‘We need to know what’s going on’: views of family members toward the sexual expression of people with dementia in residential aged care

This paper reports on a study which explored the views and attitudes of family members towards the sexual expression of residents with dementia in residential aged care facilities in two states in Australia. Recruitment was challenging and only seven family members agreed to an interview on this topic. Data were analysed using a constant comparative method. Family were generally supportive of residents’ rights to sexual expression, but only some types of behaviours were approved of. There was an acknowledgement that responding to residents’ sexuality was difficult for staff and many families believed that they should be kept informed of their relative’s sexual behaviours and moreover be involved in decision making about it. Findings suggest the need for family education and a larger study to better understand the views and motivations of family carers and how these might impact on the sexual expression of the older person with dementia living in residential aged care.

Prevalence of health behaviours in pregnancy at service entry in a Queensland health service district

Objective: Limited prevalence data for unhealthy pregnancy health behaviours make it difficult to prioritise primary prevention efforts for maternal and infant health. This study's objective was to establish the prevalence of cigarette smoking, sufficient fruit and vegetable intake and sufficient physical activity among women accessing antenatal clinics in a Queensland (Australia) health service district. Method: Cross-sectional self-reported smoking status, daily fruit and vegetable intake, weekly physical activity and a range of socio-demographic variables were obtained from women recruited at their initial antenatal clinic visit, over a three-month recruitment phase during 2007. Results: Analyses were based on 262 pregnant women. The study sample was broadly representative of women giving birth in the district and state, with higher representation of women with low levels of education and high income. More than one quarter of women were smoking. Few women met the guidelines for sufficient fruit (9.2%), vegetables (2.7%) or physical activity (32.8%) during pregnancy. Conclusions: There were low levels of adherence to health behaviour recommendations for pregnancy in this sample. Implications: There is a clear need to develop and evaluate effective pregnancy behaviour interventions to improve primary prevention in maternal and infant health. Brief minimal contact interventions that can be delivered through primary care to create a greater primary prevention focus for maternal and infant health would be worth exploring.

Is recovery driven by central or peripheral factors? A role for the brain in recovery following intermittent-sprint exercise

Prolonged intermittent-sprint exercise (i.e., team sports) induce disturbances in skeletal muscle structure and function that are associated with reduced contractile function, a cascade of inflammatory responses, perceptual soreness, and a delayed return to optimal physical performance. In this context, recovery from exercise-induced fatigue is traditionally treated from a peripheral viewpoint, with the regeneration of muscle physiology and other peripheral factors the target of recovery strategies. The direction of this research narrative on post-exercise recovery differs to the increasing emphasis on the complex interaction between both central and peripheral factors regulating exercise intensity during exercise performance. Given the role of the central nervous system (CNS) in motor-unit recruitment during exercise, it too may have an integral role in post-exercise recovery. Indeed, this hypothesis is indirectly supported by an apparent disconnect in time-course changes in physiological and biochemical markers resultant from exercise and the ensuing recovery of exercise performance. Equally, improvements in perceptual recovery, even withstanding the physiological state of recovery, may interact with both feed-forward/feed-back mechanisms to influence subsequent efforts. Considering the research interest afforded to recovery methodologies designed to hasten the return of homeostasis within the muscle, the limited focus on contributors to post-exercise recovery from CNS origins is somewhat surprising. Based on this context, the current review aims to outline the potential contributions of the brain to performance recovery after strenuous exercise.

Impact of cognitive behaviour therapy via mail for cessation of benzodiazepine use : a series of case reports

Benzodiazepines are widely prescribed to manage sleep disorders, anxiety and muscular tension. While providing short-term relief, continued use induces tolerance and withdrawal, and in older users, increases the risk of falls. However, long-term prescription remains common, and effective interventions are not widely available. This study developed a self-managed cognitive behaviour therapy package for cessation of benzodiazepine use delivered to participants via mail (M-CBT) and trialled its effectiveness as an adjunct to a general practitioner (GP)-managed dose reduction schedule. In the pilot trial, participants were randomly assigned to GP management with immediate or delayed M-CBT. Significant recruitment and engagement problems were experienced, and only three participants were allocated to each condition. After immediate M-CBT, two participants ceased use, while none receiving delayed treatment reduced daily intake by more than 50%. Across the sample, doses at 12 months remained significantly lower than baseline, and qualitative feedback from participants was positive. While M-CBT may have promise, improved engagement of GPs and participants is needed for this approach to substantially impact on community-wide benzodiazepine use.

Hospital liability for sexual assault of a patient

Hospital liability for alleged sexual assault upon a medicated patient by an orderly - non-delegable duty owed by a hospital to its patients - vicarious liability - liability for criminal conduct by employer - recruitment processes - assessment of damages.

Fasting increases serum bilirubin levels in clinically normal, healthy males but not females : a retrospective study from phase I clinical trial participants

Aim: To examine if fasting affects serum bilirubin levels in clinical healthy males and females. Methods: We utilised retrospective data from phase 1 clinical trials where blood was collected in either a fed or fasting state at screening and pre-dosing time points and analysed for total bilirubin levels as per standard clinical procedures. Participants were clinically healthy males (n = 105) or females (n = 30) aged 18 to 48 inclusive who participated in a phase 1 clinical trial in 2012 or 2013. Results: We found a statistically significant increase in total serum bilirubin levels in fasting males as compared to non-fasting males. The fasting time correlated positively with increased bilirubin levels. The age of the healthy males did not correlate with their fasting bilirubin level. We found no correlation between fasting and bilirubin levels in clinically normal females. Conclusions: The recruitment and screening of volunteers for a clinical trial is a time-consuming and expensive process. This study clearly demonstrates that testing for serum bilirubin should be conducted on non-fasting male subjects. If fasting is required, then participants should not be excluded from a trial based on an elevated serum bilirubin that is deemed non-clinically significant.

Critical success factors for the implementation of a knowledge management system in a knowledge-based engineering firm

This research identifies factors that are crucial to the success of a knowledge management system (KMS) implementation in a prominent Australian engineering consultancy firm. The study employs the Delphi method to solicit the opinions of experienced market leaders in the Australian construction industry, and then benchmarks the organisational profile of the consultancy firm against the Delphi findings. From this comparative case study, recommendations are made pertaining to the organisational and cultural changes required within the consultancy firm in order to improve its readiness to successfully implement a KMS.

The influence of school science teachers : the differential importance attributed by males and females to encouragement from science teachers

Research on the achievement and retention of female students in science and mathematics is located within a context of falling levels of participation in physical science and mathematics courses in Australian schools, and underrepresentation of females in some science, technology, engineering and mathematics (STEM) courses. The Interests and Recruitment in Science (IRIS) project is an international project that aims to contribute to understanding and improving recruitment, retention and gender equity in STEM higher education. Nearly 3500 first year students in 30 Australian universities responded to the IRIS survey of 5-point Likert items and open responses. This paper explores gender differences in first year university students’ responses to three questions about important influences on their course choice. The IRIS study found good teachers were rated highly by both males and females as influential in choosing STEM courses, and significantly higher numbers of females rated personal encouragement from senior high school science teacher as very important. In suggestions for addressing sex disparities in male-dominated STEM courses, more females indicated the importance of good teaching/encouragement and more females said (unspecified) encouragement. This study relates to the influence of school science teachers and results are discussed in relation to implications for science education.

Starting out in STEM : a study of young men and women in first year science, technology, engineering and mathematics courses

In late 2011, first year university students in science, technology, engineering and mathematics (STEM) courses across Australia were invited to participate in the international Interests and Recruitment in Science (IRIS) study. IRIS investigates the influences on young people's decisions to choose university STEM courses and their subsequent experiences of these courses. The study also has a particular focus on the motivations and experiences of young women in courses such as physics, IT and engineering given the low rates of female participation in these fields. Around 3500 students from 30 Australian universities contributed their views on the relative importance of various school and non-school influences on their decisions, as well as insights into their experiences of university STEM courses so far. It is hoped that their contributions will help improve recruitment, retention and gender equity in STEM higher education and careers.

Attracting and retaining specialist teachers and non-teaching professionals in Queensland secondary schools : a report to the Queensland Department of Education and Training

This report provides the Queensland Department of Education and Training (DET) with independent evidence based data to enable the identification of barriers and enablers to effective attraction and retention of suitably qualified people to specialist teaching and non‐teaching roles in Queensland secondary schools. The scope of this report is to consider the strategic imperatives, trends, and drivers as they apply to the recruitment and retention of specialised teachers and non‐teaching professionals. The research was specifically designed to inform DET on innovative and novel strategies to recruit and retain staff within Education Queensland in areas specifically identified as at risk of experiencing shortages in the near future. Those areas considered to be at risk of experiencing shortages included: • Teaching principals • Specialist teachers in mathematics, science, industrial technology and design, and special education • Non‐teaching professional roles, such as speech pathologists, occupational therapists, physiotherapists and registered nurses providing services in schools to students with special needs.

Management [5th Asia-Pacific Edition]

The fifth edition of this text has been thoroughly updated, continuing its strong emphasis on the importance of the Asian region to contemporary Australian and New Zealand organisations. Many Asian case examples are featured to illustrate key management concepts, and these provide a useful basis for comparison with management practices in Australia and New Zealand. Numerous practical examples throughout the text highlight contemporary management issues, such as: •workplace diversity •sustainability •ethics/corporate social responsibility •the impact of technology •innovation in the workplace •globalisation •employee engagement •flexible working arrangements •work-life balance •generational issues in the workplace •skills shortages in various industries •the importance of effective employee recruitment and training •organisational culture •workforce flexibility and casualisation •the ‘24/7’ nature of contemporary communication technology, including social media •outsourcing Management, 5th Asia Pacific edition, has also retained the features that have made previous editions so popular with students and lecturers, including the Career Readiness Workbook activities at the end of the book, and the accompanying Interactive Study Guide with its vast array of multimedia resources.

Management : Foundations and Applications (2nd Asia-Pacific Edition)

The second edition of this text has been thoroughly updated, continuing its strong emphasis on the importance of the Asian region to contemporary Australian and New Zealand organisations. Many Asian case examples are featured to illustrate key management concepts, and these provide a useful basis for comparison with management practices in Australia and New Zealand. Numerous practical examples throughout the text highlight contemporary management issues, such as: •workplace diversity •sustainability •ethics/corporate social responsibility •the impact of technology •innovation in the workplace •globalisation •employee engagement •flexible working arrangements •work-life balance •generational issues in the workplace •skills shortages in various industries •the importance of effective employee recruitment and training •organisational culture •workforce flexibility and casualisation •the ‘24/7’ nature of contemporary communication technology, including social media •outsourcing Management, Foundation and Applications, 2nd Asia-Pacific edition, has also retained the features that made its previous edition so popular with students and lecturers, including the Career Readiness Workbook activities at the end of the book, and the accompanying Interactive Study Guide with its vast array of multimedia resources.

The consultative process used in outreach : a narrative account

Aim The aim of this paper was to provide a narrative account of the communication skills used in an effective outreach consultation utilizing Neighbour’s consultative model. Other consultation models were considered; however, because of their overly comprehensive approach or emphasis on behaviour modification, these were deemed inappropriate. Background The nursing profession has endured significant changes of late and as a result is developing more autonomous roles in both the community and the acute health care settings. In the past, the term consultancy was used within the medical context; nowadays, there are advance nurse practitioners for whom consultancy is an integral part of their role. Although every nursing interaction is in essence a consultation, the fact that nurses are taking up on new advanced roles highlights the necessity for nurses to develop their consultation skills even further. Therefore, it makes sense to explore what aspects of that consultancy role needs special consideration in order to ensure that positive outcomes are achieved. Conclusions This paper has used a narrative account to uncover those salient skills needed to enhance the therapeutic relationship with a patient requiring the services of outreach. Furthermore, the application of a recognized consultation model was used to elucidate the underpinning knowledge of systematic history taking and assessment as well as demonstrating the communication skills and strategies needed to increase the patient’s participation and empowerment throughout the consultation. Relevance to clinical practice Effective communication skills encompassed in a consultative model are integral to the success in safeguarding the well-being of patients requiring advanced levels of care. Prejudging or pre-empting information being conveyed can be detrimental to patient safety and may prolong or complicate treatment plans.

Is age a factor in the success or failure of remote monitoring in heart failure? Telemonitoring and structured telephone support in elderly heart failure patients

Background There are few data regarding the effectiveness of remote monitoring for older people with heart failure. We conducted a post-hoc sub-analysis of a previously published large Cochrane systematic review and meta-analysis of relevant randomized controlled trials to determine whether structured telephone support and telemonitoring were effective in this population. Methods A post hoc sub-analysis of a systematic review and meta-analysis that applied the Cochrane methodology was conducted. Meta-analyses of all-cause mortality, all-cause hospitalizations and heart failure-related hospitalizations were performed for studies where the mean or median age of participants was 70 or more years. Results The mean or median age of participants was 70 or more years in eight of the 16 (n=2,659/5,613; 47%) structured telephone support studies and four of the 11 (n=894/2,710; 33%) telemonitoring studies. Structured telephone support (RR 0.80; 95% CI=0.63-1.00) and telemonitoring (RR 0.56; 95% CI=0.41-0.76) interventions reduced mortality. Structured telephone support interventions reduced heart failure-related hospitalizations (RR 0.81; 95% CI=0.67-0.99). Conclusion Despite a systematic bias towards recruitment of individuals younger than the epidemiological average into the randomized controlled trials, older people with heart failure did benefit from structured telephone support and telemonitoring. These post-hoc sub-analysis results were similar to overall effects observed in the main meta-analysis. While further research is required to confirm these observational findings, the evidence at hand indicates that discrimination by age alone may be not be appropriate when inviting participation in a remote monitoring service for heart failure.