Factors Influencing the Body Composition of Adolescents and Young Adults with Down Syndrome

The aim of this thesis was to describe the body composition of adolescents and young adults with Down syndrome and relationships with physiological, behavioural and social factors including dietary intake and physical activity. A high proportion of adolescents and young adults with Down syndrome had an anthropometry and body composition indicative of overweight and obesity. Young people with Down syndrome need to be supported to be more physically active and consume a healthier diet

The impact of eLearning tools on the interprofessional learning experience in a first year foundations health unit

Foundations for Professional Health Practice 100 is a first year first semester unit that was developed for the Faculty of Health Sciences’ interprofessional common first year. To investigate the effectiveness of eLearning tools to assist the students in meeting two of the unit learning outcomes a cross sectional survey was undertaken. Results of the survey demonstrated that most eLearning tools (eg. Blackboard quizzes, wiki, Elluminate Live!, iPortfolio, Turnitin, and vodcasts) were effective in enabling students to achieve one or more of the course learning outcomes. These results show the value of using eLearning tools in first year tertiary courses to enhance student engagement and academic progress

Feasibility of assessing diet with a mobile food record for adolescents and young adults with Down syndrome

Technology-based methods for assessing diet in those with disability remains largely unexplored. The aim was to assess the feasibility of assessing diet with an image-based mobile food record application (mFR) in 51 adolescents and young adults with Down syndrome (PANDs). Adherence was also assessed with the instruction to include a fiducial marker object in the before and after eating images. The PANDs sample completed a four-day mFR and results were compared with a sample of young adults from the Connecting Health and Technology study (CHAT, n = 244). Compared to the CHAT sample, PANDs participants reported more fruit (2.2 ± 1.8 versus 1.0 ± 0.9 serves respectively) and vegetables (2.4 ± 1.3 versus 1.9 ± 1.0 serves, respectively), but no differences in energy-dense nutrient-poor (EDNP) foods and beverages were observed. Compared to CHAT, PANDs participants captured fewer images with the mFR (4.9 ± 2.3 versus 4.0 ± 1.5 images, respectively). Adherence to the instruction to include the fiducial marker in images was lower for PANDs compared with the CHAT sample (90.3% versus 96.5%). Due to the quality of information captured in images and the high acceptability of the fiducial marker, the mFR shows great promise as a feasible method of assessing diet in adolescents and young adults with Down syndrome

Health Conditions and Their Impact among Adolescents and Young Adults with Down Syndrome

Objective: To examine the prevalence of medical conditions and use of health services among young adults with Down syndrome and describe the impact of these conditions upon their lives. Methods: Using questionnaire data collected in 2011 from parents of young adults with Down syndrome we investigated the medical conditions experienced by their children in the previous 12 months. Univariate, linear and logistic regression analyses were performed. Results: We found that in addition to the conditions commonly experienced by children with Down syndrome, including eye and vision problems (affecting 73%), ear and hearing problems (affecting 45%), cardiac (affecting 25%) and respiratory problems (affecting 36%), conditions also found to be prevalent within our young adult cohort included musculoskeletal conditions (affecting 61%), body weight (affecting 57%), skin (affecting 56%) and mental health (affecting 32%) conditions and among young women menstrual conditions (affecting 58%). Few parents reported that these conditions had no impact, with common impacts related to restrictions in opportunities to participate in employment and community leisure activities for the young people, as well as safety concerns. Conclusion: There is the need to monitor, screen and provide appropriate strategies such as through the promotion of healthy lifestyles to prevent the development of comorbidities in young people with Down syndrome and, where present, to reduce their impact

International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist

Feasibility of Assessing Diet with a Mobile Food Record for Adolescents and Young Adults with Down Syndrome

Technology‐based methods for assessing diet in those with disability remains largely unexplored. The aim was to assess the feasibility of assessing diet with an image‐based mobile food record application (mFR) in 51 adolescents and young adults with Down syndrome (PANDs). Adherence was also assessed with the instruction to include a fiducial marker object in the before and after eating images. The PANDs sample completed a four‐day mFR and results were compared with a sample of young adults from the Connecting Health and Technology study (CHAT, n = 244). Compared to the CHAT sample, PANDs participants reported more fruit (2.2 ± 1.8 versus 1.0 ± 0.9 serves respectively) and vegetables (2.4 ± 1.3 versus 1.9 ± 1.0 serves, respectively), but no differences in energy‐dense nutrient‐poor (EDNP) foods and beverages were observed. Compared to CHAT, PANDs participants captured fewer images with the mFR (4.9 ± 2.3 versus 4.0 ± 1.5 images, respectively). Adherence to the instruction to include the fiducial marker in images was lower for PANDs compared with the CHAT sample (90.3% versus 96.5%). Due to the quality of information captured in images and the high acceptability of the fiducial marker, the mFR shows great promise as a feasible method of assessing diet in adolescents and young adults with Down syndrome

'It's very hard to find what to put in the kid's lunch': What Perth parents think about food for school lunch boxes

Aim: To describe the factors affecting school food selection by parents of young children attending low socioeconomic schools in Perth and recommend the features of resources parents need to make healthier choices. Methods: Nine focus groups of parents of young children attending low socioeconomic status schools in Perth were conducted where parents were asked about the food their children ate at school and their opinions of school food resources. Results: Focus group discussion centred on the themes of the challenge of being a good parent by providing healthy lunch box food; making compromises in what their children eat at school and the barriers to healthy eating in the school environment. Parents were concerned about what their children were eating at school but the barriers of convenience, child preference, cost and food safety prevented them from including healthier food in the lunch box. The amount of time allowed for eating and lack of refrigeration were school-based barriers that impacted on the type and amount of food selected. Parents liked colourful, practical school food resources with recipes and nutrition information aimed at children. Conclusions: Parents want help with selecting lunch box food/drinks that are nutritious, convenient, inexpensive and appealing for children to eat. Schools need to be supported to introduce healthy eating programs and should review the time given for young children to eat at school. Dietitians need to consider the home food environment and what motivates parents to make food choices for their children

Challenges and Opportunities Implementing an ePortfolio Approach to Interprofessional Health Education in Australia

Background/Rationale: The assurance of learning of key capabilities and competencies by university graduates is a world-wide movement: measures such as the Collegiate Learning Assessment (Hardison & Vilamovska, 2009) attempt to report quantitative measures. In recent years there has been growing interest in capturing broader and, in the United States, essential learning outcomes (Association of American Colleges and Universities, 2004) and learning over time through ePortfolios (Rhodes, 2011). In Australia, universities have implemented graduate attributes (Coates, 2010). Curtin University has a whole of curriculum approach to mapping and evaluating achievement, and focal to this is its newly implemented iPortfolio (Oliver, 2009). Methods/Methodology: The Health Sciences faculty has recently implemented an interprofessional capability framework, and an interprofessional first year curriculum. Curtin University’s iPortfolio is an online space for students and staff to create, share and publish evidence of their learning achievements and professional development. It provides social networking features that encourage students to seek feedback from on their work and achievement of learning outcomes. iPortfolio has been utilised in one of the large (1800 student) first semester units Foundations for Professional Health Practice 100 as a tool for evaluating student development of key professional skills and as a means of giving and receiving feedback from an interprofessional peer learning group.Results: Early anecdotal evidence suggests that despite the challenges of introducing new technology to a large cohort, students engaged with the technology and are using it effectively to reflect on their learning. There were several challenges introducing iPortfolio which were faced by staff and students however through communication and responsiveness of information technology staff these were overcome. Conclusion: Introducing new iPortfolio technology into a new large interprofessional unit brings challenges which when overcome lead to unique and exciting opportunities for collaboration and learning in interprofessional peer learning groups in health

Ensuring Health Graduates' Employability in a Changing World: Developing Interprofessional Practice Capabilities Using a Framework to Inform Curricula

Curtin University introduced an interprofessional first year curriculum in the Faculty of Health Sciences in 2011. This curriculum, now delivered to over 3,300 first year health science students annually, consists of five common compulsory units, eight optional units (specific to several courses) and one discipline specific unit for each course. Significantly, the learning outcomes are informed by an Interprofessional Capability Framework (Brewer & Jones, 2013). This paper reports on a study which aimed to analyse the use of the capability framework in supporting the development of the desired interprofessional capabilities. This qualitative study was based on data from student reflective journals in one of the large common units. The sample consisted of 105 of the 411 students enrolled in one of the common units (response rate 25.6 percent) in the second major teaching period (semester two) in 2011. The data was analysed via NVivo8© to provide a holistic view of the content of the reflections as they related to the Interprofessional Capability Framework. The results indicate that the use of the Interprofessional Capability Framework in structuring the learning outcomes has influenced student learning. This is evidenced by the correlation between the themes which emerged during the coding of the data and the Interprofessional Capability Framework. For example, ‘Client-centred’ was the most frequently coded theme, followed by Collaboration, Team Function, and Quality Care, all of which are reflected in the Framework.The major finding of the study is that the framework did have an impact in guiding the development of the foundational interprofessional unit; the learning outcomes included key elements of the framework, the learning experiences were designed to meet these outcomes, and the assessment utilising a reflective journal was designed to measure the development of novice interprofessional capabilities