Increasing food insecurity severity is associated with lower diet quality.

OBJECTIVE: Food insecurity may reduce diet quality, but the relationship between food insecurity severity and diet quality is under-researched. This study aimed to examine the relationship between diet quality and severity of household food insecurity. DESIGN: A cross-sectional, online survey used the United States Department of Agriculture Household Food Security Six-item Short Form to classify respondents as food secure or marginally, moderately or severely food insecure. The Australian Recommended Food Score (ARFS; scored 0­73) determined diet quality (ARFS total and sub-scale scores). Survey-weighted linear regression (adjusted for age, sex, income, education, location and household composition) was conducted. SETTING: Tasmania, Australia. PARTICIPANTS: Community-dwelling adults (aged 18 years and over). RESULTS: The mean ARFS total for the sample (n 804, 53 % female, 29 % aged > 65 years) was 32·4 (sd = 9·8). As the severity of household food insecurity increased, ARFS total decreased. Marginally food-insecure respondents reported a mean ARFS score three points lower than food-secure adults (B = ­2·7; 95 % CI (­5·11, ­0·34); P = 0·03) and reduced by six points for moderately (B = ­5·6; 95 % CI (­7·26, ­3·90); P < 0·001) and twelve points for severely food-insecure respondents (B = ­11·5; 95 % CI (­13·21, ­9·78); P < 0·001). Marginally food-insecure respondents had significantly lower vegetable sub-scale scores, moderately food-insecure respondents had significantly lower sub-scale scores for all food groups except dairy and severely food-insecure respondents had significantly lower scores for all sub-scale scores. CONCLUSIONS: Poorer diet quality is evident in marginally, moderately and severely food-insecure adults. Interventions to reduce food insecurity and increase diet quality are required to prevent poorer nutrition-related health outcomes in food-insecure populations in Australia.

The grammaticality judgement of inflectional morphology in children with and without Developmental Language Disorder.

To explore the clinical potential of grammaticality judgement tasks, this study investigated whether a Grammaticality Judgment Task (GJT) of inflectional morphology could differentiate between a clinically selected sample of children with DLD and children in mainstream (i.e. regular education) schools. We also explored the relationship between grammaticality judgement and measures of receptive vocabulary, receptive grammar, and nonword repetition. Children with DLD (n = 30; age range = 69-80 months) and mainstream children in Pre-primary, Year 1, and Year 2 (n = 89, age range = 61-96 months) were assessed on a GJT of regular past tense, third person singular, and possessive 's. The GJT was sensitive to developmental differences in mainstream children and differentiated children with DLD from Year 1 and 2 mainstream children, with DLD results consistent with a one-year delay in performance compared to controls. The GJT was the strongest discriminator of membership to a clinically selected sample of children with DLD (ROC curve analysis, area under the curve = 88%). Receptive grammar, receptive vocabulary, and nonword repetition were related to performance on the GJT. The grammaticality judgement of inflectional morphology shows promise as a reliable indicator of DLD and a measure sensitive to developmental differences in mainstream children. GJTs should continue to be explored for clinical application as a potential tool for both assessment and intervention.

'Growing your own' a case study of a collaborative training program in medical radiation science.

INTRODUCTION: Two universities run a collaborative Medical Radiation Science program where students undertake study in Tasmania before transferring to a partner university in another state to complete their program. This study assessed rates and predictors of graduate radiographers, radiation therapists and nuclear medicine technologists (collectively classified as medical radiation practitioners according to AHPRA [https://www.medicalradiationpracticeboard.gov.au/About.aspx; ahpra.gov.au/registration/registers] contemporary classification) returning to Tasmania and rural locations to practice. METHODS: A cross-sectional 22-item online survey including open-ended questions was administered via Facebook. Rates of graduates working in Tasmania and rural locations, work satisfaction, and program efficacy were assessed. Logistic regression was used to assess predictors of working in Tasmania and rural locations. RESULTS: 58 Facebook members from a total of 87 program graduates were invited to participate. Of these, 21 responded. Thirteen (62.0%) were currently working in Tasmania, of which the majority practised in regional (MMM2) areas. Most (90.5%) reported that they were happy at work, with all participants reporting the course prepared them well or very well for their first professional jobs. 71.4% stated that the provision of the first 2 years of the course in their home state influenced their decision to study medical radiation science. Being born in a rural region (MMM > 2) was a predictor for working in Tasmania (OR = 3.5) and rural locations (OR = 1.77). Males were twice as likely to work in Tasmania (OR = 2.3) and more rural locations (OR = 2.0). CONCLUSIONS: Collaboration is beneficial in producing professionals in regions with smaller enrolments limit the ability to grow their own graduates independently. Interuniversity collaborative models are recommended for other rural regions to meet local health workforce needs.

Psychometric Evaluation of the Grit Psychological Resources Scale (GPRS).

Background: Psychological resources have been shown to play a prominent role in buffering against stress and are associated with various positive constructs, including grit, defined as having the disposition to pursue long-term goals with both passion and perseverance. Objective: The objective of this study was to validate a new scale developed to measure the psychological resources of grit. Methods: A quantitative research study was conducted online with an international sample of 277 adults from a range of professional backgrounds. The psychometric properties of the 20-item Grit Psychological Resources Scale (GPRS) were evaluated by performing tests of reliability and validity. Results: Reliability tests provided evidence of high internal consistency (α = 0.91) and test-retest reliability (r = 0.75). Demographic variables did not significantly predict scores or influence survey completion. Face, content and convergent validity provided additional psychometric support for the GPRS with this sample. Confirmatory factor analysis results supported a second-order model with four sub-scales. The first-order factors loaded highly onto the second-order factor, with correlations ranging from 0.80 to 0.97. Conclusion: The GPRS showed satisfactory psychometric properties, indicating that the scale is a reliable and valid instrument for measuring the psychological resources of grit. This scale can be used to identify more targeted developmental approaches for personal and professional growth. Further, the tool enables information to be gathered on changes pre- and post-improvement initiatives to assess their effectiveness in training and continuing education.

Exploring Community-Based Suicide Prevention in the Context of Rural Australia: A Qualitative Study.

Suicide rates in rural communities are higher than in urban areas, and communities play a crucial role in suicide prevention. This study explores community-based suicide prevention using a qualitative research design. Semi-structured interviews and focus groups asked participants to explore community-based suicide prevention in the context of rural Australia. Participants recruited ((n = 37; ages 29-72, Mean = 46, SD = 9.56); female 62.2%; lived experience 48.6%) were self-identified experts, working in rural community-based suicide prevention (community services, program providers, research, and policy development) around Australia. Data were thematically analysed, identifying three themes relating to community-based suicide prevention: (i) Community led initiatives; (ii) Meeting community needs; and (iii) Programs to improve health and suicidality. Implementing community-based suicide prevention needs community-level engagement and partnerships, including with community leaders; gatekeepers; community members; people with lived experience; services; and professionals, to "get stuff done". Available resources and social capital are utilised, with co-created interventions reflecting diverse lifestyles, beliefs, norms, and cultures. The definition of "community", community needs, issues, and solutions need to be identified by communities themselves. Primarily non-clinical programs address determinants of health and suicidality and increase community awareness of suicide and its prevention, and the capacity to recognise and support people at risk. This study shows how community-based suicide prevention presents as a social innovation approach, seeing suicide as a social phenomenon, with community-based programs as the potential driver of social change, equipping communities with the "know how" to implement, monitor, and adjust community-based programs to fit community needs.

Comparison of stationary and dynamic fractional CO2 laser modalities of large burns treatment: Experimental laboratory model.

OBJECTIVES: To experimentally compare two fractional ablative CO2 laser handpieces intended for the treatment of large area burn scars. Each handpiece coverage rate, depth of penetration and application time were measured and compared in a simulation model of large area burns scars using a dynamic/roller handpiece (small footprint) and a stationary/stamping handpiece (large footprint). METHODS: A 30 W fractional ablative CO2 laser was applied using 2 different handpieces and footprints on a A4 size paper stack. The handpieces were a stationary (stamping) handpiece with 7 × 7 (49 pixels/square shape) and dynamic (roller) handpiece with 7 × 1 (7 pixels/single row shape). For both handpieces the laser settings were fixed at "High" power (30 W), providing an energy level of 100 mJ/pixel. Both handpieces were applied perpendicular to the surface, with the process repeated for the dynamic handpiece with an angled operation. The depth of laser penetration was assessed by the number of pages of paper having visible holes and burn area coverage time measured under each handpiece/condition. RESULTS: The application time was faster and the penetration deeper for the dynamic handpiece compared to the stationary handpiece in both the perpendicular and angled conditions. This study has practical implications for lasers operators to improve time efficacy in large area scars with improved clinical endpoints. CONCLUSION: The fractional ablative dynamic handpiece demonstrated superior application efficiency compared to the stationary handpiece in the simulated treatment of large surface area burn scars, reducing treatment time with improved depth of penetration.

Match-play movement demands of international and domestic women's rugby sevens players in an elite dual-level tournament.

OBJECTIVES: To characterize and compare match-play movement demands via Global Positioning Systems (GPS) between international and domestic women's rugby sevens players performing in a novel elite dual-level tournament, with consideration to position and tournament characteristics. DESIGN: Fifty-four rugby sevens players; twenty-one international(5 speed edges, 8 backs, 8 forwards), and thirty-three domestic(10 speed edges, 11 backs, 12 forwards) wore GPS devices during an elite dual-level tournament covering 2 seasons, with 367 full match-play data files analysed. Internationaland domestic players were distributed evenly between competing teams. METHODS: Match-play movement demands were characterized by distance, speed, and acceleration-based indices from 5 to 10 Hz GPS devices. RESULTS: International players recorded significantly higher high-intensity match-play movement demands compared to domestic players in distance in high and very high-speed zones (P = 0.01, P = 0.03, P = 0.01, P = 0.03), maximal acceleration (P = 0.001), maximal velocity (P < .001), speed exertion (P = 0.01), , and acceleration load density (P = 0.03) . Positional analysis demonstrated forwards displayed the largest significant differences between international and domestic players. . Total and relative match-play movement demands of the dual-leveltournament also showed comparable demands to previous international tournament research . CONCLUSIONS: Results identify key points of difference in match-play movement demands between player levels in women's rugby sevens, and provides important information on the characteristics of playing positions, and of a dual-level tournament of this nature. This will improve the design and implementation of structures from domestic to international level.

Severity of Food Insecurity among Australian University Students, Professional and Academic Staff.

Assessments of the severity of food insecurity within Australian university students are lacking, and the experience of food insecurity in Australian university staff is unknown. A cross-sectional online survey in March 2022 aimed to characterize the severity of food insecurity in students, professional and academic staff at the University of Tasmania (UTAS). The Household Food Security Survey Module six-item short form assessed food security status in addition to seven demographic and education characteristics for students and six demographic and employment characteristics for staff. Participants were categorized as having high, marginal, low, or very low food security. Multivariate binary logistic regression identified students and staff at higher risk of food insecurity. Among student respondents (n = 1257), the prevalence of food insecurity was 41.9% comprising 8.2% marginal, 16.5% low, and 17.3% very low food security. Younger, non-binary, first-year enrolled, on campus, and international students were at significantly higher risk of food insecurity. Among staff (n = 560), 16.3% were food insecure comprising 3.8% marginal, 5.5% low, and 7.0% very low food security. Professional staff, staff on casual contracts, and staff recently employed, were at significantly higher risk of food insecurity. Our findings suggest a high occurrence of food insecurity in UTAS students and staff, with a large proportion of food insecure staff and students experiencing very low food security. Our findings have implications for efforts towards reducing food insecurity at university campuses through a holistic and integrated approach, advocating for food systems that support healthy, sustainable, and equitable food procurement and provision for both university students and staff.

The new normal for food insecurity? A repeated cross-sectional survey over 1 year during the COVID-19 pandemic in Australia.

BACKGROUND: Food insecurity during the COVID-19 pandemic has been impacted by necessary public health restrictions. Tasmania, an island state south of the Australian mainland, recorded no community transmission of COVID-19 between May 2020 to November 2021 due to strong border restrictions. This study aimed to determine the changes in prevalence and sociodemographic predictors of food insecurity throughout the COVID-19 pandemic in Tasmania, Australia. METHODS: In May 2020 (survey 1: during lockdown), September 2020 (survey 2: eased restrictions) and May 2021 (survey 3: 1-year post-lockdown), cross-sectional, online surveys using convenience sampling methods determined food insecurity in Tasmanian adults using the USDA Household Food Security Survey Module: Six-Item Short Form, in addition to key sociodemographic questions. Crude and age-adjusted prevalence of food insecurity was calculated, and binary logistic regression determined at-risk groups and changes in prevalence over time. RESULTS: The age-adjusted prevalence of food insecurity was 27.9% during lockdown (n = 1168), 19.5% when restrictions had eased (n = 1097) and 22.6% 1-year post-lockdown (n = 1100). Young adults, Aboriginal and/or Torres Strait Islander people, individuals with disabilities, families with dependents and temporary residents were at highest risk across all time points. CONCLUSIONS: The prevalence of food insecurity was higher than pre-pandemic levels across all three time points. Our results indicate the potential long-term impacts of the COVID-19 pandemic on food security in Australia, where despite easing social distancing restrictions and a lack of COVID-19 transmission, the prevalence of food insecurity reduced, but did not recover to pre-pandemic levels 1-year following a lockdown.

Can ten days of heat acclimation training improve temperate-condition rowing performance in national-level rowers?

This study investigated whether heat acclimation (HA) could improve rowing performance in temperate conditions in national-level rowers. Using a parallel-group design, eleven rowers (3 female, 8 male, age: 21±3 years, height: 182.3±6.8cm, mass: 79.2±9.0kg, [Formula: see text]: 61.4±5.1ml·kg·min-1) completed either a HA intervention (HEAT, n = 5) or acted as controls (CON, n = 6). The intervention replaced usual cross-training sessions and consisted of an hour of submaximal cycling or rowing ergometry in either 34±0°C for HEAT or 14±1°C for CON daily over two five-day blocks (10 sessions total), separated by 72h. Participants performed the '10+4' test that consists of 10-min submaximal rowing and a 4-min time-trial (TT) in temperate conditions (20±0°C) before and after the intervention. Heat acclimation following the 10-session intervention was evidenced by large significant (p<0.05) decreases in maximum tympanic temperature (d = -1.68) and rate of perceived exertion (RPE) (d = -2.26), and a large significant increase in sweat loss (d = 0.91). Large non-significant (p>0.05) decreases were seen in average tympanic temperature (d = -3.08) and average heart rate (d = -1.53) in HEAT from session 2 to session 10 of the intervention. Furthermore, a large significant increase was seen in plasma volume (d = 3.74), with large significant decreases in haemoglobin concentration (d = -1.78) and hematocrit (d = -12.9). Following the intervention, large non-significant increases in respiratory exchange ratio (d = 0.87) and blood lactate (d = 1.40) as well as a large non-significant decrease in RPE (d = -1.23) were seen in HEAT during the 10-min submaximal rowing. A large significant decrease in peak heart rate (d = -2.27), as well as a large non-significant decrease in relative [Formula: see text] (d = -0.90) and large non-significant increases in respiratory exchange ratio (d = 1.18), blood lactate concentration (d = 1.25) and power output (d = 0.96) were seen in HEAT during the 4-min TT. This study suggests that a 10-session HA intervention may elicit HA in national-level rowers, with potential to improve 4-min TT performance in temperate conditions.

Achieving Long-term Goals Amidst Uncertainty: An Integrative Model for the Psychological Resources of Grit.

This article proposes an integrative model for the psychological resources of grit. The growing body of work in nursing on the topic of grit indicates considerable interest in achieving long-term goals, especially amidst uncertainty from the COVID-19 pandemic. Motivational behaviors are thought to influence engagement in continuing education in nursing, thereby improving clinical practice and patient outcomes. The model was informed by a comprehensive review of the literature. Sixteen attributes for acquiring and strengthening four psychological resources of grit were identified. Each attribute is discussed along with interrelationships and implications for professional nursing development. Given the complex demands placed on health professionals, this model is both timely and relevant for all nurse and education providers interested in enhancing personal characteristics that may mitigate against stress and build capabilities for goal achievement. [J Contin Educ Nurs. 2022;53(8):355-363.].

Development of a scale to measure the psychological resources of grit in adults.

Grit, a personality trait characterized by  having passion and perseverance for long-term goals, has been linked to increased performance, retention, and well-being in various fields. In the 15 years since the original grit scale was published, many studies have investigated factors that promote grit. However, a scale has not yet been developed measuring characteristics that can contribute to higher levels of grit. This study aimed to develop a novel scale to measure the psychological resources of grit. The Delphi technique was used to obtain consensus from a national and international panel of academics and practitioners who are experts in grit and related constructs. A total of 30 participants rated 100 scale items over three rounds of online surveys. Experts agreed that items selected for the final scale (n = 20) were essential, with 85% rating them as important or very important. The scale, called the Grit Psychological Resources Scale, has promise as a helpful tool for practitioners involved in staff development and building capabilities that contribute to goal achievement.

High occurrence of food insecurity in young people attending a youth mental health service in regional Australia.

AIM: Despite the relationship between food insecurity and poor mental health, food insecurity in young people attending mental health services in Australia remains understudied. This study aimed to determine the occurrence and predictors of food insecurity, and the relationship with dietary factors in young people attending a mental health service. METHODS: A cross-sectional online survey was conducted in a sample of young people (15-25 years) who attended a mental health service in Launceston, Australia. The survey utilised a single-item food insecurity screening tool and eight demographic, health and service use questions. Five questions determined self-reported intake of fruit, vegetables, breakfast, water, sugar-sweetened beverages and takeaway foods. Binary logistic regression determined predictors of food insecurity. Cross-tabulations determined differences in dietary intake according to food security. RESULTS: Of survey respondents (n = 48; 68% female), 40% (n = 19) were food insecure. Respondents living out of home or in unstable accommodation were at significantly higher risk of food insecurity (odds ratio [OR]: 4.43; SE: 0.696; 95% CI: 1.13-17.34; p = 0.032) compared to those living with their parents. Those receiving government financial assistance (OR: 5.00; SE: 0.676; 95% CI: 1.33-18.81; p = 0.017) were also at significantly higher risk of food insecurity. Regardless of food security status, self-reported intake of fruits, vegetables and breakfast were low, and respondents regularly consumed takeaway foods and sugar-sweetened beverages. CONCLUSIONS: There was a high occurrence of food insecurity and poor dietary intake in young people attending a youth mental health service demonstrating that initiatives to support access to healthy food in this group should be a priority, with potential benefits for mental health outcomes.

The Effect of Intradialytic Range of Motion Exercise on Dialysis Adequacy and Fatigue in Hemodialysis Patients.

BACKGROUND: Many hemodialysis patients experience fatigue as a result of not achieving dialysis adequacy. PURPOSE: This study was designed to determine the effect of intradialytic range-of-motion exercises on dialysis adequacy and fatigue in patients undergoing hemodialysis. METHODS: In this two-arm experimental study with repeated measures, participants were allocated to treatment ( n = 25, 23 completed) and control ( n = 25, 24 completed) groups using computerized simple random sampling. Participants in the treatment group performed 30-minute weekly intradialytic exercise sessions in addition to receiving standard care, whereas those in the control group received standard care only. RESULTS: Fatigue and dialysis characteristics were reported at baseline, at the midpoint (end of Week 4), and at the end of Week 8. Whereas mean Kt/V (dialysis adequacy) and urea reduction ratio increased and the fatigue level decreased in the treatment group, these variables did not change in the control group. Significant mean differences in Kt/V, urea reduction ratio, and fatigue between the groups were observed at the end of Week 8. CONCLUSIONS: Intradialytic range-of-motion exercises are recommended for patients undergoing hemodialysis to increase dialysis adequacy and reduce fatigue.

Anthocyanin intake is associated with improved memory in older adults with mild cognitive impairment.

Research on the role of dietary anthocyanins in preventing cognitive decline in older adults shows promise. This study investigated the association between usual anthocyanin intake and indices of memory and cognition in 40 older adults diagnosed with mild cognitive impairment that were recruited to a randomized clinical trial. It was hypothesized that daily anthocyanin intake would be similar to healthy older adults and that higher anthocyanin intake would be associated with better cognitive performance. Cognitive performance was assessed using a battery of tests including the Rey Auditory Verbal Learning Test (RAVLT). Dietary intake was assessed through 3-day food records and anthocyanin intake was quantified using the PhenolExplorer food composition database. Multivariate linear regression compared differences in cognitive performance between higher (>10 mg/d) and lower consumers (<10 mg/d). Overall, participants had low median intake of anthocyanins (5.3; interquartile range [IQR], 32.1 mg/d), with the lower consumer group eating negligible anthocyanins (median, 0.13; IQR, 1.5 mg/d), and the higher consumer group eating above the national average (median, 35.5; IQR, 71.5 mg/d). On the RAVLT, the higher anthocyanin consumer group recalled a greater number of words after a short delay and a distracter task (B, 2.07; standard error [SE], 0.93; 95% confidence interval [CI], 0.18-3.96; P = .03) and longer delay of 20 minutes (B, 2.68; SE, 1.11; 95% CI, 0.43-4.94; P = .02); and forgot less words after a long delay of 20 minutes (B, -2.63; SE, 0.63; 95% CI, -3.90 to -1.35; P< .001). Further investigation of the protective role of the usual consumption of dietary anthocyanins for memory and cognition in pathological and normal aging appears warranted. Trial registration: This cross-sectional study uses baseline data from a randomized controlled trial registered with the Australian New Zealand Clinical Trials Registry (ACTRN12618001184268).

The Impact of the COVID-19 Pandemic on Rural Food Security in High Income Countries: A Systematic Literature Review.

Prior to the COVID-19 pandemic, rural-dwelling people in high-income countries were known to have greater challenges accessing healthy food than their urban counterparts. The COVID-19 pandemic has impacted food supplies across the world, and public health restrictions have changed the way people shop for food, potentially exacerbating food insecurity. This systematic literature review aimed to synthesize the available evidence on the impact of the COVID-19 pandemic on aspects of food insecurity in rural populations residing in high-income countries. Five electronic databases were searched, identifying 22 articles that assessed food insecurity prevalence or data on food availability, access, utilization and the stability of the food supply in rural populations during the COVID-19 pandemic. Ten studies examined the prevalence of food insecurity in rural populations, with the reported prevalence ranging from 15% to 95%. Where rural/urban comparisons were presented, most studies (n = 5; 71%) reported that food insecurity was significantly higher in rural regions. Five studies examined the availability of food and eight studies examined access to food, identifying that rural populations often had lower food availability and access to food during the pandemic. In contrast, two studies identified positive effects such as more gardening and increased online access to food. Rural populations experienced multiple changes to food utilization, such as reduced diet quality and food safety observed in eight studies, but this was not shown to be different from urban populations. Additionally, the food supply in rural regions was perceived to be affected in two studies. The results of this review may be used to inform region-specific mitigation strategies to decrease the impact of the current COVID-19 pandemic and future global events on food security. However, the lack of consistency in study outcomes in research on rural populations limits the identification of priority areas for intervention at a global-scale.

Hot water immersion; potential to improve intermittent running performance and perception of in-game running ability in semi-professional Australian Rules Footballers?

This study investigated whether hot water immersion (HWI) could heat acclimate athletes and improve intermittent running performance and perception of in-game running ability, during a competitive Australian Rules Football (ARF) season. Fifteen male semi-professional ARF athletes (Mean (SD); age: 22 (3) years, height: 182.3 (6.5) cm, mass: 80.5 (5.1) kg) completed either HWI (HEAT, N = 8, 13 (2) sessions, 322 (69) min exposure, 39.5 (0.3) °C) or acted as a control (CON, N = 7, no water immersion) over 6-weeks. Athletes completed a 30-15 Intermittent Fitness Test pre and post-intervention to assess intermittent running performance (VIFT), with perception of in-game running ability measured. Heat acclimation was determined via change in resting plasma volume, as well as physiological and perceptual responses during HWI. HEAT elicited large PV expansion (mean ± 90% CI: d = 1.03 ± 0.73), large decreases in heart rate (d = -0.89 ± 0.70), thermal sensation (d = -2.30 ± 1.15) and tympanic temperature (d = -1.18 ± 0.77). Large improvements in VIFT were seen in HEAT (d = 1.67 ± 0.93), with HEAT showing a greater improvement in VIFT when compared to CON (d = 0.81 ± 0.88). HEAT also showed greater belief that in-game running ability improved post-intervention (d = 2.15 ± 1.09) compared to CON. A 6-week HWI intervention can elicit heat acclimation, improve perception of in-game running ability, and potentially improve VIFT in semi-professional ARF athletes.

Psychometric properties of the Nepali language version of the Depression Anxiety Stress Scales (DASS-21).

AIM: To assess the psychometric properties of the Nepali language version of the Depression Anxiety Stress Scales (DASS-21). DESIGN: Descriptive, cross-sectional survey. METHODS: The DASS-21 was administered (May-July 2019) among 794 randomly selected older adults aged ≥60 years. Factor structure was evaluated using exploratory and confirmatory factor analyses. Cronbach's alpha was calculated, and correlation analyses with quality of life evaluated convergent validity. RESULTS: Exploratory factor analysis indicated that the 21 items loaded on three factors, with factor loadings ranging from 0.50-0.88. Confirmatory factor analysis suggested a four-factor model including the three subscales and an additional common 'general distress' factor, which demonstrated a better overall fit. Good reliability was found for each subscale, with Cronbach's alphas 0.79 for Anxiety, 0.91 for Stress, and 0.93 for Depression. The Nepali language version of the DASS-21 satisfied convergent validity with all subscales depicting significant negative correlations with quality of life demonstrating adequate psychometric properties.

Food insecure households faced greater challenges putting healthy food on the table during the COVID-19 pandemic in Australia.

The COVID-19 pandemic negatively affected the Australian food supply. However, it has remained unclear how food access, food availability and consumption were impacted, especially for households experiencing food insecurity. This study aimed to determine the association between food security and cooking and eating habits, food access and availability, self-sufficiency and perceptions of the food supply at the beginning of the COVID-19 pandemic in Tasmania, Australia. Throughout May-June 2020 during strict social distancing restrictions, a cross-sectional survey was conducted including the U.S. Household Food Security Survey Module Six-Item Short Form, twenty Likert scale questions on cooking and eating habits, food access, self-sufficiency and perceptions of the food supply (responses from 1 = strongly agree to 5 = strongly disagree), two questions on food availability and eleven socio-demographic questions. Survey data (n = 1067) were analysed using multivariate linear regression, and binary logistic regression. Food insecure households were significantly more likely to agree they were consuming less fresh food compared with food secure households (Mean difference between scale responses (MD) = 0.66; 95%CI:0.36-0.66; p < 0.001), and significantly more food insecure households agreed it was more difficult to get to the shops (MD = 0.49; 95%CI:0.34-0.64; p < 0.001) and they had less money available for food than prior to the COVID-19 pandemic (MD = 0.95; 95%CI:0.79-1.10; p < 0.001). Compared to food secure households, food insecure households were at significantly greater risk of foods being unavailable to them (OR:1.75; 95%CI:1.33-2.35; p < 0.001) and were less likely to have sufficient food stored in their homes (OR:0.48; 95%CI: 0.33-0.687; p < 0.001). This study indicates there was a disproportionate impact of the COVID-19 pandemic on food insecure households, related to food availability and access, with effects on cooking and eating habits.

Formative online multiple-choice tests in nurse education: An integrative review.

AIM: The aim of this integrative review is to explore how formative online multiple-choice tests used in nurse education promote self-regulated learning and report on pedagogies that support their design. BACKGROUND: Online multiple-choice tests are widely used as learning and formative assessment tools in a range of educational contexts. However, little is known about how these tools are used to promote patterns of learner self-regulation. It is important that nurses and nursing students develop the capability to self-regulate learning to be effective lifelong learners and navigate complex and unfamiliar practice environments. DESIGN: A five-stage approach guided this integrative review: problem identification, literature search, data evaluation, data analysis and presentation. METHOD: A systematic search of ERIC, Web of Science, Ovid Medline, Scopus, PubMed, Embase and CINAHL was conducted in February 2021. Seventeen peer-reviewed papers were identified that discussed formative online multiple-choice tests in nurse education. Purposive sampling and ancestry searching identified an additional paper. Articles were analysed and sorted into themes of outcomes (presented as components of self-regulated learning theory) and pedagogy. RESULTS: Formative online multiple-choice tests are used with good effect in nurse education as measured by knowledge gain and exam performance, increased confidence and learner satisfaction. There was no literature that explored metacognitive outcomes and minimal literature considered behavioural outcomes. Pedagogy supporting the implementation of multiple-choice tests was lacking in most articles. CONCLUSIONS: Formative online multiple-choice tests are widely used with good effect in nurse education. However, opportunities for further research on how these tools can encourage metacognition and self-regulatory behaviours is warranted.