The use of virtual reality hypnosis with two cases of autism spectrum disorder : a feasibility study

The use of a ‘virtual reality’ hypnotherapeutic procedure was trialled for feasibility as a possible treatment modality for autism (4 sessions over 2 weeks) with 2 boys aged 14 and 15 years old. The aim of the study was to determine if the procedure would be acceptable to autistic patients and thus have some potential as an intervention for reducing anxieties and/or alleviating symptoms associated with autism. Results indicated that the procedure had no effect on autistic symptoms, however, the parents of both boys reported that their son enjoyed the sessions, was attentive and relaxed throughout and that they would pursue this procedure if it were available. Furthermore, they indicated that they believed it was an effective technique to gain their son's attention, and this, combined with the fact that the boys found it enjoyable and engaging, led them to believe there is significant potential for this particular treatment modality.

The new higher education reality: what is an appropriate model to address the widening participation agenda?

Along with the massification of higher education comes a need for new models to support the success of greater numbers of diverse students. A greater proportion of these students are ‘non-traditional’ in terms of preparedness, socioeconomic status  and geography. This paper introduces an Associate Degree model designed to support this new higher education reality of broader student cohorts, thin regional markets and cross-sectoral collaboration. Background literature on challenges facing the higher education sector and its prospective students is presented, with a particular focus on regionality. An argument is made for the role of curriculum and pedagogy as enablers of non-traditional student success. This is supported by the results of a mixed-methods exploratory study. This Associate Degree model was attractive to students and institutes. Students experienced similar levels of challenge, workload and progress to their traditional peers. While technology was essential for the success of the model, it played a supporting role to the relationships and multiple modes of learning it facilitated. This article provides insights for institutions seeking to address the broadening participation agenda.

Evidence-based chronic heart-failure management programs : myth or reality?

Background Chronic heart-failure management programmes (CHF-MPs) have become part of standard care for patients with chronic heart failure (CHF). Objective To investigate whether programmes had applied evidence-based expert clinical guidelines to optimise patient outcomes. Design A prospective cross-sectional survey was used to conduct a national audit. Setting Community setting of CHF-MPs for patients postdischarge. Sample All CHF-MPs operating during 2005–2006 (n=55). Also 10–50 consecutive patients from 48 programmes were recruited (n=1157). Main outcome measures (1) Characteristics and interventions used within each CHF-MP; and (2) characteristics of patients enrolled into these programmes. Results Overall, there was a disproportionate distribution of CHF-MPs across Australia. Only 6.3% of hospitals nationally provided a CHF-MP. A total of 8000 postdischarge CHF patients (median: 126; IQR: 26–260) were managed via CHF-MPs, representing only 20% of the potential national case load. Significantly, 16% of the caseload comprised patients in functional New York Heart Association Class I with no evidence of these patients having had previous echocardiography to confirm a diagnosis of CHF. Heterogeneity of CHF-MPs in applied models of care was evident, with 70% of CHF-MPs offering a hybrid model (a combination of heart-failure outpatient clinics and home visits), 20% conducting home visits and 16% conducting an extended rehabilitation model of care. Less than half (44%) allowed heart-failure nurses to titrate medications. The main medications that were titrated in these programmes were diuretics (n=23, 96%), β-blockers (n=17, 71%), ACE inhibitors (ACEIs) (n=14, 58%) and spironolactone (n=9, 38%). Conclusion CHF-MPs are being implemented rapidly throughout Australia. However, many of these programmes do not adhere to expert clinical guidelines for the management of patients with CHF. This poor translation of evidence into practice highlights the inconsistency and questions the quality of health-related outcomes for these patients.

The dynamics of women’s network relationships: the good, bad and reality

The lack of women in leadership positions remains a persistent social phenomenon. The aim of the paper is to investigate how networking is connected to leadership aspirations and examine women’s understanding and practice of networking as a career developmental skill.

Theoretical explanations around women’s lack of leadership has focused on women’s organisational constraints, their outsider status and the conditions of women within the broader community; however, what is mostly absent from research is how women’s relationships with each other influence opportunities for leadership. Women often experience the ‘glass ceiling’ at the mid-career level, therefore the research focussed on networking at the mid-career level in order to better understand how women draw on networking to help achieve their career goals.

This paper responds to the persistent challenges that women face in networking by examining how networks are created, understood, and enacted by women. This paper reports on recent research that investigated how a select group of mid-career women understood and practiced networking. The paper discusses survey and interview data to analyse how women’s way of networking may influence career aspirations and identifies ways that women can strengthen their networking in order to build capacity and mobility for leadership.

Optometry training simulation with augmented reality and haptics

Optometry is an essential health care profession that has existed for many centuries and is still evolving. However, the training approaches for optometrists are not yet on par with the latest technological evolution. The traditional supervisor-student training mode could not provide good immersion and repeatability, while most existing vision-based computer-assisted simulations provide even worse immersion on screens. In this paper, we propose an effective system for optometry training simulation with two major components: augmented reality and haptics. These components are integrated with the actual slit lamp and are able to greatly enhance the immersion for typical optometry training tasks such as foreign body removal. Medical doctors are also involved in suggesting configurations and validating visual and haptic rendering results. Preliminary user studies show very positive feedbacks from optometry students.

Independent and joint associations of TV viewing time and snack food consumption with the metabolic syndrome and its components; a cross-sectional study in Australian adults

Background:
Television (TV) viewing time is positively associated with the metabolic syndrome (MetS) in adults. However, the mechanisms through which TV viewing time is associated with MetS risk remain unclear. There is evidence that the consumption of energy-dense, nutrient poor snack foods increases during TV viewing time among adults, suggesting that these behaviors may jointly contribute towards MetS risk. While the association between TV viewing time and the MetS has previously been shown to be independent of adult’s overall dietary intake, the specific influence of snack food consumption on the relationship is yet to be investigated. The purpose of this study was to examine the independent and joint associations of daily TV viewing time and snack food consumption with the MetS and its components in a sample of Australian adults.

Methods:
Population-based, cross-sectional study of 3,110 women and 2,572 men (>35 years) without diabetes or cardiovascular disease. Participants were recruited between May 1999 and Dec 2000 in the six states and the Northern Territory of Australia. Participants were categorised according to self-reported TV viewing time (low: 0-2 hr/d; high: >2 hr/d) and/or consumption of snack foods (low: 0-3 serves/d; high: >3 serves/d). Multivariate odds ratios [95% CI] for the MetS and its components were estimated using gender-specific, forced entry logistic regression.

Results:
OR [95% CI] for the MetS was 3.59 [2.25, 5.74] (p≤0.001) in women and 1.45 [1.02, 3.45] (p = 0.04) in men who jointly reported high TV viewing time and high snack food consumption. Obesity, insulin resistance and hypertension (women only) were also jointly associated with high TV viewing time and high snack food consumption. Further adjustment for diet quality and central adiposity maintained the associations in women. High snack food consumption was also shown to be independently associated with MetS risk [OR: 1.94 (95% CI: 1.45, 2.60), p < 0.001] and hypertension [OR: 1.43 (95% CI: 1.01, 2.02), p = 0.05] in women only. For both men and women, high TV viewing time was independently associated with the MetS and its individual components (except hypertension).

Conclusion:
TV viewing time and snack food consumption are independently and jointly associated with the MetS and its components, particularly in women. In addition to physical activity, population strategies targeting MetS prevention should address high TV time and excessive snack food intake.

Educational inequalities in TV viewing among older adults: a mediation analysis of ecological factors

Background
Television (TV) viewing, a prevalent leisure-time sedentary behaviour independently related to negative health outcomes, appears to be higher in less educated and older adults. In order to tackle the social inequalities, evidence is needed about the underlying mechanisms of the association between education and TV viewing. The present purpose was to examine the potential mediating role of personal, social and physical environmental factors in the relationship between education and TV viewing among Australian 55–65 year-old adults.

Methods
In 2010, self-reported data was collected among 4082 adults (47.6% men) across urban and rural areas of Victoria, for the Wellbeing, Eating and Exercise for a Long Life (WELL) study. The mediating role of personal (body mass index [BMI], quality of life), social (social support from family and friends, social participation at proximal level, and interpersonal trust, social cohesion, personal safety at distal level) and physical environmental (neighbourhood aesthetics, neighbourhood physical activity environment, number of televisions) factors in the association between education and TV viewing time was examined using the product-of-coefficients test of MacKinnon based on multilevel linear regression analyses (conducted in 2012).

Results
Multiple mediating analyses showed that BMI (p ≤ 0.01), personal safety (p < 0.001), neighbourhood aesthetics (p ≤ 0.01) and number of televisions (p ≤ 0.01) partly explained the educational inequalities in older adult’s TV viewing. No proximal social factors mediated the education-TV viewing association.

Conclusions
Interventions aimed to reduce TV viewing should focus on personal (BMI) and environmental (personal safety, neighbourhood aesthetics, number of televisions) factors, in order to overcome educational inequalities in sedentary behaviour among older adults.

Effectiveness and feasibility of virtual reality and gaming system use at home by older adults for enabling physical activity to improve health-related domains: a systematic review

Background
use of virtual reality and commercial gaming systems (VR/gaming) at home by older adults is receiving attention as a means of enabling physical activity.

Objective
to summarise evidence for the effectiveness and feasibility of VR/gaming system utilisation by older adults at home for enabling physical activity to improve impairments, activity limitations or participation.

Methods
a systematic review searching 12 electronic databases from 1 January 2000–10 July 2012 using key search terms. Two independent reviewers screened yield articles using pre-determined selection criteria, extracted data using customised forms and applied the Cochrane Collaboration Risk of Bias Tool and the Downs and Black Checklist to rate study quality.

Results
fourteen studies investigating the effects of VR/gaming system use by healthy older adults and people with neurological conditions on activity limitations, body functions and physical impairments and cognitive and emotional well-being met the selection criteria. Study quality ratings were low and, therefore, evidence was not strong enough to conclude that interventions were effective. Feasibility was inconsistently reported in studies. Where feasibility was discussed, strong retention (≥70%) and adherence (≥64%) was reported. Initial assistance to use the technologies, and the need for monitoring exertion, aggravation of musculoskeletal symptoms and falls risk were reported.

Conclusions
existing evidence to support the feasibility and effectiveness VR/gaming systems use by older adults at home to enable physical activity to address impairments, activity limitations and participation is weak with a high risk of bias. The findings of this review may inform future, more rigorous research.