Description:
Objectives: To assess the utility and functionality of the X-Patch® as a measurement tool to study head impact exposure in Australian Football. Accuracy, precision, reliability and validity were examined. Designs: Laboratory tests and prospective observational study. Methods: Laboratory tests on X-Patch® were undertaken using an instrumented Hybrid III head and neck and linear impactor. Differences between X-Patch® and reference data were analysed. Australian Football players wore the X-Patch® devices and games were video-recorded. Video recordings were analysed qualitatively for head impact events and these were correlated with X-Patch® head acceleration events. Wearability of the X-Patch® was assessed using the Comfort Rating Scale for Wearable Computers. Results: Laboratory head impacts, performed at multiple impact sites and velocities, identified significant correlations between headform-measured and device-measured kinematic parameters (p < 0.05 for all). On average, the X-Patch®-recorded peak linear acceleration (PLA) was 17% greater than the reference PLA, 28% less for peak rotational acceleration (PRA) and 101% greater for the Head Injury Criterion (HIC). For video analysis, 118 head acceleration events (HAE) were included with PLA ≥30 g across 53 players. Video recordings of X-Patch®-measured HAEs (PLA ≥30 g) determined that 31.4% were direct head impacts, 9.3% were indirect impacts, 44.1% were unknown or unclear and 15.3% were neither direct nor indirect head impacts. The X-Patch® system was deemed wearable by 95–100% of respondents. Conclusions: This study reinforces evidence that use of the current X-Patch® devices should be limited to research only and in conjunction with video analysis.
Description:
Objectives: COAST (Chiropractic Observation and Analysis Study) aimed to describe the clinical practices of chiropractors in Victoria, Australia. Design: Cross-sectional study using the BEACH (Bettering the Evaluation and Care of Health) methods for general practice. Setting and participants: 180 chiropractors in active clinical practice in Victoria were randomly selected from the list of 1298 chiropractors registered on Chiropractors Registration Board of Victoria. Twenty-four chiropractors were ineligible, 72 agreed to participate, and 52 completed the study. Main outcome measures: Each participating chiropractor documented encounters with up to 100 consecutive patients. For each chiropractor-patient encounter, information collected included patient health profile, patient reasons for encounter, problems and diagnoses, and chiropractic care. Results: Data were collected on 4464 chiropractor-patient encounters from 52 chiropractors between 11 December 2010 and 28 September 2012. In most (71%) encounters, patients were aged 25-64 years; 1% of encounters were with infants (age < 1 year; 95% CI, 0.3%-3.2%). Musculoskeletal reasons for encounter were described by patients at a rate of 60 per 100 encounters (95% CI, 54-67 encounters) and maintenance and wellness or check-up reasons were described at a rate of 39 per 100 encounters (95% CI, 33-47 encounters). Back problems were managed at a rate of 62 per 100 encounters (95% CI, 55-71 encounters). The most frequent care provided by the chiropractors was spinal manipulative therapy and massage. Conclusions: A range of conditions are managed by chiropractors in Victoria, Australia, but most commonly these conditions are musculoskeletal-related. These results can be used by stakeholders of the chiropractic profession in workforce development, education and health care policy.
Description:
Present health funding models can place onerous pressures on rural health services. Staff may lack the time, resources, access to data, and the expertise needed to complete complex and lengthy funding submissions. This present study describes an innovative capacity-building approach to working with Victorian rural communities seeking to access health care funding through the Regional Health Services Program. This approach used several strategies: engaging stakeholders in targeted rural communities, developing an information kit and running a workshop on preparing submissions to the Regional Health Services Program, facilitating community consultations, and providing ongoing support with submissions. Six rural communities were supported in this way. Four have been funded to date, with a combined annual recurrent budget for new primary health care services of over $2.5 million. Each community has developed a service delivery model that meets the particular needs of their local area. This capacity-building approach is both effective and replicable to other health funding opportunities. The definitive version of this article is available at www3.interscience.wiley.com
Description:
Present health funding models can place onerous pressures on rural health services. Staff may lack the time, resources, access to data, and the expertise needed to complete complex and lengthy funding submissions. This present study describes an innovative capacity-building approach to working with Victorian rural communities seeking to access health care funding through the Regional Health Services Program. This approach used several strategies: engaging stakeholders in targeted rural communities, developing an information kit and running a workshop on preparing submissions to the Regional Health Services Program, facilitating community consultations, and providing ongoing support with submissions. Six rural communities were supported in this way. Four have been funded to date, with a combined annual recurrent budget for new primary health care services of over $2.5 million. Each community has developed a service delivery model that meets the particular needs of their local area. This capacity-building approach is both effective and replicable to other health funding opportunities. The definitive version of this article is available at www3.interscience.wiley.com
Description:
This paper investigates the health and welfare needs of students (n = 15,806) and the current service model in Catholic schools in the Ballarat Diocese of Victoria, Australia. Catholic schools use a service model underpinned by an ethos of pastoral care; there is a strong tradition of self-reliance within the Catholic education system for meeting students' health and welfare needs. The central research questions are: What are the emerging health and welfare needs of students? How does pastoral care shape the service model to meet these needs? What model/s might better meet students' primary health care needs? The research methods involved analysis of(1) extant databases of expressed service needs including referrals (n = 1,248) to Student Services over the last 2.5 years, (2) trends in the additional funding support such as special needs funding for students and the Education Maintenance Allowance for families, and (3) semi-structured individual and group interviews with 98 Diocesan and school staff responsible for meeting students' health and welfare needs. Analysis of expressed service needs revealed a marked increase in service demand, and in the complexity and severity of students' needs. Thematic analysis of qualitative interview data revealed five pressing issues: the health and welfare needs of students; stressors in the school community; rural isolation; role boundaries and individualised interventions; and self-reliant networks of care. Explanations for many of these problems can be located in wider social and economic forces impacting upon the church and rural communities. It was concluded that the pastoral care model-as it is currently configured-is not equipped to meet the escalating primary health care needs of students in rural areas. This paper considers the implications for enhanced primary health care in both rural communities and in schools.
Description:
This paper investigates the health and welfare needs of students (n = 15,806) and the current service model in Catholic schools in the Ballarat Diocese of Victoria, Australia. Catholic schools use a service model underpinned by an ethos of pastoral care; there is a strong tradition of self-reliance within the Catholic education system for meeting students' health and welfare needs. The central research questions are: What are the emerging health and welfare needs of students? How does pastoral care shape the service model to meet these needs? What model/s might better meet students' primary health care needs? The research methods involved analysis of(1) extant databases of expressed service needs including referrals (n = 1,248) to Student Services over the last 2.5 years, (2) trends in the additional funding support such as special needs funding for students and the Education Maintenance Allowance for families, and (3) semi-structured individual and group interviews with 98 Diocesan and school staff responsible for meeting students' health and welfare needs. Analysis of expressed service needs revealed a marked increase in service demand, and in the complexity and severity of students' needs. Thematic analysis of qualitative interview data revealed five pressing issues: the health and welfare needs of students; stressors in the school community; rural isolation; role boundaries and individualised interventions; and self-reliant networks of care. Explanations for many of these problems can be located in wider social and economic forces impacting upon the church and rural communities. It was concluded that the pastoral care model-as it is currently configured-is not equipped to meet the escalating primary health care needs of students in rural areas. This paper considers the implications for enhanced primary health care in both rural communities and in schools.
Description:
The task of dragging sheep into position for shearing has been reported by shearers as the most physically demanding and one of the highest injury risk aspects of shearing, particularly with regard to back injury. This study aimed to identify which of the currently used drag paths induced the lowest energy consumption and risk of injury. The drag path with the lowest work economy (oxygen cost per sheep dragged per minute) and highest injury risk is used by left-handed shearers who are shearing from a workstation which is designed for right-handed shearers. Importantly, there were no significant differences in the work economy of the two drag paths which were used most frequently and which involved the lowest injury risk. These data have been used in advocating the adoption of simple shearing shed design solutions to assist in the control of injury risk and energy expenditure in the wool industry.
Description:
Retrospective data extraction from two complementary mortality datasets determined the descriptive epidemiology and population rates in unintentional drowning deaths at surf beaches (n = 129). The annual average crude surf beach drowning rate was 0.28 per 100 000 population for males and 2.36 per 100 000 population for international tourists. The study generated hypotheses for risk assessment to assist intervention: adult males, international tourists, people with cardiovascular conditions, and exposure to rip currents.
Is self-reporting workplace activity worthwhile? Validity and reliability of Occupational Sitting and Physical Activity Questionnaire in desk-based workers BMC Public Health
Description:
Background: Accelerometers can obtain precise measurements of movements during the day. However, the individual activity pattern varies from day-to-day and there is limited evidence on measurement days needed to obtain sufficient reliability. The aim of this study was to examine variability in accelerometer derived data on sedentary behaviour and physical activity at work and in leisure-time during week days among Danish office employees. Methods: We included control participants (n = 135) from the Take a Stand! Intervention; a cluster randomized controlled trial conducted in 19 offices. Sitting time and physical activity were measured using an ActiGraph GT3X+ fixed on the thigh and data were processed using Acti4 software. Variability was examined for sitting time, standing time, steps and time spent in moderate-to-vigorous physical activity (MVPA) per day by multilevel mixed linear regression modelling. Results: Results of this study showed that the number of days needed to obtain a reliability of 80% when measuring sitting time was 4.7 days for work and 5.5 days for leisure time. For physical activity at work, 4.0 days and 4.2 days were required to measure steps and MVPA, respectively. During leisure time, more monitoring time was needed to reliably estimate physical activity (6.8 days for steps and 5.8 days for MVPA). Conclusions: The number of measurement days needed to reliably estimate activity patterns was greater for leisure time than for work time. The domain specific variability is of great importance to researchers and health promotion workers planning to use objective measures of sedentary behaviour and physical activity.
Description:
Background: Accelerometers can obtain precise measurements of movements during the day. However, the individual activity pattern varies from day-to-day and there is limited evidence on measurement days needed to obtain sufficient reliability. The aim of this study was to examine variability in accelerometer derived data on sedentary behaviour and physical activity at work and in leisure-time during week days among Danish office employees. Methods: We included control participants (n = 135) from the Take a Stand! Intervention; a cluster randomized controlled trial conducted in 19 offices. Sitting time and physical activity were measured using an ActiGraph GT3X+ fixed on the thigh and data were processed using Acti4 software. Variability was examined for sitting time, standing time, steps and time spent in moderate-to-vigorous physical activity (MVPA) per day by multilevel mixed linear regression modelling. Results: Results of this study showed that the number of days needed to obtain a reliability of 80% when measuring sitting time was 4.7 days for work and 5.5 days for leisure time. For physical activity at work, 4.0 days and 4.2 days were required to measure steps and MVPA, respectively. During leisure time, more monitoring time was needed to reliably estimate physical activity (6.8 days for steps and 5.8 days for MVPA). Conclusions: The number of measurement days needed to reliably estimate activity patterns was greater for leisure time than for work time. The domain specific variability is of great importance to researchers and health promotion workers planning to use objective measures of sedentary behaviour and physical activity.
Description:
In the context of a growing population of people experiencing mental illness worldwide, mental health nurses are a crucial workforce. Their recruitment and retention, however, is in decline. Drawing on qualitative data obtained from interviews with mental health nurses () in ictoria, Australia, the paper employs a range of concepts from role theory to explore professional identity within mental health nursing. The data highlight three key issues in relation to the future recruitment and retention of : (i) the ambiguity of the role; (ii) the weak definition and lack of understanding of the scope of the role by nursing students; and (iii) a lack of communication about as a profession to a wider audience. These findings indicate three avenues through which recruitment and retention in mental health nursing could be improved: (i) public communication; (ii) training and educating of the next generation of ; and (iii) more accurately defining the role of the MHN.
Description:
Nursing management of physical deterioration of patients within acute mental health settings is observed, recorded, and actively managed with the use of standardized Adult Deterioration Detection System (ADDS) charts. Patient deterioration may require the urgent assistance of a hospital rapid response or Medical Emergency Team. A five-and-a-half-year (2011–2016) audit of hospital-wide Medical Emergency Team attendances was conducted in an acute mental health unit of a single large 250 bed regional hospital in Victoria, Australia. Data were extracted from the hospitals’ quality and patient safety program, RISKMan, and entered into a statistical data program for analysis. A total of 140 patient records were analysed, and the ‘Worried’ category (34%, n = 47) was the principle reason for a Medical Emergency Team call in a mental health ward, followed by hypotension (23%, n = 31) and a low Glasgow Coma Score (16%, n = 22). Upon further investigation of the ‘Worried’ category, the most common conditions recorded were an altered conscious state (22%, n = 9), low oxygen saturation (20%, n = 8), or chest pain (17%, n = 7). Activation of Medical Emergency Team calls predominantly occurred in the daylight morning hours (6am–12md). When data were compared to the general hospital patients, the context of the physiological deterioration of the mental health patients was strikingly similar. Further research is recommended to ascertain the extent and frequency with which staff working in mental health units are performing vital signs monitoring as an essential component of detection of early signs of physiological deterioration.
Description:
Aims and objectives To investigate the prevalence of depression in the third trimester of pregnancy and identify the related demographic risk factors. Background Antenatal depression as a disabling and treatable disease has a wide-ranging impact on perinatal women and has received extensive attention from researchers. Design A cross-sectional survey was conducted at three public hospitals. Methods Demographic questionnaire was developed from the literature review, and depression was assessed using the Edinburgh Postnatal Depression Scale. A binary logistic regression model was used to assess the association between depression and demographic predictors. STROBE checklist for cross-sectional studies was applied in this paper (see Appendix S1). Result A total of 773 pregnant women participated in the study. 29.6% of participants scored more than 9 points on Edinburgh Postnatal Depression Scale. In the final logistic model, living in rural area, marital satisfaction, assisted reproductive technology, lacking of prenatal health knowledge and life events were strongly significantly associated with antenatal depression. Moreover, living in an extended family, without Medicare insurance, unemployed, working as civil servants or healthcare workers, and lower household income also predicted antenatal depression. However, education level, smoking or drinking before pregnancy was found not to be associated with antenatal depression. Conclusion Our findings suggest that the prevalence of antenatal depression was high. Satisfied with the current marital status, pregnancy without assisted reproductive technology, knowledge of perinatal care and no life events recently were considered as the protective factors for antenatal depression. Relevance to clinical practice Antenatal psychological interventions should focus on how to improve the marital satisfaction and the relationship with their family members. More attentions should be paid to the women who have had some life events recently or received assisted reproductive technology for pregnancy.
Description:
AbstractObjectives Australian Football League (AFL) players have a high risk of injury. Anecdotally, this injury risk is greater in emerging players (i.e. those in their first year), compared with established players (with 3+ years of experience). This study aimed to conduct the first comparison of injury risk and playing experience in these two player groups across a large number of AFL clubs. Design Prospective, cohort. Methods Injuries, game participation and training participation were collected weekly by 8 AFL clubs for 61 emerging and 64 established players. Injury incidence rates (IIR) and Cox proportional hazard models for time to first injury, separately for games and training, were computed. Results The game IIR was significantly higher for emerging than established players: 45.6 (95% CI: 35.7, 57.6) versus 18.3 (95% CI: 13.1, 24.9) per 1000 game-hours. Emerging players also had a higher training IIR than did the established players: 9.6 (95% CI: 7.6, 11.9) versus 8.9 (95% CI: 7.0, 11.1) per 1000 training-hours. Emerging players were significantly less likely to remain injury free in games than established players (HR = 3.46, 95% CI: 1.27, 9.45). A similar outcome was seen in training sessions, although to a lesser degree (HR = 1.41, 95% CI: 1.19, 1.69). Conclusions Despite efforts to modify the playing/training program of emerging players, this group remain at greater risk of injury in games and training sessions, compared with established players. Continued efforts should be made toward understanding reasons for this increased risk to better prevent injury during the early years of a professional football career.
Description:
In South Australia, health and safety representatives (HSRs) may undertake three levels of training, commencing at basic level, then progressing through advanced level to continuing level. A survey of 1,200 HSRs in SA was conducted to assess their beliefs about accident causation and accident prevention. In regard to accident causation, the survey found that HSRs showed a tendency to favour behavioural causation over workplace environment or systems-type causation. In regard to accident prevention, HSRs at all levels of training had a preference for low-order controls. However, there appears to be some shift in thinking by the time HSRs have completed all levels of training (that is, to the continuing training level), though the thinking of most remains distinctly safe-worker in orientation.
Description:
In South Australia, health and safety representatives (HSRs) may undertake three levels of training, commencing at basic level, then progressing through advanced level to continuing level. A survey of 1,200 HSRs in SA was conducted to assess their beliefs about accident causation and accident prevention. In regard to accident causation, the survey found that HSRs showed a tendency to favour behavioural causation over workplace environment or systems-type causation. In regard to accident prevention, HSRs at all levels of training had a preference for low-order controls. However, there appears to be some shift in thinking by the time HSRs have completed all levels of training (that is, to the continuing training level), though the thinking of most remains distinctly safe-worker in orientation.
Description:
OBJECTIVES: To develop a valid and reliable video-based decision-making test to examine and monitor the decision-making performance of Australian football umpires. DESIGN: Validation assessments with test re-test reliability. METHODS: A video-based decision-making test was developed from a pool of 156 video-based decision-making situations. Australian football umpires (n=56) and players (n=45) participated in two separate phases of analysis. In phase one, players completed a test re-test reliability assessment with a 100 video-clips. Results indicated 24 clips were a reliable measure of decision-making performance. In phase two, umpires completed a test re-test protocol with 80 clips, 24 of which were the reliable clips identified by the player cohort in phase one. These 24 clips provided a measure of construct validity. Face and content validity were assessed by skill acquisition specialists, expert umpire coaches, and umpires. RESULTS: From each of phase one and two of the reliability assessment, 24 clips were found to have a kappa value greater than 0.30, providing a total of 48 reliable video-clips. Construct validity was supported, with the umpire group performing significantly better than the player group on the 24 clips presented to both groups on each testing occasion. Face and content validity were also demonstrated. CONCLUSIONS: This investigation demonstrated the ability prospectively to determine reliability and validity of the video-based decision-making test designed specifically for Australian football umpires. Establishing the validity and reliability of the video clips ensures future investigations can accurately and consistently measure the decision-making performance of Australian football umpires.
Description:
Aims and objectives To review communication interventions that aim to improve regular care interactions between people with dementia and their carers in various settings; and to examine the impact of such interventions on both carer and care-receiver outcomes. Background Effective communication is imperative to ensure quality of care for people living with dementia. Due to neurodegenerative changes, people with dementia encounter ongoing and progressive difficulties in both understanding and expressing themselves. This in turn creates challenges for carers, which highlights the need for equipping them with necessary communication skills to respond to the specific communication needs of people with dementia. Design Systematic review and meta-analysis. Method Medline, Embase, CINAHL, ProQuest and PsycINFO databases were searched for eligible interventions with any date of the publication. Hand searching was also conducted through reviewing the reference lists of relevant articles. The screening and selection of studies were based on the inclusion/exclusion criteria for eligibility and the methodological quality assessment checklist. Random-effects meta-analyses were conducted on comparable quantitative data. The review is reported following the PRISMA reporting guidelines. Results Seventeen studies were included in the final review, including 12 randomised controlled trials (RCTs), three nonrandomised controlled trials (NRCTs) and two controlled before-after interventions. The intervention designs, settings and outcome measures were varied. The findings suggest that the communication training had a positive impact on both carer and care-receiver outcomes, albeit to different degrees. The intervention effects were found to be strongest on carer communication skills and knowledge. Conclusion There is solid evidence for the positive impact of communication training on the skills and knowledge of carers. More research is needed regarding the effects of such educational interventions on carer physio-psychological outcomes and care-receiver neuropsychiatric symptoms. It is important to establish best practices in training design, develop validated outcome measures and adopt consistent reporting approaches. Relevance to clinical practice The increasing global prevalence of people with dementia manifests across clinical and community contexts. The profound impact of dementia on communication and associated care raises the imperative for enhanced health worker and carer communication skills to meet the needs of this particular client group. The findings of this review indicate that educational interventions incorporating face-to-face and diverse instructional delivery methods in dementia communication showed positive outcomes for communication skills in all carer groups and warrant inclusion as strategies in dementia training.
Description:
Aims and objectives To review communication interventions that aim to improve regular care interactions between people with dementia and their carers in various settings; and to examine the impact of such interventions on both carer and care-receiver outcomes. Background Effective communication is imperative to ensure quality of care for people living with dementia. Due to neurodegenerative changes, people with dementia encounter ongoing and progressive difficulties in both understanding and expressing themselves. This in turn creates challenges for carers, which highlights the need for equipping them with necessary communication skills to respond to the specific communication needs of people with dementia. Design Systematic review and meta-analysis. Method Medline, Embase, CINAHL, ProQuest and PsycINFO databases were searched for eligible interventions with any date of the publication. Hand searching was also conducted through reviewing the reference lists of relevant articles. The screening and selection of studies were based on the inclusion/exclusion criteria for eligibility and the methodological quality assessment checklist. Random-effects meta-analyses were conducted on comparable quantitative data. The review is reported following the PRISMA reporting guidelines. Results Seventeen studies were included in the final review, including 12 randomised controlled trials (RCTs), three nonrandomised controlled trials (NRCTs) and two controlled before-after interventions. The intervention designs, settings and outcome measures were varied. The findings suggest that the communication training had a positive impact on both carer and care-receiver outcomes, albeit to different degrees. The intervention effects were found to be strongest on carer communication skills and knowledge. Conclusion There is solid evidence for the positive impact of communication training on the skills and knowledge of carers. More research is needed regarding the effects of such educational interventions on carer physio-psychological outcomes and care-receiver neuropsychiatric symptoms. It is important to establish best practices in training design, develop validated outcome measures and adopt consistent reporting approaches. Relevance to clinical practice The increasing global prevalence of people with dementia manifests across clinical and community contexts. The profound impact of dementia on communication and associated care raises the imperative for enhanced health worker and carer communication skills to meet the needs of this particular client group. The findings of this review indicate that educational interventions incorporating face-to-face and diverse instructional delivery methods in dementia communication showed positive outcomes for communication skills in all carer groups and warrant inclusion as strategies in dementia training.