Out & Online effectiveness of a tailored online multi-symptom mental health and wellbeing program for same-sex attracted young adults: Study protocol for a randomised controlled trial
- Authors: Abbott, Jo-Anne , Klein, Britt , McLaren, Suzanne , Austin, David , Molloy, Mari , Meyer, Denny , McLeod, Bronte
- Date: 2014
- Type: Text , Journal article
- Relation: Trials Vol. 15, no. 1 (2014), p. 1-19
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- Description: Background: Same-sex attracted young adults have been found to experience higher rates of mental health problems and greater difficulties in accessing specialist mental health care services compared to their heterosexual peers. Internet-based mental health interventions have the potential to be more engaging and accessible to young adults compared to those delivered face-to-face. However, they are rarely inclusive of lesbian women and gay men. Thus, the current study aims to evaluate the effectiveness of an online mental health and wellbeing program, Out & Online (http://www.outandonline.org.au), in comparison to a wait-list control group, for reducing anxiety and depressive symptoms in same-sex attracted young adults aged between 18 and 25 years. Methods/Design: We are recruiting, through media and community organisations, 200 same-sex attracted young adults with anxiety and/or depressive symptoms and mild to moderate psychological distress (Kessler-10 score between 16 to 21). Participants will be randomly allocated to the intervention (the online program) or the wait-list control group based on a permuted blocked randomisation method to allow for stratification by gender. Participants in the intervention group will receive a tailored program for up to three types of mental health difficulties simultaneously. The primary outcome of anxiety and/or depressive symptoms, and secondary outcomes related to psychological distress, wellbeing and health behaviour will be measured at pre-intervention (0 week), post-intervention (8 weeks) and at a 3-month follow-up (20 weeks). Discussion: This online mental health and wellbeing program will be one of the first online interventions to be designed specifically to be relevant for same-sex attracted individuals. If the program is found to be effective it will improve access to specialist same-sex attracted-relevant mental health services for young adults and will facilitate wellbeing outcomes for these individuals. This program will also be a significant development in the delivery of tailored interventions that target multiple types of mental health conditions simultaneously. © 2014 Abbott et al.
Hip and knee osteoarthritis affects younger people, too
- Authors: Ackerman, Ilana , Kemp, Joanne , Crossley, Kay , Culvenor, Adam , Hinman, Rana
- Date: 2017
- Type: Text , Journal article , Review
- Relation: Journal of Orthopaedic and Sports Physical Therapy Vol. 47, no. 2 (2017), p. 67-79
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- Description: Although osteoarthritis (OA) has traditionally been considered a disease of older age, hip and knee OA can and does affect younger adults, with a profound impact on psychosocial well-being and work capacity. Obesity and a history of traumatic knee injury (eg, anterior cruciate ligament rupture and/or meniscal tear) are key risk factors for the accelerated development of knee OA, while structural hip deformities (including those contributing to femoroacetabular impingement syndrome) are strong predictors of early-onset hip OA. In view of these associations, rising rates of obesity and sports injuries are concerning, and may signal a future surge in OA incidence among younger people. Assessment of hip and knee OA in younger people should focus on a patient-centered history, comprehensive physical examination, performance-based measures, and patient-reported outcome measures to enable monitoring of symptoms and function over time. Referral for imaging should be reserved for people presenting with atypical signs or symptoms that may indicate diagnoses other than OA. Nonpharmacological approaches are core strategies for the management of hip and knee OA in younger people, and these include appropriate disease-related education, activity modifcation (including for work-related tasks), physical therapist-prescribed exercise programs to address identifed physical impairments, and weight control or weight loss. High-quality evidence has shown no beneft of arthroscopy for knee OA, and there are no published clinical trials to support the use of hip arthroscopy for OA. Referral for joint-conserving or joint replacement surgery should be considered when nonpharmacological and pharmacological management strategies are no longer effective. © 2017 Journal of Orthopaedic & Sports Physical Therapy.
The association between selected molecular biomarkers and ambulatory blood pressure patterns in African chronic kidney disease and hypertensive patients compared with normotensive controls : protocol for a longitudinal study
- Authors: Adeoye, Abiodun , Adebayo, Oladimeji , Abiola, Busayo , Iwalokun, Bamidele , Tayo, Bamidele , Charchar, Fadi , Ojo, Akinlolu , Cooper, Richard
- Date: 2020
- Type: Text , Journal article
- Relation: JMIR Research Protocols Vol. 9, no. 1 (Jan 2020), p. 8
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- Description: Background: Chronic kidney disease (CKD) is a burgeoning epidemic in sub-Saharan Africa. Abnormal blood pressure variations are prevalent in CKD and potentiate the risk of cardiovascular morbidity and mortality. Certain genetic variants (angiotensin II receptor type 1 1166 A>C and angiotensin-converting enzyme insertion and deletion polymorphisms) and biomarkers such as interleukin-6, tumor necrosis factor, soluble (s) E-selectin, homocysteine, and highly sensitive C-reactive protein have been shown to affect blood pressure variability among non-African CKD, hypertensive. and nonhypertensive CKD population. However, the contributions of the pattern, genetic, and environmental determinants of ambulatory blood pressure in African CKD have not been characterized. Understanding these interactions may help to develop interventions to prevent major cardiovascular events among people with CKD. Objective: The overarching objective of this study is to identify, document, and develop approaches to address related phenomic, genetic, and environmental determinants of ambulatory blood pressure patterns in African CKD and non-CKD hypertensive patients compared with normotensive controls. Methods: This is a longitudinal short-term follow-up study of 200 adult subjects with CKD and 200 each of age-matched hypertensives without CKD and apparently healthy controls. Demographic information, detailed clinical profile, electrocardiography, echocardiography, and 24-hr ambulatory blood pressure measurements will be obtained. Blood samples will be collected to determine albumin-creatinine ratio, fasting plasma glucose, lipid profile, electrolytes, urea and creatinine, C-reactive protein, serum homocysteine, fibroblast growth factor-23, and complete blood count, while 2 mL blood aliquot will be collected in EDTA (ethylenediaminetetraacetic acid) tubes and mixed using an electronic rolling system to prevent blood clots and subsequently used for DNA extraction and genetic analysis. Results: A total of 239 participants have been recruited so far, and it is expected that the recruitment phase will be complete in June 2020. The follow-up phase will continue with data analysis and publications of results. Conclusions: This study will help stratify Nigerian CKD patients phenotypically and genotypically in terms of their blood pressure variations with implications for targeted interventions and timing of medications to improve prognosis.
Ovarian cancer, cancer stem cells and current treatment strategies : a potential role of magmas in the current treatment methods
- Authors: Ahmed, Nuzhat , Kadife, Elif , Raza, Ali , Short, Mary , Jubinsky, Paul , Kannourakis, George
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Cells Vol. 9, no. 3 (Mar 2020), p. 35
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- Description: Epithelial ovarian cancer (EOC) constitutes 90% of ovarian cancers (OC) and is the eighth most common cause of cancer-related death in women. The cancer histologically and genetically is very complex having a high degree of tumour heterogeneity. The pathogenic variability in OC causes significant impediments in effectively treating patients, resulting in a dismal prognosis. Disease progression is predominantly influenced by the peritoneal tumour microenvironment rather than properties of the tumor and is the major contributor to prognosis. Standard treatment of OC patients consists of debulking surgery, followed by chemotherapy, which in most cases end in recurrent chemoresistant disease. This review discusses the different origins of high-grade serous ovarian cancer (HGSOC), the major sub-type of EOC. Tumour heterogeneity, genetic/epigenetic changes, and cancer stem cells (CSC) in facilitating HGSOC progression and their contribution in the circumvention of therapy treatments are included. Several new treatment strategies are discussed including our preliminary proof of concept study describing the role of mitochondria-associated granulocyte macrophage colony-stimulating factor signaling protein (Magmas) in HGSOC and its unique potential role in chemotherapy-resistant disease.
Analysis of interrupted time-series relating to statewide sports injury data
- Authors: Akram, Muhammad , Finch, Caroline
- Date: 2015
- Type: Text , Journal article
- Relation: Australasian Epidemiologist Vol. 22, no. 1 (2015), p. 29-31
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- Description: This study aims to present a new approach towards the analysis of intervention time-series studies in the context of sports-related injury data. We used Victoria-wide hospital admission injury data associated with the sport of Australian football during the period 2006 to 2013. To estimate the state-wide effect of an implemented exercise training intervention that aimed to reduce the number of football-related injuries, time-series analysis was performed using a generalised least square (GLS) method. We show how the GLS method can be used to evaluate the impact of the intervention. Trend and seasonal patterns time series were also assessed using the 'Seasonal and Trend decomposition using Loess' nonparametric seasonal decomposition procedure. The model identified a decreasing trend in the seasonally adjusted number of injuries after the implementation of the intervention in the hospital admission data. The seasonal decomposition plots also indicate strong seasonal patterns in the injury time series.
Nurses' cognitive and perceptual bias in the identification of clinical deterioration cues
- Authors: Al-Moteri, Modi , Cooper, Simon J. , Symmons, Mark , Plummer, Virginia
- Date: 2020
- Type: Text , Journal article
- Relation: Australian Critical Care Vol. 33, no. 4 (2020), p. 333-342
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- Description: Background: Perception and processing of clinical cues have rarely been investigated in the nursing literature despite their relevance to the early identification and management of clinical deterioration. Aim: This study used a hypovolemic shock scenario from the Feedback Incorporating Review and Simulation Techniques to Act on Clinical Trends (FIRST2ACT) virtual simulation program, equipped with an eye tracker, to investigate cue processing during the management of patient deterioration. Result: The study revealed that attention deviation distorted interpretation of subsequent cues, causing 63% of participants to exhibit a cognitive bias (heightened sensitivity to specific but noncritical cues) and 65% to exhibit at least one episode of nonfixation on clinically relevant cues. Attention deviation and distorted interpretations of clinical cues will have an impact on patient safety. Conclusion: The findings are likely to have important implications for understanding error and associated training implications. © 2019 Australian College of Critical Care Nurses Ltd
Clinical deterioration of ward patients in the presence of antecedents : A systematic review and narrative synthesis
- Authors: Al-Moteri, Modi , Plummer, Virginia , Cooper, Simon J. , Symmons, Mark
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Australian Critical Care Vol. 32, no. 5 (2019), p. 411-420
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- Description: Aim: The aim of this review was to identify and synthesise published accounts of recognising and responding to patient deterioration in the presence of deterioration antecedents. Design: The systematic review canvassed four electronic databases/ search engines for studies of adult ward patients who had altered physiological parameters before developing major adverse events. Synthesis Methods: The findings were synthesised using a narrative approach. Results: Clinical deterioration can be missed by nurses, even with adequate charting. Delays in recognising and responding to patient deterioration remains an international patient safety concern, and strategies to enhance recognition of patient deterioration have not achieved consistent improvements. The lack of significant and sustained improvement through targeted training suggests the problem may be rooted in human behaviour and local ward culture. Nurses play a pivotal role in recognising and responding to patient deterioration; however, patient records do not facilitate tracking of all nurse decisions and actions, and any undocumented care cannot be easily captured by auditing processes. Conclusion: Failure to recognise clinical deterioration was evident even with adequate charting. It is not clear if nurses do not recognise clinical deterioration because they failed to interpret the signs of deterioration or they made a conscious decision not to escalate based on their clinical judgement or they lacked attention at the time of the event. Whatever the reason, focus is warranted for nurses' decisionmaking after the recording of clinical deterioration signs and the role of human factors in delayed recognition, before maximum benefit of any strategy can be achieved.
Adolescent pornography use : A systematic literature review of research trends 2000-2017
- Authors: Alexandraki, Kyriaki , Stavropoulos, Vasileios , Anderson, Emma , Latifi, Mohammad , Gomez, Rapson
- Date: 2018
- Type: Text , Journal article , Review
- Relation: Current Psychiatry Reviews Vol. 14, no. 1 (2018), p. 47-58
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- Description: Background: Pornography Use (PU) has been defined as the viewing of explicit materials in the form of pictures and videos, in which people are performing intercourse with clearly exposed and visible genitals. The prevalence of PU has increased dramatically among adolescents, partly attributed to the wide availability of such online material. Objective: The aim of this systematic literature review is to map the research interest in the field and to examine whether statistically significant results have emerged from the areas of research focus. Methods: To address these aims: a) the PRISMA guidelines are adopted and; b) an integrative conceptualization (derived from the merging of two widely accepted models of understanding of Internet use behaviours) was introduced to guide the synthesis of the findings. Results: In total, 57 studies were integrated into the present literature review. Findings were concep-tualized/ classified into individual, contextual and activity factors related to PU in adolescence. In that context, individual associated factors, such as development, victimization, mental health and religiosity, appear to have primarily captivated research interest demonstrating significant relationships with adolescent PU. Conclusion: Results indicate that more research focus on contextual and activity related factors is required to improve the level of understanding of adolescent PU and to inform a more holistic conceptual framework of understanding of the phenomenon during adolescence that could potentially guide future research.
Defining timeliness in care for patients with lung cancer : protocol for a scoping review
- Authors: Ansar, Adnan , Lewis, Virginia , McDonald, Christine , Liu, Chaojie , Rahman, Muhammad Aziz
- Date: 2020
- Type: Text , Journal article
- Relation: BMJ Open Vol. 10, no. 11 (2020), p. 1-7
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- Description: Introduction Cancer is the second leading cause of death worldwide, and lung cancer is the single leading cause of cancer mortality worldwide. Early diagnosis of lung cancer is the key to better prognosis and longer survival. While there are substantial literature reporting delays in cancer diagnosis, there is a lack of consensus in the definitions and terms used to describe a € delay' in the treatment pathway. The aim of this scoping review is to identify and critically synthesise the operational definitions and terminologies used to describe the timely initiation of care and consequent treatments over the care pathway for patients with lung cancer. This scoping review will also compare how timeliness was operationalised in Western and Asian countries. Methods and analysis The scoping review will use the methodology described by Arksey and O'Malley and endorsed by the Joanna Briggs Institute. MEDLINE, EMBASE, CINAHL and PsycINFO electronic databases will be searched. Grey literature sources and the reference lists of key studies will be used to identify additional relevant studies. The scoping review will include all studies, irrespective of study methodology and quality. Two reviewers will independently screen all titles and abstracts to identify eligible studies for inclusion. The full texts of identified studies will be further examined and charted using a data extraction form. A narrative synthesis will be performed to assess and categorise available definitions of timeliness. Ethics and dissemination Ethical approval is not needed as this scoping review will be reviewing already published articles. The results produced from this review will be submitted to a scientific peer-reviewed journal for publication and will be presented at scientific meetings. ©
Modification of the body sensations interpretation questionnaire (BSIQ-M) : Validity and reliability
- Authors: Austin, David , Richards, Jeffrey , Klein, Britt
- Date: 2006
- Type: Text , Journal article
- Relation: Journal of Anxiety Disorders Vol. 20, no. 2 (2006), p. 237-251
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- Description: The catastrophic misinterpretation model [Behav. Res. Ther. 24 (1986) 461-470] proposes that panic attacks result from misinterpretation of interoceptive stimuli as precursors to physical or psychological emergency. Inconclusive evidence for the model may be partly explained by limitations of the questionnaires developed to measure catastrophic misinterpretation. For example, the Body Sensations Interpretation Questionnaire (BSIQ) is unable to clarify whether anxiety-related interpretations of ambiguous interoceptive stimuli represent catastrophic misinterpretations or responses masking feared outcomes (e.g., heart failure). Additionally, it lacks items relating to several DSM-IV criteria for panic, thereby limiting content validity. Reliability is also potentially compromised due to experimenter-coding of participant-generated responses. A modified form of the BSIQ was developed to address these limitations and evaluated with non-anxious controls (n=34) and people with panic disorder (n=38). The revised questionnaire demonstrated good to excellent internal consistency, inter-rater reliability, and construct validity and is a useful development of the BSIQ.
Managing panic disorder in general practice
- Authors: Austin, David , Blashki, Grant , Barton, David , Klein, Britt
- Date: 2005
- Type: Text , Journal article
- Relation: Australian Family Physician Vol. 34, no. 7 (2005), p. 563-571
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- Description: BACKGROUND: Panic disorder (PD) is common in the community and contributes to significant distress and decreased quality of life for people who suffer from it. Most people with PD will present in the first instance to their general practitioner or hospital emergency department for assistance, often with a focus on somatic symptoms and concerns. OBJECTIVE: This article aims to assist the GP to manage this group of patients by providing an outline of aetiology, approaches to assessment, and common management strategies. DISCUSSION Although GPs have an important role to play in ruling out any causal organic basis for panic symptoms, the diagnosis of PD can usually be made as a positive diagnosis on the basis of careful history taking. Thorough and empathic education is a vital step in management. The prognosis for PD can be improved by lifestyle changes, specific psychological techniques, and the judicious use of pharmacotherapy.
Do GPs use electronic mental health resources? A qualitative study
- Authors: Austin, David , Pier, Ciaran , Mitchell, Joanna , Schattner, Peter , Wade, Victoria , Pierce, David , Klein, Britt
- Date: 2006
- Type: Text , Journal article
- Relation: Australian Family Physician Vol. 35, no. 5 (2006), p. 365-366
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- Description: BACKGROUND: The Better Outcomes in Mental Health Care (BOMHC) initiative encourages general practitioners to use electronic mental health resources (EMHRs) during consultation with patients requiring psychological assistance. However, there is little data on GPs' acceptance and use of EMHRs. METHOD: Semistructured interviews were conducted with 27 GPs to determine their attitude toward EMHRs, and their use during consultation with patients. RESULTS: Few GPs reported frequently using EMHRs in consultation. Identified barriers to use included lack of familiarity with information technology, and insufficient knowledge of available resources. Identified advantages of electronic resources included high patient acceptance, time efficiency, and improved quality of information. DISCUSSION: General practitioners recognise several advantages of utilising electronic resources for managing patients with mental illness. However, GPs are not sufficiently familiar with electronic resources to use them effectively. This could be overcome by education.
Meaningful and effective consultation and the construction industry of Victoria, Australia
- Authors: Ayers, Gerard , Culvenor, John , Sillitoe, Jim , Else, Dennis
- Date: 2013
- Type: Text , Journal article
- Relation: Construction Management and Economics Vol. 31, no. 6 (2013), p. 542-567
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- Description: Consultation between employers and employees is mandated under Australian occupational health and safety legislation. For consultation to be considered meaningful and effective, it is generally accepted that moral and ethical principles such as trust, honesty, commitment and respect need to be recognized and applied by individuals during consultation. It is also considered that an organization's level of cultural maturity is an important element in the ability of individuals to freely engage in meaningful and effective consultation. If the value of consultation is best reflected in the degree of input and control that workers have regarding the very decisions that affect them, and if the level of worker involvement is a reflection of an organization's level of cultural maturity, it is debateable whether the notion of applying moral and ethical principles during consultation, and the adoption of the paradigm of organizational and cultural maturity, have been successfully developed and embraced in the commercial and industrial sector of the construction industry of Victoria, Australia. © 2013 Taylor and Francis Group, LLC.
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Cultural relevance of the quality-of-life tools for people with kidney failure
- Authors: Ayoub, Abdelbasit , Nelson, Katherine , Wood, Pamela
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Renal Care Vol. 39, no. 4 (2013), p. 236-245
- Full Text: false
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- Description: Background Many tools are used to examine the Quality of Life (QOL) of patients with kidney disease, but little is known about how culturally relevant they are and why one should utilise one tool over another. As part of a larger study on the QOL of dialysis patients in United Arab Emirates, the cultural relevance of two tools (SF-36 and the QOL Index) was examined. This paper suggests a model to establish cultural relevance of QOL tools. Method A descriptive comparative survey design using a mixed method design was used in 2007 to study the QOL of 161 patients on dialysis and 350 people from the community. The cultural relevance of each tool was assessed by (i) examining missed questions, (ii) asking respondents about the cultural relevance of each tool, (iii) asking respondents what questions could be added or deleted to make the tools more culturally relevant and (iv) asking respondents to identify the factors that might contribute to their QOL. Results Of respondents, 94.7% from the dialysis sample and 90.4% from the community sample considered both tools culturally relevant. The QOL Index tool had more missing data. Many of the themes generated from the analysis of the qualitative data were addressed by the subscales of both tools. Themes not addressed by either tool were concerned with values, safety and country. Conclusion Cultural adaptation of QOL tools needs to follow well-established guidelines. The target population should be involved in establishing the cultural relevance of QOL tools.
Quality of life among individuals with rugby-related spinal cord injuries in South Africa : A descriptive cross-sectional study
- Authors: Badenhorst, Marelise , Brown, James , Lambert, Mike , van Mechelen, Willem , Verhagen, Evert
- Date: 2018
- Type: Text , Journal article
- Relation: BMJ Open Vol. 8, no. 6 (2018), p. 1-12
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- Description: Objectives Rugby-related spinal cord injuries (SCIs) are rare but life altering and traumatic events. Little is known about the long-term consequences and outcomes of players who have sustained these injuries. This study investigated current quality of life (QoL) and factors associated with QoL, among individuals with rugby-related SCI in South Africa, by using the International Classification of Functioning, Disability and Health (ICF) framework. Design Descriptive cross-sectional study. Setting Rugby-related SCI population of South Africa, as captured in the BokSmart/Chris Burger Petro Jackson Players' Fund database. Participants Ninety (n=90) of the 102 eligible players on the database agreed to participate in the study. Main outcome measure The relationship between QoL, as measured with the WHO Quality of Life questionnaire (WHOQOL-BREF) and specific independent variables (demographic information, level of independence and participation in various activities and life roles) was investigated. Variables that were significantly associated with QoL in bivariate analyses were included in multiple linear regression analyses. Results The mean score and SD of the WHOQOL-BREF was 15.1±2.3 arbitrary units. Participation (an ICF framework construct) and income were significantly associated with overall QoL (p<0.001). Participation was the only variable significantly associated with all QoL subdomains (p<0.001). Additionally, number of health concerns, type of healthcare (public vs private) and level of education were significantly associated with various QoL domains (p<0.001). Conclusions On average, these individuals with rugby-related SCI presented with higher QoL scores than other comparable SCI studies. However, lower levels of participation and income, certain levels of education, increased health concerns and use of public healthcare were associated with lower levels of QoL. Sporting bodies have a responsibility to optimise player welfare, by acting on the modifiable factors associated with QoL.
Evidence of direct cardiac damage following high-intensity exercise in chronic energy restriction : A case report and literature review
- Authors: Baird, Marianne , Grace, Fergal , Sculthorpe, Nicholas , Graham, Scott , Fleming, Audrey , Baker, Julien
- Date: 2017
- Type: Text , Journal article
- Relation: Medicine Vol. 96, no. 27 (2017), p. 1-7
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- Description: Rationale: Following prolonged endurance events such as marathons, elevated levels of cardiospecific biomarkers are commonly reported. Although transiently raised levels are generally not considered to indicate clinical myocardial damage, comprehension of this phenomenon remains incomplete. The popularity of high-intensity interval training highlights a paucity of research measuring cardiac biomarker response to this type of exercise. This a posteriori case report discusses the elevation of cardiac troponins (cTn) associated with short interval, high-intensity exercise. Patient concerns: In this case report, an apparently healthy 29-year-old recreationally active female presented clinically raised cardiac troponin I (cTnI) levels (>0.04 ng/mL), after performing high-intensity cycle ergometer sprints. As creatine kinase (CK) is expressed by multiple organs (e.g., skeletal muscle, brain, and myocardium), cTnI assays were performed to determine any changes in total serum CK levels not originating from skeletal muscle damage. Diagnosis: A posteriori the individual's daily energy expenditure indicated chronically low-energy availability. Psychometric testing suggested that the individual scored positive for disordered eating, highly for fatigue levels, and low in mental health components. Outcomes: The current case report provides novel evidence of elevated cTnI occurring as a result of performing short duration, high intensity, cycle ergometer exercise in an individual with self-reported chronically depleted energy balance. A schematic to identify potentially “at risk” individuals is presented. Lessons: Considering this as a case report, results cannot be generalized; however, the main findings suggest that individuals who habitually restrict their calorie intake below their bodies’ daily energy requirements, may have elevated biomarkers of exercise induced myocardial stress from performing high-intensity exercise.
Tobacco retailer density and smoking behavior in a rural Australian jurisdiction without a tobacco retailer licensing system
- Authors: Baker, John , Masood, Mohd , Rahman, Muhammad Aziz , Thornton, Lukar , Begg, Stephen
- Date: 2021
- Type: Text , Journal article
- Relation: Tobacco Induced Diseases Vol. 19, no. (2021), p. 1-10
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- Description: INTRODUCTION An emerging body of research has developed around tobacco retailer density and its contribution to smoking behavior. This cross-sectional study aimed to determine the association between tobacco retailer density and smoking behavior in a rural Australian jurisdiction without a tobacco retailer licensing system in place. METHODS A local government database (updated 2018) of listed tobacco retailers (n=93) was accessed and potential unlisted tobacco retailers (n=230) were added using online searches. All retailers (n=323) were visited in 2019 and GPS coordinates of retailers that sold tobacco (n=125) were assigned to suburbs in ArcMap. A community survey conducted in the Local Government Area provided smoking and sociodemographic data amongst adult respondents (n=8981). Associations between tobacco retailer density (calculated as the number of retailers per km2 based on respondents' suburb of residence) and daily, occasional and experimental smoking were assessed using multilevel logistic regression analysis. Separate models with and without covariates were undertaken. RESULTS Without adjusting for possible confounders, living in suburbs with greater retailer density did not increase the odds of daily smoking (OR=1.01; 95% CI: 0.92-1.12), occasional smoking (OR=1.05; 95% CI: 0.94-1.18), or experimental smoking (OR=0.98; 95% 0.92- 1.05). However, after adjustment, living in suburbs with greater retailer density increased the odds of occasional smoking behavior (AOR=1.37; 95% CI: 1.10-1.71) but not daily or experimental smoking. CONCLUSIONS This study found a significant positive association between tobacco retailer density and the likelihood of occasional smoking in a rural Australian jurisdiction without a tobacco retailer licensing system in place. The findings strengthen calls for the introduction of a comprehensive, positive tobacco retailer licensing system to provide a framework for improving compliance with legislation and to reduce the overall availability of tobacco products in the community. © 2021 Baker J. et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 International License. (https://creativecommons.org/licenses/by/4.0/)
Implementation of pressure ulcer prevention best practice recommendations in acute care: an observational study
- Authors: Barker, Anna , Kamar, Jeannette , Tyndall, Tamara , White, Lyn , Hutchinson, Anastasia , Klopfer, Nicole , Weller, Carolina
- Date: 2012
- Type: Text , Journal article
- Relation: International Wound Journal Vol. 10, no. 3 (June 2012), p. 313-320
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- Description: Pressure ulcers are a common but preventable problem in hospitals. Implementation of best practice guideline recommendations can prevent ulcers from occurring. This 9-year cohort study reports prevalence data from point prevalence surveys during the observation period, and three practice metrics to assess implementation of best practice guideline recommendations: (i) nurse compliance with use of a validated pressure ulcer risk assessment and intervention checklist; (ii) accuracy of risk assessment scoring in usual-care nurses and experienced injury prevention nurses; and (iii) use of pressure ulcer prevention strategies. The prevalence of hospital-acquired pressure ulcers decreased following implementation of an evidence-based prevention programme from 12 center dot 6% (2 years preprogramme implementation) to 2 center dot 6% (6 years postprogramme implementation) (P < 0 center dot 001). Audits between 2003 and 2011 of 4368 patient medical records identified compliance with pressure ulcer prevention documentation according to best practice guidelines was high (>84%). A sample of 270 patients formed the sample for the study of risk assessment scoring accuracy and use of prevention strategies. It was found usual-care nurses under-estimated patients' risk of pressure ulcer development and under-utilised prevention strategies compared with experienced injury prevention nurses. Despite a significant reduction in prevalence of hospital-acquired pressure ulcers and high documentation compliance, use of prevention strategies could further be improved to achieve better patient outcomes. Barriers to the use of prevention strategies by nurses in the acute hospital setting require further examination. This study provides important insights into the knowledge translation of pressure ulcer prevention best practice guideline recommendations at The Northern Hospital.
Soil chemical markers distinguishing human and pig decomposition islands : a preliminary study
- Authors: Barton, Philip , Reboldi, Anna , Dawson, Blake , Ueland, Maiken , Strong, Craig , Wallman, James
- Date: 2020
- Type: Text , Journal article
- Relation: Forensic Science, Medicine, and Pathology Vol. 16, no. 4 (2020), p. 605-612
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- Description: The decomposition of vertebrate cadavers on the soil surface produces nutrient-rich fluids that enter the soil profile, leaving clear evidence of the presence of a cadaver decomposition island. Few studies, however, have described soil physicochemistry under human cadavers, or compared the soil between human and non-human animal models. In this study, we sampled soil to 5 cm depth at distances of 0 cm and 30 cm from cadavers, as well as from control sites 90 cm distant, from five human and three pig cadavers at the Australian Facility for Taphonomic Experimental Research (AFTER). We found that soil moisture, electrical conductivity, nitrate, ammonium, and total phosphorus were higher in soil directly under cadavers (0 cm), with very limited lateral spread beyond 30 cm. These patterns lasted up to 700 days, indicating that key soil nutrients might be useful markers of the location of the decomposition island for up to 2 years. Soil phosphorus was always higher under pigs than humans, suggesting a possible difference in the decomposition and soil processes under these two cadaver types. Our preliminary study highlights the need for further experimental and replicated research to quantify variability in soil properties, and to identify when non-human animals are suitable analogues. © 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Antimicrobial resistance in community and nosocomial Escherichia coli urinary tract isolates, London 2005-2006
- Authors: Bean, David , Krahe, Daniel , Wareham, David
- Date: 2008
- Type: Text , Journal article
- Relation: Annals of Clinical Microbiology and Antimicrobials Vol. 7, no. (June 2008 2008), p.
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- Description: Background: Escherichia coli is the commonest cause of community and nosocomial urinary tract infection (UTI). Antibiotic treatment is usually empirical relying on susceptibility data from local surveillance studies. We therefore set out to determine levels of resistance to 8 commonly used antimicrobial agents amongst all urinary isolates obtained over a 12 month period. Methods: Antimicrobial susceptibility to ampicillin, amoxicillin/ clavulanate, cefalexin, ciprofloxacin, gentamicin, nitrofurantoin, trimethoprim and cefpodoxime was determined for 11,865 E. coli urinary isolates obtained from community and hospitalised patients in East London. Results: Nitrofurantoin was the most active agent (94% susceptible), followed by gentamicin and cefpodoxime. High rates of resistance to ampicillin (55%) and trimethoprim (40%), often in combination were observed in both sets of isolates. Although isolates exhibiting resistance to multiple drug classes were rare, resistance to cefpodoxime, indicative of Extended spectrum
- Description: C1