The association between adolescent self-reported physical activity and wellness : the missing piece for youth wellness programs

Purpose Potential positive associations between youth physical activity and wellness scores could emphasize the value of youth physical activity engagement and promotion interventions, beyond the many established physiological and psychological benefits of increased physical activity. The purpose of this study was to explore the associations between adolescents' self-reported physical activity and wellness. Methods This investigation included 493 adolescents (165 males and 328 females) aged between 12 and 15 years. The participants were recruited from six secondary schools of varying socioeconomic status within a metropolitan area. Students were administered the Five-Factor Wellness Inventory and the International Physical Activity Questionnaire for Adolescents to assess both wellness and physical activity, respectively. Results Data indicated that significant associations between physical activity and wellness existed. Self-reported physical activity was shown to be positively associated with four dimensions including friendship, gender identity, spirituality, and exercise—the higher order factor physical self and total wellness, and negatively associated with self-care, self-worth, love, and cultural identity. Conclusion This study suggests that relationships exist between self-reported physical activity and various elements of wellness. Future research should use controlled trials of physical activity and wellness to establish causal links among youth populations. Understanding the nature of these relationships, including causality, has implications for the justification of youth physical activity promotion interventions and the development of youth physical activity engagement programs.

Radiographic imaging for traumatic ankle injuries : a demand profile and investigation of radiological reporting timeframes from an Australian tertiary facility

Background Radiographic examinations of the ankle are important in the clinical management of ankle injuries in hospital emergency departments. National (Australian) Emergency Access Targets (NEAT) stipulate that 90 percent of presentations should leave the emergency department within 4 hours. For a radiological report to have clinical usefulness and relevance to clinical teams treating patients with ankle injuries in emergency departments, the report would need to be prepared and available to the clinical team within the NEAT 4 hour timeframe; before the patient has left the emergency department. However, little is known about the demand profile of ankle injuries requiring radiographic examination or time until radiological reports are available for this clinical group in Australian public hospital emergency settings. Methods This study utilised a prospective cohort of consecutive cases of ankle examinations from patients (n=437) with suspected traumatic ankle injuries presenting to the emergency department of a tertiary hospital facility. Time stamps from the hospital Picture Archiving and Communication System were used to record the timing of three processing milestones for each patient's radiographic examination; the time of image acquisition, time of a provisional radiological report being made available for viewing by referring clinical teams, and time of final verification of radiological report. Results Radiological reports and all three time stamps were available for 431 (98.6%) cases and were included in analysis. The total time between image acquisition and final radiological report verification exceeded 4?hours for 404 (92.5%) cases. The peak demand for radiographic examination of ankles was on weekend days, and in the afternoon and evening. The majority of examinations were provisionally reported and verified during weekday daytime shift hours. Conclusions Provisional or final radiological reports were frequently not available within 4 hours of image acquisition among this sample. Effective and cost-efficient strategies to improve the support provided to referring clinical teams from medical imaging departments may enhance emergency care interventions for people presenting to emergency departments with ankle injuries; particularly those with imaging findings that may be challenging for junior clinical staff to interpret without a definitive radiological report.

Radiographer commenting of trauma radiographs : a survey of the benefits, barriers and enablers to participation in an Australian healthcare setting

Introduction Radiographer abnormality detection systems that highlight abnormalities on trauma radiographs (‘red dot’ system) have been operating for more than 30 years. Recently, a number of pitfalls have been identified. These limitations initiated the evolution of a radiographer commenting system, whereby a radiographer provides a brief description of abnormalities identified in emergency healthcare settings. This study investigated radiographers' participation in abnormality detection systems, their perceptions of benefits, barriers and enablers to radiographer commenting, and perceptions of potential radiographer image interpretation services for emergency settings. Methods A cross-sectional survey was implemented. Participants included radiographers from four metropolitan hospitals in Queensland, Australia. Conventional descriptive statistics, histograms and thematic analysis were undertaken. Results Seventy-three surveys were completed and included in the analysis (68% response rate); 30 (41%) of respondents reported participating in abnormality detection in 20% or less of examinations, and 26(36%) reported participating in 80% or more of examinations. Five overarching perceived benefits of radiographer commenting were identified: assisting multidisciplinary teams, patient care, radiographer ability, professional benefits and quality of imaging. Frequently reported perceived barriers included ‘difficulty accessing image interpretation education’, ‘lack of time’ and ‘low confidence in interpreting radiographs’. Perceived enablers included ‘access to image interpretation education’ and ‘support from radiologist colleagues’. Conclusions A range of factors are likely to contribute to the successful implementation of radiographer commenting in addition to abnormality detection in emergency settings. Effective image interpretation education amenable to completion by radiographers would likely prove valuable in preparing radiographers for participation in abnormality detection and commenting systems in emergency settings.

Functional independence following subacute inpatient rehabilitation was not affected by age among older patients recovering from cardiac-related hospital admissions

Introduction Older people recovering from cardiac events requiring an acute hospital admission may experience a decline in physical function limiting their ability to return home to their previous accommodation. Subacute inpatient rehabilitation therapies have potential to assist recovery of physical functioning. However, it is unknown whether age influences the length of stay or physical functioning at discharge from subacute inpatient rehabilitation for this population. Objectives This study examined the outcomes of a cohort of older patients recovering from a cardiac event requiring hospitalisation to investigate the association between age and physical function at discharge, as well as age and length of rehabilitation stay. Methods Participants included 145 consecutive inpatient admissions to a subacute geriatric assessment and rehabilitation unit with a cardiac condition as their primary reason for hospital admission. Participants were required to complete a multi-disciplinary physical functioning assessment within 72 hours of admission to the unit, and again within 72 hours prior to discharge from the unit. The primary outcome measure was the Functional Independence Measure motor score. Demographic and clinical information, including length of stay and discharge destination, were also recorded. Results A total n=126 (87%) participants, with a mean (standard deviation) age of 79 (10) years, had both assessments completed and were included in analyses. Participants who had passed away (n=4, 3%), or did not have both assessments completed per protocol were excluded from analyses. Discharge destinations included home (n=101, 80%), residential aged care (n=17, 13%) and another hospital (n=8, 6%). The (median, interquartile range) Functional Independence Measure motor score was higher at discharge (79, 71 to 84) than admission (61, 48 to 71); z=7.75 p<0.001. Age was not associated with Functional Independence Measure motor score at discharge (t= -0.18, p=0.86), or length of stay in the rehabilitation unit (t= -0.52, 0.60). Conclusion Any perception that age may be associated with longer lengths of stay and reduced physical function outcomes among patients with cardiac conditions admitted for subacute inpatient rehabilitation for older adults is not supported data from this investigation. Older age should not be considered a disincentive when considering the suitability of patients with cardiac diagnoses for this type of inpatient rehabilitation or their potential physical functioning outcome.

The design and development of music eScape: A new iPhone mood management music App

The physical, emotional, educational and social developmental challenges of adolescence can be associated with high levels of emotional vulnerability. Thus, the development of effective emotion-regulation strategies is crucial during this time period. Young people commonly use music to identify, express and regulate their emotions. Modern mobile technology provides an engaging, easily accessible means of assisting young people through music. A systematic contextual review identified 20 iPhone applications addressing emotions through music and two independent raters, using the Mobile App Rating Scale (MARS), evaluated the quality of the apps. Their characteristics, key features and overall quality will be presented. Three participatory design workshops (N=13, 6 males, 7 females; age 15-25) were conducted to explore young people’s use of music to enhance wellbeing. Young people were also asked to trial existing mood and music apps and to conceptualise their ultimate mood targeting music application. A thematic analysis of the participatory design workshops content identified the following music affect-regulation strategies: relationship building, modifying cognitions, modifying emotions, and immersing in emotions. The application of the key learnings from the mobile app review and participatory design workshops and the design and development of the music eScape app were presented and implications for future research was discussed.

Obesity and comorbid risk factors for cardiovascular disease among physically inactive patients with musculoskeletal disorders : a targeted intervention for this priority patient group is warranted

Introduction The benefits of physical activity are established and numerous; not the least of which is reduced risk of negative cardiovascular events. While sedentary lifestyles are having negative impacts across populations, people with musculoskeletal disorders may face additional challenges to becoming physically active. Unfortunately, interventions in ambulatory hospital clinics for people with musculoskeletal disorders primarily focus on their presenting musculoskeletal complaint with cursory attention given to lifestyle risk factors; including physical inactivity. This missed opportunity is likely to have both personal costs for patients and economic costs for downstream healthcare funders. Objectives The objective of this study was to investigate the presence of obesity, diabetes, diagnosed cardiac conditions, and previous stroke (CVA) among insufficiently physically active patients accessing (non-surgical) ambulatory hospital clinics for musculoskeletal disorders to indicate whether a targeted risk-reducing intervention is warranted. Methods A sub-group analysis of patients (n=110) who self-reported undertaking insufficient physical activity level to meet national (Australian) minimum recommended guidelines was conducted. Responses to the Active Australia Survey were used to identify insufficiently active patients from a larger cohort study being undertaken across three (non-surgical) ambulatory hospital clinics for musculoskeletal disorders. Outcomes of interest included body mass index, Type-II diabetes, diagnosed cardiac conditions, previous CVA and patients’ current health-related quality of life (Euroqol-5D). Results The mean (standard deviation) age of inactive patients was 56 (14) years. Body mass index values indicated that n=80 (73%) were overweight n=26 (24%), or obese n=45 (49%). In addition to their presenting condition, a substantial number of patients reported comorbid diabetes n=23 (21%), hypertension n=25 (23%) or an existing heart condition n=14 (13%); 4 (3%) had previously experienced a CVA as well as other comorbid conditions. Health-related quality of life was also substantially impacted, with a mean (standard deviation) multi-attribute utility score of 0.51 (0.32). Conclusion A range of health conditions and risk factors for further negative health events, including cardiovascular complications, consistent with physically inactive lifestyles were evident. A targeted risk-reducing intervention is warranted for this high risk clinical group.

What’s Mime got to do with it?

What has Mime got to do with Corporate Communication? As a professional Mime artist on both stage and screen for more than 25 years, the author has been adapting and applying the techniques of Mime to the corporate communication context over a number of years, coaching corporate CEO’s, Executives and Managers, representing both public and private sector corporations and organisations. This unusual inter-contextual skill transfer is the subject of both a book and series of VODCasts by the author (currently in the final stages of completion), which form part of the author’s Doctoral Research and from which this paper is substantially drawn. The author’s professional background is multi-disciplinary – encompassing theatre, television, media, music, tertiary education and corporate training contexts. It is also inter-disciplinary – concerned with the commonality of different artistic mediums and forms and how, where and why these professional disciplines: intersect; interact, and inform each other – and therefore how they support each other - rather than losing creative/professional opportunities because of areas where they might conflict. This paper examines in particular the physicality of presentation and communication – beyond ‘generic’ body-language analysis. It involves the analysis, manipulation and stylisation of human physicality to support and enhance individual inter-professional communication, and how mime performance skills specifically, inform that process. This paper discusses:- • how mime skills clarify and enhance inter-professional communication. • what adaptations need to be applied in that context • getting a ‘performance’ from ‘non-performers’

Blind Collaboration

This paper examines the creation, development and implementation of an artistic process termed by the author ‘Blind Collaboration’. The process involves musicians collaborating on an album of contemporary music where they, the collaborators, do not see or hear each other nor record in the same studio at the same time as their fellow musicians. The notion of musicians recording separately or indeed remotely is not new, however what is new is the ‘blind’ aspect of the process. Each musician is completely unaware of any others’ contributions, and is therefore uninfluenced by what the others might play. None of the musicians hears the overall result until the final mix. The principal focus of this case study lies in the analysis of specific aspects and outcomes of the creative/artistic process - how it evolved, how it was managed, how it was influenced by the particular artists involved and how the Blind Collaboration process ultimately shaped the final musical work.

Concurrent validity of accelerations measured using a tri-axial inertial measurement unit while walking on firm, compliant and uneven surfaces

Although accelerometers are extensively used for assessing gait, limited research has evaluated the concurrent validity of these devices on less predictable walking surfaces or the comparability of different methods used for gravitational acceleration compensation. This study evaluated the concurrent validity of trunk accelerations derived from a tri-axial inertial measurement unit while walking on firm, compliant and uneven surfaces and contrasted two methods used to remove gravitational accelerations: i) subtraction of the best linear fit from the data (detrending), and; ii) use of orientation information (quaternions) from the inertial measurement unit. Twelve older and twelve younger adults walked at their preferred speed along firm, compliant and uneven walkways. Accelerations were evaluated for the thoracic spine (T12) using a tri-axial inertial measurement unit and an eleven-camera Vicon system. The findings demonstrated excellent agreement between accelerations derived from the inertial measurement unit and motion analysis system, including while walking on uneven surfaces that better approximate a real-world setting (all differences <0.16 m.s−2). Detrending produced slightly better agreement between the inertial measurement unit and Vicon system on firm surfaces (delta range: −0.05 to 0.06 vs. 0.00 to 0.14 m.s−2), whereas the quaternion method performed better when walking on compliant and uneven walkways (delta range: −0.16 to −0.02 vs. −0.07 to 0.07 m.s−2). The technique used to compensate for gravitational accelerations requires consideration in future research, particularly when walking on compliant and uneven surfaces. These findings demonstrate trunk accelerations can be accurately measured using a wireless inertial measurement unit and are appropriate for research that evaluates healthy populations in complex environments.

Managing Ethical Dilemmas

This chapter reviews almost a decade of research and writing undertaken by the authors into ethical dilemmas faced by leaders in a number of different operational contexts, including schools, universities and the public sector. The importance of this body of work is emphasised by one of our research participants who argued that ethical dilemmas were the 'bread and butter' of what leaders do. The chapter comprises four main sections. The first section overviews key theoretical aspects as background to the chapter, including relevant discussions about ethics and ethical decision-making. The second section synthesises the research findings from our work in the three contexts noted above, drawing out a set of learnings that contribute to better understandings of the nature, complexities and challenges of ethical dilemmas. This section is followed by a discussion of an explanatory conceptual model of ethical dilemmas that was developed initially from the literature and confirmed by our research. The model reminds us of some of the critical issues at play in ethical dilemmas, and some of the consequences and implications for organisational culture building they can generate. By way of a short scenario, the final section provides a theory-to-practice illustration of an ethical dilemma in action. A set of recommendations, drawn from the ideas of school leaders who have worked with this and similar dilemmas, is offered as a way forward to better understanding and resolution of such dilemmas so prevalent in our schools today.

Unlocking the "reminder" potential when viewers pause programs : results from a laboratory test of a new online medium

The branded pause advertisement is a recently developed online television-advertising format that displays a full-screen still-image banner ad whenever a viewer pauses a streaming-video program. This study used a controlled lab experiment to compare the effectiveness of branded pause advertisements with normal online television advertisements. The results demonstrate that branded pause advertisements are effective but only when combined with a long-exposure advertisement for the same brand. Despite their short exposure time, pause advertisements function as effective reminders, building awareness through repeat exposure. The findings of the current study were similar regardless of whether pause advertisements were activated as a result of viewers’ pausing at a time of their own choosing or whether viewers were interrupted.

Universal codes from switching strategies

We discuss algorithms for combining sequential prediction strategies, a task which can be viewed as a natural generalisation of the concept of universal coding. We describe a graphical language based on Hidden Markov Models for defining prediction strategies, and we provide both existing and new models as examples. The models include efficient, parameterless models for switching between the input strategies over time, including a model for the case where switches tend to occur in clusters, and finally a new model for the scenario where the prediction strategies have a known relationship, and where jumps are typically between strongly related ones. This last model is relevant for coding time series data where parameter drift is expected. As theoretical contributions we introduce an interpolation construction that is useful in the development and analysis of new algorithms, and we establish a new sophisticated lemma for analysing the individual sequence regret of parameterised models.

Follow the leader if you can, hedge if you must

Follow-the-Leader (FTL) is an intuitive sequential prediction strategy that guarantees constant regret in the stochastic setting, but has poor performance for worst-case data. Other hedging strategies have better worst-case guarantees but may perform much worse than FTL if the data are not maximally adversarial. We introduce the FlipFlop algorithm, which is the first method that provably combines the best of both worlds. As a stepping stone for our analysis, we develop AdaHedge, which is a new way of dynamically tuning the learning rate in Hedge without using the doubling trick. AdaHedge refines a method by Cesa-Bianchi, Mansour, and Stoltz (2007), yielding improved worst-case guarantees. By interleaving AdaHedge and FTL, FlipFlop achieves regret within a constant factor of the FTL regret, without sacrificing AdaHedge’s worst-case guarantees. AdaHedge and FlipFlop do not need to know the range of the losses in advance; moreover, unlike earlier methods, both have the intuitive property that the issued weights are invariant under rescaling and translation of the losses. The losses are also allowed to be negative, in which case they may be interpreted as gains.

Paratransit demand of disabled people

This paper estimates the demand for transportation systems that are used primarily by disabled individuals. These systems are known as paratransit systems and have experienced large increases in number and average size over the past 15 years. We first use a national database and standard time series techniques to model aggregate demand. We then use a unique data set of administrative records from a paratransit system in central Virginia to estimate standard and nonstandard count models of individual demand. We conclude that most of the demand growth is from new passengers, but that predicting the growth of new passengers is very difficult. Our results also highlight the importance of incorporating autocorrelation and possible sample attrition into standard count models.