The effect of varying diagnostic terminology within patient discharge information on expected mild traumatic brain injury outcome

This study aimed to determine if systematic variation of the diagnostic terminology embedded within written discharge information (i.e., concussion or mild traumatic brain injury, mTBI) would produce different expected symptoms and illness perceptions. We hypothesized that compared to concussion advice, mTBI advice would be associated with worse outcomes. Sixty-two volunteers with no history of brain injury or neurological disease were randomly allocated to one of two conditions in which they read a mTBI vignette followed by information that varied only by use of the embedded terms concussion (n = 28) or mTBI (n = 34). Both groups reported illness perceptions (timeline and consequences subscale of the Illness Perception Questionnaire-Revised) and expected Postconcussion Syndrome (PCS) symptoms 6 months post injury (Neurobehavioral Symptom Inventory, NSI). Statistically significant group differences due to terminology were found on selected NSI scores (i.e., total, cognitive and sensory symptom cluster scores (concussion > mTBI)), but there was no effect of terminology on illness perception. When embedded in discharge advice, diagnostic terminology affects some but not all expected outcomes. Given that such expectations are a known contributor to poor mTBI outcome, clinicians should consider the potential impact of varied terminology on their patients.

The role of food regulation in promoting health

Food regulations are a series of laws and guidelines that focus on food that can be bought and sold in Australia. This system includes laws and regulations that address, food safety, food handling, what ingredients can go in a food, what a food can be called, what information needs to be included on a label, how a food can be advertised and promoted and developing a food industry that is both economically strong and supports the health of Australia's people and it's environment.

"But we’re already doing it!" Examining conceptual blurring between health promotion and palliative care

Over the past decade, an increasing number of palliative care service providers have attempted to integrate health promotion into their organisational practice. A key factor in the success of this endeavour has been the recognition by these providers of the conceptual ‘fit’ between two seemingly disparate approaches to health care. When informed of the elements of health promotion, palliative care professionals have expressed their recognition in their declaration: ‘But we’re already doing it!’ (Rosenberg 2007). Yet it appears that this association between the two suggests that health promotion in palliative care organisations is being understood in poorly defined ways. ‘Health promotion’ can be incorrectly assumed to be synonymous with ‘health education’; ‘death education’ can be understood to be synonymous with providing information about palliative care resources. Whilst these activities may be worthwhile within themselves, their presence in the activities of an organisation does not constitute the practice of health promoting palliative care (HPPC) (Kellehear 1999)...

The Fukushima nuclear power plant disaster and percetions of health risk communication : a case study

This case study was conducted to explore the perceptions of health risk messages sent by the Japanese Government following the Fukushima nuclear power plant disaster. The content of health risk messages from the Japanese Government and the Japanese national broadcaster (NHK) were analysed and semi-structured interviews were conducted with a sample of Tokyo residents. Initially, participants trusted these messages but as the crisis unfolded they became sceptical about the messages. Participants felt the messages did not communicate health risk information effectively because the messages were; not supported by evidence, inconsistent, delayed and changed over time. Despite widespread access to the internet, social media and mobile telephones, most participants relied on television news for information about the health risks. The Japanese Government urgently needs to re-build trust by engaging the community in the planning and development phases of health risk communication strategies.

Partial mediation role of self-efficacy between positive social interaction and mental health in family caregivers for dementia patients in Shanghai

We explored the mediation effect of caregiver self-efficacy on the influences of behavioral and psychological symptoms (BPSD) of dementia care recipients (CRs) or family caregivers’ (CGs) social supports (informational, tangible and affectionate support and positive social interaction) on CGs’ mental health. We interviewed 196 CGs, using a battery of measures including demographic data of the dyads, CRs’ dementia-related impairments, and CGs’ social support, self-efficacy and the Medical Outcome Study (MOS) Short-Form (SF-36) Health Survey. Multiple regression analyses showed that gathering information on self-efficacy and managing CG distress self-efficacy were the partial mediators of the relationship between positive social interaction and CG mental health. Managing caregiving distress self-efficacy also partial mediated the impact of BPSD on CG mental health. We discuss implications of the results for improving mental health of the target population in mainland China.

Research participation by people with intellectual disability and mental health issues : an examination of the processes of consent

Balancing the demands of research and ethics is always challenging and even more so when recruiting vulnerable groups. Within the context of current legislation and international human rights declarations, it is strongly advocated that research can and must be undertaken with all recipients of health care services. Research in the field of intellectual disability presents particular challenges in regard to consenting processes. This paper is a critical reflection and analysis of the complex processes undertaken and events that occurred in gaining informed consent from people with intellectual disability to participate in a study exploring their experiences of being an inpatient in mental health hospitals within Aotearoa/New Zealand. A framework based on capacity, information and voluntariness is presented with excerpts from the field provided to explore consenting processes. The practical implications of the processes utilised are then discussed in order to stimulate debate regarding clearer and enhanced methods of gaining informed consent from people with intellectual disability.

Setting water quality objectives for the health of freshwater fish

An important responsibility of the Environment Protection Authority, Victoria, is to set objectives for levels of environmental contaminants. To support the development of environmental objectives for water quality, a need has been identified to understand the dual impacts of concentration and duration of a contaminant on biota in freshwater streams. For suspended solids contamination, information reported by Newcombe and Jensen [ North American Journal of Fisheries Management , 16(4):693--727, 1996] study of freshwater fish and the daily suspended solids data from the United States Geological Survey stream monitoring network is utilised. The study group was requested to examine both the utility of the Newcombe and Jensen and the USA data, as well as the formulation of a procedure for use by the Environment Protection Authority Victoria that takes concentration and duration of harmful episodes into account when assessing water quality. The extent to which the impact of a toxic event on fish health could be modelled deterministically was also considered. It was found that concentration and exposure duration were the main compounding factors on the severity of effects of suspended solids on freshwater fish. A protocol for assessing the cumulative effect on fish health and a simple deterministic model, based on the biology of gill harm and recovery, was proposed. References D. W. T. Au, C. A. Pollino, R. S. S Wu, P. K. S. Shin, S. T. F. Lau, and J. Y. M. Tang. Chronic effects of suspended solids on gill structure, osmoregulation, growth, and triiodothyronine in juvenile green grouper epinephelus coioides . Marine Ecology Press Series , 266:255--264, 2004. J.C. Bezdek, S.K. Chuah, and D. Leep. Generalized k-nearest neighbor rules. Fuzzy Sets and Systems , 18:237--26, 1986. E. T. Champagne, K. L. Bett-Garber, A. M. McClung, and C. Bergman. {Sensory characteristics of diverse rice cultivars as influenced by genetic and environmental factors}. Cereal Chem. , {81}:{237--243}, {2004}. S. G. Cheung and P. K. S. Shin. Size effects of suspended particles on gill damage in green-lipped mussel perna viridis. Marine Pollution Bulletin , 51(8--12):801--810, 2005. D. H. Evans. The fish gill: site of action and model for toxic effects of environmental pollutants. Environmental Health Perspectives , 71:44--58, 1987. G. C. Grigg. The failure of oxygen transport in a fish at low levels of ambient oxygen. Comp. Biochem. Physiol. , 29:1253--1257, 1969. G. Holmes, A. Donkin, and I.H. Witten. {Weka: A machine learning workbench}. In Proceedings of the Second Australia and New Zealand Conference on Intelligent Information Systems , volume {24}, pages {357--361}, {Brisbane, Australia}, {1994}. {IEEE Computer Society}. D. D. Macdonald and C. P. Newcombe. Utility of the stress index for predicting suspended sediment effects: response to comments. North American Journal of Fisheries Management , 13:873--876, 1993. C. P. Newcombe. Suspended sediment in aquatic ecosystems: ill effects as a function of concentration and duration of exposure. Technical report, British Columbia Ministry of Environment, Lands and Parks, Habitat Protection branch, Victoria, 1994. C. P. Newcombe and J. O. T. Jensen. Channel suspended sediment and fisheries: A synthesis for quantitative assessment of risk and impact. North American Journal of Fisheries Management , 16(4):693--727, 1996. C. P. Newcombe and D. D. Macdonald. Effects of suspended sediments on aquatic ecosystems. North American Journal of Fisheries Management , 11(1):72--82, 1991. K. Schmidt-Nielsen. Scaling. Why is animal size so important? Cambridge University Press, NY, 1984. J. S. Schwartz, A. Simon, and L. Klimetz. Use of fish functional traits to associate in-stream suspended sediment transport metrics with biological impairment. Environmental Monitoring and Assessment , 179(1--4):347--369, 2011. E. Al Shaw and J. S. Richardson. Direct and indirect effects of sediment pulse duration on stream invertebrate assemb ages and rainbow trout ( Oncorhynchus mykiss ) growth and survival. Canadian Journal of Fish and Aquatic Science , 58:2213--2221, 2001. P. Tiwari and H. Hasegawa. {Demand for housing in Tokyo: A discrete choice analysis}. Regional Studies , {38}:{27--42}, {2004}. Y. Tramblay, A. Saint-Hilaire, T. B. M. J. Ouarda, F. Moatar, and B Hecht. Estimation of local extreme suspended sediment concentrations in california rivers. Science of the Total Environment , 408:4221--

Evidence-Based Health Practice

Research is one of the subjects that students in the health professions often find challenging and yet the process of finding, critiquing, using and evaluating information is essential to professional development and practice. This book introduces fundamental research concepts that are relevant to the wider health-care and disability support sector while also making strong connections to the various areas of practice that students identify with.Examples and cases are taken from a wide range of professions and countries to help students understand the significance of research used by colleagues from other disciplines and become interprofessional practitioners.

How much information can be obtained from tracking the position of the leading edge in a scratch assay?

Moving cell fronts are an essential feature of wound healing, development and disease. The rate at which a cell front moves is driven, in part, by the cell motility, quantified in terms of the cell diffusivity $D$, and the cell proliferation rate �$\lambda$. Scratch assays are a commonly-reported procedure used to investigate the motion of cell fronts where an initial cell monolayer is scratched and the motion of the front is monitored over a short period of time, often less than 24 hours. The simplest way of quantifying a scratch assay is to monitor the progression of the leading edge. Leading edge data is very convenient since, unlike other methods, it is nondestructive and does not require labeling, tracking or counting individual cells amongst the population. In this work we study short time leading edge data in a scratch assay using a discrete mathematical model and automated image analysis with the aim of investigating whether such data allows us to reliably identify $D$ and $\lambda$�. Using a naıve calibration approach where we simply scan the relevant region of the ($D$;$\lambda$�) parameter space, we show that there are many choices of $D$ and $\lambda$� for which our model produces indistinguishable short time leading edge data. Therefore, without due care, it is impossible to estimate $D$ and $\lambda$� from this kind of data. To address this, we present a modified approach accounting for the fact that cell motility occurs over a much shorter time scale than proliferation. Using this information we divide the duration of the experiment into two periods, and we estimate $D$ using data from the first period, while we estimate �$\lambda$ using data from the second period. We confirm the accuracy of our approach using in silico data and a new set of in vitro data, which shows that our method recovers estimates of $D$ and $\lamdba$� that are consistent with previously-reported values except that that our approach is fast, inexpensive, nondestructive and avoids the need for cell labeling and cell counting.

Promoting resilience and effective workplace functioning in international students in health courses

The purpose of this project was to improve the quality of the learning experiences of international students in nursing, public health and nutrition and dietetics, both at university and in the clinical setting. The university worked in partnership with three major metropolitan health care facilities/services in Queensland to develop a framework and resources designed to promote quality work-integrated learning experiences for international students and clinical supervisory staff. The Resilience in International Student Education (RISE) model consists of student and staff workshops complemented by a purpose-built Cultural Connections for Learning (CCL) website that provides access to a wide variety of information and other learning resources. Quantitative and qualitative evaluations indicate that the approach is highly valued by participants as it promotes useful dialogue, sharing of experiences and greater understanding regarding quality learning experiences for international students in the health workplace. It provides an ideal springboard for promoting collaboration between international students and clinical supervisors in the workplace. The resources developed have the potential to enhance student learning as well as clinical teaching. The challenge will be to achieve continued progress within international student education through the development of sustainable strategies to embed the program within the context of individual curricula.

Overview of building information modelling in healthcare projects

In this paper, we explore how BIM functionalities together with novel management concepts and methods have been utilized in thirteen hospital projects in the United States and the United Kingdom. Secondary data collection and analysis were used as the method. Initial findings indicate that the utilization of BIM enables a holistic view of project delivery and helps to integrate project parties into a collaborative process. The initiative to implement BIM must come from the top down to enable early involvement of all key stakeholders. It seems that it is rather resistance from people to adapt to the new way of working and thinking than immaturity of technology that hinders the utilization of BIM.

Semantic search as inference : applications in health informatics

This thesis developed new search engine models that elicit the meaning behind the words found in documents and queries, rather than simply matching keywords. These new models were applied to searching medical records: an area where search is particularly challenging yet can have significant benefits to our society.

The Mobile Application Rating Scale (MARS): A new tool to measure the quality of health mobile applications

Smartphone technology provides free or inexpensive access to mental health and wellbeing resources. As a result the use of mobile applications for these purposes has increased significantly in recent years. Yet, there is currently no app quality assessment alternative to the popular ‘star’-ratings, which are often unreliable. This presentation describes the development of the Mobile Application Rating Scale (MARS) a new measure for classifying and rating the quality of mobile applications. A review of existing literature on app and web quality identified 25 published papers, conference proceedings, and online resources (published since 1999), which identified 372 explicit quality criteria. Qualitative analysis identified five broad categories of app quality rating criteria: engagement, functionality, aesthetics, information quality, and overall satisfaction, which were refined into the 23-item MARS. Independent ratings of 50 randomly selected mental health and wellbeing mobile apps indicated the MARS had excellent levels of internal consistency (α = 0.92) and inter-rater reliability (ICC = 0.85). The MARS provides practitioners and researchers with an easy-to-use, simple, objective and reliable tool for assessing mobile app quality. It also provides mHealth professionals with a checklist for the design and development of high quality apps.

Understanding negation and family history to improve clinical information retrieval

We present a study to understand the effect that negated terms (e.g., "no fever") and family history (e.g., "family history of diabetes") have on searching clinical records. Our analysis is aimed at devising the most effective means of handling negation and family history. In doing so, we explicitly represent a clinical record according to its different content types: negated, family history and normal content; the retrieval model weights each of these separately. Empirical evaluation shows that overall the presence of negation harms retrieval effectiveness while family history has little effect. We show negation is best handled by weighting negated content (rather than the common practise of removing or replacing it). However, we also show that many queries benefit from the inclusion of negated content and that negation is optimally handled on a per-query basis. Additional evaluation shows that adaptive handing of negated and family history content can have significant benefits.

Associations between physical activity and other health behaviors in a representative sample of US adolescents

OBJECTIVES This study examined the associations between physical activity and other health behaviors in a representative sample of US adolescents. METHODS In the 1990 Youth Risk Behavior Survey, 11631 high school students provided information on physical activity; diet; substance use; and other negative health behaviors. Logistic regression analyses examined associations between physical activity and other health behaviors in a subset of 2652 high-active and 1641 low-active students. RESULTS Low activity was associated with cigarette smoking, marijuana use, lower fruit and vegetable consumption, greater television watching, failure to wear a seat belt, and low perception of academic performance. For consumption of fruit, television watching, and alcohol consumption, significant interactions were found with race/ethnicity or sex, suggesting that sociocultural factors may affect the relationships between physical activity and some health behaviors. CONCLUSIONS Low physical activity was associated with several other negative health behaviors in teenagers. Future studies should examine whether interventions for increasing physical activity in youth can be effective in reducing negative health behaviors.