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A mixed methods study exploring the association between low carbohydrate diets, quality of life, and glycaemic control in Australian adults living with type 1 diabetes mellitus
No full textThe use of Information and Communication Technology (ICT) in the Teacher Professional Education Program (TPEP) for English teachers in Indonesia
No full textEvaluating the effectiveness of pressure mattresses for people over 50 years of age in community settings
No full textIron deficiency, supplementation, and sports performance in female athletes:A systematic review
No full textBackground: Iron facilitates key biological functions underpinning sports performance, and up to 60% of female athletes experience iron deficiency. However, the effects of iron deficiency on sports performance in female athletes is unclear, as are the degree of benefits of iron supplementation (FeSup). This study characterizes the effects of iron deficiency and FeSup on sports performance in high-level female athletes. Methods: Searches of the electronic databases MEDLINE, SPORTDiscus, Web of Science, Scopus, and CINAHL were performed in July 2023. Studies were included that evaluated the effects of iron deficiency or FeSup on sports performance in high-level (maximal oxygen uptake (VO 2max) > 45 mL/kg/min, or trained > 5 h/week) iron deficient (ID) (serum ferritin (sFer) < 40 µg/L) female athletes. Studies were assessed using a modified Downs and Black Quality Assessment Checklist. Results: A total of 23 studies comprising 669 athletes (age range: 13–47 years) across 16 sports were included in the review. Iron deficiency negatively affects endurance performance by 3%–4%. However, endurance performance improved by 2%–20% when ID athletes were treated with 100 mg/day of elemental iron for up to 56 days via oral supplementation, or bi-daily via parenteral administration over 8–10 days. ID non-anemic athletes with low sFer stores may be predisposed to reduced maximal aerobic capacity. However, maximal aerobic capacity improved by 6%–15% following 16 mg/day–100 mg/day of elemental iron for 36–126 days. Isokinetic strength and anaerobic power performance may be impeded (–23% to +4%) among ID athletes, but the effect of FeSup on anaerobic power varied markedly (–5% to +9%) following 100 mg/day of elemental iron over 42–56 days, or 100 mg of elemental iron bi-daily over 8–10 days. The quality of studies was moderate (77%), ranging from low (57%) to high (100%). Moststudies (n = 18) contained group sizes ≤ 20 athletes, thus limiting the likelihood of detecting significant effects (statistical power > 0.80). Conclusion: High-level ID female athletes experience a negative impact on endurance performance, which can be improved by supplementing with ∼100 mg of elemental iron per day or bi-daily. The decrements in other performance parameters characterizing a range of sports coincide with the severity of iron deficiency.</p
‘I tried to get into their shoes and their culture’. Care worker experiences in cultural end-of-life care:Interpretative phenomenological analysis
No full textAim: What are care workers' lived experiences caring for people of culturally and linguistically diverse backgrounds during end-of-life care?. Design: Interpretative phenomenological analysis. Methods: The lived experiences of 11 care workers within the Australian Capital Territory and region who have cared for someone of a culturally and linguistically diverse background during end-of-life care were captured. Each care worker was interviewed individually and answered a series of semi-structured open-ended questions. Results: Using interpretative phenomenological analysis, three group experiential themes were derived: (i) navigating cultural shock and death, (ii) the hard work of communication and (iii) searching for deeper connections with client and self. Within these were key elements: Care workers worked hard to embrace cultural diversity, but struggled to meet cultural needs, particularly in relation to the unpredictable timeline of dying. Care workers relied on themselves and their improvisation, but experienced self-blame for inadequate care and unexpected challenges in communication. Blurred boundaries in relation to therapeutic relationships were apparent, and care workers felt alone with emotional burden, but also found belonging and joy in their work. Conclusion: Care workers' experiences are vital to understanding the barriers and challenges in providing culturally appropriate end-of-life care. Care workers repeatedly experienced an emotional burden and vicarious trauma throughout their work in this field. Care workers were self-reliant in all aspects of care including communication and consistently desired education, training, resources and support. There remains inadequate research on care workers and their role within the Australian healthcare context. Implications for the Profession and/or Patient Care: Care workers need access to support and resources including professional translators to provide culturally appropriate end-of-life care. Workplaces and registered nurses should facilitate training and provide guidance to care workers. A person-centred approach is required during all client encounters while maintaining appropriate therapeutic relationships including therapeutic use of self and professional boundaries. Reporting Method: COREQ Checklist. Patient or Public Contribution: During this study, care workers were interviewed on their experiences caring for people of culturally and linguistically diverse backgrounds during end-of-life care. Patients were not directly involved within this study, but their views may have been expressed through the care workers' experience.</p
The challenges of coeliac disease at work:A contestation of the politics of inclusion
Get PDFBy focusing on the experiences of employees living with coeliac disease as evidenced in UK employment tribunal cases, this paper interrogates the way practices of exclusion are performed in legal and organisational contexts that purport to promote values of inclusion. In paying attention to how differences are constructed and negotiated, the paper unpacks the way organisational practices mobilise an array of workplace mechanisms to produce complex dynamics of exclusion. Applying Laclau and Mouffe’s logics of equivalence and difference, we show how questionable impulses and practices emerge in a workplace environment characterised by unclarity and vagueness. One impulse, for example, involves privatising and individualising the condition of employees with coeliac disease, giving rise to patronising and stigmatising attitudes that can turn them into victims. However, we also identify workplace mechanisms countering these tendencies, which can underpin forms of collective support in the struggle for recognition. Our study thus contributes to the body of sociological literature that pays attention to health-related workplace injustices by challenging the purported promotion of health-based inclusion through a focus on tribunal cases, leading to suggestions for further research into the way medical conditions are theorised and ‘lived’ at work.</p
Young people's participation in their own mental health care:Session-by-session feedback in youth mental health services (headspace)
Get PDFAim: Young people's participation in their own mental healthcare requires ways for them to provide feedback to their clinicians on how they are experiencing their treatment. Key dimensions of session experience are willingness to attend, feeling listened to and understood, working on issues important to them, feeling hopeful for the future and feeling that things are improving in their lives. This study reports on young people's session experiences over time and by key demographics for headspace youth mental health services. Methods: The sample comprised 16 484 young people aged 12–25 years who commenced an episode of care at one of the 150 headspace centres between 1 July 2021 and 30 June 2022 and who had attended at least two services. Data were collected via the routinely collected headspace minimum data set. Results: Overall, young people reported very positive session experiences over all the session dimensions. Few demographic differences were found: session ratings were more positive for young adults (18+ years) compared with adolescents (under 18 years). Scores on all five dimensions improved with more visits, and willingness to attend and working on issues important to the young person were strong predictors of service engagement. Better session experience scores were associated with more positive ratings of quality of life. Conclusions: Young people experience their headspace sessions very positively, and more positive experiences are associated with better service engagement and quality of life. Routinely collecting session feedback gives young people a valuable way to participate in and inform their own care.</p
Transformer-Based Approach for Predicting Transactive Energy in Neurorehabilitation
No full textAdvancements in robotic neurorehabilitation have made it imperative to enhance the safety and personalization of physical human-robot interactions (pHRI). Estimation and management of energy transfer between humans and robots is essential for enhancing safety during the rehabilitation. Traditional control methods, which rely on coordinate-based monitoring of robot velocity and external forces, often fail in unstructured environments due to their susceptibility to sensor noise and limited adaptability to individual patient needs. This paper introduces the concept of transactive energy, a coordinate-invariant entity that captures the energy dynamics between the human and the robot during robot-assisted rehabilitation and can be used for personalized robot control. However, estimation of such energy transfer is a complex process and therefore, we have developed a transformer-based model to predict the transactive potential energy. The proposed model is implemented on an ankle rehabilitation robot which is a compliant parallel robot and provides the required three rotational degrees of freedom (DOF). The model learns from the data obtained from the experiments carried out using the ankle robot with five stroke patients on two types of controllers: an impedance controller operated in zero impedance control mode and a trajectory tracking controller. This study provides a baseline, for future research on energy-based control mechanisms in pHRI applications, by utilizing the advanced deep learning models
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
An ecosystem approach to the evaluation and impact analysis of heterogeneous preventive and/or early interventions projects for veterans and first responders in seven countries
No full textBACKGROUND: Cumulative exposure to critical incidents and life-threatening events leads to significant risk for Veterans and First Responders (VFRs) developing mental ill health and disorders. Philanthropic organisations, Movember and Distinguished Gentleman's Ride, funded 15 organisations to conduct early intervention Projects across seven countries. The Projects aim to improve the mental health and wellbeing of VFRs, their families/significant others. This paper describes the novel external evaluation and impact analysis methods to identify effective Projects having positive impact on VFRs and their families, provide return on investment and the overall Grant Program.METHODS: We take an ecosystem real-world approach, which recognises the context and aims to manage the complexities involved, uses a complexity and systems perspective, multi-step mixed methods and approaches. The evaluation is from three perspectives of: Projects; Project comparisons; Grant program. Embedded in the evaluation design are methods, knowledge sharing and organisational learning activities for all stakeholders. Data is collected by the Projects and evaluation team on input, throughputs, and output indicators. Analysis tools include Global Impact Analytics Framework, multi-layered statistical analysis, performance evaluation using an efficient decision support approach, Project and Grant program social return on investment, visual linking and data connection platform and assessment of gendered lens approaches.IMPLICATIONS: The complexity and heterogeneity of Projects implemented in the real world continues to present significant evaluation challenges and limitations for project leads, stakeholders, researchers and evaluators. Our ecosystem approach and novel evaluation methodology will reduce the uncertainty around real world implementation, provide key learnings for project stakeholders and more broadly implementation researchers.</p