Twelve-month effectiveness of a parent-led, family-focused weight-management program for prepubertal children : a randomized, controlled trial

BACKGROUND Parenting-skills training may be an effective age-appropriate child behavior-modification strategy to assist parents in addressing childhood overweight. OBJECTIVE Our goal was to evaluate the relative effectiveness of parenting-skills training as a key strategy for the treatment of overweight children. DESIGN The design consisted of an assessor-blinded, randomized, controlled trial involving 111 (64% female) overweight, prepubertal children 6 to 9 years of age randomly assigned to parenting-skills training plus intensive lifestyle education, parenting-skills training alone, or a 12-month wait-listed control. Height, BMI, and waist-circumference z score and metabolic profile were assessed at baseline, 6 months, and 12 months (intention to treat). RESULTS After 12 months, the BMI z score was reduced by ∼10% with parenting-skills training plus intensive lifestyle education versus ∼5% with parenting-skills training alone or wait-listing for intervention. Waist-circumference z score fell over 12 months in both intervention groups but not in the control group. There was a significant gender effect, with greater reduction in BMI and waist-circumference z scores in boys compared with girls. CONCLUSION Parenting-skills training combined with promoting a healthy family lifestyle may be an effective approach to weight management in prepubertal children, particularly boys. Future studies should be powered to allow gender subanalysis.

An assessment of the potential of family day care as a nutrition promotion setting in South Australia

Articles > Journals > Health journals > Nutrition & Dietetics: The Journal of the Dieticians Association of Australia articles > March 2003 Article: An assessment of the potential of Family Day Care as a nutrition promotion setting in South Australia. (Original Research). Article from:Nutrition & Dietetics: The Journal of the Dieticians Association of Australia Article date:March 1, 2003 Author:Daniels, Lynne A.; Franco, Bunny; McWhinnie, Julie-Anne CopyrightCOPYRIGHT 2006 Dietitians Association of Australia. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights or concerns about this content should be directed to customer service. (Hide copyright information) Related articles Ads by Google TAFE Child Care Courses Government accredited courses. Study anytime, anywhere. www.seeklearning.com.au Get Work in Child Care Certificate III Children's Services 4 Day Course + Take Home Assessment HBAconsult.com.au Abstract Objective: To assess the potential role of Family Day Care in nutrition promotion for preschool children. Design and setting: A questionnaire to examine nutrition-related issues and practices was mailed to care providers registered in the southern region of Adelaide, South Australia. Care providers also supplied a descriptive, qualitative recall of the food provided by parents or themselves to each child less than five years of age in their care on the day closest to completion of the questionnaire. Subjects: 255 care providers. The response rate was 63% and covered 643 preschool children, mean 4.6 (SD 2.8) children per carer. Results: There was clear agreement that nutrition promotion was a relevant issue for Family Day Care providers. Nutrition and food hygiene knowledge was good but only 54% of respondents felt confident to address food quality issues with parents. Sixty-five percent of respondents reported non-neutral approaches to food refusal and dawdling (reward, punishment, cajoling) that overrode the child's control of the amount eaten. The food recalls indicated that most children (> 75%) were offered fruit at least once. Depending on the hours in care, (0 to 4, 5 to 8, greater than 8 hours), 20%, 32% and 55%, respectively, of children were offered milk and 65%, 82% and 87%, respectively, of children were offered high fat and sugar foods. Conclusions: Questionnaire responses suggest that many care providers are committed to and proactive in a range of nutrition promotion activities. There is scope for strengthening skills in the management of common problems, such as food refusal and dawdling, consistent with the current evidence for approaches to early feeding management that promote the development of healthy food preferences and eating patterns. Legitimising and empowering care providers in their nutrition promotion role requires clear policies, guide lines, adequate pre- and in-service training, suitable parent materials, and monitoring.

The ontological deficiencies of process modeling in practice

Business process modeling is widely regarded as one of the most popular forms of conceptual modeling. However, little is known about the capabilities and deficiencies of process modeling grammars and how existing deficiencies impact actual process modeling practice. This paper is a first contribution towards a theory-driven, exploratory empirical investigation of the ontological deficiencies of process modeling with the industry standard Business Process Modeling Notation (BPMN). We perform an analysis of BPMN using a theory of ontological expressiveness. Through a series of semi-structured interviews with BPMN adopters we explore empirically the actual use of this grammar. Nine ontological deficiencies related to the practice of modeling with BPMN are identified, for example, the capture of business rules and the specification of process decompositions. We also uncover five contextual factors that impact on the use of process modeling grammars, such as tool support and modeling conventions. We discuss implications for research and practice, highlighting the need for consideration of representational issues and contextual factors in decisions relating to BPMN adoption in organizations.

A Delphi study to validate an advanced practice nursing tool

Aim This paper is a report of a study conducted to validate an instrument for measuring advanced practice nursing role delineation in an international contemporary health service context using the Delphi technique. Background Although most countries now have clear definitions and competency standards for nurse practitioners, no such clarity exists for many advanced practice nurse roles, leaving healthcare providers uncertain whether their service needs can or should be met by an advanced practice nurse or a nurse practitioner. The validation of a tool depicting advanced practice nursing is essential for the appropriate deployment of advanced practice nurses. This paper is the second in a three-phase study to develop an operational framework for assigning advanced practice nursing roles. Method An expert panel was established to review the activities in the Strong Model of Advanced Practice Role Delineation tool. Using the Delphi technique, data were collected via an on-line survey through a series of iterative rounds in 2008. Feedback and statistical summaries of responses were distributed to the panel until the 75% consensus cut-off was obtained. Results After three rounds and modification of five activities, consensus was obtained for validation of the content of this tool. Conclusion The Strong Model of Advanced Practice Role Delineation tool is valid for depicting the dimensions of practice of the advanced practice role in an international contemporary health service context thereby having the potential to optimize the utilization of the advanced practice nursing workforce.

Inquiry-based science in a primary classroom : professional development impacting practice

The critical factor in determining students' interest and motivation to learn science is the quality of the teaching. However, science typically receives very little time in primary classrooms, with teachers often lacking the confidence to engage in inquiry-based learning because they do not have a sound understanding of science or its associated pedagogical approaches. Developing teacher knowledge in this area is a major challenge. Addressing these concerns with didactic "stand and deliver" modes of Professional Development (PD) has been shown to have little relevance or effectiveness, yet is still the predominant approach used by schools and education authorities. In response to that issue, the constructivist-inspired Primary Connections professional learning program applies contemporary theory relating to the characteristics of effective primary science teaching, the changes required for teachers to use those pedagogies, and professional learning strategies that facilitate such change. This study investigated the nature of teachers' engagement with the various elements of the program. Summative assessments of such PD programs have been undertaken previously, however there was an identified need for a detailed view of the changes in teachers' beliefs and practices during the intervention. This research was a case study of a Primary Connections implementation. PD workshops were presented to a primary school staff, then two teachers were observed as they worked in tandem to implement related curriculum units with their Year 4/5 classes over a six-month period. Data including interviews, classroom observations and written artefacts were analysed to identify common themes and develop a set of assertions related to how teachers changed their beliefs and practices for teaching science. When teachers implement Primary Connections, their students "are more frequently curious in science and more frequently learn interesting things in science" (Hackling & Prain, 2008). This study has found that teachers who observe such changes in their students consequently change their beliefs and practices about teaching science. They enhance science learning by promoting student autonomy through open-ended inquiries, and they and their students enhance their scientific literacy by jointly constructing investigations and explaining their findings. The findings have implications for teachers and for designers of PD programs. Assertions related to teaching science within a pedagogical framework consistent with the Primary Connections model are that: (1) promoting student autonomy enhances science learning; (2) student autonomy presents perceived threats to teachers but these are counteracted by enhanced student engagement and learning; (3) the structured constructivism of Primary Connections resources provides appropriate scaffolding for teachers and students to transition from didactic to inquiry-based learning modes; and (4) authentic science investigations promote understanding of scientific literacy and the "nature of science". The key messages for designers of PD programs are that: (1) effective programs model the pedagogies being promoted; (2) teachers benefit from taking the role of student and engaging in the proposed learning experiences; (3) related curriculum resources foster long-term engagement with new concepts and strategies; (4) change in beliefs and practices occurs after teachers implement the program or strategy and see positive outcomes in their students; and (5) implementing this study's PD model is efficient in terms of resources. Identified topics for further investigation relate to the role of assessment in providing evidence to support change in teachers' beliefs and practices, and of teacher reflection in making such change more sustainable.

A new family of Marx generator based on resonant converter

This paper presents a novel topology to generate high voltage with utilization of slow and fast power switches. New concepts used in this topology include numbers of diode-capacitor units in parallel with resonant circuits which are connected to a positive buck-boost converter. The resonant circuit reverses the voltage polarity of the capacitors. This configuration has capability of generating a flexible high voltage with certain number of capacitors. The advantage of this topology is to use slow switches, less number of diodes and capacitors compare to Marx generator. Simulations have been performed to verify the proposed topology.

Implementing an emergency department patient admission predictive tool : insights from practice

Purpose: This paper aims to show that identification of expectations and software functional requirements via consultation with potential users is an integral component of the development of an emergency department patient admissions prediction tool. ---------- Design/methodology/approach: Thematic analysis of semi-structured interviews with 14 key health staff delivered rich data regarding existing practice and future needs. Participants included emergency department staff, bed managers, nurse unit managers, directors of nursing, and personnel from health administration. ---------- Findings: Participants contributed contextual insights on the current system of admissions, revealing a culture of crisis, imbued with misplayed communication. Their expectations and requirements of a potential predictive tool provided strategic data that moderated the development of the Emergency Department Patient Admissions Prediction Tool, based on their insistence that it feature availability, reliability and relevance. In order to deliver these stipulations, participants stressed that it should be incorporated, validated, defined and timely. ---------- Research limitations/implications: Participants were envisaging a concept and use of a tool that was somewhat hypothetical. However, further research will evaluate the tool in practice. ---------- Practical implications: Participants' unsolicited recommendations regarding implementation will not only inform a subsequent phase of the tool evaluation, but are eminently applicable to any process of implementation in a healthcare setting. ---------- Originality/value: The consultative process engaged clinicians and the paper delivers an insider view of an overburdened system, rather than an outsider's observations.

Revisiting 'how we learn' in academia : practice-based learning exchanges in three Australian universities

Ideas of 'how we learn' in formal academic settings have changed markedly in recent decades. The primary position that universities once held on shaping what constitutes learning has come into question from a range of experience-led and situated learning models. Drawing on findings from a study conducted across three Australian universities, the article focuses on the multifarious learning experiences indicative of practice-based learning exchanges such as student placements. Building on both experiential and situated learning theories, the authors found that students can experience transformative and emotional elucidations of learning, that can challenge tacit assumptions and transform the ways they understand the world. It was found that all participants (hosts, students, academics) both teach and learn in these educative scenarios and that, contrary to common (mis)perceptions that academics live in 'ivory towers', they play a crucial role in contributing to learning that takes place in the so-called 'real world'.

Vulnerability factors for disaster-induced child post-traumatic stress disorder : the case for low family resilience and previous mental illness

Objective: The aim of the present study was to investigate whether parent report of family resilience predicted children’s disaster-induced post-traumatic stress disorder (PTSD) and general emotional symptoms, independent of a broad range of variables including event-related factors, previous child mental illness and social connectedness. ---------- Methods: A total of 568 children (mean age = 10.2 years, SD = 1.3) who attended public primary schools, were screened 3 months after Cyclone Larry devastated the Innisfail region of North Queensland. Measures included parent report on the Family Resilience Measure and Strengths and Difficulties Questionnaire (SDQ)–emotional subscale and child report on the PTSD Reaction Index, measures of event exposure and social connectedness. ---------- Results: Sixty-four students (11.3%) were in the severe–very severe PTSD category and 53 families (28.6%) scored in the poor family resilience range. A lower family resilience score was associated with child emotional problems on the SDQ and longer duration of previous child mental health difficulties, but not disaster-induced child PTSD or child threat perception on either bivariate analysis, or as a main or moderator variable on multivariate analysis (main effect: adjusted odds ratio (ORadj) = 0.57, 95% confidence interval (CI) = 0.13–2.44). Similarly, previous mental illness was not a significant predictor of child PTSD in the multivariate model (ORadj = 0.75, 95%CI = 0.16–3.61). ---------- Conclusion: In this post-disaster sample children with existing mental health problems and those of low-resilience families were not at elevated risk of PTSD. The possibility that the aetiological model of disaster-induced child PTSD may differ from usual child and adolescent conceptualizations is discussed.

Pandemic (H1N1) 2009 Influenza Outbreak in Australia: Impact on Emergency Departments.

Executive summary Objective: The aims of this study were to identify the impact of Pandemic (H1N1) 2009 Influenza on Australian Emergency Departments (EDs) and their staff, and to inform planning, preparedness, and response management arrangements for future pandemics, as well as managing infectious patients presenting to EDs in everyday practice. Methods This study involved three elements: 1. The first element of the study was an examination of published material including published statistics. Standard literature research methods were used to identify relevant published articles. In addition, data about ED demand was obtained from Australian Government Department of Health and Ageing (DoHA) publications, with several state health departments providing more detailed data. 2. The second element of the study was a survey of Directors of Emergency Medicine identified with the assistance of the Australasian College for Emergency Medicine (ACEM). This survey retrieved data about demand for ED services and elicited qualitative comments on the impact of the pandemic on ED management. 3. The third element of the study was a survey of ED staff. A questionnaire was emailed to members of three professional colleges—the ACEM; the Australian College of Emergency Nursing (ACEN); and the College of Emergency Nursing Australasia (CENA). The overall response rate for the survey was 18.4%, with 618 usable responses from 3355 distributed questionnaires. Topics covered by the survey included ED conditions during the (H1N1) 2009 influenza pandemic; information received about Pandemic (H1N1) 2009 Influenza; pandemic plans; the impact of the pandemic on ED staff with respect to stress; illness prevention measures; support received from others in work role; staff and others’ illness during the pandemic; other factors causing ED staff to miss work during the pandemic; and vaccination against Pandemic (H1N1) 2009 Influenza. Both qualitative and quantitative data were collected and analysed. Results: The results obtained from Directors of Emergency Medicine quantifying the impact of the pandemic were too limited for interpretation. Data sourced from health departments and published sources demonstrated an increase in influenza-like illness (ILI) presentations of between one and a half and three times the normal level of presentations of ILIs. Directors of Emergency Medicine reported a reasonable level of preparation for the pandemic, with most reporting the use of pandemic plans that translated into relatively effective operational infection control responses. Directors reported a highly significant impact on EDs and their staff from the pandemic. Growth in demand and related ED congestion were highly significant factors causing distress within the departments. Most (64%) respondents established a ‘flu clinic’ either as part of Pandemic (H1N1) 2009 Influenza Outbreak in Australia: Impact on Emergency Departments. the ED operations or external to it. They did not note a significantly higher rate of sick leave than usual. Responses relating to the impact on staff were proportional to the size of the colleges. Most respondents felt strongly that Pandemic (H1N1) 2009 Influenza had a significant impact on demand in their ED, with most patients having low levels of clinical urgency. Most respondents felt that the pandemic had a negative impact on the care of other patients, and 94% revealed some increase in stress due to lack of space for patients, increased demand, and filling staff deficits. Levels of concern about themselves or their family members contracting the illness were less significant than expected. Nurses displayed significantly higher levels of stress overall, particularly in relation to skill-mix requirements, lack of supplies and equipment, and patient and patients’ family aggression. More than one-third of respondents became ill with an ILI. Whilst respondents themselves reported taking low levels of sick leave, respondents cited difficulties with replacing absent staff. Ranked from highest to lowest, respondents gained useful support from ED colleagues, ED administration, their hospital occupational health department, hospital administration, professional colleges, state health department, and their unions. Respondents were generally positive about the information they received overall; however, the volume of information was considered excessive and sometimes inconsistent. The media was criticised as scaremongering and sensationalist and as being the cause of many unnecessary presentations to EDs. Of concern to the investigators was that a large proportion (43%) of respondents did not know whether a pandemic plan existed for their department or hospital. A small number of staff reported being redeployed from their usual workplace for personal risk factors or operational reasons. As at the time of survey (29 October –18 December 2009), 26% of ED staff reported being vaccinated against Pandemic (H1N1) 2009 Influenza. Of those not vaccinated, half indicated they would ‘definitely’ or ‘probably’ not get vaccinated, with the main reasons being the vaccine was ‘rushed into production’, ‘not properly tested’, ‘came out too late’, or not needed due to prior infection or exposure, or due to the mildness of the disease. Conclusion: Pandemic (H1N1) 2009 Influenza had a significant impact on Australian Emergency Departments. The pandemic exposed problems in existing plans, particularly a lack of guidelines, general information overload, and confusion due to the lack of a single authoritative information source. Of concern was the high proportion of respondents who did not know if their hospital or department had a pandemic plan. Nationally, the pandemic communication strategy needs a detailed review, with more engagement with media networks to encourage responsible and consistent reporting. Also of concern was the low level of immunisation, and the low level of intention to accept vaccination. This is a problem seen in many previous studies relating to seasonal influenza and health care workers. The design of EDs needs to be addressed to better manage infectious patients. Significant workforce issues were confronted in this pandemic, including maintaining appropriate staffing levels; staff exposure to illness; access to, and appropriate use of, personal protective equipment (PPE); and the difficulties associated with working in PPE for prolonged periods. An administrative issue of note was the reporting requirement, which created considerable additional stress for staff within EDs. Peer and local support strategies helped ensure staff felt their needs were provided for, creating resilience, dependability, and stability in the ED workforce. Policies regarding the establishment of flu clinics need to be reviewed. The ability to create surge capacity within EDs by considering staffing, equipment, physical space, and stores is of primary importance for future pandemics.

Dramatic character development personas to tailor apartment designs for different residential lifestyles

This chapter reports on research work that aims to overcome some limitations of conventional community engagement for urban planning. Adaptive and human-centred design approaches that are well established in human-computer interaction (such as personas and design scenarios) as well as creative writing and dramatic character development methods (such as the Stanislavsky System and the Meisner Technique) are yet largely unexplored in the rather conservative and long-term design context of urban planning. Based on these approaches, we have been trialling a set of performance based workshop activities to gain insights into participants’ desires and requirements that may inform the future design of apartments and apartment buildings in inner city Brisbane. The focus of these workshops is to analyse the behaviour and lifestyle of apartment dwellers and generate residential personas that become boundary objects in the cross-disciplinary discussions of urban design and planning teams. Dramatisation and embodied interaction of use cases form part of the strategies we employed to engage participants and elicit community feedback.

Infant and young child feeding indicators and determinants of poor feeding practices in India : secondary data analysis of National Family Health Survey 2005–06

Background: In India, poor feeding practices in early childhood contribute to the burden of malnutrition and infant and child mortality. Objective. To estimate infant and young child feeding indicators and determinants of selected feeding practices in India. Methods: The sample consisted of 20,108 children aged 0 to 23 months from the National Family Health Survey India 2005–06. Selected indicators were examined against a set of variables using univariate and multivariate analyses. Results: Only 23.5% of mothers initiated breastfeeding within the first hour after birth, 99.2% had ever breastfed their infant, 89.8% were currently breastfeeding, and 14.8% were currently bottle-feeding. Among infants under 6 months of age, 46.4% were exclusively breastfed, and 56.7% of those aged 6 to 9 months received complementary foods. The risk factors for not exclusively breastfeeding were higher household wealth index quintiles (OR for richest = 2.03), delivery in a health facility (OR = 1.35), and living in the Northern region. Higher numbers of antenatal care visits were associated with increased rates of exclusive breastfeeding (OR for ≥ 7 antenatal visits = 0.58). The rates of timely initiation of breastfeeding were higher among women who were better educated (OR for secondary education or above = 0.79), were working (OR = 0.79), made more antenatal clinic visits (OR for ≥ 7 antenatal visits = 0.48), and were exposed to the radio (OR = 0.76). The rates were lower in women who were delivered by cesarean section (OR = 2.52). The risk factors for bottle-feeding included cesarean delivery (OR = 1.44), higher household wealth index quintiles (OR = 3.06), working by the mother (OR=1.29), higher maternal education level (OR=1.32), urban residence (OR=1.46), and absence of postnatal examination (OR=1.24). The rates of timely complementary feeding were higher for mothers who had more antenatal visits (OR=0.57), and for those who watched television (OR=0.75). Conclusions: Revitalization of the Baby Friendly Hospital Initiative in health facilities is recommended. Targeted interventions may be necessary to improve infant feeding practices in mothers who reside in urban areas, are more educated, and are from wealthier households.

Thinking spatially, acting collaboratively : a GIS-based health decision support system for improving the collaborative health-planning practice

The field of collaborative health planning faces significant challenges due to the lack of effective information, systems and the absence of a framework to make informed decisions. These challenges have been magnified by the rise of the healthy cities movement, consequently, there have been more frequent calls for localised, collaborative and evidence-driven decision-making. Some studies in the past have reported that the use of decision support systems (DSS) for planning healthy cities may lead to: increase collaboration between stakeholders and the general public, improve the accuracy and quality of the decision-making processes and improve the availability of data and information for health decision-makers. These links have not yet been fully tested and only a handful of studies have evaluated the impact of DSS on stakeholders, policy-makers and health planners. This study suggests a framework for developing healthy cities and introduces an online Geographic Information Systems (GIS)-based DSS for improving the collaborative health planning. It also presents preliminary findings of an ongoing case study conducted in the Logan-Beaudesert region of Queensland, Australia. These findings highlight the perceptions of decision-making prior to the implementation of the DSS intervention. Further, the findings help us to understand the potential role of the DSS to improve collaborative health planning practice.

ePortfolio use by university students in Australia : Informing excellence in policy and practice. Supplementary report : October 2010

In April 2007, the Australian Learning and Teaching Council (ALTC)commissioned a study to examine the diverse approaches to ePortfolio use by students in Australian universities. The goals were to consider the scope, penetration and reasons for use of ePortfolios, and to examine the issues associated with their implementation in higher education. One of the central research activities in the project was a national audit which sought to establish a picture of current and emerging ePortfolio activities in Australian academic institutions. The data collection activities took place in late 2007 and the findings were presented and discussed in the final project report, published in October 2008. In 2010, the idea of a ‘follow up survey’ was developed. The resulting supplementary research activity was undertaken to update the data collected by the AeP project team in late 2007. The plan behind this ‘postscript to AeP’ project was to refresh the picture of ePortfolio practice in Australia by collecting new data to identify and map the use of ePortfolios in adult learning across the higher education, vocational education and training (VET) and the adult community education (ACE) sectors. The supplementary project has been referred to as the ‘AeP PS survey’.