Brachial plexus injury: living with uncertainty

A traumatic brachial plexus injury (BPI) has life-changing consequences for patients and their families. Despite advancements in treatments final outcome is unpredictable depending on factors including time to treatment, injury severity, neural regeneration, and available interventions. The final outcome may not be seen for up to four years. This study aimed to explore the impact of uncertainty on people with a traumatic BPI. Secondary qualitative analysis was conducted on data from a study exploring outcomes important to patients with a traumatic BPI. Data from semi-structured interviews with adult traumatic BPI patients (n = 13) were analyzed using reflexive thematic analysis. Three major themes were identified in the qualitative data: (i) “I don’t know what happened to me,” focused on uncertainty in diagnosis. (ii) “I went to work one day… and then it all changed” centered around uncertainty in the future. (iii) Coping with uncertainty. The results illustrate that people with a traumatic BPI face uncertainty regarding diagnosis, prognosis, and surrounding their roles in the future. Individuals respond to uncertainty in different ways and this needs to be understood by health care professionals. IMPLICATIONS FOR REHABILITATIONHealth professionals should consider uncertainty in all their contacts with people who have experienced a traumatic brachial plexus injury.People with a traumatic brachial plexus injury experience uncertainty in different ways therefore education and information given may be optimized if tailored to the individual rather than generic.Increasing awareness of the injury and its presentation in non-specialist acute care clinicians may accelerate diagnosis and reduce initial uncertainty.Acknowledging the presence of uncertainty is important during the shared decision-making in brachial plexus injuries. Health professionals should consider uncertainty in all their contacts with people who have experienced a traumatic brachial plexus injury. People with a traumatic brachial plexus injury experience uncertainty in different ways therefore education and information given may be optimized if tailored to the individual rather than generic. Increasing awareness of the injury and its presentation in non-specialist acute care clinicians may accelerate diagnosis and reduce initial uncertainty. Acknowledging the presence of uncertainty is important during the shared decision-making in brachial plexus injuries.</p

“I'm not the anti-smoker now. I just don't smoke anymore”: social obstacles to quitting smoking among emerging adults

Background: Emerging adulthood presents unique challenges to smoking cessation that are not well understood. During this phase, smoking identities can develop that become obstacles for quitting, particularly in social situations where smoking is accepted and expected. Using a social identity approach, this study explores how social relationships and normative group behaviours can be barriers to transitioning from a smoker to non-smoker identity. Method: Six focus groups of five participants (N = 30) were conducted with participants aged 18-25 years (57% male). Participants’ smoking status was ascertained to construct six groups, two each of daily smokers, occasional (non-daily) smokers, and ex-smokers. Results: Salient in-group identities invoked out-group comparisons that could create barriers to change including feeling conflicted about becoming a “non-smoker”, and maintenance of pro-smoking group norms. Three subthemes were identified: 1) Managing the division between smoker and non-smoker groups; 2) The isolation associated with navigating others’ expectations about quitting when attempting to quit; and 3) Encountering normative in-group smoking-related behaviours when attempting to quit. Conclusions: The transition from smoker to non-smoker, when understood from a social identity approach, is not straightforward. Identifying as a smoker can invoke negative judgements from non-smokers while, conversely, attempting to quit may lead to perceived rejection among smokers. Further research is needed to explore whether perceptions of social risk can be reduced by increasing the salience of a transitional “quitter” identity that helps to reduce the perceived gap between “smoker” and “non-smoker”.</p

Content analysis of school websites: policies and programs to support healthy eating and the environment

Abstract Preschools and primary schools are important settings for the development of healthy eating habits and awareness of environmentally friendly practices. This study explored South Australian government schools’ policies and programs in relation to healthy eating and environmentally friendly aspects of food choice (such as packaging), and whether any schools approached these issues in combination. Websites of 18 government preschools and primary schools in the Greater Adelaide region, stratified by low, medium and high socioeconomic status were reviewed for publicly available policies and other relevant content. A content analysis was undertaken, with policies and programs analysed deductively and thematically. Healthy eating (n = 8) and environment (n = 3) related policies were found on preschool websites only. The main themes observed across the three categories of interest (healthy eating, environmentally friendly practices and low-waste healthy foods) included the presence/absence of formal policy, promotional strategies and implementation. Expectations of children bringing healthy ‘nude’ foods that were environmentally friendly were mentioned informally on the websites but were not part of policy documents. Policies and programs around healthy eating and environmentally friendly practices (in combination) were lacking. There is scope to address this gap to improve health and sustainable outcomes within the school environment context

sj-pdf-2-jhs-10.1177_17531934231212973 - Supplemental material for Development of a core outcome set for traumatic brachial plexus injury

Supplemental material, sj-pdf-2-jhs-10.1177_17531934231212973 for Development of a core outcome set for traumatic brachial plexus injury by Caroline Miller, Jane Cross, Dominic M. Power and Christina Jerosch-Herold in Journal of Hand Surgery (European Volume)</p

sj-pdf-4-jhs-10.1177_17531934231212973 - Supplemental material for Development of a core outcome set for traumatic brachial plexus injury

Supplemental material, sj-pdf-4-jhs-10.1177_17531934231212973 for Development of a core outcome set for traumatic brachial plexus injury by Caroline Miller, Jane Cross, Dominic M. Power and Christina Jerosch-Herold in Journal of Hand Surgery (European Volume)</p

sj-pdf-1-jhs-10.1177_17531934231212973 - Supplemental material for Development of a core outcome set for traumatic brachial plexus injury

Supplemental material, sj-pdf-1-jhs-10.1177_17531934231212973 for Development of a core outcome set for traumatic brachial plexus injury by Caroline Miller, Jane Cross, Dominic M. Power and Christina Jerosch-Herold in Journal of Hand Surgery (European Volume)</p

sj-pdf-3-jhs-10.1177_17531934231212973 - Supplemental material for Development of a core outcome set for traumatic brachial plexus injury

Supplemental material, sj-pdf-3-jhs-10.1177_17531934231212973 for Development of a core outcome set for traumatic brachial plexus injury by Caroline Miller, Jane Cross, Dominic M. Power and Christina Jerosch-Herold in Journal of Hand Surgery (European Volume)</p

School lunchboxes as an opportunity for health and environmental considerations: a scoping review

SummaryVery little research has focussed on children’s school lunchboxes from both a health and environment standpoint. This scoping review explores studies that considered children’s lunchbox food consumption trends at school and the environmental impacts of lunchbox contents. We conducted a scoping review of peer-reviewed literature with a focus on lunchboxes of children in preschool or primary school settings that contained food packed from home, through the lens of food and nutrition in combination with environmental outcomes—particularly food and/or packaging waste. The review included 10 studies, with articles from Australia, USA, Spain, New Zealand and the UK. Half of them were intervention studies aiming to shift knowledge levels and attitudes of teachers, parents and children with regard to reducing packaged food choices and food waste, and improving dietary habits. Acknowledging the complexity of lunchbox packing and consumption practices, this review recommends the consideration of socio-ecological influences on children’s health and sustainability behaviour, and mobilizing their pro-environmental agency

Additional file 1: of Measuring research impact: a large cancer research funding programme in Australia

Appendix 1 Chief investigator survey questions. (DOCX 14 kb

MOESM1 of Patient-reported GP health assessments rather than individual cardiovascular risk burden are associated with the engagement in lifestyle changes: population-based survey in South Australia

Additional file 1. Lifestyle questions used to create the variables related to the adequacy of lifestyle risk factors recommendations