13361 research outputs found
Sort by
Evaluation of the research capacity and culture within the Allied Health workforce in Northern New South Wales Local Health District: a cross-sectional observational study.
Get PDFBackground:Health professionals working in health services are uniquely placed to carry out research to improve health service provision. Improving research capacity and culture in health organisations benefits patients, health professionals, health services and society more broadly. This cross-sectional observational study aimed to evaluate the current research capacity and culture within the Allied Health workforce in the publicly funded, non-metropolitan Northern New South Wales (NNSW) Local Health District (LHD). Additionally, the study aimed to explore whether Allied Health staff have undertaken research with Aboriginal and Torres Strait Islander Peoples, and if so, whether the research was conducted in a culturally safe and responsive way. Methods:The validated Research Capacity and Culture tool was administered to the Allied Health workforce in NNSWLHD to evaluate the research capacity and culture, within and across three domains (Organisation, Team and Individual), including research involvement, perceived barriers and motivators for undertaking research, and participants’ experience in conducting research with Aboriginal and Torres Strait Islander Peoples. Quantitative data were analysed descriptively, and median responses between domains were compared. Qualitative data were obtained through two open-ended questions and were thematically analysed. Results:A total of 147 Allied Health professionals from 15 disciplines completed the survey. Participants reported low-to-moderate levels of skills and success across all three domains. Most participants were not currently involved in research. Motivators for undertaking research included encouragement by managers, research mentoring, and a problem identified that needs changing, whilst barriers were lack of time, other work roles take priority, lack of suitable backfill, and staff shortages. Few participants reported having ever contributed to a research project involving Aboriginal and Torres Strait Islander Peoples.Conclusions:Research capacity building strategies within Allied Health in NNSWLHD should utilise a “whole of system” approach, including research career pathways, funding, backfill, mentoring, opportunities to upskill in research writing and develop skills to conduct research in a culturally safe and responsive way. Supporting Aboriginal and Torres Strait Islander clinicians to build research capacity can shape the health research agenda, inform health policies, support evidence-led clinical care, and in turn, the well-being of Aboriginal and Torres Strait Islander People
The future is here: Digital techniques and tools for home assessments
No full textIntroduction: Over the past decade, and accelerated by the pandemic, there has been a shift to telehealth and alternative methods of home risk assessments. Technologies such as smartphones, virtual reality, AI, and three-dimensional scanning are showing promise as providing solutions to old and new problems such as home safety, workforce shortages, and large geographical distances that face occupational therapists in conducting routine home risk assessments for clients. Learning objectives: To explore the range, limitations, and benefits of the current array of technical solutions for use in a telehealth environment. While the specific focus is on conducting home falls risk assessments in older people, content will be applicable to other client cohorts. Educational methods: Attendees will be introduced to a variety of devices (e.g. iPhone, smart watches, virtual reality, and three-dimensional scanning) and provided with an opportunity to consider the potential integration into clinical practice. Using real-world scenarios, participants will gain hands on experience in assessment of home environments through a digital lens. Facilitated by digital natives (Gen Z) supervised by digital immigrants (academics), this is designed to be a fun, hands-on workshop. Relevance to occupational therapy knowledge and practice: A growing ageing population has increased healthcare demands to support ageing in the community. A home safety risk assessment performed by an occupational therapist can support this goal; however, due to various limitations with traditional practice, there is a need to investigate what the digital world can offer to become a digitally competence profession. The future is here
“The Pressure to Do It All”: Qualitatively exploring body image, eating attitudes and mental health in postpartum women
No full textIssue AddressedThe postpartum period, a time known to instil joy and fulfilment, is dominated by unreasonable and often unattainable expectations for mothers to achieve perfection across multiple domains. Despite prior research confirming that body image dissatisfaction, disordered eating and postpartum depression are prevalent in the postpartum, mothers remain pressured to maintain active and healthy lifestyles while juggling the demands of parenthood.MethodsThis qualitative phenomenological study investigated body image, eating attitudes and mental health of the lived experiences of 182 Australian postpartum women through open-ended survey questions. Mothers over 18 years (M = 33.50, SD = 7.22) with biological children under four years of age completed an online survey and were recruited through social media.ResultsResponses to six open-ended questions were examined using thematic template analysis, which generated three themes: (i) Grieving Old Self: Finding Acceptance Amidst Changes to Appearance, (ii) Convenience is Key: Balancing Child-Centred Nutrition and Mindful Choices Amid Time Constraints, and (iii) The Cognitive Load: Demands of Motherhood Supersede Positive Mental Health.ConclusionsFindings demonstrated the complexities that mothers experience and emphasised that the postpartum period is a time of personal transformation and growth, as well as considerable vulnerability toward the development of adverse physical and psychological outcomes. Mothers continue to experience body image dissatisfaction, are too time-poor to eat healthily and are cognitively burdened by increased responsibility. So what? Significant attention and robust resources are needed from healthcare providers to mitigate these likely outcomes, offer preventative strategies to decrease risks to psychological health, and normalise mothers' experiences
Enhanced recovery pathways reduce length of stay and improve outcomes in hip and knee arthroplasty
Get PDFAim: To synthesize evidence from randomized controlled trials (RCTs) comparing Enhanced Recovery After Surgery (ERAS) protocols with standard care for primary hip and knee arthroplasty. Design: Systematic review of randomized controlled trials. Method: A comprehensive search of four databases identified RCTs comparing enhanced recovery pathways with standard care in hip and knee arthroplasty. Primary outcome was length of stay, with secondary outcomes including patient-reported outcomes, functional measures, and complications. Assessment of methodological quality was performed using the Cochrane risk-of-bias tool. Narrative and tabular synthesis was utilised for all individual studies and comparisons between ERAS and standard care pathways were grouped and reported on. Results: Five RCTs (710 patients) met inclusion criteria. ERAS pathways reduced length of by an average of 4.7 days compared to standard care. Patients in ERAS protocols demonstrated superior early functional recovery, particularly in the first postoperative week, with improved performance in mobility tests and daily activities. Patient-reported outcomes generally favored ERAS protocols, though measurement heterogeneity limited synthesis. No studies reported increased complications with ERAS implementation. Conclusion: ERAS pathways significantly reduce length of stay following primary hip and knee arthroplasty while improving early functional recovery and without compromising patient safety. While early functional benefits were evident, standardisation of outcome measures is needed to improve comparability across studies. Key practice points • Enhanced recovery pathways reduce hospital length of stay without increasing complications. • Early postoperative mobility and function are improved with enhanced recovery. • Further research is needed to refine protocols and standardise outcome measures
The development, delivery, and evaluation of novel longitudinal empathy-focused communication skills training at a UK medical school
Get PDFBackground:Empathy benefits patients and clinicians, yet medical students' empathy often declines during training. A key factor is that communication skills teaching is rarely empathy-focused, evidence-based, or longitudinal. Aim: To establish principles of best practice for training and curriculum design based on existing literature; audit our existing curriculum; and design and pilot elements of a longitudinal curriculum based on existing evidence and our experience. Methods: We audited the existing curriculum to identify gaps in empathy-focused communication training and compared our findings with systematic review evidence. Students, educators, and patient representatives developed and refined a preliminary curriculum as equal partners in co-production workshops. Results: The audit showed that empathy training was concentrated in the early years, focusing on active listening and rapport-building, with little evidence-based content or longitudinal reinforcement. Co-production workshops generated recommendations, including formative workplace-based assessments with patient feedback, structured home visits during early training, and patient advocacy experiences. A new longitudinal curriculum was developed, embedding advanced empathy skills, evidence-based positive messaging strategies, and integrated assessments throughout the clinical years. Pilot sessions using role-play with “difficult” patients showed that students and tutors better understood empathy in challenging consultations. Discussion and conclusion: We identified and addressed key gaps in empathy training using a systematic, evidence-based, co-produced approach. The resulting curriculum offers a practical, adaptable model for developing lasting empathic communication skills across medical education. Innovation: We developed a replicable model that combines longitudinal home visits, workplace-based empathy assessments with patient feedback, and integration of evidence-based communication strategies throughout the medical curriculum
Intelligent Condition Monitoring of High-Formwork Support Systems: A Hybrid FEM-Deep Learning Approach with Large Language Model Integration
Get PDFHigh-formwork support systems (HFSSs) play a crucial role in constructing complex projects. However, insufficient monitoring techniques can sometimes lead to catastrophic failures of these structures. This study presents an integrated framework for monitoring HFSS that combines numerical simulation, deep learning, and a Retrieval-Augmented Generation (RAG) system. A finite element model of HFSS was first developed and optimized using a Genetic Algorithm-Particle Swarm Optimization hybrid algorithm, generating structural response data for three critical conditions: Normal operation, local instability, and global instability. These datasets were then used to train a Recurrent Neural Network Long Short-Term Memory (RNN-LSTM) network, which can correctly predict the working states of the structure. Moreover, the effectiveness of RNN-LSTM and convolutional neural network (CNN) was compared. The results demonstrated that RNN-LSTM has superior performance over CNN in predicting the working status of HFSS. Furthermore, the study developed an RAG system incorporating GPT technology and a domain-specific knowledge graph to automate structural health monitoring (SHM) report generation. Several assessment metrics were involved to evaluate the RAG model's performance. The findings indicate that the RAG model could generate accurate and reasonable SHM reports for HFSS
Psychiatric harm claims from observing loved ones killed or injured through medical negligence
No full textThis article considers the possibility that a person who observes a family member being killed or injured as a result of medical negligence could successfully bring an action against the medical professional for their psychiatric injury. United Kingdom law makes such claims extremely difficult. Australian law differs materially, and it is hoped that, if an Australian court were to hear such a case, it would be more sympathetic to such claims, if negligence and causation could be proven, than has occurred elsewhere
Investigating Associations between Maternal Mindfulness, Mental Health, Interoception and Mother-Infant Relationship during Pregnancy and Post-Partum in a Non-Clinical Community Sample
Get PDFPregnancy and the postpartum period are times of significant transition for women, with changes in maternal physical and mental health. The relationship between a mother and her infant has been recognised as laying the foundation for later child development. There is considerable evidence that this early relationship is influenced by a woman's wellbeing during pregnancy and in the early post-partum period. Mindfulness has been found to have positive health outcomes, primarily in reducing maternal stress, anxiety, and depression. However, there remains a need for considering the influence of mindfulness on the mother-infant relationship during pregnancy and the first trimester post-partum. Given the limited research on interoception in pregnancy, this maternal variable was included to acknowledge the importance of embodiment in maternal mindfulness, mental health, and mother-infant relationship. Its relevance was assessed through the associations with all the other measures. This study was the first to explore associations between maternal mindfulness, mental health (depression, anxiety, and stress), interoception, and mother-infant relationship during pregnancy and post-partum across three time points in a non-clinical community sample. This can provide possible avenues for assessment and support strategies by pre and perinatal healthcare practitioners. Women were assessed at 20+ weeks gestation (110), approximately 36-week gestation (72) and 10-12 weeks postpartum (67). Their age ranged from 18 to 47 (M = 33.22). The majority were from Australia and the rest from New Zealand, UK, USA, and Canada. They were from middle to upper class socioeconomic background and from high school/equivalent to doctoral degree educational level, with the majority holding a bachelor's degree. The maternal variables were assessed with self-report questionnaires. Changes in the maternal variables during pregnancy and postpartum across three timepoints were analysed using ANOVA. Correlations were investigated using Pearson correlational analyses. Maternal depression and anxiety significantly decreased from pregnancy to postpartum with p = 0.035 for the difference in depressive scores (EPDS) and p = 0.012 for the difference in anxiety scores (DASS-21 subscale). Mother-infant relationship during pregnancy increased from the second to the third trimester of gestation, with p = 0.004 for the difference in maternal-foetal attachment scores. Significant correlations were found between all maternal variables across the three timepoints. Mindfulness and interoception positively correlated with mother-infant relationship during pregnancy and postpartum and negatively correlated with maternal depression, anxiety, and stress. A power analysis was conducted using G*Power calculation by Tabachnick & Fidell. The sample size required to estimate a medium effect was 100 participants, with power set at 0.95 and an alpha at 0.05. The current sample size (N 110) satisfied this to get meaningful results. The decrease in depression and anxiety post childbirth may confirm untested speculation in the literature that pregnancy, childbirth, and the transition to motherhood may not necessarily represent a risk factor for mental health but enrichment of identity and mitigation of mild/moderate depression in a non-clinical sample. Maternal mindfulness, mental health, and interoception may have an important impact on the quality of mother-infant relationship during pregnancy and post-partum, with potential consequences on infant development and wellbeing. The findings of this study have significant implication for prenatal support programs aiming to reduce the risk for postnatal psychological disorders and mother-infant relationship difficulties by promoting mother-infant relationship and maternal embodiment through interoception and wellbeing during pregnancy. Pre and perinatal practitioners and therapists working in a range of healthcare and clinical settings may support pregnant women through mindfulness relationship-based programs to promote mindfulness, interoception, and their relationship with their developing infant in utero and post-partum, thus impacting infant healthy development. Future research with larger sample sizes is needed to increase the statistical power to detect smaller effect sizes. Furthermore, the use of objective or observational measures should be considered for future studies to represent a stronger study design.<br/
What police had to do during the chaos of Bondi – and what comes next
No full textOn Sunday evening, Bondi Beach was the scene of a mass shooting that has shocked Australia.At the time of writing 16 people have been killed, including one of the gunmen, and another 40 people have been wounded.The attack has been declared a terrorist act.Many questions remain, including: how common are these types of attacks, did the police get their initial response right and what action needs to be taken to prevent another attack like this
Top management's green inclusive leadership and sustainable competitive advantage in manufacturing firms: The enabling role of internal CSR communication
Get PDFAchieving sustainable competitive advantage has become increasingly complex amid intense global environmental pressures. While leadership is widely recognized as an enabler of competitiveness, little is known about how top management’s green inclusive leadership fosters sustainable competitive advantage through dynamic organizational capabilities such as green shared vision and green mindfulness. Drawing on the natural resourcebased view, we theorize that top management’s green inclusive leadership strengthens sustainable competitive advantage in manufacturing firms through these capabilities and that internal corporate social responsibility communication reinforces these effects. Data were collected in two waves from a purposive sample of 215 middle-level managers working in Pakistan’s manufacturing sector and analyzed using PROCESS macro models in SPSS. We found that green inclusive leadership directly predicts sustainable competitive advantage, and that green mindfulness, but not green shared vision, mediates this relationship. We also identify a sequential pathway in which green inclusive leadership enhances green shared vision, which subsequently fosters green mindfulness,thereby improving sustainable competitive advantage. Crucially, this sequential mediation is stronger when internal corporate social responsibility communication is high, underscoring the role of communication as a strategic organizational capability. By integrating leadership, vision, mindfulness, and communication, this study advances the natural resource-based view and demonstrates how sustainability messages shared within organizations deepen employee engagement with leadership-driven environmental strategies