Experiences of Rural and Metropolitan Background Applicants in Preparing for and Completing a Regionally Focused Multiple Mini-interview for Admission into a Regional Medical Program.

BACKGROUND: To better target rural background and rurally interested applicants during medical school admission, it is increasingly common for rural medical programs to include multiple mini-interview (MMI) scenarios designed to screen for rural interest. It remains unclear whether the inclusion of regionally/rurally focused MMI scenarios positively impacts the selection of rural background applicants and evidence is limited regarding why rural background applicants may perform worse on the MMI. Therefore, this study explored how rural and metropolitan applicants prepare for and perceive the MMI for admission to a regional medical pathway. METHODS: A mixed-methods survey was sent to provisional entry regional pathway medical school applicants who had completed an MMI. The survey was distributed before any offers of admission had been released. RESULTS: Rural applicants spent less time and money preparing for the MMI and felt less prepared (P < 0.05). However, time and money spent, and resources used to prepare were not associated with feeling more prepared (all P > 0.05). Respondents mostly felt that the MMI process aligned with their expectations (83%), is fair (64%), and helps a rural program select the most suitable applicants (61%). Rural applicants generally felt that they had an advantage over other applicants (61%) while most metropolitan applicants did not (23%; P = 0.002). DISCUSSION: Applicants to a regional medical pathway are generally supportive of the MMI process. It appears valuable for applicants to prepare for the MMI by understanding the format and requirements; however, investing substantial time and money does not underpin feeling better prepared. MMI scenarios which include a regional focus are perceived to advantage rural applicants.

Associations between health-related quality of life and health behaviors in Australian nursing students.

Health-related quality of life (HRQoL) is being increasingly studied as an indicator of wellbeing. This study evaluated the HRQoL of nursing students and relationships between lifestyle behaviors including smoking, diet, alcohol intake and physical activity. A cross-sectional study was conducted in 2018 using the Short-Form 12V2 to measure the HRQoL of 475 students from both regional and metropolitan universities in Queensland, Australia. z-scores were aggregated into a Physical Composite Score (PCS) and a Mental Composite Score (MCS). Multivariate linear regression was used to explore the associations. Nursing students (94.5% female) had lower HRQoL scores relative to the general Australian population. Students enrolled at the regional university, with higher income; higher intakes of vitamin A, calcium, and iodine; and more physical activity had a higher Mental Composite Score, but those with health conditions and high intakes of meat, fat, carbohydrates, and sugar reported lower Physical Composite Score compared to their counterparts. Skipping breakfast, physical inactivity, and alcohol score were inversely associated with HRQoL. This study highlights the need for strategies to address the poor lifestyle and HRQoL in nursing students to support their physical and mental health.

Association between dietary patterns and sociodemographics: A cross-sectional study of Australian nursing students.

Lack of time, financial issues, and stressful clinical and educational environments in nursing studies promote higher intakes of convenience and fast foods loaded with fat and sugar, which are linked to reduced mental and physical health. In this study, we examined the dietary patterns of nursing students and their associated sociodemographic factors to inform the development of future health-promotion interventions. A total of 548 Bachelor of Nursing students were invited to complete a survey. Associations were explored using χ2 and logistic regression. Three dietary patterns were identified: healthy (fruit, vegetables, and legumes), Western (loaded with fat, sugar, and salt), and unbalanced. Only 21% of participants were classified as following a healthy dietary pattern, and more likely to be older (>35 years old) and have a personal annual income between $AUD20 000-$59 999 and $60 000-$99 999. Students with one to two and three or more children were more likely to follow a Western dietary pattern. There is a need to develop interventions to improve the dietary behaviors of nursing students by health-promoting activities and the provision of online health resources.

Low Health Literacy Is Associated With Risk of Developing Type 2 Diabetes in a Nonclinical Population.

PURPOSE: The purpose of this study was to examine associations among risk of type 2 diabetes (T2D), health literacy levels, and sociodemographic characteristics in a nonclinical adult population to assist in the development of effective T2D prevention programs. METHODS: The Health Literacy Questionnaire and Australian Type 2 Diabetes Risk Assessment Tool were included in an online survey. Participants were a random sample of adults residing in each Australian state and territory. Data were analyzed with descriptive statistics and multinomial logistic regression. RESULTS: A total of 1279 Australian adults participated (52% female; mean ± SD age, 61 ± 12 years). Most were at medium (42.4%) or high (46.9%) risk of developing T2D. The lowest health literacy scores were found for the domains "critical appraisal of health information" and "navigating the health care system." After controlling for covariates, participants at the highest risk of developing T2D were significantly more likely to be unemployed, have ≥1 chronic conditions, or have a mental health condition. Furthermore, they were significantly more likely to develop T2D if they scored low in 1 of the following health literacy domains: critical appraisal of health information, navigating the health care system, actively managing health, social support, and health care provider support. CONCLUSIONS: Health literacy was associated with increased risk for developing T2D and should therefore be part of diabetes prevention initiatives. Specifically, new health promotion initiatives need to help people develop skills required to critically appraise health information and navigate the health care system. Health practitioners and educators should ensure that health information developed for consumers is uncomplicated and easily understood.

Effect of probiotics and synbiotics consumption on serum concentrations of liver function test enzymes: a systematic review and meta-analysis.

PURPOSE: The gut-liver interaction suggests that modification of gut bacterial flora using probiotics and synbiotics may improve liver function. This systematic review and meta-analysis aimed to clarify the effect of probiotics and synbiotics consumption on the serum concentration of liver function enzymes. METHODS: PubMed (MEDLINE), Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library (Central) were searched from 1980 to August 2017 for studies where adults consumed probiotics and/or synbiotics in controlled trials and changes in liver function enzymes were examined. RESULTS: A total of 17 studies (19 trials) were included in the meta-analysis. Random effects meta-analyses were applied. Probiotics and synbiotics significantly reduced serum alanine aminotransferase [- 8.05 IU/L, 95% confidence interval (CI) - 13.07 to - 3.04; p = 0.002]; aspartate aminotransferase (- 7.79 IU/L, 95% CI: - 13.93 to - 1.65; p = 0.02) and gamma-glutamyl transpeptidase (- 8.40 IU/L, 95% CI - 12.61 to - 4.20; p < 0.001). Changes in the serum concentration of alkaline phosphatase and albumin did not reach a statistically significant level. Changes to bilirubin levels were in favour of the control group (0.95 µmol/L, 95% CI 0.48-1.42; p < 0.001). Subgroup analysis suggested the existence of liver disease at baseline, synbiotics supplementation and duration of supplementation ≥ 8 weeks resulted in more pronounced improvement in liver function enzymes than their counterparts. CONCLUSIONS: Probiotics and synbiotics may be suggested as supplements to improve serum concentration of liver enzymes, especially when synbiotics administered for a period ≥ 8 weeks and in individuals with liver disease.