893 resultados para Physical Examination


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Background: Women with young children (under 5 years) are a key population group for physical activity intervention. Previous evidence highlights the need for individually tailored programs with flexible delivery mechanisms for this group. Our previous pilot study suggested that an intervention primarily delivered via mobile phone text messaging (MobileMums) increased self-reported physical activity in women with young children. An improved version of the MobileMums program is being compared with a minimal contact control group in a large randomised controlled trial (RCT). Methods/design: This RCT will evaluate the efficacy, feasibility and acceptability, cost-effectiveness, mediators and moderators of the MobileMums program. Primary (moderate-vigorous physical activity) and secondary (intervention implementation data, health service use costs, intervention costs, health benefits, theoretical constructs) outcomes are assessed at baseline, 3-months (end of intervention) and 9-months (following 6-month no contact: maintenance period). The trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12611000481976; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=336109).The intervention commences with a face-to-face session with a behavioural counsellor to initiate rapport and gather information for tailoring the 12-week text message program. During the program participants also have access to a: MobileMums Participant Handbook, MobileMums refrigerator magnet, MobileMums Facebook(C) group, and a MobileMums website with a searchable, on-line exercise directory. A nominated support person also receives text messages for 12-weeks encouraging them to offer their MobileMum social support for physical activity. Discussion: Results of this trial will determine the efficacy and cost-effectiveness of the MobileMums program, and the feasibility of delivering it in a community setting. It will inform the broader literature of physical activity interventions for women with young children and determine whether further investment in the translation of the program is warranted.

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The overarching aim of this programme of work was to evaluate the effectiveness of the existing learning environment within the Australian Institute of Sport (AIS) elite springboard diving programme. Unique to the current research programme, is the application of ideas from an established theory of motor learning, specifically ecological dynamics, to an applied high performance training environment. In this research programme springboard diving is examined as a complex system, where individual, task, and environmental constraints are continually interacting to shape performance. As a consequence, this thesis presents some necessary and unique insights into representative learning design and movement adaptations in a sample of elite athletes. The questions examined in this programme of work relate to how best to structure practice, which is central to developing an effective learning environment in a high performance setting. Specifically, the series of studies reported in the chapters of this doctoral thesis: (i) provide evidence for the importance of designing representative practice tasks in training; (ii) establish that completed and baulked (prematurely terminated) take-offs are not different enough to justify the abortion of a planned dive; and (iii), confirm that elite athletes performing complex skills are able to adapt their movement patterns to achieve consistent performance outcomes from variable dive take-off conditions. Chapters One and Two of the thesis provide an overview of the theoretical ideas framing the programme of work, and include a review of literature pertinent to the research aims and subsequent empirical chapters. Chapter Three examined the representativeness of take-off tasks completed in the two AIS diving training facilities routinely used in springboard diving. Results highlighted differences in the preparatory phase of reverse dive take-offs completed by elite divers during normal training tasks in the dry-land and aquatic training environments. The most noticeable differences in dive take-off between environments began during the hurdle (step, jump, height and flight) where the diver generates the necessary momentum to complete the dive. Consequently, greater step lengths, jump heights and flight times, resulted in greater board depression prior to take-off in the aquatic environment where the dives required greater amounts of rotation. The differences observed between the preparatory phases of reverse dive take-offs completed in the dry-land and aquatic training environments are arguably a consequence of the constraints of the training environment. Specifically, differences in the environmental information available to the athletes, and the need to alter the landing (feet first vs. wrist first landing) from the take-off, resulted in a decoupling of important perception and action information and a decomposition of the dive take-off task. In attempting to only practise high quality dives, many athletes have followed a traditional motor learning approach (Schmidt, 1975) and tried to eliminate take-off variations during training. Chapter Four examined whether observable differences existed between the movement kinematics of elite divers in the preparation phases of baulked (prematurely terminated) and completed take-offs that might justify this approach to training. Qualitative and quantitative analyses of variability within conditions revealed greater consistency and less variability when dives were completed, and greater variability amongst baulked take-offs for all participants. Based on these findings, it is probable that athletes choose to abort a planned take-off when they detect small variations from the movement patterns (e.g., step lengths, jump height, springboard depression) of highly practiced comfortable dives. However, with no major differences in coordination patterns (topology of the angle-angle plots), and the potential for negative performance outcomes in competition, there appears to be no training advantage in baulking on unsatisfactory take-offs during training, except when a threat of injury is perceived by the athlete. Instead, it was considered that enhancing the athletes' movement adaptability would be a more functional motor learning strategy. In Chapter Five, a twelve-week training programme was conducted to determine whether a sample of elite divers were able to adapt their movement patterns and complete dives successfully, regardless of the perceived quality of their preparatory movements on the springboard. The data indeed suggested that elite divers were able to adapt their movements during the preparatory phase of the take-off and complete good quality dives under more varied take-off conditions; displaying greater consistency and stability in the key performance outcome (dive entry). These findings are in line with previous research findings from other sports (e.g., shooting, triple jump and basketball) and demonstrate how functional or compensatory movement variability can afford greater flexibility in task execution. By previously only practising dives with good quality take-offs, it can be argued that divers only developed strong couplings between information and movement under very specific performance circumstances. As a result, this sample was sometimes characterised by poor performance in competition when the athletes experienced a suboptimal take-off. Throughout this training programme, where divers were encouraged to minimise baulking and attempt to complete every dive, they demonstrated that it was possible to strengthen the information and movement coupling in a variety of performance circumstances, widening of the basin of performance solutions and providing alternative couplings to solve a performance problem even when the take-off was not ideal. The results of this programme of research provide theoretical and experimental implications for understanding representative learning design and movement pattern variability in applied sports science research. Theoretically, this PhD programme contributes empirical evidence to demonstrate the importance of representative design in the training environments of high performance sports programmes. Specifically, this thesis advocates for the design of learning environments that effectively capture and enhance functional and flexible movement responses representative of performance contexts. Further, data from this thesis showed that elite athletes performing complex tasks were able to adapt their movements in the preparatory phase and complete good quality dives under more varied take-off conditions. This finding signals some significant practical implications for athletes, coaches and sports scientists. As such, it is recommended that care should be taken by coaches when designing practice tasks since the clear implication is that athletes need to practice adapting movement patterns during ongoing regulation of multi-articular coordination tasks. For example, volleyball servers can adapt to small variations in the ball toss phase, long jumpers can visually regulate gait as they prepare for the take-off, and springboard divers need to continue to practice adapting their take-off from the hurdle step. In summary, the studies of this programme of work have confirmed that the task constraints of training environments in elite sport performance programmes need to provide a faithful simulation of a competitive performance environment in order that performance outcomes may be stabilised with practice. Further, it is apparent that training environments can be enhanced by ensuring the representative design of task constraints, which have high action fidelity with the performance context. Ultimately, this study recommends that the traditional coaching adage 'perfect practice makes perfect", be reconsidered; instead advocating that practice should be, as Bernstein (1967) suggested, "repetition without repetition".

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Maternal obesity, excess weight gain and lifestyle behaviours during pregnancy have been associated with future overweight and other adverse health outcomes for mothers and babies. This study compared the nutrition and physical activity behaviours of Australian healthy (BMI ≤ 25 k/m2) and overweight (BMI ≥ 25 kg/m2) pregnant women and described their knowledge and receipt of health professional advice early in pregnancy. Methods Pregnant women (n=58) aged 29±5 (mean±s.d.) years were recruited at 16±2 weeks gestation from an Australian metropolitan hospital. Height and weight were measured using standard procedures and women completed a self administered semi-quantitative survey. Results Healthy and overweight women had very similar levels of knowledge, behaviour and levels of advice provided except where specifically mentioned. Only 8% and 36% of participants knew the correct recommended daily number of fruit and vegetable serves respectively. Four percent of participants ate the recommended 5 serves/day of vegetables. Overweight women were less likely than healthy weight women to achieve the recommended fruit intake (4% vs. 8%, p=0.05), and more likely to consume soft drinks or cordial (55% vs 43%, p=0.005) and take away foods (37% vs. 25%, p=0.002) once a week or more. Less than half of all women achieved sufficient physical activity. Despite 80% of women saying they would have liked education about nutrition, physical activity and weight gain, particularly at the beginning of pregnancy, less than 50% were given appropriate advice regarding healthy eating and physical activity. Conclusion Healthy pregnancy behaviour recommendations were not being met, with overweight women less likely to meet some of the recommendations. Knowledge of dietary recommendations was poor and health care professional advice was limited. There are opportunities to improve the health care practices and education pregnant women received to improve knowledge and behaviours. Pregnant women appear to want this.

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Construction contracts often provide that the decision of an independent certifier is final and binding. The effect of a contractual term like this has been debated in the courts over time. This paper considers the binding nature of certificates in the context of traditional construction contract arrangements and also considers the implications for more complex contracts like those entered into to facilitate public private partnerships. This article considers the response of the courts and the drafting implications and argues that a different focus would be advantageous.

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Since the introduction of the National Human Papillomavirus Vaccine Program (NHPVP) in 2007, few studies have assessed women's knowledge, beliefs and attitudes towards cervical screening and human papillomavirus (HPV) vaccination in Australia. It is imperative to ascertain this, as substantial changes are anticipated to the National Cervical Screening Program (NCSP) through a process called 'the Renewal', to ensure any changes that are introduced will be acceptable and well understood by women. The objectives of this study were to describe Queensland women's current knowledge of cervical cancer/screening and HPV, their beliefs and attitudes towards Pap smears and the HPV vaccine and seek their advice on effective methods for communicating changes to the NCSP in their communities. This research was a descriptive-exploratory study that incorporated a combination of qualitative and quantitative methods within the context of the Health Belief Model (HBM). A computer-assisted telephone interview (CATI) survey of 1002 Queensland women was conducted in Phase 1 of the study. During Phase 2 of the study, 23 focus groups were conducted throughout Queensland to gather in-depth information about women's knowledge, awareness and acceptance about cervical cancer prevention strategies. This study found high levels of awareness of HPV (over 60%) and the HPV vaccine (over 86%) amongst Queensland women. However, it also identified considerable uncertainty amongst participants about perceived susceptibility to cervical cancer, especially, the link between cervical cancer, HPV and sexual activity. Women also had limited understanding of the benefit of the Pap smear as a preventative strategy, with many women thinking the main purpose of the Pap smear was for the early detection of cancer. Despite high awareness of HPV, women participating in this study also had significant knowledge deficits about their susceptibility to HPV and the severity of HPV infection. Queensland women had high levels of awareness of the HPV vaccine, which was most commonly via the media. High acceptance of the HPV vaccine was found amongst participants although awareness of the full benefits of vaccination was not evident with little acknowledgement that the quadrivalent vaccine used in the NHPVP would also prevent genital warts. Extensive barriers to having Pap smears, including physical and psychological discomfort, were identified and the most common barriers to vaccination were concerns about side effects and a lack of information upon which to make a decision about consent. Women described enablers for screening participation, such as reminder systems and practitioner characteristics, and expressed positive views towards self collected testing as an enabler, particularly for women who did not attend screening. As this study was conducted with Queensland women it may therefore not be representative of women from other parts of Australia and as participants were more likely to report they were regular screeners than Queensland women overall, these results may not be representative of women least likely to participate in cervical screening. The use of self-reported cervical screening history may also have led to over-reporting of screening status and previous abnormalities by participants. This study reveals significant gaps in Queensland women's knowledge that require effective communication strategies to address. Recommendations from this study highlight the need for increased community education to raise awareness about primary and secondary cervical cancer prevention strategies, training of cervical screening providers in sensitive examination techniques, a reduction in costs associated with screening, the exploration of alternative service models and communication plans that incorporate methods women trust and recommend for disseminating information about changes to the NCSP. This study is the first large study to explore women's perceptions of the Pap smear and barriers to screening, their knowledge about HPV and their attitudes towards the HPV vaccine in Queensland, since the introduction of the NHPVP. It highlights considerable uncertainty about many aspects of cervical cancer and primary and secondary prevention strategies available in Australia and identified many barriers to cervical screening and concerns about HPV vaccination. These knowledge gaps and barriers need to be taken into account and addressed within the context of anticipated changes to the NCSP to ensure benefits are maximised for women in future primary and secondary cervical cancer prevention strategies in the Australian context.

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This thesis studied technology’s role in promoting and supporting active lifestyles through behavioural strategies to reduce sedentary time and increase physical activity. The five studies included (1) development of a self-report instrument quantifying daily sedentary behaviour and light-intensity physical activity; (2) establishment of instrument validity and reliability; (3) use of an online personal activity monitor to successfully reduce sedentary time and increase physical activity; (4) identification of positive differences in total wellness as related to high/low levels of sitting time combined with insufficient/sufficient physical activity; and (5) improvement of total wellness through positive changes in sedentary behaviour and physical activity.

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This thesis explored the current state of knowledge management in policing. A psychometric instrument was created and validated for use within police agencies as a means of facilitating the capture and transferral of critical investigative knowledge. The aim is to ensure that investigative expertise is not lost when detectives retire or leave the service. Improved knowledge management strategies that rely on this psychometric instrument can lead to greater efficiency and effectiveness in criminal investigation.

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In this paper we explore the relationship between monthly random breath testing (RBT) rates (per 1000 licensed drivers) and alcohol-related traffic crash (ARTC) rates over time, across two Australian states: Queensland and Western Australia. We analyse the RBT, ARTC and licensed driver rates across 12 years; however, due to administrative restrictions, we model ARTC rates against RBT rates for the period July 2004 to June 2009. The Queensland data reveals that the monthly ARTC rate is almost flat over the five year period. Based on the results of the analysis, an average of 5.5 ARTCs per 100,000 licensed drivers are observed across the study period. For the same period, the monthly rate of RBTs per 1000 licensed drivers is observed to be decreasing across the study with the results of the analysis revealing no significant variations in the data. The comparison between Western Australia and Queensland shows that Queensland's ARTC monthly percent change (MPC) is 0.014 compared to the MPC of 0.47 for Western Australia. While Queensland maintains a relatively flat ARTC rate, the ARTC rate in Western Australia is increasing. Our analysis reveals an inverse relationship between ARTC RBT rates, that for every 10% increase in the percentage of RBTs to licensed driver there is a 0.15 decrease in the rate of ARTCs per 100,000 licenced drivers. Moreover, in Western Australia, if the 2011 ratio of 1:2 (RBTs to annual number of licensed drivers) were to double to a ratio of 1:1, we estimate the number of monthly ARTCs would reduce by approximately 15. Based on these findings we believe that as the number of RBTs conducted increases the number of drivers willing to risk being detected for drinking driving decreases, because the perceived risk of being detected is considered greater. This is turn results in the number of ARTCs diminishing. The results of this study provide an important evidence base for policy decisions for RBT operations.

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Background The construct of total wellness includes a holistic approach to the body, mind and spirit components of life. While the health benefits of reducing sedentary behavior and increasing physical activity are well documented, little is known about the influence on total wellness of an internet-based physical activity monitor designed to help people to achieve higher physical activity levels. Purpose The purpose of this four-week, personal activity monitor-based intervention program was to reduce sedentary behavior and increase physical activity levels in daily living for sedentary adults and to determine if these changes would also be associated with improvement in total wellness. Methods Twenty-two men and 11 women (27 years ± 4.0) were randomly assigned to either an intervention (n = 18) or control group (n = 15). The intervention group interacted with an online personal activity monitor (Gruve Solution™) designed to reduce sedentary time and increase physical activity during activities of daily living. The control group did not interact with the monitor, as they were asked to follow their normal daily physical activities and sedentary behavior routines. The Wellness Evaluation of Lifestyle (WEL) inventory was used to assess total wellness. Sedentary time, light, walking, moderate and vigorous intensity physical activities were assessed for both intervention and control groups at baseline and at week-4 by the 7-day Sedentary and Light Intensity Physical Activity Log (7-day SLIPA Log) and the International Physical Activity Questionnaire (IPAQ). Results Significant increases in pre-post total wellness scores (from 64% ± 5.7 to 75% ± 8.5) (t (17) = -6.5, p < 0.001) were observed in the intervention group by the end of week four. Intervention participants decreased their sedentary time (21%, 2.3 hours/day) and increased their light (36.7%, 2.5 hours/day), walking (65%, 1057 MET-min/week), moderate (67%, 455 MET-min/week) and vigorous intensity (60%, 442 MET-min/week) physical activity (all p < 0.001). No significant differences for total wellness were observed between the groups at baseline and no pre-post significant differences were observed for any outcome variable in the control group. Conclusion Total wellness is improved when sedentary, but sufficiently physically active adults, reduce sedentary time and increase physical activity levels (i.e. light, walking, moderate and vigorous).

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Physical activity (PA) has many beneficial physical and mental health effects. Physical inactivity is considered the fourth leading risk factor for global mortality. At present there are no systematic reviews on PA patterns among South Asian adults residing in the region. The present study aims to systematically evaluate studies on PA patterns in South Asian countries. A five-staged comprehensive search of the literature was conducted in Medline, Web of Science and SciVerse Scopus using keywords ‘Exercise’, ‘Walking’, ‘Physical activity’, ‘Inactivity’, ‘Physical Activity Questionnaire’, ‘International Physical Activity Questionnaire’, ‘IPAQ’, ‘Global Physical Activity Questionnaire’ and ‘GPAQ’, combined with individual country names. The search was restricted to English language articles conducted in humans and published before 31st December 2012. To obtain additional data a manual search of the reference lists of articles was performed. Data were also retrieved from the search of relevant web sites and online resources. The total number of hits obtained from the initial search was 1,771. The total number of research articles included in the present review is eleven (India-8, Sri Lanka-2, Pakistan-1). In addition, eleven country reports (Nepal-3, Bangladesh-2, India-2, Sri Lanka-2, Bhutan-1, Maldives-1) of World Health Organization STEPS survey from the South-Asian countries were retrieved online. In the research articles the overall prevalence of inactivity was as follows; India (18.5%-88.4%), Pakistan (60.1%) and Sri Lanka (11.0%-31.8%). STEPS survey reports were available from all countries except Pakistan. Overall in majority of STEPS surveys females were more inactive compared to males. Furthermore, leisure related inactivity was >75% in studies reporting inactivity in this domain and people were more active in transport domain when compared with the other domains. In conclusion, our results show that there is a wide variation in the prevalence of physical inactivity among South-Asian adults within and between countries. Furthermore, physical inactivity in South Asian adults was associated with several socio-demographic characteristics. Majority of South Asian adults were inactive during their leisure time. These Factors need to be considered when planning future interventions and research aimed at improving PA in the region.

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This article critically considers distinctions between, social enterprise and social entrepreneurship from a theoretical perspective. Using case study analysis of 10 non-governmental organisations the paper explores these concepts empirically. Findings on social enterprise reveal a focus on the purpose of social businesses, while findings on social entrepreneurship reveal an emphasis on the processes underlying innovative and entrepreneurial activity for social purposes. Discussion of these findings indicates important developments relevant to informing the growing area of social enterprise and social entrepreneurship research. Implications extend to understanding the need for action to achieve social change, and an acceptance of risk when existing actions fail to achieve their intended outcomes.

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Voltammetric techniques have been introduced to monitor the formation of gold nanoparticles produced via the reaction of the amino acid glycyl-L-tyrosine with Au(III) (bromoaurate) in 0.05 M KOH conditions. The alkaline conditions facilitate amino acid binding to Au(III), inhibit the rate of reduction to Au(0), and provide an excellent supporting electrolyte for voltammetric studies. Data obtained revealed that a range of time-dependent gold solution species are involved in gold nanoparticle formation and that the order in which reagents are mixed is critical to the outcome. Concomitantly with voltammetric measurements, the properties of gold nanoparticles formed are probed by examination of electronic spectra in order to understand how the solution environment present during nanoparticle growth affects the final distribution of the nanoparticles. Images obtained by the ex situ transmission electron microscopy (TEM) technique enable the physical properties of the nanoparticles isolated in the solid state to be assessed. Use of this combination of in situ and ex situ techniques provides a versatile framework for elucidating the details of nanoparticle formation.

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We investigate the physical origins of etching observed during Ti diffusion. The relationship between observed etch depth and water vapor content in the annealing environment is quantified. The dynamics of the etching process are also identified. It is discovered that water vapor content is essential for etching and that there is a characteristic delay before etching is observed. From these observations we can conclude that the process is electrochemical in nature with ionic defects diffusing into the Ti strip from the lithium niobate and these defects catalyzing the dissociation of water into reactive ions.

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This study considers the challenges in representing women from other cultures in the crime fiction genre. The study is presented in two parts; an exegesis and a creative practice component consisting of a full length crime fiction novel, Batafurai. The exegesis examines the historical period of a section of the novel—post-war Japan—and how the area of research known as Occupation Studies provides an insight into the conditions of women during this period. The exegesis also examines selected postcolonial theory and its exposition of representations of the 'other' as a western construct designed to serve Eurocentric ends. The genre of crime fiction is reviewed, also, to determine how characters purportedly representing Oriental cultures are constricted by established stereotypes. Two case studies are examined to investigate whether these stereotypes are still apparent in contemporary Australian crime fiction. Finally, I discuss my own novel, Batafurai, to review how I represented people of Asian background, and whether my attempts to resist stereotype were successful. My conclusion illustrates how novels written in the crime fiction genre are reliant on strategies that are action-focused, rather than character-based, and thus often use easily recognizable types to quickly establish frameworks for their stories. As a sub-set of popular fiction, crime fiction has a tendency to replicate rather than challenge established stereotypes. Where it does challenge stereotypes, it reflects a territory that popular culture has already visited, such as the 'female', 'black' or 'gay' detective. Crime fiction also has, as one of its central concerns, an interest in examining and reinforcing the notion of societal order. It repeatedly demonstrates that crime either does not pay or should not pay. One of the ways it does this is to contrast what is 'good', known and understood with what is 'bad', unknown, foreign or beyond our normal comprehension. In western culture, the east has traditionally been employed as the site of difference, and has been constantly used as a setting of contrast, excitement or fear. Crime fiction conforms to this pattern, using the east to add a richness and depth to what otherwise might become a 'dry' tale. However, when used in such a way, what is variously eastern, 'other' or Oriental can never be paramount, always falling to secondary side of the binary opposites (good/evil, known/unknown, redeemed/doomed) at work. In an age of globalisation, the challenge for contemporary writers of popular fiction is to be responsive to an audience that demands respect for all cultures. Writers must demonstrate that they are sensitive to such concerns and can skillfully manage the tensions caused by the need to deliver work that operates within the parameters of the genre, and the desire to avoid offence to any cultural or ethnic group. In my work, my strategy to manage these tensions has been to create a back-story for my characters of Asian background, developing them above mere genre types, and to situate them with credibility in time and place through appropriate historical research.