An integrative review of enablement in primary health care
- Authors: Frost, Jane , Currie, Marian , Cruickshank, Mary
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Primary Care & Community Health Vol. 6, no. 4 (2015), p. 264-278
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- Description: Objectives: To review how enablement is conceptualized and practiced in primary health care and to explore the factors that influence patient enablement in this setting. Method: A narrative integrative literature review was undertaken. Results: Twenty-four articles specifically relating to enablement in primary health care were identified. Three literature reviews, 4 qualitative studies, and 17 quantitative studies were included in the analysis. Conclusions: In the primary health care setting, the concept of enablement is well defined as an outcome measure of quality. The literature exploring the practice of enablement is sparse, but 2 randomized controlled trials suggest enablement is linked to better outcomes for patients with asthma and diabetes. Primary factors influencing enablement included the practitioners’ open communication style, the degree to which the practitioner is patient centered, and longer consultations. Other factors found to be associated with enablement were the presenting health issue, general state of health, ethnicity, the patient’s own coping strategies and degree of independence, and socioeconomic status. The association between enablement and patients’ expectations and satisfaction is less clear. The majority of research on enablement was carried out among general practitioners. Further research into the degree to which patients are enabled by a wider range of health care providers is needed. Additional qualitative research would provide a deeper understanding of the attributes of enablement in the primary health care setting.
Decade of Medicare : The contribution of private practice dietitians to chronic disease management and diabetes group services
- Authors: Cant, Robyn , Ball, Lauren
- Date: 2015
- Type: Text , Journal article
- Relation: Nutrition and Dietetics Vol. 72, no. 3 (2015), p. 284-290
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- Description: Aim: To review changes in utilisation of dietetics services through the Medicare Chronic Disease Management program over the last decade and describe patient uptake in 2013. Methods: Dietetics service data were extracted from published Medicare statistics for the periods (i) January 2004 to December 2013 and (ii) January to December 2013. Data comprised individual dietetics services by state and patient demography, and group services data for provider professions regarding type 2 diabetes: dietitians, diabetes educators and exercise physiologists. t-test was used to investigate the association of dietetics' individual service utilisation and workforce statistics. Results: Individual dietetics Chronic Disease Management consultations in private practice have increased annually since 2004. Dietetics has remained the third largest provider. In 2013, a total of 302910 individual consultations were conducted; 7% of allied health consultations. Likewise, individual services for Indigenous Australians increased since 2008. Utilisation of group services for type 2 diabetes comprised <2% of dietetics services. Dietitians provided more group services than diabetes educators but considerably fewer than exercise physiologists. Middle-aged and older patients were common, with highest uptake by those aged 55-74 years. Overall, total and per capita utilisation rates were considerably higher in NSW, Victoria and Queensland compared to less populous states, although this disparity has reduced since 2010. Conclusions: As 10 years has elapsed since the program's inception, further evaluation of the policy is needed to examine large variations in dietetics' Chronic Disease Management uptake by state and territory in both individual and group services. © 2015 Dietitians Association of Australia.
Implementation of concussion guidelines in community Australian Football and Rugby League - The experiences and challenges faced by coaches and sports trainers
- Authors: Kemp, Joanne , Newton, Joshua , White, Peta , Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 19, no. 4 (2015), p.305-310
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: Objectives: While guidelines outlining the appropriate management of sport-related concussion have been developed and adapted for use within community sport, it remains unknown how they are experienced by those responsible for implementing them.: Design: Longitudinal study.: Methods: 111 coaches and sports trainers from community-level Australian Football and Rugby League teams completed pre- and post-season surveys assessing their attitudes towards using concussion guidelines. Participants also provided post-season feedback regarding their experiences in using the guidelines.: Results: 71% of participants reported using the guidelines in the preceding season. Post-season attitude was related to pre-season attitude (p = 0.002), football code (p = 0.015), and team role (p = 0.045). An interaction between team role and guideline use (p = 0.012) was also found, with coaches who had used the guidelines, and sports trainers who had not, reporting more positive post-season attitudes towards using the concussion guidelines. Implementation challenges included disputing of decisions about return-to-play by players, parents, and coaches, and a perceived lack of time. Recommendations for improved guideline materials included using larger fonts and providing for witnessing of advice given to players.: Conclusions: This is the first study to examine the implementation of concussion guidelines in community sport. Training of coaches/sports trainers needs enhancement. In addition, new education should be developed for parents/players about the importance of the return-to-play advice given to them by those who follow these guidelines. Information provided by those who attempted to use the guidelines will assist the refinement of implementation and dissemination processes around concussion guidelines across sports. © 2015 Sports Medicine Australia
Organisational barriers to effective pain management amongst oncology nurses in Saudi Arabia
- Authors: Alqahtani, Mohammed , Jones, Linda , Holroyd, Eleanor
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Hospital Administration Vol. 5, no. 1 (2015), p. 81-89
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- Description: Cancer pain is a multi-dimensional syndrome with a combination of acute and chronic pain that causes physical, psycho-social, behavioural, emotional and spiritual problems resulting in adverse effects on patients’ quality of life. Nurses need to be well prepared with knowledge on pain assessment and management techniques in oncology units, due to their vital role in the decision-making process regarding pain management. However, limited research has been conducted regarding nurses’ barriers regarding pain management in oncology units, especially in Saudi Arabia. The overall aim of this study was to explore the nurses’ perceived barriers that hinder the delivery of effective pain management to cancer patients. Five focus group discussions were conducted using a purposive sampling of six to eight nurses in each group, with a total of 35 oncology nurses. The results of focus group analysis revealed two main thematic categories with associated sub themes, being nurses’ workloads, and the absence of health team collaboration. This study provides an increased awareness of the barriers that may hinder the efficacy of pain management provided to cancer patients in Saudi Arabia context. Significant implications will benefit nursing practice, administration and education, in addition to identifying potential future research.
Participation in sport and physical activity : associations with socio-economic status and geographical remoteness
- Authors: Eime, Rochelle , Charity, Melanie , Harvey, Jack , Payne, Warren
- Date: 2015
- Type: Text , Journal article
- Relation: BMC public health Vol. 15, no. (2015), p. 1-12
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- Description: BACKGROUND: Many factors influence participation in sport and Physical Activity (PA). It is well established that socio-economic status (SES) is a critical factor. There is also growing evidence that there are differences in participation patterns according to residential location. However, little is known more specifically about the relationship of PA participation and frequency of participation in particular contexts, to SES and residential location. This study investigated the relationship of participation, and frequency and context of participation, to SES and location. METHODS: Three aspects of participation were investigated from data collected in the Exercise, Recreation and Sport Survey (ERASS) 2010 of persons aged 15+ years: any participation (yes, no), regular participation (<12 times per year, ≥ 12 times per year) and level of organisation of participation setting (non-organised, organised non-club setting, club setting). RESULTS: The rates of both any and regular PA participation increased as SES increased and decreased as remoteness increased. However, participation in PA was SES- or remoteness-prohibitive for only a few types of PA. As remoteness increased and SES decreased, participation in many team sports actually increased. For both SES and remoteness, there were more significant associations with overall participation, than with regular participation or participation in more organised contexts. CONCLUSIONS: This study demonstrates the complexity of the associations between SES and location across different contexts of participation. Nevertheless, it seems that once initial engagement in PA is established, SES and remoteness are not critical determinants of the depth of engagement.
Rural community nurses : insights into health workforce and health service needs in Tasmania
- Authors: Terry, Daniel , Lê, Quynh , Hoang, Ha , Barrett, Annette
- Date: 2015
- Type: Text , Journal article
- Relation: The International Journal of Health, Wellness, and Society Vol. 5, no. 3 (2015), p. 109-120
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- Description: Abstract: Community nurses often work in isolation, particularly in rural areas where many other non-government adjunct health services are absent. At times, they feel overwhelmed, stressed and undervalued while undertaking diverse responsibilities. The study aimed to examine the benefits and challenges community nurses experience when working in rural and remote areas of Tasmania, Australia while determining the specialty skills and practices to meet rural health needs. An explorative research design using a phenomenological approach was adopted. Data were collected through semi-structured interviews with a convenient sample of 15 community nurses from the North and North-west areas of Tasmania. This yielded insight into the rural workforce challenges, gaps in services and the community nurses' lived experience of providing adequate health services to these communities. The results indicated significant variations in the structure and type of community nursing services and a number of key challenges were identified within the profession. Despite these challenges community nurses interviewed indicated high levels of job satisfaction and long term employment. Given the diversity in both community nursing roles and factors impacting on the role further research is required to examine the exact roles and levels of integration between specialist and generalist community nursing roles while exploring and more clearly defining the role of the contemporary community nurse in Australia. Consideration should also be given to embracing community nursing diversity which is an important aspect of best practice for future community nursing.
Socioecological factors potentially associated with participation in physical activity and sport : A longitudinal study of adolescent girls
- Authors: Eime, Rochelle , Casey, Meghan , Harvey, Jack , Sawyer, Neroli , Symons, Caroline , Payne, Warren
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 18, no. 6 (2015), p. 684-690
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- Description: Objectives: Many adolescents are not physically active enough to receive associated health benefits. Furthermore, participation in physical activity generally declines during adolescence, and to a greater degree for females. Longitudinal research is required to better understand the determinants of change in physical activity by adolescent females to inform physical activity-related policy and practice. This study explored patterns of change in socioecological factors hypothesised to be associated with physical activity and sport, across the adolescent period for females. Methods: This longitudinal study employed three annual surveys of females from metropolitan and non-metropolitan areas recruited in Year 7 (n=328) and Year 11 (n=112). Self-report measures included questions regarding general barriers to participation, as well as factors relating to the socioecological domains. Results: The barriers where significant changes within or differences between cohorts were observed were mostly intrapersonal (lack of energy, lack of time due to other leisure activities). Lack of time was more prevalent in the Year 11 cohort than in the Year 7 cohort. Perceived importance of life priorities mainly related to education and study and more so for the Year 11 cohort. Perceived competence declined for the Year 7 cohort. Support from family and peers trended downwards in both cohorts, whereas access to facilities increased both within and between cohorts. Conclusions: Significant patterns of change in the determinants of physical activity participation were observed across the adolescent period. It is important to consider flexible structure and scheduling of physical activity and strategies to develop competency in childhood and early adolescence. (C) 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.
Teeth Tales : A community-based child oral health promotion trial with migrant families in Australia
- Authors: Gibbs, Lisa , Waters, Elizabeth , Christian, Bradley , Gold, Lisa , Young, Dana , De Silva, Andrea , Calache, Hanny , Gussy, Mark , Watt, Richard , Riggs, Elisha , Tadic, Maryanne , Hall, Martin , Gondal, Iqbal , Pradel, Veronika , Moore, Laurence
- Date: 2015
- Type: Text , Journal article
- Relation: BMJ Open Vol. 5, no. 6 (2015), p. 1-13
- Relation: http://purl.org/au-research/grants/arc/LP100100223
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- Description: Objectives: The Teeth Tales trial aimed to establish a model for child oral health promotion for culturally diverse communities in Australia. Design: An exploratory trial implementing a communitybased child oral health promotion intervention for Australian families from migrant backgrounds. Mixed method, longitudinal evaluation. Setting: The intervention was based in Moreland, a culturally diverse locality in Melbourne, Australia. Participants: Families with 1-4-year-old children, self-identified as being from Iraqi, Lebanese or Pakistani backgrounds residing in Melbourne. Participants residing close to the intervention site were allocated to intervention. Intervention: The intervention was conducted over 5 months and comprised community oral health education sessions led by peer educators and follow-up health messages. Outcome measures: This paper reports on the intervention impacts, process evaluation and descriptive analysis of health, knowledge and behavioural changes 18 months after baseline data collection. Results: Significant differences in the Debris Index (OR=0.44 (0.22 to 0.88)) and the Modified Gingival Index (OR=0.34 (0.19 to 0.61)) indicated increased tooth brushing and/or improved toothbrushing technique in the intervention group. An increased proportion of intervention parents, compared to those in the comparison group reported that they had been shown how to brush their child's teeth (OR=2.65 (1.49 to 4.69)). Process evaluation results highlighted the problems with recruitment and retention of the study sample (275 complete case families). The child dental screening encouraged involvement in the study, as did linking attendance with other community/cultural activities. Conclusions: The Teeth Tales intervention was promising in terms of improving oral hygiene and parent knowledge of tooth brushing technique. Adaptations to delivery of the intervention are required to increase uptake and likely impact. A future cluster randomised controlled trial would provide strongest evidence of effectiveness if appropriate to the community, cultural and economic context.
The contribution of sport participation to overall health enhancing physical activity levels in Australia : A population-based study
- Authors: Eime, Rochelle , Harvey, Jack , Charity, Melanie , Casey, Meghan , van Uffelen, Jannique , Payne, Warren
- Date: 2015
- Type: Text , Journal article
- Relation: BMC Public Health Vol. 15, no. 1 (2015), p. 1-12
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- Description: Background: The contribution of sport to overall health-enhancing leisure-time physical activity (HELPA) in adults is not well understood. The aim was to examine this in a national sample of Australians aged 15+ years, and to extend this examination to other ostensibly sport-associated activities. Methods: The 2010 Exercise, Recreation and Sport Survey (ERASS) was conducted by telephone interview in four quarterly waves. Data from this survey were analysed to categorise leisure-time physical activity (LTPA) as HELPA or non-HELPA, and to categorise HELPA activities and sessions of HELPA activity by setting and frequency. The contribution of sport to HELPA was estimated, both directly through activities and settings classified as sport per se, and indirectly through other fitness activities ostensibly related to preparation for sport and enhancement of sport performance. Results: Of 21,602 respondents, 82 % reported some LTPA in the 12 months prior to the survey. In aggregate, respondents reported 37,020 activity types in the previous 12 months, of which 94 % were HELPA. Of HELPA activities, 71 % were non-organised, 11 % were organised but not sport club-based, and 18 % were sport club-based. Of all sport activities, 52 % were HELPA. Of sport HELPA, 33 % was sport club-based and 78 % was undertaken ≥12 times/year. Sport club members were significantly more likely to have participated in running, but significantly less likely to have participated in walking or aerobics/fitness training, than non-club members. Conclusions: Club sport participation contributes considerably to LTPA at health enhancing levels. Health promotion policies, and more specifically physical activity policies, should emphasize the role of sport in enhancing health. Sport policy should recognise the health-promoting role of community-based sport in addition to the current predominant focus on elite pathways. © 2015 Eime et al.
The perceptions of community change through promoting positive sexual health : a teenage pregnancy program evaluation
- Authors: Lê, Quynh , Auckland, Stuart , Nguyen, Hoang , Terry, Daniel
- Date: 2015
- Type: Text , Journal article
- Relation: Universal Journal of Public Health Vol. 3, no. 2 (2015), p. 55-64
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- Description: Teenage pregnancy is associated with adverse social, economic and health outcomes for both mother and child. The factors frequently associated with teenage pregnancy or related sexual health issues include teenagers' knowledge, attitudes, and beliefs about sex and other social-economic factors such as levels of poverty, academic success or failure, and parents' education. This paper reports on the evaluation of a teenage pregnancy program conducted in the Southern and North Western regions of Tasmania to address the high levels of teenage pregnancy and sexually transmitted infection (STIs) in these regions. The aim of the study was to examine the effectiveness of the Teenage Pregnancy Programs by examining any evidence for a community change in attitudes and behaviours, and any changes in youth awareness about sexual health. The study adopted a qualitative approach and data were collected from a total of 25 participants (17 who were interviewed and eight who participated in focus groups) residing in the target regions. Data were analysed using thematic analysis using Nvivo 9.0. The study results indicated that the program was well managed and delivered. There were reported changes in the awareness, attitudes and behaviours regarding sexual health within the target communities, which were considered necessary for young people to make well informed choices. The evaluation of the program provides valuable knowledge regarding the processes and outcomes that may have application in future community based sexual health initiatives may be delivered into regional communities.
Workplace health and safety issues among community nurses : a study regarding the impact on providing care to rural consumers
- Authors: Terry, Daniel , Lê, Quynh , Nguyen, Uyen , Hoang, Hoang
- Date: 2015
- Type: Text , Journal article
- Relation: BMJ Open Vol. 5, no. 8 (2015), p.
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- Description: Objectives: The objective of the study was to investigate the types of workplace health and safety issues rural community nurses encounter and the impact these issues have on providing care to rural consumers. Methods: The study undertook a narrative inquiry underpinned by a phenomenological approach. Community nursing staff who worked exclusively in rural areas and employed in a permanent capacity were contacted among 13 of the 16 consenting healthcare services. All community nurses who expressed a desire to participate were interviewed. Data were collected using semistructured interviews with 15 community nurses in rural and remote communities. Thematic analysis was used to analyse interview data. Results: The role, function and structures of community nursing services varied greatly from site to site and were developed and centred on meeting the needs of individual communities. In addition, a number of workplace health and safety challenges were identified and were centred on the geographical, physical and organisational environment that community nurses work across. The workplace health and safety challenges within these environments included driving large distances between client's homes and their office which lead to working in isolation for long periods and without adequate communication. In addition, other issues included encountering, managing and developing strategies to deal with poor client and carer behaviour; working within and negotiating working environments such as the poor condition of patient homes and clients smoking; navigating animals in the workplace; vertical and horizontal violence; and issues around workload, burnout and work-related stress. Conclusions: Many nurses achieved good outcomes to meet the needs of rural community health consumers. Managers were vital to ensure that service objectives were met. Despite the positive outcomes, many processes were considered unsafe by community nurses. It was identified that greater training and capacity building are required to meet the needs among all staff.
A systematic review of core implementation components in team ball sport injury prevention trials
- Authors: O'Brien, James , Finch, Caroline
- Date: 2014
- Type: Text , Journal article
- Relation: Injury Prevention Vol. 20, no. 5 (2014), p.357-362
- Relation: http://purl.org/au-research/grants/nhmrc/565900
- Relation: http://purl.org/au-research/grants/nhmrc/1058737
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- Description: Abstract BACKGROUND: Recently, the use of specific exercise programmes to prevent musculoskeletal injuries in team ball sports has gained considerable attention, and the results of large-scale, randomised controlled trials have supported their efficacy. To enhance the translation of these interventions into widespread use, research trials must be reported in a way that allows the players, staff and policymakers associated with sports teams to implement these interventions effectively. In particular, information is needed on core implementation components, which represent the essential and indispensable aspects of successful implementation. OBJECTIVES: To assess the extent to which team ball sport injury prevention trial reports have reported the core implementation components of the intervention, the intervention target and the use of any delivery agents (ie, staff or other personnel delivering the intervention). To summarise which specific types of intervention, intervention target and delivery agents are reported. To develop consensus between reviewers on the reporting of these components. METHODS: Six electronic databases were systematically searched for English-language, peer-reviewed papers on injury prevention exercise programme (IPEP) trials in team ball sports. The reporting of all eligible trials was assessed by two independent reviewers. The reporting of the three core implementation components were coded as 'yes', 'no' or 'unclear'. For cases coded as 'yes', the specific types of interventions, intervention targets and delivery agents were extracted and summarised. RESULTS: The search strategy identified 52 eligible trials. The intervention and the intervention target were reported in all 52 trials. The reporting of 25 trials (48%) specified the use of delivery agents, the reporting of three trials (6%) specified not using delivery agents, and in the reporting of the remaining 24 trials (46%) the use of delivery agents was unclear. The reported intervention type was an IPEP alone in 43 trials (83%), education/instruction in how to deliver an IPEP in three trials (6%) and multiple types of interventions (including an IPEP) in six trials (12%). Players were the most commonly reported intervention target (88%, n=46), followed by multiple targets (8%, n=4) and coaches (4%, n=2). Of the 25 trials for which delivery agents were reported, 13 (52%) reported a single type of delivery agent and 12 (48%) multiple types. The types of delivery agents reported included coaches, physiotherapists, athletic trainers and team captains. CONCLUSIONS: The current reporting of core implementation components in team ball sport IPEP trials is inadequate. In many trial reports, it is unclear whether researchers delivered the IPEP directly to players themselves or engaged delivery agents (eg, coaches, physiotherapists, athletic trainers) to deliver the programme. When researchers do interact with delivery agents, the education/instruction of delivery agents should be acknowledged as an intervention component and the delivery agents as an intervention target. Detailed reporting of implementation components in team ball sport IPEP trials will facilitate the successful replication of these interventions by intended users in practice and by researchers in other studies.
Ambulatory blood pressure may be designed as the primary efficacy outcome in clinical trials on renal denervation
- Authors: Wang, Yutang
- Date: 2014
- Type: Text , Letter , Journal article
- Relation: International Journal of Cardiology Vol. 176, no. 3 (2014), p. 1262-1263
- Relation: http://purl.org/au-research/grants/nhmrc/1062671
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An e-health intervention designed to increase workday energy expenditure by reducing prolonged occupational sitting habits
- Authors: Pedersen, Scott , Cooley, Dean , Mainsbridge, Casey
- Date: 2014
- Type: Text , Journal article
- Relation: Work Vol. 49, no. 2 (2014), p. 289-295
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- Description: Methods: Over a 13-week period participants (n=17) in the intervention group were regularly exposed to a passive prompt delivered through their desktop computer that required them to stand up and engage in a short-burst of physical activity, while the control group (n=17) was not exposed to this intervention. Instead, the control group continued with their normal work routine. All participants completed a pre- and post- intervention survey to estimate workplace daily energy expenditure (calories). Background: Desk-based employees face multiple workplace health hazards such as insufficient physical activity and prolonged sitting. Objective: The objective of this study was to increase workday energy expenditure by interrupting prolonged occupational sitting time and introducing short-bursts of physical activity to employees' daily work habits. Results: There was a significant 2 (Group) × 2 (Test) interaction, F (1, 32)=9.26, p < 0.05. The intervention group increased the calories expended during the workday from pre-test (M=866.29 ± 151.40) to post-test (M=1054.10 ± 393.24), whereas the control group decreased calories expended during the workday from pre-test (M=982.55 ± 315.66) to post-test (M=892.21 ± 255.36). Conclusions: An e-health intervention using a passive prompt was an effective mechanism for increasing employee work-related energy expenditure. Engaging employees in regular short-bursts of physical activity during the workday resulted in reduced sitting time, which may have long-term effects on the improvement of employee health.
An examination of writing pauses in the handwriting of children with developmental coordination disorder
- Authors: Prunty, Mellissa , Barnett, Anna , Wilmut, Kate , Plumb, Mandy
- Date: 2014
- Type: Text , Journal article
- Relation: Research in Developmental Disabilities Vol. 35, no. 11 (2014), p. 2894-2905
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- Description: Difficulties with handwriting are reported as one of the main reasons for the referral of children with Developmental Coordination Disorder (DCD) to healthcare professionals. In a recent study we found that children with DCD produced less text than their typically developing (TD) peers and paused for 60% of a free-writing task. However, little is known about the nature of the pausing; whether they are long pauses possibly due to higher level processes of text generation or fatigue, or shorter pauses related to the movements between letters. This gap in the knowledge-base creates barriers to understanding the handwriting difficulties in children with DCD. The aim of this study was to characterise the pauses observed in the handwriting of English children with and without DCD. Twenty-eight 8-14 year-old children with a diagnosis of DCD participated in the study, with 28 TD age and gender matched controls. Participants completed the 10 min free-writing task from the Detailed Assessment of Speed of Handwriting (DASH) on a digitising writing tablet. The total overall percentage of pausing during the task was categorised into four pause time-frames, each derived from the literature on writing (250 ms to 2 s; 2-4 s; 4-10 s and >10 s). In addition, the location of the pauses was coded (within word/between word) to examine where the breakdown in the writing process occurred. The results indicated that the main group difference was driven by more pauses above 10 s in the DCD group. In addition, the DCD group paused more within words compared to TD peers, indicating a lack of automaticity in their handwriting. These findings may support the provision of additional time for children with DCD in written examinations. More importantly, they emphasise the need for intervention in children with DCD to promote the acquisition of efficient handwriting skill.
An exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds : A protocol paper for Teeth Tales
- Authors: Gibbs, Lisa , Waters, Elizabeth , De Silva, Andrea , Riggs, Elisha , Moore, Laurence , Armit, Christine , Johnson, Britt , Morris, Michal , Calache, Hanny , Gussy, Mark , Young, Dana , Tadic, Maryanne , Christian, Bradley , Gondal, Iqbal , Watt, Richard , Pradel, Veronika , Truong, Mandy , Gold, Lisa
- Date: 2014
- Type: Text , Journal article
- Relation: BMJ Open Vol. 4, no. 3 (2014), p. 1-14
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- Description: Introduction: Inequalities are evident in early childhood caries rates with the socially disadvantaged experiencing greater burden of disease. This study builds on formative qualitative research, conducted in the Moreland/Hume local government areas of Melbourne, Victoria 2006-2009, in response to community concerns for oral health of children from refugee and migrant backgrounds. Development of the community-based intervention described here extends the partnership approach to cogeneration of contemporary evidence with continued and meaningful involvement of investigators, community, cultural and government partners. This trial aims to establish a model for child oral health promotion for culturally diverse communities in Australia. Methods and analysis: This is an exploratory trial implementing a community-based child oral health promotion intervention for Australian families from refugee and migrant backgrounds. Families from an Iraqi, Lebanese or Pakistani background with children aged 1-4 years, residing in metropolitan Melbourne, were invited to participate in the trial by peer educators from their respective communities using snowball and purposive sampling techniques. Target sample size was 600. Moreland, a culturally diverse, inner-urban metropolitan area of Melbourne, was chosen as the intervention site. The intervention comprised peer educator led community oral health education sessions and reorienting of dental health and family services through cultural Competency Organisational Review (CORe). Ethics and dissemination: Ethics approval for this trial was granted by the University of Melbourne Human Research Ethics Committee and the Department of Education and Early Childhood Development Research Committee. Study progress and output will be disseminated via periodic newsletters, peer-reviewed research papers, reports, community seminars and at National and International conferences. Trial registration number: Australian New Zealand Clinical Trials Registry (ACTRN12611000532909).
Antibiotic resistant Shigella is a major cause of diarrhoea in the Highlands of Papua New Guinea
- Authors: Greenhill, Andrew , Guwada, Carlton , Siba, Valentine , Michael, Audrey , Yoannes, Mution , Wawarie, Yolandah , Ford, Rebecca , Siba, Peter , Horwood, Paul
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Infection in Developing Countries Vol. 8, no. 11 (2014), p. 1391-1397
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- Description: Introduction: Diarrhoea remains a major cause of illness in Papua New Guinea (PNG); however, little is known about its aetiology. As a result of the cholera outbreak that spread throughout PNG in 2009-2011, we conducted diarrhoeal surveillance in Eastern Highlands Province. Methodology: Following informed consent and a brief questionnaire, participants provided a stool sample or duplicate rectal swabs. Samples were tested for common bacterial pathogens Salmonella spp., Shigella spp., Vibrio spp., Campylobacter spp. and Yersinia enterocolitica using established culture methods. Enteric parasites were detected using microscopy. Results: A total of 216 participants were enrolled; where age was recorded, 42% were under 5 years of age, 6.7% were 5 to 17 years of age and 51.3% ≥18 years of age. One or more pathogens were detected in 68 (31.5%) participants, with Shigella (primarily S. flexneri) being the most commonly isolated (47 of 216 participants). Enteric parasites were detected in 23 of the 216 participants, occurring as a co-infection with another pathogen in 12 of 23 cases. No Vibrio cholerae was detected. Shigella isolates were commonly resistant to ampicillin, tetracycline, co-trimoxazole and chloramphenicol. Conclusions: Shigellae, specifically S. flexneri, are important pathogens in the highlands of PNG. While most studies in low-income settings focus on childhood aetiology, we have demonstrated the importance of Shigella in both children and adults. Enteric parasites remain present and presumably contribute to the burden of gastrointestinal illness. While improvements in sanitation and hygiene would help lower the burden of all aetiologies of infectious diarrhoea, additional control strategies targeting Shigella may also be warranted. © 2014 Greenhill et al.
Changes in muscle activation following balance and technique training and a season of Australian football
- Authors: Donnelly, Cyril , Elliott, Bruce , Doyle, Tim , Finch, Caroline , Dempsey, Alasdair , Lloyd, David
- Date: 2014
- Type: Text , Journal article
- Relation: Journal of Science and Medicine in Sport Vol. 18, no. 3 (2014), p.348-352
- Relation: http://purl.org/au-research/grants/nhmrc/565900
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- Description: Objectives: Determine if balance and technique training implemented adjunct to 1001 male Australian football players' training influenced the activation/strength of the muscles crossing the knee during pre-planned and unplanned sidestepping. Design: Randomized Control Trial. Methods: Each Australian football player participated in either 28 weeks of balance and technique training or 'sham' training. Twenty-eight Australian football players (balance and technique training, n = 12; 'sham' training, n = 16) completed biomechanical testing pre-to-post training. Peak knee moments and directed co-contraction ratios in three degrees of freedom, as well as total muscle activation were calculated during pre-planned and unplanned sidestepping. Results: No significant differences in muscle activation/strength were observed between the 'sham' training and balance and technique training groups. Following a season of Australian football, knee extensor (p = 0.023) and semimembranosus (p = 0.006) muscle activation increased during both pre-planned sidestepping and unplanned sidestepping. Following a season of Australian football, total muscle activation was 30% lower and peak valgus knee moments 80% greater (p = 0.022) during unplanned sidestepping when compared with pre-planned sidestepping. Conclusions: When implemented in a community level training environment, balance and technique training was not effective in changing the activation of the muscles crossing the knee during sidestepping. Following a season of Australian football, players are better able to support both frontal and sagittal plane knee moments. When compared to pre-planned sidestepping, Australian football players may be at increased risk of anterior cruciate ligament injury during unplanned sidestepping in the latter half of an Australian football season.
Detection of enteric viral and bacterial pathogens associated with paediatric diarrhoea in Goroka, Papua New Guinea
- Authors: Soli, Kevin , Maure, Tobias , Kas, Monalisa , Bande, Grace , Bebes, Sauli , Luang-Suarkia, Dagwin , Siba, Peter , Morita, Ayako , Umezaki, Masahiro , Greenhill, Andrew , Horwood, Paul
- Date: 2014
- Type: Text , Journal article
- Relation: International Journal of Infectious Diseases Vol. 27, no. (2014), p. 54-58
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- Description: Objectives: The aim of this study was to investigate the viral and bacterial causes of acute watery diarrhoea in hospitalized children in Papua New Guinea. Methods: A retrospective analysis was conducted on stool samples collected from 199 children (age > 5 years) admitted to the paediatric ward of Goroka General Hospital from August 2009 through November 2010. A large range of viral and bacterial enteric pathogens were targeted using real-time PCR/RT-PCR assays. Results: Young children were much more likely to be admitted with acute gastroenteritis, with 62.8% of patients aged >1 year and 88.4% aged >2 years. An enteric pathogen was detected in 69.8% (n= 138) of patients. The most commonly detected pathogens were Shigella spp (26.6%), rotavirus (25.6%), adenovirus types 40/41 (11.6%), enterotoxigenic Escherichia coli (11.1%), enteropathogenic E. coli (8.5%), norovirus G2 (6.0%), and Campylobacter spp (4.0%). Norovirus G1, sapovirus, and Salmonella spp were also detected, but below our statistical limit of detection. Vibrio cholerae and astrovirus were not detected in any patients. Mixed infections were detected in 22.1% of patients, with Shigella and rotavirus most commonly detected in co-infections with other pathogens. Conclusions: This study demonstrates that Shigella and rotavirus are the major pathogens associated with acute paediatric gastroenteritis in this setting. © 2014 The Authors.
Development, feasibility and usability of an online psychological intervention for men with prostate cancer : My road ahead
- Authors: Wootten, Addie , Abbott, Jo-Anne , Chisholm, Katherine , Austin, David , Klein, Britt , McCabe, Marita , Murphy, Declan , Costello, Anthony
- Date: 2014
- Type: Text , Journal article
- Relation: Internet Interventions Vol. 1, no. 4 (2014), p. 188-195
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- Description: Men with prostate cancer are not routinely offered psychosocial support despite strong evidence that being diagnosed with prostate cancer poses significant quality of life concerns and places the patient at elevated risk of developing a range of mental health disorders. The objective of this study was to develop an online psychological intervention for men with prostate cancer and to pilot test the feasibility and acceptability of the intervention. Development of the intervention involved a multidisciplinary collaboration, adapting face-to-face and group intervention strategies for an online format. The full online intervention and moderated forum were pilot tested with 64 participants who were recruited from urology practices in Melbourne, Victoria, Australia. After consenting to participate and creating a personal account in the online programme, participants completed baseline demographic questionnaires. Participants were provided access to the programme for 6-12. weeks. After completing the programme participants completed an online survey to assess intervention and forum utilisation and satisfaction, as well as suggest intervention refinements following their use of the intervention. Patient satisfaction was calculated using mean responses to the satisfaction questionnaire. The intervention was received positively with 47.82% of participants highly satisfied with the programme, and 78.26% said they would recommend it to a friend. Participants' qualitative feedback indicated good acceptability of the online intervention. A number of technical and participant engagement issues were identified and changes recommended as a result of the feasibility testing. © 2014 .