Adherence to nutrition supplements among patients with a fall-related lower limb fracture

Background The purpose of this study was to provide a detailed evaluation of adherence to nutrition supplements by patients with a lower limb fracture. Methods These descriptive data are from 49 nutritionally“ at-risk” patients aged 70+ years admitted to the hospital after a fall-related lower limb fracture and allocated to receive supplementation as part of a randomized, controlled trial. Supplementation commenced on day 7 and continued for 42 days. Prescribed volumes aimed to meet 45% of individually estimated theoretical energy requirements to meet the shortfall between literature estimates of energy intake and requirements. The supplement was administered by nursing staff on medication rounds in the acute or residential care settings and supervised through thrice-weekly home visits postdischarge. Results Median daily percent of the prescribed volume of nutrition supplement consumed averaged over the 42 days was 67% (interquartile range [IQR], 31–89, n = 49). There was no difference in adherence for gender, accommodation, cognition, or whether the supplement was self-administered or supervised. Twenty-three participants took some supplement every day, and a further 12 missed <5 days. For these 35 “nonrefusers,” adherence was 82% (IQR, 65–93), and they lost on average 0.7% (SD, 4.0%) of baseline weight over the 6 weeks of supplementation compared with a loss of 5.5% (SD, 5.4%) in the “refusers” (n = 14, 29%), p = .003. Conclusions We achieved better volume and energy consumption than previous studies of hip fracture patients but still failed to meet target supplement volumes prescribed to meet 45% of theoretical energy requirements. Clinicians should consider alternative methods of feeding such as a nasogastric tube, particularly in those patients where adherence to oral nutrition supplements is poor and dietary intake alone is insufficient to meet estimated energy requirements.

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.

Getting that piece of paper : mental health nurses' experience of undertaking doctoral studies in Victoria, Australia

The aim of this study was to explore the experience of mental health nurses undertaking doctoral studies. The study was conducted in Victoria, Australia. A descriptive exploratory approach to inquiry was used for this study. Participants were mental health nurses who had successfully completed a doctoral qualification. Eligibility for inclusion required participants to be residing in Victoria (irrespective of where their doctoral studies were undertaken) and to have conducted their research within the domain of mental health and/or currently employed in the field of mental health nursing. Of the 20 potential participants invited, 16 accepted the invitation. Five emergent themes were explicated from narrative analyses. These themes were being a trail blazer, positioning for professional advancement, achieving a balance between competing priorities, maintaining a commitment to the development of the profession, and a point of affirmation. An understanding of the experience of undertaking doctoral studies can be used to influence the development of strategies to encourage more mental health nurses to consider undertaking a doctoral degree.

Curbing paper wastage using flavoured feedback

In November 2009 the researcher embarked on a project aimed at reducing the amount of paper used by Queensland University of Technology (QUT) staff in their daily workplace activities. The key goal was to communicate to staff that excessive printing has a tangible and negative effect on their workplace and local environment. The research objective was to better understand what motivates staff towards more ecologically sustainable printing practises, whilst meeting their job’s demands. The current study is built on previous research that found that one interface does not address the needs of all users when creating persuasive Human Computer Interaction (HCI) interventions targeting resource consumption. In response, the current study created and trialled software that communicates individual paper consumption in precise metrics. Based on preliminary research data different metric sets have been defined to address the different motivations and beliefs of user archetypes using descriptive and injunctive normative information.

Towards airport passenger experience models

This paper reports on the study of passenger experiences and how passengers interact with services, technology and processes at an airport. As part of our research, we have followed people through the airport from check-in to security and from security to boarding. Data was collected by approaching passengers in the departures concourse of the airport and asking for their consent to be videotaped. Data was collected and coded and the analysis focused on both discretionary and process related passenger activities. Our findings show the interdependence between activities and passenger experiences. Within all activities, passengers interact with processes, domain dependent technology, services, personnel and artifacts. These levels of interaction impact on passenger experiences and are interdependent. The emerging taxonomy of activities consists of (i) ownership related activities, (ii) group activities, (iii) individual activities (such as activities at the domain interfaces) and (iv) concurrent activities. This classification is contributing to the development of descriptive models of passenger experiences and how these activities affect the facilitation and design of future airports.

Complaining in cyberspace : the motives and forms of hotel guests’ complaints online

Traditionally, consumers who have been dissatisfied with service have typically complained to the frontline personnel or to a manager in either a direct (face-to-face, over the phone) manner, indirect by writing, or done nothing but told friends and family of the incident. More recently, the Internet has provided various “new” ways to air a grievance, especially when little might have been done at the point of service failure. With the opportunity to now spread word-of-mouth globally, consumers have the potential to impact the standing of a brand or a firm's reputation. The hotel industry is particularly vulnerable, as an increasing number of bookings are undertaken via the Internet and the decision process is likely to be influenced by what other previous guests might post on many booking-linked sites. We conducted a qualitative study of a key travel site to ascertain the forms and motives of complaints made online about hotels and resorts. 200 web-based consumer complaints were analyzed using NVivo 8 software. Findings revealed that consumers report a wide range of service failures on the Internet. They tell a highly descriptive, persuasive, and credible story, often motivated by altruism or, at the other end of the continuum, by revenge. These stories have the power to influence potential guests to book or not book accommodation at the affected properties. Implications for managers of hotels and resorts are discussed.

Factors that affect health outcomes in adults with type 2 diabetes : a cross-sectional study

Background: Factors that individually influence blood sugar control, health-related quality of life, and diabetes self-care behaviors have been widely investigated; however, most previous diabetes studies have not tested an integrated association between a series of factors and multiple health outcomes. ---------- Objectives: The purposes of this study are to identify risk factors and protective factors and to examine the impact of risk factors and protective factors on adaptive outcomes in people with type 2 diabetes.---------- Design: A descriptive correlational design was used to examine a theoretical model of risk factors, protective factors, and adaptive outcomes.---------- Settings: This study was conducted at the endocrine outpatient departments of three hospitals in Taiwan. Participants A convenience sample of 334 adults with type 2 diabetes aged 40 and over.---------- Methods: Data were collected by a self-reported questionnaire and physiological examination. Using the structural equation modeling technique, measurement and structural regression models were tested.---------- Results: Age and life events reflected the construct of risk factors. The construct of protective factors was explained by diabetes symptoms, coping strategy, and social support. The construct of adaptive outcomes comprised HbA1c, health-related quality of life, and self-care behaviors. Protective factors had a significant direct effect on adaptive outcomes (β = 0.68, p < 0.001); however, risk factors did not predict adaptive outcomes (β = − 0.48, p = 0.118).---------- Conclusions: Identifying and managing risk factors and protective factors are an integral part of diabetes care. This theoretical model provides a better understanding of how risk factors and protective factors work together to influence multiple adaptive outcomes in people living with type 2 diabetes.

Using the semantic grid to build bridges between museums and indigenous communities

In this paper we describe a Semantic Grid application designed to enable museums and indigenous communities in distributed locations, to collaboratively discuss, describe and annotate digital objects and documents in museums that originally belonged to or are of cultural or historical significance to indigenous groups. By extending and refining an existing application, Vannotea, we enable users on access grid nodes to collaboratively attach descriptive, rights and tribal care metadata and annotations to digital images, video or 3D representations. The aim is to deploy the software within museums to enable the traditional owners to describe and contextualize museum content in their own words and from their own perspectives. This sharing and exchange of knowledge will hopefully revitalize cultures eroded through colonization and globalization and repair and strengthen relationships between museums and indigenous communities.

Perceptions of the psychological well-being and care of older home care clients : clients and their carers

Aim. To explore and compare older home care clients’ (65+) and their professionals’ perceptions of the clients’ psychological well-being and care and to identify possible differences in these perceptions. Background. Psychological well-being is considered an important dimension of quality of life. With advancing age, older people require home care support to be able to remain in their own home. The main goal of care is to maximise their independence and quality of life. Design. Descriptive, survey design with questionnaire. Methods. A postal questionnaire was distributed to 200 older home care clients and 570 social and health care professionals in 2007. The total response rate was 63%. The questionnaire consisted of questions about clients’ psychological well-being and the provision of care by home care professionals. The differences in responses between clients and professionals were analysed using cross-tabulations, the Pearson Chi-Square Test and Fisher’s Exact Tests. Results. The professional group believed that their clients did not have plans for the future. They believed that their clients felt themselves depressed and suffering from loneliness significantly more often than the client group did. The client group were also significantly more critical of the care (motivating independent actions, physical, psychological and social care) they got from the professional group than how the professionals evaluated the care they gave. Conclusions. To be able to support older clients to continue living at home, professionals need to provide a service that meets client’s own perceptions and complex social and health care needs as well as personal sense of well-being. Relevance to clinical practice. The findings offer useful insights for the professional in planning and delivering appropriate home care services. A better understanding of differences between clients’ and professionals’ perceptions could lead to a better individualised care outcome.

Preservice teachers’ memories of their secondary science education experiences

Understanding preservice teachers’ memories of their education may aid towards articulating high-impact teaching practices. This study describes 246 preservice teachers’ perceptions of their secondary science education experiences through a questionnaire and 28-item survey. ANOVA was statistically significant about participants’ memories of science with 15 of the 28 survey items. Descriptive statistics through SPSS further showed that a teacher’s enthusiastic nature (87%) and positive attitude towards science (87%) were regarded as highly memorable. In addition, explaining abstract concepts well (79%), and guiding the students’ conceptual development with practical science activities (73%) may be considered as memorable secondary science teaching strategies. Implementing science lessons with one or more of these memorable science teaching practices may “make a difference” towards influencing high school students’ positive long-term memories about science and their science education. Further research in other key learning areas may provide a clearer picture of high-impact teaching and a way to enhance pedagogical practices.

Examining research productivity of Chinese TEFL academics across departments and institutes

This study aims to benchmark Chinese TEFL academics’ research productivities, as a way to identify and, subsequently, address research productivity issues. This study investigated 182 Chinese TEFL academics’ research outputs and perceptions about research across three Chinese higher education institutions using a literature-based survey. ANOVA, t-tests and descriptive statistics were used to analyse data from and between the three institutions. Findings indicated that more than 70% of the TEFL academics had produced no research in 10 of the 12 research output fields during 2004-2008. The English Language and Literature Department in the national university outperformed all other departments at the three institutes for most of the research output categories. While a majority of the participants seemed to hold positive perceptions about research, t-tests and ANOVA indicated that their research perceptions were significantly different across institutes and departments. Developing TEFL research capacity requires tertiary institutions to provide research-learning opportunities.

Effectiveness of nurse-led preoperative assessment services for elective surgery : a systematic review

Background--The admission and assessment of patients for elective procedures is a task faced by all healthcare organisations that provide elective surgical services. Several different strategies have been used to facilitate the management of these tasks. Nurse-led preadmission clinics or services have been implemented in many health services as one of these management strategies; however their effectiveness has not been established. Objectives--The objective of this review was to examine the available research on the effectiveness of nurse-led elective surgery preoperative assessment clinics or services on patient outcomes.--Results--Of the 19 included articles, there were 10 audits of patient and hospital data, 3 surveys or questionnaires, 3 descriptive studies, 1 action research design, 1 prospective observational study and 1 RCT. Five of ten studies reporting data on cancellations rates found that nurse-led preadmission services reduced the number of day-of-surgery cancellations. Non-attendance for surgery was also reduced, with nine studies reporting decreases in the number of patients failing to attend. Eight studies reporting data on patient or parent satisfaction found high levels of satisfaction with nurse-led preadmission services. Three of four studies investigating the effect of the nurse-led preadmission service on patient anxiety found a reduction in reported anxiety levels. Three studies found that preoperative preparation was enhanced by the use of a nurse-led preadmission service.--Conclusions--While all included studies reported evidence of effectiveness for nurse-led preadmission services on a wide range of outcomes for elective surgery patients, the lack of experimental trials means that the level of evidence is low, and further research is needed.--Implications for practice--Nurse-led preadmission services may be an effective strategy for reducing procedural cancellations, failure to attend for procedures, and patient anxiety, however currently the evidence level is low.

Interest from Tertiary Educated Persons in Fostering Children with Higher Care needs under a Professional (Paid) Model Compared with General Foster Care

The number of Australian children requiring foster care due to abuse and neglect is increasing at a faster rate than suitable carers can be recruited. Currently increased numbers of foster children are presenting with higher care needs. Evidence suggests carers with a higher education could contribute to placement stability and ultimately provide more positive outcomes for this group of children. This paper explores the level of interest by tertiary educated persons toward a model of fostering for children with higher needs. Using a descriptive survey methodology, a convenience sample of 644 university undergraduate and postgraduate students within faculties of health sciences, and education, arts and social sciences was employed. Psychology students in the 17-26 year old age group showed greatest interest in a professional foster care model and this was statistically significant (p=0.002 955 CI .000-.010) when compared to other health professionals and other age groups. Education students held the highest interest in general fostering although not statistically significant. When these survey results were extrapolated to the total number of health professionals in Australia there could be 8,385 potential recruits for a model professional foster care. Focused campaigns are required to source professional as recruits to fostering with the benefit of servicing the placement needs of higher care needs children and contributing to general foster care resources.

Developing reflective practitioners online: The business of blogs in work integrated learning

Reflective practice is widely considered across discussions around educational psychology, professional identity, employability of graduates, and generic or graduate capabilities. Critical reflection is essential for providing a bridge between the university and the workplace, and for ultimately preparing work ready graduates (Patrick et al, 2008). Work integrated learning, particularly through internships and work placements for students, is viewed as a valuable approach for students developing skills in reflective practice. Reflective journals are one of the tools often used to encourage and develop student reflection. Shifting the reflective journal to an online interface as a reflective blog presents opportunities for more meaningful, frequent and richer interaction between the key players in a work integrated learning experience. This paper examines the adoption, implementation and refinement of the use of reflective blogs in a work integrated learning unit for business students majoring in advertising, marketing and public relations disciplines. The reflective blog is discussed as a learning and assessment tool, including the approaches taken to integrate and scaffold the blog as part of the work integrated learning experience. Graduate capabilities were used as cornerstones for students to frame students’ thinking, experiences and reflection. These capabilities emphasise the value of coherent theoretical and practical knowledge, coupled with critical, creative and analytical thinking, problem solving skills, self reliance and resilience. Underlying these graduate capabilities is a focus on assessment for learning matched with assessment of learning. Using specific triggers and prompts as part of the reflective process, and incorporating ongoing feedback from academic supervisors, students moved from descriptive levels of reflection, to more meaningful and critical reflection. Students’ blogs are analysed to identify key themes, challenges and achievements in the work integrated learning experience. Suggestions for further development and improvement, together with a model of best practice, are proposed.