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Weight- and Nutrition-Related Changes of Patients With Osteoarthritis Attending the Dietetic Orthopaedic Physiotherapy Screening Clinic: Findings From a Clinical Audit
Get PDFThe aim of this study is to describe patient experiences with the dietetic service in a multidisciplinary orthopaedic physiotherapy screening clinic for the management of osteoarthritis, specifically nutrition-related indicators of success, such as changes to weight and diet. A retrospective observational medical chart audit was conducted of patients with osteoarthritis within the dietetic clinic over a 12-month period in a large, urban setting in Australia. In total, 38 patients met the inclusion criteria; 68% were female. Patients spent an average of 182 days in dietetics care, with an average of 5 appointments per patient. Approximately one-third (32%) of patients achieved a clinically significant weight loss (> 5% of body weight), 58% had no change in weight, and 11% of patients gained weight (> 5% of body weight). Of patients in the successful weight loss group, 50% had been advised to follow a very low energy diet, compared to 19% in the no weight loss group (p = 0.05). Patients appeared to be increasing their consumption of fruits and vegetables and decreasing their discretionary foods, but changes did not reach statistical significance. We found that the current clinic was resource-intensive, provided varied nutritional treatments, and resulted in some, but limited, success. Findings from this study suggest areas for improvement in clinics that primarily serve patients with osteoarthritis.</p
Navigating wellbeing: Business war volunteer tourism and the DREAMA framework
Get PDFAmidst the grand challenges, geopolitical tensions, and resultant uncertainties of today's environment, a new category of tourism has emerged called business war volunteer tourism. This research note conceptualizes how the application of our discipline's most recent and psychologically comprehensive wellbeing framework, DREAMA, provides a mechanism through which we can begin to explore and understand business war volunteer tourists' lived experiences. In doing so, this research note contributes to the extant literature through a nuanced conceptual examination of psychological wellbeing within the business war volunteer tourism context, encouraging discussion about how environments affected by war provide opportunities to strengthen tourist wellbeing.</p
The POSITIVE Power of MAKING Mistakes: Why Getting It Wrong is Essential for Legal Learning
No full textLegal education has long been defined by precision, accuracy, and a high-stakes environment where mistakes are often seen as failures rather than opportunities for learning. The competitive nature of law school fosters a culture where students feel immense pressure to succeed, sometimes at the cost of their own well-being and professional development. However, a growing body of research suggests that learning from mistakes is crucial for developing resilience, critical thinking, and ethical decision-making skills - qualities that are essential for legal professionals
Recommendations for the design and delivery of Visually Enhanced Mental Simulation: insights from participants and facilitators
Get PDFIntroductionVisually Enhanced Mental Simulation (VEMS) is a simulation technique that combines mental simulation and think-aloud with flat plastic representations of a patient(s) and relevant assessment and treatment adjuncts. It offers simple, effective and efficient education for healthcare professionals, but there is a paucity of guidance on effective VEMS design and delivery. We aimed to explore facilitator and participant perceptions of VEMS at our institution to inform guidance for facilitators and simulation program leaders.MethodsUsing a constructivist approach, we conducted an exploratory qualitative study of the experience of VEMS participants and facilitators. The VEMS simulations at our institution ranged across community nursing, medical and surgical wards, geriatrics, emergency department, maternity and intensive care. Interviews were used to collect data on the design, delivery, experience and impact of VEMS. We analysed the data thematically, from the stance of researchers and practitioners embedded in the institution and seeking to improve our simulation delivery.ResultsThirteen interviews were conducted. Study participants’ experience with VEMS ranged from one or two sessions to more than 50 sessions. The context of VEMS experience was mostly interprofessional team-based simulation in diverse hospital or community settings. We identified five themes through our data analysis: 1) Flexibility and opportunity, 2) Unexpectedly engaging, 3) Sharper focus on teamwork, 4) Impact on simulation practice and programs and 5) Manikins are confusing.ConclusionVEMS is a feasible and flexible simulation modality in a health service where time and cost are at a premium. It was perceived as easier to deliver for facilitators with less technical simulation experience, and widely applicable to the diverse range of clinical situations faced by our healthcare teams. Participant engagement appeared to be easier to achieve than with manikin-based simulation and this has encouraged us to critically reconsider our modality choices for simulation within our health service
Overtreatment of Older People Near End of Life: A Qualitative Scoping Review of Modalities, Drivers, and Solutions
Get PDFThis study aimed to understand the drivers better to help minimise further risks of overtreatment for older people near the end of life (dysthanasia). A systematic scoping review of any publication types released in Medline, Embase, and Cochrane databases from January 2002 to January 2023 were used. Deductive thematic analysis was conducted independently and concurrently by paired reviewers. Risk of bias assessed for primary studies only using a modified version of the COREQ checklist. Twenty-one studies met the inclusion criteria. Determinants included healthcare system factors, patient-centered care, family and caregiver, and clinician perspectives. This review confirms that despite almost two decades of recognition of the potential harms of overtreatment near the end of life, society, patients, and health systems have a role to play in reducing and addressing the determinants. We offer a range of solutions for clinicians, health service managers, and members of the public to consider.</p
Dietitians’ practices and perspectives of the delivery of nutritional care to cancer survivors in the primary care setting
No full textPurpose:The number of people living longer after a cancer diagnosis is increasing. Guidelines for cancer survivorship recommend a healthy diet and maintaining a healthy weight post-treatment. While cancer survivors often express the need for professional support for nutrition management, few report seeing a dietitian. This study aimed to explore primary care dietitians’ experiences, practices, and perspectives in providing nutritional care to cancer survivors in Australia.Methods:This qualitative study used in-depth, semi-structured interviews with primary care dietitians working in private practice and community care. Interviews were recorded and transcribed. A qualitative descriptive methodological approach integrated with a working analytical framework was utilized for coding and data analysis.Results:Twenty-four dietitians working in primary care participated. Four themes and 13 sub-themes were identified: (1) diversity in dietetic practice and cancer-related care interactions; (2) accessing referral pathways and funding sources in a complex healthcare system; (3) the application of nutrition education, and upskilling in cancer care; (4) client barriers and dietitians' challenges and factors influencing confidence in cancer care.Conclusion:Dietitians in this study highlighted the need for clear referral pathways to primary care particularly as a continuation of cancer-related care following the acute setting. There is a need for tailored support for dietitians supporting people diagnosed with cancer in the primary care setting, including opportunities to upskill in cancer care
What Role do Preferential Trading Arrangements Play in Cross‑Border Worker Mobility? Some Asian Evidence
No full textUnited Nations Economic & Social Commission for Asia Pacific data on bilateral worker flows from ten Asian origin countries is used to estimate a temporary-worker migration equation and test whether a preferential trading arrangement (PTA) between the origin and host country influences the size of that migration flow. We find, first, that worker migrants respond as do other migrants except where countries share a common border; second, that PTAs can have a significant positive effect on worker migration, but only if they include service trade and visa provisions beyond the minimum required of World Trade Organization members; and, third, that while a bilateral labor agreement (BLA) and additional provisions in a PTA are not substitutes, country-pairs are found to prefer the BLA option if they share a common border, but the extended PTA option if they are linguistically and culturally distant. We also find that the negative result commonly found relating geographic distance to PTA formation is reversed when other ‘distance-related’ attributes (linguistic, religious and cultural) are included; that conclusions based on aggregated data may be misleading when applied to sub-samples; and that treating a regional agreement as if it were simply a collection of unrelated bilateral agreements risks overlooking potentially important policy constraints.<br/
SPIRIT 2025 statement: updated guideline for protocols of randomized trials
No full textThe protocol of a randomized trial is the foundation for study planning, conduct, reporting and external review. However, trial protocols vary in their completeness and often do not address key elements of design and conduct. The SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement was first published in 2013 as guidance to improve the completeness of trial protocols. Periodic updates incorporating the latest evidence and best practices are needed to ensure that the guidance remains relevant to users. Here, we aimed to systematically update the SPIRIT recommendations for minimum items to address in the protocol of a randomized trial. We completed a scoping review and developed a project-specific database of empirical and theoretical evidence to generate a list of potential changes to the SPIRIT 2013 checklist. The list was enriched with recommendations provided by lead authors of existing SPIRIT/CONSORT (Consolidated Standards of Reporting Trials) extensions (Harms, Outcomes, Non-pharmacological Treatment) and other reporting guidelines (TIDieR). The potential modifications were rated in a three-round Delphi survey followed by a consensus meeting. Overall, 317 individuals participated in the Delphi consensus process and 30 experts attended the consensus meeting. The process led to the addition of two new protocol items, revision to five items, deletion/merger of five items, and integration of key items from other relevant reporting guidelines. Notable changes include a new open science section, additional emphasis on the assessment of harms and description of interventions and comparators, and a new item on how patients and the public will be involved in trial design, conduct and reporting. The updated SPIRIT 2025 statement consists of an evidence-based checklist of 34 minimum items to address in a trial protocol, along with a diagram illustrating the schedule of enrollment, interventions and assessments for trial participants. To facilitate implementation, we also developed an expanded version of the SPIRIT 2025 checklist and an accompanying explanation and elaboration document. Widespread endorsement and adherence to the updated SPIRIT 2025 statement have the potential to enhance the transparency and completeness of trial protocols for the benefit of investigators, trial participants, patients, funders, research ethics committees, journals, trial registries, policymakers, regulators and other reviewers.</p
SPIRIT 2025 Statement: Updated Guideline for Protocols of Randomized Trials
No full textImportance: The protocol of a randomized trial is the foundation for study planning, conduct, reporting, and external review. However, trial protocols vary in their completeness and often do not address key elements of design and conduct. The SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) statement was first published in 2013 as guidance to improve the completeness of trial protocols. Periodic updates incorporating the latest evidence and best practices are needed to ensure that the guidance remains relevant to users. Herein, we systematically update the SPIRIT recommendations for minimum items to address in the protocol of a randomized trial.Observations: We completed a scoping review and developed a project specific database of empirical and theoretical evidence to generate a list of potential changes to the SPIRIT 2013 checklist. The list was enriched with recommendations provided by lead authors of existing SPIRIT/CONSORT (Consolidated Standards of Reporting Trials) extensions (harms, outcomes, nonpharmacological treatment) and other reporting guidelines (Template for Intervention Description and Replication [TIDieR]). The potential modifications were rated in a 3-round Delphi survey followed by a consensus meeting. Overall, 317 individuals participated in the Delphi consensus process and 30 experts attended the consensus meeting. The process led to the addition of 2 new protocol items, revision to 5 items, deletion/merger of 5 items, and integration of key items from other relevant reporting guidelines. Notable changes include a new open-science section, additional emphasis on the assessment of harms and description of interventions and comparators, and a new item on how patients and the public will be involved in trial design, conduct, and reporting. The updated SPIRIT 2025 statement consists of an evidence based checklist of 34 minimum items to address in a trial protocol, along with a diagram illustrating the schedule of enrollment, interventions, and assessments for trial participants. To facilitate implementation, we also developed an expanded version of the SPIRIT 2025 checklist and an accompanying explanation and elaboration document. Conclusions and Relevance: Widespread endorsement and adherence to the updated SPIRIT 2025 statement have the potential to enhance the transparency and completeness of trial protocols for the benefit of investigators, trial participants, patients, funders, research ethics committees, journals, trial registries, policy makers, regulators, and other reviewers.
A composite face effect for vertically divided faces
No full textThe composite face effect (CFE) provides evidence for holistic face processing by demonstrating that when halves of different faces are aligned to resemble a single face, recognition of the component identities is disrupted. However, if the face halves are misaligned, the component identities become easier to recognise. While the horizontal CFE – wherein the top and bottom halves of the face are aligned – has been extensively studied, the existence of a vertical CFE – involving the combination of left-right face halves – remains unclear. This study investigated the vertical CFE using composite stimuli created by pairing familiar and unfamiliar faces. Participants made familiarity judgements for aligned and misaligned vertical and horizontal composites. Familiarity judgements were made more accurately and with faster response times with misaligned compared to aligned composites. The magnitude of the vertical CFE was comparable to the horizontal CFE and was unaffected by identity priming or which half of the face was attended. However, the size of the CFE was reduced when attention was not directed to a specific face half. These findings suggest that both the vertical and horizontal CFE reflect a common mechanism for integrating facial information across the visual field, underscoring holistic processing as a fundamental process in face recognition