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Protocol for a randomized controlled trial testing the impact of feedback on familial risk of chronic diseases on family-level intentions to participate in preventive lifestyle behaviors
Get PDFThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background
Common disease risk clusters in families due to shared genetics, exposure to environmental risk factors, and because many health behaviours are established and maintained in family environments. This randomised controlled trial will test whether the provision of a family health history (FHH) risk assessment tool increases intentions and engagement in health behaviors. Message distribution and collective behavior change within family networks will be mapped using social network analysis. The relative intervention impact will be compared between families from different ethnic backgrounds.
Methods
One hundred and fifty mothers (50 Anglo-Australian, 50 Italian-Australian, 50 Vietnamese-Australian) will be recruited, with four or more other family members across three generations, including a child (aged 10-18 years). Each family is randomly assigned to intervention or control. At baseline and 6-month follow-up, all participants complete surveys to assess dietary and physical activity intentions and behaviors, attitudes towards food, and perceived disease risk. Intervention families receive a visual pedigree detailing their FHH of diabetes, heart disease, breast and bowel cancer, a health education workbook to ascertain members- disease risk (i.e. average or above average risk), and screening and primary prevention recommendations. After completion of follow-up assessments, controls will receive their pedigree and workbook. The primary hypothesis is that attitudes and lifestyle behaviors will improve more within families exposed to FHH feedback, although the extent of this improvement may vary between families from different ethnic backgrounds. Additionally, the extent of improvement in the treatment group will be moderated by the level of family disease risk, with above-average risk leading to greater improvement. A secondary aim will explore different family members- roles in message distribution and collective responses to risk using social network approaches and to compare network functioning between families with different ethnic backgrounds.
Discussion
Results will guide future health promotion programs aimed at improving lifestyle factors. This research will assess whether FHH can motivate families to adopt family-level strategies to support health promoting behaviors. Secondary analyses aim to identify change agents within the family who are particularly effective in shifting normative behaviors
Predictors of professional placement outcome: cultural background, English speaking and international student status
Get PDFThis is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.Placements provide opportunities for students to develop practice skills in professional settings. Learning in placements may be challenging for culturally and linguistically diverse (CALD) students, international students, or those without sufficient English proficiency for professional practice. This study investigated whether these factors, which are hypothesized to influence acculturation, predict poor placement outcome. Placement outcome data were collected for 854 students who completed 2747 placements. Placement outcome was categorized into ‘Pass’ or ‘At risk’ categories. Multilevel binomial regression analysis was used to determine whether being CALD, an international student, speaking ‘English as an additional language’, or a ‘Language other than English at home’ predicted placement outcome. In multiple multilevel analysis speaking English as an additional language and being an international student were significant predictors of ‘at risk’ placements, but other variables tested were not. Effect sizes were small indicating untested factors also influenced placement outcome. These results suggest that students’ English as an additional language or international student status influences success in placements. The extent of acculturation may explain the differences in placement outcome for the groups tested. This suggests that learning needs for placement may differ for students undertaking more acculturative adjustments. Further research is needed to understand this and to identify placement support strategies.No grant funds were used to support this research
Raising the Awareness of Undergraduate Nurses to the Psychosocial Impact of Living with Cancer: A Consumer Engagement in Teaching Initiative
Get PDFThis is an open access article distributed under the terms of the
Creative Commons Attribution-NonCommercial-ShareAlike 3.0
License, which allows others to remix, tweak, and build upon the
work non-commercially, as long as the author is credited and the
new creations are licensed under the identical terms.This article reflects on the development and implementation of a
consumer engagement in teaching initiative by the authors. The
authors highlight the challenges of engaging undergraduate nursing
students on the psychosocial aspects of living with cancer and other
chronic illnesses when students have very limited personal and
professional experiences to draw on. The authors discuss how they
have responded to these challenges by integrating the voices of
consumers into their classrooms. Speakers from consumer advocacy
organization, Cancer Voices SA, participated in a series of tutorials in
a 1st year topic in the Undergraduate Nursing Program at the School
of Nursing and Midwifery, Flinders University. Student feedback from
the implementation of the initiative indicated that students found
consumers’ stories and experiences of living with cancer, “moving
and powerful” and that they encouraged students to question their
assumptions about the psychosocial impacts of cancer on individuals
and families. The importance of good communication in reducing
patient distress was identified by students as an important element of
consumers’ experiences of the health care system as was the need for
transparency and information sharing between health care providers
across the health care system. For many students, consumers’ stories
and experiences had reinforced students’ commitment to studying
nursing and pursuing a career in nursing. The article concludes that
involving consumers in the education of health care professionals
encourages a much deeper understanding of and empathy for how
patients experience disease, which is integral to the provision of
patient-centered and holistic care
Statewide retrospective study of low acuity emergency presentations in New South Wales, Australia: who, what, where and why?
No full textThis is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/Abstract
Objective The present study aims to use a statewide population-based registry to assess the prevalence of low acuity emergency department (ED) presentations, describe the trend in presentation rates and to determine whether they were associated with various presentation characteristics such as the type of hospital as well as clinical and demographic variables.
Design and setting This was a retrospective analysis of a population-based registry of ED presentations in New South Wales (NSW). Generalised estimating equations with log links were used to determine factors associated with low acuity presentations to account for repeat presentations and the possibility of clustering of outcomes.
Participants Patients were included in this analysis if they presented to an ED between January 2010 and December 2014. The outcomes of interest were low acuity presentation, defined as those who self-presented (were not transported by ambulance), were assigned a triage category of 4 or 5 (semiurgent or non-urgent) and discharged back to usual residence from ED.
Results There were 10.7 million ED presentations analysed. Of these, 45% were classified as a low acuity presentation. There was no discernible increase in the rate of low acuity presentations across NSW between 2010 and 2014. The strongest predictors of low acuity ED presentation were age <40 years of age (OR 1.77); injury or musculoskeletal administrative and non-urgent procedures (OR 2.96); ear, nose and throat, eye or oral (OR 5.53); skin or allergy-type presenting problems (OR 2.84).
Conclusions Low acuity ED presentations comprise almost half of all ED presentations. Alternative emergency models of care may help meet the needs of these patients
The use of self-report questions to examine the prevalence of musculoskeletal problems: a test-retest study
No full textOpen AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.Background: Case definition has long been an issue for comparability of results obtained for musculoskeletal pain
prevalence, however the test-retest reliability of questions used to determine joint pain prevalence has not been
examined. The objective of this study was to determine question reliability and the impact of question wording,
ordering and the time between questions on responses.
Methods: A Computer Assisted Telephone Interviewing (CATI) survey was used to re-administer questions collected
as part of a population-based longitudinal cohort study. On two different occasions questions were asked of the
same sample of 203 community dwelling respondents (which were initially randomly selected) aged 18 years and
over at two time points 14 to 27 days apart (average 15 days). Reliability of the questions was assessed using
Cohen’s kappa (κ) and intraclass correlation coefficient (ICC) and whether question wording and period effects
existed was assessed using a crossover design.
Results: The self-reported prevalence of doctor diagnosed arthritis demonstrated excellent reliability (κ = 0.84 and κ = 0.79
for questionnaires 1 and 2 respectively). The reliability of questions relating to musculoskeletal pain and/or stiffness ranged
from moderate to excellent for both types of questions, that is, those related to ever having joint pain on most days for at
least a month (κ = 0.52 to κ = 0.95) and having pain and/or stiffness on most days for the last month (κ = 0.52 to κ = 0.90).
However there was an effect of question wording on the results obtained for hand, foot and back pain and/or stiffness
indicating that the area of pain may influence prevalence estimates.
Conclusions: Joint pain and stiffness questions are reliable and can be used to determine prevalence. However, question
wording and pain area may impact on estimates with issues such as pain perception and effect on activities playing a
possible role in the recall of musculoskeletal pain
Investigating the Effect of Carbon Nanotube Diameter and Wall Number in Carbon Nanotube/Silicon Heterojunction Solar Cells
No full textThis is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).Suspensions of single-walled, double-walled and multi-walled carbon nanotubes (CNTs) were generated in the same solvent at similar concentrations. Films were fabricated from these suspensions and used in carbon nanotube/silicon heterojunction solar cells and their properties were compared with reference to the number of walls in the nanotube samples. It was found that single-walled nanotubes generally produced more favorable results; however, the double and multi-walled nanotube films used in this study yielded cells with higher open circuit voltages. It was also determined that post fabrication treatments applied to the nanotube films have a lesser effect on multi-walled nanotubes than on the other two types
Constructing arbitrarily large graphs with a specified number of Hamiltonian cycles
No full textThis work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License (CC BY-SA 4.0).A constructive method is provided that outputs a directed graph which is named a broken crown graph, containing vertices and Hamiltonian cycles for any choice of integers . The construction is not designed to be minimal in any sense, but rather to ensure that the graphs produced remain non-trivial instances of the Hamiltonian cycle problem even when is chosen to be much smaller than
How Close is too Close? The Effect of a Non-Lethal Electric Shark Deterrent on White Shark Behaviour
No full textThis is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Sharks play a vital role in the health of marine ecosystems, but the potential threat that sharks pose to humans is a reminder of our vulnerability when entering the ocean. Personal shark deterrents are being marketed as the solution to mitigate the threat that sharks pose. However, the effectiveness claims of many personal deterrents are based on our knowledge of shark sensory biology rather than robust testing of the devices themselves, as most have not been subjected to independent scientific studies. Therefore, there is a clear need for thorough testing of commercially available shark deterrents to provide the public with recommendations of their effectiveness. Using a modified stereo-camera system, we quantified behavioural interactions between white sharks (Carcharodon carcharias) and a baited target in the presence of a commercially available, personal electric shark deterrent (Shark Shield Freedom7™). The stereo-camera system enabled an accurate assessment of the behavioural responses of C. carcharias when encountering a non-lethal electric field many times stronger than what they would naturally experience. Upon their first observed encounter, all C. carcharias were repelled at a mean (± std. error) proximity of 131 (± 10.3) cm, which corresponded to a mean voltage gradient of 9.7 (± 0.9) V/m. With each subsequent encounter, their proximity decreased by an average of 11.6 cm, which corresponded to an increase in tolerance to the electric field by an average of 2.6 (± 0.5) V/m per encounter. Despite the increase in tolerance, sharks continued to be deterred from interacting for the duration of each trial when in the presence of an active Shark Shield™. Furthermore, the findings provide no support to the theory that electric deterrents attract sharks. The results of this study provide quantitative evidence of the effectiveness of a non-lethal electric shark deterrent, its influence on the behaviour of C. carcharias, and an accurate method for testing other shark deterrent technologies
Spoiling suspense? Anticipatory structures as creative narrative devices in Tabish Khair’s diasporic fiction
No full textNarrative texts often aim to generate suspense, or similar type of involvement, in order to enhance plot developments through the delay or withdrawal of explicit information, or the use of unreliable characters. There are also cases, however, in which the flow of narrative progression is deliberately broken and punctuated by anticipatory elements that introduce, hint at or suggest future events, situations, and characters. My aim in this paper is to examine how a wide range of proleptic, cataphoric and other elements can function as creative anticipatory structures for the construction of fictional discourse, and I will focus on a recent diasporic novel, How to Fight Islamist Terror from the Missionary Position by Tabish Khair (2012), which extensively, almost obsessively, employs such devices. Functioning as clues that intersect narratorial levels and call for attention paradoxically à rebours, anticipatory structures are often realised via the use of different items such as mental process verbs, deictic shifts and split selves. The textual effects they generate significantly contribute to the presentation of the narrator’s point of view, but also allow the author to address loaded questions, for example the ideological mixing of the ‘threat’ and the ‘token’ of otherness in our anxious postmodern age. From a methodological point of view, I will adopt and adapt a range of different tools from the fields of postcolonial studies, stylistics, narratology and pragmatics to investigate Khair’s novel
Review of Thicker Than Water: History, Secrets and Guilt – a Memoir by Cal Flyn.
No full textReview of Thicker Than Water: History, Secrets and Guilt – a Memoir by Cal Flyn