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Nursing education in Australia
No full textMcallister, MM ORCiD: 0000-0003-1181-1610; Ryan, CL ORCiD: 0000-0002-1126-3901In 2019, according to the United Nations estimates, the Australian population reached 25 million. While a vast land mass – the world’s largest island, and the sixth largest country after Russia, Canada, China, Brazil and the USA – the continent of Australia has many parts that are sparsely populated because of its arid climate. Indeed, 35% of Australia
receives so little rain it is effectively desert. As a result, most of the population lives along the coastline in urban areas, particularly the large cities such as Melbourne, Sydney, Brisbane and Perth. The country of Australia has been inhabited for over 50,000 years. It became a British
colony in 1788, and a Federation in 1901 – with the right to govern in its own right. At this time, Australia was referred to as the Commonwealth of Australia. The federation still consists of six states and two territories. Indigenous Australians, who comprise about 4% of the population, are the Aboriginal and Torres Strait Islander peoples who are descended from groups that existed in Australia and surrounding islands before this colonisation. At the time of European settlement, over 250 languages were spoken. Today, about half these languages remain, as a result of an explicit policy of cultural assimilation (Langton, 2018). This attempt to erase Aboriginal and Torres Strait Islander culture has resulted in much grief and loss for the original Australians and there continue to be social and health disparities that result in unacceptably high morbidity and early death that need to be resolved (Pascoe, 2018)
From felon to freeman: A convict's reclaimed life
No full textReaney, JW ORCiD: 0000-0002-6533-9166This PhD consists of a speculative biography that follows the life of a convict named William Coombe, who was transported from England to Australia in 1835. The narrative recounts his life journey from a small English village through his crime, trial, transportation to and assignment in, Australia. It relates the story of his re-entry into society after gaining a conditional pardon, thus assisting to close an identified gap in convict literature. The speculative biography drew together the elements comprising his redemption: work, family, social and political activity, and other pursuits he followed in building his future. His life demonstrated that convicts could successfully rehabilitate, ‘the stain’ could be expunged and ex-convicts could make a productive contribution to society. The story also provides insights into Queensland’s colonial history and the role of convicts therein.
The exegesis explores speculative biography and the scholarly debates associated with colonial convict history. The main research questions revolve around better understanding how and why the speculative biography has been used to write the past, then how and why the creative artefact conforms and sometimes differs to this contentious biographical sub-genre. The exegesis also asks what are the key fictional and historical techniques authors typically use when mobilising this sub-genre and what specific challenges and obligations were encountered when doing so. Using the Practice-led research methodology, the exegesis offers a critical explanation of how the research questions were addressed and answered, thereby adding to the store of knowledge regarding the application of utilising the speculative biography in producing historical works within various contexts
Pediatric persistent pain: Associations among sensory modulation, attachment, functional disability, and quality of life
No full textMeredith, PJ ORCiD: 0000-0002-2981-9189IMPORTANCE: Although attachment is associated with sensory modulation among children and adolescents and insecure attachment is associated with pain severity among adolescents, relationships among sensory modulation, attachment, and function have not previously been demonstrated in a clinical sample of children and adolescents with complex persistent pain. OBJECTIVE: To investigate relationships among sensory modulation, attachment, function, and quality of life (QOL) in a pediatric population with persistent pain. DESIGN: Cross-sectional quantitative design. From October 2015 to July 2017, all children, adolescents, and parents attending a clinic for assessment completed questionnaires and were provided information and consent forms. Those who consented completed sensory modulation and attachment questionnaires. SETTING: Tertiary pain management clinic. PARTICIPANTS: Children (ages 8-12 yr) and adolescents (ages 13-18 yr) with persistent pain (pain of >3 mo duration or a specific pain disorder) and the capacity to answer questionnaires independently. MEASURES: Standardized sensory modulation, attachment, pain intensity, functional disability, and QOL questionnaires. Hypotheses were generated before data collection. RESULTS: Of 152 children and adolescents, 114 children (30 girls, 9 boys) and adolescents (68 girls, 7 boys) met study criteria and consented to participate. Hierarchical multiple regression analyses revealed that sensory sensitivity predicted disability for children and adolescents, and attachment anxiety mediated the relationship between low registration and poorer school-related QOL. CONCLUSION AND RELEVANCE: Behaviors related to insecure attachment patterns provide a mediating pathway from sensory modulation to functional disability; addressing such behaviors clinically may facilitate engagement in daily activities for children and adolescents with persistent pain. WHAT THIS ARTICLE ADDS: Results support the need to consider the interactions between sensory modulation and attachment when addressing functional abilities with occupational therapy treatment. Copyright © 2020 by the American Occupational Therapy Association, Inc
Recovery from trauma: Using liminality as a framework to explore wellness tourism
No full textHillman, WJ ORCiD: 0000-0001-6671-2527; Radel, K ORCiD: 0000-0001-9754-0131Individuals who experience a psychic trauma (sudden, overwhelming or intense emotional shock or shocks) may be motivated to seek travel experiences as a pathway to recovery. Using an inductive, grounded theory approach, the research investigated the lived experiences of 16 non-traditional, travellers who sought recovery from a traumatic event(s). Participants were drawn from a variety of countries and ranged in ages from 25-60 years. The theoretical lens of liminality was applied to understand and analyse their travel experiences in response to trauma. Liminality provides an avenue for analysis of the spaces, places, boundaries, and transitions that travellers cross both temporarily and spatially. The liminal stages of separation, transition and aggregation were evident in participant stories. However, the stages are both multi-dimensional and chaotic. While living through and within liminality, participants’ journeys were not temporally linear or one-directional. The transformation through the liminal phase, subsequently energised participants to affect their own re-creation and rise above the social, personal, and/or environmental traumas that initiated their travel experiences. In contrast to traditional liminality theory, the transformation is a normalising process via which the traveller regains their sense of self. Implications from this study are that industry stakeholders should seek greater understanding of various, more commonly experienced psychic traumas (work-related stress for example) and the impacts and consequences of these for travellers. This may inform thinking in the wellness tourism genre as well as the traditional vacation industry practice. Further investigation is needed to establish new products, services and tourism expectations to be better suited to traumatised travellers living and recovering through liminality
Enhanced primary care provided by a nurse practitioner candidate to aged care facility residents: A mixed methods study
No full textJohnston-Devin, CM ORCiD: 0000-0003-2632-5383Background: Residents of aged care facilities are at risk of potentially preventable hospitalisation. This risk is increased for those who are older, have more co-morbidities, are malnourished, taking multiple medications and have a history of previous falls.Aim: To evaluate the impact of a nurse practitioner candidate delivering care to acutely ill older adults living in aged care facilities.Methods: Nested in a larger program of research, this mixed methods study comprised: i) a descriptive analysis of interventions performed by the nurse practitioner candidate (prospectively collected data);and ii) a quasi-experimental study of patient and health service outcomes, including costs, for residents transferred to the local hospital emergency department from the study facility compared with residents from other aged care facilities presenting to the local hospital, in a 12-month period (retrospectively collected data). The intervention comprised a nurse practitioner candidate providing early intervention to residents with acute illness. This included: advanced assessment, enhanced primary care with the general practitioner, advanced care planning, and opportunistic education to facility staff. The study setting was one aged care provider of approximately 300 beds in regional Queensland, Australia.Findings: The nurse practitioner candidate completed 1790 consultations with 266 residents over the 12-month study period. Residents transferred to hospital had shorter median length of stay in the emergencydepartment (Study facility: 240 mins; Other facilities: 277 min; MWU = 153972.0; p = 0.005), cost less and fewer residents required hospital admission (Study facility: 44.6%; Other facilities: 59.0%; p = 0.0001) but representations for same or any cause were higher compared to those from other facilities. There was a 300% increase in the number of residents with Advance Care Planning in the study facility.Conclusion: Introduction of a nurse practitioner candidate working with general practitioners improved most outcomes for aged care facility residents transferred to hospital and increased documentation of advance care planning
Future potential of economic impact assessment
No full textWilliams, GA ORCiD: 0000-0002-1645-6104Economic impact assessment (EcIA) has attracted some criticism due to its limited focus. Typically, EcIA is used to validate the proposed proposals based on growth in income and employment. This paper argues that EcIA should play a more active and stronger role in impact assessment. For example, the impacts of the proposed projects should be assessed using the economic development goals rather than only changes in economic growth. The conceptual framework for the comprehensive impact assessment is discussed. Examples of indicators that can be used in relation to sustainable development goals are provided. © 2019, © 2019 IAIA
Evaluating the immediate effect of forearm and wrist orthoses on pain and function in individuals with lateral elbow tendinopathy: A systematic review
No full textHeales, LJ ORCiD: 0000-0002-4510-3324; Kean, C ORCiD: 0000-0003-0135-7178; Obst, SJ ORCiD: 0000-0003-4299-9628Background: Lateral elbow tendinopathy is associated with pain during gripping, with forearm/wrist orthoses prescribed for treatment. Objectives: To investigate the immediate effects of forearm and/or wrist orthoses on outcome measures of pain and function in individuals with lateral elbow tendinopathy. Design: Systematic review Methods: Four electronic databases were searched to identify randomised controlled trials reporting the immediate effects of forearm and/or wrist orthoses on pain and function in individuals with lateral elbow tendinopathy. The quality of evidence was rated from high to very low, using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) for the primary outcomes. Where possible, standardised mean difference (SMD) and 95% confidence intervals were calculated to compare post measures between forearm and/or wrist orthoses and control/placebo conditions. Results: The search revealed 1965 studies, of which, seven randomised crossover trials were included. Using the GRADE approach there was low quality evidence revealing a significant decrease in pain during contraction (SMD range −0.65 to −0.83) with forearm orthoses compared to a control/placebo condition. Low quality evidence revealed improvements in pain-free grip strength with the use of a forearm orthosis (SMD range 0.24–0.38), but not maximal grip strength (SMD range 0.14–0.15). Low quality evidence revealed a static wrist orthosis did not improve pain-free grip strength (SMD -0.08) or maximal grip strength (SMD -0.22). Conclusion: There is low quality evidence that forearm orthoses can immediately reduce pain during contraction and improve pain-free grip strength but not maximal grip strength in individuals with lateral elbow tendinopathy. © 2020 Elsevier Lt
Efficacy of an m-Health physical activity and sleep intervention to improve sleep quality in middle-aged adults: The refresh study randomized controlled trial
No full textVandelanotte, CL ORCiD: 0000-0002-4445-8094BACKGROUND: Poor sleep health is highly prevalent. Physical activity is known to improve sleep quality but not specifically targeted in sleep interventions. PURPOSE: To compare the efficacy of a combined physical activity and sleep intervention with a sleep-only intervention and a wait-list control, for improving sleep quality in middle-aged adults without a diagnosed sleep disorder. METHODS: Three-arm randomized controlled trial (Physical Activity and Sleep Health (PAS), Sleep Health Only (SO), Wait-list Control (CON) groups; 3-month primary time-point, 6-month follow-up) of 275 (PAS = 110, SO = 110, CON = 55) inactive adults (40-65 years) reporting poor sleep quality. The main intervention component was a smartphone/tablet "app" to aid goal setting and self-monitoring physical activity and/or sleep hygiene behaviors (including stress management), and a pedometer for PAS group. Primary outcome was Pittsburgh Sleep Quality Index (PSQI) global score. Secondary outcomes included several self-reported physical activity measures and PSQI subcomponents. Group differences were examined stepwise, first between pooled intervention (PI = PAS + SO) and CON groups, then between PAS and SO groups. RESULTS: Compared with CON, PI groups significantly improved PSQI global and subcomponents scores at 3 and 6 months. There were no differences in sleep quality between PAS and SO groups. The PAS group reported significantly less daily sitting time at 3 months and was significantly more likely to report ≥2 days/week resistance training and meeting physical activity guidelines at 6 months than the SO group. CONCLUSIONS: PIs had statistically significantly improved sleep quality among middle-aged adults with poor sleep quality without a diagnosed sleep disorder. The adjunctive physical activity intervention did not additionally improve sleep quality. CLINICAL TRIAL INFORMATION: Australian New Zealand Clinical Trial Registry: ACTRN12617000680369; Universal Trial number: U1111-1194-2680; Human Research Ethics Committee, Blinded by request of journal: H-2016-0267
Hot, tired and hungry: The snacking behaviour and food cravings of firefighters during multi-day simulated wildfire suppression
No full textFerguson, SA ORCiD: 0000-0002-9682-7971; Gupta, CC ORCiD: 0000-0003-2436-3327; Guy, JH ORCiD: 0000-0003-3000-2747; Khalesi Taharoom, SS ORCiD: 0000-0002-8208-2518; Sprajcer, MA ORCiD: 0000-0002-4966-871X; Vincent, GE ORCiD: 0000-0002-7036-7823Firefighters are exposed to numerous stressors during wildfire suppression, including working in hot temperatures and sleep restricted conditions. Research has shown that when sleep restricted, individuals choose foods higher in carbohydrates, fat, and sugar, and have increased cravings for calorie dense foods. However, there is currently no research on the combined effect of heat and sleep restriction on snacking behaviour. Conducting secondary analyses from a larger study, the current study aimed to investigate the impact of heat and sleep restriction on snacking behaviour and food cravings. Sixty-six firefighters completed three days of simulated physically demanding firefighting work and were randomly allocated to either the control (n = 18, CON; 19 °C, 8 h sleep opportunity), sleep restricted (n = 16, SR; 19 °C, 4-h sleep opportunity), hot (n = 18, HOT; 33 °C, 8 h sleep opportunity), or hot and sleep restricted (n = 14 HOT + SR; 33 °C, 4-h sleep opportunity) condition. During rest periods firefighters were able to self-select sweet, savoury, or healthy snacks from a ration pack and were asked to rate their hunger, fullness, and cravings every two hours (eating block). Mixed model analyses revealed no difference in total energy intake between conditions, however there was a significant interaction between eating block and condition, with those in the CON, HOT, and HOT + SR condition consuming significantly more energy between 1230 and 1430 compared to the SR condition (p = 0.002). Sleep restriction and heat did not impact feelings of hunger and fullness across the day, and did not lead to greater cravings for snacks, with no differences between conditions. These findings suggest that under various simulated firefighting conditions, it is not the amount of food that differs but the timing of food intake, with those that are required to work in hot conditions while sleep restricted more likely to consume food between 1230 and 1430. This has potential implications for the time of day in which a greater amount of food should be available for firefighters
Active power flow control of three-port converter for virtual power plant applications
No full textAlahakoon, S ORCiD: 0000-0002-5802-7869; Haque, M ORCiD: 0000-0002-7615-7982; Wolfs, PJ ORCiD: 0000-0001-7048-1231This paper proposes a compact power conversion system (PCS) fo virtual power plants (VPPs) formed by an IoT aggregation of many residential solar and battery systems. The falling costs of IoT technology, batteries and solar systems have exposed power conversion costs as a growing part of the total system cost. The proposed PCS is based on an isolated three port converter (TPC) and an inverter stage to facilitate grid connection. The TPC solution seeks to reduce costs by combining several power conversion devices into a single package. Any single-phase conversion system must deal with double line frequency (DLF) power fluctuations. This TPC conversion allows the DLF power components to be selectively directed to any port. The DLF components can be restrained to a filter at the grid connection port or directed to a battery system. It is generally desirable to direct DLF currents away from the PV port. A 3-level square wave modulation method is adopted to control DLF flows in the PCS and to the converters soft switching capability. The simulation model with the proposed control methods for the PCS is developed in Matlab/Simulink. The simulation and experimental results show that the DLF voltage ripple on the dc-link is suppressed. The results also show that the active power of the PV port is free of DLF oscillations