Screen media, parenting practices, and the family environment in Australia: a longitudinal study of young children’s media use, lifestyles, and outcomes for healthy weight

Few studies of media use and adiposity explore the influence of parenting on children’s lifestyle behaviors. Screen media access, bedroom television, lack of physical activity, and snacking on energy-dense foods have long been implicated in child overweight. This research used data from the first three waves of the Longitudinal Study of Australian Children to investigate, prospectively, the associations between parental practices in early to middle childhood and children’s behaviors and weight in late childhood. A path model was used to investigate whether consistent parentingpredicted setting of boundaries for access to and use of media, and was indirectly associated with children’s lifestyle behaviors that increase the likelihood of healthy weight maintenance. The findings demonstrated that children’s lifestyles pertinent to weight maintenance and media use cluster together and involve both old and newer screen media, but are also predicted by parenting practices and the family environment.

Genetic counseling for Indigenous Australians: an exploratory study from the perspective of genetic health professionals

Indigenous populations are thought to have particularly low levels of access to genetic health services, and cultural issues may be a contributing factor. This article presents the findings of the first study of genetic health service provision to Indigenous Australians. This qualitative study aimed to identify elements of culturally-competent genetic health service provision in Indigenous Australian contexts. Twelve semi-structured interviews were conducted with genetic counselors and clinical geneticists from around Australia who had delivered services to Indigenous Australians. Participants were asked to describe their experiences and identify any collective cultural needs of Indigenous clients, as well as comment on specific training and resources they had received or used. Interviews were audio-recorded and transcribed with thematic analysis conducted on the data. The findings show that participants were reluctant to generalize the needs of Indigenous peoples. Some participants asserted that Indigenous peoples have needs that differ from the general population, while others felt that there were no collective cultural needs, instead advocating an individualized approach. Being flexible and practical, taking time to build rapport, recognizing different family structures and decision-making processes, as well as socio-economic disadvantage were all identified as important factors in participants' interactions with Indigenous clients. Indigenous support workers and hospital liaison officers were seen as valuable resources for effective service provision. The implications of this study for training and practice are discussed.

Probing ion exchange in the triflic acid-guanidinium triflate system: a solid-state nuclear magnetic resonance study

Knowledge of ion exchange and transport behavior in electrolyte materials is crucial for designing and developing novel electrolytes for electrochemical device applications such as fuel cells or batteries. In the present study, we show that, upon the addition of triflic acid (HTf) to the guanidinium triflate (GTf) solid-state matrix, several orders of magnitude enhancement in the proton conductivity can be achieved. The static 1H and 19F solid-state NMR results show that the addition of HTf has no apparent effect on local molecular mobility of the GTf matrix at room temperature. At higher temperatures, however, the HTf exhibits fast ion exchange with the GTf matrix. The exchange rate, as quantified by our continuum T2 fitting analysis, increases with increasing temperature. The activation energy for the chemical exchange process was estimated to be 58.4 kJ/mol. It is anticipated that the solid-state NMR techniques used in this study may be also applied to other organic solid-state electrolyte systems to investigate their ion-exchange processes.

Clinical practice guidelines for nurse-administered procedural sedation and analgesia in the cardiac catheterization laboratory: a modified Delphi study

Aim : To develop clinical practice guidelines for nurse-administered procedural sedation and analgesia in the cardiac catheterization laboratory.

Background : Numerous studies have reported that nurse-administered procedural sedation and analgesia is safe. However, the broad scope of existing guidelines for the administration and monitoring of patients who receive sedation during medical procedures without an anaesthetist present means there is a lack of specific guidance regarding optimal nursing practices for the unique circumstances where nurse-administered procedural sedation and analgesia is used in the cardiac catheterization laboratory.

Methods : A sequential mixed methods design was used. Initial recommendations were produced from three studies conducted by the authors: an integrative review; a qualitative study; and a cross-sectional survey. The recommendations were revised according to responses from a modified Delphi study. The first Delphi round was completed by nine senior cardiac catheterization laboratory nurses. All but one of the draft recommendations met the predetermined cut-off point for inclusion with 59 responses to the second round. Consensus was reached on all recommendations.

Implications for nursing : The guidelines that were derived from the Delphi study offer 24 recommendations within six domains of nursing practice: Pre-procedural assessment; Pre-procedural patient and family education; Pre-procedural patient comfort; Intra-procedural patient comfort; Intra-procedural patient assessment and monitoring; and Postprocedural patient assessment and monitoring.

Conclusion : These guidelines provide an important foundation towards the delivery of safe, consistent and evidence-based nursing care for the many patients who receive sedation in the cardiac catheterization laboratory setting.

A neuropsychological study of prefrontal lobe function in the positive and negative subtypes of schizophrenia.

The symptoms of schizophrenia are frequently divided into positive and negative subtypes. It has been suggested that the negative symptoms are similar to those seen with prefrontal lobe cortical dysfunction. Several neuropsychological investigations of that hypothesis have been carried out, but none have directly compared a negative symptom group with a positive symptom group on the same test battery. In the present study, the Positive and Negative Syndrome Scale (PANSS; Kay, Fiszbein, & Opler, 1987) was used to distinguish two groups of 20 patients with schizophrenia with predominant positive or negative symptoms. A battery of 7 neuropsychological tests considered capable of isolating prefrontal lobe dysfunction was administered. A significant group difference was noted on 6 of the tests; the negative symptom group performed much worse than the positive symptom group. The results of this study support the hypothesis that a relationship exists between the negative symptoms of schizophrenia and prefrontal lobe dysfunction.

Prospective observational study of emergent endotracheal intubation practice in the intensive care unit and emergency department of an Australian regional tertiary hospital

Objective: The present study aimed to describe the characteristics and outcomes of intubation occurring in the ICU and ED of an Australian tertiary teaching hospital. Methods: This was a prospective observational study of intubation practice across the Geelong Hospital over a 6 month period from 1 August 2012 to 31 January 2013. Data were entered by the intubating team through an online data collection form. Results: There were 119 patients intubated and 134 attempts at intubation in the ED and ICU over a 6 month period. The first-pass success rate was 104/119 (87.4%), and all but a single patient was intubated by the second attempt. Propofol, fentanyl, midazolam and suxamethonium were the most common drugs used in rapid sequence induction. AEs were reported in 44/134 (32.8%) of intubation attempts, with transient hypoxia and hypotension being the most common. A significant adverse outcome, namely aspiration pneumonitis, occurred in one patient. There were no peri-intubation deaths. Conclusion: The majority of airways are managed by ICU and ED consultants and trainees, with success rates and AE rates comparable with other published studies. © 2014 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

The 2nd Berlin BedRest Study: protocol and implementation

Long-term bed-rest is used to simulate the effect of spaceflight on the human body and test different kinds of countermeasures. The 2nd Berlin BedRest Study (BBR2-2) tested the efficacy of whole-body vibration in addition to high-load resisitance exercise in preventing bone loss during bed-rest. Here we present the protocol of the study and discuss its implementation. Twenty-four male subjects underwent 60-days of six-degree head down tilt bed-rest and were randomised to an inactive control group (CTR), a high-load resistive exercise group (RE) or a high-load resistive exercise with whole-body vibration group (RVE). Subsequent to events in the course of the study (e.g. subject withdrawal), 9 subjects participated in the CTR-group, 7 in the RVE-group and 8 (7 beyond bed-rest day-30) in the RE-group. Fluid intake, urine output and axiallary temperature increased during bed-rest (p < .0001), though similarly in all groups (p > or = .17). Body weight changes differed between groups (p < .0001) with decreases in the CTR-group, marginal decreases in the RE-group and the RVE-group displaying significant decreases in body-weight beyond bed-rest day-51 only. In light of events and experiences of the current study, recommendations on various aspects of bed-rest methodology are also discussed.

Evaluating discussion board engagement in the MoodSwings online self-help program for bipolar disorder: protocol for an observational prospective cohort study

BACKGROUND: Online, self-guided programs exist for a wide range of mental health conditions, including bipolar disorder, and discussion boards are often part of these interventions. The impact engagement with these discussion boards has on the psychosocial well-being of users is largely unknown. More specifically we need to clarify the influence of the type and level of engagement on outcomes. The primary aim of this exploratory study is to determine if there is a relationship between different types (active, passive or none) and levels (high, mid and low) of discussion board engagement and improvement in outcome measures from baseline to follow up, with a focus on self-reported social support, stigma, quality of life and levels of depression and mania. The secondary aim of this study is to identify any differences in demographic variables among discussion users.

METHODS/DESIGN: The present study is a sub-study of the MoodSwings 2.0 3-arm randomised controlled trial (discussion board only (arm 1), discussion board plus psychoeducation (arm 2), discussion board, psychoeducation plus cognitive behavioural therapy-based tools (arm 3)). Discussion engagement will be measured via online participant activity monitoring. Assessments include online self-report as well as blinded phone interviews at baseline, 3, 6, 9 and 12 months follow up.

DISCUSSION: The results of this study will help to inform future programs about whether or not discussion boards are a beneficial inclusion in online self-help interventions. It will also help to determine if motivating users to actively engage in online discussion is necessary, and if so, what level of engagement is optimal to produce the most benefit. Future programs may benefit through being able to identify those most likely to poorly engage, based on demographic variables, so motivational strategies can be targeted accordingly.

The construction of a subset of ICNP® for patients with dementia: a Delphi consensus and a group interview study

BACKGROUND: The International Classification for Nursing Practice (ICNP®) 2013 includes over 4000 concepts for global nursing diagnoses, outcomes and interventions and is a large and complex set of standardised nursing concepts and expressions. Nurses may use subsets from the ICNP as concepts and expressions for research, education and clinical practice. The objective of this study was to identify and validate concepts for an ICNP subset to guide observations and documentation of nursing care for patients with dementia.

METHOD: The process model for developing ICNP subsets was followed, according to the guidelines adopted by the International Council of Nursing (ICN). To identify relevant and useful concepts for the subset, a modified form of the Delphi method was used. Six nurses working in healthcare services in three municipalities in Norway with postgraduate education in geriatric psychiatry and dementia care participated in two Delphi sessions. The participants reviewed and scored the concepts included in the suggested subset and had an opportunity to rewrite them and offer alternatives. To validate the subset after the Delphi study, a group interview was conducted with six other nurses with postgraduate education in geriatric psychiatry and dementia care. The group interview was recorded and transcribed, and summative content analysis was used.

RESULTS: Suitable concepts for an ICNP subset to guide observations and documentation of nursing care for patients with dementia were identified. In total, 301 concepts were identified, including 77 nursing diagnoses, 78 outcomes and 146 nursing interventions. An increased focus on concepts to describe basic psychosocial needs such as identity, comfort, connection, inclusion and engagement was recommended by nurses in the validation process.

CONCLUSIONS: Relevant and pre-formulated nursing diagnoses, goals and interventions were identified, which can be used to develop care plans and facilitate accuracy in the documentation of individuals with dementia. The participants believed that it may be difficult to find formulations for all steps of the nursing process. In particular, nursing diagnoses and psychosocial needs are often inadequately documented. The participants highlighted the need for the subset to contain essential information about psychosocial needs and communication.

The impact on family functioning of social media use by depressed adolescents: a qualitative analysis of the family options study

BACKGROUND: Adolescent depression is a prevalent mental health problem, which can have a major impact on family cohesion. In such circumstances, excessive use of the Internet by adolescents may exacerbate family conflict and lack of cohesion. The current study aims to explore these patterns within an intervention study for depressed adolescents.

METHOD: The current study draws upon data collected from parents within the family options randomized controlled trial that examined family based interventions for adolescent depression (12-18 years old) in Melbourne, Australia (2012-2014). Inclusion in the trial required adolescents to meet diagnostic criteria for a major depressive disorder via the Structured Clinical Interview for DSM-IV Childhood Disorders. The transcripts of sessions were examined using qualitative thematic analysis. The transcribed sessions consisted of 56 h of recordings in total from 39 parents who took part in the interventions.

RESULTS: The thematic analysis explored parental perceptions of their adolescent's use of social media (SM) and access to Internet content, focusing on the possible relationship between adolescent Internet use and the adolescent's depressive disorder. Two overarching themes emerged as follows: the sense of loss of parental control over the family environment and parents' perceived inability to protect their adolescent from material encountered on the Internet and social interactions via SM.

CONCLUSION: Parents within the context of family based treatments felt that prolonged exposure to SM exposed their already vulnerable child to additional stressors and risks. The thematic analysis uncovered a sense of parental despair and lack of control, which is consistent with their perception of SM and the Internet as relentless and threatening to their parental authority and family cohesion.

Effects of antidepressants on postmenopausal bone loss - a 5-year longitudinal study from the OSTPRE cohort

BACKGROUND: Osteoporosis and depression are major health problems worldwide. The association between antidepressants, a treatment for depression, and bone health needs more detailed exploration. OBJECTIVE: The present study investigates antidepressant medication use and postmenopausal bone loss over time. METHODS: A total of 1988 women (aged 57-67) participating in the Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) cohort responded to a postal enquiry and had their femoral neck bone mineral density (BMD) measured in 1999 and again in 2004. Data on antidepressant use was obtained from the National Prescription Register. Multiple regression techniques were used to test the associations, before and after adjustment for anthropometric, medical, physical and lifestyle factors. RESULTS: Over the five years of follow-up, 319 (16.0%) women purchased antidepressants. Mean baseline femoral neck BMD for the entire study group was 881mg/cm(2) (SD 123) and mean 5-year bone loss was 6.0mg/cm(2) (SD 4.7). After adjustments, users of tricyclic antidepressants (TCA) had greater annual BMD loss than non-users (-3.6mg/cm(2) vs. -1.1mg/cm(2); P=0.031). Accelerated bone loss was also associated with selective serotonin reuptake inhibitor's (SSRI) use (P=0.001) and use of other antidepressants in a dose-response way, with the latter only among women of low-weight and normal-weight women who had lost weight over the study period. CONCLUSIONS: In conclusion, the use of SSRIs seems to accelerate postmenopausal bone loss in a dose-response manner. Associations between TCA and other antidepressant use and bone loss may also exist. Thus, the possibility of increased risk of osteoporosis should be considered when prescribing antidepressants for postmenopausal women.

A green revolution in Mozambique: a study about the government possibilities to launch a sustainable green revolution

The present study is focused on the analysis of the political, economical and social factors that may interfere with the possibility of a Green Revolution as a solution for Mozambique to reach self-sufficiency and to reduce poverty. In order to perform such analysis, the study analyzes the consequences of the decolonization process in Mozambique focusing that the independence process in Mozambique did not create non-colonial models for the Agriculture Sector. Later on, the study tries to understand the impact of HIV/AIDS and Malaria on the labor force. By then, it explores the concepts of the Green Revolution and its successful history in India. At the end, it tries to evaluate if a Green Revolution is possible in Africa, especially in Mozambique, first identifying the factors, which characterized the Green Revolution in India, and trying to link those factors with the reality of Mozambique. The report is structured as followed; Chapter 2, ¿The decolonization process and its impacts on the agriculture sector¿. It gives information about the decolonization process, and explores its consequences. Chapter 3, ¿The Impacts of HIV/AIDS and Malaria on the Labor Force¿. It analyzes the impact of those diseases in the labor force. Chapter 4 ¿The Green Revolution and the Agriculture Sector¿, explores the concepts of Green Revolution, its success in India and its history in Mozambique. Chapter 5, finally, centers on conclusions, findings and recommendations.

Line extension influence on brand image: a study on the alcoholic beverage market in Brazil

The present study has the objective of understanding the influence of line extensions on the image of vodka brands. The research was performed by organizing various focus groups with vodka consumers in São Paulo. These focus groups allowed exploring and analyzing how the last line extensions of vodka brands have modified the image the consumers had of the brand. Three hypotheses were distinguished as an outcome of the research: (1) The influence of a line extension on brand image depends heavily on the initial image the consumers have of the brand. For a vodka brand with an average or bad image, launching a line extension with a perceived average or bad quality does not modify the brand image. On the contrary, for a vodka brand with a positive initial brand image, launching a line extension with perceived high quality led to a positive change in the brand image. (2) For vodka brands, a vertical line extension recognized as having high authenticity provokes a transfer of attributes from the extended product to the brand. (3) Among Keller’s (1993) dimensions of brand image, non-product related attributes and especially packaging are the one that are the most influenced by line extensions of vodka brands.

The failure of early-stage technology startups in Brazil: a study about the contributing factors to the early-death of startups between 2009 and 2014 in Southeastern Brazil

This research aimed to find out which are the main factors that lead technology startups to fail. The study focused on companies located in the Southeast region of Brazil that operated between 2009 and 2014. In the beginning, a review of the literature was done to have a better understanding of basic concepts of entrepreneurship as well as modern techniques for developing entrepreneurship. Furthermore, an analysis of the entrepreneurial scenario in Brazil, with a focus on the Southeast, was also done. After this phase, the qualitative study began, in which 24 specialists from startups were interviewed and asked about which factors were crucial in leading a technology startup to fail. After analyzing the results, four main factors were identified and these factors were validated through a quantitative survey. A questionnaire was then formulated based on the answers from the respondents and distributed to founders and executives of startups, which both failed and succeeded. The questionnaire was answered by 56 companies and their answers were treated with the factor analysis statistical method to check the validity of the questionnaire. Finally, the logistical regression method was used to know the extent to which the factors led to the startups’ failure. In the end, the results obtained suggest that the most significant factor that leads technology startups in southeastern Brazil to fail are problems with interpersonal relationship between partners or investors.

Neww challenges in the luxury universe: an exploratory study of the concept of luxury experience in the Brazilian market from the perspective of brands and consumers: a case study of Pati Piva.

Luxury has evolved over the centuries; new challenges have created questions of appropriate strategies for brands. Experience and authenticity became important aspects in the field: consumers are enjoying more material comfort and there is a trend of a cultural shift for personal fulfillment and aspiration through experience. The biggest challenge for today's luxury marketers is to not only talk to the target, but to understand how the target is shifting, while not alienating consumers and damaging the brand´s image. Considering managers and consumers perspectives separately, it would be possible to conclude that their perceptions are congruent, as many studies have presented. However, if perspectives are put together and compared, different realities could emerge. This exploratory research is based on a case study that describes both perspectives of their perception on luxury experience, consumer behavior and consumption motivations, and luxury retailing. It was developed interviews with the brand owner and 10 brand´s consumers, and also indirect observations in the brands distribution formats. In the brand perspective, the case study has shown that luxury experience involves the construction of brand experience strategy based on products, multiple retail channels, consumer engagement, personal activity, exploration of five senses and other forms. In the consumer´s perspective, results revealed that brand consumers interviwed have different luxury experience perceptions and expectations; however, what is common is that service and quality must be maintained and they reflected the overall experience. Additionally, luxury retailing influences directly the consumer´s perception that must integrate multiple channels to fulfill personal demands. The research makes contributions for both actors - brand and consumer, in the sense that translates theoretical concepts of the experience itself and tries to clarify aspects that are still unknown and explored through the exploration of ways to detect the alignment between brand and consumer expectations of the experience.