Description:
Cognitive models of anxiety and depression have long suggested a central role for future-oriented thinking in these disorders. Experimental studies suggest that anxiety and depression are characterised by distinct future-oriented thinking profiles, and that these profiles are markedly different from those of asymptomatic adults. In this paper, we review these profiles and propose two explanatory models marked by two different neurocognitive systems. The Reconstructive Memory Model emphasises a role for emotionally driven learning and retrieval in episodic foresight (i.e., the construction of future-oriented scenarios), and the Valuation Model proposes that an overweighing of risk and uncertainty estimates can be invoked to explain the future-oriented thought patterns. We consider the effectiveness of interventions aimed at altering such thought patterns. We suggest that future research aimed at elucidating the neurobiological underpinnings of future-oriented thinking in anxiety and depression can play an important role in advancing development of effective biological and psychosocial interventions for these disorders.
Description:
The World Health Organization (WHO) has recognized that errors in communication are one of the leading causes of adverse patient outcomes. Consequently, the WHO developed the High 5s Project to review, among other variables, handover of patients between shifts, professionals, and organizations. Seven countries were involved in the initial project. Australia responded by using the ISOBAR (Identify, Situation, Observations, Background, Agreed plan, and Read-back) tool as a template. However, none of the countries involved considered the social and emotional effects of handover on the staff or patients, although research has demonstrated that attitudes and values can be handed over from one nurse to another during this process. This article shows how the nurse who hands over care from one shift to the next can transfer stigma and labeling and offers suggestions for nurse educators and clinicians to apply national standards and core values to clinical practice and education.
Description:
A microstructural study of Coode Island Silt (CIS), a soft silty clay from the Melbourne area of Australia, stabilised with slag lime is reported. Slag lime is a blend of 80–85 wt% slag, 15 wt% hydrated lime, Ca(OH)2 and 3–8 wt% gypsum CaSO4.2H2O, and is typically used for soil stabilisation in roading applications. The morphologies of several homogeneous mixtures of slag lime and CIS were studied by Scanning Electron Microscopy (SEM) and X-Ray Diffraction (XRD), which indicated the formation of the cementitious phases calcium carbonate, calcium silicate hydrate, calcium aluminium silicate hydrate, and calcium aluminium silicate carbonate. The progress of the CIS-slag lime reactions was also investigated by pH measurements. Slag lime was found to very actively promote pozzolanic reactions with CIS, shown by SEM to form crystalline reticular calcium silicate hydrate and other cementitious products. The most effective pozzolanic reactions occurred in a composite containing 12.5 wt% slag lime with CIS and contained the cement mineral ettringite, contributing to its high strength. These composites constitute a new class of materials with excellent potential for construction applications.
Description:
Environmental concerns have increased the interest in winery wastewater remediation and reuse. These practices require more detailed understanding of wastewater composition to ensure optimum usage, and to minimize the risk of long term soil degradation and grape contamination. Particulate organic matter is an important contributor to the carbon burden in winery wastewaters. This article investigates the molecular structure of particulates from the most common winery wastewater treatment processes via infrared spectroscopic and thermochemolysis-gas chromatography/mass spectrometry techniques. Study of the organic composition of both influent and effluent particles enabled further insight into which compounds could prove problematic during treatment and on discharge. The yield and molecular structure of desorbed or “guest” compounds were found to strongly correlate with those produced during pyrolytic cracking. These “guest” compounds and macromolecular fragments form a continuum whose separation is based on molecular size. Polyphenolic and lignin derived compounds tended to survive the water treatment processes within assemblages of microbial detritus. No evidence was found for particles adsorbing and concentrating other unrelated organics such as anthropogenic chemicals from winery wastewaters. Any release of particulates will require careful management to prevent localized accumulation of recalcitrant compounds to toxic levels.
Description:
The aim of the present study was to gain an understanding of the experience of treatment via an Internet-based cognitive behavioural self-help protocol for social anxiety disorder. Participants were four adults, aged between 22-46 years, who fulfilled DSM-IV-TR crriteria for a diagnosis of social anxiety disorder.
Description:
"The central focus of this study is an investigation into how the implementation of a clinical pathway for the surgical procedure of transurethral resection of the prostate (TURP) impacted on clinical quality, cost, and patient and staff satisfaction at the Aga Khan University Hospital (AKUH) in Pakistan"
Description:
"The central focus of this study is an investigation into how the implementation of a clinical pathway for the surgical procedure of transurethral resection of the prostate (TURP) impacted on clinical quality, cost, and patient and staff satisfaction at the Aga Khan University Hospital (AKUH) in Pakistan"
Description:
Aims: Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results: Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion: May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk.
Description:
Aims: Raised blood pressure (BP) is the biggest contributor to mortality and disease burden worldwide and fewer than half of those with hypertension are aware of it. May Measurement Month (MMM) is a global campaign set up in 2017, to raise awareness of high BP and as a pragmatic solution to a lack of formal screening worldwide. The 2018 campaign was expanded, aiming to include more participants and countries. Methods and results: Eighty-nine countries participated in MMM 2018. Volunteers (≥18 years) were recruited through opportunistic sampling at a variety of screening sites. Each participant had three BP measurements and completed a questionnaire on demographic, lifestyle, and environmental factors. Hypertension was defined as a systolic BP ≥140mmHg or diastolic BP ≥90 mmHg, or taking antihypertensive medication. In total, 74.9% of screenees provided three BP readings. Multiple imputation using chained equations was used to impute missing readings. 1 504 963 individuals (mean age 45.3 years; 52.4% female) were screened. After multiple imputation, 502 079 (33.4%) individuals had hypertension, of whom 59.5% were aware of their diagnosis and 55.3% were taking antihypertensive medication. Of those on medication, 60.0% were controlled and of all hypertensives, 33.2% were controlled. We detected 224 285 individuals with untreated hypertension and 111 214 individuals with inadequately treated (systolic BP ≥ 140mmHg or diastolic BP ≥ 90 mmHg) hypertension. Conclusion: May Measurement Month expanded significantly compared with 2017, including more participants in more countries. The campaign identified over 335 000 adults with untreated or inadequately treated hypertension. In the absence of systematic screening programmes, MMM was effective at raising awareness at least among these individuals at risk.
Description:
On 24 January 1919, a thirty-two-year-old nurse from Sydney, Jean Williamson, disembarked at the railway station at Oodnadatta in the far north of South Australia to commence her new role as sister in charge of the Australian Inland Mission (AIM) hostel. On 18 April that year, Williamson greeted thirty-four-year-old minister from Melbourne, Coledge Harland, who had arrived by train to take up a three-year post as padre for the AIM’s central Australian parish. Just over a month later, an influenza pandemic that had already killed untold numbers of people worldwide reached the isolated township. Drawing on primary documents, including an extensive collection of previously unseen photographs, letter and diaries from Harland and Williamson, this thesis examines the management and care of pandemic influenza at Oodnadatta from May to late July 1919. Intercultural aspects of the management and care of European, Afghan, Chinese and Aboriginal patients are examined in the context of the health and lifestyle of local residents, nursing practices, medicines, foods, accommodation and the contribution of individuals, groups and their roles. This intimate microhistory sheds light on a relatively unknown, yet important group of people in Australia’s frontier history: the missioners and others who cared for seriously ill Aboriginal and non-Aboriginal patients at Oodnadatta, provided culturally sensitive care that afforded respect, dignity and compassion to all. At the time, the gravity of the world wide situation and the sheer need to provide care saw individual efforts go unnoticed; however, in hindsight, it is possible to see and appreciate the significance of what they achieved under the most difficult of circumstances.
Description:
On 24 January 1919, a thirty-two-year-old nurse from Sydney, Jean Williamson, disembarked at the railway station at Oodnadatta in the far north of South Australia to commence her new role as sister in charge of the Australian Inland Mission (AIM) hostel. On 18 April that year, Williamson greeted thirty-four-year-old minister from Melbourne, Coledge Harland, who had arrived by train to take up a three-year post as padre for the AIM’s central Australian parish. Just over a month later, an influenza pandemic that had already killed untold numbers of people worldwide reached the isolated township. Drawing on primary documents, including an extensive collection of previously unseen photographs, letter and diaries from Harland and Williamson, this thesis examines the management and care of pandemic influenza at Oodnadatta from May to late July 1919. Intercultural aspects of the management and care of European, Afghan, Chinese and Aboriginal patients are examined in the context of the health and lifestyle of local residents, nursing practices, medicines, foods, accommodation and the contribution of individuals, groups and their roles. This intimate microhistory sheds light on a relatively unknown, yet important group of people in Australia’s frontier history: the missioners and others who cared for seriously ill Aboriginal and non-Aboriginal patients at Oodnadatta, provided culturally sensitive care that afforded respect, dignity and compassion to all. At the time, the gravity of the world wide situation and the sheer need to provide care saw individual efforts go unnoticed; however, in hindsight, it is possible to see and appreciate the significance of what they achieved under the most difficult of circumstances.
Description:
Tendinopathy can be resistant to treatment and often recurs, implying that current treatment approaches are suboptimal. Rehabilitation programmes that have been successful in terms of pain reduction and return to sport outcomes usually include strength training. Muscle activation can induce analgesia, improving self-efficacy associated with reducing one's own pain. Furthermore, strength training is beneficial for tendon matrix structure, muscle properties and limb biomechanics. However, current tendon rehabilitation may not adequately address the corticospinal control of the muscle, which may result in altered control of muscle recruitment and the consequent tendon load, and this may contribute to recalcitrance or symptom recurrence. Outcomes of interest include the effect of strength training on tendon pain, corticospinal excitability and short interval cortical inhibition. The aims of this concept paper are to: (1) review what is known about changes to the primary motor cortex and motor control in tendinopathy, (2) identify the parameters shown to induce neuroplasticity in strength training and (3) align these principles with tendon rehabilitation loading protocols to introduce a combination approach termed as tendon neuroplastic training. Strength training is a powerful modulator of the central nervous system. In particular, corticospinal inputs are essential for motor unit recruitment and activation; however, specific strength training parameters are important for neuroplasticity. Strength training that is externally paced and akin to a skilled movement task has been shown to not only reduce tendon pain, but modulate excitatory and inhibitory control of the muscle and therefore, potentially tendon load. An improved understanding of the methods that maximise the opportunity for neuroplasticity may be an important progression in how we prescribe exercise-based rehabilitation in tendinopathy for pain modulation and potentially restoration of the corticospinal control of the muscle-tendon complex.
Description:
Tendinopathy can be resistant to treatment and often recurs, implying that current treatment approaches are suboptimal. Rehabilitation programmes that have been successful in terms of pain reduction and return to sport outcomes usually include strength training. Muscle activation can induce analgesia, improving self-efficacy associated with reducing one's own pain. Furthermore, strength training is beneficial for tendon matrix structure, muscle properties and limb biomechanics. However, current tendon rehabilitation may not adequately address the corticospinal control of the muscle, which may result in altered control of muscle recruitment and the consequent tendon load, and this may contribute to recalcitrance or symptom recurrence. Outcomes of interest include the effect of strength training on tendon pain, corticospinal excitability and short interval cortical inhibition. The aims of this concept paper are to: (1) review what is known about changes to the primary motor cortex and motor control in tendinopathy, (2) identify the parameters shown to induce neuroplasticity in strength training and (3) align these principles with tendon rehabilitation loading protocols to introduce a combination approach termed as tendon neuroplastic training. Strength training is a powerful modulator of the central nervous system. In particular, corticospinal inputs are essential for motor unit recruitment and activation; however, specific strength training parameters are important for neuroplasticity. Strength training that is externally paced and akin to a skilled movement task has been shown to not only reduce tendon pain, but modulate excitatory and inhibitory control of the muscle and therefore, potentially tendon load. An improved understanding of the methods that maximise the opportunity for neuroplasticity may be an important progression in how we prescribe exercise-based rehabilitation in tendinopathy for pain modulation and potentially restoration of the corticospinal control of the muscle-tendon complex.