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Fluctuating salinity during development impacts fish life histories
No full textClimate change and human activities are elevating the level and variability of salinity in freshwater ecosystems. Consequently, many aquatic species now experience more extreme developmental environments. Resultant shifts in developmental trajectories could change key life-history traits that persist into adulthood. The 'silver spoon' hypothesis posits that favourable developmental conditions lead to faster growth, earlier maturation and greater reproductive success. In contrast, the 'predictable adaptive response' hypothesis suggests that faster growth and earlier reproduction should be selected for under stressful developmental conditions because stress provides cues about a higher risk of mortality in future environments. To understand life-history responses to salinity during development, we reared a global pest, mosquitofish (Gambusia holbrooki), from birth in either freshwater control (0‰), stable-saline (10‰), or fluctuating-saline environments (0‰-20‰; mean = 10‰) until maturation. We then monitored their performance in early and late adulthood in a common garden setting. Fish in fluctuating salinity grew more slowly and had a reduced reproductive output (lower sperm count, smaller eggs) than those in stable elevated salinity. These differences are consistent with a more stable environment providing a 'silver spoon' effect. Conversely, fish in stable elevated salinity grew faster and matured earlier than those in freshwater, supporting a 'predictive adaptive response' whereby salinity is a stressor triggering faster development and accelerates reproduction. In addition, fluctuations in salinity altered the effect of higher salinity on self-maintenance. Stable elevated salinity caused a decrease in male telomere length and female gut length, but fluctuating salinity caused an increase in female gut length. Our results suggest that fluctuating versus stable salinity during development leads to distinct fish life histories. The effect sizes for some traits differed significantly between males and females, suggesting sex-specific responses to climate fluctuations.</p
Implementation of the Allied Health Assistant Workforce in the Australian Context:An Integrative Review
No full textThe Allied Health Assistant (AHA) workforce plays a critical role in enhancing the capacity, efficiency, and accessibility of allied health services across Australia. Considering significant structural reforms in sectors in which AHAs are employed, including the introduction of the National Disability Insurance Scheme (NDIS) and changes to aged care funding, this integrative review synthesizes current evidence on the utilization of AHAs across diverse settings, disciplines, and sectors. A comprehensive search of peer-reviewed and government literature from 2007 to 2025 identified 38 studies and 18 policy documents. A concept analysis identified four key concepts: service efficiency and quality, capacity building through training, contextual and structural determinants of role implementation, and tensions between role innovation and professional boundaries. Findings highlight the positive impact of AHAs on therapy access and service delivery, the importance of context-specific training and supervision, and the need for supportive organizational structures. Despite growing recognition of the AHA role, gaps remain in outcome-focused research, particularly in mental health, disability, and aged care settings. This review underscores the need for targeted workforce strategies and policy development to optimize the integration and sustainability of the AHA workforce in Australia’s evolving health landscape.</p
Ankle joint position sense acuity differences among stroke survivors at three walking ability levels: a cross-sectional study
Get PDFBackground: Despite the importance of lower limb sensation in walking highlighted in systematic reviews, there is limited research investigating the effect of proprioceptive deficits after stroke and any relationship with walking ability. Objectives: With stroke survivors of different walking ability, this study aimed to (1) explore side (affected/unaffected) and movement direction (inversion/plantar flexion) effects in ankle joint position sense (JPS) acuity, and (2) compare ankle JPS acuity between groups of stroke survivors with different walking ability. Methods: Seventy subacute stroke survivors were recruited and divided into three groups based on walking ability, as determined by their gait speed on the 10-Meter Walking Test: household (<0.4 m/s), limited community (0.4–0.8 m/s) and community (>0.8 m/s). Ankle JPS acuity was measured by the active movement extent discrimination apparatus (AMEDA). Results: A significant difference was found between sides, with the AMEDA scores for the unaffected side significantly higher than for the affected side (F 1.67 = 22.508, p < 0.001). The mean AMEDA scores for plantar flexion were significantly higher than for inversion (F 1.67 = 21.366, p < 0.001). There was a significant linear increase in ankle JPS acuity with increasing walking ability among stroke survivors (F 1.67 = 17.802, p < 0.001). Conclusion: After stroke, ankle JPS acuity on the affected side was lower than the unaffected side. Stroke survivors had higher ankle JPS acuity in plantar-flexion movements, compared with inversion movements. Overall, stroke survivors with higher ankle JPS acuity tended to have higher walking ability, highlighting the importance of ankle JPS acuity in walking ability after stroke. These findings provide new insights into proprioceptive deficits after stroke and their relevance in neurorehabilitation.</p
Proprioception After Unilateral Stroke: Changes in the Affected and Unaffected Lower Limbs Over Time
No full textBackground: Proprioceptive deficits are common among stroke survivors and can negatively impact their balance and postural control. However, there has been little evaluation of the change in proprioceptive deficits in the lower limbs over time after stroke. This study aimed to examine proprioceptive deficits over time after stroke in both the affected and “unaffected” lower limbs. Methods: This cross-sectional study included sixty first-time unilateral stroke survivors and twenty age-matched healthy individuals. Participants after stroke were divided into three subgroups based on different time points after stroke. The generally accepted clinical time points after stroke are the first 4 weeks—the acute stage; 5–24 weeks—the subacute stage; over 24 weeks—the chronic stage. The active movement extent discrimination apparatus (AMEDA) was used to quantify ankle proprioception in plantarflexion and inversion directions, on both the affected and “unaffected” sides. Results: Lower limb proprioception scores decreased linearly over time after stroke on both the affected and “unaffected” sides (p < 0.001). Overall, proprioception scores for the stroke groups were significantly lower than those for the healthy age-matched group (p < 0.01), with the only exception being ankle plantarflexion and inversion scores on the unaffected side in the acute stroke group, which were not significantly different from their healthy counterparts. Conclusion: Ankle proprioception in both lower limbs decreased over time after a unilateral stroke, with proprioceptive acuity on the “unaffected” side diminishing linearly in the same way as that on the affected side. These observed continuing deficits in lower limb proprioception among stroke survivors raise implications for clinical neurorehabilitation.</p
The Cultural Values and Services of Wetlands: Evolution and Obligations under the Ramsar Convention
No full textUnveiling the Craving:A systematic review of pregnant women's desires for expert nutrition care in Australia
Get PDFProblem: Poor nutrition during the antenatal period can contribute to adverse health outcomes for both mother and baby. Background: Despite the importance of nutrition during pregnancy, there is limited research exploring the attitudes and experiences pregnant women possess towards nutrition care, particularly within the Australian context. Existing literature has indicated that pregnant women lack knowledge of and are not adhering to pregnancy related nutrition recommendations. Furthermore, although pregnant women rely on many health professionals for nutrition care, there are deficiencies in both the quality and quantity of care provided. Aim: The aim of this meta-aggregative review was to explore the experiences and attitudes pregnant women in Australia have towards nutrition care. Methods: Meta-aggregation was used to synthesise qualitative studies. A search strategy was applied to four electronic databases in May 2023.The findings were extracted and synthesised via the JBI approach. Findings: A total of 719 studies were identified in the initial database search with seven eligible studies included in the meta-aggregation. From 11 categories, three synthesised findings were developed: (i) approaches to nutrition care delivery matters, (ii) quality and quantity of nutrition care is insufficient, and (iii) pregnant women value nutrition care. Conclusion: This review highlights pregnant women's desires for better nutrition care in Australia, with current provision of nutrition care lacking in quality and quantity. Improved antenatal dietetics services and increased health professional nutrition training is necessary to address these concerns.</p
Grassroots modalities of learning: creating and maintaining pluriversal knowing, being and doing for collective survival
Get PDFThis special issue highlights grassroots and place-based modalities of learning. Itcontributes to pluriversal ways of thinking and living emanating from diversecontexts and place-based and culturally specific ways of knowing, being anddoing, It is written against the backdrop of global crises and it highlightspractices and possibilities emerging from diverse grassroots contexts as a wayforward for human and Earthkin collective survival. Contributions in the specialissue all speak to one or more of three key themes, threads that are woven in andacross the collection. These are: climate change adaptations, community foodeconomies, and Indigenous language and communication tools that supportgrassroots living
Determining the process components of impact assessment in health and social program implementation:A scoping review of theories, models and frameworks
Get PDFObjectives: Health and social service research impact analysis play a pivotal role in demonstrating research value. Impact analysis of programs, interventions, or policies in real-world settings is complex. There are many implementation evaluation theories, models, and frameworks (TMF) and researchers find choosing one challenging. Our objective was to systematically scope TMFs, review and chart key components of the process of implementation impact analysis to identify gaps. Study design: A scoping review was undertaken and reported using PRISMA-ScR guidelines. Methods: Systematic literature searches were conducted for impact analysis and impact assessment TMFs in MEDLINE, SCOPUS databases, hand searches, and expert directed search (2010–2024). Peer-reviewed articles were eligible for inclusion if they described an implementation evaluation TMF in English and used in the real world. Data extracted by the study team was charted in an Excel spreadsheet. Results: The review identified 71 relevant papers which included a theory (n = 6), model (n = 14), or framework (n = 51). Most considered resources and/or results, whereas only 25 % considered implementation process components. Ten frameworks were deemed comprehensive and covered at least two phases of implementation and five components. Most frameworks had not developed or tested practical tools to facilitate use of the framework. Conclusions: No frameworks were identified that incorporated all phases of implementation, nor key components of the process in each phase of implementation research. The findings highlight the need to identify key components and develop a taxonomy, glossary and tools to assess the process components of implementation in real world settings.</p
Risk Factors of Standalone and Coexisting Forms of Undernutrition Among Children in Sub-Saharan Africa:A Study Using Data from 26 Country-Based Demographic and Health Surveys
No full textINTRODUCTION: Undernutrition in low- and middle-income countries (LMICs) remains a leading public health challenge. It accounts for one-third of the under-five mortality rate in sub-Saharan Africa (SSA). This study applied the composite index of anthropometric failure (CIAF) to assess the prevalence of various standalone and coexisting forms of undernutrition and identify associated risk factors.METHODS: Nationally representative demographic health survey (DHS) data from 26 SSA countries were used. A multilevel multinomial logistic regression analysis was conducted considering the hierarchical nature of DHS data and more than two categories of outcome variable. Four models were fitted and the model with the highest log-likelihood and lowest deviance was chosen as the best-fitted model. The adjusted relative risk ratio (aRRR) with its corresponding 95% confidence interval (CI) was presented as a measure of the effect.RESULTS: The overall prevalence of undernutrition among under-five children in SSA was 34.59% (95% CI: 34.35-34.82). Additionally, 20.49% (95% CI: 20.30-20.69) and 14.09% (95% CI: 13.92-14.26) of under-five children had standalone and coexisting undernutrition, respectively. The mother's educational level and household wealth status were the most significant shared drivers for standalone and coexisting undernutrition. On the other hand, child and health service factors were differentiating factors between standalone and coexisting undernutrition. Age of the child, sex of the child, type of birth, birth weight, adherence to age-appropriate feeding, antenatal care visit (ANC), place of delivery, and maternal educational status were the most significant determinants of various undernutrition forms in 0-23-month-old children. For 24-59-month-old children, age of the child, sex of the child, type of birth, household wealth status, and maternal education were identified as the main determinants of different forms of undernutrition.CONCLUSIONS: Our analysis revealed that distal factors were shared risk factors among standalone and coexisting forms of undernutrition. However, proximal and intermediate factors varied in the type and strength of the association between standalone and coexisting undernutrition. This implies that holistic and category-specific strategies are needed to significantly reduce undernutrition among under-five children in SSA.</p