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Assessment of the bearing-down manoeuvre in pregnancy and detection of paradoxical levator ani muscle contraction using 2D transperineal ultrasound and vaginal palpation:a concurrent validity and inter-rater reliability study
No full textObjectiveTo examine the concurrent validity and inter-rater reliability of vaginal palpation as a measure of the quality of the bearing-down manoeuvre (BDM) and the detection of a paradoxical levator ani muscle contraction (LAM) in pregnant women, compared with 2D transperineal ultrasound (TPUS).DesignConcurrent validity and inter-rater reliability study.SettingPhysiotherapy clinic.PopulationTwenty pregnant women in their third trimester.MethodsThe anterior posterior diameter (APD) was measured during the BDM using TPUS by one experienced physiotherapist. An APD that shortened by >2 mm from rest was described as LAM shortening, an APD that moved by 0–2 mm was described as no change and an APD that lengthened by >2 mm was described as LAM lengthening. Vaginal palpation described the LAM during the BDM as no movement, shortening or lengthening. Participants were allowed two attempts and the best attempt was measured.Main outcome measuresAPD using TPUS and the assessor's subjective description of LAM during the BDM using vaginal palpation.ResultsTPUS detected more paradoxical LAM contractions during the BDM than palpation. Agreement between vaginal palpation and TPUS assessment for BDM was poor. The Fleiss kappa coefficients were 0.457 (90% CI 0.16–0.71) between TPUS and one assessor and 0.326 (90% CI 0.01–0.6) between TPUS and the other assessor. In addition, inter-rater reliability was poor between observers palpating the BDM, with a Fleiss kappa coefficient of 0.375 (90% CI 0.13–0.64).ConclusionsThis study did not find vaginal palpation of the BDM in pregnant women to have concurrent validity or inter-rater reliability. Clinicians should be aware of potential inaccuracies when palpating the BDM, and, where possible, seek an assessment via TPUS
Pregnant women’s experiences of extreme exposure to bushfire associated smoke:a qualitative study
No full textIn 2019/2020, multiple bushfires burned across south-east Australia converging into unprecedented megafires that burned 5.8 million hectares. From October 2019–February 2020, 80% of Australians were affected by smoke from these fires, exposing them to dramatic increases of PM2.5in the air at an average level of ∼70μg m3 per day, well above the World Health Organisation recommendation of ∼10μg m3. Maternal exposure to PM2.5has been associated with negative birth outcomes and an increased rate of birth defects, yet there is a dearth of literature regarding how pregnant women deal with exposure to bushfire smoke. The aim of this study was thus to investigate how pregnant and postpartum women experienced severe bushfire smoke associated with the 2019–2020 bushfires in south-east Australia and the strategies they used to mitigate exposure to smoke for themselves and their unborn or newborn children. Forty-three women who were exposed to fire and/or smoke from the 2019–2020 bushfires participated in one-on-one semi-structured interviews via phone or videoconference. These women were selected purposively from a larger group of women who had elected to be interviewed. After interview, data were transcribed and thematically analysed using the four phases of disaster response (prevention, preparedness, response, recovery) as a frame. Overall, our results indicated that public health advice failed to meet the unique needs of this group. While many protected their properties appropriately and were reasonably well prepared for evacuation, they were unprepared for the disruption to vital services including power and communications. Women exposed to smoke inundation were unprepared for this outcome and self-initiated a variety of strategies. The support of community was also key to recovery. There is a clear need for specific recognition of the needs of pregnant women across all phases of disaster response, incorporating public health messaging, peer support, and access to resources.</p
Primary School Teachers’ Adaptations for Struggling Writers:Survey Study of Grade 1 to 6 Teachers in Australia
Get PDFTwo hundred ninety-eight primary teachers (88% female) from across all Australian states and territories reported on the frequency with which they implemented instructional adaptations for struggling writers in their classrooms. They also rated their preparation and self-efficacy for teaching writing. The majority of participating teachers indicated they provided additional instruction on spelling, capitalization and punctuation, and sentence construction at least once a week or more often. Teachers further reported implementing additional minilessons and reteaching strategies and skills, as well as extra instruction on grammar, handwriting, text structure, revising, and planning on a monthly basis or more often. The majority of teachers reported never or only once a year using adaptations to support digital writing. The frequency with which teachers provided extra instruction on spelling, handwriting, text structure, revising, and computer use differed by grade. Only teachers’ perceived efficacy to teach writing made a unique and statistically significant contribution to predicting the use of instructional adaptations for writing and adaptations to support digital writing after controlling for teacher and classroom variables
Undergraduate nursing students challenge misconceptions towards men in nursing:A mixed-method study
No full textAIMS: To examine misconceptions towards men in nursing from the perspective of undergraduate nursing students. Specifically, this study sought to explore contributing factors of misconceptions and attributions of the success of men in nursing.DESIGN: A convergent parallel mixed-method study.METHODS: A national survey was conducted (July-September 2021). The quantitative data included demographics and responses to the Gender Misconceptions of Men in Nursing (GEMINI) scale. The qualitative data included responses to a provocative statement related to characteristics of men and their career in nursing. The GRAMMS guideline was used in reporting.RESULTS: Undergraduate nursing students (n = 1245) from 16 Australian schools of nursing responded to the survey. Quantitative analysis demonstrated that most students (96%) did not have misconceptions about men in nursing. Those who did were more likely to be men, born overseas, not in health-related employment and did not have nursing as their first choice. Four broad overarching main themes were generated in response to the statement that suggested men do not have the right attributes for nursing: (1) 'This is a very misandristic viewpoint'; (2) 'Compassion and intelligence are distributed in men and women equally'; (3) 'Men bring a different quality to nursing' (4) 'Anyone can be whatever they want to be'.CONCLUSION: Overall, nursing students did not have misconceptions about men in nursing, despite experiencing ongoing social stigma regarding archaic gender norms. The findings from this study indicate that the next-generation nurses were championing to challenge the gender stereotype and support the needs of a gender diverse society.IMPACT: Attitudes and misconceptions that elicit gender inequalities must be addressed with comprehensive strategies and de-gendered language and imagery within the profession, schools, workplaces and the media. Shifting culture and attitudes towards inclusion, values the diversity in the workforce and supports healthy workplace environments.PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.</p
Circular economy in construction:The digital transformation perspective
Get PDFThis systematic review critically examines the intersection of digital transformation and circular economy (CE) principles within the built environment. While digitalisation has been shown to enhance efficiency, safety, and sustainability in construction, its role in fostering circularity is less established. This study analyzes literature from 2010 to 2022, focusing on how digital technologies such as open-BIM, digital twins, material passports, blockchain, RFID, and gamification can integrate into and enhance the circular building lifecycle. The findings reveal that while digital tools are pivotal in design and construction phases, their application to existing structures is less straightforward, with challenges including the absence of digital twins for demolished structures, the high costs of retrofit digitalisation, and the predominant focus on environmental benefits over practical implementation. The review also highlights the need for a unified digital transformation strategy and greater cross-industry collaboration. Future research directions are proposed, including the development of localized material banks, the application of RFID in circularity, the scope of Design for Disassembly (DfD) tools, digital inventory of existing buildings, the circularity of Life Cycle Assessment (LCA) databases, and policy implications for promoting circular construction practices
Examining the psychometric properties of the headspace Youth (mental health) Service Satisfaction Scale in a mental health service in Ireland
Get PDFIntroduction: Evaluating service quality and satisfaction is central to the provision of accessible and developmentally appropriate youth mental health services. However, there are limited suitable measures and a lack of published evidence on the psychometric properties of measures to assess young people's satisfaction with youth mental health services. The headspace Youth (Mental Health) Service Satisfaction Scale (YSSS) was designed and implemented to assess young people's satisfaction with headspace mental health services in Australia. This study examined the reliability and factor structure of the YSSS in a youth mental health service in Ireland. Methods: The sample comprised 1449 young people (66.2% female) aged 12–25 years (M = 16.48, SD = 2.97). Participants completed the YSSS after their final brief intervention session through Jigsaw—The National Centre for Youth Mental Health. Confirmatory factor analysis (CFA) was performed on one- and four-factor models to test findings from previous studies. Reliability was also examined. Results: CFA supported a single-factor structure of the YSSS, and all items were suitable for inclusion. The internal consistency of the measure was deemed acceptable (α = 0.89). Conclusions: Findings suggest that the YSSS is a reliable measure for monitoring satisfaction with youth mental health services in an Irish context. The measure demonstrated a unidimensional construct of satisfaction. These findings support the broader application of the YSSS and add to existing knowledge on measuring satisfaction within youth mental health services.</p
The Biomechanics Research and Innovation Challenge:Development, Implementation, Uptake, and Reflections on the Inaugural Program
No full textBiomechanics as a discipline is ideally placed to increase awareness and participation of girls and women in science, technology, engineering, and mathematics. A nationwide Biomechanics and Research Innovation Challenge (BRInC) centered on mentoring and role modeling was developed to engage high school girls (mentees) and early-mid-career women (mentors) in the field of biomechanics through the completion of a 100-day research and/or innovation project. This manuscript describes the development, implementation, and uptake of the inaugural BRInC program and synthesizes the research and innovation projects undertaken, providing a framework for adoption of this program within the global biomechanics community. Eighty-seven high school girls in years 9 and 10 (age range: 14–16 y) were mentored in teams (n = 17) by women in biomechanics (n = 24). Using a design thinking approach, teams generated solutions to biomechanics-based problem(s)/research question(s). Eight key reflections on program strengths, as well as areas for improvement and planned changes for future iterations of the BRInC program, are outlined. These key reflections highlight the innovation, impact, and scalability of the program; the importance of a program framework and effective communication tools; and implementation of strategies to sustain the program as well as the importance of diversity and building a sense of community.</p
Promoting breastfeeding in women with gestational diabetes mellitus in high-income settings:an integrative review
Get PDFBackground: Breastfeeding provides many short- and long-term health benefits for mothers and their infants and is a particularly relevant strategy for women who experience Gestational Diabetes Mellitus (GDM) during pregnancy. However, breastfeeding rates are generally lower amongst this group of women than the general population. This review’s objective is to identify the factors that influence breastfeeding by exploring the experiences and outcomes of women in in high-income health care contexts when there is a history of GDM in the corresponding pregnancy. Methods: A comprehensive search strategy explored the electronic databases Medline, CINAHL, Web of Science and Scopus for primary studies exploring breastfeeding practices for papers published between January 2011 and June 2023. All papers were screened independently by two researchers with included papers assessed using the Crowe Critical Appraisal tool. Findings were analysed using a narrative synthesis framework. Results: From an initial search result of 1037 papers, 16 papers representing five high-income nations were included in this review for analysis – the United States of America (n = 10), Australia (n = 3), Finland (n = 1), Norway (n = 1), and Israel (n = 1). Fifteen papers used a quantitative design, and one used a qualitative design. The total number of participants represented in the papers is 963,718 of which 812,052 had GDM and 151,666 did not. Women with an immediate history of GDM were as likely to initiate breastfeeding as those without it. However, they were more likely to have the first feed delayed, be offered supplementation, experience delayed lactogenesis II and or a perception of low supply. Women were less likely to exclusively breastfeed and more likely to completely wean earlier than the general population. Maternity care practices, maternal factors, family influences, and determinants of health were contextual and acted as either a facilitator or barrier for this group. Conclusion: Breastfeeding education and support need to be tailored to recognise the individual needs and challenges of women with a history of GDM. Interventions, including the introduction of commercial milk formula (CMF) may have an even greater impact and needs to be very carefully considered. Supportive strategies should encompass the immediate and extended family who are major sources of influence.</p
Response to COVID-19 vaccination in patients on cancer therapy:Analysis in a SARS-CoV-2-naïve population
Get PDFBackground: Cancer patients have increased morbidity and mortality from COVID-19, but may respond poorly to vaccination. The Evaluation of COVID-19 Vaccination Efficacy and Rare Events in Solid Tumors (EVEREST) study, comparing seropositivity between cancer patients and healthy controls in a low SARS-CoV-2 community-transmission setting, allows determination of vaccine response with minimal interference from infection. Methods: Solid tumor patients from The Canberra Hospital, Canberra, Australia, and healthy controls who received COVID-19 vaccination between March 2021 and January 2022 were included. Blood samples were collected at baseline, pre-second vaccine dose and at 1, 3 (primary endpoint), and 6 months post-second dose. SARS-CoV-2 anti-spike-RBD (S-RBD) and anti-nucleocapsid IgG antibodies were measured. Results: Ninety-six solid tumor patients and 20 healthy controls were enrolled, with median age 62 years, and 60% were female. Participants received either AZD1222 (65%) or BNT162b2 (35%) COVID-19 vaccines. Seropositivity 3 months post vaccination was 87% (76/87) in patients and 100% (20/20) in controls (p =.12). Seropositivity was observed in 84% of patients on chemotherapy, 80% on immunotherapy, and 96% on targeted therapy (differences not satistically significant). Seropositivity in cancer patients increased from 40% (6/15) after first dose, to 95% (35/37) 1 month after second dose, then dropped to 87% (76/87) 3 months after second dose. Conclusion: Most patients and all controls became seropositive after two vaccine doses. Antibody concentrations and seropositivity showed a decrease between 1 and 3 months post vaccination, highlighting need for booster vaccinations. SARS-CoV-2 infection amplifies S-RBD antibody responses; however, cannot be adequately identified using nucleocapsid serology. This underlines the value of our COVID-naïve population in studying vaccine immunogenicity.</p