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1.
Maturitas ; 185: 108013, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38703595

ABSTRACT

Fears regarding weight gain and body changes commonly plague midlife women. The aim of this paper is to discuss the impact of weight gain and body changes on midlife women across various cultural backgrounds. Midlife weight gain in women is associated with age as opposed to menopausal status. Weight gain during midlife occurs across all cultural/ethnic groups; however, African Americans and Hispanic women exhibit higher rates of weight gain than their Caucasian counterparts. Although use of menopause hormone replacement therapy does not produce a clinical difference in weight gain, exercise decreases the risk of obesity in midlife women. Cultural differences in perception of body image exist. Recognizing these differences may help clinicians better address the weight concerns of women from diverse backgrounds. A shift in focus from weight goals to cardiometabolic risk reduction may help patients feel more successful and improve health outcomes.


Subject(s)
Menopause , Obesity , Weight Gain , Humans , Female , Menopause/ethnology , Obesity/ethnology , Obesity/prevention & control , Middle Aged , Exercise , Ethnicity , Body Image/psychology , Black or African American , Risk Factors , Hispanic or Latino
2.
Clin Obes ; 13(6): e12613, 2023 Dec.
Article in English | MEDLINE | ID: mdl-37501401

ABSTRACT

Despite the availability of evidence-based interventions to improve binge eating, Black women have some of the lowest rates of access to care for eating disorders. Innovation is needed to offer accessible and culturally relevant treatment options. To this end, using an open trial design, we investigated the feasibility and acceptability of a group-based, appetite awareness training (AAT) + lifestyle modification (LM) programme in Black women at risk for BED in a primary care setting. Participants (n = 20) were Black women recruited from a family medicine centre affiliated with a local public university, and who reported at least two binge eating episodes in the last 28 days. Participants completed a 16-session AAT + LM programme over 4 months. Key outcomes were objective binge eating (assessed by the EDE and the EDE-Q), body dissatisfaction, and weight change, all assessed at baseline, four (post-treatment) and 6 months (2-month follow-up). Ninety-five percent of participants completed assessments at post-treatment and attended nearly 60% of intervention sessions. Among completers (n = 19), body dissatisfaction and objective binge eating decreased from baseline to post-treatment and this decrease was maintained at the 2-month follow-up. In exit interviews, participants reported programme satisfaction. Providing training in appetite awareness combined with lifestyle modification principles may be useful in the treatment of body dissatisfaction and binge eating among Black women.


Subject(s)
Binge-Eating Disorder , Bulimia , Female , Humans , Appetite , Binge-Eating Disorder/therapy , Life Style , Treatment Outcome
3.
J Assist Reprod Genet ; 40(2): 265-278, 2023 Feb.
Article in English | MEDLINE | ID: mdl-36637586

ABSTRACT

PURPOSE: Staff management is the most cited ART/IVF laboratory inspection deficiency. Small ART/IVF clinics may be challenged to perform these activities by low staff volume; similarly, large ART/IVF networks may be challenged by high staff volume and large datasets. Here, we sought to investigate the performance of an automated, digital platform solution to manage this necessary task. METHODS: The ART Compass (ARTC) digital staff management platform was used to assess the clinical decision-making of ART laboratory staff. The survey modules presented standardized instructions to technologists and measured inter- and intra-technologist variability for subjective "clinical decision-making" type questions. Internal and external comparisons were achieved by providing technologists two answers: (1) a comparison to their own lab director and (2) to the most popular response collectively provided by all lab director level accounts. The platform is hosted on HIPAA compliant Amazon web servers, accessible via web browser and mobile applications for iOS (Apple) and Android mobile devices. RESULTS: Here, we investigated the performance of a digital staff management platform for single embryologist IVF practices and for three IVF lab networks (sites A, B, C) from 2020 to 2022. Embryology dish preparation survey results show variance among respondents in the following: PPE use, media volume, timing of oil overlay, and timing of moving prepared dishes to incubators. Surveying the perceived Gardner score and terms in use for early blastocysts reveals a lack of standardization of terminology and fair to poor agreement. We observed moderate inter-technologist agreement for ICM and TE grade (0.47 and 0.52, respectively). Lastly, the clinical decision of choice to freeze or discard an embryo revealed that agreement to freeze was highest for the top-quality embryos, and that some embryos can be highly contested, evenly split between choice to freeze or discard. CONCLUSIONS: We conclude that a digital platform is a novel and effective tool to automate, routinely monitor, and assure quality for staff-related parameters in ART and IVF laboratories. Use of a digital platform can increase regulatory compliance and provide actionable insight for quality assurance in both single embryologist practices and for large networks. Furthermore, clinical decision-making can be augmented with artificial intelligence integration.


Subject(s)
Fertilization in Vitro , Laboratories , Humans , Fertilization in Vitro/methods , Artificial Intelligence , Embryo Implantation , Blastocyst , Reproduction
4.
Body Image ; 42: 75-83, 2022 Sep.
Article in English | MEDLINE | ID: mdl-35660946

ABSTRACT

Negative hair experiences can impact psychological well-being and are an integral part of development through childhood, adolescence, and beyond. The current study utilized a mixed-methods approach to capture the lived experiences of girls relating to their hair. Participants were 105 girls between the ages of 10-15 years old recruited via social media, email, and social organizations with Black/African American, or biracial communities. Satisfaction with natural hair, perceived bullying and teasing relating to hair, social comparisons, and pressure from family and friends were assessed. Approximately, 22% of 10-year olds, 14% of 11-year olds, 54% of 12-year olds, 35% of 13-year olds, and 32% of 14-year olds reported experiencing hair related teasing. Engaging in hair comparison with models/celebrities in the media and peers was significantly associated with less hair satisfaction. Similarly, girls that reported greater frequency of hair-related teasing also had significantly lower scores on hair satisfaction. Finally, having friends who like one's natural hair was significantly associated with higher hair satisfaction scores. Black/African American girls and their experiences around hair have been largely neglected in psychology and body image research, and more research on this topic is required to gain a better understanding of the role it plays in developing young girls.


Subject(s)
Black or African American , Body Image , Adolescent , Black or African American/psychology , Body Image/psychology , Child , Female , Hair , Humans , Peer Group , Personal Satisfaction
5.
Curr Opin Pediatr ; 33(4): 361-367, 2021 08 01.
Article in English | MEDLINE | ID: mdl-34001715

ABSTRACT

PURPOSE OF REVIEW: Weight trends continue to increase in adolescents, but current weight-focused interventions have not demonstrated any lasting impact on overall health. Among adolescents, experiencing weight bias increases risks of harmful weight-related behaviors and decreases engagement in health-promoting behaviors, thus leading to worsened health outcomes. The Health at Every Size (HAES) approach may be an avenue to promote health holistically among adolescents without eliciting harmful weight-related behavior and improving provider-patient rapport. The purpose of this review is to summarize the literature on integrating HAES principles into healthcare and to generate recommendations for healthcare providers. RECENT FINDINGS: Research among adults shows that HAES-informed care can improve some physical health measures and generates improvements in behavioral and psychological outcomes, as well as promotion of social justice and equity. HAES-informed recommendations for adolescent care de-emphasize weight loss and focus on removing barriers to engaging in health-promoting behaviors at the point of assessment, in the diagnosis and management of medical complications, and in treatment. SUMMARY: HAES principles can be an invaluable tool for providers who aim to improve overall health whilst avoiding a focus on weight among their clients.


Subject(s)
Exercise , Health Promotion , Adolescent , Adult , Body Mass Index , Humans , Weight Loss
6.
Australas Emerg Care ; 22(1): 28-33, 2019 Mar.
Article in English | MEDLINE | ID: mdl-30998869

ABSTRACT

BACKGROUND: The aim of this study was to identify if patients presenting to a paediatric emergency department were due National Immunisation Program recommended vaccines in order to determine missed opportunities for vaccination or vaccination referral. METHOD: A hospital chart audit assessed the documentation of an immunisation history, in comparison to the immunisation histories available from national and state immunisation databases to determine accuracy; to identify if patients were due vaccines as determined by the National Immunisation Program; and to identify factors associated with those due vaccines. RESULTS: Potential opportunities to vaccinate children due vaccines were missed (10/114, 8.8%); with less than half (4/10, 40%) correctly documented as due vaccines. Despite identification of due vaccines, no vaccines were administered. Almost one third of patients (34/114, 30%) had no immunisation history documented in the chart. 'Medically at risk' children (Odds Ratio [OR] 29.7, 95% CI 4.5-196, p<0.001) were statistically more likely to be due vaccines. Likelihood of being due vaccines was higher, but not statistically significant, for those with no identified general practitioner (OR 4.5, 95% CI 0.96-20.6, p=0.08), and for those presenting with injury rather than illness (OR 2.0, 95%CI 0.51-8.1, p=0.48). CONCLUSION: Opportunities to vaccinate children presenting to the emergency department are currently being missed. A particular focus is needed for 'medically at risk' children and those with no identified general practitioner. Larger studies may confirm other risk factors. Further research is required into the attainment of an immunisation history during the hospital admission process and the accuracy of these methods.


Subject(s)
Immunization/methods , Child , Child, Preschool , Female , Humans , Immunization/statistics & numerical data , Immunization Programs/methods , Immunization Schedule , Infant , Male , Odds Ratio , Pediatric Emergency Medicine/methods , Pediatric Emergency Medicine/statistics & numerical data
7.
Nature ; 544(7649): 180-184, 2017 04 13.
Article in English | MEDLINE | ID: mdl-28273067

ABSTRACT

Aboriginal Australians represent one of the longest continuous cultural complexes known. Archaeological evidence indicates that Australia and New Guinea were initially settled approximately 50 thousand years ago (ka); however, little is known about the processes underlying the enormous linguistic and phenotypic diversity within Australia. Here we report 111 mitochondrial genomes (mitogenomes) from historical Aboriginal Australian hair samples, whose origins enable us to reconstruct Australian phylogeographic history before European settlement. Marked geographic patterns and deep splits across the major mitochondrial haplogroups imply that the settlement of Australia comprised a single, rapid migration along the east and west coasts that reached southern Australia by 49-45 ka. After continent-wide colonization, strong regional patterns developed and these have survived despite substantial climatic and cultural change during the late Pleistocene and Holocene epochs. Remarkably, we find evidence for the continuous presence of populations in discrete geographic areas dating back to around 50 ka, in agreement with the notable Aboriginal Australian cultural attachment to their country.


Subject(s)
Genome, Mitochondrial/genetics , Human Migration/history , Native Hawaiian or Other Pacific Islander/genetics , Phylogeography , Australia , Cultural Evolution , DNA, Mitochondrial/genetics , Haplotypes/genetics , History, Ancient , Humans , Phylogeny
8.
Sci Rep ; 7: 43041, 2017 03 13.
Article in English | MEDLINE | ID: mdl-28287095

ABSTRACT

Aboriginal Australians represent one of the oldest continuous cultures outside Africa, with evidence indicating that their ancestors arrived in the ancient landmass of Sahul (present-day New Guinea and Australia) ~55 thousand years ago. Genetic studies, though limited, have demonstrated both the uniqueness and antiquity of Aboriginal Australian genomes. We have further resolved known Aboriginal Australian mitochondrial haplogroups and discovered novel indigenous lineages by sequencing the mitogenomes of 127 contemporary Aboriginal Australians. In particular, the more common haplogroups observed in our dataset included M42a, M42c, S, P5 and P12, followed by rarer haplogroups M15, M16, N13, O, P3, P6 and P8. We propose some major phylogenetic rearrangements, such as in haplogroup P where we delinked P4a and P4b and redefined them as P4 (New Guinean) and P11 (Australian), respectively. Haplogroup P2b was identified as a novel clade potentially restricted to Torres Strait Islanders. Nearly all Aboriginal Australian mitochondrial haplogroups detected appear to be ancient, with no evidence of later introgression during the Holocene. Our findings greatly increase knowledge about the geographic distribution and phylogenetic structure of mitochondrial lineages that have survived in contemporary descendants of Australia's first settlers.


Subject(s)
Genetic Variation , Genome, Mitochondrial , Native Hawaiian or Other Pacific Islander/genetics , Phylogeny , Australia , Humans , Sequence Analysis, DNA
9.
Gut ; 66(6): 988-1000, 2017 06.
Article in English | MEDLINE | ID: mdl-28228488

ABSTRACT

The risks of poor transition include delayed and inappropriate transfer that can result in disengagement with healthcare. Structured transition care can improve control of chronic digestive diseases and long-term health-related outcomes. These are the first nationally developed guidelines on the transition of adolescent and young persons (AYP) with chronic digestive diseases from paediatric to adult care. They were commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology under the auspices of the Adolescent and Young Persons (A&YP) Section. Electronic searches for English-language articles were performed with keywords relating to digestive system diseases and transition to adult care in the Medline (via Ovid), PsycInfo (via Ovid), Web of Science and CINAHL databases for studies published from 1980 to September 2014. The quality of evidence and grading of recommendations was appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. The limited number of studies in gastroenterology and hepatology required the addition of relevant studies from other chronic diseases to be included.These guidelines deal specifically with the transition of AYP living with a diagnosis of chronic digestive disease and/or liver disease from paediatric to adult healthcare under the following headings;1. Patient populations involved in AYP transition2. Risks of failing transition or poor transition3. Models of AYP transition4. Patient and carer/parent perspective in AYP transition5. Surgical perspective.


Subject(s)
Gastrointestinal Diseases/therapy , Liver Diseases/therapy , Transition to Adult Care/standards , Adolescent , Chronic Disease , Evidence-Based Medicine , Humans , Outcome and Process Assessment, Health Care , Patient Education as Topic , Time Factors , Transition to Adult Care/organization & administration , Young Adult
10.
J Hum Genet ; 62(3): 343-353, 2017 Mar.
Article in English | MEDLINE | ID: mdl-27904152

ABSTRACT

Aboriginal Australians are one of the more poorly studied populations from the standpoint of human evolution and genetic diversity. Thus, to investigate their genetic diversity, the possible date of their ancestors' arrival and their relationships with neighboring populations, we analyzed mitochondrial DNA (mtDNA) diversity in a large sample of Aboriginal Australians. Selected mtDNA single-nucleotide polymorphisms and the hypervariable segment haplotypes were analyzed in 594 Aboriginal Australians drawn from locations across the continent, chiefly from regions not previously sampled. Most (~78%) samples could be assigned to mtDNA haplogroups indigenous to Australia. The indigenous haplogroups were all ancient (with estimated ages >40 000 years) and geographically widespread across the continent. The most common haplogroup was P (44%) followed by S (23%) and M42a (9%). There was some geographic structure at the haplotype level. The estimated ages of the indigenous haplogroups range from 39 000 to 55 000 years, dates that fit well with the estimated date of colonization of Australia based on archeological evidence (~47 000 years ago). The distribution of mtDNA haplogroups in Australia and New Guinea supports the hypothesis that the ancestors of Aboriginal Australians entered Sahul through at least two entry points. The mtDNA data give no support to the hypothesis of secondary gene flow into Australia during the Holocene, but instead suggest long-term isolation of the continent.


Subject(s)
DNA, Mitochondrial/genetics , Genetic Variation , Native Hawaiian or Other Pacific Islander/genetics , Phylogeny , Biological Evolution , DNA, Mitochondrial/history , Female , Gene Flow , Haplotypes , History, 21st Century , History, Ancient , Humans , Male , Native Hawaiian or Other Pacific Islander/history , Oceania , Paleontology , Phylogeography , Polymorphism, Single Nucleotide , Reproductive Isolation
11.
Curr Biol ; 26(6): 809-13, 2016 Mar 21.
Article in English | MEDLINE | ID: mdl-26923783

ABSTRACT

Australia was one of the earliest regions outside Africa to be colonized by fully modern humans, with archaeological evidence for human presence by 47,000 years ago (47 kya) widely accepted [1, 2]. However, the extent of subsequent human entry before the European colonial age is less clear. The dingo reached Australia about 4 kya, indirectly implying human contact, which some have linked to changes in language and stone tool technology to suggest substantial cultural changes at the same time [3]. Genetic data of two kinds have been proposed to support gene flow from the Indian subcontinent to Australia at this time, as well: first, signs of South Asian admixture in Aboriginal Australian genomes have been reported on the basis of genome-wide SNP data [4]; and second, a Y chromosome lineage designated haplogroup C(∗), present in both India and Australia, was estimated to have a most recent common ancestor around 5 kya and to have entered Australia from India [5]. Here, we sequence 13 Aboriginal Australian Y chromosomes to re-investigate their divergence times from Y chromosomes in other continents, including a comparison of Aboriginal Australian and South Asian haplogroup C chromosomes. We find divergence times dating back to ∼50 kya, thus excluding the Y chromosome as providing evidence for recent gene flow from India into Australia.


Subject(s)
Chromosomes, Human, Y/genetics , Native Hawaiian or Other Pacific Islander/genetics , Phylogeny , Australia , Gene Flow , Haplotypes , Humans , India , Male , Papua New Guinea/ethnology
12.
Am J Phys Anthropol ; 159(3): 367-81, 2016 Mar.
Article in English | MEDLINE | ID: mdl-26515539

ABSTRACT

OBJECTIVE: Understanding the origins of Aboriginal Australians is crucial in reconstructing the evolution and spread of Homo sapiens as evidence suggests they represent the descendants of the earliest group to leave Africa. This study analyzed a large sample of Y-chromosomes to answer questions relating to the migration routes of their ancestors, the age of Y-haplogroups, date of colonization, as well as the extent of male-specific variation. METHODS: Knowledge of Y-chromosome variation among Aboriginal Australians is extremely limited. This study examined Y-SNP and Y-STR variation among 657 self-declared Aboriginal males from locations across the continent. 17 Y-STR loci and 47 Y-SNPs spanning the Y-chromosome phylogeny were typed in total. RESULTS: The proportion of non-indigenous Y-chromosomes of assumed Eurasian origin was high, at 56%. Y lineages of indigenous Sahul origin belonged to haplogroups C-M130*(xM8,M38,M217,M347) (1%), C-M347 (19%), K-M526*(xM147,P308,P79,P261,P256,M231,M175,M45,P202) (12%), S-P308 (12%), and M-M186 (0.9%). Haplogroups C-M347, K-M526*, and S-P308 are Aboriginal Australian-specific. Dating of C-M347, K-M526*, and S-P308 indicates that all are at least 40,000 years old, confirming their long-term presence in Australia. Haplogroup C-M347 comprised at least three sub-haplogroups: C-DYS390.1del, C-M210, and the unresolved paragroup C-M347*(xDYS390.1del,M210). CONCLUSIONS: There was some geographic structure to the Y-haplogroup variation, but most haplogroups were present throughout Australia. The age of the Australian-specific Y-haplogroups suggests New Guineans and Aboriginal Australians have been isolated for over 30,000 years, supporting findings based on mitochondrial DNA data. Our data support the hypothesis of more than one route (via New Guinea) for males entering Sahul some 50,000 years ago and give no support for colonization events during the Holocene, from either India or elsewhere.


Subject(s)
Chromosomes, Human, Y/genetics , Native Hawaiian or Other Pacific Islander/genetics , Anthropology, Physical , Australia , Genetic Variation , Haplotypes , Humans , Male , Polymorphism, Single Nucleotide/genetics
13.
Nephrol Dial Transplant ; 31(4): 619-27, 2016 04.
Article in English | MEDLINE | ID: mdl-25906780

ABSTRACT

BACKGROUND: Existing Australasian and international guidelines outline antibiotic and antifungal measures to prevent the development of treatment-related infection in peritoneal dialysis (PD) patients. Practice patterns and rates of PD-related infection vary widely across renal units in Australia and New Zealand and are known to vary significantly from guideline recommendations, resulting in PD technique survival rates that are lower than those achieved in many other countries. The aim of this study was to determine if there is an association between current practice and PD-related infection outcomes and to identify the barriers and enablers to good clinical practice. METHODS: This is a multicentre network study involving eight PD units in Australia and New Zealand, with a focus on adherence to guideline recommendations on antimicrobial prophylaxis in PD patients. Current practice was established by asking the PD unit heads to respond to a short survey about practice/protocols/policies and a 'process map' was constructed following a face-to-face interview with the primary PD nurse at each unit. The perceived barriers/enablers to adherence to the relevant guideline recommendations were obtained from the completion of 'cause and effect' diagrams by the nephrologist and PD nurse at each unit. Data on PD-related infections were obtained for the period 1 January 2011 to 31 December 2011. RESULTS: Perceived barriers that may result in reduced adherence to guideline recommendations included lack of knowledge, procedural lapses, lack of a centralized patient database, patients with non-English speaking background, professional concern about antibiotic resistance, medication cost and the inability of nephrologists and infectious diseases staff to reach consensus on unit protocols. The definitions of PD-related infections used by some units varied from those recommended by the International Society for Peritoneal Dialysis, particularly with exit-site infection (ESI). Wide variations were observed in the rates of ESI (0.06-0.53 episodes per patient-year) and peritonitis (0.31-0.86 episodes per patient-year). CONCLUSIONS: Despite the existence of strongly evidence-based guideline recommendations, there was wide variation in adherence to these recommendations between PD units which might contribute to PD-related infection rates, which varied widely between units. Although individual patient characteristics may account for some of this variability, inconsistencies in the processes of care to prevent infection in PD patients also play a role.


Subject(s)
Anti-Infective Agents/therapeutic use , Antibiotic Prophylaxis/methods , Catheters, Indwelling/adverse effects , Peritoneal Dialysis/adverse effects , Peritonitis/prevention & control , Practice Patterns, Physicians' , Aged , Female , Humans , Male , Middle Aged , Peritonitis/etiology , Prospective Studies
14.
Aust Health Rev ; 39(5): 539-543, 2015 Nov.
Article in English | MEDLINE | ID: mdl-25844721

ABSTRACT

OBJECTIVES: Infants who present or are admitted to hospital with illness or with inadequate growth and development are those most at risk of decreased nutritional status. However, not all infants who present or are admitted to hospital have their growth assessed. The aim of the present study was to identify how frequently anthropometric measurements were documented in charts of infants presenting and/or admitted to a tertiary paediatric hospital. METHODS: A systematic random sample of hospital charts of infants who had presented to the emergency department between 1 July 2011 and 30 June 2012 was audited retrospectively for the presence of appropriate documentation of measurement. RESULTS: In all, 465 charts were audited, representing 10% of infants who presented to the emergency department in the year. The frequency of anthropometric measures was: birthweight 103 (22%), presentation weight 275 (59%), length 8 (2%), head circumference 15 (3%), percentiles 27 (6%) and body mass index score 1 (0%). Age of the infant was significantly associated with recording of birthweight. There were no significant relationships found between gender, socioeconomic status, gestational age, delivery type and recording of diagnosis and birthweight. CONCLUSIONS: Infant measurements were not recorded on many occasions. Assessment of growth as a marker of illness or nutritional deficit has been poorly assessed in this group. This is a missed opportunity to assess infant growth in this population, which has been found to be at risk of decreased nutritional status. Identification and treatment of growth deficits are a cost-effective method of optimising infant health worldwide.


Subject(s)
Anthropometry , Child Development/physiology , Patient Admission , Documentation , Emergency Service, Hospital , Female , Hospitals, Pediatric , Humans , Infant , Infant, Newborn , Male , Medical Audit , Queensland , Retrospective Studies
15.
J Paediatr Child Health ; 51(7): 708-12, 2015 Jul.
Article in English | MEDLINE | ID: mdl-25622697

ABSTRACT

AIM: Infant feeding can be the reason for presentation and/or admission to hospital. The aim of this study was to identify if infant feeding history was documented in charts of infants presenting and/or admitted to a paediatric hospital. METHODS: A systematic random sample of hospital charts of infants who had presented to the emergency department between 1 July 2011 and 30 June 2012 was audited for presence of documentation of feeding. RESULTS: In total, 465 charts were audited, representing 12.5% of infants who presented to the emergency department in the year. Frequency of documentation for feeding measures was as follows: feeding mode, 263 (57%); feeding type, 228 (49%); feeding frequency, 119 (26%); and with changes 89 (19%) since birth. Increasing infant age was significantly associated with less frequent recording of feeding mode, type, frequency and changes. CONCLUSION: A comprehensive feeding history is not recorded on many occasions of infant presentation and/or admission to hospital. The recording of feeding mode, type, frequency and changes is needed in order to explore the existence, or otherwise, of a relationship between feeding and the reason for presentation and/or admission.


Subject(s)
Emergency Service, Hospital/standards , Feeding Behavior , Feeding and Eating Disorders of Childhood/diagnosis , Hospitals, Pediatric/standards , Infant Nutritional Physiological Phenomena , Medical Audit , Medical Records/standards , Emergency Service, Hospital/statistics & numerical data , Female , Hospitalization , Hospitals, Pediatric/statistics & numerical data , Humans , Infant , Infant Behavior , Infant, Newborn , Male , Medical History Taking/standards , Medical History Taking/statistics & numerical data , Medical Records/statistics & numerical data , Queensland , Retrospective Studies
16.
Australas Emerg Nurs J ; 17(2): 44-50, 2014 May.
Article in English | MEDLINE | ID: mdl-24815202

ABSTRACT

OBJECTIVE: The aim of this study was to identify (a) emergency department staff knowledge, opinion and practices in relation to childhood vaccines and opportunistic immunisation in the emergency department and (b) differences between nursing and medical staff knowledge, opinion and self reported practices. METHODS: A self-administered, cross-sectional survey was offered to a convenience sample of medical and nursing staff (n=86) working in a tertiary paediatric emergency department. Variables of interest were described using frequencies and odds ratios to report differences between medical and nursing staff responses. RESULTS: An 87% survey response was achieved. The majority of staff agreed that childhood vaccines were safe (96%), effective (99%) and necessary (97%). Less than half (45%) of the staff correctly identified that there is no association between measles, mumps and rubella (MMR) vaccine and autism. Medical staff were more likely than nurses to disagree that giving multiple vaccines overloads the immune system (p<0.01), or that complementary therapies reduced the need for a child to be vaccinated (p<0.006). These knowledge deficits exist despite a reported awareness of immunisation resources. The majority (96%) of those surveyed reported that the Australian Immunisation Handbook was as a useful resource. CONCLUSION: Overall, the majority of staff agreed vaccines are safe, effective and necessary. This study highlighted that staff knowledge deficits and misconceptions about vaccines and vaccine management may be barriers to promoting opportunistic immunisation practices in ED.


Subject(s)
Attitude of Health Personnel , Emergency Service, Hospital , Health Knowledge, Attitudes, Practice , Immunization/methods , Medical Staff, Hospital/psychology , Adult , Australia , Child , Child Welfare , Clinical Competence/standards , Contraindications , Cross-Sectional Studies , Emergency Nursing/methods , Humans , Immunization/psychology , Middle Aged , Professional Practice/standards , Vaccination/methods , Vaccination/psychology
17.
Acta Paediatr ; 103(2): 131-8, 2014 Feb.
Article in English | MEDLINE | ID: mdl-24148026

ABSTRACT

UNLABELLED: The review examines whether mode of feeding is associated with risk of hospitalisation for illness during infancy in developed countries. Databases were searched for published studies that included the terms 'infant feeding' and 'hospitalisation'. Six studies were included. Breastfeeding was associated with a reduced risk of hospitalisation and adjusted analyses showed mixed results. CONCLUSION: There is no clear relationship between mode of feeding and reduction of infant hospitalisation for illness in developed countries.


Subject(s)
Bottle Feeding , Breast Feeding , Hospitalization/statistics & numerical data , Analysis of Variance , Confounding Factors, Epidemiologic , Developed Countries , Humans , Infant
18.
J Clin Epidemiol ; 65(10): 1031-40, 2012 Oct.
Article in English | MEDLINE | ID: mdl-22809618

ABSTRACT

OBJECTIVES: To identify and assess the existing cost-effectiveness evidence for sample size maintenance programs. STUDY DESIGN AND SETTING: Articles were identified by searching Cochrane Central Register of Controlled Trials Embase, CINAHL, PubMed, and Web of Science from 1966 to July 2011. Randomized controlled trials in which investigators evaluated program cost-effectiveness in postal questionnaires were eligible for inclusion. RESULTS: Fourteen studies from 13 articles, with 11,165 participants met the inclusion criteria. Thirty-one distinct programs were identified; each incorporated at least one strategy (reminders, incentives, modified questionnaires, or types of postage) aimed at minimizing attrition. Reminders, in the form of replacement questionnaires and cards, were the most commonly used strategies, with 15 and 11 studies reporting their usage, respectively. All strategies improved response, with financial incentives being the most costly. Heterogeneity between studies was too great to allow for meta-analysis of the results. CONCLUSIONS: The implementation of strategies such as no-obligation incentives, modified questionnaires, and personalized reply paid postage improved program cost-effectiveness. Analyses of attrition minimization programs need to consider both cost and effect in their evaluation.


Subject(s)
Patient Dropouts , Postal Service/economics , Randomized Controlled Trials as Topic/economics , Sample Size , Surveys and Questionnaires/economics , Australia , Cost-Benefit Analysis , Humans , Motivation , North America , Reminder Systems/economics , United Kingdom
19.
Nurs Stand ; 2(18): 42, 1988 Feb 06.
Article in English | MEDLINE | ID: mdl-27415564

ABSTRACT

The wealth of educated nurses lies within the richness of their experience.

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