Effectiveness of in-office blood pressure measurement by eye care practitioners in early detection and management of hypertension

AIM To investigate the number of hypertensive patients, the optometrist is able to identify by routinely taking blood pressure (BP) measurements for patients in "at -risk" groups, and to sample patients' opinions regarding in -office BP measurement. Many of the optometrists in Saudi Arabia practice in optical stores. These stores are wide spread, easily accessible and seldom need appointments. The expanding role of the optometrist as a primary health care provider (PHCP) and the increasing global prevalence of hypertension, highlight the need for an integrated approach towards detecting and monitoring hypertension. METHODS Automated BP measurements were made twice (during the same session) at five selected optometry practices using a validated BP monitor (Omron M6) to assess the number of patients with high BP (HBP) - in at -risk groups -visiting the eye clinic routinely. Prior to data collection, practitioners underwent a two-day training workshop by a cardiologist on hypertension and how to obtain accurate BP readings. A protocol for BP measurement was distributed and retained in all participating clinics. The general attitude towards cardiovascular health of 480 patients aged 37.2 (依12.4)y and their opinion towards in-office BP measurement was assessed using a self -administered questionnaire. RESULTS A response rate of 83.6% was obtained for the survey. Ninety -three of the 443 patients (21.0% ) tested for BP in this study had HBP. Of these, (62 subjects) 67.7% were unaware of their HBP status. Thirty of the 105 subjects (28.6%) who had previously been diagnosed with HBP, still had HBP at the time of this study, and only 22 (73.3%) of these patients were on medication. Also, only 25% of the diagnosed hypertensive patients owned a BP monitor. CONCLUSION Taking BP measurements in optometry practices, we were able to identify one previously undiagnosed patient with HBP for every 8 adults tested. We also identified 30 of 105 previously diagnosed patients whose BP was poorly controlled, twenty-two of whom were on medication. The patients who participated in this study were positively disposed toward the routine measurement of BP by optometrists.

Translating Management Storylines: developing a visual strategy to communicate science to stakeholder community, a case for Mackay, QLD

This project developed a visual strategy and graphic outcomes to communicate the results of a scientific collaborative project to the Mackay community. During 2013 and 2014 a team from CSIRO engaged with the community in Mackay to collaboratively develop a set of strategies to improve the management of the Great Barrier Reef. The result of this work was a 300+ page scientific report that needed to be translated and summarised to the general community. The aim of this project was to strategically synthesise information contained in the report and to design and produce an outcome to be distributed to the participant community. By working with the CISRO researchers, an action toolkit was developed, with twelve cards and a booklet. Each card represented the story behind a certain local management issue and the actions that the participants suggested should be taken in order to improve management of The Reef. During the design synthesis it was identified that for all management issues there was a reference to the need to develop some sort of "educational campaign" to the area. That was then translated as an underlying action to support all other actions proposed in the toolkit.

Education for sustainability in construction management curricula

In response to the call for sustainability education in construction courses, higher education institutions have started to incorporate sustainability components into their construction courses to some extent. This research aims to investigate sustainability embedded in construction management (CM) courses using the Queensland University of Technology as a case study. A content analysis of its CM course structure, unit aims, learning objectives and lecture materials is conducted to examine the sustainability elements incorporated into the CM curriculum. The results show that the course incorporates sustainability components into the existing course structure mainly through horizontal integration, embedding sustainability into general units rather than as an add-on subject. Additionally, the sustainability topics embedded in the course cover a comparatively broad and balanced range of sustainability categories, i.e. background knowledge, policies and regulations, environmental issues, social issues and economic issues as well as technology and innovation, although social sustainability aspects need to be further strengthened. This research addresses the need for urgency in the development of an effective sustainability education framework for construction courses. It is expected that the findings from this study will facilitate the improvement of sustainability education in construction courses generally.

Doctor’s knowledge and practices of traumatic brain injury management in Chinese prehospital settings

Objectives: The incidence and mortality of traumatic brain injury (TBI) has increased rapidly in the last decade in China. Appropriate ambulance service can reduce case-fatality rates of TBI significantly. This study aimed to explore the factors (age, gender, education level, clinical experience, professional title, organization, specialty before prehospital care, and training frequency) that could influence prehospital doctors’ knowledge level and practices in TBI management in China, Hubei Province. Methods: A cross-sectional questionnaire survey was conducted in two cities in Hubei Province. The self-administered questionnaire consisted of demographic information and questions about prehospital TBI management. Independent samples t-test and one-way ANOVA were used to analyze group differences in the average scores in terms of demographic character. General linear regression was used to explore associated factors in prehospital TBI management. Results: A total of 56 questionnaires were handed out and 52 (93%) were returned. Participants received the lowest scores in TBI treatment (0.64; SD=0.08) and the highest scores in TBI assessment (0.80; SD=0.14). According to the regression model, the education level was associated positively with the score of TBI identification (P=.019); participants who worked in the emergency department (ED; P=.011) or formerly practiced internal medicine (P=.009) tended to get lower scores in TBI assessment; participants’ scores in TBI treatment were associated positively with the training frequency (P=.011); and no statistically significant associated factor was found in the overall TBI management. Conclusion: This study described the current situation of prehospital TBI management. The prehospital doctors’ knowledge level and practices in TBI management were quantified and the influential factors hidden underneath were explored. The results indicated that an appropriate continuing medical education (CME) program enables improvement of the quality of ambulance service in China.

The development of a guideline of care for patients with a Sengstaken-Blakemore Tube insitu in a general Intensive Care Unit using translational change theory

Aims & Objectives - identify and diagnose the current problems associated with patient care with regard to the nursing management of patients with Sengstaken-Blakemore tubes insitu; - Identify current nursing practice currently in place within the ICU and the hospital; identify the method by which the assessment and provision of nursing care is delivered in the ICU

The motivational benefits of specific versus general optimism

This study addresses the question whether a specific, work-related form of optimistic thinking has motivational consequences in terms of work engagement above and beyond general optimism over time. A specific form of optimistic thinking is focus on opportunities. Focus on opportunities is a future-oriented belief that describes how many plans, goals, and possibilities people expect to have in their future at work. Based on a cross-lagged panel design with a two-year time lag and data from a sample of 124 German business owners, results of structural equation modeling showed that focus on opportunities positively predicted changes in work engagement over time, even when controlling for general optimism. This finding supports propositions of social cognition and self-regulation theories that emphasize the importance of a specific form of optimism that has motivating potential by referring to future work goals and opportunities

Innovative telemedicine and mobile phone technology in the management of diabetic foot ulcers

Background Diabetic foot ulcers (DFU) are a leading cause of diabetes-related hospitalisation and can be costly to manage without access to appropriate expert care. Within Queensland and indeed across many parts of Australia, there is an inequality in accessing specialist services for individuals with DFU. Recent National Health and Medical Research Council (NHMRC) diabetic foot guidelines recommend remote expert consultation with digital imaging should be made available to people with DFU to improve their clinical outcomes. Telemedicine appears to show promise in improving access to diabetic foot specialist services; however diabetic foot telemedicine models to date have relied upon videoconferencing, store and forward technology and/or customised appliances to obtain digital imagery which all require either expensive infrastructure or a timed reply to the request for advice. Whilst mobile phone advice services have been used with success in general diabetes management and telehealth services have improved diabetic foot outcomes, the rapid emergence in the use of mobile phones has established a need to review the role that various forms of telemedicine play in the management of DFU. The aim of this paper is to review traditional telemedicine modalities that have been used in the management of DFU and to compare that to new and innovative technology that are emerging. Process Studies investigating the management of DFU using various forms of telemedicine interventions will be included in this review. They include the use of videoconferencing technology, hand held digital still photography purpose built imaging devices and mobile phone imagery. Electronic databases (Pubmed, Medline and CINAHL) will be searched using broad MeSH terms and keywords that cover the intended area of interest. Findings It is anticipated that the results of this narrative review will provide delegates of the 2015 Australasian Podiatry Conference an insight into the types of emerging innovative diagnostic telemedicine technologies in the management of DFU against the backdrop of traditional and evidence based modalities. It is anticipated that the findings will drive further research in the area of mobile phone imagery and innovation in the management of DFU.

Management of persistent pain in the older people

Persistent pain is a commonly experienced symptom. It affects 25% of community-dwelling older adults and up to 80% of nursing home residents, and can have a major impact on quality of life and functional capacity. Unfortunately pain in older patients is often undertreated and misunderstood. Assessment of pain type and severity is important. Most older people, even with moderately impaired cognition, are able to self-report pain. Validated assessment tools using non-verbal pain cues are available for people with more advanced cognitive impairment. Management of pain in older people can be challenging. Physiological changes may impact on pain perception and the pharmacodynamics and pharmacokinetics of medications. Older people are often more sensitive to the adverse effects of analgesic medications and are at risk of drug–drug interactions due to the presence of co-morbidities and polypharmacy. In general, analgesic medications should be commenced at low doses, titrated based on effect and tolerability, and regularly reviewed. Contemporary pain management often utilises multiple analgesics in lower doses to optimise efficacy and avoid dose-related toxicity. A bio-psycho-social approach to the management of persistent pain, utilising a multidisciplinary team and including non-drug strategies, may produce the best results. The goal of pain management is not always to eliminate pain, since this may not be attainable, but rather to enhance function and improve quality of life. This article discusses persistent non-cancer pain in older people, its assessment and management, and the risks and benefits of pharmacological treatment in this population.