Physical aspects

As teachers, we must know about the physical developmental processes our students are experiencing. These are reflected in behaviour, emotions and relationships. And for adolescents, who are trying hard to figure out how the world operates, the physical changes they experience have a potent impact on their world view. While the sequencing of much of our physical development is pretty well according to a grand template and rolls out in much the same way from one person to the next, not everything occurs in a set way (Richter, 2006). Some aspects of our physical development cause other things to occur and are tied together. For example, hormonal changes during puberty are tied to the development of secondary sexual characteristics. However, there is individual variation at multiple levels, and we will discuss these. To complicate things, adolescents’ feelings and ideas about themselves and the ways in which they interact with the world as they grow and change are coloured by our societies’ multifaceted sets of ideals, standards and expectations for physical development. Many other things also impact on our conceptions of self and these will be discussed when we turn our attention to the development of identity through adolescence. In this chapter we will present some basic information about the types of physical changes to expect during adolescence, and consider some challenges that confront adolescents during this time of development.

Planning for knowledge-based urban development : global perspectives

Purpose: The purpose of this article is to investigate the engineering of creative urban regions through knowledge-based urban development. In recent years city administrators realised the importance of engineering and orchestrating knowledge city formation through visioning and planning for economic, socio-cultural and physical development. For that purpose a new development paradigm of ‘‘knowledge-based urban development’’ is formed, and quickly finds implementation ground in many parts of the globe.----- Design/methodology/approach: The paper reviews the literature and examines global best practice experiences in order to determine how cities are engineering their creative urban regions so as to establish a base for knowledge city formation.----- Findings: The paper sheds light on the different development approaches for creative urban regions, and concludes with recommendations for urban administrations planning for knowledge-based development of creative urban regions.----- Originality/value: The paper provides invaluable insights and discussion on the vital role of planning for knowledge-based urban development of creative urban regions.

The development and validation of Australian Indices of Child Development — Part I: conceptualisation and development

The Longitudinal Study of Australian Children (LSAC) is a major national study examining the lives of Australian children, using a cross-sequential cohort design and data from parents, children, and teachers for 5,107 infants (3–19 months) and 4,983 children (4–5 years). Its data are publicly accessible and are used by researchers from many disciplinary backgrounds. It contains multiple measures of children’s developmental outcomes as well as a broad range of information on the contexts of their lives. This paper reports on the development of summary outcome indices of child development using the LSAC data. The indices were developed to fill the need for indicators suitable for use by diverse data users in order to guide government policy and interventions which support young children’s optimal development. The concepts underpinning the indices and the methods of their development are presented. Two outcome indices (infant and child) were developed, each consisting of three domains—health and physical development, social and emotional functioning, and learning competency. A total of 16 measures are used to make up these three domains in the Outcome Index for the Child Cohort and six measures for the Infant Cohort. These measures are described and evidence supporting the structure of the domains and their underlying latent constructs is provided for both cohorts. The factorial structure of the Outcome Index is adequate for both cohorts, but was stronger for the child than infant cohort. It is concluded that the LSAC Outcome Index is a parsimonious measure representing the major components of development which is suitable for non-specialist data users. A companion paper (Sanson et al. 2010) presents evidence of the validity of the Index.

How well are Australian infants and children aged 4 to 5 years doing? Findings from the Longitudinal Study of Australian Children Wave 1

This report presents an analysis of the data from the first wave of the Longitudinal Study of Australian Children (LSAC) to explore the wellbeing of 5,107 children in the infant cohort of the study and the 4,983 children, aged 4 to 5 years, in the child cohort. Wave 1 of LSAC includes measures of multiple aspects of children’s early development. These developmental measures are summarised in the LSAC Outcome Index, a composite measure which includes an overall index as well as three separate domain scores, tapping physical development, social and emotional functioning, and learning and cognitive development.

Social infrastructure planning and sustainable community : example from south east Queensland, Australia

Social infrastructure and sustainable development represent two distinct but interlinked concepts bounded by a geographic location. For those involved in the planning of a residential development, the notion of social infrastructure is crucial to the building of a healthy community and sustainable environment. This is because social infrastructure is provided in response to the basic needs of communities and to enhance the quality of life, equity, stability and social well being. It also acts as the building block to the enhancement of human and social capital. While acknowledging the different levels of social infrastructure provision from neighbourhood, local, district and sub-regional levels, past evidence has shown that the provision at neighbourhood and local level and are affecting well-being of residents and the community sustainability. With intense physical development taking place in Australia's South East Queensland (SEQ) region, local councils are under immense pressure to provide adequate social and community facilities for their residents. This paper shows how participation-oriented, need-sensitive Integrated Social Infrastructure Planning Guideline is used to offer a solution for the efficient planning and provision of multi-level social infrastructure for the SEQ region. The paper points out to the successful implementation of the guideline for social infrastructure planning in multiple levels of spatial jurisdictions of Australia's fastest growing region.

The development and evaluation of an innovative nursing practice model to improve undergraduate nursing students' competence in paediatric physical assessment

Introduction The purpose of this study was to develop, implement and evaluate the impact of an educational intervention, comprising an innovative model of clinical decisionmaking and educational delivery strategy for facilitating nursing students‘ learning and development of competence in paediatric physical assessment practices. Background of the study Nursing students have an undergraduate education that aims to produce graduates of a generalist nature who demonstrate entry level competence for providing nursing care in a variety of health settings. Consistent with population morbidity and health care roles, paediatric nursing concepts typically form a comparatively small part of undergraduate curricula and students‘ exposure to paediatric physical assessment concepts and principles are brief. However, the nursing shortage has changed traditional nursing employment patterns and new graduates form the majority of the recruitment pool for paediatric nursing speciality staff. Paediatric nursing is a popular career choice for graduates and anecdotal evidence suggests that nursing students who select a clinical placement in their final year intend to seek employment in paediatrics upon graduation. Although concepts of paediatric nursing are included within undergraduate curriculum, students‘ ability to develop the required habits of mind to practice in what is still regarded as a speciality area of practice is somewhat limited. One of the areas of practice where this particularly impacts is in paediatric nursing physical assessment. Physical assessment is a fundamental component of nursing practice and competence in this area of practice is central to nursing students‘ development of clinical capability for practice as a registered nurse. Timely recognition of physiologic deterioration of patients is a key outcome of nurses‘ competent use of physical assessment strategies, regardless of the practice context. In paediatric nursing contexts children‘s physical assessment practices must specifically accommodate the child‘s different physiological composition, function and pattern of clinical deterioration (Hockenberry & Barrera, 2007). Thus, to effectively manage physical assessment of patients within the paediatric practice setting nursing students need to integrate paediatric nursing theory into their practice. This requires significant information processing and it is in this process where students are frequently challenged. The provision of rules or models can guide practice and assist novice-level nurses to develop their capabilities (Benner, 1984; Benner, Hooper-Kyriakidis & Stannard, 1999). Nursing practice models are cognitive tools that represent simplified patterns of expert analysis employing concepts that suit the limited reasoning of the inexperienced, and can represent the =rules‘ referred to by Benner (1984). Without a practice model of physical assessment students are likely to be uncertain about how to proceed with data collection, the interpretation of paediatric clinical findings and the appraisal of findings. These circumstances can result in ad hoc and unreliable nursing physical assessment that forms a poor basis for nursing decisions. The educational intervention developed as part of this study sought to resolve this problem and support nursing students‘ development of competence in paediatric physical assessment. Methods This study utilised the Context Input Process Product (CIPP) Model by Stufflebeam (2004) as the theoretical framework that underpinned the research design and evaluation methodology. Each of the four elements in the CIPP model were utilised to guide discrete stages of this study. The Context element informed design of the clinical decision-making process, the Paediatric Nursing Physical Assessment model. The Input element was utilised in appraising relevant literature, identifying an appropriate instructional methodology to facilitate learning and educational intervention delivery to undergraduate nursing students, and development of program content (the CD-ROM kit). Study One employed the Process element and used expert panel approaches to review and refine instructional methods, identifying potential barriers to obtaining an effective evaluation outcome. The Product element guided design and implementation of Study Two, which was conducted in two phases. Phase One employed a quasiexperimental between-subjects methodology to evaluate the impact of the educational intervention on nursing students‘ clinical performance and selfappraisal of practices in paediatric physical assessment. Phase Two employed a thematic analysis and explored the experiences and perspectives of a sample subgroup of nursing students who used the PNPA CD-ROM kit as preparation for paediatric clinical placement. Results Results from the Process review in Study One indicated that the prototype CDROM kit containing the PNPA model met the predetermined benchmarks for face validity and the impact evaluation instrumentation had adequate content validity in comparison with predetermined benchmarks. In the first phase of Study Two the educational intervention did not result in statistically significant differences in measures of student performance or self-appraisal of practice. However, in Phase Two qualitative commentary from students, and from the expert panel who reviewed the prototype CD-ROM kit (Study One, Phase One), strongly endorsed the quality of the intervention and its potential for supporting learning. This raises questions regarding transfer of learning and it is likely that, within this study, several factors have influenced students‘ transfer of learning from the educational intervention to the clinical practice environment, where outcomes were measured. Conclusion In summary, the educational intervention employed in this study provides insights into the potential e-learning approaches offer for delivering authentic learning experiences to undergraduate nursing students. Findings in this study raise important questions regarding possible pedagogical influences on learning outcomes, issues within the transfer of theory to practice and factors that may have influenced findings within the context of this study. This study makes a unique contribution to nursing education, specifically with respect to progressing an understanding of the challenges faced in employing instructive methods to impact upon nursing students‘ development of competence. The important contribution transfer of learning processes make to students‘ transition into the professional practice context and to their development of competence within the context of speciality practice is also highlighted. This study contributes to a greater awareness of the complexity of translating theoretical learning at undergraduate level into clinical practice, particularly within speciality contexts.

The contribution of physical activity and sedentary behaviours to the growth and development of children and adolescents : implications for overweight and obesity

The obesity epidemic is a global trend and is of particular concern in children. Recent reports have highlighted the severity of obesity in children by suggesting: “today's generation of children will be the first for over a century for whom life expectancy falls.” This review assesses the evidence that identifies the important role of physical activity in the growth, development and physical health of young people, owing to its numerous physical and psychological health benefits. Key issues, such as “does a sedentary lifestyle automatically lead to obesity” and “are levels of physical activity in today's children less than physical activity levels in children from previous generations?”, are also discussed. Today's environment enforces an inactive lifestyle that is likely to contribute to a positive energy balance and childhood obesity. Whether a child or adolescent, the evidence is conclusive that physical activity is conducive to a healthy lifestyle and prevention of disease. Habitual physical activity established during the early years may provide the greatest likelihood of impact on mortality and longevity. It is evident that environmental factors need to change if physical activity strategies are to have a significant impact on increasing habitual physical activity levels in children and adolescents. There is also a need for more evidence-based physical activity guidelines for children of all ages. Efforts should be concentrated on facilitating an active lifestyle for children in an attempt to put a stop to the increasing prevalence of obese children

Physical activity amongst people with chronic back pain : an investigation of perceived barriers and facilitators to inform intervention development

Previous research has indicated people with non-specific low back pain who are physically inactive face a poorer prognosis than people with back pain who participate in low or moderate intensity physical activity. They also face a greater risk of other lifestyle related health conditions, such as diabetes and heart disease. For these reasons, contemporary non-surgical interventions for low back pain aim to incorporate a return to physical activity. However, there is a lack of empirical evidence supporting physical activity interventions for this purpose. It is likely that people with low back pain face additional challenges when trying to commence (or return to) regular physical activity. This exploratory qualitative research aimed to map out perceived barriers and facilitators to undertaking physical activity among people with non-specific low back pain to inform future intervention development.

Iterative development of MobileMums : a physical activity intervention for women with young children.

Background To describe the iterative development process and final version of ‘MobileMums’: a physical activity intervention for women with young children (<5 years) delivered primarily via mobile telephone (mHealth) short messaging service (SMS). Methods MobileMums development followed the five steps outlined in the mHealth development and evaluation framework: 1) conceptualization (critique of literature and theory); 2) formative research (focus groups, n= 48); 3) pre-testing (qualitative pilot of intervention components, n= 12); 4) pilot testing (pilot RCT, n= 88); and, 5) qualitative evaluation of the refined intervention (n= 6). Results Key findings identified throughout the development process that shaped the MobileMums program were the need for: behaviour change techniques to be grounded in Social Cognitive Theory; tailored SMS content; two-way SMS interaction; rapport between SMS sender and recipient; an automated software platform to generate and send SMS; and, flexibility in location of a face-to-face delivered component. Conclusions The final version of MobileMums is flexible and adaptive to individual participant’s physical activity goals, expectations and environment. MobileMums is being evaluated in a community-based randomised controlled efficacy trial (ACTRN12611000481976).

Development and validation of a new self-report instrument for measuring sedentary behaviors and light-intensity physical activity in adults

Background Low levels of physical activity and high levels of sedentary behavior (SB) are major public health concerns. This study was designed to develop and validate the 7-day Sedentary (S) and Light Intensity Physical Activity (LIPA) Log (7-day SLIPA Log), a self-report measure of specific daily behaviors. Method To develop the log, 62 specific SB and LIPA behaviors were chosen from the Compendium of Physical Activities. Face-to-face interviews were conducted with 32 sedentary volunteers to identify domains and behaviors of SB and LIPA. To validate the log, a further 22 sedentary adults were recruited to wear the GT3X for 7 consecutive days and nights. Results Pearson correlations (r) between the 7-day SLIPA Log and GT3X were significant for sedentary (r =.86, p < 0.001), for LIPA (r =.80, p < 0.001). Lying and sitting postures were positively correlated with GT3X output (r =.60 and r =.64, p < 0.001, respectively). No significant correlation was found for standing posture (r =.14, p = 0.53).The kappa values between the 7-day SLIPA Log and GT3X variables ranged from 0.09–0.61, indicating poor to good agreement. Conclusion The 7-day SLIPA Log is a valid self-report measure of SB and LIPA in specific behavioral domains.

The local library across the digital and physical city : opportunities for economic development

This paper considers the role of the public library as a community hub, engagement space, and entrepreneurial incubator in the context of the city, city governance, and local government planning. It considers this role from the perspective of library experts and their future visions for libraries in a networked knowledge economy. Public libraries (often operated by or on behalf of local governments) potentially play a pivotal role for local governments in positioning communities within the global digital network. Fourteen qualitative interviews with library experts informed the study which investigates how the relationship between digital technology and the physical library space can potentially support the community to develop innovative, collaborative environments for transitioning to a digital future. The study found that libraries can capitalise on their position as community hubs for two purposes: first, to build vibrant community networks and forge economic links across urban localities; and second, to cross the digital divide and act as places of innovation and lifelong learning. Libraries provide a specific combination of community and technology spaces and have significant tangible connection points in the digital age. The paper further discusses the potential benefits for libraries in using ICT networks and infrastructure, such as the National Broadband Network in Australia. These networks could facilitate greater use of library assets and community knowledge, which, in turn, could assist knowledge economies and regional prosperity.

What factors influence nurses’ assessment practices? Development of the Barriers to Nurses’ use of Physical Assessment Scale

Aim To develop and psychometrically test the Barriers to Nurses’ use of Physical Assessment Scale. Background There is growing evidence of failure to recognise hospitalised patients at risk of clinical deterioration, in part due to inadequate physical assessment by nurses. Yet, little is known about the barriers to nurses’ use of physical assessment in the acute hospital setting and no validated scales have been published. Design Instrument development study. Method Scale development was based on a comprehensive literature review, focus groups, expert review and psychometric evaluation. The scale was administered to 434 acute care registered nurses working at a large Australian teaching hospital between June and July 2013. Psychometric analysis included factor analysis, model fit statistics and reliability testing. Results The final scale was reduced to 38 items representing seven factors, together accounting for 57.7% of the variance: (1) reliance on others and technology, (2) lack of time and interruptions, (3) ward culture, (4) lack of confidence, (5) lack of nursing role models, (6) lack of influence on patient care, and; (7) specialty area. Internal reliability ranged from .70 to .86. Conclusion Findings provide initial evidence for the validity and reliability of the Barriers to Nurses’ use of Physical Assessment Scale and point to the importance of understanding the organisational determinants of nurses’ assessment practices. The new scale has potential clinical and research applications to support nursing assessment in acute care settings.

Why are early maturing girls less active? Links between pubertal development, psychological well-being, and physical activity among girls at ages 11 and 13

Previous research has shown that early maturing girls at age I I have lower subsequent physical activity at age 13 in comparison to later maturing girls. Possible reasons for this association have not been assessed. This study examines girls' psychological response to puberty and their enjoyment of physical activity as intermediary factors linking pubertal maturation and physical activity. Participants included 178 girls who were assessed at age 11, of whom 168 were reassessed at age 13. All participants were non-Hispanic white and resided in the US. Three measures of pubertal development were obtained at age I I including Tanner breast stage, estradiol levels, and mothers' reports of girls' development on the Pubertal Development Scale (PDS). Measures of psychological well-being at ages I I and 13 included depression, global self-worth, perceived athletic competence, maturation fears, and body esteem. At age 13, girls' enjoyment of physical activity was assessed using the Physical Activity Enjoyment Scale and their daily minutes of moderate-to-vigorous physical activity (MVPA) were assessed using objective monitoring. Structural Equation Modeling was used to assess direct and indirect pathways between pubertal development at age I I and MVPA at age 13. In addition to a direct effect of pubertal development on MVPA, indirect effects were found for depression, global self-worth and maturity fears controlling for covariates. In each instance, more advanced pubertal development at age I I was associated with lower psychological wellbeing at age 13, which predicted lower enjoyment of physical activity at age 13 and in turn lower MVPA. Results from this study suggest that programs designed to increase physical activity among adolescent girls should address the self-consciousness and discontent that girls' experience with their bodies during puberty, particularly if they mature earlier than their peers, and identify activities or settings that make differences in body shape less conspicuous.

Perceived barriers and facilitators to increasing physical activity among people with musculoskeletal disorders : a qualitative investigation to inform intervention development

Purpose Musculoskeletal conditions can impair people’s ability to undertake physical activity as they age. The purpose of this qualitative study was to investigate perceived barriers and facilitators to undertaking physical activity reported by patients accessing ambulatory hospital clinics for musculoskeletal disorders. Patients and methods A questionnaire with open-ended items was administered to patients (n=217, 73.3% of 296 eligible) from three clinics providing ambulatory services for nonsurgical treatment of musculoskeletal disorders. The survey included questions to capture the clinical and demographic characteristics of the sample. It also comprised two open-ended questions requiring qualitative responses. The first asked the participant to describe factors that made physical activity more difficult, and the second asked which factors made it easier for them to be physically active. Participants’ responses to the two open-ended questions were read, coded, and thematically analyzed independently by two researchers, with a third researcher available to arbitrate any unresolved disagreement. Results The mean (standard deviation) age of participants was 53 (15) years; n=113 (52.1%) were male. A total of 112 (51.6%) participants reported having three or more health conditions; n=140 (64.5%) were classified as overweight or obese. Five overarching themes describing perceived barriers for undertaking physical activity were "health conditions", "time restrictions", "poor physical condition", "emotional, social, and psychological barriers", and "access to exercise opportunities". Perceived physical activity facilitators were also aligned under five themes, namely "improved health state", "social, emotional, and behavioral supports", "access to exercise environment", "opportunities for physical activities", and "time availability". Conclusion It was clear from the breadth of the data that meaningful supports and interventions must be multidimensional. They should have the capacity to address a variety of physical, functional, social, psychological, motivational, environmental, lifestyle, and other perceived barriers. It would appear that for such interventions to be effective, they should be flexible enough to address a variety of specific concerns.