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Purpose: Emergency and disaster management planning is an emerging role with limited practical guidance on how it should be implemented by community, disability, health and rehabilitation service providers. This study examined the emergency preparedness of service providers and how they viewed their role and contributions to disaster risk reduction, including their capacity and willingness to facilitate preparedness planning with their clients. Materials and Methods: A questionnaire was developed and administered nationally. Descriptive statistics, multivariate regression analyses, and thematic analysis of open-ended questions provide insight on the knowledge, tools and training needs of service providers to contribute to preparedness of themselves and the people they support. Results: Facilitating emergency preparedness with people with disability was strongly associated with a high level of mental preparedness, household preparedness scores, and completion of Person-Centred Emergency Preparedness (P-CEP) training. Perceived lack of funding, insufficient tools, and exclusion of emergency planning from job descriptions were negatively associated with facilitating emergency preparedness with clients. Conclusions: Study findings lay the groundwork for development of the role and capabilities of individual service providers including the need to equip disability, health and rehabilitation service providers with training and tools to prepare themselves and the people they support for emergencies. IMPLICATIONS FOR REHABILITATION: Participation in emergency training such as psychological first aid, evacuation drills, and Person-Centred Emergency Preparedness (P-CEP) can increase the personal preparedness of service providers. Rehabilitation professionals are advised to develop their capabilities in emergency preparedness before facilitating emergency planning with their clients. Rehabilitation professionals should connect with their local emergency services to learn about disaster risks and preparedness actions they can take to increase personal emergency preparedness for themselves and their clients. [ABSTRACT FROM AUTHOR]

We aimed to report the epidemiology of lower-limb and lumbosacral injuries in Police Force recruits. We performed a cohort study of Police Force recruits undergoing a six-month training program with prospective injury data collected between 2018 and 2021. Cardiorespiratory fitness was quantified by the beep-test and police-specific-functional-capacity was quantified using a specifically designed physical performance evaluation (PPE) tool. Injury frequency and prevalence were reported. Fifteen percent (n = 180) of study Police Force recruits (n = 1,181) sustained a lower-limb or lumbosacral injury. The six-month training program significantly improved cardiorespiratory fitness (p < 0.001) and functional capacity (p < 0.001). Increased cardiorespiratory fitness at baseline decreased injury risk (OR = 0.8, 95%CI: 0.66–0.97, p = 0.019). Injury rates decreased over time and females were injured significantly earlier than males (HR = 0.70, 95%CI: 0.52 to 0.95, p = 0.021). Interventions that can pre-condition Police Force recruits prior to the commencement of their basic physical training may reduce the number of lower-limb and lumbosacral injuries. [ABSTRACT FROM AUTHOR]

Primary care is crucial to the health of people with mental illness. However, there is limited information on their reported engagement in this setting. This study surveyed 100 people with mental illness who had a general practitioner or a general practitioner and a case manager from a tertiary mental health service to determine their engagement level with their GP and what interventions they received to manage their health. Forty-four per cent had their psychotropic medications primarily prescribed by their GP, and 58% reported visiting their GP for physical health problems. Ninety-four point nine percent of participants aged 50 years and over had not received government age-recommended preventive health checks. Only 62% of participants reported being screened by their GP for psychotropic side effects. Primary care plays a crucial role in providing physical and mental health care, but service users report gaps in service. The findings suggest a need to support primary care professionals further to coordinate care across primary and secondary care settings. [ABSTRACT FROM AUTHOR]

To investigate determinants of willingness to adopt telerehabilitation, willingness of technology use, core affect regarding using telerehabilitation, and digital competencies in rehabilitation professionals in Austria and Germany before and during the COVID-19 pandemic. A cross-sectional paper-based and online survey was conducted before and during COVID-19, respectively, with three cohorts of rehabilitation professionals. Outcomes were the willingness to adopt telerehabilitation evaluated using the extended Unified Theory of Acceptance and Use of Technology; willingness of technology use using the short scale for assessing the willingness of technology use; digital competencies and core affect using the Digital Competence Framework and semantic differential, respectively. Multivariate ordinal regression analysis was performed to determine predictors. Included were 603 rehabilitation professionals. Analysis revealed differences between Austria and Germany and before and during the pandemic for most outcomes. German residency, the pandemic, and a higher educational level were most important predictors of higher willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. The pandemic increased most aspects of willingness to adopt telerehabilitation, willingness of technology use, digital competencies, and positive core affect. Results confirm that rehabilitation professionals with higher degrees are more prone to adopt innovations in healthcare.Registration: German Clinical Trials Register (DRKS00021464) The willingness to adopt telerehabilitation is associated with external factors increasing the need for alternative rehabilitation delivery, such as COVID-19, and with financial facilitators, such as reimbursement. As the willingness to adopt telerehabilitation is higher among speech and language therapists and dietitians, efforts are necessary to enhance its use in physiotherapists and occupational therapists. As a higher willingness to adopt telerehabilitation was observed in younger rehabilitation professionals and those with higher education, increasing the importance of telerehabilitation in education curricula and further knowledge transfer into practice for those already working in the field seems necessary. [ABSTRACT FROM AUTHOR]

Understanding adolescents' physical activity levels and underpinning contextual factors is crucial for health promotion. This cross-sectional study, using 24-hour time use diaries and sociodemographic variables from the Longitudinal Study of Australian Children, addressed gaps in understanding of physical activity in the before-school segment (the time between waking up and commencing classes). The study examined a) adolescents' time spent in before-school physical activity, focusing on location and shared presence, and b) sociodemographic correlates of before-school physical activity. Completed diaries by 12–13 year-olds (n = 3,201) revealed that adolescents reported an average of 10.8 minutes of daily before-school physical activity (average segment length: 114 min), mostly classified as active transport (5.7 min). Most before-school physical activity occurred in a location other than home or school (6.1 min) and with peers (6.1 min). Notably, 51% of boys and 60% of girls did not report any before-school physical activity. Through two-part regression, we found that boys, adolescents from single-parent households, and those with longer before-school segments are more likely to report before-school physical activity compared to their counterparts. Before-school initiatives should promote active transport and diverse opportunities in other settings. Research into barriers and facilitators may inform more inclusive and effective promotion strategies, including school-based initiatives. [ABSTRACT FROM AUTHOR]

Public health messages disseminated by trusted government authorities are likely to have more influence over individuals' intentions and behaviors. However, individuals worldwide have different levels of trust in government authorities, which leads to varying levels of compliance intentions. Additionally, these trust levels may vary during major public crises, such as pandemics. Based on a COVID-19 pandemic communication survey (N = 3,065) disseminated throughout six countries (Australia, Finland, Italy, South Korea, Sweden, and the United States), this study examined the association among trust in distinct government sources, cultural orientations, and health behavioral intentions. Findings indicated that trust in official health communication sources at four governmental levels (i.e. national government, the head of the national government, the national health authority, and the chief representative of the national health authority) was related to vaccination intentions and other behavioral compliance intentions (i.e. willingness to prevent COVID-19 infection in other ways). Meanwhile, these direct associations were mediated by the cultural orientations of power distance and uncertainty avoidance. Findings also revealed that the direct association of trust in government sources and the indirect relationship through the above cultural orientations varied by country. This study offers insight into the important role of credible sources and individuals' cultural orientations in the domain of health communication aimed at influencing behavioral intentions. [ABSTRACT FROM AUTHOR]

Speed and accuracy of lexical access change with healthy ageing and neurodegeneration. While a word's immediate phonological neighbourhood density (i.e. words differing by a single phoneme) influences access, connectivity to all words in the phonological network (i.e. closeness centrality) may influence processing. This study aimed to investigate the effect of closeness centrality on speed and accuracy of lexical processing pre- and post- a single word-training session in healthy younger and older adults, and adults with logopenic primary progressive aphasia (lvPPA), which affects phonological processing. Participants included 29 young and 17 older healthy controls, and 10 adults with lvPPA. Participants received one session of word-training on words with high or low closeness centrality, using a picture-word verification task. Changes in lexical decision reaction times (RT) and accuracy were measured. Baseline RT was unaffected by age and accuracy was at ceiling for controls. Post-training, only young adults' RT were significantly faster. Adults with lvPPA were slower and less accurate than controls at baseline, with no training effect. Closeness centrality did not influence performance. Absence of training effect for older adults suggests higher threshold to induce priming, possibly associated with insufficient dosage or fatigue. Implications for word-finding interventions with older adults are discussed. [ABSTRACT FROM AUTHOR]

The present study aimed to quantify the perceived needs and adequacy of realised access to post-acute services in a sample of people with acquired brain injury in the first 6-months after discharge from inpatient rehabilitation. A secondary focus was the influence of access to funding and specialist transitional rehabilitation on unmet needs. Participants were 51 adults with a median age of 50 (IQR 35–57) recruited from an inpatient rehabilitation unit in an Australian tertiary hospital. The sample was those who had an acquired brain injury, including 23 who sustained a traumatic injury and 28 who sustained a non-traumatic injury. Measures were collected via telephone at 3- and 6-months, in a prospective observational cohort design using the Needs and Provisions Complexity Scale. A series of logistic regression models were used to determine the effects of participation in a transitional rehabilitation program and funding pathway on adequacy and unmet needs. Unmet needs for rehabilitation were most commonly reported (60%), followed by unmet needs in relation to health care (40%), social care (35%), personal care (32%) and environment-related (14%). Participants who attended transitional rehabilitation were more likely to indicate unmet health care needs (OR = 6.40, 95% CI = 1.40–29.24, p = 0.02). The study highlights the need to look beyond functional impairment when conceptualising appropriate access. Additionally, the present research highlighted the need for greater work into an expectation of services. The majority of people with an acquired brain injury report unmet needs at 6 months post discharge. Present findings support the utility of patient reported measures when considering treatment evaluation with people with ABI, where assessing the personal appraisal of individuals needs may prove to be a key indicator to facilitate optimal service access. There are specific services that needed and not provided including psychological, speech pathology, family carer needs and vocational rehabilitation, and therefore are a key target for ensuring appropriate support is provided. [ABSTRACT FROM AUTHOR]

Trans and gender diverse individuals (people who identify with a gender different to what was presumed for them at birth) are one of the most medically and socially marginalized groups in our community. The COVID-19 pandemic may compound preexisting depression and thoughts of self-harm or suicide. We aimed to explore the impact of the COVID-19 pandemic on the Australian trans community. An online cross-sectional survey was conducted between 1st May 2020 and 30th June 2020, amidst strict Australia-wide social restrictions. Australian trans people aged ≥16 years were eligible to participate. Survey questions explored the impact of the COVID-19 pandemic on living situation, employment, financial situation, and healthcare. Logistic regression to assess negative impacts due to COVID-19 on depression and thoughts of self-harm or suicide (measured by Patient Health Questionnaire-9 (PHQ-9) are presented as odds ratios (95% confidence interval)). Of 1019 participants, 49.6% reported experiencing financial strain, 22% had reduced working hours, and 22.4% were unemployed (three times the national rate). Concerningly, 61.1% experienced clinically significant symptoms of depression (Patient Health Questionnaire-9 score ≥10), considerably higher than pre-COVID rates for the trans community and over twice the national rate. Moreover, 49% reported thoughts of self-harm or suicide (over three times the national rate) which was more likely if a person experienced cancelation or postponement of gender-affirming surgery (OR 1.56 (1.04, 2.35)), financial strain (OR 1.80 (1.36, 2.38)), or felt unsafe or afraid in their household (OR 1.96 (1.23, 3.08)). Given rates of clinically significant depression and thoughts of self-harm or suicide are far higher in trans people than the general population, specific strategies to improve mental health in the trans community during the COVID-19 pandemic must be made a priority for policymakers, researchers, and health service providers to prevent suicide. Supplemental data for this article is available online at [ABSTRACT FROM AUTHOR]

Physical activity (PA) participation offers many benefits for persons with multiple sclerosis (MS). Persons with MS are significantly less active than the general population; however, there is insufficient evidence regarding the association between geographical remoteness and PA participation in persons with MS. We identify PA levels across levels of rurality in an Australian MS population. The Australian MS Longitudinal Study collects regular survey data from persons with MS in Australia, including demographic, clinical, and health behavioural data. Physical activity engagement was identified with the International Physical Activity Questionnaire-short form and geographical remoteness was identified from participants' postcode using the Access and Remoteness Index for Australia. Hurdle regression analysis examined the relationship between remoteness and PA participation, and level of PA, after controlling for confounding. Data from 1260 respondents showed that 24% of persons with MS did not participate in any PA. Remoteness was not associated with the participation in any PA (OR 1.04; 89% highest density probability interval (HDPI) estimate 0.88, 1.22). Amongst those with any PA (n = 960), those living in more remote areas had, on average, higher levels of PA (RR 1.21; 89% HDPI estimate 1.11, 1.34). Physical activity promotion does not need to differ based on geographical location. Almost one quarter of persons with MS in our study recorded no participation in any physical activity (PA). Healthcare practitioners are encouraged to include the promotion of PA as part of MS management. Physical activity participation is similar for persons with MS across different geographical locations. Physical activity promotion does not need to differ based on geographical location. [ABSTRACT FROM AUTHOR]

To examine the feasibility and acceptability of a falls prevention e-learning program for physiotherapists working with people with osteoarthritis (OA). A prospective pre-post quasi-experimental approach was adopted. An e-learning program on falls prevention specific to the OA population was developed and delivered. Feasibility and acceptability data were obtained from recruitment records, MoodleTM activity logs, multiple choice quizzes and customized surveys. Of the 65 physiotherapists and near-graduate physiotherapy students who met the eligibility criteria, 50 (77%) completed the e-learning program. Participants were satisfied and considered the program to be acceptable. The program met their expectations (n = 45; 90%) and was highly relevant to their work (median 8–10 [interquartile range (IQR)] 2; range 0 [not at all relevant] to 10 [extremely relevant]). An overall improvement in knowledge was also observed (mean percentage difference 8%; 95% CI −3.49, −1.27). Given a heightened risk of falls among people with OA, ensuring physiotherapists are skilled in falls prevention is important. Our acceptability and outcomes data indicate that a falls prevention e-learning program can be feasibly delivered to physiotherapists working in OA care. Future research should assess subsequent changes in clinical practice to determine whether physiotherapists deliver care reflective of contemporary falls prevention evidence. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate the demographic, clinical characteristics, and service systems of patients with autism spectrum disorder (ASD) and/or intellectual disability presenting to a large paediatric hospital emergency department (ED) with behaviours of concern (BOC) over a two-year period. Retrospective audit of ED presentations with BOC in patients with ASD and/or intellectual disability from 1 January 2019 to 31 December 2020, at the Royal Children's Hospital, Melbourne, Australia. There were 124 presentations (84 patients) in 2019 and 129 presentations (82 patients) in 2020. The mean age was 11.7 years. 55% arrived by ambulance, 24% required physical restraint, and 26% required sedation. Re-presentation was predicted by single-parent household, child protection involvement, and requirement of an interpreter. Children and adolescents with ASD and/or intellectual disability regularly present to ED with BOC. New models of care are required to better support this highly vulnerable patient group. [ABSTRACT FROM AUTHOR]

To describe types of mental health treatment accessed by community-based stroke survivors and factors associated with access. A sub-group of registrants from the Australian Stroke Clinical Registry completed a supplementary survey 2.5 years post-stroke. Self-reported information about depression/anxiety and treatment access were collected. Demographic and clinical data were obtained through linkages with registry and government data. Staged multivariable logistic regression was conducted to examine factors associated with treatment access. Among 623 registrants surveyed (37% female, median age 69 years), 26% self-reported a medical diagnosis of depression/anxiety at 2.5 years post-stroke. Of these, only 30% reported having accessed mental health services, mostly through government-funded Medicare schemes. Younger age (odds ratio (OR) 0.95, 95% CI 0.93, 0.98), history of mental health treatment (OR 3.38, 95% CI 1.35, 8.48), feeling socially isolated (OR 2.32, 95% CI 1.16, 4.66), self-reported medical diagnosis of depression/anxiety (OR 4.85, 95% CI 2.32, 10.14), and government-subsidised team care plan arrangement (OR 4.05, 95% CI 1.96, 8.37) were associated with receiving treatment. Many stroke survivors have untreated depression/anxiety. Primary care practitioners should be supported in undertaking effective detection and management. Older and newly diagnosed individuals should be educated about depression/anxiety and available supports. Primary care providers play a pivotal role in the pathway to mental health care, and therefore should always screen for depression/anxiety and provide comprehensive assessment and referral to specialist services where necessary. Targeted psychoeducation should be provided to survivors of stroke who are older and newly diagnosed with depression/anxiety, to increase awareness about mood problems following stroke. Primary care providers should collaborate with other health professionals (e.g., through coordinating a team care arrangement plan), to address patients' multiple and complex rehabilitation needs. Rehabilitation professionals should remain informed about current evidence-based treatments for post-stroke depression/anxiety and pathways that enable their patients to access these services. [ABSTRACT FROM AUTHOR]

Mobilisation is recommended following cardiac surgery, but much less is known about its effects on physiological parameters. This study aimed to determine the effect of mobilisation on cardiorespiratory physiological parameters, and to establish the relationship between physiological parameters and physical function following cardiac surgery. Participants requiring physiotherapy following cardiac surgery were recruited. Mobilisation involved ground-based walking, while physical function was assessed using the short physical performance battery (SPPB) test. During both procedures, physiological measures of heart rate (HR), respiratory rate (RR) and percutaneous oxygen saturation (SpO2) were periodically recorded. Participant perception of breathlessness and perceived exertion were recorded pre and post mobilisation and the SPPB test. Forty-five participants (mean [SD] age 69[7] years) completed the study. HR (mean difference 10[95% CI 8 to 12] bpm) and RR (13[10 to 17] br/min) significantly increased following mobilisation, while SpO2 significantly decreased (baseline median [IQR] 95% [95%–97%] vs nadir 94% [91% to 96%], p < 0.002). There was a significant increase in dyspnoea and perceived exertion (both p < 0.001). There was a moderate relationship between total SPPB score and SpO2 during mobilisation (rs=0.45). Mobilisation following cardiac surgery increases exertion and dyspnoea and alters physiological parameters. Greater physical function is linked to maintaining a higher oxygen saturation during mobilisation. [ABSTRACT FROM AUTHOR]

To identify levels of bowel cancer information overload and associated predictors. A cross-sectional online survey of Tasmanians ≥18 years measured bowel cancer information overload using a modified Cancer Information Overload Scale. Descriptive statistics summarized participants' demographic and information overload data; linear regression investigated information overload predictors. The analysis included 3,701 Tasmanians (75.8% female). Above 50% of participants disagreed/strongly disagreed with the statements favoring information overload. Significant predictors of bowel cancer information overload included current smokers, body mass index, lower educational attainment, and living less rurally. In this study bowel cancer information overload was associated with lower educational attainment, current smokers, higher body mass index, and living less rurally. [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]

Background: The COVID-19 pandemic has presented unprecedented levels of prolonged strain on healthcare systems and healthcare workers (HCWs) globally, with nurses at the forefront. Objectives: To describe types and prevalence of occupational disruptions and exposure to COVID-19, and their impacts on mental health, moral distress, coping strategies, and help-seeking behaviours of Australian nurses. Design: A cross-sectional online anonymous survey distributed amongst Australian HCWs between 27 August and 23 October 2020. Methods: Data was collected on demographics, workplace disruption, personal relationships, and mental health. Predictors of mental health impacts and coping strategies were identified through multivariate regression analyses. Results: 7845 complete responses were returned, of which 3082 (39.3%) were from nurses and 4763 (60.7%) were from all other professions ('other HCWs'). Occupational disruption was common, with nurses specifically reporting additional paid hours (p < 0.001). Nurses were exposed to, and infected with, COVID-19 more frequently than other HCWs (p < 0.001) and were more likely to report concerns around stigmatisation from the broader community (p < 0.001). Symptoms of mental illness (anxiety, depression, PTSD and burnout) were significantly more prevalent in nurses than other HCWs, despite both groups scoring high on resilience. Common predictors of mental health symptoms included exposure to COVID-19 and worsening of personal relationships. Nurses reported a variety of coping strategies and were more likely than other HCWs to increase alcohol consumption. Engagement with formal support services was low for both groups. Personal and professional predictors for coping strategy use were identified. Conclusions: Urgent action is needed to address staff shortages and burnout which have been exacerbated by COVID-19. Initiatives that recognise the importance of nursing staff and incentivise current and future nurses to join and remain in the workforce are essential. [ABSTRACT FROM AUTHOR]

To describe the development and determine the diagnostic accuracy of the Brisbane Evidence-Based Language Test in detecting aphasia. Consecutive acute stroke admissions (n = 100; mean = 66.49y) participated in a single (assessor) blinded cross-sectional study. Index assessment was the ∼45 min Brisbane Evidence-Based Language Test. The Brisbane Evidence-Based Language Test is further divided into four 15–25 min Short Tests: two Foundation Tests (severe impairment), Standard (moderate) and High Level Test (mild). Independent reference standard included the Language Screening Test, Aphasia Screening Test, Comprehensive Aphasia Test and/or Measure for Cognitive-Linguistic Abilities, treating team diagnosis and aphasia referral post-ward discharge. Brisbane Evidence-Based Language Test cut-off score of ≤157 demonstrated 80.8% (LR+ =10.9) sensitivity and 92.6% (LR− =0.21) specificity. All Short Tests reported specificities of ≥92.6%. Foundation Tests I (cut-off ≤61) and II (cut-off ≤51) reported lower sensitivity (≥57.5%) given their focus on severe conditions. The Standard (cut-off ≤90) and High Level Test (cut-off ≤78) reported sensitivities of ≥72.6%. The Brisbane Evidence-Based Language Test is a sensitive assessment of aphasia. Diagnostically, the High Level Test recorded the highest psychometric capabilities of the Short Tests, equivalent to the full Brisbane Evidence-Based Language Test. The test is available for download from brisbanetest.org. Aphasia is a debilitating condition and accurate identification of language disorders is important in healthcare. Language assessment is complex and the accuracy of assessment procedures is dependent upon a variety of factors. The Brisbane Evidence-Based Language Test is a new evidence-based language test specifically designed to adapt to varying patient need, clinical contexts and co-occurring conditions. In this cross-sectional validation study, the Brisbane Evidence-Based Language Test was found to be a sensitive measure for identifying aphasia in stroke. [ABSTRACT FROM AUTHOR]

Pandemics threaten world stability; however, spread is mitigated with prevention behaviors. We introduce "personally relevant knowledge" to explain the knowledge–behavior gap (i.e., objective and subjective knowledge on information acquisition and behavioral change). Hypotheses are derived from prior knowledge literature, economic psychology, and relevance theory. Multimethod analysis (survey data, partial least squares structural equation path modeling [PLS-SEM], and an asymmetric information theoretic statistical analysis) is applied to H1N1 data from the USA and Australia. Personally relevant knowledge is an important addition to prior knowledge conceptualizations, and information theory uncovers asymmetric variable relationships concerning the knowledge–behavior gap, not captured by PLS-SEM. [ABSTRACT FROM AUTHOR]

This study aimed to investigate if a single, early learning experience in an aged care setting could influence speech-language pathology students': (1) attitudes towards older people; (2) confidence in communicating with older people; and (3) career aspirations in aged care. Ninety first-year undergraduate speech-language pathology students participated in a single visit to an aged care community centre. Students participated in recreational activities alongside older people and engaged in conversation. Before and after the visit, students completed surveys which examined their attitudes towards older people (UCLA Geriatrics Attitudes Scale) and self-perceived communication confidence. A Learning Reactionnaire, examining satisfaction with the experience and career aspirations, was completed post-visit. Quantitative data were analysed using descriptive statistics and non-parametric tests. Qualitative data were analysed using inductive content analysis. Students demonstrated positive changes in their attitudes towards older people and increased communication confidence. Students reported increased interest in future employment in aged care. High satisfaction towards the learning experience was reported. These preliminary findings indicate that a single, early learning experience in an aged care setting can positively shape the attitudes and self-perceived communication skills of first-year speech-language pathology students and help foster interest in pursuing a career in aged care. [ABSTRACT FROM AUTHOR]

Little was known about the role of health service utilisation on psychological distress. Using a national representative survey data in Australia, we aimed to quantify the role of disability status, types of disability, and severity of disability in their respective relationship to psychological distress in adults, and further explore the mediating effect of health service use on the disability-distress association. Data were derived from the 2015 Australian National Health Survey. Five individual actions taken for health were measured respectively, in terms of number of annual visits to general practitioner, specialist, outpatient clinic, hospital inpatient, and psychologist services. Disability was significantly associated with high psychological distress (OR = 4.46). Substantial increase in risk of high psychological distress was observed in people with psychological disability, head injury, stroke or brain damage, and intellectual disability (OR = 26.34, 18.26, 7.62). For the mediating effect of different health service use, GP services demonstrated the greatest decrease of the effect of disability on high psychological distress. GPs in the primary healthcare setting rather than psychological professionals hold a more important place to deal with the disabling and/or secondary clinical conditions as 'potential stressors'. Early screening provided by GPs for mental disorders are essential and integrated therapy will be beneficial. [ABSTRACT FROM AUTHOR]

Purpose: To describe the physical activity patterns of patients in the first week after lumbar surgery, and to investigate factors that potentially limit walking time early after surgery. Materials and methods: Adults undergoing lumbar decompression, discectomy and/or fusion surgery (N = 216, mean age 62 years, SD 13.9) were invited to participate. Walking time and step count were recorded for the first seven post-operative days, using an ActivPAL accelerometer. Participants recorded daily pain scores, supervision requirements while walking, and any complications that prevented walking. Results: On the first post-operative day, participants spent an average of 17 min (SD 20) walking, by Day 6, participants spent an average of 53 min (SD 38) walking. Participants who reported minor post-operative complications had a significantly lower step count than those without complications (p < 0.01). A lower step count was associated with a longer time to achieve independent mobility (r= −0.60, 95% CI −0.68 to −0.50), and a longer hospital admission (r= −0.70, 95% CI −0.76 to −0.63). Conclusions: This study found that patients walk for less than an hour a day over the week after lumbar surgery. Further research is required to investigate whether intervention designed to increase walking time improves post-operative activity and longer-term patient outcome. While resuming walking after lumbar surgery is a common focus of early rehabilitation, little is known about how much walking patients do, or how walking impacts recovery. The findings from this study describe activity patterns early after lumbar surgery, which may be used to inform patients about normal post-operative recovery. A lower post-operative step count was associated with several patient factors, including a fusion procedure and more severe post-operative pain, which may be used to guide peri-operative care and rehabilitation protocols. [ABSTRACT FROM AUTHOR]

This study investigated the relationship between professionalism factors and undergraduate occupational therapy students' fieldwork performance as measured by the Student Practice Education Form–Revised Edition (SPEF-R). 135 undergraduate occupational therapy students (86% 20-24 years old; 87% female) completed the Penn State College of Medicine Professionalism Questionnaire (PSCOPQ). Student fieldwork performance was measured using the Student Practice Evaluation Form–Revised Edition (SPEF-R). Multi-linear regression with bootstrapping was completed on the midway and final SPEF-R scores. Regression analysis demonstrated a range of professionalism variables to be significant predictors of fieldwork performance at the midway assessment of their fieldwork placement: Equity was a significant predictor of Self-management Skills; Enrichment and Altruism were significant predictors of Coworker Communication; and Altruism was a strong predictor of Communication Skills. No PSCOPQ variable was found to be a significant predictor of final SPEF-R performance. The findings reflect the dynamic and complex nature of professionalism in occupational therapy fieldwork settings. [ABSTRACT FROM AUTHOR]

Background: Early and objective prediction of functional outcome after stroke is an important issue in rehabilitation. Electroencephalography (EEG) has long been utilized to describe and monitor brain function following neuro-trauma, and technological advances have improved usability in the acute setting. However, skepticism persists whether EEG can provide the same prognostic value as neurological examination. Objective: The current cohort study examined the relationship between acute single-channel EEG and functional outcomes after stroke. Methods: Resting-state EEG recorded at a single left pre-frontal EEG channel (FP1) was obtained from 16 adults within 72 h of first stroke. At 30 and 90 days, measures of disability (modified Rankin Scale; mRS) and involvement in daily activities (modified Barthel Index; mBI) were obtained. Acute EEG measures were correlated with functional outcomes and compared to an early neurological examination of stroke severity using the National Institute of Health Stroke Scale (NIHSS). Classification of good outcomes (mRS ≤1 or mBI ≥95) was also examined using Receiver Operator Curve analyses. Results: One-third to one-half of participants experienced incomplete post-stroke recovery, depending on the time point and measure. Functional outcomes correlated with acute theta values (rs 0.45–0.60), with the strength of associations equivalent to previously reported values obtained from conventional multi-channel systems. Acute theta values ≥0.25 were associated with good outcomes, with positive (67-83%) and negative predictive values (70-90%) comparable to those obtained using the NIHSS. Conclusions: Acute, single-channel EEG can provide unique, non-overlapping clinical information, which may facilitate objective prediction of functional outcome after stroke. [ABSTRACT FROM AUTHOR]

Purpose: Measuring step count using activity monitors is an increasingly popular method of quantifying physical activity, however it is unknown whether gait irregularities or the use of gait aids affect the accuracy of these devices. This study evaluates the validity of the ActivPAL3, Fitbit Flex, and Jawbone UP Move activity monitors for measuring step count in hospital inpatients after lumbar fusion. Methods: The ActivPAL3 was tested on the thigh, the Fitbit, and the Jawbone were tested on the wrist and thigh, each monitor was tested 20 times. Validity was examined by calculating the percentage of steps detected by each monitor compared to the criterion measure of observed step count, the Standard Error of Measurement, and the Intraclass Correlation Coefficient. Results: The ActivPAL3 detected 85% (SD 27%) of observed steps. On the wrist, the Fitbit detected 24% (SD 34%) and the Jawbone detected 17% (SD 40%) of observed steps. On the thigh, the Fitbit detected 66% (SD 42%) and the Jawbone detected 22% (SD 35%) of observed steps. Conclusion: The ActivPAL3 activity monitor is a sufficiently valid tool to detect step count immediately after lumbar fusion. Wrist worn monitors are not recommended in this population, particularly with patients using gait aids. Walking may be quantified using activity monitoring, as both an assessment tool and as an adjunct to treatment The ActivPAL3 is sufficiently valid for use after lumbar fusion surgery The Fitbit Flex and Jawbone UP Move had low accuracy, particularly when a gait aid was used [ABSTRACT FROM AUTHOR]

The association between psychotic illness and poor physical health is now clearly articulated in the literature. By contrast the impact of depression and/or anxiety on physical health is considerably less understood, despite depression being the leading cause of disability worldwide and is associated with significantly higher prevalence of physical comorbidities than found in the general population. An Australia national cross-sectional population-based survey was conducted to ascertain the prevalence of chronic physical health conditions in persons with, and without depression and/or anxiety, allowing for demographic characteristics and lifestyle factors. The telephone-based survey was conducted using trained interviewers. Survey questions included those eliciting information about demographics, health status, and health behaviours. Independent t-tests and chi square tests showed demographic, health behaviours, and physical illness differed between those with and without depression and/or anxiety. Heart disease, high blood pressure, stroke, cancer, arthritis, chronic neck and/or back pain, and asthma were significantly higher in participants diagnosed with depression and/or anxiety. Binary logistic regression showed the strongest predictor of chronic illness was having a diagnosis of depression and/or anxiety. Depression and anxiety present major health problems impacting a considerable proportion of the population. A greater understanding of the associated physical health issues should provide impetus to broaden the physical health and mental illness research agenda to include these diagnoses. [ABSTRACT FROM AUTHOR]

This study aimed to establish whether Pastoral Care (PC) visits were an effective component of a hospitalized patient's overall health experience. Outcomes of PC visits were reported by 369 patients in 7 sites across Australia. The patient reported outcomes of PC visits included: the patients felt they could be honest with themselves, with a sense of peace, a better perspective of their illness, less anxiety, and felt more in control. Five factors of the PC visit significantly related to higher patient's overall outcomes: (a) having more Pastoral Care visits (p < 0.5 0 R 0.778, CI 0.17–1.38); (b) the patient was able to talk about what was on their mind (p < 0.01, OR1.48, CI 0.58–2.37); (c) they had something to be hopeful about (p < 0.01 OR1.18, CI 0.51–1.85); 4); the visit focused on decisions about the patient's health care (p < 0.05, OR0.70, CI 0.05–1.35); and (d) a belief in God/Higher Being (p < 0.01, OR 1.01, CI 0.43–1.71). [ABSTRACT FROM AUTHOR]

Objective: It is important to detect children with difficulties distinguishing speech-in-noise early. Prompt identification may be assisted by an evoked potential. The aims of the present study were: 1) to evaluate the frequency-following response (FFR) as a measure of binaural processing and spatial listening and, 2) to investigate the relationship between the FFR and a behavioural measure of binaural processing and spatial listening. Design: A single group, repeated measures design. The FFR was recorded in two different spatial conditions and amplitudes compared to spatial listening ability. Study Sample: Thirty-two children (aged 6.0 to 13.1 years) with a range of spatial processing abilities as measured behaviourally using the Listening in Spatialised Noise Sentences test (LiSN-S). Results: FFR waveforms were elicited using speech-like stimuli in co-located and separated conditions. A significant (p≤0.005) spatial advantage effect was observed with larger amplitudes in the separated condition. No correlations were observed between FFR amplitude and LiSN-S results. Conclusions: The FFR shows promise as a measure of binaural processing and spatial listening, but could be measuring different processes to those measured by the LiSN-S. [ABSTRACT FROM AUTHOR]

Background: Communication skills such as listening, empathy and body language are core competencies that entry level occupational therapy students must demonstrate when completing practice placements. Objective: To investigate if interpersonal skills taught to undergraduate occupational therapy students predict their practice performance. Methods: Second, third and fourth year occupational therapy students (n = 132) completed the Active-Empathetic Listening Scale (AELS); the Listening Styles Profile-Revised (LSP-R); and the Interpersonal Communication Competence Scale (ICCS). The Student Practice Evaluation Form–Revised (SPEF-R) measured students' performance at the completion of a placement. Regression analysis examined the relationships between students' interpersonal and listening skills and their fieldwork performance. Results: Higher ICCS Interaction Management subscale scores were significantly associated with better SPEF-R Communication Skills at final evaluation (β = 1.46, p < 0.05). Higher AELS Sensing subscale scores were predictive of greater Self-Management Skill performance on the SPEF-R (β = 0.84, SE = 0.42). Student's demographic characteristics were also predictive of their SPEF-R scores. The ICCS and LSP-R's subscale scores were not predictive of SPEF-R scores. Conclusion: This preliminary evidence identified several interpersonal skills that were predictive of some key SPEF-R competencies. To better prepare students to successfully complete practice placements, these interpersonal skills should be incorporated into occupational therapy education curriculum. [ABSTRACT FROM AUTHOR]

Aims: This exploratory paper investigates the demographic profile of patrons who may be underrepresented in face-to-face interviews by employing a brief version of an interview. Method: Patron interviews (n = 8,664) were conducted in seven Australian cities; 63% completed the full interview and 37% completed the brief interview. Assessed correlates of interview type comprised gender, age, pre-drinking, consumption of alcohol mixed with energy drinks, illicit drug use, involvement in verbal or physical aggression, alcohol-related injuries, and blood alcohol concentration (BAC). Results: Using a brief interview increased the response rate by 34%. Multi-level logistic regression models indicated compared to those who completed the full interview, brief interview respondents were more likely to be: male, have a BAC of ≥0.05 to <0.10 or ≥0.10 g/100 ml, report pre-drinking, and report involvement in physical aggression. Respondents were also less likely to compete the brief interview with each 1 year increase in age. Conclusion: Compared to longer interviews, brief patron interviews can capture a different and more at-risk demographic group and increase the overall response rate. These findings raise questions about the representativeness of long interview samples describing young drinkers who experience aggression. The study also provides the groundwork for future validation of brief interviews. [ABSTRACT FROM AUTHOR]

Background: It is estimated that up to a third of injuries requiring emergency department (ED) admission are alcohol-related. While injuries that are alcohol-related are unsurprising to ED staff, less is understood about the precursors to the injury event. Methods: Using data from representative ED injury patients in 22 countries, we examined associations between context of injury (private or public), cause of injury (fall or trip, being stuck/cut/or burned and violence) and alcohol use. Alcohol-related policy data were also obtained from each study locale. Results: Injuries were similarly reported in private (54%) and public settings (46%), while cause of injury was most often due to falls (39%) or being struck/cut or burned (38%). Violence-related injuries were reported by approximately 1 in 5 patients (23%). Increased odds of drinking prior to the injury event was associated with injury due to violence in private settings but not public venues. Similarly, patients from regions with fewer restrictive alcohol policies were more likely to report drinking prior to an injury event and have elevated violence-related injuries in private settings. Conclusion: Understanding the cause and context of injury and alcohol use are important components to evaluation and development of alcohol policies. [ABSTRACT FROM AUTHOR]

Objectives: Alcohol consumption and associated risk-taking behaviors, are known issues among trainees in the Australian Defence Force. We evaluated the impact and feasibility of a 1 day injury awareness program designed to reduce alcohol-related risk-taking behavior and associated harms in young naval trainees in this pilot study. Method: One hundred eight naval trainees participated in the 1 day Prevent Alcohol and Risk related Trauma in Youth (P.A.R.T.Y.) program at a hospital in Melbourne, Australia between November 2011 and March 2013. Participants completed pre- and postprogram questionnaires, on the day of the program, that included questions on perceptions of the program and their own risk-taking behavior. Alcohol-related incidents reported on their military record were collected at 12 months postprogram. Pre- and postprogram questionnaire responses were compared using descriptive statistics. Survival analysis was used to assess the association between pre-program alcohol-related incidents and the rate of reporting of alcohol-related incidents in the 12 months after the program. Results: Fifty of the 108 (46%) participants were reported for ≥1 alcohol-related incident prior to study participation. Fifteen (14%) were reported for an alcohol-related incident within 12 months of completing the program. Participants perceived the program positively with 92% reporting that the program would definitely influence their behavior after program completion compared to 82% suggesting so before. The rate of reported alcohol-related incidents following the program was higher for participants who had a preprogram incident on record than those who did not. Conclusion: Our findings suggest that PARTY participation was associated with a change in participants’ perceptions of risk-taking behavior. We found that alcohol-related incidents after attending the P.A.R.T.Y. program occurred more frequently among participants who had prior alcohol-related incidents suggesting the program may have less impact on this group. Further work is required to establish effectiveness of the P.A.R.T.Y. program in the military setting. [ABSTRACT FROM PUBLISHER]

Purpose: There is paucity of research investigating oropharyngeal dysphagia (OPD) in young children with cerebral palsy (CP), and most studies explore OPD in high-resource countries. This study aimed at determining the proportion and severity of OPD in preschool children with CP in Bangladesh, compared to Australia. Method: Cross-sectional, comparison of two cohorts. Two hundred and eleven children with CP aged 18-36 months, 81 in Bangladesh (mean = 27.6 months, 61.7% males), and 130 in Australia (mean = 27.4 months, 62.3% males). The Dysphagia Disorders Survey (DDS) - Part 2 was the primary OPD outcome for proportion and severity of OPD. Gross motor skills were classified using the Gross Motor Function Classification System (GMFCS), motor type/distribution. Results: (i) Bangladesh sample: proportion OPD = 68.1%;severity = 10.4 SD = 7.9. Australia sample: proportion OPD = 55.7%; severity = 7.0 SD = 7.5. (ii) There were no differences in the proportion or severity of OPD between samples when stratified for GMFCS (OR = 2.4, p = 0.051 and β = 1.2, p = 0.08, respectively). Conclusions: Despite overall differences in patterns of OPD between Bangladesh and Australia, proportion and severity of OPD (when adjusted for the functional gross motor severity of the samples) were equivalent. This provides support for the robust association between functional motor severity and OPD proportion/severity in children with CP, regardless of the resource context. [ABSTRACT FROM AUTHOR]

Aims: We examined parental influences on drinking over two contexts – a typical social occasion, and at ‘Schoolies’, a multiple-day mass celebration. Particular focus was placed on addressing the mixed literature on the impact of parental alcohol supply. Methods: Australian adolescents aged 17–18 completed a Last Event (N = 541) and post-Schoolies survey (N = 405). Results: Parental supply of alcohol was commonplace at the Last Event (21%) and at Schoolies (25%). At the Last Event, exclusive parental supply was associated with lower consumption (10 vs. 12 standard drinks; p = .03). However, around half supplemented parental alcohol with other sources of alcohol and this nullified any protective effects. Parental supply did not affect quantity at Schoolies, though engaging with parents in a safety discussion about drinking was protective. Across both contexts, perceived parental disapproval of risky consumption mitigated against risk. Conclusions: Identifying whether alcohol supplied by parents was combined with other sources was relevant, and parental supply per se is unlikely to be protective as this supply was commonly topped up. Parental safety discussions lowered risk at Schoolies and should continue to be promoted. Right up to the time when young adults were drinking in both typical and high-risk environments, parental disapproval continued to exert a protective influence over drinking. [ABSTRACT FROM PUBLISHER]

Purpose:Physiotherapists often prescribe self-management strategies for their patients. However, the effectiveness of these strategies in improving patient outcome is related to the rate of patient adherence. The aims of this study were to explore physiotherapists’ views on the importance and perceived rates of patient adherence to physiotherapist prescribed self-management strategies; the perceived importance of methods physiotherapists can employ to aid patient adherence and the barriers to employing these methods. Method:A cross-sectional web-based survey was emailed to 808 physiotherapist members of the Australian Physiotherapy Association. To maximize response rates, two reminder emails were utilized. Results:In total, 352 physiotherapists completed the survey (response rate 44%). A majority of physiotherapists (89%) believed that patient self-management strategies were important in improving patient outcomes; however, the mean perceived rate of patient adherence across all strategies was only 67%. Physiotherapists reported that there were a number of important methods that can be employed to aid patient adherence such as providing patient education and allowing time for patient practice; with minimal perceived barriers to employing these methods. Conclusions:Results indicate that physiotherapists perceive that patient outcomes can be positively impacted by patient adherence to a range of self-management strategies. Physiotherapists should be encouraged to implement into their routine clinical practice evidence-based methods to aid patient adherence.Implications for RehabilitationPhysiotherapists believe that patient self-management strategies are important for improving patient outcomes, however, the perceived rates of patient adherence could be improved.Physiotherapists should adopt a collaborative approach with their patients to address any barriers to adherence to positively impact on patient outcome.Physiotherapists perceive that there are a number of modifiable characteristics which determine patient adherence including patient self-efficacy, physiotherapist communication skills and the complexity of the self-management strategy.Methods that physiotherapists can employ to positively influence patient adherence may include individualizing the strategy to the patient, education and supplementary written information. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to determine if the E-Learning Plus communication partner training (CPT) programme is as effective as the Supported Conversation for Adults with Aphasia (SCATM) CPT programme in improving healthcare professionals’ confidence and knowledge communicating with patients with aphasia. Method: Forty-eight healthcare professionals working in inpatient rehabilitation participated. Participants were randomised to one of the CPT programmes. The three outcome measures were self-rating of confidence, self-rating of knowledge and a test of knowledge of aphasia. Measures were taken pre-, immediately post- and 3–4 months post-training. Data were analysed using mixed between within ANOVAs. Result: Homogeneity of variance was adequate for self-rating of confidence and test of knowledge of aphasia data to continue analysis. There was a statistically significant difference in self-rating of confidence and knowledge of aphasia for both interventions across time. No statistically significant difference was found between the two interventions. Conclusion: Both CPT interventions were associated with an increase in health care professionals’ confidence and knowledge of aphasia, but neither programme was superior. As the E-Learning Plus CPT programme is more accessible and sustainable in the Australian healthcare context, further work will continue on this CPT programme. [ABSTRACT FROM PUBLISHER]

Background:Handwriting speed is an important component of students’ ability to adequately express their ideas, knowledge and creativity in a timely and effective manner.Aims:Psychometric properties of the Handwriting Speed Test (HST) and Detailed Assessment of Speed of Handwriting (DASH) and accuracy of the norms for identifying current Australian students with handwriting speed difficulties were examined.Methods:An exploratory, cross-sectional study was conducted involving students, with and without handwriting difficulties, in Years 3–12 (mean age: 12.0 yrs, SD = 3.0 yrs; range = 7 to 18 yrs) in New South Wales (NSW; Australia). Participants were recruited through occupational therapists and schools. Students completed the HST and all DASH subtests.Results:Thirty-two students with, and 139 students without, handwriting difficulties participated. Intra-rater and inter-rater reliability were found to be excellent; sensitivity was low and specificity high for the HST and DASH. No significant differences were found between test scores and normative data for students without handwriting difficulties (year/age groups withn> 10). Conclusions: The HST and DASH are reliable assessments of handwriting speed. Further research is required into discriminant validity of the HST and DASH and need for updated norms. [ABSTRACT FROM AUTHOR]

This study aimed to explore how asymptomatic athletes with a patellar tendon abnormality (PTA), who are at high risk of developing patellar tendinopathy, alter their landing technique and net patellar tendon loads generated in response to fatigue. Seven asymptomatic players with a PTA performed five successful vertical stop-jump trials before and after a fatigue protocol. Fatigue protocol involved participants repeatedly performing sets of 30 submaximal jump exercises on a sledge apparatus followed by 30 s rest until the task failure criteria were reached. Three-dimensional ground reaction forces, lower limb kinematics and net peak patellar tendon force were recorded during the stop-jump task. No significant between-fatigue condition differences in net patellar tendon loading, or most secondary outcome variables were observed. Only some fatigue changes were seen during the vertical landing phase. Asymptomatic PTA participants did not modify their landing technique or net patellar tendon loading during a stop-jump task in response to fatigue. The lack of between-fatigue condition differences displayed by the asymptomatic PTA participants during both landing phases suggest that these individuals may not be capable of sufficient movement variability in their landing strategies to adapt to fatigue. [ABSTRACT FROM PUBLISHER]

Background: Clinical studies of alcohol and drug treatment outcomes frequently apply participant eligibility criteria (EC), which may exclude real-world treatment seekers, impairing the representativeness of studied samples. Some research exists on the impact of EC on alcohol treatment seekers. Little is known about drug treatment and country differences. Objectives: We tested and compared the degree to which commonly used EC exclude real-world treatment seekers with problem alcohol and drug use in Sweden and Australia, and compared the impact of EC on outcomes. Methods: Two large naturalistic and comparative service user samples were used. Respondents were recruited in Stockholm County (n = 1,865; data collection 2000–2002), and Victoria and Western Australia (n = 796; in 2012–2013). Follow-up interviews were conducted after 1 year. Cross-tabulations, Chi-square (χ2) tests and logistic regressions were used. Results: Percentages of the samples excluded by individual EC ranged from 5% (lack of education/literacy) to 70% (social instability) among Swedish alcohol cases and from 2% (low alcohol problem severity) to 69% (psychiatric medication) among Australian counterparts; and from 2% (age 60+ years) to 82% (social instability) among Swedish drug cases and from 1% (age 60+ years) to 67% (psychiatric medication) among Australian counterparts. Country differences and differences across substances appeared independent of country effect. Co-morbid psychiatric medication, noncompliance, poly drug use, and low education EC caused positive 1-year outcome bias; whereas female sex and old age introduced negative outcome bias. Conclusions/Importance: Commonly used EC exclude large proportions of treatment seekers. This may impair generalizability of clinical research, and the effects of many EC differ by country and drug type. [ABSTRACT FROM AUTHOR]

Background: Whether general practitioner (GP) registrars have adequate exposure to, and feel confident in, managing children’s health during training is unknown.Objectives: To determine the prevalence and associations of GP registrars’ paediatric vs. non-paediatric consultations.Methods: Cross-sectional analysis from a cohort study of Australian GP registrars’ 2010–2014 consultations.Results: 889 registrars contributed details for 26,427 (21.8% (95% CI: 21.4–22.2) paediatric consultations. Paediatric patients were more likely to be male and new to the practice. Although paediatric patients were less likely to have a chronic disease (OR 0.38, 95% CI 0.36, 0.40) and presented with fewer problems (OR 0.59, 95% CI 0.57, 0.61), registrars were more likely to seek in-consultation advice (OR 1.25, 95% CI 1.19, 1.31) and generate learning goals (OR 1.12, 95% CI 1.07, 1.18) for paediatric consultations.Discussion: GP registrars appear to feel less confident in managing paediatric compared with adult consultations, suggesting an unmet training need. [ABSTRACT FROM AUTHOR]

Purpose: To measure associations between exposure to alcohol advertising and drinking behaviors among secondary students in Victoria, Australia. Methods: Students aged 12–17 years completing a cross-sectional survey in 2011 (n= 4,413) indicated their exposure to alcohol advertising via multiple media channels. Students also indicated whether they had consumed alcohol in the past month and the number of alcoholic drinks consumed on each of the seven days preceding the survey. Students drinking five or more drinks on one of these seven days were classified as ‘risky drinkers’. Logistic regression analyses examined associations between exposure to alcohol advertising media and alcohol consumption measures, controlling for student-level demographic variables. Results: Exposure to alcohol advertising was most common through television (58%), alcohol branded merchandise (42%), and the internet (39%). After controlling for other advertising exposure measures, weekly exposure to alcohol advertising via billboards/newspapers/magazines and ownership of at least one alcohol branded item was significantly associated with consuming alcohol in the past month and at risky levels. Conclusions: Findings show high exposure to alcohol advertising among Australian youth and associations with drinking behaviors, suggesting the need for increased regulation of alcohol advertising across traditional and non-traditional media. [ABSTRACT FROM PUBLISHER]

Background: Understanding the characteristics of drug users in the night-time economy (NTE), and whether particular drugs are associated with risky practices and experience of harm, is necessary to inform targeted policy responses in this context. Objectives: To investigate the correlates of drugs used in the Australian NTE relating to demographics, alcohol use, and experience of harm. Methods: Patrons were interviewed in the NTE of five Australian cities in 2012–2013 (n = 7,028; 61.9% male, median age 22 years). A custom designed survey gathered demographic data, alcohol, and substance use on the current night, and experience of harm in/around licensed venues in the past 3 months. Multivariate logistic regression analyses examined the correlates of drug use. Results: Ecstasy was most commonly reported (4.0%), followed by cannabis (2.9%), methamphetamine (2.6%), and cocaine (1.6%). Ecstasy users were more likely to be younger and report energy drink consumption. Cannabis users were more likely to be male, and to have been involved in intoxication-related accidents/injuries and sexual aggression in/around licensed venues in the past 3 months. Methamphetamine users were more likely to have been interviewed later, and to have engaged in pre-drinking. Cocaine users were more likely to be male, aged 21 years or more, have a blood alcohol concentration of greater than 0.10%, and to have been involved in intoxication-related accidents/injuries in the past three months. Conclusions/Importance: We identified significant differences between types of drug users and the harms they experience, underscoring the need to develop innovative harm reduction policies in the NTE rather than blanket population-based approaches. [ABSTRACT FROM AUTHOR]

Current international targets aim for 90% of people diagnosed with HIV to be on antiretroviral treatment (ART). This paper aims to identify sociodemographic and attitudinal factors associated with ART non-use over time in three samples of Australian people living with HIV (PLHIV). Data for this paper were derived from an Australian cross-sectional survey of PLHIV that was repeated at three different time points: 1997, 2003, and 2012. There were approximately 1000 respondents to each survey (n = 3042 in total). The survey included approximately 250 items related broadly to health and well-being, ART use, and attitudes towards ART use. Univariate and multivariate logistic regression analyses were used. While the proportion of participants using ART increased between 1997 and 2012 (78.8–87.6%,p < .001), there was a decrease between 1997 and 2003 to 70.6% (p < .001). Factors linked to ART non-use remained steady over those 15 years. In all cohorts, people less likely to be using ART were younger and had a more recent diagnosis of HIV. In 2003 and 2012, people in full-time employment were less likely to be using ART, while those whose main source of income was a pension or social security were more likely to be using ART. Multivariate models showed that, at each time point, a belief in the health benefits of delayed ART uptake was associated with non-use. These findings suggest that there may be barriers to ART uptake that have persisted over time despite changes to clinical guidelines that now encourage early uptake. [ABSTRACT FROM PUBLISHER]

Guided by the extended parallel process model (EPPM) and reactance theory, this study examined the relationship between efficacy beliefs, reactance, and adult smokers' responses to pictorial health warning labels (HWL) on cigarette packaging, including whether efficacy beliefs or reactance modify the relationship between HWL responses and subsequent smoking cessation behavior. Four waves of data were analyzed from prospective cohorts of smokers in Australia and Canada (n = 7,120 observations) over a period of time after implementation of more prominent, pictorial HWLs. Three types of HWL responses were studied: psychological threat responses (i.e., thinking about risks from smoking), forgoing cigarettes due to HWLs, and avoiding HWLs. The results from Generalized Estimating Equation models indicated that stronger efficacy beliefs and lower trait reactance were significantly associated with greater psychological threat responses to HWLs. Similar results were found for models predicting forgoing behavior, although response efficacy was inversely associated with it. Only response efficacy was significantly associated with avoiding HWLs, showing a positive relationship. Higher self-efficacy and stronger responses to HWLs, no matter the type, were associated with attempting to quit in the followup period; reactance was unassociated. No statistically significant interactions were found. These results suggest that stronger efficacy beliefs and lower trait reactance are associated with some stronger responses to fear-arousing HWL responses; however, these HWL responses appear no less likely to lead to cessation attempts among smokers with different levels of self-efficacy to quit, of response efficacy beliefs, or of trait reactance against attempts to control their behavior. [ABSTRACT FROM AUTHOR]

Increases in childhood obesity have coincided with declines in active transportation to school. This research builds on largely atheoretical extant literature examining factors that influence walk-to-school behavior through application of the theory of planned behavior (TPB). Understanding caregivers' decision for their child to walk to/from school is key to developing interventions to promote this cost-effective and accessible health behavior. The results from an online survey of 512 caregivers provide support for the TPB, highlighting the important role of subjective norms. This suggests marketers should nurture caregivers' perception that important others approve of walking to school. [ABSTRACT FROM AUTHOR]

Purpose: In 2007, Australia published standardized terminology and definitions for three levels of thickened fluids used in the management of dysphagia. This study examined the thickness of the current Australian National Fluid Standards rheologically (i.e. viscosity, yield stress) and correlated these results with the "fork test", as described in the national standards. Method: Clinicians who prescribe or work with thickened liquids and laypersons were recruited to categorize 15 different thickened fluids of known viscosities using the fork test. The mean apparent viscosity and the yield stress for each fluid category were calculated. Result: Clear responses were obtained by both clinicians and laypersons for very thin fluids (< 90 mPa.s) and very thick fluids (> 1150 mPa.s), but large variations of responses were seen for intermediate viscosities. Measures of viscosity and yield stress were important in allocating liquids to different categories. Conclusion: Three bands of fluid viscosity with distinct intermediate band gaps and associated yield stress measures were clearly identifiable and are proposed as objective complements to the Australian National Standards. The "fork test" provides rudimentary information about both viscosity and yield stress, but is an inexact measure of both variables. [ABSTRACT FROM AUTHOR]

Purpose: To compare physical activity levels of patients in the first week after myocardial infarction (MI) and stroke.Method: We conducted an observational study using behavioural mapping. MI patients were consecutively recruited from Alfred Hospital, Melbourne. Data for stroke patients (Royal Perth Hospital or Austin Hospital, Melbourne) were retrieved from an existing database. Patients were observed for 1 min every 10 min from 8 am to 5 pm. At each observation, the patient’s highest level of physical activity, location and people present were recorded. Details of physiotherapy and occupational therapy sessions were recorded by the therapists.Results: Proportion of the day spent physically inactive was lower in MI (n = 32, median 48%) than stroke (n = 125, median 59%) patients, but this difference was not significant in univariate or multivariate (adjusting for age, walking ability and days post-event) regression. Time spent physically active was higher in MI (median 23%) than stroke (median 10%) patients (p = 0.009), but this difference did not survive multivariate adjustment (p = 0.67). More stroke patients (78%) than MI patients (19%) participated in therapy.Conclusions: This study provides the first objective data on physical activity levels of acute MI patients. While they were more active than acute stroke patients, the difference was largely attributable to walking ability.Implications for rehabilitationIn the first week after myocardial infarction, patients spent about half the day physically inactive (even though 81% were able to walk independently).Similar levels of inactivity were seen in a comparable cohort of acute stroke patients, suggesting that environmental factors play an important role.There appears to be wide scope for increasing levels of physical rehabilitation after acute cardiovascular events, though optimal timing and dose remain unclear. [ABSTRACT FROM PUBLISHER]

This study examined the accuracy of self-attachment of the activPAL activity monitor. A convenience sample of 50 participants self-attached the monitor after being presented with written material only (WMO) and then written and video (WV) instructions; and completed a questionnaire regarding the acceptability of the instructional methods. Participants positioned the monitor lower than the instructed position on the thigh (WMO −5.15 ± 2.75 cm, WV −4.16 ± 2.15 cm;p = .008 difference) and approximately 2 cm laterally from the thigh midline (WMO 1.90 ± 0.92 cm; WV 2.08 ± 1.24 cm). The orientation of the device was positioned correctly along the midline (within < 1° of vertical). Acceptability was high for both instructional methods although preference was shown for the WV instruction. In conclusion, participants consistently self-attached the activPAL close to the intended placement with either instructional method. The addition of video instruction produced a slightly more accurate attachment and was preferred by the participants. [ABSTRACT FROM PUBLISHER]

Purpose: To investigate the role of philanthropic micro-grants (maximum of $10 000) in the provision of aids and equipment for adults (aged 18–65 years of age) with complex disabilities and examine key trends in aids and equipment requests.Method: This study examined, through quantitative and qualitative analysis, aids and equipment requests (n = 371 individual applications as represented by 136 service organisations in three Australian states) received by a not-for-profit (NFP) organisation across five consecutive years of an innovative micro-grants scheme.Results: Findings highlight that living situation (living with family or living independently) significantly influences the nature of requests for respite, aids, equipment and home modifications. Specifically, people with complex disabilities living with their families require greater combined service provision (higher equipment need, respite support, home modifications) than those living independently (equipment need only). Type of disability did not influence request type. Qualitative data further indicated the “last resort” nature of respite requests, particularly for younger applicants (under 45 years of age) indicating critical unmet needs in the community.Conclusions: Results demonstrate the vital role of NFP organisations and philanthropic funds in supporting daily lifestyle aids and equipment (including respite) that might otherwise not be funded for people with complex disabilities. Although preliminary in its scope and prior to implementation of a National Disability Insurance Scheme (NDIS) in Australia, findings suggest both opportunity and risk to the uptake of community-based micro-grant funding: opportunity for users through the provision of essential aids and lifestyle supports, and risk through over-subscription and devolving of responsibility for critical support resources from public sector.Implications for RehabilitationThe aids and equipment needs of adults under the age of 65 appear to have been underestimated, poorly defined and under-serviced.Service users need more assistance for their carers (i.e. equipment to facilitate safe lifting, urgent breaks from care routines) as well as aids, equipment and modifications to help them to live a more normal life (e.g. going to the beach).Living situation (i.e. independently or with family) significantly influences the nature and extent of aids and equipment requested. Supporting adults up to the age of 65 to live more independently would positively influence carers and family, while at the same time providing opportunities for more targeted personal care supports.Philanthropic and not-for-profit schemes are helping to address these needs through micro-grant schemes for purchases under $10 000, but sustainability is questioned.The introduction of Australia’s National Disability Insurance Scheme (NDIS) presents an opportunity to consider the lifestyle needs of service users and carers, and determine who is best placed to address them. [ABSTRACT FROM PUBLISHER]

Objectives: The number of people who will require institutional care for dementia is rapidly rising. This increase raises questions about how the workforce can meet the challenge of providing quality care. A promising psychological concept that could improve staff and care recipient outcomes is staff sense of competence in their capacity to provide dementia care. The purpose of this study was to elucidate the relative importance of staff factors associated with sense of competence. Method: Sixty-one Australian dementia care staff (mostly nurses, 69%; and allied health, 21%) were recruited. Measures included the Sense of Competence in Dementia Care Staff (criterion) and standardised measures of empirically derived predictors: training, knowledge, attitudes and person-centred care strategies. Results: Standard multiple regression revealed that 33.9% of the variance in sense of competence was explained by the combination of the four predictors. Attitudes and person-centred strategies each uniquely explained a moderate amount of variance, while training and knowledge were not significant predictors of sense of competence. Conclusion: A positive attitude towards people with dementia, and stronger intentions to implement person-centred care strategies, predicted a greater sense of competence to provide care, whereas knowledge and training, commonly believed to be important contributors to sense of competence in dementia care, did not predict this outcome. Investing in strategies that address staff attitude and encourage person-centred care could influence sense of competence, and by extension, dementia care. [ABSTRACT FROM AUTHOR]