Health education and the control of intestinal worm infections in China : a new vision

Background: The transmission of soil-transmitted helminths (STHs) is associated with poverty, poor hygiene behaviour, lack of clean water and inadequate waste disposal and sanitation. Periodic administration of benzimidazole drugs is the mainstay for global STH control but it does not prevent re-infection, and is unlikely to interrupt transmission as a stand-alone intervention. Findings: We reported recently on the development and successful testing in Hunan province, PR China, of a health education package to prevent STH infections in Han Chinese primary school students. We have recently commenced a new trial of the package in the ethnically diverse Xishuangbanna autonomous prefecture in Yunnan province and the approach is also being tested in West Africa, with further expansion into the Philippines in 2015. Conclusions: The work in China illustrates well the direct impact that health education can have in improving knowledge and awareness, and in changing hygiene behaviour. Further, it can provide insight into the public health outcomes of a multi-component integrated control program, where health education prevents re-infection and periodic drug treatment reduces prevalence and morbidity.

School based youth health nurses and attrition : the reasons for moving on

Like the UK, Australia has a number of school nursing models and programmes. The School Based Youth Health Nurse Program (SBYHNP) is a new and unique model of school nursing in Queensland, Australia. The SBYHNP represents a philosophical and structural shift from traditional school nursing programmes. The purpose of this qualitative case study is to explore the reasons School Based Youth Health Nurses (SBYHN) leave school nursing. Sixteen in-depth interviews were conducted with participants who practiced as SBYHN and left the SBYHNP. This case study reveals six themes: The politics’: Navigating the organisational divide, 'Unconditional positive regard’: Surviving without team cohesion, 'Absolutely exhausted’: Maintaining physical and emotional strength, ‘Definitely geographical’: Managing the tyranny of time and distance, ‘If things fell into place’: Thinking about what could have been, and ‘A stepping stone’: Moving on to the next nursing position. This case study suggests nurses considering school nursing as a specialty should seek opportunity to understand this complex role, ensure realistic expectations and ndertake relevant qualifications. This approach may secure the investment made by nurses and schools and create demand for a highly sort after position.

Abundance and prevalence of Aedes aegypti immatures and relationships with household water storage in rural areas in southern Viet Nam

Since 2000, the Government of Viet Nam has committed to provide rural communities with increased access to safe water through a variety of household water supply schemes (wells, ferrocement tanks and jars) and piped water schemes. One possible, unintended consequence of these schemes is the concomitant increase in water containers that may serve as habitats for dengue mosquito immatures, principally Aedes aegypti. To assess these possible impacts we undertook detailed household surveys of Ae. aegypti immatures, water storage containers and various socioeconomic factors in three rural communes in southern Viet Nam. Positive relationships between the numbers of household water storage containers and the prevalence and abundance of Ae. aegypti immatures were found. Overall, water storage containers accounted for 92–97% and 93–96% of the standing crops of III/IV instars and pupae, respectively. Interestingly, households with higher socioeconomic levels had significantly higher numbers of water storage containers and therefore greater risk of Ae. aegypti infestation. Even after provision of piped water to houses, householders continued to store water in containers and there was no observed decrease in water storage container abundance in these houses, compared to those that relied entirely on stored water. These findings highlight the householders’ concerns about the limited availability of water and their strong behavoural patterns associated with storage of water. We conclude that household water storage container availability is a major risk factor for infestation with Ae. aegypti immatures, and that recent investment in rural water supply infrastructure are unlikely to mitigate this risk, at least in the short term.

Prevalence and predictors of advance directives in Australia

Background Advance care planning is regarded as integral to better patient outcomes yet little is known about the prevalence of advance directives in Australia. Aims To determine the prevalence of advance directives (ADs) in the Australian population. Methods A national telephone survey about estate and advance planning. Sample was stratified by age (18-45 and >45 years) and quota sampling occurred based on population size in each State and Territory. Results Fourteen percent of the Australian population has an AD. There is State variation with people from South Australia and Queensland more likely to have an AD than people from other states. Will making and particularly completion of a financial enduring power of attorney are associated with higher rates of AD completion. Standard demographic variables were of limited use in predicting whether a person would have an AD. Conclusions Despite efforts to improve uptake of advance care planning (including ADs), barriers remain. One likely trigger for completing an AD and advance care planning is undertaking a wider future planning process (e.g. making a will or financial enduring power of attorney). This presents opportunities to increase advance care planning but steps are needed to ensure that planning which occurs outside the health system is sufficiently informed and supported by health information so that it is useful in the clinical setting. Variations by State could also suggest that redesign of regulatory frameworks (such as a user-friendly and well publicised form backed by statute) may help improve uptake of ADs.

Doctors' knowledge of the law on withholding and withdrawing life-sustaining medical treatment

Objectives To examine the level of knowledge of doctors about the law on withholding and withdrawing life-sustaining treatment from adults who lack decision-making capacity, and factors associated with a higher level of knowledge. Design, setting and participants Postal survey of all specialists in emergency medicine, geriatric medicine, intensive care, medical oncology, palliative medicine, renal medicine and respiratory medicine on the AMPCo Direct database in New South Wales, Victoria and Queensland. Survey initially posted to participants on 18 July 2012 and closed on 31 January 2013. Main outcome measures Medical specialists’ levels of knowledge about the law, based on their responses to two survey questions. Results Overall response rate was 32%. For the seven statements contained in the two questions about the law, the mean knowledge score was 3.26 out of 7. State and specialty were the strongest predictors of legal knowledge. Conclusions Among doctors who practise in the end-of-life field, there are some significant knowledge gaps about the law on withholding and withdrawing life-sustaining treatment from adults who lack decision-making capacity. Significant consequences for both patients and doctors can flow from a failure to comply with the law. Steps should be taken to improve doctors’ legal knowledge in this area and to harmonise the law across Australia.

Prevalence of asymptomatic malaria and bed net ownership and use in Bhutan, 2013 : a country earmarked for malaria elimination

Background With dwindling malaria cases in Bhutan in recent years, the government of Bhutan has made plans for malaria elimination by 2016. This study aimed to determine coverage, use and ownership of LLINs, as well as the prevalence of asymptomatic malaria at a single time-point, in four sub-districts of Bhutan. Methods A cross-sectional study was carried out in August 2013. Structured questionnaires were administered to a single respondent in each household (HH) in four sub-districts. Four members from 25 HH, randomly selected from each sub-district, were tested using rapid diagnostic tests (RDT) for asymptomatic Plasmodium falciparum and Plasmodium vivax infection. Multivariable logistic regression models were used to identify factors associated with LLIN use and maintenance. Results All blood samples from 380 participants tested negative for Plasmodium infections. A total of 1,223 HH (92.5% of total HH) were surveyed for LLIN coverage and use. Coverage of LLINs was 99.0% (1,203/1,223 HH). Factors associated with decreased odds of sleeping under a LLIN included: washing LLINs and >nine months compared to washing LLINs every six months; HH in the least poor compared to the most poor socio-economic quintile; a HH income of Nu 5,001-10,000 (US$1 = Nu 59.55), and Nu >10,000, compared to HH with income of and keeping LLINs in a box compared to keeping them hanging in the place of use. Factors associated with use of LLINs for purposes other than the intended use included: income group Nu 1,501-3,000 and HH located one to three hours walking distance from a health centre. Conclusions There was high coverage of LLINs in the study area with regular use of LLINs throughout the year. LLIN use for purposes other than malaria prevention was low. With high coverage and regular use of LLINs, and a zero prevalence of malaria infection found in historically high-risk communities during the peak malaria season, it appears Bhutan is on course to achieve malaria elimination.

The development and evaluation of a medical imaging training immersive environment

Introduction A novel realistic 3D virtual reality (VR) application has been developed to allow medical imaging students at Queensland University of Technology to practice radiographic techniques independently outside the usual radiography laboratory. Methods A flexible agile development methodology was used to create the software rapidly and effectively. A 3D gaming environment and realistic models were used to engender presence in the software while tutor-determined gold standards enabled students to compare their performance and learn in a problem-based learning pedagogy. Results Students reported high levels of satisfaction and perceived value and the software enabled up to 40 concurrent users to prepare for clinical practice. Student feedback also indicated that they found 3D to be of limited value in the desktop version compared to the usual 2D approach. A randomised comparison between groups receiving software-based and traditional practice measured performance in a formative role play with real equipment. The results of this work indicated superior performance with the equipment for the VR trained students (P = 0.0366) and confirmed the value of VR for enhancing 3D equipment-based problem-solving skills. Conclusions Students practising projection techniques virtually performed better at role play assessments than students practising in a traditional radiography laboratory only. The application particularly helped with 3D equipment configuration, suggesting that teaching 3D problem solving is an ideal use of such medical equipment simulators. Ongoing development work aims to establish the role of VR software in preparing students for clinical practice with a range of medical imaging equipment.

Development and validation of the ankle fracture outcome of rehabilitation measure (A-FORM)

Study Design Delphi panel and cohort study. Objective To develop and refine a condition-specific, patient-reported outcome measure, the Ankle Fracture Outcome of Rehabilitation Measure (A-FORM), and to examine its psychometric properties, including factor structure, reliability, and validity, by assessing item fit with the Rasch model. Background To our knowledge, there is no patient-reported outcome measure specific to ankle fracture with a robust content foundation. Methods A 2-stage research design was implemented. First, a Delphi panel that included patients and health professionals developed the items and refined the item wording. Second, a cohort study (n = 45) with 2 assessment points was conducted to permit preliminary maximum-likelihood exploratory factor analysis and Rasch analysis. Results The Delphi panel reached consensus on 53 potential items that were carried forward to the cohort phase. From the 2 time points, 81 questionnaires were completed and analyzed; 38 potential items were eliminated on account of greater than 10% missing data, factor loadings, and uniqueness. The 15 unidimensional items retained in the scale demonstrated appropriate person and item reliability after (and before) removal of 1 item (anxious about footwear) that had a higher-than-ideal outfit statistic (1.75). The “anxious about footwear” item was retained in the instrument, but only the 14 items with acceptable infit and outfit statistics (range, 0.5–1.5) were included in the summary score. Conclusion This investigation developed and refined the A-FORM (Version 1.0). The A-FORM items demonstrated favorable psychometric properties and are suitable for conversion to a single summary score. Further studies utilizing the A-FORM instrument are warranted. J Orthop Sports Phys Ther 2014;44(7):488–499. Epub 22 May 2014. doi:10.2519/jospt.2014.4980

Twelve : the best Of IMP's 100 Songs Project 2011

12 Original recordings curated by leading national industry figures. It’s a 12 track album full of remixed, rerecorded and rejigged tracks from the project that were shortlisted by our friends at MGM Distribution, Music Sales, and EMI Music Australia. The TWELVE album is already receiving critical acclaim from Australia's music industry.

Eleven : best of 100 Songs Project 2012

Eleven original recordings curated by leading industry figures. This is a compilation album from QUT's 2012 100 Songs project. It's called Eleven: Best of 100 Songs Project 2012 and was released in May 2013. It’s an 11 track album with a bonus track, full of remixed, rerecorded and rejigged tracks from the project that were shortlisted by our friends at MGM Distribution, Mushroom Music, Island Records and Music Sales Australia. The Eleven album is already receiving critical acclaim from Australia's music industry.

Indie 100 2013

The Independent Music Project is centred around the development and creation of new music, and includes research into copyright, business models of the future, new technologies, and new audiences. The music industry is undergoing the most radical changes it has faced in almost a century. New digital technologies have made the production, distribution, and promotion of recorded music accessible to anyone with a personal computer. People can now make high-quality digital copies of music and distribute them globally within minutes. Even bastions of the established industries, such as EMI and Columbia, are struggling to make sense of the new industry terrain. The whole employment picture has changed just as radically for people who wish to make a living from music. In Australia, many of the avenues that provided employment for musicians have either disappeared or dramatically shrunk. The advertising industry no longer provides the level of employment it used to prior to the Federal deregulation of the industry in 1992. In many places, new legislative pressures on inner-city and suburban venues have diminished the number of performance spaces that musicians can work in. Just as quickly, new sectors have opened to professional musicians: computer games, ringtones, sound-enabled toys and web advertising all present new opportunities to the enterprising musician. The opportunity to distribute music internationally without being signed to a major label is very attractive to many aspiring and established professionals. No doubt the music industry will face many more challenges as technologies continue to change, as global communication gets easier and faster, and as the challenges to copyright proliferate and change. These challenges cannot be successfully met on a single front. They require research and expertise from all sectors being affected, and this is why the independent music project (IMP) exists.

Feathers

Recording produced for The Lady Electronica project

Dancing through the Air (parts one and 2) - Spirit of Akasha

Recording for ARIA nominated Film Soundtrack for Spirit of Akasha. Recorded, Mixed, and Co-produced by Phil Graham. Published by Warner Music Australia

Indie 100 2014

The Independent Music Project is centred around the development and creation of new music, and includes research into copyright, business models of the future, new technologies, and new audiences. The music industry is undergoing the most radical changes it has faced in almost a century. New digital technologies have made the production, distribution, and promotion of recorded music accessible to anyone with a personal computer. People can now make high-quality digital copies of music and distribute them globally within minutes. Even bastions of the established industries, such as EMI and Columbia, are struggling to make sense of the new industry terrain. The whole employment picture has changed just as radically for people who wish to make a living from music. In Australia, many of the avenues that provided employment for musicians have either disappeared or dramatically shrunk. The advertising industry no longer provides the level of employment it used to prior to the Federal deregulation of the industry in 1992. In many places, new legislative pressures on inner-city and suburban venues have diminished the number of performance spaces that musicians can work in. Just as quickly, new sectors have opened to professional musicians: computer games, ringtones, sound-enabled toys and web advertising all present new opportunities to the enterprising musician. The opportunity to distribute music internationally without being signed to a major label is very attractive to many aspiring and established professionals. No doubt the music industry will face many more challenges as technologies continue to change, as global communication gets easier and faster, and as the challenges to copyright proliferate and change. These challenges cannot be successfully met on a single front. They require research and expertise from all sectors being affected, and this is why the independent music project (IMP) exists.

100 Songs Project 2012

The Independent Music Project is centred around the development and creation of new music, and includes research into copyright, business models of the future, new technologies, and new audiences. The music industry is undergoing the most radical changes it has faced in almost a century. New digital technologies have made the production, distribution, and promotion of recorded music accessible to anyone with a personal computer. People can now make high-quality digital copies of music and distribute them globally within minutes. Even bastions of the established industries, such as EMI and Columbia, are struggling to make sense of the new industry terrain. The whole employment picture has changed just as radically for people who wish to make a living from music. In Australia, many of the avenues that provided employment for musicians have either disappeared or dramatically shrunk. The advertising industry no longer provides the level of employment it used to prior to the Federal deregulation of the industry in 1992. In many places, new legislative pressures on inner-city and suburban venues have diminished the number of performance spaces that musicians can work in. Just as quickly, new sectors have opened to professional musicians: computer games, ringtones, sound-enabled toys and web advertising all present new opportunities to the enterprising musician. The opportunity to distribute music internationally without being signed to a major label is very attractive to many aspiring and established professionals. No doubt the music industry will face many more challenges as technologies continue to change, as global communication gets easier and faster, and as the challenges to copyright proliferate and change. These challenges cannot be successfully met on a single front. They require research and expertise from all sectors being affected, and this is why the independent music project (IMP) exists.