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Background: Although client communications are affected by clients' assumptions about professionals' characteristics drawn from dress attire, little is known about how this dialogue operates in dietetics. The present study aimed to describe how dietitians and their clients interpret this dialogue and to explore the implications for practice., Methods: A purposive quota sample of dietitians (n = 46) from 21 health services in one state of Australia and a quota of their adult patients (n = 34) were interviewed about dietitians' nutrition education roles. Semi-structured interviews were transcribed and identified themes developed into a questionnaire to survey Australian dietitians. Analysis used frequencies and nonparametric statistics (P <0.05). Triangulation of the results obtained from the studies revealed a strong agreement between data sources., Results: Dietitians' dress attire was perceived as a key source of nonverbal communications by dietetics clients. This was recognised by 75% of the 256 dietitians who were surveyed nationally. Dietitians favoured a professional style (i.e. skirt or slacks, with top). Many clients rejected formal dress (i.e. suit, high heels) as being a potential communication barrier. Some clients viewed dietitians' bodily size/shape as a role model. Implications of dietitians' presentation (i.e. how you look) were important to both clients and dietitians., Conclusion: Dress style is implicated in nonverbal communication dialogues between the dietitian and client. As a matter of competence and to maintain congruency in communication, dietitians should be aware of their clients' preferences for formality of dress, and conduct their attire accordingly.

Background: The purpose of the study was to ascertain the place of knowledge and evidence in the context of Australian general practice nursing. General practice nursing is a rapidly developing area of specialized nursing in Australia. The provision of primary care services in Australia rests largely with medical general practitioners who employ nurses in a small business model., Methods: A statistical research design was used that included a validated instrument: the developing evidence-based practice questionnaire (Gerrish et al. 2007). A total of 1,800 Victorian practice nurses were surveyed with a return of 590 completed questionnaires, equaling a response rate of 33%., Findings: Lack of time to access knowledge for practice was a barrier for participants in this study. In-service education and training opportunities were ranked as the number one source of knowledge for general practice nurses. Experiential learning and interactions with clients, peers, medical practitioners, and specialist nurses were also considered very important sources of knowledge. Research journals were ranked much lower than experiential learning and personal interactions. Participants assessed their own skills at sourcing and translating evidence into practice knowledge as low. Younger general practice nurses were more likely than older nurses to assess themselves as competent at using the library and Internet to locate evidence., Discussion: The predominantly oral culture of nursing needs to be identified and incorporated into methods for disseminating evidence from research findings in order to increase the knowledge base of Australian general practice nurses., Conclusions: Findings from this study will be significant for policy makers and funders of Australian nursing in general practice. The establishment of a career structure for general practice nurses that includes salaried positions for clinical nurse specialists would assist in the translation of evidence into knowledge for utilization at the point of care.

Background: Little is known about how dietitians conduct their communication with individual patients in the process of nutrition education. To study this issue, both practitioners' and patients' perceptions of dietitians' skills were examined in the first phase of a two-phase study. The resulting narratives were used to develop a questionnaire to survey Australian dietitians involved in clinical practice., Methods: A purposive sample of dietitians in one state (n = 46; 12%), working in hospital, community or private practice, and a quota of their adult patients (n = 34), were interviewed. In the second stage, Australian dietitians (n = 258; 16%) responded to a national survey in 2006, which asked about educational strategies, communication skills, and professional attributes. Descriptive statistics were used to compare response distributions, and nonparametric statistics were used to examine between-group relationships. Criterion for item acceptance was established as >or=70% agreement. Triangulation of results revealed strong agreement between data sources., Results: Four main communication competencies were established: interpersonal communication skill, nonverbal communication, professional values, and counselling skill. There was no significant difference in practice by work category or experience. The communication competencies, together with 26 accompanying skills, are described., Conclusion: An understanding of this guide to communication practice might help enhance dietitian-patient relations.

Summary: Obesity levels are increasing disproportionately in immigrant children worldwide. We investigated predictors of immigrant children's obesity status in a well-documented 3-year follow-up study of children at 9 years (n = 1232) and 12 years (n = 628) of age living in inner city areas of Sydney (Australia). The major immigrant groups in this sample were from Europe, the Middle East and SE Asia. Having an obese parent and having either parent or child not being born in Australia and not playing organised sport were predictors of childhood obesity. If either parent was obese compared to non-obese, then the odds ratio for a 9-year-old child of being obese compared to normal weight was 4.9 (95% CI: 3.0-8.0); for 12-year olds the odds ratio was 8.0 (95% CI: 3.6-18). For the survey of 9-years old, a parent born outside Australia or if the child himself was born outside Australia was associated with an almost twofold chance of being obese (OR = 1.8, 95% CI: 1.1-3.0), and not participating in organised sports was significantly associated with childhood obesity. Nine-year olds who did not participate in organised sports outside of school hours were almost twice as likely to be obese (OR = 1.9, 95% CI: 1.2-2.9). When stratified by ethnicity, participation in sports was not related to lower obesity status in children of SE Asian origin. One reason for this could be because SE Asian had very limited participation in sports compared to their counterparts. Accordingly, we believe that health promotion messages to avoid obesity need to be targeted ethnic-specifically.:, (© 2008 Asian Oceanian Association for the Study of Obesity . Published by Elsevier Ltd. All rights reserved.)

BreastScreen (a free breast cancer screening service) has been implemented in Australia since 1991. Surveys conducted overseas consistently report that women of Chinese ancestry have low participation rates in breast cancer screening. Although Chinese women's use of breast cancer screening services has been investigated abroad, to date there are few studies of mammographic screening behavior among Chinese-Australian women. The purpose of this study is to explore and investigate the factors associated with mammographic decisions of Chinese-Australian women. Using a qualitative approach, in-depth interviews were conducted with 20 Chinese-Australian women. These were augmented by additional data from ethnographic observations. The findings show two facilitators: organizational factors (an invitation letter from BreastScreen and seniors' clubs arrangements) and the influence of 'significant others'. Barriers identified were fear perceptions of mammography, modesty and fear of stigmatization. This study provides a useful framework for designing and implementing mammographic screening services for Chinese-Australian women that may improve their participation rates.

Older parents of adults with intellectual disability are reported to be frequently isolated from the services designed to support their caregiving. The interaction between older parent caregivers' biographies and their involvement with the service system was examined. Parental status was predicted to be an explanatory mechanism for understanding the differential nature of their engagement with services. Analysis of interviews with 64 such caregivers of adults with intellectual disability revealed that their perceptions of their parental status were derived from a complex interaction of their values and beliefs, actions in relation to their adult child, constraints as well as resources available to them, and their relationships with service agencies. Implications for service delivery and directions for research are discussed.

A survey questioned 503 experienced practitioners about managerial tasks and responsibilities of senior professionals in four allied health fields: physiotherapy, speech-language pathology, occupational therapy, and medical radiation science. Participants worked in a range of settings, including the private and public sectors, small and large departments/units, and community and hospital-based work sites. Factor analysis identified eight managerial areas of functioning: department running, staff relations management, legislative knowledge, career path management, implementation and change, quality assurance, management of future planning, and prioritizing work. The professional field of the practitioner influenced the importances attached to these areas, while work setting and gender of practitioner had minimal impact. Level of involvement in managerial tasks had no bearing on the importance attached to competency areas. Open-ended comments added depth to the results of the factor analysis. The findings are discussed with respect to the changing requirements being placed upon health service personnel.

Following a stroke in January 1996 the author, a college lecturer, kept notes of his feelings, perceived treatment, and other people's responses to him. This paper reports these especially as they relate to the experience of illness, disability and rehabilitation. Areas covered include the experience of the stroke itself, perceptions of the process, reactions to disability and therapies, and the experience of trying to return to a 'normal' life. No claim is made for the uniqueness or significance of this account. It is simply offered as a contribution towards a better understanding of the patient's perspective on disability and rehabilitation.