Social exercise interventions for children who have complex developmental needs: A systematic review.

Exercise interventions are identified as effective treatments for children not meeting developmental milestones. This systematic review synthesizes research regarding exercise interventions that involved social participatory elements, for children with complex developmental needs. Academic Search Complete, CINAHL, Emcare, Proquest Theses and Dissertations, MEDLINE, and Google Scholar were searched systematically for relevant studies. Peer-reviewed studies meeting the review aim and published between 2000 and 2021 in English, were included. Methodological quality of 49 eligible studies (47 controlled trials, two mixed methods, total of 2355 participants) was appraised using the Mixed Methods Appraisal Tool. Narrative synthesis identified two groups of studies: Group 1 incorporated intentional social participatory elements; Group 2 likely involved incidental social participation. Most studies were of moderate to low methodological quality. Few measured impacts of interventions upon total physical activity levels. Short-term improvements in physical outcomes - particularly motor skills - were most frequently reported and were the main benefit of social exercise interventions for children with complex developmental needs, for which evidence exists. Further rigorous, longitudinal research is needed to assess social, psychological, and executive function outcomes of social exercise interventions in this population. Such interventions should incorporate booster sessions to provide children with greater opportunity to meet developmental milestones.

Genitourinary infections in Australian servicewomen.

BACKGROUND: Genitourinary infections, including those associated with the urinary tract (urinary tract infection [UTI]) and vulvovaginal region, are common in women, affecting approximately one-third of biological females. A growing female military workforce necessitates consideration of their genitourinary health risks and needs to support and enhance their occupational health, safety, and performance. METHOD: The pelvic health of active-duty servicewomen in the Australian Defense Force (ADF) was explored using an online cross-sectional survey. For the purposes of this study, only data related to genitourinary infections were extracted. The data were descriptively analysed to provide estimates of period prevalence rates. Risk factors and prevention and management strategies utilized were identified and described. RESULTS: Of the 491 servicewomen who provided survey responses, 41% (95% confidence interval [CI]: 37%-46%) reported experiencing at least one UTI and 32% (95% CI: 28%-36%) reported experiencing regular symptoms of vulvovaginal irritation during their last period of active-duty service. Service arm, length of service, and history of participation in field activities or deployment were not substantially associated with prevalence estimates. Medical assessment was the most common diagnostic strategy for UTI and antibiotics were the most common management strategy. CONCLUSION: Genitourinary infections are common in female ADF personnel and may impact on occupational health and performance. Therefore, organization-wide prevention and management approaches may be an important strategy for reducing the impact on personnel, their units and mission objectives, by reducing working days lost, utilization of health services and minimizing risks in more austere military environments.

Servicewomen's experiences of managing pelvic health in occupational settings.

BACKGROUND: Despite increasing numbers of women serving in defence forces worldwide, little is currently known about how servicewomen manage their pelvic health in the traditionally male environment of the military. OBJECTIVES: The aim of this study was to explore the impacts of pelvic health issues on Australian Defence Force servicewomen and their experiences of managing their pelvic health in occupational settings. DESIGN: A qualitative hermeneutic design. METHODS: Telephone interviews were conducted on six currently serving female members of the Australian Defence Force located Australia-wide. A semi-structured interview guide, based on the study objectives, was used to guide the audio-recorded interviews. Data were analysed thematically. RESULTS: Nine themes were identified. The first six themes explored the experiences of servicewomen in maintaining their pelvic health, including suppressing the urge to go, adjusting hydration depending on toilet access, managing menstruation, regaining 'full' fitness postpartum, awareness and prevention of pelvic health conditions, and inhibiting conversations about women's health. The last three themes explored how servicewomen coped with pelvic health conditions, including self-managing symptoms, diagnosing and treating pelvic conditions, and support for servicewomen's pelvic health. CONCLUSION: This study suggests workplace culture, low levels of insight into pelvic health norms, and limited healthcare strategies within the Australian Defence Force to support female pelvic health have contributed to servicewomen self-managing pelvic health issues using approaches that may have had significant impacts on their health and well-being.

Prevalence of lower urinary tract symptoms in a cohort of Australian servicewomen and female veterans.

INTRODUCTION AND HYPOTHESIS: Lower urinary tract symptoms (LUTS) are common in the general female population. It was hypothesised that Australian female military personnel and veterans would experience similar types and prevalence of LUTS as the broader Australian female population. METHODS: An online cross-sectional survey was utilised to explore the pelvic health of active servicewomen and veterans in the Australian Defence Force (ADF). For the purposes of this report, only the demographic and LUTS data (excluding urinary tract infections) were extracted and descriptively analysed. RESULTS: A total of 491 complete survey responses were received and analysed. Respondent characteristics were comparable to those documented in a departmental report regarding ADF servicewomen. No LUTS were reported by 38% of respondents. Regular symptoms of urinary incontinence were experienced by 27% of respondents (stress urinary incontinence = 23%, urge urinary incontinence = 16%, mixed urinary incontinence = 13%), bladder storage issues by 20-27%, and various voiding impairments by 9-27%. In addition, 41% reported regularly experiencing two or more LUTS, and for over two thirds of respondents, LUTS were an ongoing issue. Relationships between age, parity, and symptoms of urinary incontinence were also seen. CONCLUSIONS: Consistent with wider research in Australian female populations, LUTS were commonly experienced during service by ADF female military personnel and veterans. Given the high likelihood of female military personnel experiencing LUTS during their service, and a proportion experiencing ongoing symptoms, tailored monitoring and support for urinary health should be available to enhance occupational health, safety, and performance.

Relationships Between Lateral Limb Bias, Turnout, and Lower Limb Injury in a Female Pre-Professional Ballet Dancer Population.

Dancers are known to have specific limb preferences when they dance and commonly experience lower limb injury, especially early in their training. The primary aim of this study was to determine and examine the relationships between lateral limb bias, perceived turnout profile, and lower limb injury history in female pre-professional ballet dancers using current definitions of lateral bias, leg dominance, and the concept of "working" and "supporting" legs in dance. A cross-sectional survey design with retrospective recall of 12-month injury history was employed. An online questionnaire was distributed to female dancers between the ages of 16 and 21 years who were training in classical ballet at the pre-professional level in Australia. The questionnaire gathered information regarding laterality, perceived turnout asymmetry, and self-reported 12-month injury profile. Descriptive and correlation analyses were employed to describe dancer profiles and determine relationships between the three variables. Thirty-two dancers participated. The majority of participants (67%) had right-side dominance and most indicated the right leg as their preferred supporting leg (86.7%) and working leg (60%). A total of 17 participants (53.1%) reported at least one injury in the preceding 12-month period and the side injured was significantly correlated with leg dominance (rS = 0.595, p = 0.012), with the majority of injuries also affecting the preferred supporting and working leg. Dancer perceptions regarding turnout range were correlated with their perceptions of leg dominance (rS = 0.556, p = 0.001), but no statistically significant associations were found between perceptions of turnout range and injury side. In pre-professional dancers, the dominant and the preferred supporting or working leg tend to be the same leg, and the results suggest that the dominant and preferred supporting and working leg of dancers are at greatest risk of injury.

Cross-generational Physical Activity: Surveys of Children and Parents.

This study investigated the cross-generational physical activity of primary school-aged children and parents in Australia. Separate child and parent questionnaires were administered to establish a profile of the phenomenon. Cross-generational physical activity occurred across a wide variety of types of physical activity, including recreation, sport, and exercise. The study provides insight into the complexity of the physical activity partnership by showing that in a substantial proportion of partnerships, children initiate the physical activity. The importance of investigating both populations was shown as both common experiences in cross-generational physical activity, such as bonding and enjoyment were identified in addition to unique aspects. For example, child respondents disliked power, fitness, and skills mismatches whilst parent respondents disliked their children fighting and complaining. 59% of parents ranked holidays as a time they were more likely to engage in cross-generational physical activity. Findings from the surveys suggest that this physical activity partnership involves more than the provision of parental support for physical activity and modeling of a healthy behavior from parent to child.

Reliability and Precision of the Nana Protocol to Assess Body Composition Using Dual Energy X-Ray Absorptiometry.

The Nana positioning protocol is widely used to position participants to minimize technical error when undertaking body composition scanning and analysis with a Dual energy X-Ray absorptiometry (DXA) machine. Once biological and technical errors are accounted for, the only variation in test-retest results is from statistical fluctuation or machine error. Therefore, the aim of this study is to assess the test-retest reliability of the Nana positioning protocol and establish the smallest real difference percentage (SRD%). A gender-balanced group of 30 participants (15 males, 15 females) underwent two scans in succession using the Nana positioning protocol, with repositioning between scans. Percentage change in mean with typical error, Intraclass Correlation Coefficients (ICC), and standard error measurement percentage (SEM%) were used to identify the test-retest reliability and error rate of these protocols. Additionally, SRD% was calculated to assess the point at which clinically important changes occurred in a participant. The reliabilities of the whole body and regional scans were excellent. Percentage change in mean ranged between 0.00% and 0.23%. High reproducibility of the Nana positioning protocol was evident through an ICC ranging between 0.966-1.000. Additionally, typical error, SEM%, and SRD% were all low. Interestingly, fat mass was associated with the largest fluctuations observed to be associated with any of the parameters assessed. When all sources of biological and technical errors have been accounted for, the Nana positioning protocol has excellent test-retest reliability and produces low SEM% and SRD%.

A critical review of nuisance foam formation and biological methods for foam management or elimination in nutrient removal facilities.

The classifying selector was introduced to the wastewater industry in 2001, after several successful full-scale applications. The classifying selector concept distinguishes itself from the earlier surface foam wasting schemes in that negative selection pressure is maintained so that nuisance foam-causing organisms cannot gain a foothold in sufficient numbers to cause nuisance foams. The propensity of the nuisance-causing organism to attach to bubbles and establish a rising velocity is used to enrich them in a surface mixed liquor layer, where they are wasted. Neither standard texts nor the Water Environment Federation's Manuals of Practice adequately describe this, and as a result, the benefits of foam elimination obtainable through use of the classifying selector concepts have not been broadly obtained in our industry. In certain types of processes that are inherently foam trapping situations, the only solution is surface foam wasting, as foam cannot be eliminated. Potential efficiency gains possible in these situations are addressed.

Supervision, support and mentoring interventions for health practitioners in rural and remote contexts: an integrative review and thematic synthesis of the literature to identify mechanisms for successful outcomes.

OBJECTIVE: To identify mechanisms for the successful implementation of support strategies for health-care practitioners in rural and remote contexts. DESIGN: This is an integrative review and thematic synthesis of the empirical literature that examines support interventions for health-care practitioners in rural and remote contexts. RESULTS: This review includes 43 papers that evaluated support strategies for the rural and remote health workforce. Interventions were predominantly training and education programmes with limited evaluations of supervision and mentoring interventions. The mechanisms associated with successful outcomes included: access to appropriate and adequate training, skills and knowledge for the support intervention; accessible and adequate resources; active involvement of stakeholders in programme design, implementation and evaluation; a needs analysis prior to the intervention; external support, organisation, facilitation and/or coordination of the programme; marketing of the programme; organisational commitment; appropriate mode of delivery; leadership; and regular feedback and evaluation of the programme. CONCLUSION: Through a synthesis of the literature, this research has identified a number of mechanisms that are associated with successful support interventions for health-care practitioners in rural and remote contexts. This research utilised a methodology developed for studying complex interventions in response to the perceived limitations of traditional systematic reviews. This synthesis of the evidence will provide decision-makers at all levels with a collection of mechanisms that can assist the development and implementation of support strategies for staff in rural and remote contexts.

The role of context in establishing university clinics.

Healthcare systems have a vested interest in employing work-ready graduates. The challenge for universities is to find ways to provide workplace learning that incorporates student education and high quality patient care. Inland areas of Australia, similar to other rural locations globally, experience additional challenges including a relatively high incidence of ill health, increasing demand for health services, chronic workforce shortages and ageing of the existing rural health workforce. In this paper, we conceptualise and describe the research findings related to context from a consultative enquiry into university clinics conducted in 2008. Interview participants were drawn from twenty university clinics in Australia and New Zealand. A consistent theme throughout the interviews was tensions that arose between the role of education and healthcare provision within university clinics. Many interview participants described ways they managed these tensions to meet the expectations of students, educators and the community. The patient supply is the most critical factor in the context of university clinic operations. It is vital to both the educator and the healthcare provider roles. In inland areas with sparse populations a number of strategies, such as outreach clinics, hospital or health centre- based clinics and multi-disciplinary sites, will have to be developed if university clinics are to operate effectively for students and patients.

Making classifying selectors work for foam elimination in the activated-sludge process.

Classifying selectors are used to control the population of foam-causing organisms in activated-sludge plants to prevent the development of nuisance foams. The term, classifying selector, refers to the physical mechanism by which these organisms are selected against; foam-causing organisms are enriched into the solids in the foam and their rapid removal controls their population at low levels in the mixed liquor. Foam-causing organisms are wasted "first" rather than accumulating on the surface of tanks and thereby being wasted "last", which is typical of the process. This concept originated in South Africa, where pilot studies showed that placement of a flotation tank for foam removal prior to secondary clarifiers would eliminate foam-causing organisms. It was later simplified in the United States by using the aeration in aeration tanks or aerated channels coupled with simple baffling and adjustable weirs to make continuous separation of nuisance organisms from the mixed liquor.