Incidence and Risk Factors for Acute Articular Cartilage Tears in Military and Other Occupational Settings: A Systematic Review.

Damage to the articular cartilage resulting in an acute tear can lead to functional changes within the joint and increase the risk of osteoarthritis developing. There is limited understanding of the association between occupational risk factors and sustaining an acute articular cartilage tear in the military and other physically demanding occupations. Therefore, the aim of this systematic review was to identify and evaluate original research reporting on occupational risk factors associated with sustaining acute articular cartilage tears. METHODS: A systematic review following the Preferred Reporting Items for Systematic review and Meta-Analysis-Protocols was conducted and registered with the Open Science Framework. Key academic databases were searched using terms from the following concepts: risk or cause, paid occupations, and acute articular cartilage tears. RESULTS: Of an initial 941 studies, 2 studies met the eligibility criteria, both reporting data from military contexts; only one evaluated acute articular cartilage tears in both males and females. One paper focused on articular cartilage injury within the knee and the other within the ankle joint with incidence rates being 0.2 and 0.3 per 1000 person-years, respectively. People in more physically active occupations and individuals with an above-normal body mass index were reported as being at higher risk of sustaining an acute articular cartilage tear. CONCLUSION: Physically demanding occupations, such as the military, may increase the risk for acute tears of the articular cartilage. However, the findings of this review indicate there is a paucity of research to underpin understanding of the injury mechanisms and occupational risk factors for acute articular cartilage tears.

Understanding the enablers to implementing sustainable health and well-being programs for older adults in rural Australia: A scoping review.

INTRODUCTION: Supporting the health and well-being of older Australians necessitates the implementation of effective and sustainable community-based interventions. Rural settings, however, pose unique challenges to intervention implementation and sustainability, with limited research exploring strategies employed to overcome these complexities. OBJECTIVE: To identify enabling strategies that support the sustainable implementation of community-based health and well-being interventions for older adults in rural Australia. DESIGN: A scoping review, following methods by Arksey and O'Malley and enhanced by elements of the Joanna Briggs Institute methodology for scoping reviews and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), was conducted. An electronic search of seven databases was completed in April 2023. A thematic analysis was applied to provide a comprehensive and contextualised understanding of the phenomenon of interest. FINDINGS: Of 1277 records screened, 15 studies were identified and included for review. Five themes identified key enablers for rural implementation: (1) Co-designing for the local context; (2) Embedding local champions; (3) Leveraging existing local resources; (4) Maintaining impact beyond the end of the funded period and (5) Flexibility in funding models. DISCUSSION: The sustainable implementation of interventions requires active community involvement and consultation through all stages of program design and delivery to effectively meet the health and well-being needs of older rural-dwelling Australians. CONCLUSION: Our findings advocate for clear implementation guidelines to support the design, delivery and adaptation of community-based programs that appropriately reflect the unique contextual needs and strengths of rural communities.

Interprofessional education: a unique approach to addressing the challenges of student assessment.

There is emerging evidence on the value of interprofessional education (IPE) for health professional students; however, there is less focus on assessing students on IPE experiences in clinical placement contexts. Researchers have focused on student attitudes to, or readiness for, IPE. Multiple other elements need to be assessed, including formative student assessment, profession-specific competency standards, and students' interprofessional (IP) capabilities. Effective and authentic IP-assessment models are needed that can both demonstrate student learning, and facilitate successful sharing of assessment amongst professionals. Supervisor's perspectives on successful sharing of assessment amongst professions have not been addressed to date in the literature. This article describes one approach for IP-Assessment, using a complex theory framework and based on an iterative cycle of developing, implementing, and evaluating a student assessment tool within an international IP placement, which could be utilized in a range of settings. A qualitative research approach explores the strengths, challenges, and outcomes of IP-Assessment from the perspective of the supervisors. Three overarching themes were identified: acknowledging the student journey, interprofessional authenticity, and collective and collaborative learning. The process of developing and implementing IP-Assessment enabled the articulation of placement and assessment priorities and provided learning opportunities for both supervisors and students.

American and Australian family experiences while receiving a diagnosis or having treatment for idiopathic toe walking: a qualitative study.

OBJECTIVE: To understand parent journeys while navigating diagnosis, assessment or treatment of their children with idiopathic toe walking (ITW). DESIGN: Mixed methods qualitative study: analyses of survey data from the measure of processes of care-20 (MPOC-20) and semistructured interviews were analysed with an interpretative phenomenological analysis approach. Trustworthiness of data was achieved through member checking, researcher triangulation, reflexivity and transferability and comparison with the MPOC-20 results. SETTING: USA and Australia. PARTICIPANTS: Parents of children diagnosed with ITW who had seen more than one health professional during their care and lived in Australia or the USA. RESULTS: Ten parents of children aged between 3 and 13 years and diagnosed with ITW participated. Parents described complex themes relating to their journeys. The themes relating to their journeys were: (1) riding the rollercoaster of diagnosis; (2) navigating the treatment options and (3) supporting parents in the journey. Each theme was supported by parent quotes about their experiences. Challenges were not localised to one country, in spite of vastly different healthcare systems. CONCLUSIONS: These findings create opportunities for an international approach to education, treatment recommendations and outcome measures to improve patient and parent experiences. Health professionals should consider the impact on parents in navigating between health professionals when provided with a diagnosis which can have variable outcomes and varied treatment options.

Ageing well: Pilot evaluation of a dual-task training program in a rural community.

OBJECTIVE: This pilot trial examined the feasibility and effectiveness of "Ageing Well," a community-based program for improving cognitive skills and mobility of rural older people. DESIGN AND SETTING: The non-randomised, wait-list-controlled pilot trial was conducted at a regional NSW university clinic. PARTICIPANTS: Twenty-three community-dwelling adults aged 60+ who had begun to experience a decline in their physical or cognitive abilities or both. INTERVENTIONS: Dual-tasking activities simultaneously challenged participants' motor and cognitive abilities. Student facilitators encouraged participants to progress through increasing complex functional tasks in a range of contexts, including a café, supermarket and a simulated "home." MAIN OUTCOME MEASURES: The Patient Reported Evaluation of Cognitive State measured the impact of an individual's cognitive state in terms of how much they were "bothered" by problems with their cognition. Functional mobility was measured by the Timed Up-and-Go, a test of static and dynamic balance, and the Six Minute Walk Test. RESULTS: Intervention participants' Patient Reported Evaluation of Cognitive State ratings in relation to impacts on their performance of everyday skills improved substantially, whereas the control group did not change. Intervention participants walked 12% further in the Six Minute Walk Test post-intervention, while the control group distance did not change. Timed Up-and-Go time was reduced by 1 second in the intervention group. CONCLUSIONS: There is a strong interest in this dual-tasking program among older community-dwelling residents in this rural setting. The results of this pilot study support the feasibility and effectiveness of the Ageing Well program. But further trials are warranted.

Exploration of older people's perceptions of behavioural factors associated with falls.

Background: falls rates in older people continue to rise despite concerted efforts to manage falls risks. As more effective strategies to reduce falls in older people may arise from better understanding their perspectives on falls risk, this study aimed to explore perceptions and behavioural decisions that may affect risk of falling among older people living in regional Australia. Method: this qualitative research, informed by hermeneutics, explored older people's perspectives on decisions they made that could affect their falls risk. The study involved 26 participants (21 females) aged 65-84 years, residing in regional Australia. In total, 13 participated in semi-structured focus groups and 13 in semi-structured, in-depth interviews. Results: six key themes illuminated the challenges older people faced in relation to falls risk. These were: the role that independence played in decision making regarding risk; the influence of previous falls experience; older people's level of understanding of risks; ability and willingness to engage with support; the need or desire to cover up a fall history; and the influence of finances in managing risk. Older people's accounts demonstrated they experienced competing influences that impacted upon decisions they made with respect to falls risks. Most significantly, the complex interplay of these influences drove the decisions older people made, sometimes placing them at greater risk of falling. Conclusion: consideration of the multifaceted issues older people face when managing falls risk, and the influence these factors have on their behaviours, is vital to successfully reducing rates of fall related injuries in this population.

Dealing with the death of a long term patient; what is the impact and how do podiatrists cope?

BACKGROUND: It is common for podiatrists and patients to develop long term professional relationships. Patient's decline in health or death may impact a practitioner's mental wellbeing. This research aimed to understand the impact of long term patient death on podiatrists and identify coping strategies. METHOD: Australian podiatrists were eligible to participate if they had been practicing longer than 5 years and experienced the death of a long term patient in the previous 12 months. Individual semi-structured interviews were conducted with podiatrists and were audio-recorded, transcribed verbatim and individually analysed to identify key themes. Interpretative phenomenological analysis was used to explore the perceptions of podiatrists on the personal and professional impact following the death of a long term patient. RESULTS: Fifteen podiatrists (11 female) with a median of 15 (range 8-50) years' experience participated. Three major themes emerged: acknowledging connections, willing to share and listen, and creating support through starting the conversation. Participants indicated importance in recognition of the emotional influence of professional-patient relationships. They also discussed the importance of debriefing about death with the right person, which was most commonly colleagues. Participants talked about the emotional impact of death, suggesting the need for supporting discussion and resources, especially for new graduates. CONCLUSION: Death and dying can be an emotive topic and one which podiatrists may not be prepared for, yet likely to have to deal with throughout their career. These findings enable a better understanding of the impact of patient death and provide possible future directions for the profession to better support podiatrists in this area.

Impact of an international workplace learning placement on personal and professional development.

BACKGROUND/AIM: Workplace learning (WPL) placements are a mandatory part of occupational therapy courses. There is some evidence that suggests WPL placements in international settings are beneficial for students' learning, and personal and professional development. The aim of this study was to explore the impact an international WPL placement in Vietnam had on the perceived personal and professional development of a group of Australian occupational therapy graduates. METHODS: Interpretative phenomenological analysis was used to explore the perceptions of how participation in the Charles Sturt University School of Community Health's Vietnam placement influenced the personal and professional development of occupational therapy graduates. Individual semi-structured interviews were conducted with nine graduates who participated in the Vietnam placement when they were final year occupational therapy students. Interviews were audio-recorded, transcribed verbatim and individually analysed to identify key themes. FINDINGS: Two major themes emerged from the analysis: becoming resourceful, resilient and confident, and becoming respectful of difference. The participants indicated that participation in the Vietnam placement had a positive impact on their personal and professional development. CONCLUSION: Participants indicated that the Vietnam placement enabled them to develop their resourcefulness, resilience, reasoning skills, cultural competence, confidence and independence, beyond what they felt would have achieved on a domestic placement. For these reason these participants found the placement a beneficial and worthwhile experience.