 2, Model 2) were conducted using a non-inferiority design to determine if the clinical competencies of students part-educated in SLEs would be any worse than those of students educated fully in traditional clinical immersion. The RCTs were conducted simultaneously, but independently. Within each RCT, students were stratified on academic score and randomised to either the SLE group or the control ('Traditional') group, which undertook 4 weeks of traditional clinical immersion. The primary outcome measure was a blinded assessment of student competency conducted over two clinical examinations at week 4 using the Assessment of Physiotherapy Practice (APP) tool. Results Students' achievement of clinical competencies was no worse in the SLE groups than in the Traditional groups in either RCT (Margin [Δ ] ≥ 0.4 difference on APP score; RCT 1: 95% CI − 0.07 to 0.17; RCT 2: 95% CI − 0.11 to 0.16). Conclusions These RCTs provide evidence that clinical education in an SLE can in part (25%) replace clinical time with real patients without compromising students' attainment of the professional competencies required to practise. [ABSTRACT FROM AUTHOR]

Aim: To determine the impact of a pharmacist intervention on patient-guided diuretic dose adjustment in ambulatory patients with heart failure. Method: Patients with heart failure were randomised to usual care or usual care plus pharmacist intervention and followed for 3 months. Pharmacist intervention focused on patients improving self-care, recognising symptoms of fluid retention, measuring weight daily and self-adjusting diuretic dose using frusemide. The primary outcome was the number of appropriate weight-titrated frusemide dose adjustments. Secondary outcomes included the number of patients who correctly self-adjusted their frusemide dose, hospital readmissions due to fluid overload, heart failure-related knowledge and understanding, and quality of life (using validated tools). Results: 70 patients were recruited: 35 usual care (control) and 35 usual care plus pharmacist intervention. The average number of appropriate weight-titrated frusemide dose adjustments per patient per month in the control group was 0.32 ± 0.08 and in the intervention group was 0.85 ± 0.13 (p = 0.006). Hospital readmissions due to fluid overload was 31% in the control and 14% in the intervention groups (p = 0.04). There were significant differences between the groups regarding appropriate self-adjusted frusemide doses, heart failure-related knowledge and understanding, and quality of life. Conclusion: A pharmacist intervention improved the ability of heart failure patients to self-adjust their diuretic dose by using a flexible dosing regimen based on weight, resulting in quality of life improvement and a decrease in hospital readmissions due to fluid overload. [ABSTRACT FROM AUTHOR]

Objective: The risks of anorexia nervosa (AN) are well established. Despite its severity, little certainty exists for practitioners, with ethical and financial limitations yielding few controlled studies establishing effective treatments. Thus, other methods of establishing treatment effectiveness are necessary. This study presents preliminary results of an open clinical trial of a day program for adolescents with AN. Method: Participants were 26 anorectic females, 12-18 years, who completed the ''Transition Program.'' Results: Significant change emerged on measures of weight gain, and behavioral and attitudinal measures of eating pathology. Large effect sizes were evident for weight gain at 6 month follow-up. Preliminary trends suggest that treatment gains on these and other measures of eating pathology were maintained at 6 month follow-up. Discussion: Preliminary results support day program treatment for adolescents with mild-moderately severe eating disorders. Present outcomes are discussed with respect to the dearth of efficacious treatment options for adolescents. [ABSTRACT FROM AUTHOR]