156 research outputs found

    Family Care of Elderly People: Policy Issues

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    This monograph is the third of three reports on Family Care of Elderly People in Australia. The first, published as number 23 in the Centre's Reports and Proceedings series, examined theoretical issues in family care and reported results from the first stage of a three State survey. The second, published as number 38, reported the data from the full study, with descriptive rather than analytical comment. This final report recapitulates and examines the policy issues involved in dealing with the problems and issues identified in the course of the research. Given the policy importance of the issues at stake, it was decided that, before a final monograph was prepared, a working seminar of government officers and consumer representatives would be held. This seminar which involved representatives from all Australian states was held earlier this year. The Commonwealth Minister for Health, Dr Neal Blewett made a grant available to the SWRC to assist with the costs involved. At that seminar, the findings of the study were reported and the discussion focused on the circumstances of elderly people unable to live in the community without some support and of those who provide care for them in the same household. Policies addressing these circumstances were examined from the perspective of those at the seminar. In this monograph Chris Rossiter very ably summarises the issues involved, and the theoretical underpinnings of 'community care' policies and practices, before examining the range of potential responses to the problems highlighted. Not all responses are necessarily implementable, for implementation cannot exist in a vacuum, but rather is part of a broader policy context

    Curriculum renewal for interprofessional education in health

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    In this preface we comment on four matters that we think bode well for the future of interprofessional education in Australia. First, there is a growing articulation, nationally and globally, as to the importance of interprofessional education and its contribution to the development of interprofessional and collaborative health practices. These practices are increasingly recognised as central to delivering effective, efficient, safe and sustainable health services. Second, there is a rapidly growing interest and institutional engagement with interprofessional education as part of pre-registration health professional education. This has changed substantially in recent years. Whilst beyond the scope of our current studies, the need for similar developments in continuing professional development (CPD) for health professionals was a consistent topic in our stakeholder consultations. Third, we observe what might be termed a threshold effect occurring in the area of interprofessional education. Projects that address matters relating to IPE are now far more numerous, visible and discussed in terms of their aggregate outcomes. The impact of this momentum is visible across the higher education sector. Finally, we believe that effective collaboration is a critical mediating process through which the rich resources of disciplinary knowledge and capability are joined to add value to existing health service provision. We trust the conceptual and practical contributions and resources presented and discussed in this report contribute to these developments.Office of Learning and Teaching Australi

    A calming hug:Design and validation of a tactile aid to ease anxiety

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    Anxiety disorders affect approximately one third of people during their lifetimes and are the ninth leading cause of global disability. Current treatments focus on therapy and pharmacological interventions. However, therapy is costly and pharmacological interventions often have undesirable side-effects. Healthy people also regularly suffer periods of anxiety. Therefore, a non-pharmacological, intuitive, home intervention would be complementary to other treatments and beneficial for non-clinical groups. Existing at-home anxiety aids, such as guided meditations, typically employ visual and/or audio stimuli to guide the user into a calmer state. However, the tactile sense has the potential to be a more natural modality to target in an anxiety-calming device. The tactile domain is relatively under-explored, but we suggest that there are manifold physiological and affective qualities of touch that lend it to the task. In this study we demonstrate that haptic technology can offer an enjoyable, effective and widely accessible alternative for easing state anxiety. We describe a novel huggable haptic interface that pneumatically simulates slow breathing. We discuss the development of this interface through a focus group evaluating five prototypes with embedded behaviours (‘breathing’, ‘purring’, ‘heartbeat’ and ‘illumination’). Ratings indicated that the ‘breathing’ prototype was most pleasant to interact with and participants described this prototype as ‘calming’ and ‘soothing’, reminding them of a person breathing. This prototype was developed into an ergonomic huggable cushion containing a pneumatic chamber powered by an external pump allowing the cushion to ‘breathe’. A mixed-design experiment (n = 129) inducing anxiety through a group mathematics test found that the device was effective at reducing pre-test anxiety compared to a control (no intervention) condition and that this reduction in anxiety was indistinguishable from that of a guided meditation. Our findings highlight the efficacy of this interface, demonstrating that haptic technologies can be effective at easing anxiety. We suggest that the field should be explored in more depth to capture the nuances of different modalities in relation to specific situations and trait characteristics

    Interventions targeting bottle and formula feeding in the prevention and treatment of early childhood caries, overweight and obesity : an integrative review

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    Overweight, obesity and early childhood caries (ECC) are preventable conditions affecting infants and young children, with increased prevalence in those formula-fed. Previous research has focused on distinct outcomes for oral health and healthy weight gain. However, the aetiology may be linked through overlapping obesogenic and cariogenic feeding behaviours, such as increased sugar exposure through bottle propping and overfeeding. Best-practice bottle feeding and transition to cup use may concurrently reduce overweight, obesity and ECC. This integrative review aimed to identify interventions supporting best-practice formula feeding or bottle cessation and examine the intervention effects on feeding, oral health and weight outcomes. The reviewers searched nine databases and found 27 studies that met the predetermined inclusion criteria. Eighteen studies focused on populations vulnerable to ECC or unhealthy weight gain. All studies focused on carer education; however, only 10 studies utilised behaviour change techniques or theories addressing antecedents to obesogenic or cariogenic behaviours. The outcomes varied: 16 studies reported mixed outcomes, and eight reported worsened post-intervention outcomes. While some studies reported improvements, these were not maintained long-term. Many study designs were at risk of bias. Effective intervention strategies for preventing ECC and child obesity require the holistic use of interdisciplinary approaches, consumer co-design and the use of behavioural change theory

    Expertise affects inter-observer agreement at peripheral locations within a brain tumor

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    Magnetic resonance imaging (MRI) is a crucial tool for clinical brain tumor detection and delineation. Since the process of gross tumor volume delineation resides with clinicians, a better understanding of how they perform this task is required if improvements in life expectancy are to be made. Novice-expert comparison studies have been used to examine the effect of expertise on abnormality detection, but little research has investigated expertise-related differences in brain tumor delineation. In this study, undergraduate students (novices) and radiologists (experts) inspected a combination of T1 and T2 single and whole brain MRI scans, each containing a tumor. Using a tablet and stylus to provide an interactive environment, participants had an unlimited amount of time to scroll freely through the MRI slices and were instructed to delineate (i.e., draw a boundary) around any tumorous tissue. There was no reliable evidence for a difference in the gross tumor volume or total number of slices delineated between experts and novices. Agreement was low across both expertise groups and significantly lower at peripheral locations within a tumor than central locations. There was an interaction between expertise level and location within a tumor with experts displaying higher agreement at the peripheral slices than novices. An effect of brain image set on the order in which participants inspected the slices was also observed. The implications of these results for the training undertaken by early career radiologists and current practices in hospitals are discussed

    Mapping the trajectories for women and their babies from births planned at home, in a birth centre or in a hospital in New South Wales, Australia, between 2000 and 2012

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    Background: In New South Wales (NSW) Australia, women at low risk of complications can choose from three birth settings: home, birth centre and hospital. Between 2000 and 2012, around 6.4% of pregnant women planned to give birth in a birth centre (6%) or at home (0.4%) and 93.6% of women planned to birth in a hospital. A proportion of the woman in the home and birth centre groups transferred to hospital. However, their pathways or trajectories are largely unknown. Aim: The aim was to map the trajectories and interventions experienced by women and their babies from births planned at home, in a birth centre or in a hospital over a 13-year period in NSW. Methods: Using population-based linked datasets from NSW, women at low risk of complications, with singleton pregnancies, gestation 37–41 completed weeks and spontaneous onset of labour were included. We used a decision tree framework to depict the trajectories of these women and estimate the probabilities of the following: giving birth in their planned setting; being transferred; requiring interventions and neonatal admission to higher level hospital care. The trajectories were analysed by parity. Results: Over a 13-year period, 23% of nulliparous and 0.8% of multiparous women planning a home birth were transferred to hospital. In the birth centre group, 34% of nulliparae and 12% of multiparas were transferred to a hospital. Normal vaginal birth rates were higher in multiparous women compared to nulliparous women in all settings. Neonatal admission to SCN/NICU was highest in the planned hospital group for nulliparous women (10.1%), 7.1% for nulliparous women planning a birth centre birth and 5.1% of nulliparous women planning a homebirth. Multiparas had lower admissions to SCN/NICU for all thee settings (hospital 6.3%, BC 3.6%, home 1.6%, respectively). Conclusions: Women who plan to give birth at home or in a birth centre have high rates of vaginal birth, even when transferred to hospital. Evidence on the trajectories of women who choose to give birth at home or in birth centres will assist the planning, costing and expansion of models of care in NSW

    Collaborative development of a quality assurance framework for educator professional development

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    Practitioner professional development plays an important role in the education system, contributing to improved practitioner expertise, positive career experiences and retention, and thereby to the educational outcomes of children and young people. In England, a wide range and large number of organisations offer professional development to education practitioners, including multi-academy trusts and schools, university, charitable trusts, subject associations, awarding organisations and private companies (Chedzey et al. 2021). School leaders, teachers and professional development providers recognise the potential value of quality assurance processes to the overall system of practitioner professional development as a way to support informed, confident decision-making about professional development and ultimately to drive up standards of professional development across the sector (Perry et al. 2021). However, the system is largely unregulated by government or other organisations and there are few systems of quality assurance, internal or external (Musset 2010, Perry et al. 2019). As a result, practitioners report that they find it hard to make judgements about the quality of professional development available (Chedzey et al. 2021). In recent years a few initiatives have explored quality assurance measures for teacher professional development. These include the Department for Education’s (2016) Standard for teachers’ professional development, which sets out guidance to school leaders for successful professional development, and a pilot study, commissioned by Wellcome, which developed and trialled a system of quality assurance of professional development (Chedzey et al. 2021, Perry et al. 2021). Currently, the Department for Education is offering Senior Mental Health leads’ training for schools and colleges; each of the programmes funded through this initiative has been quality assured by the Carnegie Centre of Excellence for Mental Health in Schools (Department for Education 2022). In 2021, Sheffield Hallam University was commissioned by DYT to work in collaboration to develop and trial a quality assurance framework for DYT’s professional development offer. The intention was to identify where and how DYT could quality assure its offer, drawing on learning and processes from similar initiatives, such as those described above, while building on and exemplifying DYT’s existing approaches, strategies and developmental activities. The work signifies DYT’s commitment to understanding and communicating the quality of its professional development, supporting the professional learning of educators who work with learners with literacy difficulties.   In this report, we describe the approach taken to the development and trialling of the quality assurance framework. The outcome of the process is a framework for quality assurance which includes: • a flowchart offering an overview of the process; • a set of quality criteria tailored to DYT’s offer and compatible with other quality assurance measures and processes; • a process by which organisational staff can carry out self-assessment of quality, leading to identification of areas for improvement and to evidence of quality which can be shared with stakeholders. We reflect on our learning from this work, including how engagement in the self-assessment process led to consideration of how quality assurance aligns with organisational aims and strategies, and how these contribute to a coherent, organisation-wide approach to quality assurance. Next we identify some barriers to engagement in a quality assurance process such as the need to commit time to collating and reviewing evidence, and the challenges of identifying areas for improvement internally while externally communicating evidence of quality. We consider how these barriers can be overcome, for example by using a staggered approach to quality assurance in which different parts of the offer are reviewed at different times, and by seeing the process as one which can itself be improved through ongoing review. We end by recommending that other professional development organisations consider similar approaches and share the outcomes of their quality assurance and review activities. In this way, these often internal processes become more transparent, so that we collectively gain a wider understanding of how professional development activities are designed and evaluated, and ultimately achieve higher standards of professional development for all education practitioners

    Creating the first national linked dataset on perinatal and maternal outcomes in Australia: Methods and challenges

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    © 2019 Elsevier Inc. This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/ This author accepted manuscript is made available following 12 month embargo from date of publication (March 2019) in accordance with the publisher’s archiving policyBackground Data linkage offers a powerful mechanism for examining healthcare outcomes across populations and can generate substantial robust datasets using routinely collected electronic data. However, it presents methodological challenges, especially in Australia where eight separate states and territories maintain health datasets. This study used linked data to investigate perinatal and maternal outcomes in relation to place of birth. It examined data from all eight jurisdictions regarding births planned in hospitals, birth centres and at home. Data linkage enabled the first Australia-wide dataset on birth outcomes. However, jurisdictional differences in data collection created challenges in obtaining comparable cohorts of women with similar low-risk pregnancies in all birth settings. The objective of this paper is to describe the techniques for managing previously linked data, and specifically for ensuring the resulting dataset contained only low-risk pregnancies. Methods This paper indicates the procedures for preparing and merging linked perinatal, inpatient and mortality data from different sources, providing technical guidance to address challenges arising in linked data study designs. Results We combined data from eight jurisdictions linking four collections of administrative healthcare and civil registration data. The merging process ensured that variables were consistent, compatible and relevant to study aims. To generate comparable cohorts for all three birth settings, we developed increasingly complex strategies to ensure that the dataset eliminated women with pregnancies at risk of complications during labour and birth. It was then possible to compare birth outcomes for comparable samples, enabling specific examination of the impact of birth setting on maternal and infant safety across Australia. Conclusions Data linkage is a valuable resource to enhance knowledge about birth outcomes from different settings, notwithstanding methodological challenges. Researchers can develop and share practical techniques to address these challenges. Study findings suggest that jurisdictions develop more consistent data collections to facilitate future data linkage
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