Promoting Resilience amongst Young People Transitioning from Care to Independent Living: Experiences of Residential Social Care Workers

The capacity for a young adult to develop and overcome obstacles in life underpins the concept of resilience building (Gilligan, 1997). A key role of the social care worker is to ensure that young adults growing up in the care system are afforded the best possible outcomes. This includes social care workers helping young people build their resilience in preparation for the transition into independent living and aftercare. The research reported here examines the experiences and perspectives of two residential social care workers regarding the promotion of resilience amongst young people transitioning from residential care to independent living. From analysis of the data collected, three themes were identified: the importance of a secure base, maintaining consistent and long-term relationships and challenges faced by social care workers in building the resilience of care leavers. Findings concur with previous research, which identified the importance of young people having a secure base in their lives as well as long-term relationships as a source of support to aid them in their transition from care to independence. This research in exploring some of the challenges of helping build the resilience of care leavers highlights the possible value of allowing young people to engage in positive risk taking opportunities in order to build important life skills for independent livin

Development and Validation of a Food-Frequency Questionnaire for the Determination of Detailed Fatty Acid Intakes

Objective: To validate a fat intake questionnaire (FIQ) developed to assess habitual dietary intake while focusing on the assessment of detailed fatty acid intake including total trans unsaturated fatty acids (TUFA). Design: An 88 food item/food group FIQ was developed using a meal pattern technique. Validation was achieved by comparison with dietary intake assessed by a modified diet history (DH) in a cross-over design. Eighty-four individuals supplied adipose tissue biopsies for linoleic acid and total TUFA analysis as an independent validation of the FIQ and DH. Setting: Medical Centre, Dublin Airport, Republic of Ireland. Subjects: One hundred and five healthy volunteers (43 females and 62 males aged 23–63 years). Results: Significant correlations (P , 0.0005) were achieved for intakes of energy (0.78), total fat (0.77), saturated fat (0.77), monounsaturated fat (0.63), polyunsaturated fat (0.73), TUFA (0.67) and linoleic acid (0.71) assessed by the FIQ compared with the DH. Linoleic acid intake assessed by the FIQ and the DH was significantly correlated with adipose tissue concentrations (r ¼ 0.58 and 0.49, respectively; P , 0.005); however, total TUFA intake was poorly correlated with adipose tissue concentrations (r ¼ 0.17 and 0.10 for FIQ and DH, respectively). Conclusions: The FIQ compared favourably with the DH in assessing habitual diet, in particular fatty acid intake. In addition, the FIQ was successfully validated against the linoleic acid composition of adipose tissue, an independent biomarker of relative fatty acid status. The FIQ could therefore be used as an alternative to the DH as it is a shorter, less labour-intensive method

Preoperative Exercise to Improve Fitness in Patients Undergoing Complex Surgery for Cancer of the Lung or Oesophagus (PRE-HIIT): Protocol for a Randomized Controlled Trial

Patients with cancer of the lung or oesophagus, undergoing curative treatment, usually require a thoracotomy and a complex oncological resection. These surgeries carry a risk of major morbidity and mortality, and risk assessment, preoperative optimisation, and enhanced recovery after surgery (ERAS) pathways are modern approaches to optimise outcomes. Pre-operative fitness is an established predictor of postoperative outcome, accordingly, targeting pre-operative fitness through exercise prehabilitation has logical appeal. Exercise prehabilitation is challenging to implement however due to the short opportunity for intervention between diagnosis and surgery. Therefore, individually prescribed, intensive exercise training protocols which convey clinically meaningful improvements in cardiopulmonary fitness over a short period need to be investigated. This project will examine the influence of exercise prehabilitation on physiological outcomes and postoperative recovery and, through evaluation of health economics, the impact of the programme on hospital costs

Guidelines for the management of postmenopausal osteoporosis for GPs

Copyright © 2004 Royal Australian College of General Practitioners Copyright to Australian Family Physician. Reproduced with permission. Permission to reproduce must be sought from the publisher, The Royal Australian College of General Practitioners.Background: Since the last series of guidelines on the management of osteoporosis from Osteoporosis Australia was published in Australian Family Physician (October 2002), there have been further advances in our understanding of the treatment involved in both the prevention of bone loss and the management of established osteoporosis. Objective: This article provides updated guidelines for the management of postmenopausal osteoporosis to assist general practitioners identify those women at risk, and reviews current treatment strategies. DISCUSSION: Osteoporosis and its associated problems are major health concerns in Australia, especially with an aging population. While important principles of management are still considered to be maximising peak bone mass and preventing postmenopausal bone loss, new clinical trial data about drugs such as the bisphosphonates, raloxifene and oestrogen have recently become available and the relative role of various agents is gradually becoming clearer. The use of long term hormone therapy has mixed risks and benefits that requires individual patient counselling.O'Neill S; MacLennan A; Bass S; Diamond T; Ebeling P; Findlay D; Flicker L; Markwell A; Nowson C; Pocock N; Sambrook P; Singh M

Guidelines for the management of postmenopausal osteoporosis for GPs

BACKGROUND : Since the last series of guidelines on the management of osteoporosis from Osteoporosis Australia was published in Australian Family Physician (October 2002), there have been further advances in our understanding of the treatment involved in both the prevention of bone loss and the management of established osteoporosis.OBJECTIVE : This article provides updated guidelines for the management of postmenopausal osteoporosis to assist general practitioners identify those women at risk, and reviews current treatment strategies.DISCUSSION : Osteoporosis and its associated problems are major health concerns in Australia, especially with an aging population. While important principles of management are still considered to be maximising peak bone mass and preventing postmenopausal bone loss, new clinical trial data about drugs such as the bisphosphonatesr raloxifene and oestrogen have recently become available and the relative role of various agents is gradually becoming clearer. The use of long term hormone therapy has mixed risks and benefits that requires individual patient counselling.<br /

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Multidisciplinary Rehabilitation in Oesophago-gastric Cancer Surviorship

As survival rates for oesophageal and gastric cancer slowly improve, there has been an emergence of a unique cohort of cancer survivors who present with multifaceted nutritional and physical needs which are amenable to rehabilitative measures. Multidisciplinary rehabilitation in oesophago-gastric cancer has been under explored and accordingly, this thesis aimed to examine i) the feasibility, ii) the efficacy of multidisciplinary rehabilitation in oesophago-gastric cancer survivorship. Study I of this thesis established the feasibility of a 12 week multidisciplinary rehabilitation consisting of supervised and homebased exercise sessions, 1:1 dietary counselling, and group education sessions. Feasibility was demonstrated by the recruitment rate, adherence rates to exercise sessions, lack of adverse events, and positive improvements in cardiorespiratory fitness (VO2max), physical performance (six minute walk test), and global health related quality of life (HRQOL). Importantly, body composition remained stable during the 12 week programme. Study II further investigated the efficacy of the 12 week multidisciplinary rehabilitation programme by Randomised Controlled Trial. The study was powered to detect a change in the primary outcome cardiorespiratory fitness (VO2max). Participants were randomised to a usual care control group (n=22), or intervention group (n=21). Accounting for baseline values, the intervention group experienced statistically significant improvements in VO2max compared to the control group upon completion of the 12 week programme and at 3 month follow-up. As per Study I, body composition remained stable. No changes were observed in any of the secondary measures (six minute walk test, hand grip strength, 1-repitition max, accelerometer measured activity levels, and HRQOL). Study III utilized qualitative methods to explore the challenges faced in returning to physical activity in the first 6 months of recovery post-oesophagogastric cancer surgery. Participants in Study III identified a myriad of issues which are barriers to returning to physical activity post-oesophagogastric surgery, and also reported the need for rehabilitative interventions in the first six months of recovery. The results of this thesis highlight that multidisciplinary rehabilitation is effective, safe, and achievable in this complex cohort