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Background: A skin tear is a traumatic wound that occurs in up to one in five hospitalized patients. Nursing care includes application of a dressing to create a moist wound healing environment. Aim: To compare the effectiveness of two standard dressings (adhesive silicone foam vs. meshed silicone interface) to heal hospital‐acquired skin tear. Methods: An intention‐to‐treat pilot study was designed using a randomized, non‐inferiority trial in an Australian tertiary hospital setting. Consenting participants (n = 52) had acquired a skin tear within the previous 24 h and had agreed to a 3‐week follow‐up. Data were collected between 2014 and 2020. The primary outcome measure was wound healing at 21 days. Results: Baseline characteristics were similar in both arms. Per protocol, 86% of skin tears were fully healed at 3 weeks in the adhesive silicone foam group, compared to 59% in the meshed silicone interface group. Greater healing was observed across all skin tear categories in the adhesive silicone foam dressing group. In the intention‐to‐treat sample, healing was 69% and 42%, respectively. Conclusions: Results suggest the adhesive silicone foam dressing may be superior, as it produced clinically significant healing of skin tears at 3 weeks compared to the meshed silicone interface dressing. Accounting for potential loss to follow‐up, a sample of at least 103 participants per arm would be required to power a definitive study. Summary statement: What is already known about this topic? A skin tear is a traumatic wound that is commonly acquired during hospitalization that affects older adults in particular. In hospital settings, it may occur in up to one in five patients.A variety of skin tear dressings have been used in previous studies, with healing rates ranging from 34% to 97% at 21 days; however, evidence for the most effective dressing type is inconclusive.If treated inappropriately, or left untreated, minor skin tears can become chronic or complicated wounds, yet prevalence and treatment of hospital‐acquired injuries are under‐reported. What this paper adds? Based on our per‐protocol results, an adhesive silicone foam dressing may be superior, as it produced clinically significant healing of 86% of skin tears at 3 weeks compared to 59% with the meshed silicone interface dressing.Based on the methods and results from this pilot study, a future definitive trial would be feasible but would need to account for a relatively large loss to follow‐up rate. The implications of this paper: Using our intention‐to‐treat results, a future study would need a sample size of 103 per arm to be sufficiently powered, which may be impractical to achieve within a single hospital setting; thus, a multi‐site study would be advisable. [ABSTRACT FROM AUTHOR]

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

Long-term or residential services are designed to support older people who experience challenges to their physical and mental health. These services play an important role in the health and well-being of older adults who are more susceptible to problems such as malnutrition. Estimates of the significance of malnutrition require up-to-date prevalence data to inform government strategies and regulation, but these data are not currently available in Australia. The aim of this study was to collect malnutrition prevalence data on a large sample of people living in residential aged care facilities in Australia. A secondary aim was to examine the relationship between malnutrition and anthropometry (body mass index (BMI) and weight loss). This prevalence study utilised baseline data collected as part of a longitudinal study of malnutrition in 10 Residential Aged Care facilities across three states in Australia (New South Wales, South Australia, and Queensland). The malnutrition status of eligible residents was assessed by dietitians and trained student dietitians using the Subjective Global Assessment (SGA) with residents categorised into SGA-A = well nourished, SGA-B = mildly/moderately malnourished, and SGA-C = severely malnourished. Other data were extracted from the electronic record. Of the 833 listed residents, 711 residents were eligible and had sufficient data to be included in the analysis. Residents were predominantly female (63%) with a mean (SD) age of 84 (8.36) years and a mean (SD) BMI of 26.74 (6.59) kg/m2. A total of 40% of residents were categorised as malnourished with 34% (n = 241) categorised as SGA-B, and 6% (n = 42) SGA-C. Compared to the SGA, BMI and weight loss categorisation of malnutrition demonstrated low sensitivity and high specificity. These findings provide recent, valid data on malnutrition prevalence and highlight the limitations of current Australian practices that rely on anthropometric measures that under-detect malnutrition. There is an urgent need to implement a feasible aged care resident screening program to address the highly prevalent condition of malnutrition in Australia. [ABSTRACT FROM AUTHOR]

Accessible summary What is known on the subject? Around the world, recovery has become a focus in mental health policy. The participation of people accessing mental health services (consumers) and carers of such individuals in decision-making related to services forms part of this recovery orientation and studies suggest positive outcomes following such participation., However, little is known about consumer and carer desires at the earliest stages of development of new services., What this paper adds to existing knowledge? Consumers and carers desire changes to how mental health services are provided., Many factors affect consumer and carer experiences, including language use, physical design of spaces, accessibility, consideration of individual needs, practical help and how well care is continued from hospital to community settings., Carers may feel sidelined in treatment and be distressed as a result. They wish to be respected and involved in recovery., Consumers and carers wish for focus on broader health, with care taken to address physical health, psychological needs, social needs and treatment of the whole person rather than just an illness., What are the implications for practice? Consumers and carers desire partnership with professionals in recovery. Tokenistic participation should be avoided., Flexibility in how services are provided and less formality may help engage consumers and carers. Specifically, professionals may help by linking consumers and carers to services that address practical needs., Professionals should communicate with carers to draw on their expertise about the individual accessing the mental health service and help carers understand how they can assist the individual's recovery., Abstract Introduction Recovery-oriented mental health policies recognize consumer and carer participation in service decision-making as essential, but little is known about the views of these individuals in the earliest stages of service development. Aim This study sought consumer and carer perspectives addressing the establishment of a mental health research, treatment and teaching facility in their region. Methods Two 2-hr focus groups were conducted, with separate groups held for mental health consumers ( n = 9) and carers ( n = 9), respectively. Discussions pertained to mental health literacy, gaps in current services, desires for an ideal facility (in terms of physical design and services offered) and what would help in recovery. Results Inductive thematic analysis was used to generate three themes: care outside of consultations, carer involvement in recovery and holistic approaches to mental health care. Consumers desired a facility that could cater to individual needs. Carers felt excluded in recovery and unable to provide effective support. Both groups preferred holistic approaches to mental health, expressing ambivalence towards medication and hospitalization. Discussion Consumers and carers have many needs that conventional practices may not meet. Implications for practice They have clear desires for equal partnership in recovery and for transformation of conventional treatment methods. [ABSTRACT FROM AUTHOR]

Objective. There is limited evidence about how legal frameworks that underpin end-of-life decisions are applied in practice. This study aimed to identify how end-of-life decisions are made and documented in emergency departments and intensive care units. The secondary aim was to explore the extent to which the legal processes featured in these decisions. Methods. A retrospective chart audit of 85 adult patients who died in the emergency departments and intensive care units of a Queensland health service was undertaken. Quantitative data were analysed and reported using descriptive statistics. Qualitative textual data were analysed using inductive content analysis. Results. Nearly all admissions were unplanned (97.6%), and most patients (74.1%) were admitted from home. Only one patient had an advance health directive, although all had an eligible substitute decision-maker. The qualitative analysis revealed two main concepts -- 'healthcare professionals choreograph the end of life' and 'patients and families are carried on an unplanned journey'. Conclusions. There was limited documentation related to the application of the legal framework in these decisions. Healthcare professionals relied on their clinical judgment about what was in the best interest of the patient. It was common for there to be a substantial effort to achieve consensus in decision-making which coincidentally complied with the law. [ABSTRACT FROM AUTHOR]

Aim In this paper, we describe a trial protocol used to assess feasibility related to: study administration (recruitment, randomization, retention, compliance, eligibility criteria, suitability of protocol instructions and data collection questionnaires); resource and data management (suitability of site, time and budget allocation, management of personnel and data); intervention fidelity (treatment dose, violations); and effect size. Background Pressure injury can lead to increases in hospital length of stay and cost. The sacrum is identified as one of the most common anatomical pressure injury sites for hospitalized patients. Silicone foam border dressings have been proposed as one strategy to reduce pressure injury incidence; however, rigorous testing of benefit in a general medical-surgical population is required. Design Randomized controlled trial. Methods Eighty patients will be recruited after assessment of high risk of pressure injury in a large tertiary hospital in south-east Queensland, Australia. Eligible, consenting participants will be randomly allocated to either a control group (routine care) or an intervention group (routine care and a sacral prophylactic dressing). The primary outcomes comprise feasibility criteria as identified above. The secondary measure is the presence and severity of sacral pressure injury via blind assessment of digital photographs. Research ethics approval was received in October 2013. Discussion Prophylactic dressings applied to the sacrum may be an effective method for reducing pressure injury in high-risk general medical-surgical patients. However, more rigorous studies to confirm benefit are required. This pilot study will determine the feasibility and effect size to inform a larger randomized controlled trial. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to explore patient barriers to accessing services, current technology ownership/use and digital device preferences for accessing health information/health service delivery. Additionally, it aimed to explore the Theoretical Domains Framework and the acceptability of future eHealth solutions in bariatric surgery. Methods: This mixed‐method study (survey and semi‐structured interviews) was conducted in a bariatric surgery service in an Australian public hospital. Quantitative data were analysed descriptively, and the qualitative data were deductively and inductively analysed. Results: This study included 117 participants (n = 102 surveyed and n = 15 interviewed). Most participants were aged ≥51 years (n = 70, 60%), and two‐thirds were female (n = 76, 65%). One in three participants reported barriers to accessing services (n = 38, 37%), including parking, travel time, and taking time off work. Most participants preferred to receive or access additional health information via email (n = 84, 82%) and were willing to engage with health professionals via email (n = 92, 90%), text messages (n = 87, 85%), and telephone (n = 85, 83%). Deductive analysis of interviews generated three themes: 'Knowledge', 'Social influence' and 'Behavioural regulation, goals and environmental resources'. The inductive analysis generated one theme: 'Seeing a place for eHealth in service delivery'. Conclusion: This study's findings can potentially influence the development of future eHealth solutions. Text message, email, and online approaches may be suitable for delivering further information and resources to patients, particularly regarding diet and physical activity. Online health communities are being used by patients for social support and may be worth further investigation. In addition, developing a bariatric surgery mobile application may be beneficial. [ABSTRACT FROM AUTHOR]

Background: Collaboration between dental practitioners and non-dental primary care providers has the potential to improve oral health care for people in rural and remote communities, where access to oral health services is limited. However, there is limited research on collaboration between these professional disciplines. The purpose of this paper was to explore the relationships between dental practitioners and non-dental primary care providers from rural and remote areas of Queensland and to identify strategies that could improve collaboration between these disciplines from the perspective of dental participants. Methods: Semi-structured interviews were conducted between 2013 and 2015 with visiting, local and regional dental practitioners (n = 12) who had provided dental services to patients from eight rural and remote Queensland communities that did not have a resident dentist. Participants were purposely recruited through a snow ball sampling technique. Interview data were analysed using thematic analysis with the assistance of QSR Nvivo v.10. Results: Four major themes emerged from the data: (1) Communication between dental practitioners and rural primary care providers; (2) Relationships between dental and primary care providers; (3) Maintenance of professional dualism; (4) Strategies to improve interprofessional relationships (with subthemes: face to face meetings; utilisation of technology; oral health training for primary care providers; and having a community based oral health contact person). Participants observed that there was a lack of communication between the dental providers who saw patients from these rural communities and the primary care providers who worked in each community. This was attributed to poor communication, the high turnover of staff and the siloed behaviours of some practitioners. Visiting dental practitioners were likely to have stronger professional relationships with hospital nursing, administrative and allied health care staff who were often long term residents of the community. Conclusions: The findings suggest that there was little relationship between the dental personnel and primary care providers. Interprofessional collaboration between dental care providers and non-dental rural primary care providers in the rural and remote communities sampled could be improved by having regular face to face meetings between practitioners from across the health disciplines, providing oral health education to primary care providers, establishing and maintaining effective communication and referral pathways, and exploring a greater role for tele-dentistry. [ABSTRACT FROM AUTHOR]

Background: Peripartum antibiotics are commonly administered. Little is known of the attitudes of pregnant women toward peripartum antibiotics. Aim: We aimed to assess the awareness of and attitudes toward peripartum antibiotic use in Australian women. Materials and Methods: We surveyed post‐partum women at three hospitals over six months. Women reported if they received antibiotics 48 h either side of delivery and responded to statements assessing attitudes to peripartum antibiotic use. Administered antibiotics were recorded. We reported the proportion receiving antibiotics and the proportion aware of receiving them. Participants responded on five‐point Likert scales and selected side effects of concern. Results: Participants responding were 248 of 299 (83%, Royal Brisbane and Women's Hospital), 56 of 106 (53%, Caboolture Hospital) and 17 (Redcliffe Hospital, denominator not recorded). Of 183 (57%) receiving antibiotics, 134 (73%) received them pre‐delivery only, 18 (10%) post‐delivery only and 31 (17%) pre‐ and post‐delivery. Pre‐delivery, the most common indication was pre‐incisional prophylaxis for caesarean delivery (93 of 160 responses, 58%). Seventy‐nine (51%, 156 responses) of those receiving pre‐delivery antibiotics were aware. Of 49 women receiving post‐delivery antibiotics, 36 (73%) were aware. Most agreed they were worried that pre‐delivery antibiotics would affect their baby (198, 62%) and 160 (50%) were concerned about effects on their own microbiome. Most (204, 65%) agreed they would rather not take antibiotics while breastfeeding. Conclusion: Many women were unaware of receiving pre‐delivery antibiotics. Most had concerns about side effects. Improved communication regarding peripartum antibiotic use would improve patient‐centred care. [ABSTRACT FROM AUTHOR]

Sports participation is an important goal for children with cerebral palsy classified at GMFCS Level I or II, however there are no studies of parent or physiotherapist perspectives on effectiveness or overall acceptability of transition-to-sports interventions. Parent and physiotherapist perspectives of Sports Stars: a novel, practitioner-led, peer-group sports intervention (Trial registration: ACTRN12617000313336) were collected from Sports Stars Session Reports (39 children, 6–12 years, GMFCS I = 11, II = 28, Female = 12), Fidelity Evaluations (28 children), and Perspectives Surveys (Parents = 29, female = 26; Physiotherapists = 8, female = 5). Outcomes were perceived impact on: (1) sports Participation (Attendance, Involvement), (2) sports Activity Competence across Physical, Social, Cognitive and Psychological Physical Literacy domains and (3) overall acceptability. Over 84% of children Attended most sessions. Physiotherapists rated session Involvement as high (median = 3/4). In Session Reports, physiotherapists recorded quantitative improvements in Physical and Cognitive performance and described improvements across all domains. Parents reported improvements across all domains, with comments focusing on Social and Psychological performance. All physiotherapists (8/8) and most parents (26/29) reported a community-based peer-group was the intervention design of choice for sports-focused goals. Parents and physiotherapists perceived Sports Stars, a practitioner-led, peer-group sports intervention, as effective and acceptable for children with cerebral palsy with sports-focussed goals. Parents and physiotherapists agree that Sports Stars improved sports Participation and Physical, Social, Psychological and Cognitive Activity Competence for children with cerebral palsy. Children with sports-focused goals should be offered practitioner-led, peer-group sports interventions in community environments. Therapists should design sports interventions with Physical, Cognitive, Social and Psychological content and outcomes. [ABSTRACT FROM AUTHOR]

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

Objective: Speech pathology has a history of low public awareness and in the absence of current research it is unclear if community awareness has changed in recent years. This study sought to explore a regional community's awareness of speech pathology as the impetus for considering future directions pertaining to awareness and understanding of the scope of practice of this profession. Design: An anonymous online survey was created using questions from previously validated surveys on this topic, and then distributed via snowball sampling using social media. Setting: Data are from residents of the Central Queensland community in Australia. Participants: Two hundred and seven adults who live in Central Queensland completed the survey. Main outcome measures: Comparisons were drawn between the responses from this survey to those from earlier studies. Results: The majority of respondents had heard of speech pathology mostly due to personal contact, but they indicated that they did not know 'a lot' about speech pathology. Knowledgeable individuals had higher levels of education and were better able to identify speech pathologists' scope of practice. Personal contact with a speech pathologist also significantly contributed to self‐rated knowledge and accurate identification of scope of practice of speech pathologists. Conclusion: While regional Central Queensland community members have heard of speech pathology, their self‐reported knowledge of the profession continues to be low. In order to optimise service access and consumer outcomes it is recommended that the profession aims to improve community awareness of speech pathology. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Health consciousness highlights the readiness of individuals to undertake health actions and take responsibility for their health and the health of others. AIM: To examine the health consciousness of Australians and its association with health status, health-care utilisation and sociodemographic factors. METHODS: This quantitative cross-sectional study was a part of a larger project aiming to engage the general public in health-care decision-making. Adults from Queensland and South Australia (n = 1529) were recruited to participate by a panel company. The questionnaire included the Health Consciousness Scale (HCS), health status, health-care utilisation, sociodemographic and socioeconomic variables. RESULTS: The health consciousness of Australians was relatively low (mean score = 21), compared to other international administrations of the HCS, and further investigations revealed that more health-conscious people tended to live in South Australia, be female and single, experience poorer physical and mental health and were more frequent users of health-care services. DISCUSSION: The general approach to health in this sample of the Australian public may reflect 'here and now' concerns. It appears that an attitude of 'she'll be right, mate' prevails until a change in an individual's health status or their exposure to the health system demands otherwise. These findings need to be investigated further to see if they are confirmed by others and to clarify the implications for primary health programmes in Australia in redressing the public's apparent apathy. [ABSTRACT FROM AUTHOR]

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

Aim: The aim of this study was to assess the test–retest reliability, relative validity and responsiveness to change of a 20‐item fat and fibre behaviour questionnaire (FFBQ) compared with a semi‐quantitative food frequency questionnaire (FFQ). Methods: Four hundred thirty‐four primary care patients with type 2 diabetes and/or hypertension were randomised to lifestyle intervention or usual care. Data (FFBQ and FFQ) were collected at baseline and 4 months follow‐up. A subset of usual care participants (n = 27) completed the FFBQ 2 weeks after baseline. FFQ‐measured nutrients included total and saturated fat (percentage of energy; energy‐adjusted grams) and fibre (crude grams; energy‐adjusted grams). The FFBQ was scored as a total, fat and fibre index. Test–retest reliability was assessed by intra‐class correlations (ICCs); relative validity by Pearson's correlations between the FFBQ and FFQ; and responsiveness (mean change in intervention group divided by SD of usual care group change). Results: Test–retest ICCs (95% CI) were 0.87 (0.62, 0.95) for total index, 0.87 (0.69, 0.95) for fat index and 0.89 (0.69, 0.95) for fibre index. Pearson's correlations for fat index ranged from −0.50 to −0.54, and for fibre index from 0.42 to 0.56. Total index had correlations of 0.5–0.6 (or −0.5 to −0.6) with all FFQ‐measured nutrients except crude fibre. The fat index showed similar responsiveness compared with FFQ‐measured fat intake while the fibre index was significantly more responsive than FFQ‐measured fibre. Conclusions: The FFBQ may provide a suitable alternative or adjunct to FFQs for use in intervention trials in adults with chronic diseases, because of its ability to detect changes in dietary behaviours. [ABSTRACT FROM AUTHOR]

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

BackgroundThere is a growing body of literature investigating the efficacy of music interventions for children with autism spectrum disorder (ASD); however, little empirical research has been conducted into the use of musical elements to facilitate language learning. MethodsThis crossover-design study compared the responses of 22 children with ASD (Mage = 5.88 years) to sung and spoken instructions embedded into a computer-based communication intervention designed to teach receptive labelling. ResultsThere was no significant difference between the sung and spoken conditions. Following both conditions, there was a significant increase in receptive labelling skills; skills were generalised and were maintained at follow-up. A difference in group performance was found. ConclusionFurther research is required to investigate child characteristics that may impact on children's performance using this approach. [ABSTRACT FROM AUTHOR]

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

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

Governments are challenged by the need to ensure that ageing populations stay active and engaged as they age. Therefore, it is critical to investigate the role of mobility in older people's engagement in out-of-home activities, and to identify the experiences they have within their communities. This research investigates the use of transportation by older people and its implications for their out-of-home activities within suburban environments. The qualitative, mixed-method approach employs data collection methods which include a daily travel diary (including a questionnaire), Global Positioning System (GPS) tracking and semi-structured interviews with older people living in suburban environments in Brisbane, Australia. Results show that older people are mobile throughout the city, and their car provides them with that opportunity to access desired destinations. This ability to drive allows older people to live independently and to assist others who do not drive, particularly where transport alternatives are not as accessible. The ability to transport goods and other people is a significant advantage of the private car over other transport options. People with no access to private transportation who live in low-density environments are disadvantaged when it comes to participation within the community. Further research is needed to better understand the relationship between transportation and participation within the community environment, to assist policy makers and city and transportation planners to develop strategies for age-friendly environments within the community. [ABSTRACT FROM AUTHOR]

The purpose of the study was to inform policy for reform in nursing. A survey mailed to members of the Queensland Nurses' Union four times between 2001 and 2010 elicited views on their employment and working conditions, professional development and career opportunities. Results across years and sectors of nursing consistently showed dissatisfaction in many aspects of employment, particularly by nurses working in aged care. However, views on staffing numbers, skill mix, workload, work stress, pay and staff morale all showed significant improvements over the decade. For example in 2001, 48.8% of nurses believed that their pay was poor, whereas in 2010, this had reduced to 35.2%. Furthermore, there was a significant rise throughout the decade in the opinion of the value of nursing as a good career. In light of the need to address nurse workforce shortages, the trends are encouraging; however, more improvements are required in order to support recruitment and retention. [ABSTRACT FROM AUTHOR]

Informed broadly by the theory of planned behaviour, this study used qualitative methodology to understand Australian adults' sun-protective decisions. Forty-two adults participated in focus groups where they discussed behavioural (advantages and disadvantages), normative (important referents), and control (barriers and facilitators) beliefs, as well as potential social influences and images of tanned and non-tanned people. Responses were analysed using the consensual qualitative research approach to determine the dominant themes. Themes of fashion and comfort were prominent, the important role of friends and family in sun safe decision-making was highlighted, as was the availability of sun-protective measures (e.g., in an accessible place or in the environment). Additional themes included the need to model sound sun-protective behaviours to (current and future) children, the emphasis on personal choice and personal responsibility to be sun safe, and the influence of Australian identity and culture on tanning and socially acceptable forms of sun protection. These beliefs can be used to inform interventions and public health campaigns targeting sun safety among Australians, a population with the highest skin cancer incidence in the world. [ABSTRACT FROM AUTHOR]

This study examined the extent to which young adolescent alcohol use was related to alcohol-related norms and law enforcement of underage alcohol use, after accounting for known strong parent and peer correlates. Our sample consisted of 7,674 students (X¯ age = 12 years) from 30 Australian communities. Two-level (individuals nested within communities) binary logistic regression was used to examine relationships between recent alcohol use (last 30 days) and perceived community norms about alcohol use, perceived law enforcement of underage alcohol use, parent alcohol use, parent permissiveness of adolescent alcohol use, peer alcohol use, and demographic factors. Results indicated that community norms and perceived law enforcement of alcohol use were associated with alcohol use and this association was independent of parent and peer factors. After accounting for proximal social correlates, community factors were significantly associated with alcohol use among very young adolescents. [ABSTRACT FROM PUBLISHER]

Background Nutrition supplements enriched with immune function enhancing nutrients have been developed to aid wound-healing, although evidence regarding their effectiveness is limited and systematic reviews have lead to inconsistent recommendations. The present pragmatic, randomised, prospective open trial evaluated a wound-specific oral nutrition supplement enriched with arginine, vitamin C and zinc compared to a standard supplement with respect to outcomes in patients with chronic wounds in an acute care setting. Methods Twenty-four patients [11 males and 13 females; mean (SD) age: 67.8 (22.3) years] with chronic wounds (14 diabetic or venous ulcers; 10 pressure ulcers or chronic surgical wounds) were randomised to receive either a wound-specific supplement ( n = 12) or standard supplement ( n = 12) for 4 weeks, with ongoing best wound and nutrition care for an additional 4 weeks. At baseline, and at 4 and 8 weeks, the rate of wound-healing, nutritional status, protein and energy intake, quality of life and product satisfaction were measured. Linear mixed effects modelling with random intercepts and slopes were fitted to determine whether the wound-specific nutritional supplement had any effect. Results There was a significant improvement in wound-healing in patients receiving the standard nutrition supplement compared to a wound-specific supplement ( P = 0.044), although there was no effect on nutritional status, dietary intake, quality of life and patient satisfaction. Conclusions The results of the present study indicate that a standard oral nutrition supplement may be more effective at wound-healing than a specialised wound supplement in this clinical setting. [ABSTRACT FROM AUTHOR]

Aims Structural equation modelling tested hypothesized causal relationships between age, gender, pain, depression, self-efficacy, outcome expectations, functional status and quality of life in older Australians postorthopaedics surgery across three stages of their rehabilitation. Background Self-efficacy is important in forming personal beliefs about capabilities to perform functional activities, which is believed to maintain individual's quality of life. Research examining how efficacy beliefs influence functional status in older people following orthopaedic events is limited. Design A descriptive, longitudinal method was used for this study. Methods A convenience sample of 101 older people with orthopaedic surgery to lower extremities was recruited from private rehabilitation units in Brisbane, Australia. Data were collected from September 2008-November 2009. Standardized questionnaires were used to measure efficacy beliefs, functional status, and quality of life. Results Structural equation modelling revealed that depression, efficacy beliefs, age, and gender significantly influenced quality of life, as self-efficacy and gender have a direct relationship on functional status. Across three stages in the model, outcome expectation at stage 2 was the most significant predictor of functional recovery after discharge. Older men with higher quality of life at admission was positively related to self-efficacy and negatively associated with depression at stage 2: quality of life influenced outcome expectations and pain positively at stage 3. Conclusion Rehabilitation programmes play a significant role in assisting older people in resuming functional activities and quality of life following orthopaedic surgery. Enhancing self-efficacy may facilitate older people's participation and adher-ence to rehabilitation programmes during hospitalization and following discharge. [ABSTRACT FROM AUTHOR]

Aims To test a model that delineates advanced practice nursing from the practice profile of other nursing roles and titles. Background There is extensive literature on advanced practice reporting the importance of this level of nursing to contemporary health service and patient outcomes. Literature also reports confusion and ambiguity associated with advanced practice nursing. Several countries have regulation and delineation for the nurse practitioner, but there is less clarity in definition and service focus of other advanced practice nursing roles. Design A statewide survey. Methods Using the modified Strong Model of Advanced Practice Role Delineation tool, a survey was conducted in 2009 with a random sample of registered nurses/midwives from government facilities in Queensland, Australia. Analysis of variance compared total and subscale scores across groups according to grade. Linear, stepwise multiple regression analysis examined factors influencing advanced practice nursing activities across all domains. Results There were important differences according to grade in mean scores for total activities in all domains of advanced practice nursing. Nurses working in advanced practice roles (excluding nurse practitioners) performed more activities across most advanced practice domains. Regression analysis indicated that working in clinical advanced practice nursing roles with higher levels of education were strong predictors of advanced practice activities overall. Conclusion Essential and appropriate use of advanced practice nurses requires clarity in defining roles and practice levels. This research delineated nursing work according to grade and level of practice, further validating the tool for the Queensland context and providing operational information for assigning innovative nursing service. [ABSTRACT FROM AUTHOR]

Objectives:This Australian study examined individual experiences of the implementation of the Capabilities Model of Dementia Care (CMDC) and subsequent outcomes for the care of residents with dementia living in long-term care. Furthermore, this study aimed to explore those factors that facilitated and inhibited the implementation of the new model of care. Methods:The CMDC was developed and then tested in a non-randomised clinical trial. Staff, residents and family experiences of their involvement and perceptions of the model were captured at the end of 12 months. Semi-structured interviews and focus groups were conducted with the 25 participants (12 nursing staff, 6 residents with dementia, 7 family members). Questions varied depending on the participant group but were designed to assess experiences of and changes to care during the intervention. Inductive thematic analysis was used to identify the experiences of the implementation of the CMDC. Results:Five themes included: general reflections on nursing care, implementation of the CMDC intervention, positive outcomes of the CMDC intervention, challenges in the implementation of the CMDC, difficulty sustaining care and tensions between participants’ perspectives of care. Conclusion:Positive change resulted from implementation of the CMDC, however, staff mentorship was identified as a key to sustaining changes in practice. [ABSTRACT FROM PUBLISHER]

Objectives The present study examined junior residents' and registrars' preparedness to prescribe in an Australian ED. It measured the medication knowledge of participants and identified antecedent factors relevant to prescribing practice. Methods This is a prospective, exploratory study of the prescribing practices of 40 junior doctors. Data collection consisted of a participant questionnaire with three parts. Part A comprised demographic information; Part B comprised questions regarding prescribing practices; and Part C was an objective assessment of the doctor's knowledge of the most recently and most commonly prescribed medications. Results One hundred percent ( n = 40) of doctors in the study had inadequate knowledge about at least one medication when an accuracy threshold of <80% correct was used. Seventy percent ( n = 28) of the participants had inadequate knowledge of at least one medication when the lower accuracy threshold of <50% correct was used. Comparisons between medication knowledge score and Likert confidence scales showed that even though a doctor reported being completely sure about an individual medication, they most commonly only answered between four and six of the eight questions correctly for that medication. Their use of reference materials was also lacking in relation to their knowledge and level of confidence. The reported reasons for this included instructions by senior staff and time constraints. Conclusions The majority of participants in the study had inadequate knowledge on medications they had most recently prescribed and medications most commonly prescribed in the ED. Junior doctors' perceptions of their medication knowledge were inflated in relation to their actual knowledge. [ABSTRACT FROM AUTHOR]

Background: Changes in the roles of the contemporary pharmacist has seen a decline in the number and variety of extemporaneously compounded dosage forms. Pharmacy curricula reflect this change with a reduction in the emphasis on extemporaneous compounding practice. Aim: To elicit information about extemporaneously compounded dosage forms and perceptions of compounding practice from pharmacists and pharmacy students. Method: Self-administered surveys were mailed to 1063 pharmacists and offered online to 896 pharmacy undergraduates across the 4 years of a Bachelor of Pharmacy program in Queensland. Results: 382 (36%) pharmacists and 455 (51%) students completed the survey. Most pharmacists (96%) reported compounding a product in the 12 months prior to the survey, particularly semi-solids (89%) and liquids (64%) for external use. Most pharmacies (> 96%) owned basic compounding equipment, such as a slab and spatula, mortar and pestle, and cylindrical/conical measures. Half of the pharmacies used mechanical rather than electronic balances. Students expressed greater confidence in their ability to use basic compounding equipment and to perform basic compounding tasks as they progressed through the 4-year degree course. Pharmacists' views on students' ability to compound basic products at the end of their degree were generally similar to the proportion of final-year students who reported they could confidently complete the task. Conclusion: Despite a decline in extemporaneously compounded products in community pharmacy, pharmacy graduates need to be competent in compounding techniques. [ABSTRACT FROM AUTHOR]

moyle w., murfield j.e., griffiths s.g. & venturato l. (2012) Assessing quality of life of older people with dementia: a comparison of quantitative self-report and proxy accounts. Journal of Advanced Nursing 68(10), 2237-2246. Abstract Aims. This article reports on a study of quality of life of older people with dementia, as assessed by the person with dementia, family carer and care staff. Background. People with dementia can give meaningful assessments of their quality of life, but these often differ from proxy ratings. In understanding this discrepancy, the influence of age, extent of cognitive impairment and activity limitation has been investigated. A lack of conclusive associations between quality of life ratings and these variables indicates a need for further research. Methods. Fifty-eight triads comprising the person with dementia, family carer and member of care staff from four long-term care facilities were surveyed on the Quality of Life-Alzheimer's Disease questionnaire between August and December 2007. Results. There was an important difference in the Quality of Life-Alzheimer's Disease questionnaire total mean scores between groups, with the person with dementia providing the highest ratings. Level of impairment in Activities of Daily Living had an important effect on quality of life ratings, with proxies, particularly care staff, providing lower ratings when there was greater activity limitation. This was not replicated for assessments made by the person with dementia. Age or level of cognitive impairment did not influence any ratings. Conclusion. People with dementia can give assessments of their quality of life. However, discrepancy in ratings, with greater activity limitation affecting proxy ratings but not those made by the person with dementia, indicates the importance of including both self-report and proxy measures in research and care planning. [ABSTRACT FROM AUTHOR]

finlayson k., edwards h. & courtney m. (2011) Relationships between preventive activities, psychosocial factors and recurrence of venous leg ulcers: a prospective study. Journal of Advanced Nursing 67(9), 2180-2190. Abstract Aim. The aim of this study was to identify relationships between preventive activities, psychosocial factors and leg ulcer recurrence in patients with chronic venous leg ulcers. Background. Chronic venous leg ulcers are slow to heal and frequently recur, resulting in years of suffering and intensive use of healthcare resources. Methods. A prospective longitudinal study was undertaken with a sample of 80 patients with a venous leg ulcer recruited when their ulcer healed. Data were collected from 2006 to 2009 from medical records on demographics, medical history and ulcer history; and from self-report questionnaires on physical activity, nutrition, preventive activities and psychosocial measures. Follow-up data were collected via questionnaires every 3 months for 12 months after healing. Median time to recurrence was calculated using the Kaplan-Meier method. A Cox proportional-hazards regression model was used to adjust for potential confounders and determine effects of preventive strategies and psychosocial factors on recurrence. Results. There were 35 recurrences in a sample of 80 participants. Median time to recurrence was 27 weeks. After adjustment for potential confounders, a Cox proportional hazards regression model found that at least an hour/day of leg elevation, 6 or more days/week in Class 2 (20-25 mmHg) or 3 (30-40 mmHg) compression hosiery, higher social support scale scores and higher General Self-Efficacy scores remained significantly associated ( P < 0·05) with a lower risk of recurrence, while male gender and a history of deep vein thrombosis remained statistically significant risk factors for recurrence. Conclusion. Results indicate that leg elevation, compression hosiery, high levels of self-efficacy and strong social support will help prevent recurrence. [ABSTRACT FROM AUTHOR]