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Objective To examine the association between residential remoteness and stage of cancer at diagnosis, treatment uptake, and survival within the Australian Indigenous population. Design Systematic review and matched retrospective cohort study. Setting Australia. Participants Systematic review: published papers that included a comparison of cancer stage at diagnosis, treatment uptake, mortality and/or survival for Indigenous people across remoteness categories were identified (n = 181). Fifteen papers (13 studies) were included in the review. Original analyses: new analyses were conducted using data from the Queensland Indigenous Cancer Study (QICS) comparing cancer stage at diagnosis, treatment uptake, and survival for Indigenous cancer patients living in rural/remote areas (n = 627, 66%) and urban areas (n = 329, 34%). Main Outcome Measures Systematic review: Papers were included if there were related to stage of disease at diagnosis, treatment, mortality and survival of cancer. Restrictions were not placed on the outcome measures reported (e.g. standardised mortality ratios versus crude mortality rates). Original analyses: Odds ratios (OR, 95%CI) were used to compare stage of disease and treatment uptake between the two remoteness groups. Treatment uptake (treated/not treated) was analysed using logistic regression analysis. Survival was analysed using Cox proportional hazards regression. The final multivariate models included stage of cancer at diagnosis and area-level socioeconomic status (SEIFA). Results Existing evidence of variation in cancer outcomes for Indigenous people in remote compared with metropolitan areas is limited. While no previous studies have reported on differences in cancer stage and treatment uptake by remoteness within the Indigenous population, the available evidence suggests Indigenous cancer patients are less likely to survive their cancer the further they live from urban centres. New analysis of QICS data indicates that Indigenous cancer patients in rural/remote Queensland were less likely to be diagnosed with localised disease and less likely to receive treatment for their cancer compared to their urban counterparts. Conclusion More research is needed to fully understand geographic differentials in cancer outcomes within the Indigenous population. Knowing how geographical location interacts with Indigenous status can help to identify ways of improving cancer outcomes for Indigenous Australians. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to determine the clinical activity profile of preregistration physiotherapy students during clinical placements and their clinical activity contribution to health service delivery. Methods: Clinical activity data for 2014 were obtained from five Queensland public sector hospitals providing preregistration physiotherapy students clinical education in three key clinical areas (cardiorespiratory, musculoskeletal and neurological) over four 5-week placement blocks. Data regarding the number of student occasions of service (OOS) and the length of the OOS (LOOS) were collected to determine the average OOS and LOOS per student in each clinical area. Results: Twenty weeks of student data were collected from each hospital in each clinical area, representing 29.1% of cardiorespiratory, musculoskeletal and neurorehabilitation student placements. Students completed 19 051 OOS. The average OOS per student per block for cardiorespiratory, musculoskeletal and neurorehabilitation placements was 98.3, 74.0 and 72.4 respectively. Two-way ANOVA revealed a main effect of weeks (F = 402.1, P < 0.001) and clinical area (F =1331.5, P < 0.001) for LOOS.In addition, an interaction was found between clinical placement week and clinical area for LOOS (F = 8.4, P < 0.001). Conclusions: Student clinical activity data are useful for understanding the student contribution to health services. Student contribution appears to increase throughout the clinical placement and consideration should be given to the clinical educator : student ratio to enhance overall student contribution. What is known about the topic?: Quantitative data describing physiotherapy student clinical care activity during placements are limited. What does this paper add?: This paper profiles physiotherapy student clinical care activity and the changes occurring over 5-week placements. What are the implications for practitioners?: Physiotherapy students provide clinical activity for health services that changes over their 5-week placement. Student clinical activity should be considered when responding to placement demand and planning service delivery. [ABSTRACT FROM AUTHOR]

Aims and objectives To determine presence of clinical complications related to dysphagia and to explore their operational outcomes. Background Dysphagia is a common complication of stroke. The management of poststroke dysphagia is multidisciplinary with nurses playing a key role in screening for dysphagia risk, monitoring tolerance of food and fluids and checking for the development of complications such as fever, dehydration and change in medical status. Dysphagia often results in further complications including aspiration pneumonia and the need for nasogastric feeding. Dysphagia-related complications have been shown to have a significant impact on morbidity and mortality, length of stay and cost of admission. Design Retrospective cohort study. Methods A total of 110 patients presenting with an ischaemic stroke were chart-audited. Results Aspiration pneumonia poststroke was found to be significantly associated with increased overall length of stay, poorer functional outcomes poststroke as well as being associated with a high risk of mortality. The presence of a nasogastric tube was also associated with reduced functional outcomes poststroke and increased risk of death. Conclusion High prevalence and cost of complications associated with stroke highlight the complexity of providing nursing and allied health care to this patient population. This provides a snapshot of dysphagia-related complications experienced by stroke patients. Relevance to clinical practice This paper highlights that poststroke complications can significantly impact on patient outcomes and operational factors such as cost of admission; therefore, poststroke care requires a multidisciplinary approach to management. Furthermore, preventing and managing complications poststroke is a key element of nursing care and has the potential to significantly reduce incidence of mortality, length of stay and cost of hospital admission. [ABSTRACT FROM AUTHOR]

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

There has been much talk in sociological circles of bodies as 'projects' or 'choices,' but surprisingly little examination of how these projects and choices are experienced. Consumer culture has been described as heralding a new era in body-self relations, but few have explored the experience of body-self relations. Body-self relations emerged as central to understanding in this study of the experience of the body at different ages (20-30, 45-55 and 70+ years), demonstrating the utility of empirical investigations in this area. This paper describes an orientation to the body that was common to the sample of 20 young people (aged 20-30 years) interviewed as part of this study. This orientation informed their health-related behaviours such as diet and exercise, but some participants found it to be problematic. Their voices demonstrate that bodily 'choices' may actually be experienced as irrational and even psychopathological compulsions. This experiential perspective suggests that normality may be continuous with pathology, and that differences are of degree rather than kind. The findings have implications for the treatment and prevention of eating disorders and obesity. [ABSTRACT FROM AUTHOR]

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

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

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

Tuckett A, Hegney D, Parker D, Eley RM, Dickie R. International Journal of Nursing Practice 2011; 17: 444-454. The top eight issues Queensland Australia's aged-care nurses and assistants-in-nursing worried about outside their workplace: A qualitative snapshot The attainment of a work-life balance is an important issue for recruitment, retention and workforce planning. This paper aims to report on the free text data provided by the aged-care sector nurses around perceptions of important work-life issues. Data were written responses of aged-care nurses to the open-ended request at the end of a survey, which asked them to list up to five political/social/environmental issues concerning them outside of their work. For aged-care nurses, when asked to list political/social/environmental issues they were concerned about outside of work in late 2007, there emerged considered issues around work and life. Among the top eight themes there is an intriguing balance between the themes work, industrial relations, aged care/elder care and health-care services compared with the themes environment, water, societal values and housing. Qualitative insights into the political/social/environmental issues aged-care nurses are concerned about outside of your work suggest their desire for a labour/life or work/life harmony. Aged-care nurses place an equal importance on the nature of labour and the basics of life. The findings provide information for aged-care sector managers and workforce planners on areas in need of consideration to recruit and retain a workforce within aged care. [ABSTRACT FROM AUTHOR]

chang a.m., gardner g.e., duffield c. & ramis m.-a. (2010) A Delphi study to validate an Advanced Practice Nursing tool. Journal of Advanced Nursing 66(10), 2320–2330. Aim. This paper is a report of a study conducted to validate an instrument for measuring advanced practice nursing role delineation in an international contemporary health service context using the Delphi technique. Background. Although most countries now have clear definitions and competency standards for nurse practitioners, no such clarity exists for many advanced practice nurse roles, leaving healthcare providers uncertain whether their service needs can or should be met by an advanced practice nurse or a nurse practitioner. The validation of a tool depicting advanced practice nursing is essential for the appropriate deployment of advanced practice nurses. This paper is the second in a three-phase study to develop an operational framework for assigning advanced practice nursing roles. Method. An expert panel was established to review the activities in the Strong Model of Advanced Practice Role Delineation tool. Using the Delphi technique, data were collected via an on-line survey through a series of iterative rounds in 2008. Feedback and statistical summaries of responses were distributed to the panel until the 75% consensus cut-off was obtained. Results. After three rounds and modification of five activities, consensus was obtained for validation of the content of this tool. Conclusion. The Strong Model of Advanced Practice Role Delineation tool is valid for depicting the dimensions of practice of the advanced practice role in an international contemporary health service context thereby having the potential to optimize the utilization of the advanced practice nursing workforce. [ABSTRACT FROM AUTHOR]

This paper reports the reanalysis of data collected in a study of 3 determinants of classroom environment (viz. year level, subject, and school type) using multivariate analysis of variance and multilevel analysis. Data were collected from 2,211 students in Queensland Catholic and government schools. The Catholic School Classroom Environment Questionnaire, which assesses student affiliation, interactions, cooperation, task orientation, order and organisation, individualisation, and teacher control, was administered to the sample. The original multivariate analyses which used the class as the unit of analysis were supplemented by similar analyses using the student as the unit of analysis and multilevel analyses. While multilevel analyses yielded tests of significance results similar to multivariate analyses conducted with the class as the unit of analysis, effect sizes for the multilevel analyses were similar to those reported for multivariate tests conducted with the student as the unit of analysis. [ABSTRACT FROM AUTHOR]

This paper examines the influence which participants’ task strategy has on directional control–response compatibility. Two experiments are reported in which participants were grouped according to the strategies they reported using while driving a simulated analogy of an underground coal mine shuttle car. In Experiment 1, compatibility effects were found for participants who reported adopting the wheel-referenced instruction. No reaction time compatibility effects were observed for participants who adopted a rule-based strategy for all trials. Participants were given rule-based instruction in Experiment 2. Seven participants followed the instruction, and no reaction time compatibility effect was observed. However, 15 participants reported adopting a wheel-referenced strategy during ‘compatible’ trials, and directional compatibility effects were found. In summary, regardless of the instructions provided during experimental situations, individuals may identify action features which they consider helpful in achieving the task goal, and these different strategies influence directional control–response compatibility. [ABSTRACT FROM PUBLISHER]

Intervention to improve educational attainment for children in out-of-home care is increasingly being recognized as important for their well-being and future opportunities. This paper reports on a mixed method study of the school engagement or connectedness of young people in care. The study comprised a survey of 202 young people in care in Queensland, Australia, and a matched comparison group of young people not in care, plus interviews with a subset of 65 young people in care who were surveyed. Both the school environment and the perceived levels of support influenced school engagement, with those who were assisted by carers and caseworkers more likely to be positively connected with school. These young people perceived education as a pathway to achieving work and life goals. The findings suggest that active and focused attention on young people's school engagement should be part of case planning and monitoring as it offers an additional strategy for improving their educational experience. [ABSTRACT FROM AUTHOR]

Objective. Telehealth has for many years been identified as a potential contributor to reducing healthcare access inequality. For these benefits to be realised, patients must be accepting and satisfied with the delivery of healthcare in this manner. Measuring patient satisfaction across a large geographical area is important to ensure that investments in telehealth are delivering the benefits that are intended. Methods. A brief survey was automatically issued on completion of a patient's telehealth appointment, requesting patient feedback on their experience and information on the location of where they participated in the appointment. These results were compared to an article review which sought examples of other patient satisfaction measures that compared rural and urban populations. Results. No significant correlations between survey responses and established demographic indices were found. When stratified by the Modified Monash Model band from which the patient participated in their telehealth appointment from, an ANOVA test determined that rurality was not a predictor of survey response. A review of articles found four articles that compared rural and urban satisfaction responses. Conclusion. No evidence of a patient's location influencing their satisfaction with telehealth was observed. This may be attributed to a variety of technical improvements introduced over the past 5-10 years that have made participating in telehealth appointments less technically demanding and more accessible. Telehealth is likely to be contributing to a reduction in healthcare access inequality in Queensland. [ABSTRACT FROM AUTHOR]

Objective. This paper describes the effects of a maternity consumer representative training program on participants' confidence to fulfil this role and engagement in representative activities. Methods. The present study was a descriptive, pre-post evaluation design with a 3-month follow-up. Fifty-eight people completed the program and 55 agreed to participate in the evaluation. Participants completed questionnaires to assess confidence to undertake consumer representative roles and reported on their engagement with consumer activities. Results. Participants' perceived confidence to function in the role of consumer representative differed significantly before and after the workshop (F(2,18) = 7.057, P < 0.001), as did confidence in decision making (F (2,16) = 7.615, P = 0.005), confidence in negotiating outcomes and liaising with key people (F(2,18) = 7.154, P = 0.005), and confidence in making use of relevant networks (F (2,18) = 4.319, P = 0.029). There was a decline in confidence at 3 months, with confidence at this time no longer significantly different from that at the time of recruitment. Engagement with consumer organisations increased by 45% compared with rates at commencement of the project. Conclusions. The program enhanced participants' confidence to fulfil a maternity consumer representative role but was not sustained. Further research is needed as to how to best support maternity consumer representatives and assess their contribution to promoting woman-centred care. [ABSTRACT FROM AUTHOR]

This paper describes a research-driven initiative aimed at enhancing the emergent literacy skills of students (aged 4;7-5;6 years) from low socioeconomic, culturally diverse backgrounds attending their first (prep) year at a public metropolitan primary school in Queensland. All students (n = 63) from the three prep classes were exposed to their regular classroom literacy curriculum; students in one class received an additional 15 weeks of targeted intervention conducted by the classroom teacher, the speech pathologist, and teacher aides. The intervention consisted of one 30-minute whole class session and one 30-minute small-group session per day, four days a week. The sessions targeted phonological awareness, vocabulary, story grammar, and sentence structure, using scripted session plans. Results indicated that prep students in all three classes made significant progress on measures of spoken language during their first year of school. Following intervention, the students in the intervention class showed greater improvement on a standardised test of phonological awareness than their peers who received regular classroom instruction. This intervention effect was not apparent for any of the other spoken language measures. Implications of the results of this pilot project for the implementation of a larger-scale intervention initiative are reported. [ABSTRACT FROM AUTHOR]

Objective. The primary aim of the present study was to identify the activities that nurses in community mental health services undertake. Method. A dataset containing records of the community and ambulatory interventions involving the nursing staff of 252 mental health facilities was analysed. Results. Nurses spend most of their time performing clinical care (78%), followed by clinical organisation (12%), mental health administration (6%) and integration activities (4%). There were minimal differences between treating units located in metropolitan, rural and remote areas in terms of the numbers of consumers receiving care, the time nurses spent with consumers, the types of nursing activities undertaken and the amounts of time spent on each of the four types of nursing activities. Conclusions. These findings suggest that nurses in mental health community settings spend more time in clinical care than nurses in other healthcare settings. What is known about the topic? Community settings are increasingly becoming the primary focus for mental health care in Australia. Nurses are providing community-based care for consumers with increased levels of acuity. There is a paucity of documented evidence about the activities nurses perform in community mental health settings. What does this paper add? This study provides a comprehensive understanding of the activities undertaken by nurses in community mental health settings. The findings presented emphasise the high proportion of clinical care performed by nurses in community mental health settings. No significant differences were noted in the provision of clinical care between metropolitan, rural and regional mental health services. What are the implications for practitioners? A comprehensive understanding of the activities of nurses in community mental health settings provides the basis for understanding the important role nursing plays in this area of care delivery. [ABSTRACT FROM AUTHOR]

Background/aim Evidence-based practice and research are beginning and endpoints on a research continuum. Progression along the continuum builds research capacity. Occupational Therapy has a low evidence base, thus, clinicians are not implementing evidence-based practice or publishing research. Barriers to implementing evidence-based practice and engaging in research include a lack of confidence. This research gauged Occupational Therapists' research experience, support needs and barriers, and compared levels of research anxiety between allied health disciplines. Methods A cross-sectional survey was sent to Health Practitioners in northern Queensland in May- June 2011. Responses about experience, support needs and barriers, between Occupational Therapists, were analysed using Chi-square 'goodness of fit' tests. Multivariate analysis compared responses between disciplines about research anxiety. This paper reports results for the subset of Occupational Therapists. Results The whole population, consisting of 152 Occupational Therapists, was sent a questionnaire, from which 86 responded. More Occupational Therapists than not had experience of evidence-based practice and less support was required, but they had little experience of producing research and required more support. The amount of support required for activities along the research continuum was inversely related to the level of experience in these tasks. Barriers included lack of staff and time. Occupational Therapists were more anxious about research (53 of 79, 67%) than all other Health Practitioner disciplines combined (170 of 438, 39%, P < 0.0001). Conclusion A cohesive strategy should focus on consolidating Occupational Therapists' evidence-based practice skills and building confidence. Clinicians wishing to engage in research need access to academic support. Academics and clinicians should work closely to produce clinically relevant research. [ABSTRACT FROM AUTHOR]

ABSTRACT Having sufficient power to detect effect sizes of an expected magnitude is a core consideration when designing studies in which inferential statistics will be used. The main aim of this study was to investigate the statistical power in studies published in the International Journal of Mental Health Nursing. From volumes 19 (2010) and 20 (2011) of the journal, studies were analysed for their power to detect small, medium, and large effect sizes, according to Cohen's guidelines. The power of the 23 studies included in this review to detect small, medium, and large effects was 0.34, 0.79, and 0.94, respectively. In 90% of papers, no adjustments for experiment-wise error were reported. With a median of nine inferential tests per paper, the mean experiment-wise error rate was 0.51. A priori power analyses were only reported in 17% of studies. Although effect sizes for correlations and regressions were routinely reported, effect sizes for other tests (χ2-tests, t-tests, ANOVA/MANOVA) were largely absent from the papers. All types of effect sizes were infrequently interpreted. Researchers are strongly encouraged to conduct power analyses when designing studies, and to avoid scattergun approaches to data analysis (i.e. undertaking large numbers of tests in the hope of finding 'significant' results). Because reviewing effect sizes is essential for determining the clinical significance of study findings, researchers would better serve the field of mental health nursing if they reported and interpreted effect sizes. [ABSTRACT FROM AUTHOR]

ABSTRACT Over the past two decades, child protection authorities internationally have begun to implement models of family participation in child protection decision-making. Debate exists about the extent to which these models promote family involvement in decision-making. While a significant body of research on family and professional experience and perceptions of models of family participation in decision-making has emerged, there has been little observational research of these approaches. In this paper, we report on observational data from 11 family group meetings (FGMs) in a child protection context in Queensland, Australia. Under Queensland child protection law, these meetings are referred to as an inclusive process for child protection decision-making and planning. We draw on observational data to analyse how family inclusion in child protection decision-making is facilitated, or limited, by the FGM process. We consider tensions in the realization of a participatory ethos in child protection services systems and discuss what practitioners can practically do to enhance family participation in child protection decision-making. [ABSTRACT FROM AUTHOR]

Aims. This paper is a report of the study of nurses' attitudes to the use of seclusion. More specifically, the aim was to address the relationship between burnout, job satisfaction and therapeutic optimism and justification of the use of seclusion. Background. Research findings demonstrate that nurses continue to view seclusion as a necessary intervention. Factors that might be associated with attitudes have not been examined. Methods. Questionnaires were distributed to nurses employed in inpatient units across eight mental health services in Queensland in 2008. Heyman Attitudes to Seclusion Survey, Elsom Therapeutic Optimism Scale, Maslach's Burnout Inventory and Minnesota Satisfaction Questionnaires were completed (N = 123). Data analysis involved descriptive statistics and Pearson product-moment correlation coefficients. Results. Most participants considered certain behaviours particularly those involving harm to self, others or to property as appropriate reasons for the use of seclusion and were consistent with their perceptions of the likely practice on their unit. An association was found between therapeutic optimism and emotional exhaustion (burnout) and justifications for the use of seclusion. Participants with higher optimism scores and lower scores for emotional exhaustion were significantly less likely to support the use of seclusion in specific situations. Conclusions. The relationship between therapeutic optimism and emotional exhaustion gives new information that might influence strategies and approaches taken with the aim of reducing seclusion use. Further research is warranted to explore these relationships and their implications. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a correlational study of the relationships between work-related injury-risk events and modifiable risk factors in a nursing population after controlling for socioeconomic factors. Background. Nurses are at high risk for work-related injury. Work-related injury is strongly influenced by psychosocial factors and physical job-related exposures, but the magnitude of effect from modifiable factors remains unclear. Method. Data were based on the Work Outcomes Research Cost-benefit survey conducted in Australia during 2005 and 2006. The study sample of 5724 represented ~14% of nurses in Queensland, Australia. Logistic regression was used to determine the magnitude of association of psychological distress (represented by the Kessler 6 score: six-item scale of psychological distress), the number of health conditions and various socioeconomic factors with work place injury. Results. High psychological distress was associated with a 5% probability of injury. As the number of health conditions increased, the probability of injury increased; 3 and ≥6 health conditions increased the chance of injury by 5% and 15% compared with no health conditions. Compared with the total sample, nurses who reported high levels of psychological distress demonstrated greater sensitivity to the number of health conditions. Computation of the marginal effects showed little difference in the likelihood of injury when the total sample was compared with nurses with <5 years of work experience. Conclusion. Effective occupational health and safety workplace programmes that target modifiable factors such as psychological distress and physical health conditions may improve the health capital of nurses and productivity levels within the profession. [ABSTRACT FROM AUTHOR]

Aims and objectives: This paper reports a study aimed at exploring the nursing practices associated with the administration of pro re nata (PRN) postoperative analgesia to children, and at gaining a preliminary understanding of the decisions that nurses make about this important intervention. Background: Nurses are responsible for assessing and administering the appropriate medication at the appropriate time to the child in pain. There was scant published research about the administration of postoperative PRN analgesia to children, or about the decision-making processes inherent in this aspect of clinical nursing care. Design: A sequential mixed methods explanatory study with two data collection phases -- quantitative followed by qualitative -- was conducted. Results: Nurses used multiple strategies to ascertain children's need for postoperative PRN analgesia, including reference to pain assessment tools, focussing on the behavioural cues of children, involving parents and children, and drawing upon personal and professional backgrounds and experience. Evaluation of the effectiveness of PRN postoperative analgesia was poorly communicated. Conclusions: Decision-making associated with the selection and administration of appropriate analgesia to children is complex. In-service education should be developed and offered to nurses working with children postoperatively to ensure the appropriate use of PRN pain relief. Relevance to clinical practice: Documentation surrounding this task is poor and needs to be addressed as a matter of urgency to ensure quality patient outcomes. [ABSTRACT FROM AUTHOR]

Objective. This paper presents the findings of research which explored how International Medical Graduates (IMGs) understand and integrate with the allied health system in relation to multidisciplinary care. Methods. An open-ended, exploratory qualitative design comprised of thirty (n = 30) open-ended, in-depth interviews with IMGs employed in a public hospital in Queensland, Australia. Results. Many IMGs have no experience with allied health support in their country of origin. Multidisciplinary collaboration is a new concept for IMGs integrating into the Australia healthcare system. Learning about the allied health system, including how to work effectively within the context of the multidisciplinary team, is an important topic that needs to be addressed as a matter of priority. Conclusions. There is a strong need to focus on improving strategies for integrating IMGs into the allied health system. In particular, IMGs require information to help them understand the roles and referral processes associated with interfacing with the allied health system. INSET: What is known about the topic?. [ABSTRACT FROM AUTHOR]

Objective: Suicide among Indigenous Australians is a well-recognized public health issue. Due to scarcity of epidemiological investigations in this area the exact size of this problem and its main characteristics remain uncertain. In this paper we present trends and methods of Indigenous suicides based on the Queensland Suicide Register for the period 1994--2007. Methods: Trends of age-standardized suicide rates were calculated for Indigenous and non-Indigenous populations. Suicide methods were compared between the two groups, with particular focus on hanging. Discriminant analysis was used to ascertain the size of under-estimation of suicide rates due to a considerable number of cases with unknown ethnicity in the Queensland Suicide Register. Results: Between 1994 and 2007, Indigenous populations had suicide rates 2.2 times higher than non-Indigenous Australians. Age-specific suicide rates for Indigenous men were highest in the 25 -- 34 age group, while in women they were highest among 15 -- 24 year olds. In children younger than 15 years, Indigenous suicide rate was almost ten times higher than of non-Indigenous counterparts. More than 90% of Indigenous suicides occurred by hanging. It was estimated that lack of information about ethnicity for 7% of suicide cases might have caused an under-estimation of Indigenous suicide mortality for 15.4% in men and 9.1% in women in the period 1994--2007. Conclusions: Suicide mortality of Indigenous Australians has reached alarming levels, particularly among youths. The unique profile of Indigenous suicides indicates the need for specifically tailored preventative programmes. [ABSTRACT FROM AUTHOR]

Australian residential aged care does not have a system of quality assessment related to clinical outcomes, or comprehensive quality benchmarking. The Residential Care Quality Assessment was developed to fill this gap; and this paper discusses the process by which preliminary benchmarks representing high and low quality were developed for it. Data were collected from all residents (n = 498) of nine facilities. Numerator-denominator analysis of clinical outcomes occurred at a facility-level, with rank-ordered results circulated to an expert panel. The panel identified threshold scores to indicate excellent and questionable care quality, and refined these through Delphi process. Clinical outcomes varied both within and between facilities; agreed thresholds for excellent and poor outcomes were finalised after three Delphi rounds. Use of the Residential Care Quality Assessment provides a concrete means of monitoring care quality and allows benchmarking across facilities; its regular use could contribute to improved care outcomes within residential aged care in Australia. [ABSTRACT FROM AUTHOR]

Purpose: To examine the response or pre- and postmatch salivary immunoglobulin A concentration ([s-IgA]) to Australian Football League (AFL) match play and investigate the acute and cumulative influence of player workload and postmatch [s-IgA] after repeated participation in AFL match play. Methods: Eleven elite AFL athletes (21.8 ± 2.4 y, 186.9 ± 7.9 cm, 87.4 ± 7.5 kg) were monitored throughout 3 matches during the preseason that were separated by 7 d. Saliva samples were collected across each AFL match at 24 h and 1 h prematch and 1, 12, 36, and 60 h postmatch to determine [s-IgA]. Global positioning systems (GPS) with integrated triaxial accelerometers were used to determine total player workload during match play. Hypothesis testing was conducted for time-dependent changes in [s-IgA] and player load using a repeated-measures ANOVA. Results: Player load during match 3 (1266 ± 124.6 AU) was significantly (P < .01) greater than in match 1 (1096 ± 115.1 AU) and match 2 (1082 ± 90.4 AU). Across match 3, [s-IgA] was significantly (P < .01) suppressed at 2 postmatch measures (12 and 36 h) compared with prematch measures (24 and 1 h), which coincided with significantly (P < .01) elevated player load. Conclusion: The findings indicate that an increase in player load during AFL preseason match play resulted in compromised postmatch mucosal immunological function. Longitudinal assessment of AFL-match player load and mucosal immunological function across the first 60 h of recovery may augment monitoring and preparedness strategies for athletes. [ABSTRACT FROM AUTHOR]

A new method to estimate design discharge quantiles is described based on converting multi-day rainfall P to flood event runoff RO, factored to generate discharge Q. The so-called PROQ transfer function is founded on simple flood volume-peak and GRADEX rainfall-runoff tanh relationships. Performance testing of PROQ, in both at-site and regional design flood contexts up to 1 in 100 annual exceedance probability, was made using south east Queensland streamgauge data. A statistical comparison against proven methods showed that the PROQ transform has significant potential as an alternative for design flood estimation. An example of how PROQ can be used within a design flood framework and recommendations for further enhancement are provided. Abbreviations: AEP: Annual exceedance probability; AMS: Annual maximum series, extracted from the flood record at a gauge site; ANOVA: Analysis of variance; ARR: Australian Rainfall and Runoff guidelines; A-S: At-site. Describes a set of methods to estimate design flood quantiles by statistical analysis of the flood record at an individual gauge site; E: Nash–Sutcliffe efficiency; FFA: Flood frequency analysis; G-B: Multiple Grubbs-Beck test recommended by ARR 2019 for low flow censoring. Used for at-site flood frequency analysis; GEV: General extreme value probability distribution; GRADEX: Gradient of extreme values. Design flood probability concept originating in France based on parallelism of rainfall and runoff quantile curves; L: Retention of rainfall within the catchment during flood event, expressed as a depth; LP3: Log Pearson 3 probability distribution; P: Rainfall depth; PRM: Probabilistic Rational Method. An ARR method for ungauged, undeveloped Australian catchments superseded in 2016; PROQ: Transfer function based on converting P to RO and then factoring RO to estimate Q; PW: Palmen and Weeks. Regional method for ungauged, undeveloped Queensland catchments developed by Palmen and Weeks (2011); R: Retention curve number. Used in probabilistic charting of design floods based on PROQ; RE: Absolute relative error; REG: Regional. Describes a set of methods to estimate design flood quantiles using information obtained from at-site analyses of several representative catchments within a region; RO: Flood event runoff depth; SR30: Strike rate of estimates within ±30% tolerance. [ABSTRACT FROM AUTHOR]

With the aim to solve long-standing problems of taxonomic delimitation within the E. obovatus species complex (E. obovatus G.Don, E. arnhemicus F.Muell., E. sp. Mt Bellenden Ker (L.J.Brass 18336) Qld Herbarium and E. coorangooloo J.F.Bailey & C.T.White), diversity and relatedness were assessed using a combined population genetics and morphometric approach among 181 and 102 individuals respectively. Simple sequence-repeat (SSR) markers were analysed with clustering methods, analysis of molecular variance (AMOVA) and STRUCTURE. The morphometric data were analysed using cluster and classification and regression tree (CART) methods. The morphometric and genetic analyses together resolve discrete groups corresponding to E. arnhemicus , E. coorangooloo , E. obovatus and E. sp. Mt Bellenden Ker. Elaeocarpus arnhemicus is clearly distinct from all other entities on most of the morphometric and genetic analyses. By contrast, E. sp. Mt Bellenden Ker and E. obovatus were not clearly separated from each other in many morphometric analyses, but can be distinguished clearly by the strongly curved pedicels in early bud and hairy ovary, and, to a lesser extent, by the frequent occurrence of two racemes per axil and cuneate leaf bases, and on the results of the genetic analyses. Elaeocarpus coorangooloo exhibits considerable genetic admixture with the other entities, but it is morphologically distinct. SSR profiles suggested that E. arnhemicus and E. obovatus may be tetraploid, whereas the other entities are diploid. This study has clarified the taxonomic limits of the currently recognised species E. arnhemicus , E. obovatus and E. coorangooloo and supports recognition of E. sp. Mt Bellenden Ker at subspecies rank, described herein as E. obovatus subsp. umbratilis Y.Baba & Crayn. A key to all taxa and revised accounts of E. arnhemicus , E. obovatus subsp. obovatus and E. coorangooloo are provided. [ABSTRACT FROM AUTHOR]

Background: While drink driving continues to be significantly more common among male drivers, there is evidence from many countries that shows a growing trend of women engaging in this risky behaviour. The aims of the current study were threefold: (i) determine to what extent a sample of women drivers reported engaging in drink driving behaviour by expanding the construct into a range of definitions, (ii) determine if there were significant differences in self-reported engagement in drink driving behaviours in accordance with hazardous drinking behaviour, and (iii) identify which situational or personal factors would increase women drivers’ likelihood to engage in drink driving through presenting a range of scenarios. Method: Data were collected using an on-line, purpose-designed survey and promoted to reach women aged 17 years and older, living in Queensland, Australia. In addition to questions relating to demographic characteristics, participants completed items relating to engagement in seven drink driving related behaviours in the previous 12-month period, hazardous drinking as measured by the Alcohol Use Disorders Identification Test, and likelihood of driving when unsure if over the legal limit for licence type across a range of scenarios manipulating different situational factors. A total of 644 valid responses were received in the two-week period the study was advertised. Results: The results demonstrate women’s self-reported engagement in drink driving behaviour ranged from 12.6% (driving when they believed they were over the legal limit) to over 50.0% (driving when unsure if over the legal limit the morning after drinking alcohol) and was significantly more likely among those who reported hazardous levels of alcohol use. Circumstances in which women reported they would drive when unsure if over the legal BAC limit were when they were a few blocks from home, if they subjectively felt they were not too intoxicated, or if they needed their car to get somewhere the next morning. Conclusion: Examining drink driving behaviour by way of responses to nuanced definitions provided valuable insight into self-reported engagement in the behaviour and highlights the usefulness of multi-measure dependent variables in order to illuminate a more accurate acknowledgement into both the type (and extent) of drink driving behaviours. [ABSTRACT FROM AUTHOR]

Both hip fractures and vitamin D (25‐hydroxyvitamin D (25‐OHD)) deficiency are more common in winter in regions with temperate climates, but few data exist for a sub‐tropical climate. In a South East Queensland tertiary hospital over a 7‐year period, there were significantly more hip fractures in winter than the other three seasons (analysis of variance P = 0.003), with associated higher frequency of 25‐OHD deficiency – 42.5% in winter compared to 28.5% in summer, odds ratio 1.86 (95% confidence interval 1.35–2.56), P = 0.0001. Seasonality of hip fracture and 25‐OHD deficiency occurs even in a sub‐tropical climate. [ABSTRACT FROM AUTHOR]

The main objective of this study is to describe incidence rates (IRs) of low-speed vehicle run-over events among children aged 0 to 14 years in Queensland, Australia, from 1999 to 2009, by Indigenous Australian status. Data on low-speed vehicle run-over events among children aged 0 to 14 years in Queensland were obtained for 11 calendar years (1999-2009) from all relevant data sources using International Classification of Diseases (ICD) codes, text description, word searches, and medical notes and were manually linked. Crude fatal and nonfatal IRs were calculated for Indigenous and non-Indigenous children; trends over time were analyzed by chi-square test for trend. Relative risks (RRs) were also calculated. Data on demographics, health service usage/outcomes, incident characteristics, and injury characteristics were obtained. Descriptive and multivariate analyses were performed in order to investigate whether these characteristics varied with Indigenous status. IRs were higher among Indigenous Australian children aged 0 to 14 years (21.76/100,000/annum) than other Australian children (14.09), for every year of the 11-year study. The age group most at risk for low-speed vehicle run-over events were young children aged 0 to 4 years, where incidence was 2.13 times greater among Indigenous Australian children (95% confidence interval [CI] = 1.67-2.71). There were no significant changes in incidence of low-speed vehicle run-overs among Indigenous Australian children for 0 to 4, 5 to 9, and 10 to 14 years or overall (0-14 years), during the 11-year study period. Over three quarters (n = 107) of low-speed vehicle run-over events involving Indigenous Australian children occurred outside of major cities (43.7% in other Australian children). These data indicate that Indigenous Australian children are at increased risk of low-speed vehicle run-over events and that characteristics of these events may vary as a function of Indigenous status. These results highlight that culturally specific interventions to reduce low-speed vehicle run-over events are required. [ABSTRACT FROM AUTHOR]

Objective: We investigated the factors influencing speech perception in babble for 5-year-old children with hearing loss who were using hearing aids (HAs) or cochlear implants (CIs). Design: Speech reception thresholds (SRTs) for 50% correct identification were measured in two conditions - speech collocated with babble, and speech with spatially separated babble. The difference in SRTs between the two conditions give a measure of binaural unmasking, commonly known as spatial release from masking (SRM). Multiple linear regression analyses were conducted to examine the influence of a range of demographic factors on outcomes. Study sample: Participants were 252 children enrolled in the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) study. Results: Children using HAs or CIs required a better signal-to-noise ratio to achieve the same level of performance as their normal-hearing peers but demonstrated SRM of a similar magnitude. For children using HAs, speech perception was significantly influenced by cognitive and language abilities. For children using CIs, age at CI activation and language ability were significant predictors of speech perception outcomes. Conclusions: Speech perception in children with hearing loss can be enhanced by improving their language abilities. Early age at cochlear implantation was also associated with better outcomes. [ABSTRACT FROM AUTHOR]

Aim: Haemophilus influenzae continues to cause invasive disease in children despite widespread Hib immunisation. The significance of non-B serotypes continues to be investigated, with evidence of increased invasive non-typeable H. influenzae (NTHi) world-wide. The aim of this study was to examine the current epidemiological and clinical features of invasive H. influenzae disease in children in Queensland, Australia.Methods: A retrospective review was performed of all cases of invasive H. influenzae disease in children <18 years of age in Queensland between January 2002 and December 2011. Cases were identified from pathology records and data requested from treating hospitals.Results: Laboratory data were obtained for 144 cases and clinical/demographic data for 123 cases. The majority (72%) of cases were children <5 years of age. Annual incidence rate for all children <5 years was 7.4/100 000, and for Aboriginal and Torres Strait Islander children <5 years was 10.2/100 000. Serotype was reported for 132 isolates, 69 NTHi and 63 encapsulated strains. The most common clinical diagnoses were pneumonia, meningitis and bacteraemia without clinical focus. Of the patients, 5 patients died, and 12 had significant morbidity at hospital discharge.Conclusions: While rates of invasive H. influenzae disease have decreased dramatically following the introduction of Hib vaccination, H. influenzae remains a cause of significant morbidity and mortality, and Aboriginal and Torres Strait Islander children remain particularly vulnerable. [ABSTRACT FROM AUTHOR]

To measure the prevalence and severity of Generalised Anxiety Disorder ( GAD), hypo- and hypercortisolaemia, and their association in a sample of prostate cancer ( PCa) patients, 97 Australian PCa patients completed a background questionnaire and the GAD-7, and provided a sample of saliva collected 30-45 min after waking. The mean GAD7 score was 9.67 ( SD = 3.09), and prevalence rates for current anxiety were higher than those reported for non- PCa males of a similar age. Mean salivary cortisol concentrations (30.78 nmol/L, SD = 13.97 nmol/L) were also higher than for age-comparative non- PCa men. There was a significant inverse correlation between GAD and cortisol ( r = −. 209, p < .05), and four subgroups of GAD-cortisol patients were able to be identified, with evidence of both hyper- and hypocortisolaemia. These findings provide initial neurobiological evidence of the chronic and profound nature of stress experienced by PCa patients, and also suggest a possible measure that might be used to identify most at-risk PCa patients. [ABSTRACT FROM AUTHOR]

Aim Spot-tests of urine pH are claimed to be an accessible biomarker of net acid excretion ( NAE), and as such, they may be able to determine changes in an individual's intake of acid- or base-forming foods. To test this hypothesis, we aimed to determine if spot-tests of urine pH could index NAE and relay the consumption of a fruit and vegetable (F&V) concentrate whilst determining this concentrate's capacity to modulate NAE. Methods In a double blind, placebo-controlled, cross-over trial, healthy adults (n = 13) were allocated by simple randomisation to receive a F&V concentrate or placebo for three days each, with diet standardised throughout. Measurements of 24-hour NAE, 24-hour urine pH and spot-tests of urine pH were taken throughout the study. Results The 24-hour urine pH predicted 24-hour NAE ( P = <0.0001). However, spot-tested urine pH displayed prediction intervals too wide to infer 24-hour NAE and inconsistent ability to reflect concentrate ingestion, despite 24-hour NAE and 24-hour urine pH decreasing (−25.8 mEq, 95% CI −44.3 to −7.4, P = 0.01, d = 0.94) and increasing (+0.51, 95% CI 0.25-0.79, P = 0.002, d = 1.3), respectively, following supplementation. Conclusions Spot-tests of urine pH are not a valid dietary biomarker of daily NAE and were unable to reliably track changes, despite a F&V concentrate clearly modulating the daily rate of NAE. [ABSTRACT FROM AUTHOR]

This study evaluated a parent-delivered social and emotional skills intervention—the Secret Agent Society (SAS) for children with high-functioning autism spectrum disorders (HF-ASD). The study was a pre–post follow-up design with an 8-week baseline period and 6-week follow-up period. Participants were 38 parents and 41 children recruited from regional/rural Queensland and metropolitan Brisbane, Australia. Child participants completed measures of social skills and emotion management, and parents completed measures related to child behavioral problems, parent self-efficacy, child anxiety, and parent emotional distress at pre-intervention, post intervention, and 6-week follow-up. Analyses of outcomes were conducted with a series of repeated-measures MANOVAs and one-way ANOVAs at post intervention and 6-week follow-up. There were significant improvements in child social skills reported by parents with gains maintained at 6-week follow-up with large effect sizes. Parent self-efficacy, child behavior, and child anxiety levels also improved significantly. In addition, outcomes from the SAS self-directed program were compared with the original clinic-based program conducted by Beaumont and Sofronoff. Results indicated greater changes in social skills outcomes in the clinic-based program and no difference between groups on emotional management strategies. The limitations of the study and clinical implications are discussed. [ABSTRACT FROM AUTHOR]

Aims and objectives This study aimed to establish the scale of alcohol-related injuries originating in the home. Background Despite recent media and public attention on alcohol-related injuries occurring at licensed venues, many occur in other locations including the home. Design A retrospective observational study. Methods Emergency department surveillance data sourced from the Queensland Injury Surveillance Unit were interrogated for alcohol-related emergency department presentations from 2003-2012 (n = 12,296). Descriptive analysis was undertaken to assess alcohol involvement in injury, and analysis of variance was used to determine the differences among group means and their associated presentations. The relationship between demographic variables and injury location was assessed using p value of <0·05 as statistically significant. Results Of all injuries that were positively identified as being alcohol related, 41·07% occurred at the 'other' location, 36·14% 'at home', 13·00% on the street and 9·78% at licensed premises. Of these, males ( n = 2635; 59%) represented a higher proportion than females ( n = 1807; 41%). Of injuries identified as domestic violence by spouse or partner ( n = 510), 59·5% occurred 'at home'. Conclusions This is the first study to investigate alcohol-related injuries occurring at home. The home accounts for a greater proportion of injuries than the frequently assessed licensed premises location. Further research is required to validate these findings in a wider setting. Relevance to clinical practice A public health campaign is required to minimise harm associated with alcohol-related injuries in the home, and nurses are positioned to inform health policy makers around this issue. Furthermore, emergency department nurses are in a unique position to provide brief interventions around safe alcohol consumption and injury prevention. [ABSTRACT FROM AUTHOR]

Aim: To examine the reproducibility in measurement of physical activity performance using the ActiGraph®GT3X+ accelerometer in children aged 8–16 years with Acquired Brain Injury (ABI). Methods: Reproducibility of standardized tasks: Thirty-two children with ABI (12 years 1 month, SD = 2 years 4 months; 20 males; Gross Motor Function Classification System I = 17, II = 15) performed the following activities on 2 consecutive days while wearing an accelerometer and a heart rate monitor: quiet sitting, slow walking (SW), moderate walking (MW), fast walking (FW) and rapid stepping on/off a block (STEP). Intra-class correlation coefficients (ICC) were calculated. Performance variability: Fifty-one participants (12 years 1 month, SD = 2 years 5 months; 27 males; GMFCS I = 26, II = 25) wore an accelerometer for 4 days in the community and reliability coefficients were calculated using standardized 12-hour time spent in moderate-to-vigorous physical activity (MVPA). Results: Test–re-test reproducibility was excellent for all activities (SW, ICC = 0.90; MW, ICC = 0.83; FW, ICC = 0.91; STEP, ICC = 0.89). Three days of monitoring produced excellent variability estimates of MVPA (R= 0.78). Conclusion: Therapists can confidently use accelerometry as a reproducible measure of physical activity under standardized walking and stepping conditions, as well as in the community for children with ABI. [ABSTRACT FROM PUBLISHER]

Background: While there is a significant focus on the health and well-being of women during pregnancy, labour and birth, much less emphasis is placed on the care of postpartum women and their infants in primary care following the birth. Some studies have investigated the role of GPs in postpartum care, and others examined facilitators and barriers to mothers accessing care. However there is little information available to investigate the effect of practice related factors on access to care of mothers and infants at this time.Methods: A 20-item questionnaire for completion by the practice managers was mailed to 497 general practices in Southern Queensland, Australia between February and July 2013. Questionnaire items included practice demographics, practice procedures and personnel including appointment scheduling, billing, practice nurse function and qualifications and a free-text option for comments. Descriptive statistics are presented as numbers and percentages. Chi Squared test compared practice location with methods of identification of postpartum women, practice size with other Queensland data and ANOVA compared practice size with the number of postpartum appointments. Logistic regression was used to predict variables that were related to booked appointment times. Free text responses were grouped in common themes.Results: The response rate was 27.4 %. At 67.2 % of the practices, mothers had to self-identify as needing a postpartum consultation and most consultations were allocated 15 minutes or less. Only 20 % of practices accepted the government insurance payment (bulk-billing) for all maternal and infant services, with more practices bulk-billing children only. Out-of-pocket expenses ranged from $10-$60. Nearly 80 % of practice nurses saw postpartum mothers or infants 'nearly always' or 'sometimes'. Approximately 30 % had midwifery or child health training. There were higher odds of longer booked appointment times for solo practitioner practices (unadj OR 3.30 95%CI 1.03-10.57), but no other variables predicted booked appointment timesConclusions: This study identified a number of practice related factors that, if addressed, could positively impact on postpartum care. These include ensuring ongoing practice relationships to assist with booking appropriate consultation times and guaranteeing that there are no financial impediments to women accessing care. Some factors can easily be adapted within practices. Others would require changes of policy at a local or national level. [ABSTRACT FROM AUTHOR]

Aim Nutrition is important for pressure ulcer prevention. This randomised control pilot study assessed the feasibility of conducting a larger trial to test the effectiveness of a patient-centred intervention for improving the dietary intakes of patients at risk of pressure ulcer in hospital. Methods A 3-day intervention targeting patients at risk of pressure ulcer was developed, based on three main foundations: patient education, patient participation and guided goal setting. The intervention was piloted in three wards in a metropolitan hospital in Queensland, Australia. Participants were randomised into control or intervention groups and had their oral intakes monitored. A subset of intervention patients was interviewed on their perceptions of the intervention. Feasibility was tested against three criteria: ≥75% recruitment; ≥80% retention; and ≥80% intervention fidelity. Secondary outcomes related to effects on energy and protein intakes. Results Eighty patients participated in the study and 66 were included in final analysis. The recruitment rate was 82%, retention rate was 88%, and 100% of intervention patients received the intervention. Patients viewed the intervention as motivating and met significantly more of their estimated energy and protein requirements over time. Conclusion This pilot study indicates that the intervention is feasible and acceptable by patients at risk of pressure ulcer. A larger trial is needed to confirm the effectiveness of the intervention in the clinical setting. [ABSTRACT FROM AUTHOR]

We compared mothers who exercised predominantly in group settings, those who exercised predominantly in individual settings, and those who exercised equally in group and individual contexts among the following: (a) satisfaction of basic psychological needs (autonomy, competence, and relatedness); (b) self-determined exercise motivation; and (c) psychological well-being. With clear implications for mothers’ exercise interventions we found that exercising either predominantly in group contexts or in mixed group and individual settings was associated with mothers having significantly higher satisfaction of basic psychological needs and self-determined exercise motivation than those exercising predominantly alone. [ABSTRACT FROM PUBLISHER]

This research provides support for a direct comparison between the home and boarding environments, the inference being that boarding staff who fulfil an in loco parentis role have an integral part to play in the developmental outcomes of adolescents (boarders). Research in the area of family functioning has found that adolescents tend to view the family environment more negatively than their parents and that these discrepant perceptions have been linked to both internalising and externalising disorders in adolescents. In an attempt to further clarify the influence of the parenting role of boarding staff and of the boarding environment in general, 121 staff and 415 boarders from schools in Queensland, Australia, were asked to rate the boarding environment on levels of conflict, social support and climate. It was found that boarders, like adolescents in the home environment, perceived significantly higher levels of conflict and lower levels of social support and positive climate than did staff. These findings lend further support to the conceptualisation of the boarding environment as a home away from home. The implications of these findings for boarders' developmental outcomes are discussed. [ABSTRACT FROM AUTHOR]

Aims and Objectives The study aims to evaluate the effects of a communication skills training programme on community aged care staff's knowledge of communication support in dementia and on staff's care experience. Background Dementia can lead to impairments in communication. Therefore, quality community-based dementia care requires that staff be skilled communicators, equipped to facilitate interactions with people with dementia. The current investigation evaluated the effectiveness of the MESSAGE Communication Strategies in Dementia for Care Staff training programme with respect to knowledge of communication support and the staff/caregiver experience. Design A multi-centre controlled pretest/post-test design with randomised cohort allocation was used. Outcome measures were completed at baseline, immediately after training (training group only), and at three-month follow-up. Methods Thirty-eight care staff working in community aged care participated and completed all outcome measures (training = 22; control = 16).Training and control groups completed the following outcome measures: knowledge of communication support strategies, self-efficacy, preparedness to provide care, strain in nursing care and attitude to dementia care. Staff in the training group provided written feedback on the training. Results A significant improvement in knowledge scores from baseline was found for the training group both immediately after training and at three-month follow-up. There was also a significant training effect for self-efficacy and preparedness to provide care. No significant difference was found for the control group for any measure. No significant training effects were found for measures of strain or attitudes to dementia care. Feedback from staff suggests that the training was well received. Conclusions The MESSAGE training was positively received by staff and had a significant effect on care staff knowledge, and confidence to provide care for people with dementia. Relevance to clinical practice The easily accessible multimedia training programme is well received by staff and has the potential to improve quality of care. [ABSTRACT FROM AUTHOR]

Depression is a potentially life threatening affective disorder that is highly prevalent in individuals with autism spectrum disorders (ASD). This study aimed to evaluate the feasibility, acceptability and preliminary efficacy of a cognitive behavioural intervention for depression in adolescents with ASD. Participants were randomly assigned to the intervention group, or wait-list control group. Although recruitment was extremely difficult, attendance was favourable and attrition was low, and participants reported being satisfied with the programme. No significant treatment effect was revealed on the Beck Depression Inventory or Emotion Regulation Questionnaire. However despite the small sample size ( n = 20), there was a trending treatment effect measured by the Depression Anxiety Stress Scale: Depression Subscale. Limitations and areas of future research are discussed. [ABSTRACT FROM AUTHOR]

Aim. To systematically evaluate the impact of several design features on chart-users' detection of patient deterioration on observation charts with early-warning scoring-systems. Background. Research has shown that observation chart design affects the speed and accuracy with which abnormal observations are detected. However, little is known about the contribution of individual design features to these effects. Design. A 2929292 mixed factorial design, with data-recording format (drawn dots vs. written numbers), scoring-system integration (integrated colour-based system vs. non-integrated tabular system) and scoring-row placement (grouped vs. separate) varied within-participants and scores (present vs. absent) varied between-participants by random assignment. Methods. 205 novice chart-users, tested between March 2011-March 2014, completed 64 trials where they saw real patient data presented on an observation chart. Each participant saw eight cases (four containing abnormal observations) on each of eight designs (which represented a factorial combination of the within-participants variables). On each trial, they assessed whether any of the observations were physiologically abnormal, or whether all observations were normal. Response times and error rates were recorded for each design. Results. Participants responded faster (scores present and absent) and made fewer errors (scores absent) using drawn-dot (vs. written-number) observations and an integrated colour-based (vs. non-integrated tabular) scoring-system. Participants responded faster using grouped (vs. separate) scoring-rows when scores were absent, but separate scoring-rows when scores were present. Conclusion. Our findings suggest that several individual design features can affect novice chart-users' ability to detect patient deterioration. More broadly, the study further demonstrates the need to evaluate chart designs empirically. [ABSTRACT FROM AUTHOR]

Animals are increasingly being used in a range of social work settings and extant research demonstrates they can offer a wide range of benefits to humans. With other professions, social work is oriented towards caring for people but does not officially recognise (non-human) animals. Given the rise in animal-related interventions and emergence of veterinary social work, we argue that this needs to change. We recognise that obstacles to change include social work's history of dichotomising (or falsely dividing) humans from animals, and focusing exclusively on human experiences of social problems (such as poverty). Using a programme example of a canine-assisted therapy project for child sexual abuse victims/survivors in Bundaberg (Central Queensland, Australia), we consider some of the ethical and practical issues associated with animal-assisted therapies (AATs). We examine whether AATs can benefit both humans and animals by positively changing people's attitudes and behaviours towards animals. We argue that the ethical legitimacy of AATs rests on their willingness to understand animals as sentient beings with needs of their own, not just possessions or tools for humans to use. [ABSTRACT FROM AUTHOR]

Objective. Intravenous thrombolysis with tissue plasminogen activator (tPA) improves patient outcomes in acute ischaemic stroke. Because its benefit is time-dependant, treatment delays must be minimised. The aim of the present study was to review patient characteristics, timeliness of tPA delivery and clinical outcome in patients receiving t-PA in a tertiary hospital stroke unit in Queensland, and to compare the findings with those of other Australian studies. Methods. The present study was a retrospective study conducted between 1 January 2010 and 31 December 2012. Information was collected regarding demographics, stroke characteristics, timeliness of tPA delivery, clinical outcome, safety outcome and protocol deviation. Results. Of 490 patients admitted with ischaemic stroke, 57 (11.6%) received tPA. Compared with other studies, the patients in the present study had more severe stroke (median National Institutes of Health Stroke Scale (NIHSS) score), more cardioembolic strokes and more patients receiving tPA between 3 and 4.5 h of symptoms onset. Median symptom onset to treatment time was 175 min and median door to needle time was 97 min. At 3 months, 21.1% of patients had died and 41.5% had a favourable outcome (modified Rankin scale≤2). Symptomatic intracerebral haemorrhage occurred in 5.3% of patients and protocol deviations occurred in 21.1%. Overall, delivery and outcomes of tPA at the Princess Alexandra Hospital were comparable to those reported in other Australian studies of usual care. Several challenges and strategies for optimal thrombolysis were identified, with supporting evidence from selected Australian sites. Conclusion. The proportion of eligible stroke patients who receive tPA in a timely manner remains less than ideal at our centre. More accurate patient selection and reductions in treatment delays serve as targets for quality improvement efforts that have broad applicability. [ABSTRACT FROM AUTHOR]

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

Aim To evaluate the effect of early-warning scoring system design on the speed and accuracy of scoring. Background Despite the widespread implementation of early-warning scoring systems in hospitals, the speed and accuracy with which chart-users determine patients' early-warning scores has received minimal research attention. Design Within-subjects, with scoring-system design as the independent variable. Methods Forty-seven novice chart-users were presented with realistic vital sign observations recorded on charts with three different scoring-system designs. The rows for recording individual vital sign scores were either: (1) grouped together beneath all of the vital sign rows; (2) separated, with each row presented immediately below the corresponding vital sign row; or (3) excluded altogether. Participants' response times and error rates for determining the overall scores were measured for 54 time-points per design. Data were collected in December 2012-January 2013. Results Contrary to predictions, participants responded fastest and made the fewest errors when using the chart design without individual vital sign scoring-rows. For the other two designs, participants were faster when the rows for scoring individual vital signs were separated (vs. grouped), but accuracy did not differ. For both of these designs, significantly more time-points were affected by scoring errors compared with adding errors. Finally, data for patients with more serious derangements yielded greater response times and error rates on all three charts. Conclusion Early-warning scoring systems may be more effective without individual vital sign scoring-rows. Even when charts are designed by multi-disciplinary teams of human factors specialists and clinicians, empirical evaluations are essential. [ABSTRACT FROM AUTHOR]