A cluster randomised trial of an internet-based intervention program for tinnitus distress in an industrial setting

The effectiveness of a therapist-supported Internet intervention program for tinnitus distress in an industrial setting was evaluated using a cluster randomised design. Fifty-six Australian employees of two industrial organisations were randomly assigned, based on their work site (18 work sites from BP Australia and five from BHP Billiton), to either a cognitive behavioural therapy (CBT) program or an information-only control program. Participants were assessed at pre- and postprogram, measuring tinnitus distress, depression, anxiety, stress, quality of life, and occupational health. The CBT program was not found to be superior to the information program for treating tinnitus distress. A high attrition rate and small sample size limit the generalisability of the findings, and further developments of the program and assessment process are needed to enhance engagement and compliance.

Associations between neighbourhood and household environmental variables and fruit consumption : exploration of mediation by individual cognitions and habit strength in the GLOBE study

Objective The present study examined associations of several home and neighbourhood environmental variables with fruit consumption and explored whether these associations were mediated by variables derived from the Theory of Planned Behaviour (TPB) and by habit strength.

Design Data of the Dutch GLOBE study on household and neighbourhood environment, fruit intake and related factors were used, obtained by self-administered questionnaires (cross-sectional), face-to-face interviews and audits.

Setting The city of Eindhoven in the Netherlands

Subjects Adults (n 333; mean age 58 years, 54 % female).

Results Multiple mediation analyses were conducted using regression analyses to assess the association between environmental variables and fruit consumption, as well as mediation of these associations by TPB variables and by habit strength. Intention, perceived behaviour control, subjective norm and habit strength were associated with fruit intake. None of the neighbourhood environmental variables was directly or indirectly associated with fruit intake. The home environmental variable ‘modelling behaviour by family members’ was indirectly, but not directly, associated with fruit intake. Habit strength and perceived behaviour control explained most of the mediated effect (71·9 %).

Conclusions Modelling behaviour by family members was indirectly associated with fruit intake through habit strength and perceived behaviour control. None of the neighbourhood variables was directly or indirectly, through any of the proposed mediators, associated with adult fruit intake. These findings suggest that future interventions promoting fruit intake should address a combination of the home environment (especially modelling behaviour by family members), TPB variables and habit strength for fruit intake.

Fictional inquiry : an alternative process to inspire creativity in children's co-design projects

Children's creativity is a valuable resource for architectural design, and attempts have been made throughout the world to involve children in the design process of their environments. Previous children's co-design projects often followed a problem solving process, however, this process has limitations in stimulating children's creativity. Research has found that children's creativity is different to adult's creativity: Instead of creative problem solving skills, children's creativity is most evident in their imagination and originality of thinking. Addressing this issue, an alternative process in children's co-design projects was experimented: Fictional Inquiry. In this paper, two case studies are used to illustrate how the fictional inquiry process is applied in children's co-design projects.* These two projects were both joint educational projects between Deakin University and schools in Geelong and Melbourne. Through several weeks' of workshops, children and university architecture students worked in small groups to develop architectural design solutions. It was observed that creative design outcomes have been achieved in these two projects, which suggested that Fictional Inquiry was an effective process to inspire children's creativity. Applying the Fictional Inquiry process, Deakin University is currently working with another school in the Geelong Region, with the aim of achieving creative architectural design outcomes.

Safety and acceptability of practice-nurse-managed care of depression in patients with diabetes or heart disease in the Australian TrueBlue study

Objectives:
To determine the safety and acceptability of the TrueBlue model of nurse-managed care in the primary healthcare setting.

Development of an inverse routine to predict residual stresses in the material based on a bending test

Bending and reverse bending are the dominant material deformations in roll forming, and hence property data derived from bend tests could be more relevant than tensile test data for numerical simulation of a roll forming process. Recent investigations have shown that residual stresses change the material behavior close to the yield in a bending test. So, residual stresses introduced during prior steel processing operations may affect the roll forming process, and therefore they need to be included in roll forming simulations to achieve improved model accuracy. Measuring the residual stress profile experimentally is time consuming and has limited accuracy while analytical models that are available require detailed information about the pre-processing conditions that is generally not available for roll forming materials. The main goal of this study is to develop an inverse routine that determines a residual stress profile through the material thickness based on experimental pure bend test data. A numerical model of the skin passing (temper rolling) process is performed to introduce a residual stress profile in DP780 steel sheet. The skin passed strips are used in a pure bending simulation to record moment-curvature data and this data is then applied in an inverse analysis to predict the residual stress profile in the material. Comparison of the residual stress profile predicted by the inverse routine with that calculated by finite element analysis (FEA) indicates an inverse approach combined with pure bend test may present an alternative to predict residual stresses in sheet metals.

A preliminary study of the 20-m multistage shuttle run as a predictor of peak VO2 in Hong Kong Chinese students

The purpose of the present study was to determine the validity of the 20-meter multistage shuttle run (MSR) for predicting peak VO2 in Hong Kong Chinese students, ages 12-15 years. Fifty-five subjects, 27 boys and 28 girls, performed the MSR in the school environment and had peak VO2 determined in the laboratory. A correlation of 0.72 (p is less than 0.001) was found between peak VO2 and predicted peak VO2 using an equation previously developed with Canadian children (6). However, maximal shuttle run speed alone was a better predictor in this group (r=0.74, SEE=4.6 ml.kg-1.min-1, p is less than 0.001). Multiple-regression analysis (best-subsets) was performed and the best predictor variables were maximal speed and sex with either triceps skinfold or weight. For practical application in the school setting, the equation peak VO2=24.2-5.0(sex) minus 0.8(age) plus 3.4(maximal speed) (r=0.82, SEE=4.0), where for sex, male = 0 and female = 1, is suggested.

Issues and challenges associated with nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory: a qualitative study

Aims and objectives
To explore issues and challenges associated with nurse-administered procedural sedation and analgesia in the cardiac catheterisation laboratory from the perspectives of senior nurses.

Background
Nurses play an important part in managing sedation because the prescription is usually given verbally directly from the cardiologist who is performing the procedure and typically, an anaesthetist is not present.

Design
A qualitative exploratory design was employed.

Methods
Semi-structured interviews with 23 nurses from 16 cardiac catheterisation laboratories across four states in Australia and also New Zealand were conducted. Data analysis followed the guide developed by Braun and Clark to identify the main themes.

Results
Major themes emerged from analysis regarding the lack of access to anaesthetists, the limitations of sedative medications, the barriers to effective patient monitoring and the impact that the increasing complexity of procedures has on patients' sedation requirements.

Conclusions
The most critical issue identified in this study is that current guidelines, which are meant to apply regardless of the clinical setting, are not practical for the cardiac catheterisation laboratory due to a lack of access to anaesthetists. Furthermore, this study has demonstrated that nurses hold concerns about the legitimacy of their practice in situations when they are required to perform tasks outside of clinical practice guidelines. To address nurses' concerns, it is proposed that new guidelines could be developed, which address the unique circumstances in which sedation is used in the cardiac catheterisation laboratory.

Relevance to clinical practice
Nurses need to possess advanced knowledge and skills in monitoring for the adverse effects of sedation. Several challenges impact on nurses' ability to monitor patients during procedural sedation and analgesia. Preprocedural patient education about what to expect from sedation is essential.

Sociodemographic factors associated with healthy eating and food security in socio-economically disadvantaged groups in the UK and Victoria, Australia

Objective
To investigate the associations between sociodemographic factors and both diet indicators and food security among socio-economically disadvantaged populations in two different (national) contextual settings.

Design
Logistic regression was used to determine cross-sectional associations between nationality, marital status, presence of children in the household, education, employment status and household income (four low income categories) with daily fruit and vegetable consumption, low-fat milk consumption and food security.

Setting
Socio-economically disadvantaged neighbourhoods in the UK and Australia.

Subjects
Two samples of low-income women from disadvantaged neighbourhoods: (i) in the UK, the 2003–05 Low Income Diet and Nutrition Survey (LIDNS; n 643); and (ii) in Australia, the 2007–08 Resilience for Eating and Activity Despite Inequality (READI; n 1340).

Results
The influence of nationality, marital status and children in the household on the dietary outcomes varied between the two nations. Obtaining greater education qualifications was the most telling factor associated with healthier dietary behaviours. Being employed was positively associated with low-fat milk consumption in both nations and with fruit consumption in the UK, while income was not associated with dietary behaviours in either nation. In Australia, the likelihood of being food secure was higher among those who were born outside Australia, married, employed or had a greater income, while higher income was the only significant factor in the UK.

Conclusions
The identification of factors that differently influence dietary behaviours and food security in socio-economically disadvantaged populations in the UK and Australia suggests continued efforts need to be made to ensure that interventions and policy responses are informed by the best available local evidence.

Thinking with the body: Mind and movement in the work of Wayne McGregor | Random Dance

Thinking with the Body was an exhibition at London's Wellcome Collection, offering a glimpse into Wayne McGregor | Random Dance's interdisciplinary research and the impact it has in the rehearsal studio. Staged in the run-up to the first performances of Atomos at Sadler's Wells (Oct 2013), the exhibition featured the results of over a decade of interdisciplinary research into choreographic creativity which has been applied in the studio, in dance education, and to increase public understanding.

Wellcome Collection is a free visitor destination exploring the connections between medicine, life and art in the past, present and future. Wellcome Collection is part of the Wellcome Trust, a global charitable foundation dedicated to achieving improvements in human and animal health.

The exhibition finished on 27 October 2013, but the film exhibits are still available to view online.

'Wide-awake drunkenness'? Investigating the association between alcohol intoxication and stimulant use in the night-time economy

Aims: We tested whether patrons of the night-time economy who had co-consumed energy drinks or illicit stimulants with alcohol had higher blood alcohol concentration (BAC) levels than patrons who had consumed only alcohol. Design: Street intercept surveys (n=4227) were undertaken between 9 p.m. and 5 a.m. over a period of 7 months. Setting: Interviews were undertaken with patrons walking through entertainment precincts, queuing to enter venues or exiting venues in five Australian cities. Participants: The response rate was 92.1%; more than half the study sample was male (60.2%) and the median age was 23 years (range 18-72). Measurements: Data were collected on demographics, length of drinking session, venue types visited, types and quantity of alcohol consumed and other substance use. A BAC reading was recorded and a subsample of participants was tested for other drug use. Findings: Compared with the total sample (0.068%), illicit stimulant consumers (0.080%; P=0.004) and energy drink consumers (0.074%; P<0.001) had a significantly higher median BAC reading, and were more likely to engage in pre-drinking (65.6, 82.1 and 77.6%, respectively, P<0.001) and longer drinking sessions (4, 5 and 4.5 hours, respectively, P<0.001). However, stimulant use was not associated independently with higher BAC in the final multivariable model (illicit stimulants P=0.198; energy drinks P=0.112). Interaction analyses showed that stimulant users had a higher BAC in the initial stages of the drinking session, but not after 4-6 hours. Conclusions: While stimulant use does not predict BAC in and of itself, stimulants users are more likely to engage in prolonged sessions of heavy alcohol consumption and a range of risk-taking behaviours on a night out, which may explain higher levels of BAC among stimulants users, at least in the initial stages of the drinking session.

Spiritual connections made through music making: sharing faith and music in an Australian setting

The musical involvement of people over the centuries is fundamentally interwoven with spiritual experiences (Seifert 2011). This paper discusses the connection between music and spirituality in an inter-denominational group in the southeastern suburbs of Melbourne. With ethical clearance, through semi-structured interviews with two church leaders and the music worship team, subsequently employing Interpretative Phenomenological Analysis (IPA), I analysed and codified the data gathered. Two overarching themes are discussed: insights into music and spirituality; and connecting music to worship with self and others. The findings show that music in worship may provide a rich pathway for people to explore, experience, and express their spirituality, and to connect to the wider multicultural society. It also adds to the current debates on whether music has spiritual significance for some people apart from community expressions of spirituality through music. Limitations of the current study are knowledged and generalizations cannot be made regarding connections to music and spirituality. However, the findings do indicate that music in worship can enrich one’s spiritual experience and connection with God and others.

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.

Improving quantification using curtain flow chromatography columns in the analysis of labile compounds: a study on amino acids.

The performance of curtain flow chromatography column technology with MS detection was evaluated for the analysis of labile compounds. The curtain flow column design allows for separations that are faster and/or more sensitive than conventional columns, depending on how exactly the curtain flow column is configured. For example, when mass spectral detection is employed, the curtain flow column can yield separations that are 5-times faster than conventional columns when the curtain flow and the conventional columns have the same internal diameter. Or when the internal diameter of the conventional column is reduced in order to yield the same analytical through-put as the curtain flow column, the sensitivity on the curtain flow column can be as much as 66-fold higher than the conventional column. As a consequence of the higher analytical through-put less standardization is required in the analysis of labile compounds because less sample degradation is apparent. Consequently the sample integrity is preserved yielding data of a higher quality.