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Public-private partnerships for sustainable development of the global health sector
No full textGlobally, public health system is over-crowded and under-resourced. There is a role for the private provision of healthcare to fill this gap. Public-private partnerships (PPP) models are often seen as a long-term contractual arrangement between the public and private sector, with the aim to provide a partnership mechanism for developing public service provision over a period by development of infrastructure assets in health, education and transportation. Therefore, countries in the pursuit of sustained long-run macroeconomic stabilization are adopting PPP models for investing in health infrastructure for economic development and growth. Post pandemic PPPs are crucial, as countries are facing challenges of communicable diseases, inadequate infrastructure, shortage of healthcare professionals, limited health insurance, fragmented unequal healthcare system and urban-rural disparities in healthcare services provision. Global healthcare systems need to be more integrated with technology to enhance healthcare delivery with positive patient outcomes
Physical health and health behaviours of Australians with psychosis
No full textPeople living with psychosis live up to 20 years less compared to the general population. Cardiometabolic ill-health and barriers to health-related behaviour are significant contributors. This is a cross-sectional descriptive study of cardiometabolic health and health behaviours of consumers attending a public community mental health service in an Australian city. One hundred and fourteen consumers currently living with psychosis participated. Standard measures of cardiometabolic health, quality of life and, health-related behaviours were utilised. Data were analysed using descriptive statistics. The cohort reported higher fruit intake and physical activity, and lower excess alcohol use compared to previous studies. Health-related behaviours including smoking and vegetable intake were poorer than previously reported. Participants had low levels of cardiometabolic health (e.g. abnormal lipids). Physical and mental quality of life was also lower than for general populations. Improved efforts to address physical health for people with mental health conditions are urgently needed.</p
Conceptualisation of Food Addiction for development of a system to guide practice
No full textFood addiction is a complex construct with mixed support in the academic community and debate surrounds its inclusion as a clinical diagnostic condition. Non-inclusion of food addiction as a clinical diagnostic category poses a risk as it limits access to clinical assistance for people in situations where a diagnosis, and subsequent support that can be accessed following diagnosis, is the only affordable means of treatment. With this in mind, further investigation of the evidence surrounding support of the construct is warranted. No diagnostic criteria or measurement instruments currently exist to measure food addiction as a behavioural concept. Without a proposed set of diagnostic criteria which have been shown to validly measure food addiction using a behavioural model, it is unlikely that it will be accepted into a diagnostic manual as a diagnostic clinical condition. Similarly, without an instrument to measure food addiction using a behavioural framework, the evidence required to support a behavioural model for food addiction cannot be established. To date, food addiction has been investigated using a primarily substance addiction model with the Yale Food Addiction Scale (YFAS) (Gearhardt, Corbin, and Brownell, 2009). An updated version of the YFAS has been developed based on the DSM-5 criteria for substance use disorder (Gearhardt et al., 2016). While research has been conducted exploring food addiction using a primarily substance addiction model, no measurement tool has previously been examined based on a behavioural addiction model using proposed behavioural addiction criteria. This program of research explores the structure and utility of a behavioural scale to measure food addiction based on a behavioural model of food addiction and is presented in three stages. In Stage 1, a behavioural scale for food addiction was developed based on Griffiths’ (1996) model of addiction, and Koob’s (2008) model of the addictive process. This understanding of how addiction occurs, and the criteria that can be applied to addiction, was used in the development of a scale to assess food addiction when conceptualised as a behavioural addiction. The behavioural food addiction scale was piloted and a Cronbach’s α of .93 was observed among a sample of 217 Australian adults aged 18 to 69 years (M = 35.89, SD = 12.78) recruited via Facebook, Twitter and email using a snowball sampling procedure. This stage resulted in the development of proposed diagnostic criteria for food addiction from a behavioural perspective. In Stage 2, data measuring a range of factors associated with food addiction including, BMI, Binge Eating Disorder, impulsivity, emotional eating and other addictions was examined. Twenty Australian adults aged 20 to 55 years (M = 38.1, SD = 7.55) were recruited at university open days and residential schools. During this stage correlates of food addiction were investigated and the extent to which food addiction (as measured by the behavioural food addiction scale) was influenced by factors such as Binge Eating Disorder, impulsivity, emotional eating and other addictions were explored. In Stage 3, the acceptance of Behavioural Food Addiction Scale, and the usability of the scale, was explored with four clinicians working with people demonstrating problem eating behaviour. In this stage, support for the newly developed scale was established among clinicians working with people who demonstrated problem eating behaviours. Additionally, this support was illustrated both in terms of support for use of the Behavioural Food Addiction Scale and with support for usability of the scale. Taken together this program of research provides a strong basis for viewing food addiction as a behavioural addiction, as opposed to a substance addiction as it is currently commonly presented. the developed behavioural addiction scale achieved a Cronbach’s α of .93 in the pilot study and small positive corelations were discovered between diagnosis and three eating situations; eating when watching television (τ = 0.15, n = 216, p = .02 (2-tailed)), eating when alone (τ = .14, n = 216, p = .031 (2-tailed)), and eating when upset (τ = .13, n = 216, p = .046 (2-tailed)). This indicates that the scale validly measures the construct of food addiction from a behavioural perspective, supporting continued use and further investigation. The results provide a solid basis for continuing work to encourage inclusion of food addiction as a behavioural addiction in diagnostic manuals. The research also demonstrates preliminary support for the scale to be utilised in clinical contexts to assist those with problem eating behaviours. This utilisation includes identifying problem food, identifying settings in which problems occur and establishing whether food addiction may be a contributing factor in an effort to direct treatment. Further research is necessary with larger sample sizes to establish estimates of behavioural food addiction among specific populations. This should include a larger, representative Australian adult population as well as clinical populations (e.g. participants with diagnosed binge eating disorder, overweight and obese populations) to establish how generalisable these results are to the Australian population as a whole and specific clinical populations. There is also scope for adaptation of the scale to suit specific populations such as adolescents or children. Further research is needed to assess the utility of the existing scale among these populations and develop adaptations of the BFAS specific to these populations. The results demonstrated here provide support for food addiction as a behavioural addiction and develop the concept of food addiction as a clinical diagnostic category.</p
Blockchain-based secured data sharing in healthcare: A systematic literature review
No full textBlockchain technology is increasingly recognised for its potential to enhance the security, reliability, and resilience of distributed systems. By ensuring data integrity and protecting against unauthorised access, blockchain creates immutable and transparent records, making it an appealing option for various applications. In the current healthcare landscape, secure data sharing is essential for improving patient outcomes, streamlining healthcare operations, and ensuring compliance with legal standards. This paper conducts a systematic literature review to explore how blockchain can be utilised as a security solution for health data sharing. We assess the strengths and weaknesses of blockchain-based solutions in areas such as secure data management, data sharing, access control, trust and transparency, and authentication and authorisation. Our findings indicate that blockchain has significant potential to secure health data sharing, although we identify certain limitations in blockchain-based access control systems and propose potential solutions. Additionally, this paper provides detailed insights into future research directions in this domain.</p
Dataset for Why Weight? Development of a Tool to Identify Factors Affecting Participation of Women in Resistance Exercise
No full textStatistics from the National Health Survey (2017-18) indicate that 54% of females (35-44 y.o) fail to reach recommended physical activity levels which is unchanged from 2011-2012 figures. Additionally, a reported 80% of women currently have insufficient resistance exercise training levels to achieve optimal health benefits for chronic disease prevention. While the exact reason is not known, fitness professionals may play a role. The role of fitness professionals in delivering physical activity for healthy agendas has been examined and demonstrated that fitness professionals can both educate and support individuals to increase physical activity levels. With growing public awareness in the fitness industry, Personal Trainers and other health professionals require skills to promote engagement and adherence to physical activity, particularly resistance exercise training. Whilst each profession has their own scope of practice, in order to achieve a positive outcome, which to date has been limited/stagnant, some commonality between, and within scope of practices, may need to be achieved. Utilising the large body of research existing around elements to guide resistance training promotion and engagement, my project is aiming to successfully ascertain interest in provision of education/resources/advice to link research to the 'real world'. A second objective is to then develop a tool focussed on eliciting preferences and behaviours towards physical activity which could be useful to a broader sector of the community. Specifically, such a tool could be adopted by health professionals such as Exercise Physiologists, Exercise Scientists and Personal Trainers, to use within their scope of practice to better engage middle aged women in resistance exercise to sufficient levels for chronic disease prevention.</p
Using a hybrid Delphi/nominal group technique to develop a tool for appraising the quality of mixed-method grounded theory research
No full textBACKGROUND: Among the many methodological approaches used to generate new knowledge in nursing research are mixed methods and grounded theory. However, it can be challenging for researchers to achieve and demonstrate the philosophically congruent integration required in mixed-method, grounded-theory research. AIM: To use a hybrid of Delphi and nominal group techniques to develop a tool to appraise the quality of mixed-method, grounded-theory research. METHOD: The extant literature informed the construction of an evidence-based checklist and explanatory notes that were discussed and voted upon by experienced mixed-method and grounded-theory researchers. The tool was progressively piloted in three projects employing varying grounded-theory approaches. DISCUSSION: Experienced mixed-method and grounded-theory researchers discussed and voted on the construction of an evidence-based checklist and explanatory notes informed by the extant literature. The researchers piloted the tool in three rounds, with reference to previous studies that used various grounded-theory approaches. CONCLUSION: This study reports an effective strategy for gaining consensus to develop a tool demonstrating content, inter-rater and concurrent reliability. IMPLICATIONS FOR PRACTICE: Nurse researchers of various levels of expertise can use the tool developed in this study, which will accommodate future advances in mixed-method and grounded-theory research.</p
Installation and inclined loading of a suction caisson anchor in calcareous sand
No full textThis paper reports a series of centrifuge tests conducted on a stiffened suction caisson anchor in a medium dense calcareous sand. The aims were to provide insight into the behaviour of the anchor during installation and under operational monotonic loadings, and to propose corresponding design approaches to be used in practice. The sand was collected from the Pluto field of Australia's North-West Shelf and characterised through consolidated-drained triaxial compression tests and cone penetration tests (CPT). For assessing caisson installation resistance, a conventional shear resistance method and a CPT-based method were calibrated hinging on the measured caisson installation resistance, effective radial stress, cone tip penetration resistance and friction angle of the sand. Under inclined loadings, with reducing loading angle at the padeye (and hence mooring angle at the mudline), the ultimate capacity increased and the rotational failure mechanism changed to a more lateral translational mechanism. For assessing ultimate capacity, an extended analytical model was presented and verified against the centrifuge test data capturing stress and dilatancy with a simple yet robust systematic approach to include particle breakage. Particle breakage under inclined loading was shown to increase with reducing loading angle. The anchor vertical-horizontal failure envelope was approximated by a parabolic expression.</p
Obstetric ultrasound and women with obesity: Do we need industry guidance?
No full textAustralia, like many developed countries is experiencing an obesity crisis, with maternal obesity associated with increased risks of fetal and maternal complications. For obstetric sonographers, there are technical challenges to exclude a fetal anomaly or pregnancy complication in a woman with obesity. Furthermore, scan times are often longer, greater probe pressure is needed and follow up scans are often undertaken to complete examinations. There are numerous studies reporting high rates of work-related musculoskeletal disorders (WRMSDs) amongst sonographers and papers that provide tips and tricks to improve imaging and ergonomics. However, there is no specific industry guidance by way of a guideline, consensus statement or position paper from our leading professional associations, on how we can address this complex issue obstetric sonographers encounter when scanning women with obesity, or our communication with women about the difficulties faced. Given the high and increasing rates of obesity, the high risk of pain and WRMSDs for sonographers and limitations associated with these examinations, this raises the question—is it time for our industry to discuss guidance and communication in obstetric ultrasound for women with obesity to mitigate sonographer risk of WRMSDs, while ensuring safe, high quality care for these women?.</p
A novel approach based on quantum key distribution using BB84 and E91 protocol for resilient encryption and eavesdropper detection
No full textQuantum cryptography is anticipated to drive substantial advancements in the field of cybersecurity. The impending arrival of quantum cryptography has the potential to compromise current encryption methods, thereby possibly compromising the effectiveness of traditional key management-based security protocols. Quantum cryptography represents a burgeoning area that necessitates thorough examination and scrutiny to validate its efficacy in safeguarding data and securely distributing secret keys. One fundamental quantum key distribution protocol, BB84, encounters challenges when operating with fewer quantum bits (qubits) and bases that only support up to 8 qubits. This limitation weakens the system's security, making brute force, intercept, and resend attacks less challenging. Consequently, this study proposes a method to enhance the security of the BB84 protocol, to reduce susceptibility to attacks and eavesdropping. The proposed improved BB84 protocol utilizes 9, 12, and 16 quantum bits along with two, and three bases to significantly bolster security, allowing authorized parties to prevent the key distribution process and eliminate the use of compromised keys. Additionally, this study has implemented the E91 quantum key distribution
protocol utilizing the Entanglement Pair Generation method to produce secure keys. While the existing E91 protocol ensures security through Bell’s theorem and Bell’s inequality, it overlooks the impact of noise,
leading to inaccuracies in eavesdropper detection. Hence, this study introduces an additional security
measure. Whenever an eavesdropper attempts to measure the quantum state, the proposed E91 protocol collapses its state from |10⟩ to |11⟩, setting the first qubit to |1⟩ and the other qubit to |0⟩, thus providing the eavesdropper with incorrect information, accompanied by a phase angle of 15π/8. This leads to misconception and misconfiguration, preventing eavesdroppers from obtaining useful details about transferred quantum states and compromising the keys. Additionally, considering that the proposed E91 protocol relies on
entangled particles and utilizes double qubit gates, which are inherently noisier than single qubit gates and susceptible to quantum decoherence, this study employs error mitigation techniques in the final measurement to predict outcomes more efficiently</p
The effect of age on heart rate variability indices during and following high-intensity continuous exercise in masters and young cyclists
No full textThis study compared heart rate variability (HRV) parameters of cardiovascular autonomic regulation between well-trained masters and young cyclists at rest, during and following a continuous cycle (CTS) protocol. Ten masters (age = 56 ± 5 years) and eight young (age = 26 ± 3 years) cyclists completed a 100 min experimental protocol consisting of a 60 min CTS cycling bout at 95% of Ventilatory Threshold 2 followed by 40 min of supine recovery. Beat-to-beat heart rate was measured continuously, and HRV parameters analysed at standardised 5 min intervals during rest, exercise and recovery. The root mean square of the successive differences (RMSSD), low-frequency power and high-frequency power parameters were corrected by division of the R-R interval (time domain), or R-R interval squared (frequency domain). Further, the RMSSD and RMSSD:RR for successive 60-s R-R intervals at the onset (0–10 min) and offset (60–70 min) of CTS exercise were analysed over 10-min periods. The natural logarithm (Ln) of skewed parameters was taken for analysis. Significant interaction effects (P 0.05). This data shows that cardiac autonomic regulation during, or immediately following CTS exercise may not be influenced by age, but masters athletes may exhibit a lower baseline for parasympathetic activity.</p