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Moisturizers, Emollients, or Barrier Preparations for the Prevention of Pressure Injury: A Systematic Review and Meta-Analysis
No full textSignificance: Pressure injuries are prevalent, yet preventable global health care problem estimated to affect 14% of hospital patients and up to 46% of aged care residents. One common prevention strategy is improving skin integrity through emollient therapy to optimize hydration and avoid skin breakdown. Therefore, this study aimed to review the literature and determine effectiveness of inert emollients, moisturizers, and barrier preparations compared with standard care, to prevent pressure injury in aged care or hospital settings.
Recent Advances: Search terms were derived with database searches, including ProQuest, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, Science Direct, Scopus, and the Cochrane library. The Robins1 and Risk of Bias 2 (Rob2) quality appraisal tools were used. A meta-analysis of the effects of interventions was conducted (random effects). Four studies met the inclusion criteria, with heterogeneous quality. Pooling of nonrandomized studies found that the application of emollients, moisturizers or barrier preparations did not significantly reduce incidence of pressure injury compared with standard care (relative risk 0.50, 95% confidence interval: 0.15–1.63, Z = 1.15, p = 0.25).
Critical Issues: This review suggests that the use of inert moisturizers, emollients, or barrier preparations for preventing pressure injuries was not effective to prevent pressure injury in aged care or hospital settings. However, there was a distinct lack of randomized controlled trials (RCTs), with only one meeting the inclusion criteria. Furthermore, most of the included studies did not report on the frequency of application of the product, making it difficult to determine if application was in line with current international guidelines. One included study, which utilized a combination of neutral body wash and emollient demonstrated a significant reduction in the development of stage one and two pressure injuries. This combination of care may further support skin integrity and should be further examined in future trials.
Future Directions: Future studies should ideally be RCTs, which control for skin cleansing, and implement an inert moisturizer emollient or barrier preparation as part of a pressure injury reduction bundle of care. Standardization of the application of the product, the volume of product applied at each application, and the quality of the product should also be considered
Association of Business and Professional Members, South Pacific Division
No full textThe Association of Business and Professional Men (ABPM) was formed following discussions that took place between laymen in Sydney, Australia, in the late 1950s
Mathematics in Science: The Role of the History of Science in Communicating the Significance of Mathematical Formalism in Science
No full textThe use of a historical profile for illustrating the significance of the mathematical components of a scientific law is discussed in this paper. Such an approach addresses the need for the purposive use of scientific laws rather than the blind substitutionary procedures characteristic of most problem-solvers. The approach has the potential for increasing female participation in the physical sciences because of its reliance on learning modes favourable to female participation. © 1992 Kluwer Academic Publishers
The Effect of an Online Multimodal Lifestyle Intervention on Mental Health and Emotional Wellness: A Randomised Control Trial
No full textPURPOSE: This study examined the effect of an online multimodal lifestyle intervention, which incorporated evidence-based strategies from Lifestyle Medicine and Positive Psychology, on the mental health and emotional wellness of adults throughout Australia and New Zealand.
BACKGROUND: Common mental health disorders have reached epidemic proportions worldwide (1). In the US, one in five adults have a common mental health disorder (2), and in Australia, a similar number have experienced an affective disorder in the past twelve months (3). Antidepressants are ranked in the top three most commonly used therapeutic drug classes in the US (4), and are the most commonly used psychotropic medications in Australia (5). A new paradigm is needed focusing on primary prevention to address this burgeoning mental health problem.
METHODS: 508 individuals self-selected to participate in the study and were randomized to an intervention or delay-controlled group. Both groups completed an online survey using validated instruments which assessed the participantsʼ emotional wellness at three intervals: baseline, and at 3 months and 6 months post-intervention. 425 individuals completed the baseline assessment and entered the study (intervention n=217, control group n=208), and 359 (84%) completed the post intervention questionnaire. The intervention group participated in a 10-week online multimodal lifestyle intervention, called “The Live More Project” also known as The Lift Project”(6).
RESULTS: Overall, the cohort was in the ‘normal’ range at baseline for the domains of emotional wellness measured. At 3 months, significant reductions were observed in symptoms of ‘depression’ (-31%, p
CONCLUSIONS: This study supports the use of an online multimodal lifestyle intervention combining strategies from Lifestyle Medicine and Positive Psychology for the promotion of mental health and emotional wellness among normal populations (i.e. primary prevention). Further analyses will examine the impact of the intervention on subnormal populations to assess its potential role in secondary and tertiary prevention
The Influence of Gender and Age on the Outcomes of and Adherence to a Digital Interdisciplinary Mental Health Promotion Intervention in an Australasian Nonclinical Setting: Cohort Study
No full textBackground: The global prevalence of mental health disorders is at a crisis point, particularly in the wake of COVID-19, prompting calls for the development of digital interdisciplinary mental health promotion interventions (MHPIs) for nonclinical cohorts. However, the influence of gender and age on the outcomes of and adherence to MHPIs is not well understood.
Objective: The aim of this study was to determine the influence of gender and age on the outcomes of and adherence to a 10-week digital interdisciplinary MHPI that integrates strategies from positive psychology and lifestyle medicine and utilizes persuasive systems design (PSD) principles in a nonclinical setting.
Methods: This study involved 488 participants who completed the digital interdisciplinary MHPI. Participants completed a pre and postintervention questionnaire that used: (1) the “mental health” and “vitality” subscales from the Short Form 36 (SF-36) Health Survey; (2) the Depression, Anxiety and Stress Scale (DASS-21); and (3) Satisfaction With Life Scale (SWL). Adherence to the digital interdisciplinary MHPI was measured by the number of educational videos the participants viewed and the extent to which they engaged in experiential challenge activities offered as part of the program.
Results: On average, the participants (N=488; mean age 47.1 years, SD 14.1; 77.5% women) demonstrated statistically significant improvements in all mental health and well-being outcome measures, and a significant gender and age interaction was observed. Women tended to experience greater improvements than men in the mental health and well-being measures, and older men experienced greater improvements than younger men in the mental health and vitality subscales. Multiple analysis of variance results of the adherence measures indicated a significant difference for age but not gender. No statistically significant interaction between gender and age was observed for adherence measures.
Conclusions: Digital interdisciplinary MHPIs that utilize PSD principles can improve the mental health and well-being of nonclinical cohorts, regardless of gender or age. Hence, there may be a benefit in utilizing PSD principles to develop universal MHPIs such as that employed in this study, which can be used across gender and age groups. Future research should examine which PSD principles optimize universal digital interdisciplinary MHPIs
Lifestyle Medicine and Health Coaching – A Perfect Marriage?
No full textWhile the field of lifestyle medicine has been growing rapidly world-wide over the past two decades in particular, the prevalence of chronic (lifestyle-related) disease is increasing, particularly in developed nations. Lifestyle Medicine approaches are a promising basis for preventing, managing and reversion chronic disease; however, these approaches are based almost exclusively on individual behavioral change. Such changes are best developed and supported with a health-coaching methodolog
Reflections of Community in the Learning Environment
No full textThis chapter explores the concept of community and its relevance in understanding the character of authentic Christian schools. The discussion grows out of the perspective of Christian education’s distinctive character as presented in the previous edition of Revealing Jesus in the Learning Environment: Making a World of Difference (Roy, 2020, chap. 1).
It is not uncommon to associate schools of any kind with the concept of community. In the Christian school sector in particular over the last two decades, some Christian schools have begun identifying themselves as “communities of faith.” This chapter regards such a practice as a valid description of authentic Christian schools. However, the view is taken that this should not be done casually or without thoughtful consideration. At first glance, connotations of faith would imply a school’s representation of Christian faith, or even religious denominational identity. But it is much deeper than that. It depends on what is meant by “faith” in this context. It must be something more than a mere label. This chapter seeks to explore the meanings and significance of some of these terms in such a context. It also seeks to reinstate human presence that is thoughtful, intentional, and dynamic. The chapter features three anecdotes that exemplify the character of schools as communities of faith, and in so doing, posits principles and criteria to guide the strategic response of Christian schools and systems, and ensure the creation of conditions likely to facilitate the realisation of community
The Incidence of Nosocomial Bloodstream Infection and Urinary Tract Infection in Australian Hospitals Before and During the COVID-19 Pandemic: An Interrupted Time Series Study
No full textBackground
The COVID-19 pandemic has had a significant impact on healthcare including increased awareness of infection prevention and control (IPC). The aim of this study was to explore if the heightened awareness of IPC measures implemented in response to the pandemic influenced the rates of healthcare associated infections (HAI) using positive bloodstream and urine cultures as a proxy measure. Methods
A 3 year retrospective review of laboratory data from 5 hospitals (4 acute public, 1 private) from two states in Australia was undertaken. Monthly positive bloodstream culture data and urinary culture data were collected from January 2017 to March 2021. Occupied bed days (OBDs) were used to generate monthly HAI incidence per 10,000 OBDs. An interrupted time series analysis was undertaken to compare incidence pre and post February 2020 (the pre COVID-19 cohort and the COVID-19 cohort respectively). A HAI was assumed if positive cultures were obtained 48 h after admission and met other criteria. Results
A total of 1,988 bloodstream and 7,697 urine positive cultures were identified. The unadjusted incident rate was 25.5 /10,000 OBDs in the pre-COVID-19 cohort, and 25.1/10,000 OBDs in the COVID-19 cohort. The overall rate of HAI aggregated for all sites did not differ significantly between the two periods. The two hospitals in one state which experienced an earlier and larger outbreak demonstrated a significant downward trend in the COVID-19 cohort (p = 0.011). Conclusion
These mixed findings reflect the uncertainty of the effect the pandemic has had on HAI’s. Factors to consider in this analysis include local epidemiology, differences between public and private sector facilities, changes in patient populations and profiles between hospitals, and timing of enhanced IPC interventions. Future studies which factor in these differences may provide further insight on the effect of COVID-19 on HAIs
Participative Leadership in the Toronto Seventh-day Adventist Church
No full textProblem: Respect for an authoritarian style of leadership in the church has diminished. Due to societal and cultural changes church members are seeking greater participation in the decision making processes in the church. It was the purpose of this project to investigate the response of the pastor and church board toward education in principles determining participative leadership, and assess commitment to implementation of such a leadership style in the church.
Method: A series of four seminars was conducted in which Biblical and organisational determinants of participative leadership were discussed. There were twenty members on the board, although not all attended regularly. Shifts in perception were measured by instruments conducted at the beginning and end of the seminar series.
Results: Although the group was small, measurement indicated that the seminar series successfully increased perception of the nature of participative leadership, its advantages, its basis in the New Testament, and the relationship of various organisational principles to successful participative leadership in the church.
The commitment to implementation of a participative style of leadership was high at the conclusion of the series.
Conclusion: The project demonstrated the viability of an educative process in motivating the church board toward acceptance of its leadership role in the church. Board members can be educated to maximise the contribution of every church member in the decision-making processes of the church