Medicine and Health Sciences Commons^™

Parents’ Beliefs And Knowledge About The Management Of Acute Otitis Media: A Qualitative Study, Malene Hansen, Janine Howlett, Chris Del Mar, Tammy Hoffmann

Malene Hansen

Acute otitis media is a common reason for antibiotic prescribing, despite strong evidence that antibiotics provide minimal benefit. Studies have demonstrated that patients’ (or parents’) expectations of antibiotics often influence general practitioners’ (GPs) decision to prescribe antibiotics, but few have explored parents’ expectations of the management of infections in children, or which factors influence the development of these expectations. This study aimed to explore parents’ knowledge and beliefs about the management of acute otitis media in children.

Young People's Help-Seeking For Mental Health Problems., Debra Rickwood, Frank P. Deane, Coralie J. Wilson, Joseph V. Ciarrochi

joseph Ciarrochi

This paper summarises an ambitious research agenda aiming to uncover the factors that affect help-seeking among young people for mental health problems. The research set out to consider why young people, and particularly young males, do not seek help when they are in psychological distress or suicidal; how professional services be made more accessible and attractive to young people; the factors that inhibit and facilitate help-seeking; and how community gatekeepers can support young people to access services to help with personal and emotional problems. A range of studies was undertaken in New South Wales, Queensland and the ACT, using both …

When Simplifying Life Is Not So Bad: The Link Between Rigidity, Stressful Life Events, And Mental Health In An Undergraduate Population, Joseph Ciarrochi, Frank Deane, Terry Said

joseph Ciarrochi

Decades of research have generally shown that being more rigid is associated with poorer mental health. We investigated whether all aspects of what has been termed “rigidity” are harmful. In particular, we hypothesized that the desire for simple structure (DSS) will not be associated with poor mental health, and in some cases might be associated with better mental health. In contrast, the intolerance of uncertainty (IU) was hypothesized to be associated with a wide range of indices of poor mental health. We also hypothesized that people high in IU would be less resilient in the face of stressful life events. …

Cognitive Ability And Health-Related Behaviors During Adolescence: A Prospective Study Across Five Years, Joseph Ciarrochi, Patrick Heaven, Timothy Skinner

joseph Ciarrochi

Longitudinal research on the links between intelligence and health behaviors among adolescents is rare. We report longitudinal data in which we assessed the relationships between intelligence as assessed in Grade 7 and consequential health outcomes in Grade 11. The mean age of respondents (N=420; 188 males, 232 females) was 12.30 years (SD=0.49) in Grade 7and 16.17 years (SD=0.45) in Grade 11. They completed standardized verbal and numerical ability tests and a measure of conscientiousness in Grade 7 and health related questions in Grade 11. Results indicated that higher intelligence was associated with a number of healthy behaviors including delay in …

Disadvantages Of Being An Individualist In An Individualistic Culture: Idiocentrism, Emotional Competence, Stress, And Mental Health, Gregory Scott, Joseph Ciarrochi, Frank Deane

joseph Ciarrochi

Based on past cross-cultural research, it was hypothesised that people who had strong individualistic values and beliefs within an individualistic culture would have smaller social support networks, lower emotional competence, lower intentions to seek help from a variety of sources, and poorer mental health. A total of 276 first-year students attending an Australian university completed an anonymous survey assessing individual differences in individualism (i.e., idiocentrism), social support, emotional competence, hopelessness, depression, and suicide ideation. As expected, idiocentrism was associated with smaller and less satisfying social support networks, less skill in managing both self and others' emotions, lower intentions to seek …

Parallel Processes In Clinical Supervision: Implications For Coaching Menthal Health Practitioners, Trevor P. Crowe, Lindsay G. Oades, Frank P. Deane, Joseph Ciarrochi, Virginia C. Willliams

joseph Ciarrochi

No abstract provided.

Emotional Intelligence Moderates The Relationship Between Stress And Mental Health, Joseph Ciarrochi, Frank Deane, Stephen Anderson

joseph Ciarrochi

Despite a great deal of popular interest and the development of numerous training programs in emotional intelligence (EI), some researchers have argued that there is little evidence that EI is both useful and different from other, well established constructs. We hypothesized that EI would make a unique contribution to understanding the relationship between stress and three important mental health variables, depression, hopelessness, and suicidal ideation. University students (n=302) participated in a cross-sectional study that involved measuring life stress, objective and self-reported emotional intelligence, and mental health. Regression analyses revealed that stress was associated with: (1) greater reported depression, hopelessness, and …

Relations Between Social And Emotional Competence And Mental Health: A Construct Validation Study, Joseph Ciarrochi, Gregory Scott, Frank Deane, Patrick Heaven

joseph Ciarrochi

Researchers working fairly independently of each other have created numerous measures of social and emotional competence (SEC). These measures tend to correlate (sometimes highly) with each other and with measures of stressful events, suggesting potential redundancy. We evaluated which, if any, SEC variables predicted unique variance in social and mental health after controlling for other SEC variables in the study and the impact of stressful events. Three-hundred and thirty-one university students participated in an anonymous, cross-sectional study. We measured stressful events, and a wide variety of SECs, including: social problem solving skill (effective problem orientation, automatic processing, and problem solving), …

Professionalism Under Fire: Conflict, War And Epidemics, Michelle Mclean, Vikram Jha, John Sandars

Michelle McLean

Today’s medical students (tomorrow’s doctors) will be entering a world of conflict, war and regular outbreaks of infectious diseases. Despite numerous international declarations and treaties protecting human rights, the last few decades has been fraught with reports of ‘‘lapses’’ in medical professionalism involving torture and force-feeding of detainees (e.g. captured during the War on Terror) and health care professionals refusing to treat infected patients (e.g. HIV and Ebola). This paper provides some historical background to the changing status of a physician’s duty to treat and how medical practitioners came to be involved in the inhumane treatment of detainees during the …

Child Obesity Service Provision: A Cross-Sectional Survey Of Physiotherapy Practice Trends And Professional Needs, Nikki Milne, Nancy Low Choy, Gary Leong, Roger Hughes, Wayne Hing

Wayne Hing

This study explored current physiotherapy practice trends for management of children who are overweight or obese. The professional needs of physiotherapists working with this population were also assessed, including the perceived need for physiotherapy clinical guidelines for prevention and management of children with obesity. A cross-sectional survey design was used, with questionnaires purposefully distributed through 13 key physiotherapy services throughout Australia. Snowball sampling resulted in completed questionnaires from 64 physiotherapists who provided services to children. Half (n = 33, 52%) of respondents provided services specifically to overweight or obese children. Of those providing services, one-quarter had prior training specific to …

The Impact Of An Inpatient Hospital Admission On Patients’ Physical Functioning And Quality Of Life In The Oncology Setting, Andrew Murnane, Justin Keogh, Fiona Magat, Sonya Imbesi, Marie Coulombe, Sharni Patchell, Allan Abbott

Allan D. Abbott

Objective: Cancer can affect an individual’s level of physical function and health related quality of life (HRQoL). Those requiring hospital admission may be at risk of further decline during hospitalisation. The aim of this study was to investigate physical functioning and HRQoL of cancer patients on admission and over the course of their hospital admission. Methods: A prospective observational study was undertaken on the inpatient wards of a specialist oncology hospital. Assessment measures were taken bi-weekly until discharge from hospital or if they became too unwell to continue. Functional outcome measures included timed-up and go test (TUG), 30 second sit …

The Impact Of An Inpatient Hospital Admission On Patients’ Physical Functioning And Quality Of Life In The Oncology Setting, Andrew Murnane, Justin Keogh, Fiona Magat, Sonya Imbesi, Marie Coulombe, Sharni Patchell, Allan Abbott

Justin Keogh

Objective: Cancer can affect an individual’s level of physical function and health related quality of life (HRQoL). Those requiring hospital admission may be at risk of further decline during hospitalisation. The aim of this study was to investigate physical functioning and HRQoL of cancer patients on admission and over the course of their hospital admission. Methods: A prospective observational study was undertaken on the inpatient wards of a specialist oncology hospital. Assessment measures were taken bi-weekly until discharge from hospital or if they became too unwell to continue. Functional outcome measures included timed-up and go test (TUG), 30 second sit …

Identified Health Concerns And Changes In Management Resulting From The Healthy Kids Check In Two Queensland Practices, Rae Thomas, Jenny Doust, Kartik Vasan, Bianca Rajapakse, Leanne Mcgregor, Evan Ackermann, Chris Del Mar

Jenny Doust

Objectives: To determine how many children had health problems identified by the Healthy Kids Check (HKC) and whether this resulted in changes to clinical management. Design, setting and participants: A medical records audit from two Queensland general practices, identifying 557 files of children who undertook an HKC between January 2010 and May 2013. Main outcome measures: Child health problems identified in the medical records before, during and after the HKC. Results: Most children in our sample had no problems detected in their medical record (56%), 21% had problems detected during the HKC assessment, 19% had problems detected before, and 4% …

Treatment Of Asthma Exacerbations With The Human-Powered Nebuliser: A Randomised Parallel-Group Clinical Trial, M Therese Lysaught, Christopher J. Hallberg, Rene Antonio Najarro, Fausto Cea Gill, Clara Villatoro, Ana Celia Diaz De Uriarte, Lars E. Olson

M. Therese Lysaught

Aims: The aim of this study was to compare a low-cost, human-powered nebuliser compressor with an electric nebuliser compressor for the treatment of mild to moderate asthma exacerbations in adults and children. Methods: This was a non-blinded, parallel-group, equivalence study, with 110 subjects between 6 and 65 years of age, conducted in the emergency department of a district hospital in Ilopango, El Salvador. Participants were assigned by random allocation to receive a 2.5-mg dose of salbutamol from the experimental human-powered nebuliser or the electric nebuliser control. All assigned participants completed treatment and were included in analysis. The study was not …

Characterization Of A Human Powered Nebulizer Compressor For Resource Poor Settings, Christopher J. Hallberg, M Therese Lysaught, Christopher E. Zmudka, William K. Kopesky, Lars E. Olson

M. Therese Lysaught

Respiratory disease accounts for three of the ten leading causes of death worldwide. Many of these diseases can be treated and diagnosed using a nebulizer. Nebulizers can also be used to safely and efficiently deliver vaccines. Unfortunately, commercially available nebulizers are not designed for use in regions of the world where lung disease is most prevalent: they are electricity-dependent, cost-prohibitive, and not built to be reliable in harsh operating conditions or under frequent use. To overcome these limitations, the Human Powered Nebulizer compressor (HPN) was developed. The HPN does not require electricity; instead airflow is generated manually through a hand-crank …

Identified Health Concerns And Changes In Management Resulting From The Healthy Kids Check In Two Queensland Practices, Rae Thomas, Jenny Doust, Kartik Vasan, Bianca Rajapakse, Leanne Mcgregor, Evan Ackermann, Chris Del Mar

Rae Thomas

Objectives: To determine how many children had health problems identified by the Healthy Kids Check (HKC) and whether this resulted in changes to clinical management. Design, setting and participants: A medical records audit from two Queensland general practices, identifying 557 files of children who undertook an HKC between January 2010 and May 2013. Main outcome measures: Child health problems identified in the medical records before, during and after the HKC. Results: Most children in our sample had no problems detected in their medical record (56%), 21% had problems detected during the HKC assessment, 19% had problems detected before, and 4% …

Shoulder Pain In Primary Care Part 2: Predictors Of Clinical Outcome To 12 Months, Mark Laslett, Michael Steele, Wayne Hing, Peter Mcnair, Angela Cadogan

Wayne Hing

Objective: Identify predictor variables and models for clinical outcomes for primary care shoulder pain patients to 12 months follow-up. Design: A non-randomized audit with measures of pain and disability at 3 weeks, 3, 6 and 12 months. Patients: Of 208 patients, 161 agreed to participate with 96.9, 98.1, 87.0 and 83.9% follow-up at 3 weeks, 3, 6 and 12 months respectively. Treatment consisted of exercise and manual therapy-based physiotherapy and corticosteroid injection under specified selection criteria. Methods: Potentially useful baseline variables were evaluated in univariate logistic regressions with the dependent variables determined by SPADI Questionnaire at 3 weeks, 3, 6 …

Shoulder Pain Patients In Primary Care Part 1: Clinical Outcomes Over 12 Months Following Standardized Diagnostic Workup, Corticosteroid Injections, And Community Based Care, Mark Laslett, Michael Steele, Wayne Hing, Peter Mcnair, Angela Cadogan

Wayne Hing

Objective: Measure changes in pain and disability of primary care shoulder pain patients over a 12-month period. Design: A non-randomized audit with repeated measures of pain and disability at 3 weeks, 3, 6 and 12 months. Patients: Of 208 patients, 161 agreed to participate with 96.9%, 98.1%, 86.3%, 83.9% follow-up at 3 weeks, at 3, 6 & 12 months, respectively. Mean age was 44 years, mean symptom duration 3.6 months. Methods: Patients were treated with protocol driven corticosteroid injection and community based care. Primary outcome measure was the Shoulder Pain and Disability index (SPADI) questionnaire. Based on the SPADI and …

Television Watching, Diet Quality, And Physical Activity And Diabetes Among Three Ethnicities In The United States, Fatma G. Huffman, Joan A. Vaccaro, Joel C. Exebio, Gustavo C. Zarini, Timothy Katz, Zisca Dixon

Joan A. Vaccaro

Diabetes is a world-wide epidemic associated with multiple environmental factors. Prolonged television viewing (TV) time has been related to increased risk of obesity and type 2 diabetes in several studies. TV viewing has been positively associated with cardiovascular disease risk factors, lower energy expenditure, over-eating high-calorie and high-fat foods. The objective of this study was to assess the associations of hours of TV viewing with dietary quality, obesity and physical activity for three ethnic minorities with and without type 2 diabetes. Diet quality and physical activity were inversely related to prolonged TV viewing. African Americans and participants with type 2 …

Clinical Decision-Making Tools: How Effective Are They In Improving The Quality Of Health Care?, Lyndal Trevana, Kirsten Mccaffery, Glenn Salkeld, Paul Glasziou, Chris Del Mar, Jenny A. Doust, Tammy Hoffmann

Christopher Del Mar

Exec Summary Clinical decision-making tools can be considered in two broad categories – those designed to be used by clinicians and those designed to promote shared decision making with the clinician and patient together. The potential effect of computerised clinical decision support systems (CDSS) on variations in practice is not well understood, and CDSS are currently not a recommended means of improving evidence-based practice, or patient outcomes, since the mechanisms of success and failure are not well defined and the potential impact on workflows and adverse events are poorly evaluated. Despite numerous randomised controlled trials, there is poor quality evidence …

The Effect Of Yoga Postures On Balance, Flexibility, And Strength In Healthy High School Females, Betsy Donahoe-Fillmore, C. Brahler, Mary Fisher, Kelly Beasley

Betsy Donahoe-Fillmore

Objective: The purpose of this study was to document the effects of yoga interventions on balance, flexibility, and strength in adolescent girls 14 to 18 years. Study Design: Quasi-experimental, nonrandomized. Background: Research on the effects of yoga on balance, flexibility, and strength has focused on adults, although yoga is being marketed to all ages. Methods and Measures: A convenience sample of 33 female adolescents participated in yoga training 2 times per week and a walking program 3 times per week, for 7 weeks. The instructor-led group received instruction from a registered yoga therapist in person, while the video-led group watched …

Clinical Decision-Making Tools: How Effective Are They In Improving The Quality Of Health Care?, Lyndal Trevana, Kirsten Mccaffery, Glenn Salkeld, Paul Glasziou, Chris Del Mar, Jenny A. Doust, Tammy Hoffmann

Jenny Doust

Exec Summary Clinical decision-making tools can be considered in two broad categories – those designed to be used by clinicians and those designed to promote shared decision making with the clinician and patient together. The potential effect of computerised clinical decision support systems (CDSS) on variations in practice is not well understood, and CDSS are currently not a recommended means of improving evidence-based practice, or patient outcomes, since the mechanisms of success and failure are not well defined and the potential impact on workflows and adverse events are poorly evaluated. Despite numerous randomised controlled trials, there is poor quality evidence …

Clinical Decision-Making Tools: How Effective Are They In Improving The Quality Of Health Care?, Lyndal Trevana, Kirsten Mccaffery, Glenn Salkeld, Paul Glasziou, Chris Del Mar, Jenny A. Doust, Tammy Hoffmann

Paul Glasziou

Exec Summary Clinical decision-making tools can be considered in two broad categories – those designed to be used by clinicians and those designed to promote shared decision making with the clinician and patient together. The potential effect of computerised clinical decision support systems (CDSS) on variations in practice is not well understood, and CDSS are currently not a recommended means of improving evidence-based practice, or patient outcomes, since the mechanisms of success and failure are not well defined and the potential impact on workflows and adverse events are poorly evaluated. Despite numerous randomised controlled trials, there is poor quality evidence …

Searching For Randomized Controlled Trials And Systematic Reviews On Exercise: A Descriptive Study, Antonio Jose Grande, Tammy Hoffmann, Paul Glasziou

Paul Glasziou

The current paradigm of science is to accumulate as much research data as possible, with less thought given to navigation or synthesis of the resulting mass, which hampers locating and using the research. The aim here was to describe the number of randomized controlled trials (RCTs) and systematic reviews (SRs) focusing on exercise, and their journal sources, that have been indexed in PubMed over time. DESIGN AND SETTING: Descriptive study conducted at Bond University, Australia. METHOD: To find RCTs, a search was conducted in PubMed Clinical Queries, using the category “Therapy” and the Medical Subject Headings (MeSH) term “Exercise”. To …

Objective Benefits, Participant Perceptions And Retention Rates Of A New Zealand Community-Based, Older-Adult Exercise Programme, Justin Keogh, John Rice, Denise Taylor, Andrew Kilding

Justin Keogh

INTRODUCTION: Most exercise studies for older adults have been university- or hospital-based. Little is known about the benefits and factors influencing long-term participation in community-based exercise programmes, especially in New Zealand. AIM: To quantify the objective benefits, participant perceptions and retention rates of a New Zealand community-based exercise programme for adults (60 years or older). METHODS: Study 1 involved assessing the benefits of 12 weeks’ training on a convenience sample of 62 older adults commencing the never2old Active Ageing programme. Study 2 assessed the perceptions of 150 current participants on a variety of programme components that could act as barriers …

Access To Hospital Interpreter Services For Limited English Proficient Patients In New Jersey: A Statewide Evaluation, Glenn Flores, Sylvia Torres, Linda Holmes, Debbie Salas-Lopez, Mara Youdelman, Sandra Tomany-Korman

Debbie Salas-Lopez MD, MPH

CONTEXT/OBJECTIVES: We surveyed New Jersey (NJ) hospitals to assess current language services and identify policy recommendations on meeting limited English proficiency (LEP) patients' needs.

METHODS: Survey with 37 questions regarding hospital/patient features, interpreter services, and resources/policies needed to provide quality interpreter services.

RESULTS: Sixty-seven hospitals responded (55% response rate). Most NJ hospitals have no interpreter services department, 80% provide no staff training on working with interpreters, 31% lack multilingual signs, and 19% offer no written translation services. Only 3% of hospitals have full-time interpreters, a ratio of 1 interpreter:240,748 LEP NJ residents. Most hospitals stated third-party reimbursement for interpreters would …

"…Is It Normal To Be This Sore?": Using An Online Forum To Investigate Barriers To Physical Activity., Tammy Toscos, Sunny Consolvo, David Mcdonald

Tammy R Toscos

The importance of regular physical activity to overall health has been well established, yet U.S. adults are leading increasingly sedentary lives. Research suggests that lowering perceived barriers to physical activity is a critical part of interventions that encourage physical activity. In this paper, we describe the top five barriers—two of which have not been reported as principle barriers in the literature—that emerged from our systematic qualitative coding of an online forum used to support a three month healthy lifestyle intervention. Based on our analysis, we identify design considerations for technologies that encourage and support physical activity. Understanding the needs of …

Public Health Marketing: Is It Good And Is It Good For Everyone?, Stephen Holden, Damian Cox

Damian Cox

We define public health marketing broadly as the use of marketing tools (segmentation, targeting, position­ing, and the four Ps) to encourage behaviour change that will deliver the social good defined as public health. We explore the ethical challenges and risks that confront public health and social marketers. In particular, we note that public health marketers with a self-defined goal of delivering a social good face two major ethical challenges: the first is establishing the ethicality of the social good itself; the second is distributing the social good in an ethically defensible way. In particular, we draw attention to the central …

Communicating With Parents And Children About Screening Results, Tammy Hoffmann, Rae Thomas, Chris Del Mar

Rae Thomas

Conducting a screening program is one thing, communicating the results to individuals is another altogether. We believe effective communication to to be the nexus of health decision-making. How you convey screening choices and results to parents, teachers, and children may have both positive and negative consequences to parental and teacher perceptions of the child's behavior, expectations of his/her future development, and the child's view of themselves. In this chapter, we address the challenges and necessity of informed consent, the importance of understanding the implications of false positive and false negative results, and the potential consequences of communcating screening results. We …

Probiotics: Achieving A Better Regulatory Fit, Diane E. Hoffmann, Claire M. Fraser, Francis Palumbo, Jacques Ravel, Virginia Rowthorn, Jack Schwartz

Virginia Rowthorn

In 2007, the National Institutes of Health (NIH) launched the Human Microbiome Project (HMP), a $150 million initiative to characterize the microbial communities found at several different sites on the human body and to analyze the role of these microbes in human health and disease. Many lines of research have demonstrated the significant role of the microbiota in human physiology. The microbiota is involved, for example, in the healthy development of the immune system, prevention of infection from pathogenic or opportunistic microbes, and maintenance of intestinal barrier function. The HMP findings are helping us understand the role and variation of …