Methods and preliminary results for a data linkage project to determine long-term survival after intensive care unit admission

Aims: To describe a local data linkage project to match hospital data with the Australian Institute of Health and Welfare (AIHW) National Death Index (NDI) to assess longterm outcomes of intensive care unit patients. Methods: Data were obtained from hospital intensive care and cardiac surgery databases on all patients aged 18 years and over admitted to either of two intensive care units at a tertiary-referral hospital between 1 January 1994 and 31 December 2005. Date of death was obtained from the AIHW NDI by probabilistic software matching, in addition to manual checking through hospital databases and other sources. Survival was calculated from time of ICU admission, with a censoring date of 14 February 2007. Data for patients with multiple hospital admissions requiring intensive care were analysed only from the first admission. Summary and descriptive statistics were used for preliminary data analysis. Kaplan-Meier survival analysis was used to analyse factors determining long-term survival. Results: During the study period, 21 415 unique patients had 22 552 hospital admissions that included an ICU admission; 19 058 surgical procedures were performed with a total of 20 092 ICU admissions. There were 4936 deaths. Median follow-up was 6.2 years, totalling 134 203 patient years. The casemix was predominantly cardiac surgery (80%), followed by cardiac medical (6%), and other medical (4%). The unadjusted survival at 1, 5 and 10 years was 97%, 84% and 70%, respectively. The 1-year survival ranged from 97% for cardiac surgery to 36% for cardiac arrest. An APACHE II score was available for 16 877 patients. In those discharged alive from hospital, the 1, 5 and 10-year survival varied with discharge location. Conclusions: ICU-based linkage projects are feasible to determine long-term outcomes of ICU patients

Empirical derivation and validation of a wandering typology

OBJECTIVES: To develop and validate a wandering typology. ---------- DESIGN: Cross-sectional, correlational descriptive design. ---------- SETTING:: Twenty-two nursing homes and six assisted living facilities. ---------- PARTICIPANTS: One hundred forty-two residents with dementia who spoke English, met Diagnostic and Statistical Manual for Mental Disorders, Fourth Edition, criteria for dementia, scored less than 24 on the Mini-Mental State Examination (MMSE), were ambulatory (with or without assistive device), and maintained a stable regime of psychotropic medications were studied. ---------- MEASUREMENTS: Data on wandering were collected using direct observations, plotted serially according to rate and duration to yield 21 parameters, and reduced through factor analysis to four components: high rate, high duration, low to moderate rate and duration, and time of day. Other measures included the MMSE, Minimum Data Set 2.0 mobility items, Cumulative Illness Rating Scale—Geriatric, and tympanic body temperature readings. ---------- RESULTS: Three groups of wanderers were identified through cluster analysis: classic, moderate, and subclinical. MMSE, mobility, and cardiac and upper and lower gastrointestinal problems differed between groups of wanderers and in comparison with nonwanderers. ---------- CONCLUSION: Results have implications for improving identification of wanderers and treatment of possible contributing factors.

The phenomenon of resilience as described by adults who have experienced mental illness

Aim: This paper is a report of a study to explore the phenomenon of resilience in the lives of adult patients of mental health services who have experienced mental illness. ---------- Background: Mental illness is a major health concern worldwide, and the majority experiencing it will continue to battle with relapses throughout their lives. However, in many instances people go on to overcome their illness to lead productive and socially engaged lives. Contemporary mental health nursing practice primarily focuses on symptom reduction, and working with resilience has not generally been a consideration. ---------- Method: A descriptive phenomenological study was carried out in 2006. One participant was recruited through advertisements in community newspapers and newsletters and the others using the snowballing method. Information was gathered through in-depth individual interviews which were tape-recorded and subsequently transcribed. Colaizzi's original seven-step approach was used for data analysis, with the inclusion of two additional steps. ---------- Findings: The following themes were identified: Universality, Acceptance, Naming and knowing, Faith, Hope, Being the fool and Striking a balance, Having meaning and meaningful relationships, and 'Just doing it'. The conceptualization identified as encapsulating the themes was 'Viewing life from the ridge with eyes wide open', which involved knowing the risks and dangers ahead and making a decision for life amid ever-present hardships. ---------- Conclusion: Knowledge about resilience should be included in the theoretical and practical education of nursing students and experienced nurses. Early intervention, based on resilience factors identified through screening processes, is needed for people with mental illness.

Understanding parental physical activity : meanings, habits, and social role influence

Objectives: The research aimed to explore parents’ understandings of physical activity (PA), patterns of PA-related behaviour, and how constructions of social role expectations might influence their PA behaviour. Design and Method: Using a qualitative descriptive design and adopting a social constructionism approach to broaden interpretations of parents’ understandings, 40 adults (21 mothers, 19 fathers; aged 23 to 49 years) living in South East Queensland, Australia participated in semi-structured individual and group interviews. The interviews were analysed using thematic analysis. Results: Parents had clear understandings of what constitutes PA and engaged in various activities which were integrated with or independent of the children. Being active with children, however, was not always constructed favourably in which many parents described the difficulties of being active with their children. All individuals experienced changes in their PA behaviours after having children. For most, a decline in PA level, intensity, and structure was experienced; however, some did experience parenthood as a time to be active. A level of acceptance for the lack of activity performed was also expressed as were feelings of resentment and envy for those who maintained previous activity habits. Parenting and partner roles were considered most influential on PA-related behaviour and were constructed in ways that had both positive and negative influences on activity performance. Parents, however, were empowered to construct strategies to resolve conflicts between social role performance and being active. Conclusion: Results show that parents experience unique difficulties that intervention work should consider when designing programs aimed at increasing parental PA.

Masculinity, rurality and violence

The assumption that the size, anonymity and weakened social controls of urban living generates social conflict, disorganization and higher rates of crime and violence has been an article of faith in much criminological and social scientific inquiry since the nineteenth century (i.e. Tönnies 1897; Shaw and McKay 1931; Levin and Lindesmith 1937; Nisbet 1970; Baldwin and Bottoms 1976; Felson 1994). The paper challenges this article of criminological faith and questions the utility of urban centric criminological theorizing about the causes of violence in rural settings. Drawing on descriptive data that show that rural men present a relatively high risk of inflicting harm upon themselves and others, this paper explores the larger socio-criminological question as to why this might be. The question is examined in relation to the processes of community formation that shape the everyday architecture of rural life. We explore how that architecture has historically valorized violent expressions of masculinity grounded in a relationship between men's bodies and the rural landscapes they inhabit - but how the legitimacy of these violent expressions are being challenged by sweeping social, economic and political changes. One psycho-social response to these sweeping social changes to rural life, we conclude, is a resort to violence as a largely strategic practice deployed to recreate an imagined rural gender order.

Who and Why? Demographic and psychographic differences between consumers who have altered their shopping behaviour during a recession and those who have not

Research suggests that people differ in terms of changing their shopping behaviour during a recession. This paper reports on a preliminary descriptive study assessing what influences those consumers who have altered their shopping behaviour during such times. Driving the alteration of shopping behaviour were both demographic (age, gender, education, and nationality) and psychographic variables (attitudes, and head vs. heart decision making). Overall, the findings show that there are statistically significant differences between the two groups’ that marketers can address in their marketing strategies during the recession.

Relational factors that explain supply chain relationships

Purpose: The purpose of this paper is to gain a better understanding of the types of relationships that exist along the supply chain and the capabilities that are needed to manage them effectively. ---------- Design/methodology/approach: This is exploratory research as there has been little empirical research into this area. Quantitative data were gathered by using a self-administered questionnaire, using the Australian road freight industry as the context. There were 132 usable responses. Inferential and descriptive analysis, including factor analysis, confirmatory factor and regression analysis was used to examine the predictive power of relational factors in inter-firm relationships. ---------- Findings: Three factors were identified as having significant influence on relationships: sharing, power and interdependency. “Sharing” is the willingness of the organisation to share resources with other members of the supply chain. “Power” relates to exercising control based on experience, knowledge and position in the supply chain. “Interdependency” is the relative levels of dependency along the supply chain. ---------- Research limitations/implications: The research only looks at the Australian road freight industry; a wider sample including other industries would help to strengthen the generalisability of the findings. ---------- Practical implications: When these factors are correlated to the types of relationship, arm's length, cooperation, collaboration and alliances, managerial implications can be identified. The more road freight businesses place importance on power, the less they will cooperate. The greater the importance of sharing and interdependency, the greater is the likelihood of arm's length relationships. ---------- Originality/value: This paper makes a contribution by describing empirical work conducted in an under-researched but important area – supply chain relationships in the Australian road freight industry.

Modeling factors that influence exercise and dietary change among midlife Australian women: results from the Healthy Aging of Women Study

The objective of this study was to investigate the factors that influence midlife women to make positive exercise and dietary changes. In late 2005 questionnaires were mailed to 866 women aged 51–66 years from rural and urban locations in Queensland, Australia and participating in Stage 2 of the Healthy Aging of Women Study. The questionnaires sought data on socio-demographics, body mass index (BMI), chronic health conditions, self-efficacy, exercise and dietary behavior change since age 40, and health-related quality of life. Five hundred and sixty four (69%) were completed and returned by early 2006. Data analysis comprised descriptive and bivariate statistics and structural equation modeling. The results showed that midlife is a significant time for women to make positive health behavior changes. Approximately one-third of the sample (34.6%) indicated that they had increased their exercise and around 60% had made an effort to eat more healthily since age 40. Modeling showed self-efficacy to be important in making both exercise and dietary changes. Although education appeared to influence self-efficacy in relation to exercise change, this was not the case for dietary change. The study has application for programs promoting healthy aging among women, and implies that those with low education, high BMI and poor mental health may need considerable support to improve their lifestyles.

Nursing resource implications of the unoccupied bed

Objective: To explore the specific factors that impact on nursing resources in relation to the ‘unoccupied bed’. Design: Descriptive observational Setting: Multiple wards in single site, tertiary referral hospital Main outcome measure: Identification and classification of tasks related to the unoccupied bed. Results: Our study identified three main areas of nursing work, which centre on the ‘unoccupied bed’: 1) bed preparation for admission; 2) temporary transfer; 3) bed preparation post patient discharge. Conclusion: The unoccupied bed is not resource neutral and may involve considerable nursing time. The time associated with each of the reasons for the bed being unoccupied remains to be quantified.

Needing to connect : The effect of self and others on young people’s involvement with their mobile phones

The present research was a preliminary examination of young Australians’ mobile phone behaviour. The study explored the relationship between, and psychological predictors of, frequency of mobile phone use and mobile phone involvement conceptualised as people’s cognitive and behavioural interaction with their mobile phone. Participants were 946 Australian youth aged between 15 and 24 years. A descriptive measurement tool, the Mobile Phone Involvement Questionnaire (MPIQ), was developed. Self-identity and validation from others were explored as predictors of both types of mobile phone behaviour. A distinction was found between frequency of mobile phone use and mobile phone involvement. Only self-identity predicted frequency of use whereas both self-identity and validation from others predicted mobile phone involvement. These findings reveal the importance of distinguishing between frequency of use and people’s psychological relationship with their phone and that factors relating to one’s self-concept and approval from others both impact on young people’s mobile phone involvement.

Don’t judge a superannuation default investment option by its name

With the massive decline in savings arising from the Global Financial Crisis (GFC), it is timely to review superannuation fund investment and disclosure strategies in the lead-up to the crisis. Accordingly, this study examines differences among superannuation funds’ default investment options in terms of naming and framing over three years from 2005 to 2007, as presented in product disclosure statements (PDSs). The findings indicate that default options are becoming more alike regardless of their name, and consequently, members may face increasing difficulties in distinguishing between balanced and growth-named default options when comparing them across superannuation funds. Comparability is also likely to be constrained by variations in the framing of default options presented in investment option menus in PDSs. These findings highlight the need for standardisation of default option definitions and disclosures to ensure descriptive accuracy, transparency and comparability.

An evaluation of IS-impact utility and intuitiveness

This study is conducted within the IS-Impact Research Track at Queensland University of Technology (QUT). The goal of the IS-Impact Track is, "to develop the most widely employed model for benchmarking information systems in organizations for the joint benefit of both research and practice" (Gable et al, 2006). IS-Impact is defined as "a measure at a point in time, of the stream of net benefits from the IS [Information System], to date and anticipated, as perceived by all key-user-groups" (Gable Sedera and Chan, 2008). Track efforts have yielded the bicameral IS-Impact measurement model; the "impact" half includes Organizational-Impact and Individual-Impact dimensions; the "quality" half includes System-Quality and Information-Quality dimensions. The IS-Impact model, by design, is intended to be robust, simple and generalisable, to yield results that are comparable across time, stakeholders, different systems and system contexts. The model and measurement approach employs perceptual measures and an instrument that is relevant to key stakeholder groups, thereby enabling the combination or comparison of stakeholder perspectives. Such a validated and widely accepted IS-Impact measurement model has both academic and practical value. It facilitates systematic operationalisation of a main dependent variable in research (IS-Impact), which can also serve as an important independent variable. For IS management practice it provides a means to benchmark and track the performance of information systems in use. From examination of the literature, the study proposes that IS-Impact is an Analytic Theory. Gregor (2006) defines Analytic Theory simply as theory that ‘says what is’, base theory that is foundational to all other types of theory. The overarching research question thus is "Does IS-Impact positively manifest the attributes of Analytic Theory?" In order to address this question, we must first answer the question "What are the attributes of Analytic Theory?" The study identifies the main attributes of analytic theory as: (1) Completeness, (2) Mutual Exclusivity, (3) Parsimony, (4) Appropriate Hierarchy, (5) Utility, and (6) Intuitiveness. The value of empirical research in Information Systems is often assessed along the two main dimensions - rigor and relevance. Those Analytic Theory attributes associated with the ‘rigor’ of the IS-Impact model; namely, completeness, mutual exclusivity, parsimony and appropriate hierarchy, have been addressed in prior research (e.g. Gable et al, 2008). Though common tests of rigor are widely accepted and relatively uniformly applied (particularly in relation to positivist, quantitative research), attention to relevance has seldom been given the same systematic attention. This study assumes a mainly practice perspective, and emphasises the methodical evaluation of the Analytic Theory ‘relevance’ attributes represented by the Utility and Intuitiveness of the IS-Impact model. Thus, related research questions are: "Is the IS-Impact model intuitive to practitioners?" and "Is the IS-Impact model useful to practitioners?" March and Smith (1995), identify four outputs of Design Science: constructs, models, methods and instantiations (Design Science research may involve one or more of these). IS-Impact can be viewed as a design science model, composed of Design Science constructs (the four IS-Impact dimensions and the two model halves), and instantiations in the form of management information (IS-Impact data organised and presented for management decision making). In addition to methodically evaluating the Utility and Intuitiveness of the IS-Impact model and its constituent constructs, the study aims to also evaluate the derived management information. Thus, further research questions are: "Is the IS-Impact derived management information intuitive to practitioners?" and "Is the IS-Impact derived management information useful to practitioners? The study employs a longitudinal design entailing three surveys over 4 years (the 1st involving secondary data) of the Oracle-Financials application at QUT, interspersed with focus groups involving senior financial managers. The study too entails a survey of Financials at four other Australian Universities. The three focus groups respectively emphasise: (1) the IS-Impact model, (2) the 2nd survey at QUT (descriptive), and (3) comparison across surveys within QUT, and between QUT and the group of Universities. Aligned with the track goal of producing IS-Impact scores that are highly comparable, the study also addresses the more specific utility-related questions, "Is IS-Impact derived management information a useful comparator across time?" and "Is IS-Impact derived management information a useful comparator across universities?" The main contribution of the study is evidence of the utility and intuitiveness of IS-Impact to practice, thereby further substantiating the practical value of the IS-Impact approach; and also thereby motivating continuing and further research on the validity of IS-Impact, and research employing the ISImpact constructs in descriptive, predictive and explanatory studies. The study also has value methodologically as an example of relatively rigorous attention to relevance. A further key contribution is the clarification and instantiation of the full set of analytic theory attributes.

Wandering and the physical environment

Background/Rationale Guided by the need-driven dementia-compromised behavior (NDB) model, this study examined influences of the physical environment on wandering behavior. Methods Using a descriptive, cross-sectional design, 122 wanderers from 28 long-term care (LTC) facilities were videotaped 10 to 12 times; data on wandering, light, sound, temperature and humidity levels, location, ambiance, and crowding were obtained. Associations between environmental variables and wandering were evaluated with chi-square and t tests; the model was evaluated using logistic regression. Results In all, 80% of wandering occurred in the resident’s own room, dayrooms, hallways, or dining rooms. When observed in other residents’ rooms, hallways, shower/baths, or off-unit locations, wanderers were likely (60%-92% of observations) to wander. The data were a good fit to the model overall (LR [logistic regression] χ2 (5) = 50.38, P < .0001) and by wandering type. Conclusions Location, light, sound, proximity of others, and ambiance are associated with wandering and may serve to inform environmental designs and care practices.

Adherence to nutrition supplements among patients with a fall-related lower limb fracture

Background The purpose of this study was to provide a detailed evaluation of adherence to nutrition supplements by patients with a lower limb fracture. Methods These descriptive data are from 49 nutritionally“ at-risk” patients aged 70+ years admitted to the hospital after a fall-related lower limb fracture and allocated to receive supplementation as part of a randomized, controlled trial. Supplementation commenced on day 7 and continued for 42 days. Prescribed volumes aimed to meet 45% of individually estimated theoretical energy requirements to meet the shortfall between literature estimates of energy intake and requirements. The supplement was administered by nursing staff on medication rounds in the acute or residential care settings and supervised through thrice-weekly home visits postdischarge. Results Median daily percent of the prescribed volume of nutrition supplement consumed averaged over the 42 days was 67% (interquartile range [IQR], 31–89, n = 49). There was no difference in adherence for gender, accommodation, cognition, or whether the supplement was self-administered or supervised. Twenty-three participants took some supplement every day, and a further 12 missed <5 days. For these 35 “nonrefusers,” adherence was 82% (IQR, 65–93), and they lost on average 0.7% (SD, 4.0%) of baseline weight over the 6 weeks of supplementation compared with a loss of 5.5% (SD, 5.4%) in the “refusers” (n = 14, 29%), p = .003. Conclusions We achieved better volume and energy consumption than previous studies of hip fracture patients but still failed to meet target supplement volumes prescribed to meet 45% of theoretical energy requirements. Clinicians should consider alternative methods of feeding such as a nasogastric tube, particularly in those patients where adherence to oral nutrition supplements is poor and dietary intake alone is insufficient to meet estimated energy requirements.

An assessment of the potential of family day care as a nutrition promotion setting in South Australia

Articles > Journals > Health journals > Nutrition & Dietetics: The Journal of the Dieticians Association of Australia articles > March 2003 Article: An assessment of the potential of Family Day Care as a nutrition promotion setting in South Australia. (Original Research). Article from:Nutrition & Dietetics: The Journal of the Dieticians Association of Australia Article date:March 1, 2003 Author:Daniels, Lynne A.; Franco, Bunny; McWhinnie, Julie-Anne CopyrightCOPYRIGHT 2006 Dietitians Association of Australia. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights or concerns about this content should be directed to customer service. (Hide copyright information) Related articles Ads by Google TAFE Child Care Courses Government accredited courses. Study anytime, anywhere. www.seeklearning.com.au Get Work in Child Care Certificate III Children's Services 4 Day Course + Take Home Assessment HBAconsult.com.au Abstract Objective: To assess the potential role of Family Day Care in nutrition promotion for preschool children. Design and setting: A questionnaire to examine nutrition-related issues and practices was mailed to care providers registered in the southern region of Adelaide, South Australia. Care providers also supplied a descriptive, qualitative recall of the food provided by parents or themselves to each child less than five years of age in their care on the day closest to completion of the questionnaire. Subjects: 255 care providers. The response rate was 63% and covered 643 preschool children, mean 4.6 (SD 2.8) children per carer. Results: There was clear agreement that nutrition promotion was a relevant issue for Family Day Care providers. Nutrition and food hygiene knowledge was good but only 54% of respondents felt confident to address food quality issues with parents. Sixty-five percent of respondents reported non-neutral approaches to food refusal and dawdling (reward, punishment, cajoling) that overrode the child's control of the amount eaten. The food recalls indicated that most children (> 75%) were offered fruit at least once. Depending on the hours in care, (0 to 4, 5 to 8, greater than 8 hours), 20%, 32% and 55%, respectively, of children were offered milk and 65%, 82% and 87%, respectively, of children were offered high fat and sugar foods. Conclusions: Questionnaire responses suggest that many care providers are committed to and proactive in a range of nutrition promotion activities. There is scope for strengthening skills in the management of common problems, such as food refusal and dawdling, consistent with the current evidence for approaches to early feeding management that promote the development of healthy food preferences and eating patterns. Legitimising and empowering care providers in their nutrition promotion role requires clear policies, guide lines, adequate pre- and in-service training, suitable parent materials, and monitoring.