- Docking, Sean, Rio, Ebonie, Cook, Jill, Carey, David, Fortington, Lauren
- Authors: Docking, Sean , Rio, Ebonie , Cook, Jill , Carey, David , Fortington, Lauren
- Date: 2019
- Subjects: 1106 Human Movement and Sports Science , 1116 Medical Physiology , 1117 Public Health and Health Services , AFL , Football , Injury , Tendinopathy , Tendon pathology , UTC
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/166775 , vital:13497 , https://doi.org/10.1016/j.jsams.2018.07.016 , ISBN:1440-2440
- Description: Background: Tendon pathology on imaging has been associated with an increased risk of developing symptoms. This evidence is based on classifying the tendon as normal or pathological. It is unclear whether the extent of tendon pathology is associated with the development or severity of symptoms. Objectives: To investigate whether the presence and extent of tendon pathology on ultrasound tissue characterisation (UTC), or a previous history of symptoms, were associated with the development of symptoms over a football season. Methods: 179 male Australian football players underwent UTC imaging of their Achilles and/or patellar tendon at the start of the pre-season. Players completed monthly OSTRC overuse questionnaires to quantify the presence and severity of Achilles and/or patellar tendon symptoms. Risk factor analysis was performed to identify associations between imaging and the development of symptoms. Results: A pathological Achilles tendon increased the risk of developing symptoms (RR = 3.2, 95%CI 1.7–5.9). Conversely, a pathological patellar tendon was not significantly associated with the development of symptoms (RR = 1.8, 95%CI 0.9–3.7). Quantification of tendon structure using UTC did not enhance the ability to identify athletes who developed symptoms. Previous history of symptoms was the strongest predictor for the development of symptoms (Achilles RR = 3.0 95%CI 1.8–4.8; patellar RR = 3.7 95%CI 2.2–6.1). Conclusion: Tendon pathology was associated with the development of self-reported symptoms; however previous history of symptoms was a stronger risk factor. The extent of disorganisation quantified by UTC should not be used as a marker for the presence or severity of current and future symptoms.
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- Reviewed:
Seasonal time-loss match injury rates and burden in South African under-16 rugby teams
- Sewry, Nicola, Verhagen, Evert, Lambert, Mike, van Mechelen, Willem, Readhead, Clint, Viljoen, Wayne, Brown, James
- Authors: Sewry, Nicola , Verhagen, Evert , Lambert, Mike , van Mechelen, Willem , Readhead, Clint , Viljoen, Wayne , Brown, James
- Date: 2019
- Subjects: 1106 Human Movement and Sports Science , 1116 Medical Physiology , 1117 Public Health and Health Services , Injury and prevention , Team sport , Youth
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/166693 , vital:13469 , https://doi.org/10.1016/j.jsams.2018.06.007 , ISBN:1440-2440
- Description: Objectives: Youth rugby union is a popular sport with a high injury incidence density (IID) and burden. This high risk has called for further research into the factors affecting the injuries in youth rugby. The aim of the study was to analyse time-loss IID and burden in multiple schoolboy rugby teams over a season and the potential factors associated with injury. Design: Prospective cohort Methods: All time-loss injuries were recorded from three schools for the whole season. Overall IID and injury burden were calculated, as well as for injury event, type, location and the match quarter in which they occurred and Poisson regression analyses were performed to determine differences. Results: IID was 28.8 (18.9–38.6) injuries per 1000 player hours over the season, with an injury burden of 379.2 (343.6–414.9) days lost per 1000 player hours. The ball-carrier had a significantly higher IID (11.3 (5.2–17.5) per 1000 player hours) compared to other events, and the joint (non-bone)/ligament injuries were the most common (IID of 12.2 (5.8–18.6) per 1000 player hours) and severe type of injury (burden of 172.6 (148.5–196.6) days lost per 1000 player hours). Conclusions: The IID was similar to previous youth rugby studies, however the injury burden was much lower. The South African youth cohort showed similar factors associated with injury for inciting event (the tackle) and injury type (joint (non-bone)/ligament) and location (lower limb) as seen in other studies in both youth and senior players.
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- Kunstler, Breanne, Cook, Jill, Kemp, Joanne, O'Halloran, Paul, Finch, Caroline
- Authors: Kunstler, Breanne , Cook, Jill , Kemp, Joanne , O'Halloran, Paul , Finch, Caroline
- Date: 2019
- Subjects: 1106 Human Movement and Sports Science , 1116 Medical Physiology , 1117 Public Health and Health Services , Exercise , Health behavior , Health promotion , Physical therapists
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/166681 , vital:13482 , https://doi.org/10.1016/j.jsams.2018.06.002 , ISBN:1440-2440
- Description: Objectives: To determine: (i) the behaviour change techniques used by a sample of Australian physiotherapists to promote non-treatment physical activity; and (ii) whether those behaviour change techniques are different to the techniques used to encourage adherence to rehabilitation exercises. Design: Cross-sectional survey. Method: An online self-report survey was advertised to private practice and outpatient physiotherapists treating patients with musculoskeletal conditions. The use of 50 behaviour change techniques were measured using five-point Likert-type scale questions. Results: Four-hundred and eighty-six physiotherapists responded to the survey, with 216 surveys fully completed. Most respondents (85.1%) promoted non-treatment physical activity often or all of the time. Respondents frequently used 29 behaviour change techniques to promote non-treatment physical activity or encourage adherence to rehabilitation exercises. A similar number of behaviour change techniques was frequently used to encourage adherence to rehabilitation exercises (n = 28) and promote non-treatment physical activity (n = 26). Half of the behaviour change techniques included in the survey were frequently used for both promoting non-treatment physical activity and encouraging adherence to rehabilitation exercises (n = 25). Graded tasks was the most, and punishment was the least, frequently reported technique used to promote non-treatment physical activity and encourage adherence to rehabilitation exercises. Conclusions: Respondents reported using similar behaviour change techniques to promote non-treatment physical activity and encourage adherence to rehabilitation exercises. The variability in behaviour change technique use suggests the behaviour the physiotherapist is promoting influences their behaviour change technique choice. Including the frequently-used behaviour change techniques in non-treatment physical activity promotion interventions might improve their efficacy. © 2018 Sports Medicine Australia
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- Reviewed:
- Guo, Yu-fang, Plummer, Virginia, Lam, Louisa, Wang, Yan, Cross, Wendy, Zhang, Jing-ping
- Authors: Guo, Yu-fang , Plummer, Virginia , Lam, Louisa , Wang, Yan , Cross, Wendy , Zhang, Jing-ping
- Date: 2019
- Subjects: 1110 Nursing , 1117 Public Health and Health Services , 1701 Psychology , Burnout , Nurses , Resilience , Stress
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/166890 , vital:13519 , https://doi.org/10.1111/jocn.14637 , ISBN:0962-1067
- Description: Aims and objectives: To investigate burnout among nurses from Australia and China and explore the effects of resilience and turnover intention on nurse burnout between the two countries. Background: Nursing shortages and burnout have become serious problems worldwide in recent years. In both developed and developing countries, such as Australia and China, nurse burnout levels are high and therefore attract concern from nurse managers, hospital administrators, nurse educators and researchers. However, few studies have been conducted exploring the differences in burnout and its predictors between Australian and Chinese nurses, particularly investigating the differences in the effect sizes of the predictors. Design: A comparative cross-sectional design was employed. Methods: A total of 100 Australian nurses and 197 Chinese nurses participated in the study. Australian participants completed an online questionnaire, while Chinese participants completed a hardcopy questionnaire. Burnout, resilience and turnover intention were measured. Results: Burnout was worse for Australian participants than Chinese participants. Only having turnover intention significantly predicted burnout in Australian participants, while low resilience, having turnover intention and low level of regular exercise strongly predicted burnout in Chinese participants. The effect size of turnover intention on burnout in the Australian group was almost twice that of the Chinese group. Conclusion: The findings of this study show that there are differences in burnout between Australian and Chinese nurses. The effects of resilience and turnover intention on burnout between the two groups are also identified. Relevance to clinical practice: The differences in nurse burnout and the effects of resilience and turnover intention on burnout should be better understood by nurse managers from Australia and China. Moreover, developing effective strategies relevant to their own country to reduce nurse burnout is recommended.
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- Reviewed:
- Earl, Catherine, Taylor, Philip, Cannizzo, Fabian
- Authors: Earl, Catherine , Taylor, Philip , Cannizzo, Fabian
- Date: 2018
- Subjects: 1117 Public Health and Health Services , 1503 Business and Management , 1608 Sociology , Aging , Older workers , Australian , University sector , Managment , Attitudes
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/165958 , vital:13369 , https://doi.org/10.1093/workar/wax024 , ISBN:2054-4650
- Description: As with other industrialized nations Australia's population is aging and older workers are encouraged to work for longer. At the same time, Australia's university sector, which is aging, is being reconfigured through changes that potentially marginalize its older workers as higher education institutions try to become more competitive in a global market. In this context, youthfulness appears to embody competitiveness and academic institutions are increasingly aspiring to a young workforce profile. This qualitative article builds on previous research to explore to what extent ageist assumptions shape attitudes to older workers and human resource management (HRM) practices within Australian universities even when HRM practitioners are well versed in antidiscrimination legislation that (unlike the Age Discrimination in Employment Act in the United States) applies to workers of all ages. Semistructured interviews conducted with 22 HRM practitioners in Australian universities reveal that university HRM practices generally overlook the value of retaining an older workforce by conflating "potential" with "youthfulness," assuming that staff potential and performance share a negative correlation with age. While mostly lower-ranked institutions have attempted to retain older academics to maintain an adequate labor supply, this study finds that university policies targeting the ongoing utilization of older workers generally are underdeveloped. Consequently, the availability of late career employment arrangements is dependent upon institutions' strategic goals, with favorable ad hoc solutions offered to academics with outstanding performance records, while a rhetoric of performance decline threatens to marginalize older academic researchers and teachers more generally.
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- Reviewed:
- Petrass, Lauren, Blitvich, Jennifer
- Authors: Petrass, Lauren , Blitvich, Jennifer
- Date: 2018
- Subjects: 1117 Public Health and Health Services , Adolescents , Aquatic rescues , Drowning , Drowning prevention , Intervention
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/165591 , vital:13318 , https://doi.org/10.1007/s10900-018-0472-6 , ISBN:0094-5145
- Description: Drowning is an important public health issue with major impacts on young adults aged 15–24 years, yet little is known about the causal factors for drowning for this group. As young adults recreate with peers in unpatrolled aquatic environments, the capacity to perform effective and efficient rescues seems pivotal. This study examined perceived ability of young adults to perform a rescue; determined the level of aquatic rescue knowledge; and measured the effect of an aquatic rescue intervention. In total, 135 participants completed pre- and post-intervention surveys and rescue practical testing. Wilcoxon matched pairs signed rank tests were used to assess significant differences pre- and post-intervention and Mann–Whitney tests used to compare groups. Pre-intervention, participants had a low level of rescue knowledge (Mdn = 50) and the relationship between perceived rescue ability and practical rescue testing was weak (rs = 0.33, p ≤ 0.001). Post-intervention, ability to perform a contact tow demonstrated significant improvement (z = − 9.09, p < 0.001, r = − 0.79) and rescue knowledge also improved significantly (Mdn = 100, z = − 9.42, p < 0.001, r = − 0.81). Many young adults lacked both the physical capacity and knowledge required to safely perform a rescue, a factor that may place them at increased drowning risk if they attempt an aquatic rescue. As a rescue based intervention can significantly improve competency of young adults regardless of previous experience and/or qualifications, research needs to consider how best these competencies can be promoted and/or developed with this high risk group.
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- Reviewed:
A patient agent to manage blockchains for remote patient monitoring
- Uddin, Ashraf, Stranieri, Andrew, Gondal, Iqbal, Balasubramanian, Venki
- Authors: Uddin, Ashraf , Stranieri, Andrew , Gondal, Iqbal , Balasubramanian, Venki
- Date: 2018
- Subjects: 0807 Library and Information Studies , 1117 Public Health and Health Services , Blockchain , Electronic Health Record , Mulit-Level Storage , Multiple Blockchain , Patient Agent , Remote Patient Monitoring
- Type: Text , Conference proceedings , Conference Paper
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/166746 , vital:13463 , https://doi.org/10.3233/978-1-61499-914-0-105 , ISBN:09269630 (ISSN); 9781614999133 (ISBN)
- Description: Continuous monitoring of patient's physiological signs has the potential to augment traditional medical practice, particularly in developing countries that have a shortage of healthcare professionals. However, continuously streamed data presents additional security, storage and retrieval challenges and further inhibits initiatives to integrate data to form electronic health record systems. Blockchain technologies enable data to be stored securely and inexpensively without recourse to a trusted authority. Blockchain technologies also promise to provide architectures for electronic health records that do not require huge government expenditure that challenge developing nations. However, Blockchain deployment, particularly with streamed data challenges existing Blockchain algorithms that take too long to place data in a block, and have no mechanism to determine whether every data point in every stream should be stored in such a secure way. This article presents an architecture that involves a Patient Agent, coordinating the insertion of continuous data streams into Blockchains to form an electronic health record. , Studies in Health Technology and Informatics
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- Reviewed:
Assessment and monitoring practices of Australian fitness professionals
- Bennie, Jason, Wiesner, Glen, van Uffelen, Jannique, Harvey, Jack, Craike, Melinda, Biddle, Stuart
- Authors: Bennie, Jason , Wiesner, Glen , van Uffelen, Jannique , Harvey, Jack , Craike, Melinda , Biddle, Stuart
- Date: 2018
- Subjects: 1106 Human Movement and Sports Science , 1116 Medical Physiology , 1117 Public Health and Health Services , Aerobic fitness , Neuromotor fitness , Personal trainers , Strength training
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/164198 , vital:12992 , https://doi.org/10.1016/j.jsams.2017.07.010 , ISBN:1440-2440
- Description: Objectives: Assessment and monitoring of client health and fitness is a key part of fitness professionals’ practices. However, little is known about prevalence of this practice. This study describes the assessment/monitoring practices of a large sample of Australian fitness professionals. Design: Cross-sectional. Methods: In 2014, 1206 fitness professionals completed an online survey. Respondents reported their frequency (4 point-scale: [1] ‘never’ to [4] ‘always’) of assessment/monitoring of eight health and fitness constructs (e.g. body composition, aerobic fitness). This was classified as: (i) ‘high’ (‘always’ assessing/monitoring ≥5 constructs); (ii) ‘medium’ (1–4 constructs); (iii) ‘low’ (0 constructs). Classifications are reported by demographic and fitness industry characteristics. The odds of being classified as a ‘high assessor/monitor’ according to social ecological correlates were examined using a multiple-factor logistic regression model. Results: Mean age of respondents was 39.3 (±11.6) years and 71.6% were female. A total of 15.8% (95% CI: 13.7%–17.9%) were classified as a ‘high’ assessor/monitor. Constructs with the largest proportion of being ‘always’ assessed were body composition (47.7%; 95% CI: 45.0%–50.1%) and aerobic fitness (42.5%; 95% CI: 39.6%–45.3%). Those with the lowest proportion of being ‘always’ assessed were balance (24.0%; 95% CI: 24.7%–26.5%) and mental health (20.2%; 95% CI: 18.1%–29.6%). A perceived lack of client interest and fitness professionals not considering assessing their responsibility were associated with lower odds of being classified as a ‘high assessor/monitor’. Conclusions: Most fitness professionals do not routinely assess/monitor client fitness and health. Key factors limiting client health assessment and monitoring include a perceived lack of client interest and professionals not considering this their role. © 2017
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- Reviewed:
Cardiac response to exercise in normal ageing : What can we learn from masters athletes?
- Beaumont, Alexander, Campbell, Amy, Grace, Fergal, Sculthorpe, Nicholas
- Authors: Beaumont, Alexander , Campbell, Amy , Grace, Fergal , Sculthorpe, Nicholas
- Date: 2018
- Subjects: 1102 Cardiorespiratory Medicine and Haematology , 1103 Clinical Sciences , 1117 Public Health and Health Services , Athletes , Cardiac remodelling , Cardiac response , Diastolic function , Healthy ageing , Systolic function
- Type: Text , Journal article , Review
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/166747 , vital:13501 , https://doi.org/10.2174/1573403X14666180810155513 , ISBN:1573-403X
- Description: Background: Ageing is associated with an inexorable decline in cardiac and vascular function, resulting in an increased risk of Cardiovascular Disease (CVD). Lifestyle factors such as exercise have emerged as a primary therapeutic target in the prevention of CVD, yet older individuals are frequently reported as being the least active, with few meeting the recommended physical activity guidelines. In contrast, well trained older individuals (Masters athletes) have superior functional capacity than their sedentary peers and are often comparable with young non-athletes. Therefore, the 'masters' athlete may be viewed as a unique non-pharmacological model which may allow researchers to disentangle the inexorable from the preventable and the magnitude of the unavoidable 'true' reduction in cardiac function due to ageing. Conclusion: This review examines evidence from studies which have compared cardiac structure and function in well trained older athletes, with age-matched controls but otherwise healthy. © 2018 Bentham Science Publishers.
- Full Text:
- Reviewed:
- Authors: Beaumont, Alexander , Campbell, Amy , Grace, Fergal , Sculthorpe, Nicholas
- Date: 2018
- Subjects: 1102 Cardiorespiratory Medicine and Haematology , 1103 Clinical Sciences , 1117 Public Health and Health Services , Athletes , Cardiac remodelling , Cardiac response , Diastolic function , Healthy ageing , Systolic function
- Type: Text , Journal article , Review
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/166747 , vital:13501 , https://doi.org/10.2174/1573403X14666180810155513 , ISBN:1573-403X
- Description: Background: Ageing is associated with an inexorable decline in cardiac and vascular function, resulting in an increased risk of Cardiovascular Disease (CVD). Lifestyle factors such as exercise have emerged as a primary therapeutic target in the prevention of CVD, yet older individuals are frequently reported as being the least active, with few meeting the recommended physical activity guidelines. In contrast, well trained older individuals (Masters athletes) have superior functional capacity than their sedentary peers and are often comparable with young non-athletes. Therefore, the 'masters' athlete may be viewed as a unique non-pharmacological model which may allow researchers to disentangle the inexorable from the preventable and the magnitude of the unavoidable 'true' reduction in cardiac function due to ageing. Conclusion: This review examines evidence from studies which have compared cardiac structure and function in well trained older athletes, with age-matched controls but otherwise healthy. © 2018 Bentham Science Publishers.
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- Reviewed:
Co-circulation of influenza A H5, H7, and H9 viruses and co-infected poultry in live bird markets, Cambodia
- Horwood, Paul, Horm, Srey, Suttie, Annika, Thet, Sopheak, Rith, Phalla, Sorn, San, Holl, Davun, Tum, Sothyra, Ly, Sowath, Karlsson, Erik, Tarantola, Arnaud, Dussart, Philippe
- Authors: Horwood, Paul , Horm, Srey , Suttie, Annika , Thet, Sopheak , Rith, Phalla , Sorn, San , Holl, Davun , Tum, Sothyra , Ly, Sowath , Karlsson, Erik , Tarantola, Arnaud , Dussart, Philippe
- Date: 2018
- Subjects: 1103 Clinical Sciences , 1108 Medical Microbiology , 1117 Public Health and Health Services , Virus RNA , Cambodia , Influenza A , Poultry , Virus load
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/164400 , vital:13060 , https://doi.org/10.3201/eid2402.171360 , ISBN:1080-6040
- Description: Longitudinal surveillance of 2 live bird markets in Cambodia revealed year-round, high co-circulation of H5, H7, and H9 influenza viruses. We detected influenza A viruses in 51.3% of ducks and 39.6% of chickens, and co-infections, mainly by H5 and H9 viruses, in 0.8% of ducks and 4.5% of chickens. © 2018 Centers for Disease Control and Prevention (CDC). All rights Reserved.
- Full Text:
- Reviewed:
- Authors: Horwood, Paul , Horm, Srey , Suttie, Annika , Thet, Sopheak , Rith, Phalla , Sorn, San , Holl, Davun , Tum, Sothyra , Ly, Sowath , Karlsson, Erik , Tarantola, Arnaud , Dussart, Philippe
- Date: 2018
- Subjects: 1103 Clinical Sciences , 1108 Medical Microbiology , 1117 Public Health and Health Services , Virus RNA , Cambodia , Influenza A , Poultry , Virus load
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/164400 , vital:13060 , https://doi.org/10.3201/eid2402.171360 , ISBN:1080-6040
- Description: Longitudinal surveillance of 2 live bird markets in Cambodia revealed year-round, high co-circulation of H5, H7, and H9 influenza viruses. We detected influenza A viruses in 51.3% of ducks and 39.6% of chickens, and co-infections, mainly by H5 and H9 viruses, in 0.8% of ducks and 4.5% of chickens. © 2018 Centers for Disease Control and Prevention (CDC). All rights Reserved.
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- Reviewed:
- Burleigh, Tyrone, Stavropoulos, Vasileios, Liew, Lucas, Adams, Baxter, Griffiths, Mark
- Authors: Burleigh, Tyrone , Stavropoulos, Vasileios , Liew, Lucas , Adams, Baxter , Griffiths, Mark
- Date: 2018
- Subjects: 1117 Public Health and Health Services , 1701 Psychology , Internet gaming disorder , Video gaming , Gamer-avatar relationship , Online addiction , Depression
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/165254 , vital:13204 , https://doi.org/10.1007/s11469-017-9806-3 , ISBN:1557-1874
- Description: Research into Internet gaming disorder (IGD) literature largely uses cross-sectional designs and seldom examines gaming context-related factors. Therefore, the present study combined a cross-sectional and longitudinal design to examine depression and the gameravatar relationship (GAR) as risk factors in the development of IGD among emerging adults. IGD behaviors of 125 gamers (64 online gamers, Mage = 23.3 years, SD = 3.4; 61 offline gamers, Mage = 23.0 years, SD = 3.4) were assessed using the nine-item Internet Gaming Disorder Scale Short Form (IGDS-SF9; Pontes and Griffiths Revista Argentina de Ciencias del Comportamiento, 7, 102–118, 2015a; Computers in Human Behavior, 45, 137–143, 2015b). The Self-Presence Scale (Ratan and Dawson Communication Research, 2015) and the Beck Depression Inventory (Beck et al. 1996) were also used to assess gamers’ levels of GAR and depressive symptoms, respectively. Regression and moderation analyses revealed that depression and the GAR act as individual risk factors in the development of IGD over time. Furthermore, the GAR exacerbates the IGD risk effect of depression.
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- Reviewed:
Detection of low pathogenicity influenza a(H7n3) virus during duck mortality event, Cambodia, 2017
- Suttie, Annika, Yann, Sokhoun, Phalla, Y., Tum, Sothyra, Deng, Yi-Mo, Hul, Vibol, Horm, Viseth, Barr, Ian, Greenhill, Andrew, Horwood, Paul, Osbjer, Kristina, Karlsson, Erik, Dussart, Philippe
- Authors: Suttie, Annika , Yann, Sokhoun , Phalla, Y. , Tum, Sothyra , Deng, Yi-Mo , Hul, Vibol , Horm, Viseth , Barr, Ian , Greenhill, Andrew , Horwood, Paul , Osbjer, Kristina , Karlsson, Erik , Dussart, Philippe
- Date: 2018
- Subjects: 1103 Clinical Sciences , 1108 Medical Microbiology , 1117 Public Health and Health Services , Influenza A(H7N3) , Duck mortality event , Cambodia
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/166463 , vital:13456 , https://doi.org/10.3201/eid2406.172099 , ISBN:1080-6040
- Description: In January 2017, an estimated 3,700 (93%) of 4,000 Khaki Campbell ducks (Anas platyrhynchos domesticus) died in Kampong Thom Province, Cambodia. We detected low pathogenicity avian influenza A(H7N3) virus and anatid herpesvirus 1 (duck plague) in the affected flock; however, the exact cause of the mortality event remains unclear.
- Full Text: false
- Reviewed:
- Vriend, Ingrid, Hesselink, Arlette, Kemler, Ellen, Gouttebarge, Vincent, Van Mechelen, Willem, Verhagen, Evert
- Authors: Vriend, Ingrid , Hesselink, Arlette , Kemler, Ellen , Gouttebarge, Vincent , Van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Subjects: 1106 Human Movement and Sports Science , 1117 Public Health and Health Services , 1701 Psychology , Skiing , Wounds and injuries , Ski racing
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/166912 , vital:13550 , https://doi.org/10.1136/injuryprev-2016-042179 , ISBN:1353-8047
- Description: Objective Helmet use in Dutch recreational skiers and snowboarders (DRSS) remains low. This study evaluated the effects of exposure to a nationwide intervention on relevant determinants of helmet use and helmet use in DRSS. Methods The intervention mapping protocol was used to develop an in-season intervention programme targeted at adult DRSS. A prospective single-cohort study was conducted to evaluate the impact of intervention exposure on determinants of helmet use (ie, knowledge about head injury risk and preventive measures, risk perception, attitudes to head injury risk and helmet use and intention to helmet use) and self-reported helmet use. A random sample of 363 DRSS from an existing panel participated in this study. Data were collected using online questionnaires before and immediately after the 2010/2011 intervention season. In a separate sample of 363 DRSS, intervention reach was assessed after the 2010/2011 season. Results Overall, no significant associations were found between intervention exposure and the determinants of helmet use. However, subgroup analyses revealed intervention effects on risk perception and knowledge in specific subpopulations. Intervention exposure had a significant, positive effect on helmet use in DRSS (β=0.23; 95% CI 0.017 to 0.44). Subgroup analyses revealed that this effect was found in: (1) skiers, (2) female DRSS, (3) young skiers and (4) intermediate skiers. Overall, intervention reach was 28.1%, with differences found between skiers and snowboarders. Conclusions Exposure to a nationwide intervention programme was associated with increased selfreported helmet use in DRSS. Differences were found in intervention effectiveness and reach between subpopulations. These differences must be taken into account when developing and evaluating future interventions.
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Estimating the international burden of sport-related death : A review of data sources
- Kucera, Kristen, Fortington, Lauren, Wolff, Catherine, Marshall, Stephen, Finch, Caroline
- Authors: Kucera, Kristen , Fortington, Lauren , Wolff, Catherine , Marshall, Stephen , Finch, Caroline
- Date: 2018
- Subjects: 1117 Public Health and Health Services , 1701 Psychology
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/163288 , vital:12822 , https://doi.org/10.1136/injuryprev-2017-042642 , ISBN:1353-8047
- Description: Introduction Despite detailed recommendations for sports injury data capture provided since the mid-1990s, international data collection efforts for sport-related death remains limited in scope. The purpose of this paper was to review the data sources available for studying sport-related death and describe their key features, coverage, accessibility and strengths and limitations. Methods The outcomes of interest for this review was death occurring as a result of participation in organised sport-related activity. Data sources used to enumerate death in sport were identified, drawing from the authors’ knowledge/experience and review of key references from international organisations. The general purpose, case identification, structure, strengths and limitations of each source in relation to collection of data for sport-related death were summarised, drawing on examples from the international published literature to illustrate this application. Results Seven types of resources were identified for capturing deaths in sport. Data sources varied considerably in their ability to identify: participant status, sport relatedness of the death, types of sport-related deaths they capture, level of detail provided about the circumstances and medical care received. The most detailed sources were those that were dedicated to sports surveillance. Sport relatedness and type of sport may not be reliably captured by systems not dedicated to sports injury surveillance. Only one source permitted international comparisons and was limited to one sport (soccer). Conclusion Data on sport-related death are currently collected across a wide variety of data sources. This review highlights the need for robust, comprehensive approaches with standardised methodologies enabling linkage between sources and international comparisons.
- Full Text:
- Reviewed:
- Authors: Kucera, Kristen , Fortington, Lauren , Wolff, Catherine , Marshall, Stephen , Finch, Caroline
- Date: 2018
- Subjects: 1117 Public Health and Health Services , 1701 Psychology
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/163288 , vital:12822 , https://doi.org/10.1136/injuryprev-2017-042642 , ISBN:1353-8047
- Description: Introduction Despite detailed recommendations for sports injury data capture provided since the mid-1990s, international data collection efforts for sport-related death remains limited in scope. The purpose of this paper was to review the data sources available for studying sport-related death and describe their key features, coverage, accessibility and strengths and limitations. Methods The outcomes of interest for this review was death occurring as a result of participation in organised sport-related activity. Data sources used to enumerate death in sport were identified, drawing from the authors’ knowledge/experience and review of key references from international organisations. The general purpose, case identification, structure, strengths and limitations of each source in relation to collection of data for sport-related death were summarised, drawing on examples from the international published literature to illustrate this application. Results Seven types of resources were identified for capturing deaths in sport. Data sources varied considerably in their ability to identify: participant status, sport relatedness of the death, types of sport-related deaths they capture, level of detail provided about the circumstances and medical care received. The most detailed sources were those that were dedicated to sports surveillance. Sport relatedness and type of sport may not be reliably captured by systems not dedicated to sports injury surveillance. Only one source permitted international comparisons and was limited to one sport (soccer). Conclusion Data on sport-related death are currently collected across a wide variety of data sources. This review highlights the need for robust, comprehensive approaches with standardised methodologies enabling linkage between sources and international comparisons.
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- Reviewed:
Exploring young Australian adults’ asthma management to develop an educational video
- Coombs, Nicole, Allen, Louise, Cooper, Simon J., Cant, Robyn, Beauchamp, Alison, Laszcyk, Jacki, Giannis, Anita, Hopmans, Ruben, Bullock, Shane, Waller, Susan, McKenna, Lisa, Peck, Blake
- Authors: Coombs, Nicole , Allen, Louise , Cooper, Simon J. , Cant, Robyn , Beauchamp, Alison , Laszcyk, Jacki , Giannis, Anita , Hopmans, Ruben , Bullock, Shane , Waller, Susan , McKenna, Lisa , Peck, Blake
- Date: 2018
- Subjects: 1117 Public Health and Health Services , 1302 Curriculum and Pedagogy , Asthma , Asthma management , Australia , e-simulation , Health education , Young adults
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/164629 , vital:13088 , https://doi.org/10.1177/0017896917740721 , ISBN:0017-8969
- Description: Objective: This study explored young university students’ (aged 18–24 years) health literacy, asthma experiences and help-seeking behaviours to inform the development of a web-based asthma education intervention relevant to this age group. Design: Exploratory mixed-methods design incorporateing a health literacy survey and interviews, plus the development of a web-based educational video. Setting: Participants were students at two universities in the state of Victoria, Australia. Method: In total, 20 asthma sufferers were interviewed by trained pairs of university students. Interpretative phenomenology underpinned the narrative analysis and enabled the description of the participants’ lived experience. A branching e-simulation video was developed. Results: A number of key themes were identified: ‘Life with asthma’, including ‘A life of vigilance’ regarding asthma triggers, lifestyle limitations and heightened sensitivities; ‘Asthma management – call Mum’, a lack of knowledge and support systems with substantial maternal reliance; ‘Health literacy: family and Dr Google’, denoting low health literacy levels with passive reluctant involvement in personal health management; and ‘Information gathering – one size doesn’t fit all’ – in the form of the need for immediate gratification and resource variety. Based on interviewees’ words and terminology, we designed an interactive branching educational video for YouTube portraying a young person (an actor) during an asthma flare-up. Conclusion: Young adults lacked insight into their condition and even after moving away from home, relied on Google searches and/or parents’ advice. To enhance health-seeking behaviours, interactive programmes with smartphone access may be valuable. Our open access programme Help Trent Vent provides an educational resource for young people with asthma and for health education teams, to reinforce asthma knowledge. © 2017, © The Author(s) 2017.
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- Authors: Coombs, Nicole , Allen, Louise , Cooper, Simon J. , Cant, Robyn , Beauchamp, Alison , Laszcyk, Jacki , Giannis, Anita , Hopmans, Ruben , Bullock, Shane , Waller, Susan , McKenna, Lisa , Peck, Blake
- Date: 2018
- Subjects: 1117 Public Health and Health Services , 1302 Curriculum and Pedagogy , Asthma , Asthma management , Australia , e-simulation , Health education , Young adults
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/164629 , vital:13088 , https://doi.org/10.1177/0017896917740721 , ISBN:0017-8969
- Description: Objective: This study explored young university students’ (aged 18–24 years) health literacy, asthma experiences and help-seeking behaviours to inform the development of a web-based asthma education intervention relevant to this age group. Design: Exploratory mixed-methods design incorporateing a health literacy survey and interviews, plus the development of a web-based educational video. Setting: Participants were students at two universities in the state of Victoria, Australia. Method: In total, 20 asthma sufferers were interviewed by trained pairs of university students. Interpretative phenomenology underpinned the narrative analysis and enabled the description of the participants’ lived experience. A branching e-simulation video was developed. Results: A number of key themes were identified: ‘Life with asthma’, including ‘A life of vigilance’ regarding asthma triggers, lifestyle limitations and heightened sensitivities; ‘Asthma management – call Mum’, a lack of knowledge and support systems with substantial maternal reliance; ‘Health literacy: family and Dr Google’, denoting low health literacy levels with passive reluctant involvement in personal health management; and ‘Information gathering – one size doesn’t fit all’ – in the form of the need for immediate gratification and resource variety. Based on interviewees’ words and terminology, we designed an interactive branching educational video for YouTube portraying a young person (an actor) during an asthma flare-up. Conclusion: Young adults lacked insight into their condition and even after moving away from home, relied on Google searches and/or parents’ advice. To enhance health-seeking behaviours, interactive programmes with smartphone access may be valuable. Our open access programme Help Trent Vent provides an educational resource for young people with asthma and for health education teams, to reinforce asthma knowledge. © 2017, © The Author(s) 2017.
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Girls' transition from participation in a modified sport program to club sport competition - A study of longitudinal patterns and correlates
- Eime, Rochelle, Harvey, Jack, Charity, Melanie
- Authors: Eime, Rochelle , Harvey, Jack , Charity, Melanie
- Date: 2018
- Subjects: 1117 Public Health and Health Services , Female , Modified sport programs , Sport
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/165644 , vital:13286 , https://doi.org/10.1186/s12889-018-5609-0 , ISBN:1471-2458
- Description: Background: Participation in sport is very popular for young children. Many children participate in entry-level modified sports programs. These programs are modified to match the developmental capacity of children and are aimed at development of fundamental motor skills and sport-specific skills, rather than competition. There is limited research on the longitudinal tracking of children in these programs and into club-based competition. Research suggests that most children drop-out of the sport and do not transition into club-based competition. Furthermore, more females than males drop-out of sport. The aim of this study is to investigate longitudinally, the patterns and demographic predictors of children's transition from modified sport programs to club sport competition for females. Methods: This study analysed sport participation for females in a popular Australian, predominantly female, sport. Players of the modified sports program were followed over 4 years to determine their pattern of transition: transition to junior player status, withdraw from the sport, or continue in the modified program. Pattern of transition was compared across age (4-10), geographical region (metropolitan/non-metropolitan) and socio-economic status (SES). Logistic regression was used to model the effect of the three factors on the likelihood of transition. Results: A total of 13,760 female children (aged 4-10) participated in the modified sport in the first year. The majority (59%) transitioned from the modified sport program and into club competition. However the rate of transition varied with age, residential location and socio-economic status, and there was an interaction between region and SES, with SES having a significant influence on transition in the metropolitan region. The peak sport entry age with the highest rates of transition was 7-9 years. Conclusions: This study demonstrated that whilst the majority of female participants continued participantion and tranisitioned from the modified sport program and into club competition, the strongest correlate of transition was age of entry, with transition rate peaking among those who commenced at age 7-9 years. It is recommended that, in order to maximise continued participation, sport policy and strategic developments should consider the possibility that targeting the very young is not the optimum recruitment strategy for fostering continued sport participation. © 2018 The Author(s).
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- Authors: Eime, Rochelle , Harvey, Jack , Charity, Melanie
- Date: 2018
- Subjects: 1117 Public Health and Health Services , Female , Modified sport programs , Sport
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/165644 , vital:13286 , https://doi.org/10.1186/s12889-018-5609-0 , ISBN:1471-2458
- Description: Background: Participation in sport is very popular for young children. Many children participate in entry-level modified sports programs. These programs are modified to match the developmental capacity of children and are aimed at development of fundamental motor skills and sport-specific skills, rather than competition. There is limited research on the longitudinal tracking of children in these programs and into club-based competition. Research suggests that most children drop-out of the sport and do not transition into club-based competition. Furthermore, more females than males drop-out of sport. The aim of this study is to investigate longitudinally, the patterns and demographic predictors of children's transition from modified sport programs to club sport competition for females. Methods: This study analysed sport participation for females in a popular Australian, predominantly female, sport. Players of the modified sports program were followed over 4 years to determine their pattern of transition: transition to junior player status, withdraw from the sport, or continue in the modified program. Pattern of transition was compared across age (4-10), geographical region (metropolitan/non-metropolitan) and socio-economic status (SES). Logistic regression was used to model the effect of the three factors on the likelihood of transition. Results: A total of 13,760 female children (aged 4-10) participated in the modified sport in the first year. The majority (59%) transitioned from the modified sport program and into club competition. However the rate of transition varied with age, residential location and socio-economic status, and there was an interaction between region and SES, with SES having a significant influence on transition in the metropolitan region. The peak sport entry age with the highest rates of transition was 7-9 years. Conclusions: This study demonstrated that whilst the majority of female participants continued participantion and tranisitioned from the modified sport program and into club competition, the strongest correlate of transition was age of entry, with transition rate peaking among those who commenced at age 7-9 years. It is recommended that, in order to maximise continued participation, sport policy and strategic developments should consider the possibility that targeting the very young is not the optimum recruitment strategy for fostering continued sport participation. © 2018 The Author(s).
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- Authors: Desmond, Sharon
- Date: 2018
- Subjects: 1110 Nursing , 1117 Public Health and Health Services , 1605 Policy and Administration , Climate-change , Social care , Hospitals , Professionals , Australia
- Type: Text , Journal article , Review
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/165107 , vital:13209 , https://doi.org/10.1071/ah16217 , ISBN:0156-5788
- Description: The aim of the present paper was to review the opportunities currently available to health service planners to advance sustainable development in their future-facing roles within health service organisation. Critical challenges and enablers to facilitate health services planners in adopting a pro-environmental lens are discussed. What is known about the topic? Despite its harmful effect on the environment, health has been slower than other industries to embrace the sustainable development agenda. The attitudes and knowledge base of health service planners with regard to environmental sustainability has not been widely studied. For health service planners, embracing pro-environmental considerations in sustainable model of care development is a powerful opportunity to review care paradigms and prepare for the implementation of meaningful, improved health and system efficiency. What does this paper add? This paper advances the case for health service planners to embrace a pro-environmental stance and guides health service leaders in the preparation and implementation of sustainable and improved health and system efficiency. What are the implications for practitioners? Health service planers are in an ideal position to champion the sustainable development agenda as they explore what care is delivered, how care is delivered and where care is delivered. External policy, health service leadership and carbon literacy are advanced as critical contextual factors to facilitate the key role that health service planners can play in building sustainable healthcare organisations.
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- Stares, Jordan, Dawson, Brian, Peeling, Peter, Drew, Michael, Heasman, Jarryd, Rogalski, Brent, Colby, Marcus
- Authors: Stares, Jordan , Dawson, Brian , Peeling, Peter , Drew, Michael , Heasman, Jarryd , Rogalski, Brent , Colby, Marcus
- Date: 2018
- Subjects: 1106 Human Movement and Sports Science , 1116 Medical Physiology , 1117 Public Health and Health Services , Rehabilitation , Sprint distance , Subsequent injury , Survival analysis , Training load
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/165492 , vital:13332 , https://doi.org/10.1016/j.jsams.2018.03.012 , ISBN:1440-2440
- Description: Objectives: Examine the influence of rehabilitation training loads on return to play (RTP) time and subsequent injury in elite Australian footballers. Design: Prospective cohort study. Methods: Internal (sessional rating of perceived exertion: sRPE) and external (distance, sprint distance) workload and lower limb non-contact muscle injury data was collected from 58 players over 5 seasons. Rehabilitation periods were analysed for running workloads and time spent in 3 rehabilitation stages (1: off-legs training, 2: non-football running, 3: group football training) was calculated. Multi-level survival analyses with random effects accounting for player and season were performed. Hazard ratios (HR) and 95% confidence intervals (CI) for each variable were produced for RTP time and time to subsequent injury. Results: Of 85 lower limb muscle injuries, 70 were rehabilitated to RTP, with 30 cases of subsequent injury recorded (recurrence rate = 11.8%, new site injury rate = 31.4%). Completion of high rehabilitation workloads delayed RTP (distance: >49,775 m [reference: 34,613–49,775 m]: HR 0.12, 95%CI 0.04–0.36, sRPE: >1266 AU [reference: 852–1266 AU]: HR 0.09, 95%CI 0.03–0.32). Return to running within 4 days increased subsequent injury risk (3–4 days [reference: 5–6 days]: HR 25.88, 95%CI 2.06–324.4). Attaining moderate-high sprint distance (427–710 m) was protective against subsequent injury (154–426 m: [reference: 427–710 m]: HR 37.41, 95%CI 2.70–518.64). Conclusions: Training load monitoring can inform player rehabilitation programs. Higher rehabilitation training loads delayed RTP; however, moderate-high sprint running loads can protect against subsequent injury. Shared-decision making regarding RTP should include accumulated training loads and consider the trade-off between expedited RTP and lower subsequent injury risk.
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Identifying high risk loading conditions for in-season injury in elite Australian football players
- Stares, Jordan, Dawson, Brian, Peeling, Peter, Heasman, Jarryd, Rogalski, Brent, Drew, Michael, Colby, Marcus, Dupont, Gregory, Lester, Leanne
- Authors: Stares, Jordan , Dawson, Brian , Peeling, Peter , Heasman, Jarryd , Rogalski, Brent , Drew, Michael , Colby, Marcus , Dupont, Gregory , Lester, Leanne
- Date: 2018
- Subjects: 1106 Human Movement and Sports Science , 1116 Medical Physiology , 1117 Public Health and Health Services , Training load , Injury , Acute:chronic workload ratio , Australian football , Global positioning system
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/165101 , vital:13261 , https://doi.org/10.1016/j.jsams.2017.05.012 , ISBN:1440-2440
- Description: Objectives To examine different timeframes for calculating acute to chronic workload ratio (ACWR) and whether this variable is associated with intrinsic injury risk in elite Australian football players. Design Prospective cohort study. Methods Internal (session rating of perceived exertion: sRPE) and external (GPS distance and sprint distance) workload and injury data were collected from 70 players from one AFL club over 4 seasons. Various acute (1–2 weeks) and chronic (3–8 weeks) timeframes were used to calculate ACWRs: these and chronic load categories were then analysed to determine the injury risk in the subsequent month. Poisson regression with robust errors within a generalised estimating equation were utilised to determine incidence rate ratios (IRR). Results Altering acute and/or chronic timeframes did not improve the ability to detect high injury risk conditions above the commonly used 1:4 week ACWR. Twenty-seven ACWR/chronic load combinations were found to be “high risk conditions” (IRR > 1, p < 0.05) for injury within 7 days. Most (93%) of these conditions occurred when chronic load was low or very low and ACWR was either low (<0.6) or high (>1.5). Once a high injury risk condition was entered, the elevated risk persisted for up to 28 days. Conclusions Injury risk was greatest when chronic load was low and ACWR was either low or high. This heightened risk remained for up to 4 weeks. There was no improvement in the ability to identify high injury risk situations by altering acute or chronic time periods from 1:4 weeks.
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Identifying priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India : A qualitative inquiry
- Jagnoor, Jagnoor, Bekker, Sheree, Chamania, Shobha, Potokar, Tom, Ivers, Rebecca
- Authors: Jagnoor, Jagnoor , Bekker, Sheree , Chamania, Shobha , Potokar, Tom , Ivers, Rebecca
- Date: 2018
- Subjects: 1103 Clinical Sciences , 1117 Public Health and Health Services , 1199 Other Medical and Health Sciences , Burns , Health service , India , Injury , Rehabilitation
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/164634 , vital:13098 , https://doi.org/10.1136/bmjopen-2017-020045 , ISBN:2044-6055
- Description: Objectives This study aimed to identify priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India. Design Qualitative inquiry; data were collected through semistructured in-depth interviews and focus group discussions. Setting Nine sites in urban and rural settings across India, through primary, secondary and tertiary health facilities. Participants Healthcare providers, key informants, burns survivors and/or their carers. Results Participants acknowledged the challenges of burns care and recovery, and identified the need for prolonged rehabilitation. Challenges identified included poor communication between healthcare providers and survivors, limited rehabilitation services, difficulties with transportation to health facility and high cost associated with burns care. Burns survivors and healthcare providers identified the stigma attached with burns as the biggest challenge within the healthcare system, as well as in the community. Systems barriers (eg, limited infrastructure and human resources), lack of economic and social support, and poor understanding of recovery and rehabilitation were identified as major barriers to recovery. Conclusions Though further research is needed for addressing gaps in data, strengthening of health systems can enable providers to address issues such as developing/providing, protocols, capacity building, effective coordination between key organisations and referral networks.
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- Authors: Jagnoor, Jagnoor , Bekker, Sheree , Chamania, Shobha , Potokar, Tom , Ivers, Rebecca
- Date: 2018
- Subjects: 1103 Clinical Sciences , 1117 Public Health and Health Services , 1199 Other Medical and Health Sciences , Burns , Health service , India , Injury , Rehabilitation
- Type: Text , Journal article
- Identifier: http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/164634 , vital:13098 , https://doi.org/10.1136/bmjopen-2017-020045 , ISBN:2044-6055
- Description: Objectives This study aimed to identify priority policy issues and health system research questions associated with recovery outcomes for burns survivors in India. Design Qualitative inquiry; data were collected through semistructured in-depth interviews and focus group discussions. Setting Nine sites in urban and rural settings across India, through primary, secondary and tertiary health facilities. Participants Healthcare providers, key informants, burns survivors and/or their carers. Results Participants acknowledged the challenges of burns care and recovery, and identified the need for prolonged rehabilitation. Challenges identified included poor communication between healthcare providers and survivors, limited rehabilitation services, difficulties with transportation to health facility and high cost associated with burns care. Burns survivors and healthcare providers identified the stigma attached with burns as the biggest challenge within the healthcare system, as well as in the community. Systems barriers (eg, limited infrastructure and human resources), lack of economic and social support, and poor understanding of recovery and rehabilitation were identified as major barriers to recovery. Conclusions Though further research is needed for addressing gaps in data, strengthening of health systems can enable providers to address issues such as developing/providing, protocols, capacity building, effective coordination between key organisations and referral networks.
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