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Beliefs about the controllability and usefulness of emotions may influence successful emotion regulation across multiple emotional disorders and could thus be influential mechanisms in long-term mental health outcomes. However, to date there has been little empirical work in this area. Our aim was to fill this gap, by examining the links between emotion beliefs and common emotional disorder symptoms. Specifically, we examined whether emotion beliefs can account for significant variance in depression, anxiety, and stress symptoms, and explored which profiles of emotion beliefs might characterise each of these symptom categories. A sample of 948 Australian university students completed self-report measures of emotion beliefs and emotional disorder symptoms. A path analysis indicated that emotion beliefs accounted for a modest but significant 11%, 12%, and 9% of the variance in depression, anxiety, and stress symptoms, respectively (ps <.001). A latent profile analysis revealed six different profiles of combinations of emotion beliefs and emotional disorder symptom levels, collectively reinforcing the transdiagnostic relevance of emotion beliefs across each symptom category. Overall, our results indicate the importance of considering emotion beliefs in conceptualisations of depression, anxiety, and stress, and suggest that emotion beliefs may be a useful assessment and treatment target. What is already known about this topic: Ford and Gross's (2018, 2019) theoretical framework of emotion beliefs posits that believing positive and negative emotions are uncontrollable and useless is detrimental for emotion regulation efforts and mental health outcomes. Beliefs about emotions being uncontrollable are associated with increased emotional disorder symptoms. The limited research examining beliefs about the usefulness of emotions indicates that believing emotions are useless is also associated with increased emotional disorder symptoms. What this topic adds: This study is the first to comprehensively examine controllability and usefulness beliefs across the negative and positive valence domains. We systematically mapped the emotion belief profiles characterising depression, anxiety, and stress symptoms, and found profiles with stronger maladaptive emotion beliefs tended to have greater emotional disorder symptoms. We found that both belief categories across both valence domains are relevant to emotional disorder symptoms, but beliefs about the controllability of negative emotion were particularly important. [ABSTRACT FROM AUTHOR]

Suicide in children is a significant and growing problem. The "zero suicide" framework (ZSF) is one approach to suicide prevention used in health services for adults and children. This paper reports on the introduction of the first suicide prevention pathway (SPP) based on ZSF at a Child and Youth Mental Health Service (CYMHS) in Australia. It begins by describing the adaptations made to elements of the SPP originally designed for adults to meet the needs of children. Lessons learned in applying the SPP in the service are then discussed. The aim is to inform and improve practice in the use of zero suicide approaches in child and youth mental health settings in Australia and worldwide. [ABSTRACT FROM AUTHOR]

This article describes a review undertaken in 2012-2013 by Nutrition and Dietetics, Flinders University, to assess the Indigenous health curriculum of the Bachelor of Nutrition and Dietetics (BND) and Masters of Nutrition and Dietetics (MND). An action research framework was used to guide and inform inquiry. This involved four stages, each of which provided information to reach a final decision about how to progress forward. First, relevant information was collected to present to stakeholders. This included identification of acknowledged curriculum frameworks, a review of other accredited nutrition and dietetics courses in Australia, a review of Indigenous health topics at Flinders University, including liaison with the Poche Centre for Indigenous Health and Well-Being (Indigenous health teaching and research unit), and a review of BND and MND current curriculum related to Indigenous health. Second, input was sought from stakeholders. This involved a workshop with practising dietitians and nutritionists from South Australia and the Northern Territory and discussions with Flinders University Nutrition and Dietetics academic staff. Third, a new curriculum was developed. Nine areas were identified for this curriculum, including reflexivity, approach and role, history and health status, worldview, beliefs and values, systems and structures, relationship building and communication, food and food choice, appreciating and understanding diversity, and nutrition issues and health status. Fourth, a final outcome was achieved, which was the decision to introduce a core, semester-long Indigenous health topic for BND students. A secondary outcome was strengthening of Indigenous health teaching across the BND and MND. The process and findings will be useful to other university courses looking to assess and expand their Indigenous health curriculum.

Given the short-and long-term health implications associated with overweight and obesity plus the likelihood of overweight or obesity to continue into adulthood, addressing the causes of overweight and obesity in childhood is a significant public health concern. One underlying cause of overweight and obesity is insufficient physical activity. The Department of Health and Aging recommends children engage in at least 60 minutes of moderate to vigorous physical activity (MVPA) per day; however, these recommendations are met less frequently with increasing age, and girls less often meet these recommendations than boys. School lunch times have been identified as an ideal time for maximizing children's physical activity (PA), but studies have shown variable levels of PA among children during this time and research indicates that during school lunch times, girls are consistently less active than boys. Understanding influences on girls' participation in PA during this time may help to increase levels of PA for this demographic. Two South Australian schools, one government and one independent, were included in the sample. Four focus groups (three or four participants per group: total 13 participants) focusing on girls' perceptions of PA during the lunch break were conducted. Transcripts and field notes were analyzed using a social constructionist framework and thematic content analysis. The expectation to participate in activities considered "gender appropriate", maturation, and bullying/teasing were identified as explicit barriers to participation in lunch time play. Other important barriers included a "girls'" school uniform and feelings of inadequate competency. The ability to renegotiate gender stereotypes, a unisex school uniform, and perceived high competency were important facilitators of lunch time PA. Low levels of lunch time PA evident in many young adolescent girls may be due to many complex social factors. Therefore, these barriers may need to be addressed before any environmental interventions are likely to be effective.

Background: People with kidney failure face a multitude of psychosocial stressors that affect disease trajectory and health outcomes. Objectives: To investigate psychosocial factors affecting people with kidney failure before or at start of kidney replacement therapy (KRT) and kidney supportive and palliative care (KSPC) phases of illness and to explore role of social worker during the illness trajectory. Methods: We conducted a secondary data audit of patients either before or at start of KRT (Phase 1) and at the KSPC (Phase 2) of illness and had psychosocial assessments between March 2012 and March 2020 in an Australian setting. Results: Seventy‐nine individuals, aged 70 ± 12 years, had at least two psychosocial assessments, one in each of the two phases of illness. The median time between social worker evaluations in Phase 1 and Phase 2 was 522 (116−943) days. Adjustment to illness and treatment (90%) was the most prevalent psychosocial issue identified in Phase 1, which declined to 39% in Phase 2. Need for aged care assistance (7.6%−63%; p < 0.001) and carer support (7.6%−42%; p < 0.001) increased significantly from Phase 1 to Phase 2. There was a significant increase in psychosocial interventions by the social worker in Phase 2, including supportive counselling (53%−73%; p < 0.05), provision of education and information (43%−65%; p < 0.01), and referrals (28%−62%; p < 0.01). Conclusion: Adults nearing or at the start of KRT experience immense psychosocial burden and adaptive demands that recognisably change during the course of illness. The positive role played by the nephrology social worker warrants further investigation. [ABSTRACT FROM AUTHOR]

Nutritional deficiencies following malabsorptive surgeries are a major concern. Purpose: To present clinical-based, mid-term nutritional outcomes in single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) patients using a nutritional supplement based on the American Society for Metabolic & Bariatric Surgery (ASMBS) guidelines. Setting: Single private institute, Australia. Materials and Methods: Data from 196 patients who underwent a primary SADI-S by a single surgeon from January 2017 through March 2022 were retrospectively analysed. All patients received either original or altered formulated nutritional supplementation throughout the study. In total, three formulae, slightly different from each other, were used at three different time points to formulate the supplement. Results: In total, 196 patients were included. The average age and preoperative body mass index were 44.9 ± 6.7 years and 43.6 ± 22.5 kg/m2, respectively. Nutritional follow-up was available on 77.5%, 73.2%, 73.4%, and 59.7% of patients at 12, 24, 36, and 48 months, respectively. At baseline, 48.3%, 30%, 14.9%, 13.3%, 12.4%, 3.8%, 2.3%, and 0.5% of the patients had vitamin D, calcium, folic acid, total protein, iron, vitamin B12, copper, and vitamin A deficiencies, respectively. Postoperatively, mild to moderate vitamin deficiencies were noted in 14.2% of the patients in the first 18 months; however, at 4 years, the cohort had zero nutritional deficiencies. There were no long-term complications, revisions/conversions, or mortalities related to nutritional deficiencies. Conclusion: Factors, like preoperative and postoperative early, aggressive correction of nutritional deficiencies, regular laboratory monitoring and follow-ups with the multidisciplinary team, and adherence to our formulated nutritional supplement, have contributed to favourable nutritional outcomes at 4 years. [ABSTRACT FROM AUTHOR]

This article explores the range of intravitreal injection (IVI) practices among ophthalmologists in Australia and New Zealand. The study aimed to identify variations in IVI techniques and opportunities to reduce the consumption of supplies. The survey found that a dedicated procedure room was the most common setting for IVIs, and masks and sterile gloves were the most commonly used personal protective equipment (PPE). Chlorhexidine was the most common antiseptic agent used, and most respondents used either a custom IVI pack or a standard dressing pack. The study concludes that there is a wide range of techniques and equipment used in IVIs, and there is an opportunity for waste reduction and standardization. [Extracted from the article]

The number of people living with diabetes is expected to rise to 578 million by 2030 and to 700 million by 2045, exacting a severe socioeconomic burden on healthcare systems around the globe. This is also reflected in the increasing numbers of people with ocular complications of diabetes (namely, diabetic macular oedema (DMO) and diabetic retinopathy (DR)). In one study examining the global prevalence of DR, 35% of people with diabetes had some form of DR, 7% had PDR, 7% had DMO, and 10% were affected by these vision-threatening stages. In many regions of the world (Australia included), DR is one of the top three leading causes of vision loss amongst working age adults (20–74 years). In the management of DMO, the landmark ETDRS study demonstrated that moderate visual loss, defined as doubling of the visual angle, can be reduced by 50% or more by focal/grid laser photocoagulation. However, over the last 20 years, antivascular endothelial growth factor (VEGF) and corticosteroid therapies have emerged as alternative options for the management of DMO and provided patients with choices that have higher chances of improving vision than laser alone. In Australia, since the 2008 NHMRC guidelines, there have been significant developments in both the treatment options and treatment schedules for DMO. This working group was therefore assembled to review and address the current management options available in Australia. [ABSTRACT FROM AUTHOR]

Achondroplasia is the most common form of skeletal dysplasia. In addition to altered growth, children and young people with achondroplasia may experience medical complications, develop and function differently to others and require psychosocial support. International, European and American consensus guidelines have been developed for the management of achondroplasia. The Australian focused guidelines presented here are designed to complement those existing guidelines. They aim to provide core care recommendations for families and clinicians, consolidate key resources for the management of children with achondroplasia, facilitate communication between specialist, local teams and families and support delivery of high‐quality care regardless of setting and geographical location. The guidelines include a series of consensus statements, developed using a modified Delphi process. These statements are supported by the best available evidence assessed using the National Health and Medicine Research Council's criteria for Level of Evidence and their Grading of Recommendations Assessment, Development and Evaluation (GRADE). Additionally, age specific guides are presented that focus on the key domains of growth, medical, development, psychosocial and community. The guidelines are intended for use by health professionals and children and young people with achondroplasia and their families living in Australia. [ABSTRACT FROM AUTHOR]

Existing research has explored media planning from the perspective of integrated marketing communication (IMC) as a continuously improving strategic process used to plan and coordinate the use of paid, earned, shared, and owned (PESO) media. However, to date, the practice of integration in media planning has mostly been explored from advertising and marketing perspectives. The consideration of public relations practitioner perspectives has been limited to preferencing earned media and the pairing of complementary media types. Based on semi-structured interviews conducted with 25 public relations practitioners in Australia, nuanced perspectives on contemporary integrated practice were found. Of note, public relations practitioners' media planning choices were influenced by considerations of and consequences for stakeholders beyond consumers, which led to a risk-based mindset for some practitioners. In addition, the strength or lack of media angles and changing earned media landscape determined planning choices. Although evaluation occurred, there is room for improvement based on existing models. This study offers a public relations lens to media planning in support of ongoing, interdisciplinary integration and likewise opportunities for public relations to enhance its practice. (178 words) [ABSTRACT FROM AUTHOR]

Refugees lose their networks and support systems on their journey from their home country. In addition, they may expe‐ rience torture, trauma, and socio‐economic hardship. A critical question concerning refugee wellbeing is how refugee belonging, inclusivity, and community connectedness can be better understood, strengthened, and promoted. In this arti‐ cle, we discuss how members of the Tamil Seniors Group, supported by the NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), develop social networks in Australia. Based on two focus group discussions, this article analyses their experiences through the intersection of age and gender to elucidate the challenges and affordances of networking and establishing social relations in Australia. [ABSTRACT FROM AUTHOR]

Background: Excessive use of specialized formula for cow's milk allergy was reported in England, but complete analysis has not been undertaken and trends in other countries are unknown. Some specialized formula products, especially amino‐acid formula (AAF), have high free sugars content. We evaluated specialized formula trends in countries with public databases documenting national prescription rates. Methods: Cross‐sectional analysis of national prescription databases in the United Kingdom, Norway and Australia. Outcomes were volume and cost of specialized formula, and proportion of infants prescribed specialized formula. Expected volumes assumed 1% cow's milk allergy incidence and similar formula feeding rates between infants with and without milk allergy. Results: Prescribed volumes of specialized formula for infants rose 2.8‐fold in England from 2007 to 2018, with similar trends in other regions of the United Kingdom. Volumes rose 2.2‐fold in Norway from 2009 to 2020 and 3.2‐fold in Australia from 2001 to 2012. In 2020, total volumes were 9.7‐ to 12.6‐fold greater than expected in England, 8.3‐ to 15.6‐fold greater than expected in Norway and 3.3‐ to 4.5‐fold greater than expected in Australia, where prescribing restrictions were introduced in 2012. In Norway, the proportion of infants prescribed specialized formula increased from 2.2% in 2009 to 6.9% in 2020, or 11.2‐ to 13.3‐fold greater than expected. In 2020, specialized formula for infants cost US$117 (103 euro) per birth in England, US$93 (82 euro) in Norway and US$27 (23 euro) in Australia. Soya formula prescriptions exceeded expected volumes 5.5‐ to 6.4‐fold in England in 1994 and subsequently declined, co‐incident with public health concerns regarding soya formula safety. In 2020, 30%–50% of prescribed specialized formula across the three countries was AAF. Conclusions: In England, Norway and Australia, specialized formula prescriptions increased in the early 21st century and exceeded expected levels. Unnecessary specialized formula use may make a significant contribution to free sugars consumption in young children. [ABSTRACT FROM AUTHOR]

Background: The Zero Suicide framework is a system-wide approach to prevent suicides in health services. It has been implemented worldwide but has a poor evidence-base of effectiveness.Aims: To evaluate the effectiveness of the Zero Suicide framework, implemented in a clinical suicide prevention pathway (SPP) by a large public mental health service in Australia, in reducing repeated suicide attempts after an index attempt.Method: A total of 604 persons with 737 suicide attempt presentations were identified between 1 July and 31 December 2017. Relative risk for a subsequent suicide attempt within various time periods was calculated using cross-sectional analysis. Subsequently, a 10-year suicide attempt history (2009-2018) for the cohort was used in time-to-recurrent-event analyses.Results: Placement on the SPP reduced risk for a repeated suicide attempt within 7 days (RR = 0.29; 95% CI 0.11-0.75), 14 days (RR = 0.38; 95% CI 0.18-0.78), 30 days (RR = 0.55; 95% CI 0.33-0.94) and 90 days (RR = 0.62; 95% CI 0.41-0.95). Time-to-recurrent event analysis showed that SPP placement extended time to re-presentation (HR = 0.65; 95% CI 0.57-0.67). A diagnosis of personality disorder (HR = 2.70; 95% CI 2.03-3.58), previous suicide attempt (HR = 1.78; 95% CI 1.46-2.17) and Indigenous status (HR = 1.46; 95% CI 0.98-2.25) increased the hazard for re-presentation, whereas older age decreased it (HR = 0.92; 95% CI 0.86-0.98). The effect of the SPP was similar across all groups, reducing the risk of re-presentation to about 65% of that seen in those not placed on the SPP.Conclusions: This paper demonstrates a reduction in repeated suicide attempts after an index attempt and a longer time to a subsequent attempt for those receiving multilevel care based on the Zero Suicide framework. [ABSTRACT FROM AUTHOR]

Background: Since the introduction in 1984 of Australia's publicly-funded universal healthcare system, Medicare, healthcare financing has relied on a mix of public and private sources to meet the needs of the population (Sowa et al., Appl Health Econ Health Policy 15:31-41, 2018). However, in recent years, there has been a decline in the number of Australians choosing to purchase private health insurance (PHI), particularly within the young adult age group with the proportion of insurance customers aged 20 to 29 falling from 10.3 to 9.4% between 2012 and 2017 (Sivey, The Conversation, 2017). Young adults are critical to private health insurance funding models as their involvement offsets the drawdown by older adults (Dalzell and Borys, ABC News, 2019). While this issue is widely reported in the Australian media, few empirical studies have explored the factors that enable or constrain young adults' enrolment in PHI.Methods: To address the scarcity of research about the motivational factors behind young adult decision-making, this study conducted a survey of 594 Australian young adults aged between 18 and 30 years. Within this age group, the survey sought an equal split of participants who were members and non-members of PHI schemes.Conclusion: The findings identified perceived value and trust in insurers as additional motivational factors alongside traditional measures of recognition of the problem and involvement in the problem. Differences between the insured and uninsured groups were identified which help to shape a more holistic understanding of the key motivational factors and barriers in relation to Australian young adults' enrolment in PHI. [ABSTRACT FROM AUTHOR]

Objective: The Zero Suicide Framework, a systems approach to suicide prevention within a health service, is being implemented across a number of states in Australia, and internationally, although there is limited published evidence for its effectiveness. This paper aims to provide a description of the implementation process within a large health service in Australia and describes some of the outcomes to date and learnings from this process. Method: Gold Coast Mental Health and Specialist Services has undertaken an implementation of the Zero Suicide Framework commencing in late 2015, aiming for high fidelity to the seven key elements. This paper describes the practical steps undertaken by the service, the new practices embedded, emphasis on supporting staff following the principles of restorative just culture and the development of an evaluation framework to support a continuous quality improvement approach. Results: Improvements have been demonstrated in terms of processes implementation, enhanced staff skills and confidence, positive cultural change and innovations in areas such as the use of machine learning for identification of suicide presentations. A change to 'business as usual' has benefited thousands of consumers since the implementation of a Suicide Prevention Pathway in late 2016 and achieved reductions in rates of repeated suicide attempts and deaths by suicide in Gold Coast Mental Health and Specialist Services consumers. Conclusion: An all-of-service, systems approach to suicide prevention with a strong focus on cultural shifts and aspirational goals can be successfully implemented within a mental health service with only modest additional resources when supported by engaged leadership across the organisation. A continuous quality improvement approach is vital in the relentless pursuit of zero suicides in healthcare. [ABSTRACT FROM AUTHOR]

Food insecurity is a significant problem in many countries, including Australia. Consequently, food hubs, through which food is distributed using a supermarket style layout, have become an important new source of charity food provision. However, little is known about users' experiences. We draw on ethnographic research to understand the everyday experiences of people using South Australian food hubs. We suggest that attempts to produce a more dignified experience by creating a normalizing experience of shopping is not being achieved, because of the shame and stigma surrounding poverty, confusing operational processes, poor food quality, staff attitudes, and the disciplinary capacity of food hubs. [ABSTRACT FROM AUTHOR]

This study aimed to explore the experience of being a Community Foodies (CF) peer educator with respect to personal benefits, specifically, personal development, wellbeing and empowerment. Qualitative semi-structured telephone interviews conducted with metropolitan and country peer educators of the CF programme. The CF programme in South Australia (SA) delivers nutrition education to disadvantaged communities. Ten adult peer educators from the CF programme: seven from country SA and three from Adelaide. Phenomenon of interest is that peer educators' perceptions of personal growth and development from involvement in the CF programme. The interviews were audiotaped and analysed thematically. The experience of being a nutrition peer educator improved personal skills and knowledge, dietary habits, self-esteem, confidence, sense of belonging and civic engagement. Peer educators felt that the CF programme was run in a straightforward, easy to understand way, with a welcoming environment and abundant support from the coordinators. Apart from benefits to themselves, peer educators appeared to be most proud of their capacity to contribute to the nutritional health of the broader community. Peer education programmes in disadvantaged communities provide policy makers with valuable and cost-effective approaches to improve health, build self-efficacy, strengthen community engagement, and, foster active participation and trust. [ABSTRACT FROM AUTHOR]

Sufficient information and support for breastfeeding mothers is vital to encourage optimal infant feeding practices. Infant feeding apps give breastfeeding instructions and access to information however, little is known about mothers' perceptions about these resources. This study investigated mothers' use and experiences of infant feeding apps with a feeding tracker component, including how information within these apps is used, initial reasons for downloading, the role of the app in infant feeding, and perceived benefits and disadvantages of infant feeding apps. In-depth interviews were conducted with nine Australian breastfeeding mothers who had used an infant feeding app in the last year. Interviews were recorded, transcribed verbatim and coded prior to thematic analysis. The findings revealed that infant feeding apps provide mothers with objective information to guide their breastfeeding decisions and other aspects of baby care. This objective approach to infant feeding gives mothers a perception of greater control, confidence and efficacy at a time of transition and stress in the early stages of parenting an infant. While, overall, the mothers were positive about infant feeding apps, they also expressed concerns regarding overreliance on the app, feeling overwhelmed with the data and questioning the credibility of the information. [ABSTRACT FROM AUTHOR]

Australian women shoulder the bulk of household duties including family food provisioning, despite increasing participation in the workforce. This research aimed to understand employed mothers' daily-lived experience of family food provisioning, in particular, the intersection between family food provisioning, gender inequality and nutritional guidelines as they impact women's time and health. Semi-structured interviews were conducted with 22 employed mothers in South Australia. Participants had at least one child aged less than 13 years. Qualitative data was analysed using a thematic content approach. Time-scarcity was common and associated with stress in relation to family food provisioning; this relationship was particularly apparent among employed mothers who were also studying. Most mothers valued nutrition and strove to provide nutritious meals, although they tended to work from their own nutritional understandings, not the national nutrition guidelines; they saw the nutrition guidelines as unhelpful because of the time demands that were implied. The study invites policy makers, practitioners and researchers to consider time for family food provisioning as a social determinant of family as well as women's health, and structural strategies to address this health inequity for women. [ABSTRACT FROM AUTHOR]

Objective: To obtain clinicians' views on the use of cortical auditory evoked potentials (CAEP) in the clinical pathway. Design: A questionnaire aimed at clinicians who use the HEARLab system with the Aided Cortical Assessment (ACA) Module. Results compared for Australians (where HEARLab produced) to other countries Sample: The questionnaire was completed by 49 clinicians; 33 from Australia and 13 clinicians outside of Australia and 3 clinicians, destination unknown. Results: The findings of this research demonstrated that clinicians using CAEPs found them valuable for clinical practice. CAEPs were used to verify or modify hearing aid fittings and were used for counselling parents to reinforce the need for hearing aids. With the use of speech token as the stimulus clinicians had more relevant information to increase confidence in decision-making on paediatric hearing management. Conclusions: The main benefit from the use of CAEPs (using speech token stimuli) was for infant hearing aid fitting programmes, to facilitate earlier decisions relating to hearing aid fitting, for fine-tuning the aids and as an additional measure for cochlear implant referrals. [ABSTRACT FROM AUTHOR]

Background: Neuroinflammation and human endogenous retroviruses (HERV) are thought to have a role in the pathophysiology of amyotrophic lateral sclerosis (ALS). Therapy directed against endogenous retroviruses has demonstrated positive effects during in vitro and biomarker studies. Consequently, the present study was undertaken to assess the safety and tolerability of long-term antiretroviral therapy (ART), Triumeq (abacavir, lamivudine, and dolutegravir) exposure in patients with ALS, and efficacy against biomarkers of disease progression. Methods: Patients were observed during a 10-week lead-in period before receiving Triumeq treatment for 24 weeks at four specialist ALS centers. The primary outcomes were safety and tolerability. Secondary outcomes included HERV-K expression levels, urinary p75ECD levels, neurophysiological parameters, and clinical indicators. The ENCALS prediction model was applied to provide an estimate of the cohort survival. The trial was registered (NCT02868580). Findings: 40 patients with ALS received Triumeq and 35 (88%) completed treatment. There were no drug-related serious adverse events; one patient was withdrawn from the study due to a drug-associated increase in liver enzymes. A favorable response on HERV-K expression levels was observed, accompanied by a decline in ALSFRS-R progression rate of 21.8% (95% CI −4.8%–48.6%) and the amount of urinary p75ECD measured. One patient died five months after stopping treatment, while five were expected to have died during the treatment period (interquartile range 2–8). Interpretation: Long-term Triumeq exposure was safe and well tolerated in this cohort. There was suggestive indication for a possible biological response in some pharmacodynamic and clinical biomarkers. A larger international phase 3 trial will be deployed to assess the effect of Triumeq on overall survival and disease progression. Funding: Funding was provided by the FightMND Foundation; MND Research Institute of Australia; MND Association, United Kingdom, and GSK. ViiV Healthcare provided the Triumeq. [ABSTRACT FROM AUTHOR]

Objective: To determine the effectiveness of a computer-based intervention designed to increase sit-stand desk usage and help reverse workplace physical inactivity.Background: Sit-stand desks have been successful in reducing workplace sedentary behavior, but the challenge remains for an effective method to increase the usage in order to experience the health and productivity benefits.Method: Data collection (1-year field study with 194 workers) used a novel method of computer software that continuously recorded objective electric sit-stand desk usage, while taking into account the time a worker spends away from their desk (breaks, meetings). During the baseline period, all workers' desk usage was recorded by the software, and the intervention period consisted of software reminders and real-time feedback to all workers to change desk positions. Pooled means were calculated to determine desk usage patterns, and effect sizes and pairwise mean differences were analyzed to test for intervention significance.Results: The intervention doubled desk usage by increasing ~1 change to ~2 changes per work day. There was a 76% reduction in workers who never used the sit-stand function of the desk. Medium to large effect sizes from the intervention were observed in all three primary outcome measures (desk in sitting/standing position and desk position changes per work day).Conclusion: These findings demonstrate an effective intervention that increased postural transitioning and interrupted prolonged inactivity while remaining at the workstation.Application: The methods and results in this research study show that we can quantify an increase in desk usage and collect aggregate data continuously. [ABSTRACT FROM AUTHOR]

This study uses an online quasi-experiment with a national sample from Australia to evaluate public acceptance of hydrogen exports. It explores the complex communications environment that messaging about hydrogen exports is typically encountered in. We find that acceptance of green hydrogen exports is significantly higher than blue or brown hydrogen exports, and acceptance of blue hydrogen exports higher than brown hydrogen exports. Additionally, results show economic-framed benefit messages are associated with lesser public acceptance when encountered in communication contexts that outline differently-focused environmental downsides (competing contexts), but not same-focused economic downsides (conflicting contexts). In contrast, environment-framed benefit messages are associated with lesser public acceptance when presented in communication contexts that outline same-focused environmental downsides (conflicting contexts), but not differently-focused economic downsides (competing contexts). Overall, the study indicates message framing can impact acceptance of hydrogen exports, and that organisations should consider the informational context within which their communications will be received. • Public acceptance of green hydrogen exports higher than blue or brown hydrogen exports. • Environment-benefit framing leads to marginally higher acceptance than economic-benefit. • Conflicting and competing informational contexts affect acceptance of hydrogen exports. [ABSTRACT FROM AUTHOR]

Objective: To examine dietary Na and K intake at eating occasions in Australian adults and identify the contribution of major food sources to Na and K at different eating occasions.Design: Secondary analysis of 24 h recall diet data from the Australian Health Survey (2011-2013).Setting: Nationally representative survey in Australia.Subjects: Male and female Australians aged 18-84 years (n 7818).Results: Dinner contributed the greatest proportion to total daily Na intake (33 %) and K intake (35 %). Na density was highest at lunch (380 mg/MJ) and K density highest at between-meal time eating occasions (401 mg/MJ). Between-meal time eating occasions provided 20 % of daily Na intake and 26 % of daily K intake. The major food group sources of Na were different at meal times (breads and mixed dishes) compared with between-meal times (cakes, muffins, scones, cake-type desserts). The top food group sources of K at meal times were potatoes and unprocessed meat products and dishes.Conclusions: Foods which contributed to Na and K intake differed according to eating occasion. Major food sources of Na were bread and processed foods. Major food sources of K were potatoes and meat products and dishes. Public health messages that emphasise meal-based advice and diet patterns high in vegetables, fruits and unprocessed foods may also aid reduction in dietary Na intake and increase in dietary K intake. [ABSTRACT FROM AUTHOR]

Background: Diet is an important contributor to risk of cardiovascular disease (CVD) and integral in management and delaying progression. Little is known however about whether increased CVD risk or established CVD has any influence on dietary intakes of Australian adults or children residing in the same household. This study aimed to determine whether the presence of CVD or CVD risk factors influences dietary intake of Australian adults and if the presence of an adult with increased CVD risk influences the dietary intake of a child living in the same household.Methods: Data were sourced from the 2011-2013 Australian Health Survey for: (1) adults ≥18 years with risk factors or established CVD and (2) children 2-17 years residing in the same household as adults with CVD risk factors or established CVD. Selected nutrient intakes (total fat, saturated fat plus trans fat, alpha-linolenic acid, total long chain omega 3 fatty acids, fibre and sodium) collected by repeated 24 h recalls were compared to national dietary recommendations and to the intakes of all other adults and children surveyed. Standard errors of the estimates were calculated using the replicate weights method, and an alpha value of <0.05 considered statistically significant.Results: Six thousand two hundred sixty five of 9435 adults surveyed were identified as having CVD risk factors or established disease and of these 1609 had a child in the same household that also contributed data in this survey. No differences were observed in adjusted mean dietary intakes between those without risk factors or established CVD and those with, except for total energy and sodium which were significantly lower in the adults with CVD risk factors and/or established disease. However sodium intakes across both groups were higher than recommended targets. There were no differences for selected nutrients between children residing with affected adults and other children surveyed.Conclusions: While intakes of Australian adults with CVD risk factors or established disease were favourable for sodium, compared to unaffected adults, there is still scope for improvement as many Australian adults, despite CVD risk, are unable to achieve targets for selected nutrients. Effective dietary behaviour change strategies and resources are urgently needed. [ABSTRACT FROM AUTHOR]

Aims: Catheter ablation can be lifesaving in ventricular tachycardia (VT) storm, but the underlying substrate in patients with storm is not well characterized. We sought to compare the clinical factors, substrate, and outcomes differences in patients with sustained monomorphic VT who present for catheter ablation with VT storm versus those with a nonstorm presentation. Methods: Consecutive ischemic (ICM; n = 554) or nonischemic cardiomyopathy patients (NICM; n = 369) with a storm versus nonstorm presentation were studied (ICM storm 186; NICM storm 101). Results: In ICM, storm compared with nonstorm patients had significantly lower left ventricular (LV) ejection fraction (EF), greater number of antiarrhythmic drug (AAD) failures, slower VTs, greater number of scarred LV segments, higher incidence of anterior, septal, and apical endocardial LV scar (all P < 0.05). However, outcomes in follow-up were similar (12-month ventricular arrhythmia [VA]-free survival: 51% vs. 52%, P = 0.6; survival free of death/transplant 75% vs. 87%, P = 0.7). In addition to the above differences, NICM storm patients were also older; however, the extent and distribution of scar was similar except for a higher incidence of lateral endocardial scar in storm patients (P = 0.05). VA-free survival (36% vs. 47%, P = 0.004) and survival free of death/transplant, however, were worse in NICM storm than nonstorm patients (72% vs. 88%, P = 0.001). NICM storm patients had worse VA-free survival than ICM storm patients. Conclusion: There are differences in clinical factors and scar patterns in patients undergoing VT ablation who present with VT storm versus thosewith a nonstorm presentation. Clinical outcomes areworse in NICM storm patients. [ABSTRACT FROM AUTHOR]

Background: Venous thromboembolism (VTE) remains a common problem in critically ill patients. Pharmacologic prophylaxis is currently the standard of care based on high-level evidence from randomized controlled trials. However, limited evidence exists regarding the effectiveness of intermittent pneumatic compression (IPC) devices. The Pneumatic compREssion for preventing VENous Thromboembolism (PREVENT trial) aims to determine whether the adjunct use of IPC with pharmacologic prophylaxis compared to pharmacologic prophylaxis alone in critically ill patients reduces the risk of VTE.Methods/design: The PREVENT trial is a multicenter randomized controlled trial, which will recruit 2000 critically ill patients from over 20 hospitals in three countries. The primary outcome is the incidence of proximal lower extremity deep vein thrombosis (DVT) within 28 days after randomization. Radiologists interpreting the scans are blinded to intervention allocation, whereas the patients and caregivers are unblinded. The trial has 80 % power to detect a 3 % absolute risk reduction in proximal DVT from 7 to 4 %.Discussion: The first patient was enrolled in July 2014. As of May 2015, a total of 650 patients have been enrolled from 13 centers in Saudi Arabia, Canada and Australia. The first interim analysis is anticipated in July 2016. We expect to complete recruitment by 2018.Trial Registration: Clinicaltrials.gov: NCT02040103 (registered on 3 November 2013). Current controlled trials: ISRCTN44653506 (registered on 30 October 2013). [ABSTRACT FROM AUTHOR]

The focus of this paper is direct dollar value to the individual graduate of an investment in a National University business administration degree. To assess this value, recent data from the US census bureau is combined in a Net Present Value (NPV) analysis with results of a survey of graduates of Business school graduates of a large university to estimate the Net Present Value of their investment. Consistent with findings in other countries, e.g., Australia, the study finds that the cost benefit analysis approach used in this paper reveals that in the USA, the unemployment among those with only a high school degree is typically double the unemployment for those with only a college degree. [ABSTRACT FROM AUTHOR]

Issue addressed Local governments are uniquely placed to influence the food environment of their communities through healthy eating policies (HEPs) but very few have done so. Methods Using a community-based participatory approach, Healthy Eating Local Policies and Programs built the capacity of South Australian local governments to develop and implement a HEP by leading the development of a HEP framework then mentoring local governments to develop their own local policy tailored to their community. Results Over a 2-year period, 31 of the 68 local governments worked towards developing a HEP, with 14 receiving endorsement by December 2013. Conclusions Local governments are ready to model healthy eating practices and adopt healthy eating policy that supports the health of their communities. A HEP developed using a participatory approach and with the flexibility to be tailored to local preferences and demographics appears feasible, although the process may be lengthy. This process and outcome appears applicable and transferable to other local governments. So what? As local governments take up their responsibilities in promoting health and wellbeing, HEPs provide important structural mechanisms to enable councils to facilitate healthy eating in their local communities. [ABSTRACT FROM AUTHOR]

The article discusses the research which examines the uptake of long-acting reversible contraceptive (LARC) methods after abortion among women presenting abortions through a major abortion provider in Australia. It states that a quarter of women chose LARC method after abortion. It notes that women aged 16-19 were less likely to have LARC insertion. It mentions that immediate LARC provision occurred often after surgical abortion.

Aim This cross-sectional study explores associations between migrant Indian mothers' use of controlling feeding practices (pressure to eat, restriction and monitoring) and their concerns and perceptions regarding their children's weight and picky eating behaviour. Methods A total of 230 mothers with children aged 1-5 years, residing in Australia for 1-8 years, participated by completing a self-reported questionnaire. Results Perceptions and concerns regarding children's weight were not associated with any of the controlling feeding practices. A positive association was noted between pressure-feeding and perceptions of pickiness after adjusting for covariates: children's age, gender and weight-for-age Z-score. Girls, older children, and children with higher weight-for-age Z-scores were pressure-fed to a greater extent. Conclusions This study supports the generalisation of findings from Caucasian literature that pressure-feeding and perceptions of pickiness are positively related. [ABSTRACT FROM AUTHOR]

Background: Childhood obesity is one of the most pressing public health challenges of the 21st century. Reformulating commonly eaten food products is a key emerging strategy to improve the food supply and help address rising rates of obesity and chronic disease. This study aimed to monitor reformulation of Australian child-oriented food products (products marketed specifically to children) from 2009-2011. Methods: In 2009, all child-oriented food products in a large supermarket in metropolitan Adelaide were identified. These baseline products were followed up in 2011 to identify products still available for sale. Nutrient content data were collected from Nutrient Information Panels in 2009 and 2011. Absolute and percentage change in nutrient content were calculated for energy, total fat, saturated fat, sugars, sodium and fibre. Data were descriptively analysed to examine reformulation in individual products, in key nutrients, within product categories and across all products. Two methods were used to assess the extent of reformulation; the first involved assessing percentage change in single nutrients over time, while the second involved a set of nutrient criteria to assess changes in overall healthiness of products over time. Results: Of 120 products, 40 remained unchanged in nutrient composition from 2009-2011 and 80 underwent change. The proportions of positively and negatively reformulated products were similar for most nutrients surveyed, with the exception of sodium. Eighteen products (15%) were simultaneously positively and negatively reformulated for different nutrients. Using percentage change in nutrient content to assess extent of reformulation, nearly half (n = 53) of all products were at least moderately reformulated and just over one third (n = 42) were substantially reformulated. The nutrient criteria method revealed 5 products (6%) that were positively reformulated and none that had undergone negative reformulation. Conclusion: Positive and negative reformulation was observed to a similar extent within the sample indicating little overall improvement in healthiness of the child-oriented food supply from 2009-2011. In the absence of agreed reformulation standards, the extent of reformulation was assessed against criteria developed specifically for this project. While arbitrary in nature, these criteria were based on reasonable assessment of the meaningfulness of reformulation and change in nutrient composition. As well as highlighting nutrient composition changes in a number of food products directed to children, this study emphasises the need to develop comprehensive, targeted and standardised reformulation benchmarks to assess the extent of reformulation occurring in the food supply. [ABSTRACT FROM AUTHOR]

Background: The gram-negative organism, Burkholderia pseudomallei, is responsible for the disease melioidosis. Septic arthritis and osteomyelitis due to B. pseudomallei are rare but recognised presentations of the disease. Methods: A prospective database of all cases of melioidosis in the Northern Territory of Australia has been kept since October 1989. Entries to April 2009 were reviewed and cases involving bone and/or joint were investigated. We also present in detail the case reports of 3 presentations of bone and joint melioidosis. Results: There were 536 presentations of melioidosis during the 20-year study period. Amongst these, there were 13 patients with primary septic arthritis and 7 cases of primary osteomyelitis. Septic arthritis and osteomyelitis were secondary to primary melioidosis elsewhere in 14 and 7 patients respectively. Melioidosis patients with bone/joint involvement were more likely to be Indigenous (p = 0.006) and female (p = 0.023) compared to patients with other presentations of disease. Conclusions: Timely microbiological diagnosis and prompt treatment of melioidosis involving bone and/or joint with appropriate intravenous antibiotics is important, as is adequate surgical drainage and debridement where indicated. A subsequent protracted course of antibiotic eradication therapy is important to avoid relapse of disease. [ABSTRACT FROM AUTHOR]

Background: Successful completion of randomized trials depends upon efficiently and ethically screening patients and obtaining informed consent. Awareness of modifiable barriers to obtaining consent may inform ongoing and future trials. Objective: The objective of this study is to describe and examine determinants of consent rates in an international heparin thromboprophylaxis trial (Prophylaxis for ThromboEmbolism in Critical Care Trial, clinicaltrials.gov NCT00182143). Design: Throughout the 4-year trial, research personnel approached eligible critically ill patients or their substitute decision makers for informed consent. Whether consent was obtained or declined was documented daily. Setting: The trial was conducted in 67 centers in 6 countries. Measurements and main results: A total of 3764 patients were randomized. The overall consent rate was 82.2% (range, 50%-100%) across participating centers. Consent was obtained from substitute decision makers and patients in 90.1% and 9.9% of cases, respectively. Five factors were independently associated with consent rates. Research coordinators with more experience achieved higher consent rates (odds ratio [OR], 3.43; 95% confidence interval, 2.42-4.86; P b .001 for those with N10 years of experience). Consent rates were higher in smaller intensive care units with less than 15 beds compared with intensive care units with 15 to 20 beds, 21 to 25 beds, and greater than 25 beds (all ORs, b0.5; P b .001) and were higher in centers with more than 1 full-time research staff (OR, 1.95; 95% confidence interval, 1.28-2.99; P b .001). Consent rates were lower in centers affiliated with the Canadian Critical Care Trials Group or the Australian and New Zealand Intensive Care Society Clinical Trials Group compared with other centers (OR, 0.57; 95% confidence interval, 0.42-0.77; P b .001). Finally, consent rates were highest during the pilot trial, lowest during the initiation of the full trial, and increased over years of recruitment (P b .001). Conclusions: Characteristics of study centers, research infrastructure, and experience were important factors associated with successfully procuring informed consent to participate in this thromboprophylaxis trial. [ABSTRACT FROM AUTHOR]

Title: Comparison of informed consent in Indian & Australian physiotherapy clinical practice..Design: Review of literature by incorporating a case study which compares the obligations of obtaining informed consent in India and Australia and by identifying the barriers in obtaining it in India. Conclusion: Despite of some hurdles, some elements of informed consent can be practically implemented in Indian physiotherapy clinical practice, and it should be obtained for respecting patient autonomy and for enhancing therapeutic outcome. [ABSTRACT FROM AUTHOR]

The article determines the international variation in and factors associated with hospital readmission after ST-segment elevation myocardial infarction (STEMI) and country-level care patterns in controlled patients from the U.S., Canada, Australia, New Zealand and European countries from July 13, 2004 to May 11, 2006. Findings revealed the higher readmission rates for the U.S. than other countries, and the shortest median length of hospital stay for U.S. patients and the longest for patients in Germany. Results of multivariable logistic regression analysis identified multivessel disease and U.S. location as independent predictors of readmission but not of in-hospital death or 30-day post-admission death.

Objective: To increase our understanding of parents’ perceptions of the influence of television food advertising on children’s food choices. Design: Five focus group discussions. Subjects: Thirty-two parents (24 women and eight men) of children attending primary school. Setting: Adelaide, South Australia. Data analyses: The focus group discussions were taped and transcribed and coded as themes. Transcripts were verified and coding was audited. All researchers met regularly to analyse data and reach consensus on emergent themes (researcher triangulation). Results: Parents who participated in the study indicated that television is a powerful source of information for children’s food choices. Parents expressed concern about the negative influence of television food advertising on children’s food preferences. They suggested that the current regulations governing television food advertising were not adequately enforced. Parents wanted to see an overall reduction in the volume of food advertisements directed at children, and an increase in advertisements promoting healthy foods. Parents expressed mixed views about banning food advertisements directed at children. Conclusion: In order for television food advertising to be health-enhancing for children, parents in the study suggested the need for restrictions on advertising practices, tighter enforcement of existing regulations and an increase in healthy food advertisements. The present research shows that parents want to see changes in the current arrangements governing television food advertising to children. [ABSTRACT FROM AUTHOR]

This study analysed a sample of food advertisements shown during 63 hours of children's programming to investigate compliance and non-compliance with one of the Australian Children's Television Standards (CTS): CTS 20.2a. This standard regulates the way premium offers may, and may not, be used to sell products to children. Of the 1721 advertisements contained in the sample, 544 (32%) were for food. A significantly higher number of food advertisements (41%) were shown during 'C' programs (which are specifically regulated and produced for children six to 13 years of age and suitable for viewing without adult supervision), compared with 30% during the less regulated 'G' programs (P = <0.001) (suitable for children to view without adult supervision but not produced specifically for a child audience). Over one-third of food advertisements (36%) in 'C' time contained a premium offer compared with 17% in 'G' time (P = < 0.0001). Using a precisely defined interpretation of CTS 20.2a, this study found 30 (31%) of food advertisements breached the standard during 'C' programs. This was a significantly higher proportion than the 54 (12%) of breaches in 'G' time (P = < 0.0001). From this study, the current regulatory system has not resulted in more responsible food advertising during 'C' programs, and the widespread breaches of CTS 20.2a indicate this standard is ineffective as a means of regulating food advertising. The Australian Broadcasting Authority has recognised that children need protection from unfair marketing practices and the improper use of premium offers to promote a food product, therefore CTS 20.2a needs urgent review to make it more effective. [ABSTRACT FROM AUTHOR]

The case focuses on the challenge faced by the Australian Tourist Commission, the Australian Government statutory authority promoting Australia as a tourist destination to the international outbound traveller. With other countries offering attractive alternatives to tourists, ATC now must decide how best to promote Australia to the growing number of Indian tourists. The case provides details of the Indian tourism industry, background of ATC, marketing strategy adopted, past campaigns done by the organization and challenges faced amidst competition. Finally, the decision problem is framed in the context of developing a communication campaign for the coming year. [ABSTRACT FROM AUTHOR]