Medicine and Health Sciences Commons^™

Medical Practioners' Knowledge And Self-Reported Practices Of Substitute Decision Making And Implementation Of Advance Care Plans, C Cartwright, J Montgomery, Jerome Rhee, Ning Zwar, A Banbury

Professor Colleen M Cartwright

Background Advance care planning (ACP) provides patients with the ability to make their decisions known about how they would like to be treated if they lose capacity. Medical practitioners have a key role to play in providing information on ACP to their patients. This research explores their knowledge and attitudes to advance care planning and how this affects their practice. Aim The objective of this study is to assess the NSW medical practitioners' knowledge and self-reported practice of ACP. Methods A postal survey of a random sample of 650 general practitioners plus 350 medical specialists from specialties most often involved …

Modulation Of Soleus H-Reflex During Shortening And Lengthening Muscle Actions In Young And Older Adults, Yung-Sheng Chen, Shi Zhou, Colleen Cartwright

Professor Colleen M Cartwright

The Hoffmann reflex (H-reflex) is dependently modulated during isometric and anisometric muscle actions. However, the manner of the H-reflex modulation during dynamic muscle movements in relation to ageing is less stated in the literature. This study was designed to investigate the effects of ageing on soleus (SOL) H-reflex modulation during dynamic muscle actions. Twenty young (24±4 years of age) and 20 older adults (73±5 years of age) voluntarily participated in the study. The SOL H-reflex was measured during passive and active shortening and lengthening muscle actions in a sitting position. The older group showed a lower ratio of the maximal …

Effects Of Ankle Joint Position And Submaximal Muscle Contraction Intensity On Soleus H-Reflex Modulation In Young And Older Adults, Yung-Sheng Chen, Shi Zhou, Colleen Cartwright

Professor Colleen M Cartwright

This study investigated the effects of ankle joint position and submaximal contraction intensity on soleus (SOL) H-reflex modulation. Twenty young (25.1 ± 4.8 years) and 20 older adults (74.2 ± 5.1 years) performed plantar flexions during 10%, 30% and 50% maximal voluntary contractions (MVC) and at ankle positions of neutral (0°), plantar flexion (20°) and dorsiflexion (-20°) in a sitting position. The SOL H-reflex gain in older adults was relatively lower than that in young adults during 10%, 30% and 50% MVC. The SOL H-reflex gain was significantly affected by the intensity of plantar flexion in the respective ankle joint …

Leadership Of Non-Profit Organizations In The Aged Care Sector In Australia, Shankar Sankaran, Colleen Cartwright, Jacqueline Kelly, Kelly Shaw, Jeffrey Soar

Professor Colleen M Cartwright

This paper will describe an organizational change program to be carried out in two not-for-profit organizations in Australia that are providing aged and community care. A pilot project was carried out to secure a research grant from the Australian Federal Government for a three-year research project to strengthen leadership in the not-for-profit aged and community care sector. The paper will summarize the findings from the pilot project, which used systems thinking approaches such as scenario planning. It will also explain an action research approach being proposed to test the leadership framework (developed through the pilot project) in real environments. The …

Test-Retest Reliability Of The Soleus H-Reflex Is Affected By Joint Positions And Force Levels, Yungsheng Chen, Shi Zhou, Colleen Cartwright, Zachary Crowley, Robert Baglin, Fang Wang

Professor Colleen M Cartwright

The H-reflex has been extensively used to exam the spinal motoneuron excitability. However, no report has demonstrated the test-retest reliability of the H-reflex assessment during voluntary muscle contractions and its relation to joint positions. The purpose of this study was to determine the test-retest reliability of the soleus (SOL) H-reflex during rest and 10, 30, 50% maximal voluntary contractions (MVC) at the ankle joint angles of neutral (0deg), plantarflexion (20deg), and dorsiflexion (-20deg), respectively in a sitting position. Ten healthy participants (age 24.9 ± 5 years, height 168.3±8.8 cm, weight 62.7±12.3 kg) were tested for the SOL H-reflex on two …

Test–Retest Reliability Of The Soleus H-Reflex Is Affected By Joint Positions And Muscle Force Levels, Yung-Sheng Chen, Shi Zhou, Colleen Cartwright, Zachary Crowley, Robert Baglin, Fang Wang

Professor Colleen M Cartwright

The purpose of this study was to determine the test–retest reliability of the soleus (SOL) H-reflex during rest and isometric contractions at 10%, 30%, and 50% of the maximal voluntary force (MVC) at the ankle joint angles of neutral (0°), plantarflexion (20°), and dorsiflexion (−20°) respectively, in a sitting position. Ten healthy participants, with mean age of 24.9 ± 5.0 (SD) years, height 168.3 ± 8.8 cm, weight 62.7 ± 12.3 kg, were tested for the SOL H-reflex (Hmax) on two separate occasions within 7 days. The intraclass correlation coefficient (ICC) for the test–retest of the SOL H-reflex during rest …

Leadership In Faith-Based Aged And Community Care, Kelly Shaw, Colleen Cartwright, Shankar Sankaran, Jacqueline Kelly, Bob Dick, Alan Davies, Jocelyn Craig

Professor Colleen M Cartwright

Purpose – The purpose of this paper is to identify the domains of performance needed by leaders in aged and community care not-for-profit organisations. Design/methodology/approach – Focus groups and individual interviews were conducted with senior managers employed by faith-based aged and community care not-for-profit organisations, academics in ageing and business fields and senior government employees from aged services departments and agencies in Australia. Results were content transcribed and analysed thematically in order to identify the major themes that emerged. Findings – A total of 37 people participated in the study. The domains of performance identified by participants as required of …

Factors Affecting Provision Of Successful Monitoring In Home Telehealth, Rachel Wade, Kelly Shaw, Colleen Cartwright

Professor Colleen M Cartwright

Aim: To investigate acceptance and usage issues in relation to Telehealth products as used by frail older clients of the Transition Care Program and their carers. Method: The study design was a quasi-randomised controlled clinical trial. A stratified random sample of participants was allocated to one of five groups using a random number table. Study participants who were already in possession of a pendant alarm provided by the study service provider at study commencement, or were assessed as needing a pendant alarm, were allocated to the first number out of 1 (control group), 4 or 5 (home Telehealth monitoring with …

Factors Relating To Home Telehealth Acceptance And Usage Compliance, Rachel Wade, Colleen Cartwright, Kelly Shaw

Professor Colleen M Cartwright

Aim: This paper investigates the acceptance of in-home telehealth by frail older adults and carers of the Transition Care Program (TCP), and evaluates telehealth acceptance as a predictor for usage compliance.

Method: A stratified random sample of participants was allocated to one of five groups: either a control group or to receive telehealth monitoring of their vital signs for a period of 12 or 24 weeks; with or without a medical alarm pendant.

Results: Before being trained in and using telehealth, the majority of participants and carers demonstrated acceptance of the technology by reporting that they perceived it would be …

What Do Emergency Physicians Think Of The Law?, Ben White, Lindly Willmott, Malcolm Parker, Colleen Cartwright, Gail Williams

Professor Colleen M Cartwright

The authors reflect on the knowledge that emergency physicians have of law as it pertains to end of life care and on a research project funded by the Australian Research Council which will investigate the legal knowledge that medical specialists have. They suggest that an improved understanding of law will help doctors manage legal risk and reduce possible exposure to criminal, civil or disciplinary action. They argue that the research may lead to better outcomes for patients and their families.

End-Of-Life Care For Gay, Lesbian, Bisexual And Transgender People, Colleen Cartwright, Mark Hughes, Tania Lienert

Professor Colleen M Cartwright

There is little understanding in Australia of the special issues faced by gay, lesbian, bisexual and transgender people in end-of-life care and advance care planning. This exploratory study aimed to achieve an initial understanding of these issues to inform the development of a larger study involving gay, lesbian, bisexual and transgender service users. Consultations were carried out with 19 service providers and 6 gay, lesbian, bisexual and transgender community members in the Northern Rivers and metropolitan Sydney areas of New South Wales, Australia. Participants reported barriers to health care service access due to discrimination, inappropriate care and lack of knowledge …

The Legal Role Of Medical Professionals In Decisions To Withhold Or Withdraw Life-Sustaining Treatment: Part 2 (Queensland), L Willmott, B White, M Parker, Colleen Cartwright

Professor Colleen M Cartwright

This is the second article in a series of three that examines the legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment from adults who lack capacity. This article considers the position in Queensland, including the parens patriae jurisdiction of the Supreme Court. A review of the law in this State reveals that medical professionals play significant legal roles in these decisions. However, the law is problematic in a number of respects and this is likely to impede medical professionals' legal knowledge in this area. The article examines the level of training medical professionals receive on …

The Legal Role Of Medical Professionals In Decisions To Withhold Or Withdraw Life-Sustaining Treatment: Part 1 (New South Wales), B White, L Willmott, P Trowse, M Parker, Colleen Cartwright

Professor Colleen M Cartwright

This is the first article in a series of three that examines the legal role of medical professionals in decisions to withhold or withdraw life-sustaining treatment from adults who lack capacity. This article considers the position in New South Wales. A review of the law in this State reveals that medical professionals play significant legal roles in these decisions. However, the law is problematic in a number of respects and this is likely to impede medical professionals’ legal knowledge in this area. The article examines the level of training medical professionals receive on issues such as advance directives and substitute …

Effects Of 12-Week Tai Chi Training On Soleus H-Reflex And Muscle Strength In Older Adults: A Pilot Study, Yung-Sheng Chen, Zachary Crowley, Shi Zhou, Colleen Cartwright

Professor Colleen M Cartwright

The purpose of this study was to determine the effects of 12-week Tai Chi (TC) training on the soleus (SOL) H-reflex modulation and plantarflexion muscle strength in older adults. Twenty volunteers were assigned into training (N = 14; 72.2 ± 3.7 years of age) and control (N = 6; 74.2 ± 6.1 years of age) groups. The participants in the TC group practiced Yang style TC 1 h per session, 3 sessions per week, for 12 weeks, guided by a qualified TC instructor. The ratio of the maximal peak-to-peak amplitude of SOL H-reflex (H max) to M-wave (M max) was …

Ethical Challenges In End-Of-Life Care For Glbti Individuals, Colleen Cartwright

Professor Colleen M Cartwright

No abstract provided.

The Housing And Support Needs Of People With An Intellectual Disability Into Older Age, Kelly Shaw, Colleen Cartwright, Jocelyn Craig

Professor Colleen M Cartwright

Background: People with intellectual disabilities (IDs) are growing older as a population cohort. Many live at home with family members who are their carers but who are also becoming older and less able to provide care. The housing and support preferences of people with IDs and their carers into older age are poorly characterised in the literature. Methods: Focus groups and individual interviews were conducted with 15 people with IDs who work in supported employment and with 10 family members who care for adults with IDs. Data were thematically analysed independently by two researchers. Results: The major themes that emerged …

Effect Of 12 Weeks Of Tai Chi Training On Soleus Hoffmann Reflex And Control Of Static Posture In Older Adults, Colleen Cartwright, Yungsheng Chen, Shi Zhou

Professor Colleen M Cartwright

Objective To investigate the effect of 12 weeks of Tai Chi training on soleus (SOL) Hoffmann reflex (H-reflex) modulation and postural control in standing under 4 sensory conditions in older adults. Design Experimental research design with pre- and posttraining tests in a training group and a control group. Setting University biomechanics laboratory. Participants Community-dwelling older adults (N=34) were assigned to a training (n=20; mean ± SD age, 72.9±4.4y) and a control (n=14; mean ± SD age, 72.9±6.5y) group. Intervention Tai Chi participants attended a 1-hour session of Yang style Tai Chi, 3 sessions a week, for 12 weeks, while control …

Test–Retest Reliability Of The Soleus H-Reflex Is Affected By Joint Positions And Muscle Force Levels, Yungsheng Chen, Shi Zhou, Colleen Cartwright, Zachary Crowley, Robert Baglin, Fang Wang

Professor Colleen M Cartwright

The purpose of this study was to determine the test-retest reliability of the soleus (SOL) H-reflex during rest and isometric contractions at 10%, 30%, and 50% of the maximal voluntary force (MVC) at the ankle joint angles of neutral (0°), plantarflexion (20°), and dorsiflexion (-20°) respectively, in a sitting position. Ten healthy participants, with mean age of 24.9 ± 5.0 (SD) years, height 168.3 ± 8.8 cm, weight 62.7 ± 12.3 kg, were tested for the SOL H-reflex (Hmax) on two separate occasions within 7 days. The intra-class correlation coefficient (ICC) for the test–retest of the SOL H-reflex during rest …

End-Of-Life Decision-Making And Patient Self-Determination : A Multi-Stakeholder Analysis, Mph Thesis, University Of Queensland, Brisbane, Colleen Cartwright

Professor Colleen M Cartwright

No abstract provided.

Factors Impacting On The Lives Of Terminally Ill Older People, And Requests For Euthanasia, Phd Thesis, University Of Queensland, Colleen Cartwright

Professor Colleen M Cartwright

No abstract provided.

Affordable Rental Housing For Older People In Australia: What Do Older People Want?, Colleen Cartwright

Professor Colleen M Cartwright

No abstract provided.

Prevention Of Falls And Near-Falls In Community-Dwelling Older People: A Randomised Trial, Nancy Peel, Colleen Cartwright, Margaret Steinberg, Gail Williams

Professor Colleen M Cartwright

No abstract provided.

End-Of-Life Decision-Making: Perspectives Of Northern Territory Doctors, Nurses And Community Members, Colleen Cartwright, G Robinson, Margaret Steinberg, Gail Williams, W Tyler

Professor Colleen M Cartwright

No abstract provided.

Investigating Models Of Affordable Housing For Older People And People With Disabilities In The Mid North Coast Region Of New South Wales, Colleen Cartwright

Professor Colleen M Cartwright

No abstract provided.

Physicians' Experiences With End-Of-Life Decision-Making: Survey In 6 European Countries And Australia, Rurik Lofmark, Tore Nilstun, Colleen M. Cartwright, Susanne Fischer, Agnes Van Der Heide, Freddy Mortier, Michael Norup, Lorenzo Simonato, Bregje D. Onwuteaka-Philipsen

Professor Colleen M Cartwright

Background: In this study we investigated (a) to what extent physicians have experience with performing a range of end-of-life decisions (ELDs), (b) if they have no experience with performing an ELD, would they be willing to do so under certain conditions and (c) which background characteristics are associated with having experience with/or being willing to make such ELDs. Methods: An anonymous questionnaire was sent to 16,486 physicians from specialities in which death is common: Australia, Belgium, Denmark, Italy, the Netherlands, Sweden and Switzerland. Results: The response rate differed between countries (39–68%). The experience of foregoing life-sustaining treatment ranged between 37% …

Mental Capacity In Medical Practice And Advance Care Planning: Clinical, Ethical And Legal Issues, Colleen Cartwright, Malcolm Parker

Professor Colleen M Cartwright

No abstract provided.

A Multi-Disciplinary Approach To Advance Care Planning: Pilot Study Report, Colleen Cartwright, Jill Phillips, J Rodwell

Professor Colleen M Cartwright

No abstract provided.

Decision-Making In Terminal Care: Older People Seek More Involvement, Colleen Cartwright, Margaret Steinberg

Professor Colleen M Cartwright

No abstract provided.

Influence Of Physicians' Life-Stance On Attitudes Towards End-Of-Life Decisions And Actual End-Of-Life Decision-Making In Six Countries, Joachim Cohen, J Van Delden, Freddy Mortier, Rurik Lofmark, Michael Norup, Colleen Cartwright, Karin Faisst, C Canova, J Bilsen

Professor Colleen M Cartwright

Aim: To examine how physicians’ life stances affect their attitudes to end-of-life decisions and their actual end-of-life decision-making. Methods: Practising physicians from various specialties involved in the care of dying patients in Belgium, Denmark, The Netherlands, Sweden, Switzerland and Australia received structured questionnaires on end-of-life care, which included questions about their life stance. Response rates ranged from 53% in Australia to 68% in Denmark. General attitudes, intended behaviour with respect to two hypothetical patients, and actual behaviour were compared between all large life-stance groups in each country. Results: Only small differences in life stance were found in all countries in …

Medical Decisions At The End Of Life: Attitudes And Practices Of Australian Medical Practitioners, Colleen Cartwright, Gail Williams, Malcolm Parker, Margaret Steinberg

Professor Colleen M Cartwright

No abstract provided.