Referrals to hospital emergency departments from residential aged care facilities: stuck in a time warp

This research aimed to describe the number and type of residents admitted to emergency departments (EDs) over 2 years; and to explore nurses' perceptions of the reasons why residential aged care facility (RACF) residents are referred to EDs. The research objective was addressed in a retrospective exploratory study using data on admissions to EDs from RACFs (N = 3,094) at the participating organisation over a 2-year period, and interview data on seven RACF and four ED nurses' perceptions of the issues involved. Most residents presenting at EDs required urgent medical attention. Major themes identified by RACF and ED nurses included issues related to staff competency, availability of general practitioners, lack of equipment in RACFs, residents and family members requesting referrals, communication difficulties, and poor attitudes towards RACF staff. There is a need to use strategies to detect residents whose conditions are deteriorating and treat them promptly in RACFs.

Alcohol, masculinity, honour and male barroom aggression in an Australian sample

Introduction and Aims
The link between alcohol and men's aggression is well established, although growing evidence also points to individual and learned social factors. The aim of the present study was to investigate the relationships between male alcohol-related aggression (MARA) among young Australian men and heavy episodic drinking, trait aggression, masculinity, concerns about social honour and expected positive consequences of MARA.

Design and Methods
The total sample comprised 170 men aged 18–25 years who completed an online questionnaire exploring beliefs and attitudes towards MARA.

Results
Those who reported heavy episodic drinking were more likely to be involved in an incident of MARA. In addition, those who were involved in MARA had higher levels of trait aggression, concern for social honour and expected positive consequences of aggression in bars than did those without such involvement. The relationship between socially constructed masculinity factors (a combined variable reflecting masculinity, social honour and expected positive consequences) and MARA was mediated by heavy episodic drinking. Social honour accounted for almost all of the predictive power of masculinity factors. Heavy episodic drinking and trait aggression remained significant predictors of MARA in a multivariate model.

Discussion and Conclusions
The findings from the current study may assist in developing preventative techniques for young men which target masculinity concerns and the consequences of participating in MARA.

Sexting prevalence and correlates: a systematic literature review

Despite considerable controversy and speculation regarding sexting behaviour and its associated risks, to date there has been no integration and analysis of empirical literature on this topic. To collect and synthesise findings of the prevalence of sexting, its correlates, and the context in which it occurs, a systematic search of databases was conducted. Thirty-one studies, reporting on sexting prevalence and a diverse range of related variables, met inclusion criteria. The estimated mean prevalence weighted by sample size was calculated, with trends indicating sexting is more prevalent amongst adults than adolescents, older age is predictive of sexting for adolescents but not adults, and more individuals report receiving sexts than sending them. The correlates of sexting behaviour were grouped in terms of demographic variables, sexual and sexual risk behaviours, attitudes towards sexting, perceived outcomes of sexting, motivations for sexting, mental health and well-being variables, and attachment dimensions. Findings are discussed in terms of the trends indicated by the data, which provided substantiation that sexting behaviour is associated with numerous behavioural, psychological, and social factors. Limitations of the current research literature and future directions are also presented.

I wish I was 21 now beyond doping in the Australian peloton

An investigation into the reasons for doping among professional athletes (cyclists) and attitudes towards and assessments of current attempts and form of legislation and regulation of doping, inlcuding prospects for reform, and types of reform required.

Education and work in service of the nation: Canadian and Australian girls' fiction, 1908-1921

This chapter compares early twentieth-century Australian novels by Ethel Turner, Mary Grant Bruce, and Lilian Turner to Canadian novels by Nellie McClung and L.M. Montgomery to demonstrate important differences in attitudes towards education and work. Girls’ fiction in these white settler colonies has many similarities, containing strong ideals related to domesticity, education, employment, and femininity. In the Canadian fiction, attitudes towards women’s higher education and employement are generally much more positive. Although both Australian and Canadian girls’ fiction typically conclude with marriage, Montgomery’s Anne of Green Gables and Nellie McClung’s Pearlie Watson are offered the opportunity to pursue higher education and use this education to teach others. In contrast, Lilian Turner’s Paradise and the Perrys, Ethel Turner’s Fair Ines, and Mary Grant Bruce’s ’Possum emphasise the importance of domesticity while also showing how girls sought to earn income without leaving home. Through our comparison of these Canadian and Australian novels, all published between 1908 and 1921, we demonstrate how the different feminine ideals embodied through these heroines are inevitably intertwined with the needs of the nation

Bridging the copyright and licensing knowledge gap

Objectives: The purpose of this project was to examine the copyright and licensing knowledge gap of academic staff to identify their current understanding of, and attitudes towards, copyright, licensing and the open access movement in relation to the content they use, create, and share in their teaching and research practice. The motivation behind this study was to gather information to assist the Library in creating and providing effective information resources and training for academic staff.

Methods: An anonymous online survey was distributed to Faculty of Health academic staff at Deakin University. Seventy individuals in the Faculty of Health completed the survey.

Results: The results suggested that most of the academics have used content created by others in their teaching materials, but they are not confident about complying with copyright or licensing conditions whilst doing so. Most had not posted any of their own content online, but would generally be willing for it to be used by others, with attribution. Around half had never posted their published articles in an institutional or discipline repository, but again, would be willing for them to be used for educational purposes. Most academics have never shared their research data online, and some were very unwilling to do so - despite current pushes to broaden access to research data sets. Finally, most had never applied a Creative Commons licence to a piece of work, and over half were unaware of what rights they had retained under publishing agreements for their work. It was strongly indicated that an informational website would be very helpful in providing guidance around topics of copyright, licensing and sharing.

Conclusions: Results were largely consistent with other similar studies conducted around these topics. There is a clear role for librarians to continue providing such training and resources as the push for Open Access resources, publishing, and data only gains momentum.

Duty and service in the Great War

One hundred years ago many Australian men valiantly went to fight in the Great War. They went for King and country, travel and adventure but there were also many, for very good and different reasons, who chose not to go. Historian Bart Ziino explores some of the conflicting and complex attitudes towards duty and service.

Medicine non-adherence in kidney transplantation

Background: The increasing prevalence of chronic kidney disease, the relative shortage of kidney donors and the economic- and health-related costs of kidney transplant rejection make the prevention of adverse outcomes following transplantation a healthcare imperative. Although strict adherence to immunosuppressant medicine regimens is key to preventing kidney rejection, evidence suggests that adherence is sub-optimal. Strategies need to be developed to help recipients of kidney transplants adhere to their prescribed medicines. Findings: This review has found that a number of factors contribute to poor adherence, for example, attitudes towards medicine taking and forgetfulness. Few investigations have been conducted, however, on strategies to enhance medicine adherence in kidney transplant recipients. Strategies that may improve adherence include pharmacist-led interventions (incorporating counselling, medicine reviews and nephrologist liaison) and nurse-led interventions (involving collaboratively working with recipients to understand their routines and offering solutions to improve adherence). Strategies that have shown to have limited effectiveness include supplying medicines free of charge and providing feedback on a participant's medicine adherence without any educational or behavioural interventions. Conclusion: Transplantation is the preferred treatment option for people with end-stage kidney disease. Medicine non-adherence in kidney transplantation increases the risk of rejection, kidney loss and costly treatments. Interventions are needed to help the transplant recipient take all their medicines as prescribed to improve general well-being, medicine safety and reduce healthcare costs. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Australian adults’ knowledge of Australian agriculture

Purpose – Agriculture is a major generator of wealth and employment in Australia. However, it faces a range of economic and environmental challenges which require substantial community support. The purpose of this paper is to examine Australian adults’ Australian knowledge of, and attitudes towards, Australian agriculture. Design/methodology/approach – Online questionnaire survey of 1,026 adults conducted nationwide during August 2012. Findings – Most respondents had little knowledge of even the basic aspects of the industry but they approved of farmers’ performance of their roles. Latent class analysis showed that there are two groups of consumers with low and lower levels of knowledge. The respondents’ age, rural residence and universalist values were positive predictors of agricultural knowledge. Research limitations/implications – This was a cross-sectional, quota-based survey which examined only some aspects of agriculture. However, the findings suggest that more communication with the general public about the industry is required in order to build on the positive sentiment that exists within the community. Practical implications – More education about agriculture in schools and higher education is indicated. Social implications – The poor state of knowledge of agriculture threatens the social contract upon which agricultural communities depend for survival. Originality/value – The study highlights the poor state of general knowledge about agriculture in Australia. The findings could be used as a baseline against which the efficacy of future education programmes could be assessed.

Supporting healthy communities through arts programs

There are some evaluations, critical descriptions of programs and systematic reviews on the benefits to Aboriginal and Torres Strait Islander communities from participation in arts programs. These include: improved physical and mental health and wellbeing; increased social inclusion and cohesion; some improvements in school retention and attitudes towards learning; increased validation of, and connection to, culture; improved social and cognitive skills; and some evidence of crime reduction.The effects of arts programs can be powerful and transformative. However, these effects tend to be indirect.For example, using these programs to reduce juvenile anti-social behaviour largely work through diversion: providing alternative safe opportunities to risk taking, maintenance of social status, as well as opportunities to build healthy relationships with Elders and links with culture.Art forms such as song, dance and painting, coupled with ceremony, are integral to cultural continuity and cultural maintenance in Indigenous Australian communities.

Supporting healthy communities through sports and recreation programs

There is some evidence, in the form of critical descriptions of programs and systematic reviews, on the benefits to Aboriginal and Torres Strait Islander communities from participation in sport and recreational programs. These include some improvements in school retention, attitudes towards learning, social and cognitive skills, physical and mental health and wellbeing; increased social inclusion and cohesion; increased validation of and connection to culture; and crime reduction.Although the effects of sports and recreation programs can be powerful and transformative, these effects tend to be indirect. For example, using these programs to reduce juvenile antisocial behaviour largely work through diversion, providing alternative safe opportunities to risk taking, maintenance of social status, as wellas opportunities to build healthy relationships with Elders and links with culture.Although Indigenous Australians have lower rates of participation in sport than non-Indigenous people, surveys suggest that around one-third of Indigenous people participate in some sporting activity (ABS 2010). That makes sports a potentially powerful vehicle for encouraging Indigenous communities to look at challenging personal and community issues.Within Indigenous communities, a strong component of sport and recreation is the link with traditional culture. Cultural activities such as hunting are generally more accepted as a form of sport and recreation than traditional dance. Therefore sport and recreation are integral in understanding ‘culture’ within Indigenous communities, as well as highlighting the culture within which sport and recreation operate.

Clinical placements in mental health: a literature review

Gaining experience in clinical mental health settings is central to the education of health practitioners. To facilitate the ongoing development of knowledge and practice in this area, we performed a review of the literature on clinical placements in mental health settings. Searches in Academic Search Complete, CINAHL, Medline and PsycINFO databases returned 244 records, of which 36 met the selection criteria for this review. Five additional papers were obtained through scanning the reference lists of those papers included from the initial search. The evidence suggests that clinical placements may have multiple benefits (e.g. improving students' skills, knowledge, attitudes towards people with mental health issues and confidence, as well as reducing their fears and anxieties about working in mental health). The location and structure of placements may affect outcomes, with mental health placements in non-mental health settings appearing to have minimal impact on key outcomes. The availability of clinical placements in mental health settings varies considerably among education providers, with some students completing their training without undertaking such structured clinical experiences. Students have generally reported that their placements in mental health settings have been positive and valuable experiences, but have raised concerns about the amount of support they received from education providers and healthcare staff. Several strategies have been shown to enhance clinical placement experiences (e.g. providing students with adequate preparation in the classroom, implementing learning contracts and providing clinical supervision). Educators and healthcare staff need to work together for the betterment of student learning and the healthcare professions.

Implementation of concussion guidelines in community Australian Football and Rugby League– the experiences and challenges faced by coaches and sports trainers

Objectives

While guidelines outlining the appropriate management of sport-related concussion have been developed and adapted for use within community sport, it remains unknown how they are experienced by those responsible for implementing them.
Design

Longitudinal study.
Methods

111 coaches and sports trainers from community-level Australian Football and Rugby League teams completed pre- and post-season surveys assessing their attitudes towards using concussion guidelines. Participants also provided post-season feedback regarding their experiences in using the guidelines.
Results

71% of participants reported using the guidelines in the preceding season. Post-season attitude was related to pre-season attitude (p = 0.002), football code (p = 0.015), and team role (p = 0.045). An interaction between team role and guideline use (p = 0.012) was also found, with coaches who had used the guidelines, and sports trainers who had not, reporting more positive post-season attitudes towards using the concussion guidelines. Implementation challenges included disputing of decisions about return-to-play by players, parents, and coaches, and a perceived lack of time. Recommendations for improved guideline materials included using larger fonts and providing for witnessing of advice given to players.
Conclusions

This is the first study to examine the implementation of concussion guidelines in community sport. Training of coaches/sports trainers needs enhancement. In addition, new education should be developed for parents/players about the importance of the return-to-play advice given to them by those who follow these guidelines. Information provided by those who attempted to use the guidelines will assist the refinement of implementation and dissemination processes around concussion guidelines across sports.

Motivational interviewing to explore culturally and linguistically diverse people's comorbidity medication self-efficacy

Aims and objectives: To examine the perceptions of a group of culturally and linguistically diverse participants with the comorbidities of diabetes, chronic kidney disease and cardiovascular disease to determine factors that influence their medication self-efficacy through the use of motivational interviewing. Background: These comorbidities are a global public health problem and their self-management is more difficult for culturally and linguistically diverse populations living in English-speaking communities. Few interventions have been tested in culturally and linguistically diverse people to improve their medication self-efficacy. Design: A series of motivational interviewing telephone calls were conducted in the intervention arm of a randomised controlled trial using interpreter services. Methods: Patients with these comorbidities aged ≥18 years of age whose preference it was to speak Greek, Italian or Vietnamese were recruited from nephrology outpatient clinics of two Australian metropolitan hospitals in 2009. Results: The average age of the 26 participants was 73·5 years. The fortnightly calls averaged 9·5 minutes. Thematic analysis revealed three core themes which were attitudes towards medication, having to take medication and impediments to chronic illness medication self-efficacy. A lack of knowledge about medications impeded confidence necessary for optimal disease self-management. Participants had limited access to resources to help them understand their medications. Conclusion: This work has highlighted communication gaps and barriers affecting medication self-efficacy in this group. Culturally sensitive interventions are required to ensure people of culturally and linguistically diverse backgrounds have the appropriate skills to self-manage their complex medical conditions. Relevance to clinical practice: Helping people to take their medications as prescribed is a key role for nurses to serve and protect the well-being of our increasingly multicultural communities. The use of interpreters in motivational interviewing requires careful planning and adequate resources for optimal outcomes.

A conceptual classification of parents’ attributions of the role of food advertising in children’s diets

Background : High levels of child obesity are triggering growing concerns about the prevalence and effects of food advertising targeted at children. Efforts to address this advertising are confounded by the expanding repertoire of media and promotional techniques used to reach and attract children. The present study explored parents’ views on food marketing and the strategies parents employ when attempting to ameliorate its effects. As part of an online survey of Australian parents’ attitudes towards a range of food advertisements, respondents were invited to provide additional comment in an open-ended question. The question was optional and asked “Are there any other comments you would like to make?”. One in five of the survey respondents (18%; n = 235) elected to answer this question by discussing their views on food advertising and children’s diets. The responses were imported into NVivo10 for coding and analysis. A grounded approach was used to draw meaning from the data and develop a proposed conceptual classification of parents’ attributions relating to food advertising and its consequences.

Results : The majority of responses related to the negative perceived effects of unhealthy food advertising on children’s diets, with few respondents considering such advertisements to be innocuous. The responses were classified into four conceptual categories reflecting differing attitudes to advertising (negative to neutral) and varying levels of locus of control (low to high). The typical characteristics of parents allocated to the four categories exhibited variation according to weight status, television viewing habits, education level, and family size. The largest number of responses was coded to the category characterized by a negative attitude toward food advertising and a low locus of control. Parents in this category were more likely than others to be overweight/obese and heavy television viewers. Parents in the negative attitude to advertising and high locus of control category nominated a variety of parenting practices that could form the basis of parent education interventions.

Conclusions : The results suggest that many Australian parents may feel disempowered in the face of high levels of advertising for unhealthy foods. The current voluntary regulatory code appears to be inadequate in scope and coverage to address this situation.