Sedentary behaviour in Australian university students: The contribution of study-related sedentary behaviour to total sedentary behaviour.

ISSUE ADDRESSED: Seated activities are attributed to increased sedentary behaviour (SB) and adverse health effects, but little is currently known about university students' SB, particularly study-related SB. This study describes the sociodemographic variations of domain-specific SB in regional Australian university students and the contribution of study-related SB to total SB. METHODS: Self-reported daily SBs from a cross-sectional survey of 451 students were used. Domain-specific and total SB were described within sub-groups, and differences examined using independent t-tests. Multinomial regression was used to examine the association of tertiles of duration in study-related SB with total and other domain-specific SBs. RESULTS: Study participants were a median age of 21 (19-25 years), mostly female (76%) and represented different years of study. On average, students spent 882 ± 292 min/day in total SB, with most SB occurring in the study, screen time and 'other activity' domains. No sociodemographic variations were found in total SB, but significantly higher study-related SB were reported by students studying full time (p < .001) and who moved from their family home to study (p < .022). Study-related SB contributed 36% of total SB, with students most sedentary during study having the highest total SB. CONCLUSIONS: This study suggests university students have high levels of SB, primarily in the domains of study, screen time and other activities. SB reduction strategies in universities and targeting screen time, across various sociodemographic groups (e.g., gender, university enrolment status, and living arrangements), may be important in reducing SB in university students. SO WHAT?: University students are highly sedentary and should be included in SB programs especially students studying full time and those who moved from their family home in the study domain.

The evolution of the Community Health Worker program in Papua New Guinea.

New Guinea (PNG) has a special history in regard to the training of Community Health Workers (CHWs) and is currently preparing its frontline health workforce to serve the 85% of the total PNG population of 7.3 million people who live in rural and remote settings. This article identifies and explains the five major developmental stages in the current CHW training program, as well as the changes that have occurred over the past century. The developmental stages are: (1) traditional; (2) early contact; (3) innovation; (4) the 1980s; and (5) new millennium. These developmental stages are discussed in the context of the early literature and investigation by the primary author and examination of the lived experiences of early missionary health workers and local people. This paper documents the development of a CHW program in PNG from the colonisation period, which began in 1883, to the present day. As a developing nation, PNG has gone through many challenges and changes to its healthcare system and has gradually developed an effective program to train its frontline primary health care (PHC) workforce. This article contributes new information with regard to the past and current development of CHW programs in PNG as well as in other developing countries. The training of competent CHWs with the essential skills and knowledge may help deliver quality and cost-effective PHC services to the rural majority and the urban disadvantaged, thereby fulfilling the PNG government's National Health Plan for 2011-2020. Systematic evaluation of the effectiveness of the CHW program will provide guidance for continued development of this frontline health workforce. Improving and introducing a competency-based curriculum is an essential step towards building a healthier nation.

Role of non-Indigenous researchers in Indigenous health research in Australia: a review of the literature.

Objective This paper explores the body of knowledge around Indigenous health research and aims to outline what roles are appropriate for non-Indigenous researchers within Indigenous health research in Australia. Methods A literature review was conducted using CINAHL, PubMed and Scopus in May 2015. The search terms were 'non-Indigenous researchers' AND 'Indigenous health research' and other combinations of these terms. Additional documents were sourced by hand using the reference lists of key articles. Results Seven thematic categories were identified: (1) Closing the Gap: implications for research; (2) history of Indigenous research; (3) developing Indigenous research using a capacity-building approach; (4) the cultural interface between Western paradigms and Indigenous knowledge; (5) ethical Indigenous research; (6) culturally safe Indigenous research; and (7) positive roles for non-Indigenous researchers in Indigenous research. Conclusion It is important that non-Indigenous researchers become more aware of culturally appropriate ways in which to undertake Indigenous research and to ensure that the research undertaken is safe, ethical and useful for participants. Fostering partnerships between non-Indigenous academic organisations and researchers and Indigenous health researchers is an important development that can promote and enhance the emerging field of Indigenous inquiry. Actively contributing to capacity building with Indigenous researchers and research initiatives is a key role that non-Indigenous researchers and academic institutions can have in improving Indigenous health. Self-determination through health research capacity building and evidence-based advocacy may provide the most useful outcomes for Indigenous people. What is known about the topic? The health status of Indigenous Australians is well below that of other Australians. Historically, research about Indigenous health has been undertaken by non-Indigenous researchers using Western research paradigms. There is a need to identify appropriate roles for non-Indigenous researchers supportive of culturally safe and ethical research. What does this paper add? This paper synthesises available knowledge about the role of non-Indigenous researchers with Indigenous health research and provides suggestions for their contribution to Indigenous research practice. What are the implications for practitioners? Non-Indigenous researchers need to: (1) focus on culturally safe research practices; (2) be willing to address power imbalances within the research process; and (3) advocate for change within academic institutions to support culturally safe research practices.

Hand therapy services for rural and remote residents: Results of a survey of Australian occupational therapists and physiotherapists.

OBJECTIVE: The aim of this study was to explore how interventions were provided to meet the needs of rural/remote residents who have had a traumatic hand injury, including the coordination of services between rural/remote and metro/regional therapists. Barriers to providing services, use of technology and professional support provided to therapists in rural/remote areas were also explored. DESIGN: Cross-sectional survey. SETTING: Metropolitan/regional and rural/remote public health facilities in Australia. PARTICIPANTS: Occupational therapists and physiotherapists who provide hand therapy to rural/remote patients. MAIN OUTCOME MEASURE: Quantitative and qualitative questionnaire responses analysed with descriptive statistics and inductive analysis. RESULTS: There were 64 respondents out of a possible 185. Over half of rural/remote respondents provided initial splinting and exercise prescriptions, and over 85% reported that they continued with exercise protocols. Videoconferencing technology for patient intervention and clinical review was used by 39.1% respondents. Barriers to providing services in rural/remote locations included transport, travelling time, limited staff, and lack of expert knowledge in hand injuries or rural/remote health care. Four major themes emerged from the open-ended questions: working relationships, patient-centred care, staff development and education, and rural and remote practice. CONCLUSION: The use of technology across Australia to support rural/remote patient intervention requires attention to achieve equity and ease of use. Flexible and realistic goals and interventions should be considered when working with rural/remote patients. A shared care approach between metropolitan/regional and rural/remote therapists can improve understanding of rural/remote issues and provide support to therapists. Further research is recommended to determine the suitability of this approach when providing hand therapy to rural/remote residents.

Effects of functional tasks exercise on older adults with cognitive impairment at risk of Alzheimer's disease: a randomised controlled trial.

OBJECTIVE: the aim of this study was to compare the effects of a functional tasks exercise programme to a cognitive training programme in older adults with mild cognitive impairment. DESIGN: a single-blind randomised control trial with the intervention group compared with an active control group. SETTING: out-patient clinic. PARTICIPANTS: older adults with mild cognitive impairment (n = 83) aged 60 and older living in the community. METHODS: participants were randomised to either a functional task exercise group (n = 43) or an active cognitive training group (n = 40) for 10 weeks. All outcome measures were undertaken at baseline, post-intervention and 6-month follow-up using Neurobehavioral Cognitive Status Examination, Trail Making Test, Chinese Version Verbal Learning Test, Category Verbal Learning Test, Lawton Instrumental Activities of Daily Living Scale and Problems in Everyday Living Test. RESULTS: the functional task exercise group showed significant between-group differences in general cognitive functions, memory, executive function, functional status and everyday problem solving ability. The improvements were sustained over time at 6-month follow-up. CONCLUSION: a functional tasks exercise programme is feasible for improving cognitive functions and functional status of older adults with mild cognitive impairment. This may serve as a cost-effective adjunct to the existing interventions for populations with mild cognitive impairment. TRIAL REGISTRATION NUMBER: ACTRN12610001025022.

Translation and validation of Chinese version of the problems in everyday living (PEDL) test in patients with mild cognitive impairment.

BACKGROUND: Cognitive impairment places older adults at increased risk of functional decline, injuries, and hospitalization. Assessments to determine whether older persons are still capable of meeting the cognitive challenges of everyday living are crucial to ensure their safe and independent living in the community. The present study aims to translate and validate the Chinese version of the Problems in Everyday Living (PEDL) test for use in Chinese population with mild cognitive impairment (MCI). METHODS: The cultural relevancy and content validity of the Chinese version of PEDL (C-PEDL) was evaluated by a seven-member expert panel. Forty patients with MCI and 40 cognitively healthy participants were recruited to examine the psychometric properties of C-PEDL. RESULTS: Significant differences in the C-PEDL scores were found between the patients with MCI and the cognitively healthy controls in both educated (F = 9.96, p = 0.003) and illiterate (F = 10.43, p = 0.004) populations. The C-PEDL had excellent test-retest and inter-rater reliabilities, with intraclass correlation coefficient at 0.95 and 0.99 respectively. The internal consistency of C-PEDL was acceptable with Chronbach's α at 0.69. The C-PEDL had moderate correlation with the Mini-Mental State Examination (r = 0.45, p = 0.004) and the Category Verbal Fluency Test (r = 0.40, p = 0.012), and a moderate negative Spearman's correlation with the Global Deteriorating Scale (r = -0.42, p = 0.007). CONCLUSIONS: The C-PEDL is a valid and reliable test for assessing the everyday problem-solving ability in Chinese older population with MCI.

The experience of living with a traumatic hand injury in a rural and remote location: an interpretive phenomenological study.

INTRODUCTION: The aim of this research study was to gain an understanding of how rural and remote residents in North Queensland, Australia, engaged in work, activities of daily living tasks and social activities following a traumatic hand injury. Findings from a previous retrospective survey with these participants revealed that patients experienced difficulties such as pain for many years after their injury; however, because of the survey methodology, the voices of participants were not heard. This study contributes to a larger project that seeks to propose a model of service delivery to rural and remote residents who have sustained a traumatic injury. METHODS: Utilising an interpretive phenomenological research design, data were gathered through in-depth, semistructured interviews. Fifteen participants were recruited into this study and questions were designed to explore the experience of having a traumatic hand injury in rural and remote areas of North Queensland. RESULTS: The thematic analysis indicated five major themes: injury and impairment, pain, occupation and activity, and resilience. Participants reported that having a hand injury often caused further injury due to the impairment. The pain experienced could be 'all consuming' yet participants reported 'pushing through' this pain to complete daily tasks. Participants reported that they would 'go mad' if they did not work and highlighted the importance of activity in their recovery. Participants felt grateful at having their hand and thought towards the future. Being self-reliant was important but they were willing to accept support from others when needed. CONCLUSIONS: Incorporating activity and occupation in rehabilitation programs as opposed to focusing on strict protocols is an important consideration in the recovery process of rural and remote residents. In particular, engaging in activity and occupation was an important part of managing the pain associated with the hand trauma. This research also found that participants demonstrated resilient qualities while recovering from a traumatic hand injury. Health professionals who work with people from a rural and remote location with a traumatic hand injury should consider a treatment model that encourages active patient participation, identifying collaborative treatment goals that align with the values of people living in rural and remote locations. Education regarding the high risk of further injury due to the nature of, and exposure to, the type of work and activity in rural and remote locations is also recommended.

Measures of everyday competence in older adults with cognitive impairment: a systematic review.

BACKGROUND: The issue of safety of the cognitively impaired elderly people living alone has been continuously raised. Traditional psychometric measures of cognitive abilities may not adequately reflect older adults' functioning in a real everyday context. OBJECTIVES: To conduct a systematic review on instruments available for evaluating the everyday problem-solving or everyday competence of the elderly with cognitive impairment and to critically review the measurement properties of the identified instruments. METHODS: We searched the databases such as Cinahl, Medline, PsycINFO, AARP Ageline, ProQuest and the Cochrane Library for the time period between January 1995 and December 2010. Reference lists of the included papers were also manually searched. RESULTS: Five instruments were included. All the instruments focused their framework on Instrumental Activities of Daily Living (IADL) domains which meet well with suggestions from other studies on the importance of IADL in determining an elderly individual's capability to live independently in the community. No available instruments for the moderate to severe impairment group were identified under this review. CONCLUSIONS: Few existing instruments to assess the ability of everyday problem-solving of the elderly with cognitive impairment can be identified in the literature. Further research validating them against functional, real-world outcomes is needed.

An exploration of subjective wellbeing among people experiencing homelessness: a strengths-based approach.

Negative perceptions of homelessness contribute to deficit models of practice, false notions of homogeneity, and marginalization. Wellbeing is a state of satisfaction with material, social, and human aspects of life and can be measured both objectively and subjectively. The study explored the meaning and experience of wellbeing in the everyday lives of 20 homeless participants through fieldwork and interviews. This study revealed that health contributed little to their overall perception of wellbeing. Keeping safe, being positive and feeling good, connecting with others, and the ability to participate in "normal" life were the key contributors of subjective wellbeing. The authors demonstrate that social exclusion experienced in homelessness has a negative effect on subjective wellbeing. Services that provide opportunities to experience social inclusion and develop community and cultural connections will improve the wellbeing of homeless persons.

Prostate cancer outcome and tissue levels of metal ions.

BACKGROUND: There are several studies examining prostate cancer and exposure to cadmium, iron, selenium, and zinc. Less data are available on the possible influence of these metal ions on prostate cancer outcome. This study measured levels of these ions in prostatectomy samples in order to examine possible associations between metal concentrations and disease outcome. METHODS: We obtained formalin fixed paraffin embedded tissue blocks of prostatectomy samples of 40 patients with PSA recurrence, matched 1:1 (for year of surgery, race, age, Gleason grading, and pathology TNM classification) with tissue blocks from 40 patients without recurrence (n = 80). Case-control pairs were compared for the levels of metals in areas adjacent to tumors. Inductively coupled plasma-mass spectrometry (ICP-MS) was used for quantification of Cd, Fe, Zn, and Se. RESULTS: Patients with biochemical (PSA) recurrence of disease had 12% lower median iron (95 µg/g vs. 111 µg/g; P = 0.04) and 21% lower zinc (279 µg/g vs. 346 µg/g; P = 0.04) concentrations in the normal-appearing tissue immediately adjacent to cancer areas. Differences in cadmium (0.489 µg/g vs. 0.439 µg/g; 4% higher) and selenium (1.68 µg/g vs. 1.58 µg/g; 5% higher) levels were not statistically significant in recurrence cases, when compared to non-recurrences (P = 0.40 and 0.21, respectively). CONCLUSIONS: There is an association between low zinc and low iron prostate tissue levels and biochemical recurrence in prostate cancer. Whether these novel findings are a cause or effect of more aggressive tumors, or whether low zinc and iron prostatic levels raise implications for therapy, remains to be investigated.

Analysis of iron, zinc, selenium and cadmium in paraffin-embedded prostate tissue specimens using inductively coupled plasma mass-spectrometry.

Formalin-fixed paraffin-embedded (FFPE) tissue specimens represent a valuable and abundant resource of pathologic material for various biomedical studies. In the present study, we report the application of high-resolution inductively coupled mass-spectrometry (ICP-MS) for quantification of Fe, Zn, Se and Cd in FFPE prostate tissue. These elements have a possible role in the development of prostate diseases: while Zn and Se are needed for a healthy prostate, Cd shows multiple toxic and carcinogenic effects. Excessive accumulation of Fe induces the production of highly reactive hydroxyl radical species, which may play a role in cancer etiopathogenesis. To assess whether the levels of these metals in the FFPE prostate tissue represent their original content, we compared their levels with those in the fresh tissue (on dry weight basis) in samples obtained from 15 patients. We found that in FFPE tissue, the recoveries of Se, Fe, Cd and Zn were progressively decreased, 97+/-11% (r=0.88), 82+/-22% (r=0.86), 59+/-23% (r=0.69) and 24+/-11% (r=0.38), respectively. Thus, the use of correction factors, determined as k=0.16 for Se, k=0.20 for Fe, k=0.27 for Cd and k=0.67 for Zn, is required to estimate the retrospective levels of these elements in the parental non-processed fresh (wet) prostate tissue. The technique used in this study enables the analysis of archival FFPE prostate tissue for the concentrations of Fe, Zn, Se and Cd to study association between the levels of these metals and prostate disease.

Reducing geriatric outpatient waiting times: Impact of an advanced health practitioner.

OBJECTIVE: To investigate the impact on patient waiting times of a role substitution model introducing an advanced allied health practitioner as the first point of contact within a geriatric outpatient context. METHODS: A pre- to postintervention design was used to determine impact over a five-year period (2008-2012). All patients referred to the geriatric specialist outpatient department were included (n = 1514). Data relating to waiting times were analysed using one-way ANOVA and post hoc Tukey tests to determine effects on patient waiting times. RESULTS: Waiting times were reduced from an average of 82 to as low as 35 days, in a context of increasing referral rates. Medical specialist capacity was increased through improvements to available outpatient times and reduced appointment lengths. Patients seen within their designated triage category timeframe increased from 47 to 86%. CONCLUSION: Health professional substitution in geriatrics can be an effective intervention for reducing patient waiting times and improving access to care.

A systematic review on research into the effectiveness of group-based sport and exercise programs designed for Indigenous adults.

OBJECTIVES: To evaluate research into the effectiveness of group-based sport and exercise programs targeting Indigenous adults on anthropometric, physiological and quality of life outcomes. DESIGN: A systematic review with quality assessment of study design. METHODS: A computer-based literature search of EBSCO, SPORTDiscus, CINAHL, Informit, Scopus, Web of Science, Medline, PubMed, Global Health, ProQuest and Discover databases was conducted. Methodological quality of individual articles was assessed using McMasters University Guidelines and Appraisal Forms for Critical Review for Quantitative Research. Results of the effectiveness of programs are then summarised. RESULTS: Six articles were identified with critical appraisal scores ranging from 6 to 12 (from a possible 15 points), with a mean score of 9.6. Five articles were of moderate to good quality. Significant improvements were observed in anthropometric, physiological and quality of life outcomes across all studies. Elements of successful group-based exercise and sport programs corresponded to global recommendations on physical activity for health for 18 to 64 year olds, and were implemented over a period of time ranging from 12 to 24 weeks to exhibit results, plus community consultation in developing programs and nutrition education. CONCLUSIONS: Group-based programs that include nutrition, exercise and/or sport components are effective in producing short to intermediate term health outcomes among Indigenous adults. Further high quality research, specifically on group-based modified sport programs for Indigenous adults that are culturally appropriate and aim to improve quality of life are needed.

Clinical use of serum prostate-specific antigen: a review.

Serum Prostate-Specific Antigen (PSA), in conjunction with digital rectal examination, is a common first-line clinical tool for the diagnosis of prostate cancer; therefore, it is essential that the clinical use of PSA be further developed to make it a more definitive tool. There are issues in screening with PSA, with regard to its lack of specificity (and sensitivity) and solutions involving various PSA parameters and derivatives have been suggested to address these issues. The literature on these parameters and research into factors found to influence levels of PSA are discussed in this review.

The experience of medical and rehabilitation intervention for traumatic hand injuries in rural and remote North Queensland: a qualitative study.

INTRODUCTION: This research explored the experience of receiving medical and rehabilitation intervention for rural and remote residents in North Queensland, Australia who had experienced a traumatic hand injury. This study contributes to larger project that seeks to propose a model of service delivery to rural and remote residents who have sustained a traumatic injury. METHODS: Utilising an interpretive phenomenological research design, data was gathered through in-depth, semi-structured interviews. Fifteen participants were recruited into this study and questions were designed to explore the experience of receiving medical and rehabilitation intervention following a traumatic hand injury for residents in rural and remote areas of North Queensland. RESULTS: The major themes that emerged were experience of medical intervention, experience of rehabilitation, travel, and technology. Participants felt that medical practitioners had a lack of local knowledge and were concerned that delays in medical intervention resulted in ongoing impairment. They reported following the exercise program they were given, often modifying it to fit with their daily routine. Metropolitan therapists appeared to have limited understanding of issues relevant to rural and remote lifestyles. There was, quite often, no occupational therapist or physiotherapist at their local facility due to staff turnover, and, when available, they had limited experience in hand injuries. The distance and cost of travel to appointments were of significant concern. The use of telehealth or telerehabilitation received a mixed response. CONCLUSION: Findings highlight the concerns regarding the provision of healthcare to rural and remote residents following a traumatic hand injury. These results provide the basis for recommendations surrounding the development of programs and service delivery models to address diverse needs in rural and remote areas.

Ethnic differences in diet and associations with clinical markers of prostate disease in New Zealand men.

OBJECTIVE: To examine ethnic differences in diet and dietary associations with clinical markers of prostate disease in New Zealand men. MATERIALS AND METHODS: A total of 1031 males (616 New Zealand European, 230 Maori and 185 Pacific Islands) aged 40-69 years, with no history of prostate cancer, completed a questionnaire covering diet. A serum prostate specific antigen (PSA) blood analysis was also undertaken. Regression models were developed to examine the ethnic-specific levels of selected dietary components, and their relationship with PSA and urinary symptom scores. RESULTS: The results confirmed previously found ethnic differences in the New Zealand diet. Combined tomato intake was positively-correlated with free PSA and % free PSA (p=0.021, r=0.197 and p=0.011, r=0.096 respectively). Beer intake was negatively-correlated with total PSA (p=0.028, r=-0.071) and free PSA (p=0.004, r=-0.094). CONCLUSION: Ethnic differences found in the consumption of foods (associated with prostate cancer) highlight the possible importance of dietary interactions for ethnic prostate cancer risk. Associations between specific foods and PSA warrant further investigation.

Demographic and clinical factors as determinants of serum levels of prostate specific antigen and its derivatives.

BACKGROUND: To characterise the association between demographic and clinical factors and levels of total prostate specific antigen (tPSA) and its molecular derivatives complexed PSA (cPSA), free PSA (fPSA) and the ratio of free to total PSA (%fPSA)] in New Zealand Maori, Pacific Islanders and Europeans, in order to determine whether reported ethnic differences in PSA can be explained by lifestyle and social factors. MATERIALS AND METHODS: Demographic and clinical factors were examined in relation to tPSA, fPSA and cPSA levels, in 1405 Maori, Pacific Island and New Zealand European men with no clinical evidence of prostate cancer, in the Wellington region of New Zealand. Any associations between levels of PSA and PSA derivatives and body mass index, smoking status, family cancer history, non-steroidal anti-inflammatory/vitamin supplement usage, number of sexual partners, age at first intercourse, previous vasectomy, marital/partnership status, educational level and socioeconomic status were investigated by backwards stepwise regression analysis, correcting for age, ethnicity and urinary symptoms. RESULTS: Not being married/partnered was associated with increased tPSA, fPSA and cPSA. tPSA and cPSA decreased with regular non-steroidal anti-inflammatory use. cPSA was decreased in subjects with a first degree relative with any form of cancer. tPSA and fPSA were decreased if the body mass index was > 34. fPSA and %fPSA were decreased in current and former smokers. CONCLUSION: Demographic and clinical factors appear to have a significant effect on levels of PSA and its various derivatives and may account for previously observed ethnic differences. It is important that these associations are taken into account when comparing individual PSA results with standard reference ranges.

Assessment of ethnic variation in serum levels of total, complexed and free prostate specific antigen. Comparison of Maori, Pacific Island and New Zealand European populations.

AIMS: To determine whether age-adjusted levels of serum total (tPSA) and complexed (cPSA) prostate specific antigen and the ratio of free to tPSA (%fPSA) differ by ethnic group independent of symptomatic disease. METHODS: The serum levels of tPSA, cPSA, and %fPSA in relation to age, ethnicity and obstructive urinary symptoms were examined in 1405 Maori, Pacific Island and New Zealand European men in the Wellington region of New Zealand, and indicative reference range estimates produced. Participants were non-randomly selected from two study populations. RESULTS: tPSA and cPSA increased with age while %fPSA decreased with age in all ethnic groups. Maori showed higher tPSA values in the 60-69 age group than other ethnic groups. cPSA increased more rapidly with age in Maori than in New Zealand Europeans or Pacific Islanders. %fPSA differed according to age across all three ethnic groups. The median and 5th percentile Pacific Island %fPSA values were higher in comparison to the %fPSA reference ranges of all other ethnic groups and were also higher than those reported in other studies. Once adjusted for urinary symptom score, only %fPSA in Pacific Island subjects remained significantly higher than that in New Zealand Europeans (P<0.001). CONCLUSIONS: Our study indicates that %fPSA differs by ethnicity independent of symptomatic prostate disease.

Comparability of serum prostate-specific antigen measurement between the Roche Diagnostics Elecsys 2010 and the Abbott Architect i2000.

BACKGROUND: Most prostate cancers are characterized by a significant rise in the production of serum prostate-specific antigen (PSA), which is used widely in screening for prostate cancer. Within New Zealand, PSA is measured on automated immunoassay analysers, including models by Abbott Laboratories (Architect i2000) and Roche Diagnostics (Elecsys 2010). These assays produce similar, but not identical, results. OBJECTIVE: To compare the measurement of PSA between the Elecsys 2010 and the Architect i2000 assay. METHODS: We measured PSA concentrations in each of 194 serum samples using both the Roche Elecsys 2010 and the Abbott Architect i2000 and compared the results using various statistical methods. RESULTS: PSA concentrations measured on the Architect i2000 system were less than those on the Elecsys 2010 system, by an average of 11%. CONCLUSION: Because the results from the two assays are different, reference intervals appropriate to the method of PSA measurement should be used.

Extended roles for allied health professionals: an updated systematic review of the evidence.

BACKGROUND: Internationally, health care services are under increasing pressure to provide high quality, accessible, timely interventions to an ever increasing aging population, with finite resources. Extended scope roles for allied health professionals is one strategy that could be undertaken by health care services to meet this demand. This review builds upon an earlier paper published in 2006 on the evidence relating to the impact extended scope roles have on health care services. METHODS: A systematic review of the literature focused on extended scope roles in three allied health professional groups, ie, physiotherapy, occupational therapy, and speech pathology, was conducted. The search strategy mirrored an earlier systematic review methodology and was designed to include articles from 2005 onwards. All peer-reviewed published papers with evidence relating to effects on patients, other professionals, or the health service were included. All papers were critically appraised prior to data extraction. RESULTS: A total of 1,000 articles were identified by the search strategy; 254 articles were screened for relevance and 21 progressed to data extraction for inclusion in the systematic review. CONCLUSION: Literature supporting extended scope roles exists; however, despite the earlier review calling for more robust evaluations regarding the impact on patient outcomes, cost-effectiveness, training requirements, niche identification, or sustainability, there appears to be limited research reported on the topic in the last 7 years. The evidence available suggests that extended scope practice allied health practitioners could be a cost-effective and consumer-accepted investment that health services can make to improve patient outcomes.