An early feeding practices intervention for obesity prevention

Objective - Report long term outcomes of the NOURISH randomized controlled trial (RCT) that evaluated a universal intervention commencing in infancy to provide anticipatory guidance to first-time mothers on ‘protective’ complementary feeding practices which were hypothesized to reduce childhood obesity risk. Subjects and Methods - The NOURISH RCT enrolled 698 mothers (mean age 30.1 years, SD=5.3) with healthy term infants (51% female). Mothers were randomly allocated to usual care or to attend two 6-session, 12-week group education modules. Outcomes were assessed five times: baseline (infants 4.3 months); 6 months after module 1 (infants 14 months); 6 months after module 2 (infants 2 years) and at 3.5 and 5 years of age. Maternal feeding practices were self-reported using validated questionnaires. BMI Z-score was calculated from measured child height and weight. Linear Mixed Models evaluated intervention (group) effect across time. Results - Retention at 5 years of age was 61%. Across ages 2-5 years, intervention mothers reported less frequent use of non-responsive feeding practices on 6/9 scales. At 5 years they also reported more appropriate responses to food refusal on 7/12 items (Ps ≤.05). No statistically significant group effect was noted for anthropometric outcomes (BMI Z-score: P=.06), or the prevalence of overweight/obesity (control 13.3% vs. intervention 11.4%, P=.66). Conclusions - Anticipatory guidance on complementary feeding resulted in first-time mothers reporting increased use of protective feeding practices. These intervention effects were sustained up to five years of age and were paralleled by a non-significant trend for lower child BMI Z-scores at all post-intervention assessment points.

The Lymphedema Evaluation in Gynecological cancer Study (LEGS): Design of a prospective, longitudinal, cohort study

Background The Lymphoedema Evaluation in Gynecological cancer Study (LEGS) was a longitudinal, observational, cohort study prospectively evaluating the incidence and risk factors of lower-limb lymphedema after treatment for gynecological cancer. Here we describe the study protocol and characteristics of the sample. Methods Women with a newly diagnosed gynecological cancer between June 1, 2008 and February 28, 2011, aged 18 years or older, and treated at one of six hospitals in Queensland, Australia, were eligible. Lymphedema was assessed by circumference measurements, bioimpedance spectroscopy, and self-reported swelling. LEGS incorporated a cohort of patients requiring surgery for benign gynecological conditions for comparison purposes. Data were collected prior to surgery and at regular intervals thereafter up to 2-years post-diagnosis. Results 546 women participated (408 cancer, 138 benign), with a 24-month retention rate of 78%. Clinical and treatment characteristics of participants were similar to the Queensland gynecological cancer population, except for a higher proportion of early-stage cervical cancers recruited to LEGS compared with Queensland proportions (89% versus 55%, respectively). Discussion Few imbalances were observed between participants with complete and incomplete follow-up data. The prospective design and collection of objective and patient-reported outcome data will allow comprehensive assessment of incidence and risk factors of lower-limb lymphedema.

Resilience and work-life balance in first-line nurse manager

Purpose The aim of this study was to explore how first-line nurse managers constructed the meaning of resilience and its relationship to work-life balance for nurses in Korea. Methods Participants were 20 first-line nurse managers working in six university hospitals. Data were collected through in-depth interviews from December 2011 to August 2012, and analyzed using Strauss and Corbin's grounded theory method. Results Analysis revealed that participants perceived work-life balance and resilience to be shaped by dynamic, reflective processes. The features consisting resilience included "positive thinking", "flexibility", "assuming responsibility", and "separating work and life". This perception of resilience has the potential to facilitate a shift in focus from negative to positive experiences, from rigidity to flexibility, from task-centered to person-centered thinking, and from the organization to life. Conclusions Recognizing the importance of work-life balance in producing and sustaining resilience in first-line nurse managers could increase retention in the Korean nursing workforce.

School-based education programmes for the prevention of child sexual abuse

Background Child sexual abuse is a significant global problem in both magnitude and sequelae. The most widely used primary prevention strategy has been the provision of school-based education programmes. Although programmes have been taught in schools since the 1980s, their effectiveness requires ongoing scrutiny. Objectives To systematically assess evidence of the effectiveness of school-based education programmes for the prevention of child sexual abuse. Specifically, to assess whether: programmes are effective in improving students’ protective behaviours and knowledge about sexual abuse prevention; behaviours and skills are retained over time; and participation results in disclosures of sexual abuse, produces harms, or both. Search methods In September 2014, we searched CENTRAL, OvidMEDLINE, EMBASE and 11 other databases.We also searched two trials registers and screened the reference lists of previous reviews for additional trials. Selection criteria We selected randomised controlled trials (RCTs), cluster-RCTs, and quasi-RCTs of school-based education interventions for the prevention of child sexual abuse compared with another intervention or no intervention. Data collection and analysis Two review authors independently assessed the eligibility of trials for inclusion, extracted data, and assessed risk of bias.We summarised data for six outcomes: protective behaviours; knowledge of sexual abuse or sexual abuse prevention concepts; retention of protective behaviours over time; retention of knowledge over time; harm; and disclosures of sexual abuse. School-

An exercise intervention during chemotherapy for women with recurrent ovarian cancer: A feasibility study

Objective: The aim of this study was to determine the feasibility of a combined supervised and home-based exercise intervention during chemotherapy for women with recurrent ovarian cancer. Secondary aims were to determine the impact of physical activity on physical and psychological outcomes and on chemotherapy completion rates. Methods: Women with recurrent ovarian cancer were recruited from 3 oncology outpatient clinics in Sydney and Canberra, Australia. All participants received an individualized exercise program that consisted of 90 minutes or more of low to moderate aerobic, resistance, core stability, and balance exercise per week, for 12 weeks. Feasibility was determined by recruitment rate, retention rate, intervention adherence, and adverse events. Aerobic capacity, muscular strength, fatigue, sleep quality, quality of life, depression, and chemotherapy completion rates were assessed at weeks 0, 12, and 24. Results: Thirty participants were recruited (recruitment rate, 63%), with a retention rate of 70%. Participants averaged 196 ± 138 min · wk of low to moderate physical activity throughout the intervention, with adherence to the program at 81%. There were no adverse events resulting from the exercise intervention. Participants who completed the study displayed significant improvements in quality of life (P = 0.017), fatigue (P = 0.004), mental health (P = 0.007), muscular strength (P = 0.001), and balance (P = 0.003) after the intervention. Participants completing the intervention had a higher relative dose intensity than noncompleters (P = 0.03). Conclusions: A program consisting of low to moderate exercise of 90 min · wk was achieved by two-thirds of women with recurrent ovarian cancer in this study, with no adverse events reported. Randomized control studies are required to confirm the benefits of exercise reported in this study.

Predicting emotional exhaustion among haemodialysis nurses

Background Understanding the organisational predictors of burnout (emotional exhaustion) in haemodialysis nurses is critical for staff retention and improving nurse and patient outcomes. Previous research has demonstrated high levels of emotional exhaustion among haemodialysis nurses; yet the relationships among nurses’ work environment, job satisfaction, stress and emotional exhaustion are poorly understood. Aim To test an explanatory model of the relationships among the nursing work environment, job satisfaction, job stress and emotional exhaustion for haemodialysis nurses, drawing on Kanter’s Structural Theory of Organisational Empowerment. Methods Using a cross-sectional design 417 haemodialysis nurses completed an online survey between October 2011 and April 2012 using validated instruments to measure the work environment, and levels of job satisfaction, job stress and emotional exhaustion. Results Overall, the explanatory model demonstrated adequate fit and we found partial support for the hypothesised relationships. Haemodialysis nurses’ work environment had a direct positive effect on job satisfaction, explaining 88% of the variance. Greater job satisfaction, in turn, predicted lower job stress, explaining 82% of the variance. Job satisfaction also had an indirect effect on emotional exhaustion by mitigating job stress. However, job satisfaction did not have a direct effect on emotional exhaustion. Conclusion The work environment of haemodialysis nurses is pivotal to the development of job satisfaction. Nurses’ job satisfaction also affects the levels of job stress and emotional exhaustion. Our findings suggest nurse managers can improve staff retention by creating empowering work environments that promote job satisfaction in haemodialysis nurses.

Why are haemodialysis nurses satisfied also experiencing burnout?

Background Haemodialysis nurses work in a technological environment caring for patients over a prolonged period of time leading to the development of unique nurse-patient relationships. In order to improve retention of nurses in this specialised area of nursing it is important to know the factors that affect job satisfaction, stress and burnout and understand how these experiences are conceptualised by haemodialysis nurses. Aim To explore the factors contributing to satisfaction with the work environment, job satisfaction, job stress and burnout in haemodialysis nurses in Australia and New Zealand. Method A quantitative dominant sequential explanatory mixed method design was used. Quantitative data was collected using an on-line questionnaire containing demographic questions and pre-existing instruments examining job satisfaction, stress, burnout and satisfaction with the work environment. The qualitative phase involved semi-structured interviews. Results 417 nurses completed the questionnaire. Overall, nurses were satisfied with their work environment and the job that they performed but there were stressors in the haemodialysis setting that led to high levels of burnout. Key themes emerged from the qualitative data related to the physical environment, intensity of nurse-patient relationships, workloads, and coping with death and dying. The qualitative findings also provide possible explanations for the high level of burnout identified in the quantitative findings. Conclusion Explanation of areas where specific nurse and patient outcomes were affected will support the development of appropriate interventions to sustain a work environment conducive to job satisfaction that also alleviates stress and burnout in these nurses.

Strenthening information literacy through collaboration: Implications for AIM

Because of its size, its excellent VET history, and its emerging higher education provision, AIM is in a special position to be an exemplar of good practice in the VET-HE transition. Many dual sector providers, by virtue of their size, tend to focus on higher education, on the assumption that VET ‘competence’ implies that their VET entrants to HE are confident and capable in information literacy skills. While this is only one of the many challenges that such students face in their undergraduate programs, it is the most critical for most of them in their quest for academic success. All students (school leavers, gap-year participants, articulating, mature age) entering HE will face specific challenges. For articulating students, the nature of credit transfer arrangements will often mean they commence studies in units that are not designated first year units. In this case, the embedded support structures are not as prominent. The existing literature is not consistent in reports on the rates of completion, retention and attrition of articulating students. There is some evidence that VET-qualified students have higher retention rates than school leavers [1], but limited information literacy skills can lead to attrition [2].

What are the contributors to job satisfaction, stress and burnout for haemodialysis nurses?

Aim To review recent studies which identify the factors that contribute to stress, burnout and job satisfaction for nurses who are working in haemodialysis units. Background Regardless of where nurses work, stress, job burnout and dissatisfaction are known to cause high rates of nurse resignations and for many of those to leave the profession entirely. Understanding factors that contribute to job satisfaction, stress and burnout could increase haemodialysis nurse retention and improve health outcomes for people receiving haemodialysis. Evaluation Studies of job stress, burnout and satisfaction for nurses working in haemodialysis units published in English from January 2000 to December 2009 were identified. Specific inclusion criteria were developed resulting in eleven articles selected for this review. Key issues Specifically for haemodialysis nurses’ job stress and burnout was found to originate from two factors related to either patient care or organisations. Patient care factors included unrealistic patient expectations, progressive decline of a patient’s health, and violence and verbal abuse from patients. Organisational factors included shortage of time to complete tasks, lack of resources and unsupportive work environments. Increased job satisfaction for haemodialysis nurses was due to having job security, freedom to use one’s judgement and the quality of nurse/physician interactions. Conclusion Job stress and burnout are problematic for haemodialysis nurses. Instituting strategies which prevent and/or ameliorate stress or burnout could result in improved job satisfaction and also the retention of highly skilled haemodialysis nurses.

Simulating droplet motion on virtual leaf surfaces

A curvilinear thin film model is used to simulate the motion of droplets on a virtual leaf surface, with a view to better understand the retention of agricultural sprays on plants. The governing model, adapted from Roy et al. (2002 J. Fluid Mech. 454, 235–261) with the addition of a disjoining pressure term, describes the gravity- and curvature driven flow of a small droplet on a complex substrate: a cotton leaf reconstructed from digitized scan data. Coalescence is the key mechanism behind spray coating of foliage, and our simulations demonstrate that various experimentally observed coalescence behaviours can be reproduced qualitatively. By varying the contact angle over the domain, we also demonstrate that the presence of a chemical defect can act as an obstacle to the droplet’s path, causing break-up. In simulations on the virtual leaf, it is found that the movement of a typical spray size droplet is driven almost exclusively by substrate curvature gradients. It is not until droplet mass is sufficiently increased via coalescence that gravity becomes the dominating force.

Wikis for women's health: Social constructivist analysis of the effectiveness of online collaborative spaces for reflective learning

Public Health undergraduate students studying the unit Women’s Health undertook a teaching and learning exercise which required them to learn to create and use a wiki website for reflective learning purposes. The Women’s Health wiki provided an online shared, collaborative, and creative space wherein the students’ perceptions of women's health issues could be discussed, reflected upon, and debated. We analysed the content developed on the Women’s Health wiki using a social constructivist theoretical framework and provided a theoretical model for how the wiki worked to aid reflective and critical thinking, as well as developing technological and communicative skills amongst students.

Personas of students accessing a peer-facilitated support for learning program

STIMulate is a support for learning program at the Queensland University of Technology in Brisbane, Australia. The program provides assistance in mathematics, science and information technology for undergraduate students. This paper develops personas - archetypal users - that represent the attitudes and motivations of students that utilise STIMulate (in particular, the IT stream). Seven different personas were developed based on interviews gathered from Peer Learning Facilitators (PLF) who are experienced students that have excelled in relevant subject areas. The personas were then validated by a PLF focus group. Developing the personas enabled us to better understand the characteristics and needs of the students using the STIMulate program, enabling a more critical analysis of the quality of the service provided.

Job satisfaction, stress and burnout in haemodialysis nurses

Haemodialysis nurses provide health care for people with end stage kidney disease leading to a unique, intense and complex interaction between nurses and patients. This study involved the development of a model which explains the relationships between the work environment, job satisfaction, stress and burnout of haemodialysis nurses in Australia and New Zealand. Results from this study identified that haemodialysis nurses, while being satisfied by their jobs, were also experiencing high levels of burnout. This study's novel contribution could lead to improving the retention of the nursing workforce which is crucial due to the growing global burden of chronic disease.

Playing Monopoly™ with real estate students

This paper outlines the results from a study into the educational use of the board game Monopoly City™ in a first year real estate unit. This game play was introduced as a fun and interactive way of achieving a number of desired outcomes including: introduction of foundational threshold concepts in real estate education; introduction of problem solving and critical analysis skills; early acculturation of real estate students to enhance student retention; early team building within the student cohort; and enhanced engagement of first year students and, all in an engaging and entertaining way. Results from this two-stage research project are encouraging. The students participating in this project have demonstrated explicit linkages between their Monopoly City™ experiences and foundation urban economic and valuation theories. Students are also recognising the role strategy and chance play in the real estate sector. Findings from this project and key success factors are presented.

Recruiting and retaining plasmapheresis donors: A critical belief analysis

This paper identifies critical beliefs underpinning intentions to commence and continue plasmapheresis donation. Whole blood (n = 624) and first-time plasmapheresis (n = 460) donors completed a cross-sectional survey assessing the belief-base of the theory of planned behaviour and rated their plasmapheresis donation intentions. While the idea of red blood cells being returned was a key deterrent for all donors, critical beliefs underlying commencement and continuation in the plasmapheresis donor panel differed and varied as a function of blood donation history. Findings will assist the development of targeted persuasion messages to optimise recruitment and retention of plasmapheresis donors in a non-remunerated context.