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Transitioning to Aboriginal community control of primary health care: The process and strategies of one community-controlled health organisation in Queensland
No full textMccalman, JR ORCiD: 0000-0002-3022-3980BACKGROUND: Aboriginal Community Controlled Health Services (ACCHSs) play a critical role in providing culturally appropriate, accessible primary healthcare (PHC) for Aboriginal and Torres Strait Islander peoples in Australia. The success of many ACCHSs has led to increased policy support for their growth and development, including the transition of state government administered PHC services to Aboriginal community control in select communities. However, there is minimal published literature available which evaluates such transitions. This paper reports on an evaluation of one ACCHS (Gurriny Yealamucka Health Service)'s experience of transitioning local PHC services to community control in Yarrabah, Queensland, with a focus on the processes and strategies which were implemented to achieve successful transition. METHODS: Data was collected from interviews with key personnel involved in the transition and organisational documents from the evaluation period. Face-to-face or telephone interviews were conducted with 14 key stakeholders, audio-recorded and transcribed with written consent. Historical organisational documents were provided by Gurriny. All interview transcripts and documents were imported into NVIVO, coded and analysed using grounded theory methods. RESULTS: Gurriny's journey of achieving community control of PHC in Yarrabah entailed an almost 30 year process of building and demonstrating organisational capacity. The first stage (1986 to 2004) was focused on establishing and developing a community-controlled health service and the second stage (2005-14) on preparing for the transition. Formal handover occurred in June 2014. Stage one strategies included: addressing community social and emotional wellbeing; consulting the community; collaborating with researchers; and, strategically building services, organisation capacity and stakeholder trust. Stage two strategies were: communicating and engaging with stakeholders; ensuring strong governance; planning and developing the services and workforce; assuring quality; and, financial planning, management and modelling. CONCLUSION: Achieving successful transition to community control of PHC for Gurriny entailed a lengthy process of substantial, ongoing organisational growth and development. Gurriny's experience provides a framework for both governments and the ACCHS sector to inform future transitions of PHC services to Aboriginal community control
Handover practices of nurses transferring trauma patients from intensive care units to the ward: A multimethod observational study
No full textCalleja, P ORCiD: 0000-0001-5674-1404Poor-quality patient handover leads to adverse patient outcomes. Consequently, handover has been identified as a national and international priority for preventing patient harm. Risks are exacerbated during transfers of trauma intensive care unit (ICU) patients to a ward because of the complexity of their injuries coupled with a de-escalation in care and monitoring. This study assessed current handover practices for ICU trauma patients, identifying barriers and facilitators to best practice handover. A multimethod design was used, including naturalistic observations of clinical handover of trauma patients transferred to a ward and semistructured interviews with both the ICU and ward nurses caring for the trauma patient. The study was conducted at an Australian metropolitan public adult teaching hospital ICU. Purposive maximal sampling of patient handover opportunities was sought. Recruitment continued until data saturation was reached using thematic analysis. Ten ICU and ward nurses were recruited, with 10 observations of handover and 20 interviews conducted. Observations of the handovers identified multiple issues, including deficits and discrepancies in the information communicated that could impact patient safety, variable handover processes, and poor patient and family involvement. Interviews elicited two major themes around the handover: practices and processes. Nurses identified that interruptions, time, and workload pressures presented barriers to handover, whilst teamwork, using a structured and systematic approach, preparation time for handover, and communication before transfer facilitated effective handover and transfer. Nurses suggested a structured tool to aid handover. This study identified clinically significant deficits and discrepancies in the information communicated to the ward nurses. Nurses identified that interruptions, time, and workload pressures presented barriers to effective handover. Teamwork where preparation and the handover event are prioritised over other activities is needed. A minimum data set for handover in conjunction with patients and family members is recommended. © 2020 Australian College of Critical Care Nurses Lt
The resilience standpoint in nursing
No full textBrien, DL ORCiD: 0000-0002-9005-3645; Mcallister, MM ORCiD: 0000-0003-1181-1610Nurses are often portrayed as surmounting enormous challenges with courage and grace (Stanley, 2008). This is a flattering image for nurses, but it has become so commonplace that people have wrongly conflated the actions of heroic nurses who have achieved extraordinary things with the inherent traits that all nurses share. But not all nurses are born strong or endowed with the traits of resiliency. This chapter draws on the resilience standpoint to critique such descriptions and suggest a more sustainable way to imagine nurses and nursing
How does poo come out my bum?
No full textReid-Searl, KA ORCiD: 0000-0001-5808-9296The content of this book is intended to help caregivers, parents and teachers engage children in learning about the importance of healthy bowel functioning
The cost of hospitalisation for youth self-harm: Differences across age groups, sex, Indigenous and non-Indigenous populations
No full textDoran, CM ORCiD: 0000-0002-9009-4906; Kinchin, I ORCiD: 0000-0003-0133-2763; Mccalman, JR ORCiD: 0000-0002-3022-3980; Russell, AM ORCiD: 0000-0002-3685-7220Objective: To report the comparative rates, average length of stay and cost per episode of hospital management for self-harm in three age cohorts: 15–19 years, 20–24 years and 25–29 years; by sex and indigeneity. Design, setting, participants: A secondary data analysis of the Australian Institute of Health and Welfare (AIHW) dataset between 1st January 2014 and 31st December 2014 inclusive. Main outcome measures: Cost per episode of hospitalised self-harm and rates by age group, sex and Indigenous status. Results: The rate of hospitalised self-harm among Australian youth was 254.0 per 100,000 population. This rate resulted in an annual cost to the healthcare system of AU4649 (95% CI 4810). Hospitalised self-harm was 21 times higher than the rate of suicide (11,820 episodes of hospitalised self-harm/564 suicides). Indigenous youth had on average a 1.4 times higher rate of hospitalised self-harm and 2.2 times higher rate of suicide than non-Indigenous counterparts. When controlling for age and sex, the average cost per episode was significantly lower for Indigenous youth compared to non-Indigenous youth, estimated marginal means 4954, respectively (p < 0.001). Conclusions: Hospitalised self-harm among Australian youth resulted in a substantial cost to the healthcare system. This cost is only part of the overall burden associated with self-harm. The rate of hospitalised self-harm was significantly higher in Indigenous youth, but the associated cost per episode was significantly lower. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature
The 30-15 intermittent fitness test: A reliable, valid, and useful tool to assess aerobic capacity in female basketball players
No full textScanlan, AT ORCiD: 0000-0002-0750-8697Purpose: The purpose of this study was to determine the reliability, validity, and usefulness of 30-15 Intermittent Fitness Test (30-15IFT) in female basketball players. Methods: Nineteen female basketball players (17.82 ± 1.94 yr, 175.4 ± 7.3 cm, 67.9 ± 7.7 kg) competing in the National Croatian League performed one trial of a continuous treadmill running test and two trials of the 30-15IFT. The 30-15IFT involves 30-s runs across a 40-m course interspersed with 15 s of walking, with running speed increasing every 45 s. The continuous treadmill running test was used as the criterion for validation. Results: High to very high reliability across test-retest trials were observed for maximal oxygen uptake (VO2max) (CV = 4.9%, ICC = 0.85), the 30-15IFT end-running velocity (VIFT) (CV = 6.0%, ICC = 0.85), and maximal heart rate (HRmax) (CV = 4.8%, ICC = 0.96). Criterion validity was supported for the 30-15IFT with strong to very strong relationships with VO2max (r =0.69), VIFT (r =0.74), and HRmax (r =0.73) attained during the continuous treadmill running test. The typical error (TE) of the 30-15IFT was greater than the smallest worthwhile change for VO2max (1.16 > 0.42 ml/kg/min), VIFT (0.56 > 0.20 km/h), and HRmax (2.15 > 1.89 bpm) adjudging usefulness of the test as marginal. The TE of 0.56 km/h (90% CI = 0.44-0.77 km/h) demonstrates changes in the performance of one to two stages (0.5-1.0 km/h) are meaningful. Conclusions: The 30-15IFT possesses acceptable reliability and validity to assess maximal aerobic fitness capacity in female basketball players. While the usefulness of the 30-15IFT was marginal, meaningful changes in performance consisted of only one to two stages. The present findings support the 30-15IFT as a practical testing option for basketball practitioners to assess fitness capacities in female players
Saskatoon berry Amelanchier alnifolia regulates glucose metabolism and improves cardiovascular and liver signs of diet-induced metabolic syndrome in rats
No full textdu Preez, R ORCiD: 0000-0003-2164-0819Saskatoon berry (Amelanchier alnifolia) is a potential functional food containing anthocyanins and flavonols, as well as ellagitannins and phenolic acids. We have determined the potential therapeutic effects of Saskatoon berry in diet-induced metabolic syndrome. Nine- to ten-week-old male Wistar rats were randomly assigned to four groups. Two groups were fed on control diets, either corn starch (C) or high-carbohydrate, high-fat diet (H) respectively, for 16 weeks. Two further groups were fed on C or H diet for 16 weeks with Saskatoon berry powder added to the diet for the final 8 weeks (CSSK, HSSK). After 16 weeks, H rats showed symptoms of metabolic syndrome, including increased body weight, visceral adiposity, systolic blood pressure, cardiac fibrosis, plasma concentrations of triglycerides and non-esterified fatty acids, and plasma activities of alanine transaminase and aspartate transaminase. Saskatoon berry intervention normalised body weight and adiposity, improved glucose tolerance, decreased systolic blood pressure, improved heart and liver structure and function with decreased infiltration of inflammatory cells, and decreased plasma total cholesterol. Further, Saskatoon berry normalised liver expression of hexokinase 1 and glycogen phosphorylase and increased glucose 6-phosphatase relative to H rats. These results suggest that Saskatoon berry regulates glycolysis, gluconeogenesis and glycogenesis to improve metabolic syndrome
Environmental impact assessment of green roofs using life cycle assessment
No full textRasul, M ORCiD: 0000-0001-8159-1321The main objective of this study was to analyse the environmental impacts of roof top greenery systems for a building in Sydney, Australia, using the Life Cycle Assessment (LCA). SimaPro software was used for the simulation. The input data for SimaPro on roof barrier, protection layer, drainage layer, filter layer, substrate, plants, etc., were taken from Sydney City Council and relevant literature. The environmental impacts of major pollutants such as Abiotic depletion, Global warming (GWP100), Ozone layer depletion (ODP), Human toxicity, Freshwater aquatic ecotoxicity, Marine aquatic ecotoxicity, Terrestrial ecotoxicity, Photochemical oxidation, Acidification and Eutrophication released from raw materials consumption and operation are compared between green roof and non-green roof. The results indicate that green roofs impact about 3 times positively in the environment compared to non-green roofs. Most of the emissions reductions were found to be in the range of 35% to 83%, however, ozone layer depletion is almost nullified when any of the green roofs are installed. It was also found that environmental impacts of both extensive and intensive green roofs are comparable; however, intensive green roofs perform slightly better and are recommended for urban life systems. © 201
Do multi-ingredient protein supplements augment resistance training-induced gains in skeletal muscle mass and strength? A systematic review and meta-analysis of 35 trials
No full textDoering, TM ORCiD: 0000-0002-6427-1067Objective: To determine the effects of multi-ingredient protein (MIP) supplements on resistance exercise training (RT)-induced gains in muscle mass and strength compared with protein-only (PRO) or placebo supplementation. Data sources: Systematic search of MEDLINE, Embase, CINAHL and SPORTDiscus. Eligibility criteria: Randomised controlled trials with interventions including RT ≥6 weeks in duration and a MIP supplement. Design: Random effects meta-analyses were conducted to determine the effect of supplementation on fat-free mass (FFM), fat mass, one-repetition maximum (1RM) upper body and 1RM lower body muscular strength. Subgroup analyses compared the efficacy of MIP supplementation relative to training status and chronological age. Results: The most common MIP supplements included protein with creatine (n=17) or vitamin D (n=10). Data from 35 trials with 1387 participants showed significant (p<0.05) increases in FFM (0.80 kg (95% CI 0.44 to 1.15)), 1RM lower body (4.22 kg (95% CI 0.79 to 7.64)) and 1RM upper body (2.56 kg (95% CI 0.79 to 4.33)) where a supplement was compared with all non-MIP supplemented conditions (means (95% CI)). Subgroup analyses indicated a greater effect of MIP supplements compared with all non-MIP supplements on FFM in untrained (0.95 kg (95% CI 0.51 to 1.39), p<0.0001) and older participants (0.77 kg (95% CI 0.11 to 1.43), p=0.02); taking MIP supplements was also associated with gains in 1RM upper body (1.56 kg (95% CI 0.80 to 2.33), p=0.01) in older adults. Summary/conclusions: When MIP supplements were combined with resistance exercise training, there were greater gains in FFM and strength in healthy adults than in counterparts who were supplemented with non-MIP. MIP supplements were not superior when directly compared with PRO supplements. The magnitude of effect of MIP supplements was greater (in absolute values) in untrained and elderly individuals undertaking RT than it was in trained individuals and in younger people. Trial registration number: CRD42017081970. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ
Grit-ability: Which grit characteristics enable success for mothers entering university?
No full textBraund, AM ORCiD: 0000-0001-5008-4415; James, DT ORCiD: 0000-0001-9591-2480Personal characteristics contributing to success in higher education has become an important area of focus in recent years. Duckworth’s (2007) grit framework shows positive correlations with a range of academic outcomes. This article explores the characteristics of grit in a study of female students who identified as mothers during their enrolment in an enabling program at CQUniversity Australia. Data was gathered from 284 participants and findings suggest that despite mothers facing competing challenges that conflict with study; demonstrating grit-ability is what enables success. The courage to begin; conscientious determination to achieve; resilience to overcome obstacles; endurance to persist; and striving for excellence were identified as key contributors to positive academic outcomes and personal fulfilment. Framework Methodology underpinned this thematic analysis using the grit terms of reference to examine survey responses. These findings highlight the relevance of grit as desirable student characteristics for experiencing success in enabling education