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1.
BMC Health Serv Res ; 21(1): 897, 2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34465324

RESUMO

BACKGROUND: Urinary catheters are useful among hospital patients for allowing urinary flows and preparing patients for surgery. However, urinary infections associated with catheters cause significant patient discomfort and burden hospital resources. A nurse led intervention aiming to reduce inpatient catheterisation rates was recently trialled among adult overnight patients in four New South Wales hospitals. It included: 'train-the trainer' workshops, site champions, compliance audits and promotional materials. This study is the 'in-trial' cost-effectiveness analysis, conducted from the perspective of the New South Wales Ministry of Health. METHODS: The primary outcome variable was catheterisation rates. Catheterisation and procedure/treatment data were collected in three point prevalence patient surveys: pre-intervention (n = 1630), 4-months (n = 1677), and 9-months post-intervention (n = 1551). Intervention costs were based on trial records while labour costs were gathered from wage awards. Incremental cost effectiveness ratios were calculated for 4- and 9-months post-intervention and tested with non-parametric bootstrapping. Sensitivity scenarios recalculated results after adjusting costs and parameters. RESULTS: The trial found reductions in catheterisations across the four hospitals between preintervention (12.0 % (10.4 - 13.5 %), n = 195) and the 4- (9.9 % (8.5 - 11.3 %), n = 166 ) and 9- months (10.2 % (8.7 - 11.7 %) n = 158) post-intervention points. The trend was statistically non-significant (p = 0.1). Only one diagnosed CAUTI case was observed across the surveys. However, statistically and clinically significant decreases in catheterisation rates occurred for medical and critical care wards, and among female patients and short-term catheterisations. Incremental cost effectiveness ratios at 4-months and 9-months post-intervention were $188 and $264. Bootstrapping found reductions in catheterisations at positive costs over at least 72 % of iterations. Sensitivity scenarios showed that cost effectiveness was most responsive to changes in catheterisation rates. CONCLUSIONS: Analysis showed that the association between the intervention and changes in catheterisation rates was not statistically significant. However, the intervention resulted in statistically significant reductions for subgroups including among short-term catheterisations and female patients. Cost-effectiveness analysis showed that reductions in catheterisations were most likely achieved at positive cost. TRIAL REGISTRATION: Registered with the Australian New Zealand Clinical Trials Registry (ACTRN12617000090314). First hospital enrolment, 15/11/2016; last hospital enrolment, 8/12/2016.


Assuntos
Cateteres de Demora , Cateteres Urinários , Adulto , Austrália/epidemiologia , Análise Custo-Benefício , Feminino , Hospitais , Humanos , Papel do Profissional de Enfermagem , Cateterismo Urinário
2.
BMC Health Serv Res ; 21(1): 901, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34470636

RESUMO

BACKGROUND: Advance Care Planning (ACP) has emerged to improve end-of-life processes and experiences. However, the available evidence presents the gloomy picture of increasing number of older people living with chronic diseases and the mismatch between their preferences for and the actual place of death. The study aimed to investigate the efficacy of normalisation of an Advance Care Planning (NACP) service delivered by specially trained Registered Nurses (RNs) in hospital and community settings. METHODS: A quasi-experimental study was conducted involving 16 sites (eight hospital and eight community sites) in Australia. Patients who were aged ≥18 years, who had at least one of nine chronic conditions, and who did not have an Advance Care Directive (ACD) were offered the NACP service. ACP was normalised as part of routine service on admission. The intervention, NACP, was a series of facilitated conversations about the components of ACP. The primary outcomes which included the completion of ACDs, and/or appointment of an Enduring Guardian (EG), were assessed in both intervention and control sites at pre and post intervention stages. Numbers of patients who completed an ACD or appointed an EG were described by count (percentage). ACD completion was compared between intervention and control sites using a logistic mixed effects regression model. The model includes fixed effects for treatment group, period, and their interaction, as well as random site level intercepts. Secondary model included potentially confounding variables as covariates, including age, sex and chronic diseases. RESULTS: The prevalence of legally binding ACDs in intervention sites has increased from five to 85 (from 0.85% in pre to 17.6% in post), whereas it has slightly decreased from five to 2 (from 1.2% in pre and to 0.49% in post) in control sites (the difference in these changes being statistically significant p < 0.001). ACD completion rate was 3.6% (n = 4) in LHD1 and 1.2% (n = 3) in LHD2 in hospital whereas it was 53% (n = 26) in LHD1 and 80% (n = 52) in LHD2 in community. CONCLUSIONS: The study demonstrated that NACP service delivered by ACP RNs was effective in increasing completion of ACDs (interaction odds ratio = 50) and was more effective in community than hospital settings. Involvement of various healthcare professionals are warranted to ensure concordance of care. TRIAL REGISTRATION: The study was retrospectively registered with the Australian New Zealand Clinical Trials Registry (Trial ID: ACTRN12618001627246 ) on 03/10/2018. The URL of the trial registry record http://www.anzctr.org.au/trial/MyTrial.aspx.


Assuntos
Planejamento Antecipado de Cuidados , Adolescente , Adulto , Diretivas Antecipadas , Idoso , Austrália/epidemiologia , Doença Crônica , Hospitais , Humanos , Ensaios Clínicos Controlados não Aleatórios como Assunto
3.
BMJ Open ; 11(9): e050833, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34475182

RESUMO

INTRODUCTION: Diabetic foot disease is a common condition globally and is over-represented in indigenous populations. The propensity for patients with diabetic foot disease to undergo minor or major limb amputation is a concern. Diabetic foot disease and lower limb amputation are debilitating for patients and have a substantial financial impact on health services. The purpose of this multicentre study is to prospectively report the presentation, management and outcomes of diabetic foot disease, to validate existing scoring systems and assess long term outcomes for these patients particularly in relation to major limb amputation. METHODS AND ANALYSIS: This is a multisite, international, prospective observational study, being undertaken at Waikato Hospital, New Zealand (NZ); Sir Charles Gairdner Hospital, the Royal Adelaide Hospital and the Queen Elizabeth Hospital, Australia. Consecutive participants with diabetic foot disease that meet inclusion criteria and agree to participate will be recruited from multidisciplinary team diabetic foot clinic, vascular clinic, dialysis and admission to hospital. Follow-up of participants will occur at 1, 3, 6 and 12 months. At recruitment and follow-up reviews, information about service details, demographic and clinical history, wound data and discharge information will be recorded. The primary outcomes are the time to wound healing, major amputation, overall mortality and amputation-free survival at 12 months. This study started in NZ in August 2020 and will commence in Australian sites in early 2021. ETHICS AND DISSEMINATION: New Zealand Central Health and Disability Ethics Committee (20/CEN/122), Waikato DHB Research Department (RDO020044), Quality Improvement HoD Sir Charles Gairdner Hospital (39715) and the Central Adelaide Local Health Network (CALHN) Human Research Ethics Committee (13928). Results will be presented at international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry (ACTRN12621000337875).


Assuntos
Diabetes Mellitus , Pé Diabético , Austrália/epidemiologia , Pé Diabético/epidemiologia , Pé Diabético/cirurgia , Humanos , Estudos Multicêntricos como Assunto , Nova Zelândia/epidemiologia , Estudos Observacionais como Assunto , Diálise Renal , Temefós
4.
Public Health Res Pract ; 31(3)2021 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-34494070

RESUMO

The emergence of the Delta variant of SARS-CoV-2 has made Australia's 'COVID-zero' strategy unviable. As signalled by the Australian Government's National plan to transition Australia's national COVID-19 response, we need to plan a pathway forward for life beyond lockdown. However, this plan must be guided by long overdue discussions on our tolerance for serious illness, and hospital and intensive care unit capacity. The modelling that informs the national transition plan remains relevant, even with increases in case numbers, but one crucial thing that does change if cases continue to escalate is the effectiveness of test, trace and isolate models. As we move into suppression mode with higher rates of the population fully vaccinated, we will no longer need to find every case. This is among the many shifts in approach that will shape our transition by early 2022 to living with - and controlling - the disease.


Assuntos
COVID-19/epidemiologia , Controle de Doenças Transmissíveis/métodos , Austrália/epidemiologia , COVID-19/prevenção & controle , Busca de Comunicante/métodos , Governo , Hospitalização/estatística & dados numéricos , Humanos , Modelos Teóricos , SARS-CoV-2
5.
Aerosp Med Hum Perform ; 92(8): 612-618, 2021 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-34503614

RESUMO

INTRODUCTION: Aerobatic flight operations involve a higher level of risk than standard flight operations. Aerobatics imposes considerable stresses on both the aircraft and the pilot. The purpose of this study was to analyze civilian aerobatic aircraft accidents in Australia, with particular emphasis on the underlying accident causes and survival outcomes.METHODS: The accident and incident database of the Australian Transport Safety Bureau was searched for all events involving aerobatic flight for the period 19802010.RESULTS: A total of 51 accidents involving aircraft undertaking aerobatic operations were identified, with 71 aircraft occupants. Of the accidents, 27 (52.9) were fatal, resulting in a total of 36 fatalities. There were 24 nonfatal accidents. In terms of injury outcomes, there were 4 serious and 9 minor injuries, and 22 accidents in which no injuries were recorded. Fatal accidents were mainly due to loss of control by the pilot (44.4), in-flight structural failure of the airframe (25.9), and terrain impact (25.9). G-LOC was considered a possible cause in 11.1 of fatal accidents. Nonfatal accidents were mainly due to powerplant failure (41.7) and noncatastrophic airframe damage (25). Accidents involving aerobatic maneuvering have a significantly increased risk of a fatal outcome (odds ratio 26).DISCUSSION: The results of this study highlight the risks involved in aerobatic flight. Exceeding the operational limits of the maneuver and the design limits of the aircraft are major factors contributing to a fatal aerobatic aircraft accident. Improved awareness of G physiology and better operational decision-making while undertaking aerobatic flight may help prevent further accidents.Newman DG. Factors contributing to accidents during aerobatic flight operations. Aerosp Med Hum Perform. 2021; 92(8):612618.


Assuntos
Acidentes Aeronáuticos , Acidentes , Aeronaves , Austrália/epidemiologia , Humanos , Razão de Chances , Fatores de Risco
6.
Artigo em Inglês | MEDLINE | ID: mdl-34501854

RESUMO

BACKGROUND: The COVID-19 crisis has caused prolonged and extreme demands on healthcare services. This study investigates the types and prevalence of occupational disruptions, and associated symptoms of mental illness, among Australian frontline healthcare workers during the COVID-19 pandemic. METHODS: A national cross-sectional online survey was conducted between 27 August and 23 October 2020. Frontline healthcare workers were invited to participate via dissemination from major health organisations, professional associations or colleges, universities, government contacts, and national media. Data were collected on demographics, home and work situations, and validated scales of anxiety, depression, PTSD, and burnout. RESULTS: Complete responses were received from 7846 healthcare workers (82.4%). Most respondents were female (80.9%) and resided in the Australian state of Victoria (85.2%). Changes to working conditions were common, with 48.5% reporting altered paid or unpaid hours, and many redeployed (16.8%) or changing work roles (27.3%). Nearly a third (30.8%) had experienced a reduction in household income during the pandemic. Symptoms of mental illness were common, being present in 62.1% of participants. Many respondents felt well supported by their workplaces (68.3%) and believed that workplace communication was timely and useful (74.4%). Participants who felt well supported by their organisation had approximately half the risk of experiencing moderate to severe anxiety, depression, burnout, and PTSD. Half (50.4%) of respondents indicated a need for additional training in using personal protective equipment and/or caring for patients with COVID-19. CONCLUSIONS: Occupational disruptions during the COVID-19 pandemic occurred commonly in health organisations and were associated with worse mental health outcomes in the Australian health workforce. Feeling well supported was associated with significantly fewer adverse mental health outcomes. Crisis preparedness focusing on the provision of timely and useful communication and support is essential in current and future crises.


Assuntos
COVID-19 , Pandemias , Ansiedade , Austrália/epidemiologia , Estudos Transversais , Depressão , Feminino , Pessoal de Saúde , Humanos , Saúde Mental , SARS-CoV-2
9.
Artigo em Inglês | MEDLINE | ID: mdl-34360276

RESUMO

The identification and announcement of the COVID-19 pandemic has been a global issue. Disaster preparedness for internal and external threats is inherent within health care environments and requires agile thinking and swift remediation. Nosocomial infection is a risk for recipients of care, especially in hospital settings, which has implications for workforce planning. The aim of this case study was to examine the community response to the internal disaster of the first nosocomial COVID-19 outbreak within an Australian rural health care environment. A critical discourse analysis method was adopted to generate and analyse data collected from three different media platforms during a six-week period. Four main themes were distilled: actions and intent, loss, well-being and recognising choice, and community action. Phase two of the study interrogated these themes to expose the power positioning of speakers and their relationships to the audiences. Strengthening communication with local communities within health care environments must be a priority in any future rural workforce disaster preparedness planning. Maintenance of trust with health service provision and delivery in rural communities is imperative. The inclusion of a robust communication plan within any risk management strategy that meets the needs of the local users of health services is mandatory.


Assuntos
COVID-19 , Infecção Hospitalar , Planejamento em Desastres , Serviços de Saúde Rural , Austrália/epidemiologia , Infecção Hospitalar/epidemiologia , Hospitais , Humanos , Pandemias , População Rural , SARS-CoV-2 , Tasmânia , Recursos Humanos
10.
BMJ Open ; 11(8): e046206, 2021 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-34385235

RESUMO

INTRODUCTION: The increase in international travel brought about by globalisation has enabled the rapid spread of emerging pathogens with epidemic and pandemic potential. While travel connectivity-based assessments may help understand patterns of travel network-mediated epidemics, such approaches are rarely carried out in sufficient detail for Oceania where air travel is the dominant method of transportation between countries. DESIGN: Travel data from the Australian Bureau of Statistics, Stats NZ and the United Nations World Tourism Organization websites were used to calculate travel volumes in 2018 within Oceania and between Oceania and the rest of the world. The Infectious Disease Vulnerability Index (IDVI) was incorporated into the analysis as an indicator of each country's capacity to contain an outbreak. Travel networks were developed to assess the spread of infectious diseases (1) into and from Oceania, (2) within Oceania and (3) between each of the Pacific Island Countries and Territories (PICTs) and their most connected countries. RESULTS: Oceania was highly connected to countries in Asia, Europe and North America. Australia, New Zealand and several PICTs were highly connected to the USA and the UK (least vulnerable countries for outbreaks based on the IDVI), and to China (intermediate low vulnerable country). High variability was also observed between the PICTs in the geographical distribution of their international connections. The PICTs with the highest number of international connections were Fiji, French Polynesia, Guam and Papua New Guinea. CONCLUSION: Travel connectivity assessments may help to accurately stratify the risk of infectious disease importation and outbreaks in countries depending on disease transmission in other parts of the world. This information is essential to track future requirements for scaling up and targeting outbreak surveillance and control strategies in Oceania.


Assuntos
Viagem Aérea , Doenças Transmissíveis , Austrália/epidemiologia , Doenças Transmissíveis/epidemiologia , Surtos de Doenças/prevenção & controle , Humanos , Pandemias , Viagem
11.
Artigo em Inglês | MEDLINE | ID: mdl-34360414

RESUMO

Pneumoconiosis, or occupational lung disease, is one of the world's most prevalent work-related diseases. Silicosis, a type of pneumoconiosis, is caused by inhaling respirable crystalline silica (RCS) dust. Although silicosis can be fatal, it is completely preventable. Hundreds of thousands of workers globally are at risk of being exposed to RCS at the workplace from various activities in many industries. Currently, in Australia and internationally, there are a range of methods used for the respiratory surveillance of workers exposed to RCS. These methods include health and exposure questionnaires, spirometry, chest X-rays, and HRCT. However, these methods predominantly do not detect the disease until it has significantly progressed. For this reason, there is a growing body of research investigating early detection methods for silicosis, particularly biomarkers. This literature review summarises the research to date on early detection methods for silicosis and makes recommendations for future work in this area. Findings from this review conclude that there is a critical need for an early detection method for silicosis, however, further laboratory- and field-based research is required.


Assuntos
Exposição Ocupacional , Pneumoconiose , Silicose , Austrália/epidemiologia , Poeira/análise , Humanos , Exposição Ocupacional/análise , Dióxido de Silício/análise , Silicose/diagnóstico
12.
Nutrients ; 13(7)2021 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-34371942

RESUMO

Food security among migrants and refugees remains an international public health issue. However, research among ethnic minorities in Australia is relatively low. This study explored the factors that influence the understanding of food labelling and food insecurity among Libyan migrants in Australia. An online survey was completed by 271 Libyan migrant families. Data collection included the 18-item US Household Food Security Survey Module (for food security) and a question from the Food Standards Australia New Zealand Consumer Label Survey (for food labelling comprehension). Multivariable logistic regression modelling was utilised to identify the predictors of food label comprehension and food security. Food insecurity prevalence was 72.7% (n = 196) while 35.8% of families (n = 97) reported limited food label understanding. Household size, food store location, and food affordability were found to be significantly related to food insecurity. However, gender, private health insurance, household annual income, education, and food store type and location were found to be significantly related to food labelling comprehension. Despite the population's high educational status and food labelling comprehension level, food insecurity remained an issue among the Libyan migrants. Policy makers should consider the incorporation of food label comprehension within a broader food security approach for migrants.


Assuntos
Compreensão , Emigrantes e Imigrantes , Insegurança Alimentar , Rotulagem de Alimentos , Abastecimento de Alimentos , Proficiência Limitada em Inglês , Leitura , Refugiados , Adulto , Austrália/epidemiologia , Comportamento do Consumidor , Estudos Transversais , Feminino , Insegurança Alimentar/economia , Abastecimento de Alimentos/economia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Líbia/etnologia , Masculino , Pessoa de Meia-Idade , Pobreza , Inquéritos e Questionários
13.
Front Public Health ; 9: 630611, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34336752

RESUMO

Background: Primary health care (PHC) services are complex systems, shaped by an interplay of factors at individual, organisational and broader system levels. For Aboriginal and Torres Strait Islander PHC services, closer relationships with the people they serve, local knowledge of community, and cultural awareness are critical. Continuous quality improvement (CQI) has proven to be an effective process for identification of priority issues in health care delivery and for instigating the design, implementation and evaluation of improvement interventions in these settings. However, wide-scale variation in care quality persists partly due to the mismatch between CQI interventions and context. Methods: This critical review of implementation frameworks for CQI in Aboriginal and Torres Strait Islander primary health care was conducted in two phases: (1) a review of primary published implementation frameworks used in PHC contexts, and (2) a comparison of key features of these frameworks with quality concepts identified by high-improving Aboriginal and Torres Strait Islander PHC services in remote Australia. Results: We found nine primary implementation frameworks previously used in PHC contexts guiding interventions within and between macro (broader contextual) level; meso (health service) level; and micro (community and inter-personal) level systems. There was commonality between these frameworks and key quality concepts in Aboriginal and Torres Strait Islander PHC. However, none of the frameworks covered all concepts with rare consideration of communities driving health improvement, two-way learning (integrating cultural knowledge into healthcare provision), and caring staff-engendering trusting relationships with community enacted through respect. Conclusion: Respect, as a secret essence, privileges the importance of culture, and is an essential element of CQI implementation frameworks for positive change in Aboriginal and Torres Strait Islander PHC services. It is essential to work with communities to design workforce models that grow a caring stable workforce to ensure improvements in quality of care that are effective for their context.


Assuntos
Serviços de Saúde do Indígena , Melhoria de Qualidade , Austrália/epidemiologia , Humanos , Grupo com Ancestrais Oceânicos , Atenção Primária à Saúde , Respeito
15.
BMC Health Serv Res ; 21(1): 816, 2021 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-34391422

RESUMO

BACKGROUND: In New South Wales (NSW), Australia there are three settings available for women at low risk of complications to give birth: home, birth centre and hospital. Between 2000 and 2012, 93.6% of babies were planned to be born in hospital, 6.0% in a birth centre and 0.4% at home. Availability of alternative birth settings is limited and the cost of providing birth at home or in a birth centre from the perspective of the health system is unknown. OBJECTIVES: The objective of this study was to model the cost of the trajectories of women who planned to give birth at home, in a birth centre or in a hospital from the public sector perspective. METHODS: This was a population-based study using linked datasets from NSW, Australia. Women included met the following selection criteria: 37-41 completed weeks of pregnancy, spontaneous onset of labour, and singleton pregnancy at low risk of complications. We used a decision tree framework to depict the trajectories of these women and Australian Refined-Diagnosis Related Groups (AR-DRGs) were applied to each trajectory to estimate the cost of birth. A scenario analysis was undertaken to model the cost for 30 000 women in one year. FINDINGS: 496 387 women were included in the dataset. Twelve potential outcome pathways were identified and each pathway was costed using AR-DRGs. An overall cost was also calculated by place of birth: $AUD4802 for homebirth, $AUD4979 for a birth centre birth and $AUD5463 for a hospital birth. CONCLUSION: The findings from this study provides some clarity into the financial saving of offering more options to women seeking an alternative to giving birth in hospital. Given the relatively lower rates of complex intervention and neonatal outcomes associated with women at low risk of complications, we can assume the cost of providing them with homebirth and birth centre options could be cost-effective.


Assuntos
Centros de Assistência à Gravidez e ao Parto , Parto Domiciliar , Austrália/epidemiologia , Entorno do Parto , Feminino , Humanos , Recém-Nascido , Parto , Gravidez
17.
Sci Total Environ ; 791: 148243, 2021 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-34412375

RESUMO

BACKGROUND: Intensification of land use threatens to increase the emergence and prevalence of zoonotic diseases, with an adverse impact on human wellbeing. Understanding how the interaction between agriculture, natural systems, climate and socioeconomic drivers influence zoonotic disease distribution is crucial to inform policy planning and management to limit the emergence of new infections. OBJECTIVES: Here we assess the relative contribution of environmental, climatic and socioeconomic factors influencing reported cryptosporidiosis across Australia from 2001 to 2018. METHODS: We apply a Bayesian spatio-temporal analysis using Integrated Nested Laplace Approximation (INLA). RESULTS: We find that area-level risk of reported disease are associated with the proportions of the population under 5 and over 65 years of age, socioeconomic disadvantage, annual rainfall anomaly, and the proportion of natural habitat remaining. This combination of multiple factors influencing cryptosporidiosis highlights the benefits of a sophisticated spatio-temporal statistical approach. Two key findings from our model include: an estimated 4.6% increase in the risk of reported cryptosporidiosis associated with 22.8% higher percentage of postal area covered with original habitat; and an estimated 1.8% increase in disease risk associated with a 77.99 mm increase in annual rainfall anomaly at the postal area level. DISCUSSION: These results provide novel insights regarding the predictive effects of extreme rainfall and the proportion of remaining natural habitat, which add unique explanatory power to the model alongside the variance associated with other predictive variables and spatiotemporal variation in reported disease. This demonstrates the importance of including perspectives from land and water management experts for policy making and public health responses to manage environmentally mediated diseases, including cryptosporidiosis.


Assuntos
Criptosporidiose , Clima Extremo , Austrália/epidemiologia , Teorema de Bayes , Criptosporidiose/epidemiologia , Humanos , Fatores Socioeconômicos
18.
BMC Med Educ ; 21(1): 439, 2021 Aug 19.
Artigo em Inglês | MEDLINE | ID: mdl-34412603

RESUMO

BACKGROUND: Due to the complex nature of healthcare professionals' roles and responsibilities, the education of this workforce is multifaceted and challenging. It relies on various sources of learning from teachers, peers, patients and may focus on Work Integrated Learning (WIL). The COVID-19 pandemic has impacted many of these learning opportunities especially those in large groups or involving in person interaction with peers and patients. Much of the curriculum has been adapted to an online format, the long-term consequence of which is yet to be recognized. The changed format is likely to impact learning pedagogy effecting both students and teachers. This requires a systematic approach to evaluation of online teaching and learning adaptation, in comparison to the previous format, where, in person education may have been the focus. METHODS: The proposed study is a broad based evaluation of health professional education in a major Australian University. The protocol describes a mixed methods convergent design to evaluate the impact of online education on students and teachers in health professional courses including Medicine, Nursing, Allied Health and Biomedical Science. A framework, developed at the university, using Contribution Analysis (CA), will guide the evaluation. Quantitative data relating to student performance, student evaluation of units, quantity of teaching activities and resource utilization will be collected and subjected to relevant statistical analysis. Data will be collected through surveys (500 students and 100 teachers), focus groups (10 groups of students) and interviews of students and teachers (50 students beyond graduation and 25 teachers, for long term follow up to 12 months). Application of CA will be used to answer the key research questions on the short term and long-term impact of online education on teaching and learning approaches. DISCUSSION: The protocol describes the study, which will be widely implemented over the various courses in Health Professional Education and Biomedical Science. It will evaluate how students and teachers engage with the online delivery of the curriculum, student performance, and resources used to implement these changes. It also aims to evaluate longitudinal outcome of student learning attributes and impact on graduate outcomes, which is poorly reported in educational literature.


Assuntos
COVID-19 , Educação Profissionalizante , Austrália/epidemiologia , Humanos , Pandemias , SARS-CoV-2
19.
Am J Sports Med ; 49(11): 3066-3075, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34398642

RESUMO

BACKGROUND: The treatment of traumatic anterior shoulder instability in professional Australian Football League (AFL) players is challenging, with an emphasis on early return to play and avoidance of instability recurrence. PURPOSE: To investigate return-to-sport (RTS) outcomes and complications after 2 different procedures for traumatic anterior shoulder instability in professional AFL players. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: We retrospectively reviewed our surgical database for professional AFL players who underwent capsulolabral stabilization or open Latarjet procedure by a single surgeon between 2006 and 2017. Outcomes included RTS, on-field performance, and complications. Between-group analyses for RTS and complications were estimated using Kaplan-Meier survival analyses. Within-group analyses for on-field performance data were performed using paired t tests with significance set at .05. RESULTS: A total of 58 capsulolabral stabilization procedures in 54 players and 32 Latarjet procedures in 29 players were included in the analysis; 93.1% of capsulolabral patients and 96.9% of Latarjet patients returned to professional AFL. The median RTS time was 6.8 months for the capsulolabral group and 7.3 months for the Latarjet group. There was no significant difference in RTS rates between the 2 groups (P = .270). Of those undergoing surgery early in the season, 75% of the capsulolabral and 71% of Latarjet group were able to RTS within the same season, at a mean time of 16.9 weeks and 18.8 weeks, respectively. There was a significant difference in instability recurrence, with 19% for the capsulolabral group and no recurrence in the Latarjet group (P = .017). There was no significant reduction in player on-field performance in either group (P < .05). CONCLUSION: In this study, the median RTS in AFL players was approximately 7 months after capsulolabral and Latarjet surgery with no compromise to on-field performance. Instability-related complications occurred only in the capsulolabral group, and the incidence increased with time.


Assuntos
Futebol Americano , Instabilidade Articular , Luxação do Ombro , Articulação do Ombro , Austrália/epidemiologia , Estudos de Coortes , Humanos , Instabilidade Articular/cirurgia , Estudos Retrospectivos , Ombro
20.
Artigo em Inglês | MEDLINE | ID: mdl-34444065

RESUMO

University students have high rates of health risk behaviours, and these may be predictive of academic success. This cross-sectional study aimed to determine the association between individual and multiple health risk behaviours and academic achievement in a sample of Australian university students. Data from the University of Newcastle Student Healthy Lifestyle Survey 2019 were used. Health risk behaviours (diet, physical activity, sitting time, sleep, alcohol consumption, smoking) were assessed, and total number of risk factors calculated. Academic achievement was assessed using self-reported grade point average (GPA). The association between health risk behaviours and GPA was explored using linear regression, adjusted for socio-demographic and student characteristics. The sample included 1543 students (mean age 25.0 ± 7.9 years, 70.6% female). Lower GPA was associated with not meeting fruit consumption recommendations (ß = -0.203), consuming >1 cup of soft drink/week (ß = -0.307), having takeaway foods ≥1 time/week (ß = -0.130), not consuming breakfast daily (ß = -0.261), not meeting sleep recommendations (ß = -0.163), exceeding single occasion alcohol consumption risk (ß = -0.277), smoking (ß = -0.393), and having a higher number of risk factors (ß = -0.105). This study identified modest associations between GPA and health risk behaviours, suggesting that further research is warranted into whether strategies to improve university students' health could modestly improve their academic achievement.


Assuntos
Sucesso Acadêmico , Adolescente , Adulto , Austrália/epidemiologia , Desjejum , Estudos Transversais , Feminino , Comportamentos de Risco à Saúde , Humanos , Masculino , Estudantes , Universidades , Adulto Jovem
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